Podcasts about Hennepin County Medical Center

11/10/24The Healthy Matters PodcastS04_E02 - Dr. Thomas Wyatt and the Hospital's Front Door (Open 24/7/365)It can be said that the emergency department is the front door between a community and healthcare - that never closes.  Within it, there's an immense team of providers working together to attend to anyone and everyone who comes in through the door - every hour of every day.  Safe to say, it's an intensely busy place with no two days ever being the same.Hennepin County Medical Center is a Level I Adult and Pediatric Trauma Center and safety net hospital, which means it's equipped to tackle the full gamma of healthcare issues in our community - from earaches to heart attacks.  It's an intricate organization with a lot of moving pieces and a new, unique leader at the top, Dr. Thomas Wyatt (MD, FACEP).  Dr. Wyatt is one of the first tribally enrolled American Indians (Shawnee/Quapaw) to chair an academic emergency department in the United States and in Episode 2 he'll discuss the importance of this role, what life is like inside and outside of the emergency department, and the many challenges facing these departments across the country.  This is an excellent chance to get an inside view of an essential piece of the healthcare puzzle and to get to know a great figure in medicine.  We hope you'll join us.Got a question for the doc or a comment on the show?Email - healthymatters@hcmed.orgCall - 612-873-TALK (8255)Keep an eye out for upcoming shows on social media!Find out more at www.healthymatters.org

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Dr. Joy is the Chief Medical Officer for Lore Health. Prior to that, she served as Senior Medical Director for Wellness and Nutrition at Intermountain Health in Salt Lake City, UT. She received her B.S. and M.D. degrees at the University of Minnesota, and M.P.H. from the University of Utah. She completed her Family Medicine Residency and Sports Medicine Fellowship at Hennepin County Medical Center in Minneapolis, MN. She is an adjunct faculty member at the University of Utah School of Medicine in the Department of Family and Preventive Medicine, and in the College of Health Department of Nutrition & Integrative Physiology. Dr. Joy is the Past President of the American College of Sports Medicine (ACSM), and the Female Athlete Triad Coalition. She Chairs the Exercise Is Medicine Governance Committee for the ACSM, and serves on the Board of Directors, and Chairs the Healthcare Sector for the National Physical Activity Plan. Her research interests lie in the areas of diabetes prevention, physical activity promotion, and the Female Athlete Triad.For information about my upcoming Online Yoga For Dudes, Brand-New Beginner's Course - email me directly at jpanasevich@gmail.com, or call or text me at 267.275.3890.

Nurses are putting pressure on Hennepin County Medical Center to improve their working conditions and have demanded oversight of the hospital go back to the county. With seven months to go until the presidential election, our panel of Gen-Z voters discussed how the economy is weighing on their voting decision.The Minnesota Book Award nominee Mona Susan Power is here. She's the author of the new book, A Council of Dolls.An emerging hip hop artist from the Mille Lacs band of Ojibwe's reservation is making music with his heroes. We'll talk to him all about it.Plus, we'll get the solar eclipse forecast from MPR Chief Meteorologist Paul Huttner.

Dr. Ann Isaksen serves as a hospitalist member at Hennepin County Medical Center, caring exclusively for patients admitted to the hospital and working with primary physicians to ensure a smooth transition from hospital to home. Outside of her medical practice, Dr. Isaksen loves to ride and show horses.

"We really all are wounded healers. And as we seek out our own healing, we become better physicians." On this episode of Doctor+, hosts Tseganesh and David interview each other about their pluses of storytelling, podcasting, and radio hosting. About the guests: Dr. Tseganesh Selameab (pronouns she/her) is a wife and mother of three amazing girls who practices primary care in St. Paul. She is a graduate of the University of Minnesota Medical School and completed her Internal Medicine residency in Boston at Boston Medical Center. Her career has focused on serving refugee and immigrant populations, as well as the urban underserved through clinical practice and community-based advocacy. Storytelling and narrative medicine have been a part of Dr. Selameab's medical journey for many years and she has been invited to share her written work at the University of Minnesota Medical School White Coat ceremony and at other Regional medical conferences. She has participated in several local story slams. Dr. Selameab serves as the current Governor for the Minnesota Chapter of the American College of Physicians. David R. Hilden MD, MPH, FACP is an internal medicine physician in Minneapolis, Minnesota. He is the Scott F. Davies Endowed Chair of the Department of Medicine at Hennepin Healthcare, where he sees patients both in the hospital and in primary care clinic and leads a department of 300 doctors, resident physicians, and advanced practice providers in 15 divisions. He is Professor of Medicine at the University of Minnesota Medical School. Dr. Hilden earned his medical degree from the University of Minnesota Medical School and later completed his residency at Hennepin County Medical Center. He also has a Master of Public Health degree in Public Health Practice and Leadership from the University of Minnesota School of Public Health. From 2019 – 2023, he was the Governor of the Minnesota Chapter of ACP. Dr. Hilden was the host of a popular live radio show on WCCO radio in Minneapolis from 2009-2021. He is currently the host of the Healthy Matters podcast now in its second season. He has received the “Top Doctor” designations from local publications “Mpls.-St. Paul Magazine” consecutively from 2017-2023 as well as “Minnesota Monthly” from 2014-2023. Dr. Hilden has been a visiting faculty member in Boston, Qatar, Israel, Palestine, Mayo Clinic in Minnesota and Hawaii, and Thailand. He lives in Minneapolis with his wife and dog and has two adult children. Support for Doctor+ has been provided by the American College of Physicians. Doctor+ is hosted by Dr. David Hilden and Dr. Tseganesh Selameab and is produced by Julie Censullo. For more information, visit doctorpluspodcast.com.

This episode of Spinal Cast features the extraordinary world of emergency services and two heroes who save lives every day. Dr. Gregg Jones and Dr. Aaron Robinson are EMS Physicians with Hennepin County Emergency Medical Services. They share valuable insights into their challenging field of work and discuss the causes of many critical calls, including those that result in spinal cord injury. Learn some life-savings tips and discover how you can be a hero too in those critical moments when experts are not immediately available.Gregg A. Jones, MDDr. Gregg Jones currently serves as Medical Director of Public Safety and Special Operations at Hennepin EMS, EMS Fellowship Program Director, Assistant Medical Director, Hennepin Emergency Medical Services, and Medical Director for Minneapolis Fire Department. Dr. Jones also serves as Medical Director for MN Task Force 1 Urban Search and Rescue Team. He completed medical School at Oregon Health and Science University and Emergency Medicine Residency training at Hennepin County Medical Center in 2018 and EMS fellowship in 2019. Prior to going to school, Dr. Jones served in the US Army, which included two combat tours to Afghanistan. His current medical interests include medical directing for large-scale events, mass casualty incident planning, paramedic education, provider wellness and the interface between prehospital medicine and law enforcement.Aaron Robinson, MD, MPHDr. Aaron Robinson is an Emergency Medicine and EMS Physician at Hennepin County Medical Center and Hennepin EMS in Minneapolis, Minnesota. He is indigenous and from the Menominee Tribe of Wisconsin. He attended undergrad at the University of Wisconsin Oshkosh before earning his MD at University of Wisconsin. He also earned an MPH from the University of Minnesota. Dr. Robinson completed his residency in Emergency Medicine at Hennepin County Medical Center and stayed to complete a fellowship in Prehospital (EMS) Medicine. His professional interests include out of hospital cardiac arrest, critical care, and health disparities. Thank you again to both Gregg and Aaron for joining us on today's podcast! This production is a collaborative effort of volunteers working to create a quality audio and visual experience around the subject of spinal cord injury. A special shout out of appreciation to Clientek for providing studio space and top-notch recording equipment. Most importantly, thank YOU for being part of the Spinal Cast audience!Interested in watching these episodes?! Check out our YouTube playlist! https://youtube.com/playlist?list=PL40rLlxGS4VzgAjW8P6Pz1mVWiN0Jou3vIf you'd like to learn more about the MCPF you can visit our website - https://mcpf.org/Donations are always welcomed - https://mcpf.org/you-can-help/

EMS One-Stop Show Notes - National EMS Museum This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. In this episode of EMS One-Stop, Host Rob Lawrence discusses the National EMS Museum (NEMSM) with President Dave Zaiman; Museum Director, Kristy Van Hoven; and Jon Krohmer, MD, immediate past-secretary and "We are EMS" coordinator. The National EMS Museum is a volunteer-led organization that collects, preserves and shares the history of emergency medical response in the United States in hopes of inspiring future professionals to take up the call. The National EMS Museum organization operates a virtual museum and produces traveling exhibitions that tour the country every year. The Collections at the National EMS Museum house over 300 years of history that cover the development of prehospital care in the United States, North America and around the world. TOP QUOTES FROM THIS EPISODE “We are here to educate the future. We are here not only to document the legacy, but here to provide a foundation and an education that EMS as a profession, as we move forward is respected, is understood, and maybe in a small part this museum can play a part in improving EMS altogether.” EPISODE CONTENTS 03:05 – Origins of the NEMSM 05:04 – The style and model of the NEMSM 07:00 – Changes underway – recruiting individuals with experience in museum activities 11:50 – President Dave Zaiman 13:20 – Getting EMS into the community 15:00 – Favorite artifacts 16:30 – From MAST pants to blood transfusion 17:20 – Fundraising effort in order to take the museum on the road 20:30 – Developing a traveling mobile “We are EMS” museum project 23:40 – How to book a traveling exhibit ADDITIONAL RESOURCES ON THIS TOPIC The National EMS Museum California Ambulance Association Siren special edition: Fifty Years of Wedworth-Townsend ABOUT OUR GUESTS Dave Zaiman Dave is currently Sales VP - Midwest at Pulsara.  For over 30 years, Dave has been working in healthcare – both as an EMS professional as well as holding several leadership roles in the healthcare technology industry. Based in Minnesota, Dave spent his first 15 years working in the field as an EMT and paramedic in the Twin Cities metro area for both Allina and Hennepin County Medical Center. Kristy Van Hoven Kristy is the museum director for the National EMS Museum and PhD candidate at the University of Leicester. Over the last 3 years, Kristy has worked with the National EMS Museum's Board of Trustees to develop and implement engaging e-volunteer opportunities and community programs that reach their digital audience. In addition to her work with the EMS Museum, Kristy volunteers at several local museums in Toronto, Ontario. Jon Krohmer, MD Dr. Krohmer served as the director of the NHTSA Office of EMS before his retirement in November 2021.  During his tenure as director, Dr. Krohmer oversaw several milestones for the profession, including the creation of EMS Agenda 2050; major revisions to the National EMS Scope of Practice Model and the National EMS Education Standards; and improvements in the collection and use of EMS data through the expansion of the National EMS Information System. Soon after the onset of the COVID-19 pandemic, Dr. Krohmer was tapped to lead the prehospital/911 team as part of the Federal Healthcare Resilience Task Force. Prior to joining NHTSA, Dr. Krohmer had decades of experience as a local EMS medical director, initially in his home state of Michigan. His EMS career began as an EMT with a volunteer rescue squad. Like many EMS professionals, he was inspired by the television show “Emergency!” and by the emergence of the relatively new field of emergency medicine. He entered medical school at the University of Michigan knowing he wanted to make EMS his career. After becoming involved in EMS at the state and national level, he also served as president of the National Association of EMS Physicians from 1998 to 2000. In 2006, he came to Washington to serve as the first deputy chief medical officer for the Department of Homeland Security Office of Health Affairs and served in several other DHS roles before joining NHTSA in 2016. RATE AND REVIEW THE EMS ONE-STOP PODCAST Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the EMS One-Stop team at editor@EMS1.com to share ideas, suggestions and feedback.

This week I share the first half of my conversation with Professor Patrick Murray host of the UCD School of Medicine MGA Clinical Influencers Podcast series. I relive my experience as a student of UCD and reminisce about the people who made my time there such a memorable experience. I discuss how my family inspired me to go into medicine, my early days as a student, and some of the cramped living situations that, in retrospect, led to some of the best days of my life. I remember the people, both the professors and fellow students, who taught me about more than just medicine. And I also discuss some of the most important things I learned about patient care and connecting with patients. Professor Patrick Murray is a Professor of Clinical Pharmacology at the University College Dublin, a consultant physician at the Mater Misericordiae University Hospital in Dublin, Ireland, and a proud graduate of UCD. He is the leader of a special podcast series, MGA Clinical Influencers Podcast – Series 2, where he interviews UCD graduates about their time at the university and shares highlights from their careers. He specializes in kidney health, and throughout his career, he has studied the prevention, diagnosis, and therapy of acute kidney injury and nephrotoxicity, as well as the pharmacotherapy of patients with kidney disease. He is board certified in nephrology, critical care medicine, and clinical pharmacology. Before his role at UCD, Patrick practiced medicine in the United States at Hennepin County Medical Center in Minneapolis, Minnesota, and the University of Chicago Hospitals in Chicago, Illinois. This week on In the Doctor's Chair: How I decided to become a doctor How my time at UCD helped me grow as a person The year I lived in a garden shed and loved it My favorite UCD professors What the tragic death of a dear friend taught me about life How I realized that family medicine was my calling Why I love being a general practitioner The importance of continuity of care Why technology will never replace the human touch in medicine Why Dublin was an exciting place to be in 1990 My early career highlights The health practitioner who inspired me the most Why do patients and doctors measure the quality of care differently Why the best skill a new doctor can develop is the ability to listen   Connect with Professor Patrick Murray University College Dublin Website Patrick Murray UCD Profile MGA Clinical Influencers Podcast – Series 2 UCD School of Medicine on Facebook UCD Medicine on Twitter In the Doctor's Chair Thanks for listening to In the Doctor's Chair, the show where you'll hear conversations that share life lessons, health habits, and leadership practices that focus on positive psychology, lifestyle medicine, and ways for you to live with more vitality. If you enjoyed this episode, please subscribe to the show and leave a comment wherever you listen to your podcasts. For more resources to help you to live with more vitality, please visit my website. Apple Podcasts | TuneIn | Google Play | Stitcher | Spotify The post #104 The Human Touch in Modern Medicine with Professor Patrick Murray – Part 1 appeared first on Mark Rowe.

Videos : The Anti-Smartphone Revolution (8:00) Heather Mac Donald On How The Delusion of Diversity Destroys Our Common Humanity (11:14) The Strange Connections of Sam Bankman-Fried & FTX (9:11) The TRUTH about IVERMECTIN (13:00)   Korean ginseng prevents oxidative stress caused by work Ohiol State University, November 07, 2022 People who are stressed may find relief from taking Korean ginseng. A study published in the Journal of Medicinal Food has revealed that the Korean ginseng called GINST15 can help reduce stress, mentally and physically. In the study, researchers from The Ohio State University in the U.S. found that Korean ginseng prevents damage caused by intense work stress due to its antioxidants. For the study, the researchers aimed to determine the effects of GINST15 supplement on hormonal and inflammatory responses to physical stress in humans. They recruited 10 women and nine men to participate in the study. The participants were tasked to complete three two-week treatment cycles with 960 milligrams (mg) of the Korean ginseng supplement, 160 mg of the Korean ginseng supplement, or a placebo, separated by a one-week washout period. After the treatment, the participants underwent an intense resistance exercise to induce physical stress. The participants also provided blood samples at rest and at various points after the exercise, particularly immediately, 30 minutes, 60 minutes, and 24 hours after exercise. Then, the researchers measured the levels of cortisol, superoxide dismutase, total glutathione, nonspecific antioxidant activity, total antioxidant power, and creatine kinase. The results showed that the supplementation of Korean ginseng reduced cortisol and increased enzymatic and nonspecific antioxidant activity. In addition, the high dose of the Korean ginseng supplement (960 mg) greatly reduced muscle damage and hypothalamic pituitary adrenal (HPA) responses to physical stress 24 hours after the intense exercise. Based on the findings of the study, the researchers concluded that taking Korean ginseng supplements can help ward off mental and physical stress by reducing cortisol levels and muscle damage. When low-income families can meet their basic needs, children are healthier Boston Medical Center, November 8, 2022 A series of reports from five cities across the US found that young children and their parents are healthier when they are able to afford basic needs. New research published by Children's HealthWatch, headquartered at Boston Medical Center, highlights the need for policymakers to improve access to and effectiveness of programs that enable all families with low incomes to afford basic needs such as food, shelter, utilities, medical care, prescription medicines and childcare. Researchers surveyed more than 18,000 families of children under age 4 in the emergency departments and primary care clinics at urban hospitals in Baltimore, Boston, Minneapolis, Philadelphia, and Little Rock. The study team created a composite measure of hardships that included a family's ability to afford food, utilities, and health care, and maintain stable housing. All hardships described in the study have previously been associated with poor child and caregiver health. This study, however, examined the differences between children living in hardship-free families versus those in families with any or multiple hardships. In all cities, living in a hardship-free family was associated with good overall health for children and caregivers, positive developmental outcomes for young children, and positive mental healthamong mothers. Nearly half of families interviewed at Hennepin County Medical Center in Minneapolis reported that they were hardship-free. At Boston Medical Center, only about one quarter of the families surveyed reported zero hardships, which may be due to higher housing costs. The reports also examine the link between childcare constraints, when parents are unable to work or attend school because of an inability to afford childcare, and hardships. In each city, parents who reported being able to access affordable childcare were more likely to be hardship free. The research teams advocate for implementing policies to increase wages, along with ensuring access to programs that support low-income families being able to meet basic needs, such as food and housing security and medical care. Further, the authors suggested screening for hardships in health care settings and connecting patients and their families to resources that promote health. (NEXT) Vitamin D vs. Flu Shots Alliance for Natural Health & Queen Mary University, November 8, 2022 New research shows vitamin D helps prevent infection. Will the crony medical establishment listen? We at ANH-USA have been beating the drum about vitamin D and its well-documented anti-viral capabilities for years, and there is new evidence demonstrating vitamin D's role in preventing respiratory infections. When faced with the choice of a cheap, safe, and effective natural immune defense against the flu, or an expensive, dangerous, and ineffective vaccine that makes drug companies billions of dollars—which will our crony health officials choose? The Queen Mary University of London study, which pooled data from 25 studies that included more than 10,000 participants, found that vitamin D supplementation reduced the risk of respiratory infections (cold and flu) by 10 percent overall—and there are reasons to think this figure greatly understates the degree of protection. The protective effect of the sunshine vitamin was even more dramatic in those who were deficient. For the deficient, which about 40% of Americans are, the risk of infection was reduced by half with vitamin D supplementation. This builds upon earlier findings from a 2010 Japanese study which found that vitamin D supplementation was as effective as the vaccine at preventing colds and flu. Predictably, the media tries to diminish these findings, stating that “not everyone is convinced that this study should lead us to the supplement aisle.” We're then told that the Institute of Medicine (IOM) has determined that adults need only 600 IU of vitamin D—an amount that most Americans do not get from sun exposure or their diet alone. The IOM also said that a vitamin D blood level of 20 ng/mL was adequate This is nonsense. The Vitamin D Council, for example, recommends 5,000 IU of vitamin D per day to achieve at least 40 ng/mL; other integrative doctors we respect advise that the D serum level needs to be around 70 in order to avoid viral infection. Other calculations have shown that IOM recommendations are only about one-tenth of what is needed to cut the incidence of diseases related to vitamin D deficiency. What this means is that most Americans are not getting the vitamin D they need, in part because health authorities at the IOM and elsewhere in the government are mistaken when telling Americans how much to take. That we do not get enough vitamin D in our diet or through sun exposure to meet a paltry 600 IU means that the number of Americans who are deficient must be staggering. It is a crime that health authorities are not telling people to take vitamin D supplements. The good news is that this study shows that those who are deficient in vitamin D—likely most Americans, given how wrong the IOM is about how much vitamin D we really need—can reduce their risk of cold or flu by 50 percent. That is more effective than the flu vaccine usually is. (NEXT) The therapeutic power of Indian frankincense for multiple sclerosis patients Ahvaz Jundishapur University of Medical Sciences (Iran), November 07, 2022 Boswellia serrata, the plant from which Indian frankincense is derived, can improve cognitive performance in people with multiple sclerosis (MS). This finding, from a study published in the Journal of Herbal Medicine, promises a new and natural way of delaying the complications and effects of MS. Neurons, the special cells that make up the nerves and the different parts of the nervous system, have what is called the myelin sheath. This is a layer that coats and protects the nerve fiber or axon, a long, thin projection that carries electrical impulses from one end of the neuron to the other. The myelin sheath insulates the axon and enhances its function, allowing it to more efficiently deliver messages between the brain and the different parts of the body. In multiple sclerosis, the immune system attacks the cells that make up the myelin sheath. This causes the nerves to “short circuit” and creates problems in the way that messages are delivered from or to the brain. With time, multiple sclerosis can result in permanent nerve impairment and damage. Researchers say B. serrata can help remedy certain symptoms and effects of multiple sclerosis, in particular, the cognitive impairment that occurs in 40 to 65 percent of patients. This usually entails problems with complex attention, a slower information processing speed, and episodic lapses in memory and executive functions. MS-related cognitive impairment has been known to affect patients quality of life, personal relationships, and vocational potential. (NEXT) Social media use increases depression and loneliness University of Pennsylvania, November 8, 2022 The link between the two has been talked about for years, but a causal connection had never been proven. For the first time, University of Pennsylvania research based on experimental data connects Facebook, Snapchat, and Instagram use to decreased well-being. Psychologist Melissa G. Hunt published her findings in the December Journal of Social and Clinical Psychology. “We set out to do a much more comprehensive, rigorous study that was also more ecologically valid,” says Hunt, associate director of clinical training in Penn's Psychology Department. To that end, the research team designed their experiment to include the three platforms most popular with a cohort of undergraduates, and then collected objective usage data automatically tracked by iPhones for active apps, not those running the background. Each of 143 participants completed a survey to determine mood and well-being at the study's start, plus shared shots of their iPhone battery screens to offer a week's worth of baseline social-media data. Participants were then randomly assigned to a control group, which had users maintain their typical social-media behavior, or an experimental group that limited time on Facebook, Snapchat, and Instagram to 10 minutes per platform per day.”Here's the bottom line,” she says. “Using less social media than you normally would leads to significant decreases in both depression and loneliness. These effects are particularly pronounced for folks who were more depressed when they came into the study.” “It is a little ironic that reducing your use of social media actually makes you feel less lonely,” she says. But when she digs a little deeper, the findings make sense. “Some of the existing literature on social media suggests there's an enormous amount of social comparison that happens. When you look at other people's lives, particularly on Instagram, it's easy to conclude that everyone else's life is cooler or better than yours.” (NEXT) Acupuncture at these specific points alleviates pain in cancer patients Guangzhou University of Chinese Medicine, November 07, 2022 Cancer causes many adverse complications, including constant pain. A study published in the journal BMC Complementary and Alternative Medicinelooked into the viability of using acupuncture to soothe this pain and cause relief to cancer patients. Although cancers are named after the body part where the tumor – or tumors, in some cases – is located, its effects can be felt in other parts of the body. In the case of bone and testicular cancers, pain is one of the first signs. In others, such as pancreatic cancer, discomfort may be a sign that the disease has progressed or metastasized. The authors of the study wanted to know if acupuncture's pain relieving properties extended to cancer patients. In a single-blind, randomized controlled pilot trial, they recruited 42 patients going through moderate to severe cancer pain. The participants were randomly assigned to one of three groups. Each group had 14 members. The first group had acupuncture at the acupoints si guan xue, while the second group combined si guan xue with commonly used acupoints. The third group served as the control and was treated only on the most frequently used acupoints.The researchers' analysis showed that the second group experienced the most cancer pain reduction at around day five. This was compared to the control group. Scores in the PGIC, EORTC QLQ-C30, or KPS did not indicate much variance among the three groups. They concluded that acupuncture at the si guan xue, combined with commonly used acupoints, was the most effective at treating pain caused by cancer. However, a larger study needed to be performed owing to the small sample size employed by the present study.

Jane Winston, MD, AAFP, CMD is a native of Wahpeton ND, and a graduate of the University of North Dakota (UND) School of Medicine and Health Sciences.  She completed an internship at Hennepin County Medical Center in Minneapolis MN, a family medicine residency program at the UND Family Practice Center in Fargo ND, and a geriatric fellowship at Sun Health/St. Joseph's in Phoenix AZ. Dr. Winston is Board Certified in Family Medicine and holds a Certificate of Added Qualifications in Geriatric Medicine.  She is a Certified Medical Director, and a Clinical Assistant Professor in Geriatrics and Family and Community Medicine at UND School of Medicine and Health Sciences. Dr. Winston retired from her geriatric medicine practice at Sanford Health in Fargo in 2020 just before the Covid-19 pandemic began.  As an advocate for age-friendly care for older adults, she volunteered and served on the North Dakota Medical Association Covid-19 Physician Advisory Group and the American Medical Directors Association (AMDA) Covid-19 State Task Force. In 2021 she was appointed to the AMDA State-Based Policy & Advocacy Subcommittee.  She is also a member of the Maricopa County Department of Public Health Medical Reserve Corp and serves as a volunteer vaccinator. She and her husband reside in Fargo ND and enjoy time away in the winter in Arizona. She has 3 stepdaughters and 4 grandchildren and one great-grandchild.  Dr. Winston also enjoys reading, cooking, walking, yoga, and traveling.   Recording Date: July 26, 2022 Interviewee: Jane Winston, M.D., A.A.F.P., C.M.D State: North Dakota Affiliation: North Central Society for Post-Acute and Long-Term Care Medicine  

Interview with Brittany Miller who is a dental student at Hennepin County Medical Center. Her info to be reached is BJMiller@umn.edu. she would be glad to assist you with any questions or concerns you may have. Enjoy.

5 DELICIOUS DINNER RECIPES to support your weight loss: https://www.chefaj.com/5-delicious-lo... ------------------------------------------------------------------------- You can get the book here: https://www.amazon.com/dp/B09GPTJNJG?... To book a consultation with Dr. Gupta: https://www.anshulguptamd.com/work-wi... Take the thyroid quiz: https://www.anshulguptamd.com/thyroid... Take the SIBO-IBS quiz: https://www.anshulguptamd.com/sibo-quiz/ Dr. Anshul Gupta MD is Board-Certified Family Medicine Physician, with advanced certification in Functional Medicine, Peptide therapy and also fellowship trained in Integrative Medicine. He has worked at the prestigious Cleveland Clinic Department of Functional Medicine as staff physician alongside Dr. Mark Hyman. He believes in empowering his patients to take control of their health and partners with them in their healing journey. He now specializes as a thyroid functional medicine doctor, and help people reverse their unresolved symptoms of thyroid dysfunction. Conventional medicine doesn't have all the answers for a vast majority of patients suffering from chronic diseases and that's where a Functional Medicine model can be helpful. Dr. Anshul Gupta experienced this himself when his acid reflux, weight issues, fatigue, brain fog, eczema, allergies, skin problems, fatty liver couldn't be handled by the conventional medical approaches. Dr. Gupta then utilised the concepts of Functional Medicine and reversed his diseases. He was not only able to get off all his medications but was able to lose weight, got unlimited energy and mental clarity which was sustainable and not a short fix to his problems. This reversal of his own disease motivated Dr. Anshul Gupta to become a Functional Medicine expert himself. You can read his personal journey, on what inspired him to share the concepts of Functional Medicine with people so that they can heal from within. Dr. Gupta completed his Family Medicine residency at Hennepin County Medical Center, Minneapolis. During this training, he also did an Integrative Medicine track where Dr. Anshul Gupta first learned about what Integrative Medicine and Functional Medicine Practitioners do. How the concepts of holistic medicines like these are used in managing chronic diseases, especially functional medicine for thyroid. His passion for working with underserved people lead him to the Northern Neck area of Virginia, where he worked for 5 years and provided services to the locals. He tried to incorporate a holistic approach with his care and his patients were always appreciative for it. He was voted the Best Doctor in Northern Neck 2018 by the Northern Neck news. Dr. Gupta next worked at Cleveland Clinic Functional Medicine Department. Upon becoming a Institute of Functional Medicine (IFM) Certified Practitioner, you can visit Dr. Gupta's IFM profile, to learn about all medical conditions Dr. Gupta treats as a Functional Medicine doctor. He also believes that knowledge is power and wants to educate people about a healthy lifestyle. As a functional and integrative medicine expert, Dr. Gupta is on a mission to help more than 1 million people to reclaim their health back. Anshul Gupta MD is one of the very few thyroid functional medicine doctors who are providing consultation to people to help them with unresolved symptoms due to thyroid dysfunction. He tries to work with his patients to work on their core imbalances by developing an individualized plan which focuses on a specific diet plan, movement, and stress reduction. Dr.Gupta is a proud father of 2 lovely children, and a lucky husband to his adorable wife. His wife is a blogger and is raising awareness and helping so many parents with concepts of respectful parenting. During his free time, he loves to travel, hike, meditate and practice yoga.

Join KDIGO Conversations in Nephrology host, Dr. Roberto Pecoits-Filho, in conversation with Dr. Chuck Herzog as they explore the challenges that occur when managing dyskalemia. They address the consequences of hyperkalemia and hypokalemia. They also discuss how both hospitalized patients and outpatients are affected by hyperkalemia. Dr. Roberto Pecoits-Filho is Senior Research Scientist at Arbor Research and Professor of Medicine at the Pontifical Catholic University of Paraná. Dr. Chuck Herzog is Professor of Medicine at the University of Minnesota, and a cardiologist at Hennepin County Medical Center. This episode was supported by Vifor Pharma.

Modern medicine has constructed an arbitrary barrier between the mind and the body. We are not segmented beings; our bodies carry us through all the experiences in our lives — the pleasures and the traumas. We'll be taking a deep dive into the latter and how psychedelics integrate into somatic experiences along with our three insightful guests. Intro (0:00 – 2:20) Our First Guest: Kelly Street (2:21 – 11:23) A Bit About Her The Body's Integration Into The Healing Journey What Yoga Contributed To This Journey Enter Psychedelic Therapy Our Second Guest: Dr. Jeff Sawyer (11:24 – 21:50) A Bit About Dr. Sawyer The Impact of Psychedelic-Assisted Therapy How Do You Unlock The Body? How Does Your Relationship With Your Body Change? Our Third Guest: Bruce Sanguin (21:51 – 33:13) A Bit About Mr. Sanguin And His Journey Psychedelic vs. Relational Therapy (In His Experience) Disassembly Reconstruction Dr. Sawyer on Dissociation (33:14 – 36:52) Mr. Sanguin on Psychedelics' Spiritual Influence (36:53 – 39:50) End (39:51 – 40:56) Bruce Sanguin, BA, M.Div., RMFT Bruce is a psychotherapist living in Victoria BC Canada. He is the author of seven books. His latest Dismantled: How Love and Psychedelics Broke a Clergyman Apart and Put Him Back Together describes his healing journey with psychedelic medicine. brucesanguin.ca. Kelly Street is passionate about the power of the mind-body connection for healing. She loves to learn and teach others how to bring that connection from the yoga mat and healing work into everyday life by adding daily practices, mantras, and body awareness. She is a yoga teacher, business coach, and the owner of Happy Rebel, a mindset-based product company. More recently, she is a student of Clinical Psychology, having realized her next life purpose is to learn and teach whole-body healing. Dr. Jeff Sawyer MD is the co-founder and CEO of The Remedy MN Ketamine TMS and brings decades of psychiatry experience to the practice, including work with patients at organizations such as Minnesota Alternatives, Alltyr Clinic, and more. He studied psychology at Brown University before moving on to S.U.N.Y. Stony Brook School of Medicine for his M.D., Hennepin County Medical Center for Family Medicine training, and psychiatric training at Mayo Clinic. He is board-certified in Adult and Addiction Psychiatry with previous board certification in Family Medicine and Integrative Medicine.

Al, previously a business owner, who opened and ran a few local wine bars in Minneapolis, as well as a catering business, discusses how his use was propelled by his busy lifestyle. He talks about the importance of mentorship, spirituality, service work, and sober housing. Al became sober on October 10th, 2002.

Previously at SMACC, Steve talked about NonSTEMI that needed the cath lab immediately and showed many ECGs which represented acute coronary occlusion (Myocardial Infarctions) but present on the ECG as very subtle findings (http://hqmeded-ecg.blogspot.com/search?q=subtle), particularly as subtle ST segment elevation that does not meet “STEMI” criteria and is diagnosed as NonSTEMI. Now, he builds on that idea and challenges the whole idea of a dichotomy between STEMI and NonSTEMI. These are NOT distinct pathologies, but rather exist on a continuum of intracoronary thrombus. Nevertheless, this false dichotomy is rarely recognised by emergency physicians or cardiologists, and patients suffer because of it. There are obvious STEMI, which always need the cath lab emergently, and for which time is myocardium. On the other hand, there are patients whose symptoms are resolved, ECG is non-diagnostic, shows no active ischemia nor subtle ST elevation, but whose troponin is positive and their resolved chest pain is due to an MI with an open artery and no ongoing myocardial cell death. These are NonSTEMI that can be treated with antiplatelet and antithrombotic therapy and get their angiogram the next day. And then there are the patients who have subtle ST elevation representing acute coronary occlusion, or who have active symptoms and/or persistent ECG ischemia. These patients do NOT have STEMI but do need the cath lab now. 25% of occlusions do NOT have diagnostic ST elevation and they do not get their angiogram until 24-36 hours later; their outcomes are worse: they have worse LV function, higher biomarkers, and higher mortality than NonSTEMI whose arteries are open at next-day cath. Steve advocates for an end to another dichotomy: activate the cath lab (Pathway A) or do NOT activate. Instead, he advocates what they, at Hennepin County Medical Center, call “Pathway B”: emergent consultation with cardiology, including a high quality emergency contrast echocardiogram to look for wall motion abnormality. Finally, he shows a variety of ECGs which represent subtle coronary occlusion or ongoing ischemia. For more head to: codachange.org/podcasts

The sixth day of the trial of Derek Chauvin, the former police officer accused of killing George Floyd, brought two key witnesses to the stand: the doctor who spent 30 minutes trying to save Mr. Floyd’s life before pronouncing him dead, and the chief of the Minneapolis Police Department. Both witnesses provided testimony that could bolster the arguments of the prosecution, which has argued that Mr. Floyd died because Mr. Chauvin knelt on him for more than nine minutes, rather than by complications of drug use or a heart condition. Here are the key takeaways from Monday. Dr. Bradford T. Wankhede Langenfeld, who was a senior resident at the Hennepin County Medical Center, said he believed that Mr. Floyd died from a lack of oxygen. Mr. Floyd’s cause of death will prove to be a determining factor in this case. The prosecution has maintained that “asphyxia,” or a deficiency of oxygen, caused Mr. Floyd’s death. During a cross-examination, Dr. Wankhede Langenfeld told Eric J. Nelson, Mr. Chauvin’s lawyer, that asphyxia can be caused by a number of factors, including drug use; a toxicology report found methamphetamine and fentanyl in Mr. Floyd’s system. --- Support this podcast: https://anchor.fm/Teddy-G/support

JR Westberg is a researcher for the Hennepin Healthcare Research Institute at the Hennepin County Medical Center in Minnesota. Hennepin County Medical Center is one of the oldest non-profit hospitals in Minnesota.  In this episode, we hear more about JR's research on opioid use after trauma and the role of research on pain medication.  Learn more about Hennepin Healthcare Research Institute: https://www.hhrinstitute.org/  To learn more about the Bloomberg American Health Initiative and the Bloomberg Fellows Program, visit https://americanhealth.jhu.edu/.

The Minneapolis police chief testified Monday that now-fired Officer Derek Chauvin violated departmental policy — and went against “our principles and the values that we have” — in pressing his knee on George Floyd’s neck and keeping him down after Floyd had stopped resisting and was in distress.Continuing to kneel on Floyd's neck once he was handcuffed behind his back and lying on his stomach was “in no way, shape or form” part of department policy or training, "and it is certainly not part of our ethics or our values,” Police Chief Medaria Arradondo said on Day Six of Chauvin's murder trial.Arradondo, the city’s first Black chief, fired Chauvin and three other officers the day after Floyd’s death last May, and in June called it “murder.”While police have long been accused of closing ranks to protect fellow members of the force charged with wrongdoing — the “blue wall of silence,” as it’s known — some of the most experienced officers in the Minneapolis department have taken the stand to openly condemn Chauvin’s treatment of Floyd.As jurors watched in rapt attention and scribbled notes, Arradondo testified not only that Chauvin, a 19-year veteran of the force, should have let Floyd up sooner, but that the pressure on Floyd’s neck did not appear to be light to moderate, as called for under the department's neck-restraint policy; that Chauvin failed in his duty to render first aid before the ambulance arrived; and that he violated policy requiring officers to de-escalate tense situations with no or minimal force if they can.“That action is not de-escalation," the police chief said. "And when we talk about the framework of our sanctity of life and when we talk about our principles and the values that we have, that action goes contrary to what we are talking about.”Arradondo's testimony came after the emergency room doctor who pronounced Floyd dead said he theorized at the time that Floyd's heart most likely stopped because of a lack of oxygen.Dr. Bradford Langenfeld, who was a senior resident on duty that night at Hennepin County Medical Center and tried to resuscitate Floyd, took the stand as prosecutors sought to establish that it was Chauvin’s knee on the Black man’s neck that killed him.Langenfeld said Floyd’s heart had stopped by the time he arrived at the hospital. The doctor said that he was not told of any efforts at the scene by bystanders or police to resuscitate Floyd but that paramedics told him they had tried for about 30 minutes and that he tried for another 30 minutes.Under questioning by prosecutors, Langenfeld said that based on the information he had, it was “more likely than the other possibilities” that Floyd's cardiac arrest — the stopping of his heart — was caused by asphyxia, or insufficient oxygen.Chauvin, 45, is charged with murder and manslaughter in Floyd's death May 25. The white officer is accused of pressing his knee into the 46-year-old man's neck for 9 minutes, 29 seconds, outside a corner market where Floyd had been arrested on suspicion of trying to pass a counterfeit $20 bill for a pack of cigarettes.Floyd’s treatment by police was captured on widely seen bystander video that sparked protests around the U.S. that descended into violence in some cases.The defense has argued that Chauvin did what he was trained to do and that Floyd's use of illegal drugs and his underlying health conditions caused his death.Nelson, Chauvin's attorney, asked Langenfeld whether some drugs can cause hypoxia, or insufficient oxygen. The doctor acknowledged that fentanyl and methamphetamine, both of which were found in Floyd's body, can do so.The county medical examiner's office ultimately classified Floyd's death a homicide — a death caused by someone else.The report said Floyd died of “cardiopulmonary arrest, complicating law enforcement subdual, restraint, and neck compression.” A summary report listed fentanyl intoxication and recent methamphetamine use under “other significant conditions” bu...

Like offensive linemen on a football team, roofers tend to go unnoticed until something bad happens. “People only think about their roof if it’s leaking, right?” says Jason Stock, chief financial officer of Central Roofing, a longtime roofing contractor in Minneapolis. “Out of sight, out of mind. If water is staying out, it’s good. If it’s coming in, it’s the end of the world.” Central Roofing has done its part to keep roofs from leaking for more than 90 years. The company started out as a “one-man shop” during the Great Depression and has since grown to serve clients across the country. Local clients and projects include the Hubert H. Humphrey School of Public Affairs at the University of Minnesota, the Hennepin County Medical Center, and the historic 1888 Masonic Temple in Minneapolis. In the following interview with reporter Brian Johnson, Stock touches on the history of Central Roofing and the impact of COVID-19 on the roofing business as a whole, among other topics.

Dr. Kalra is an interventional cardiologist and medical director of clinical research for regional cardiovascular medicine at the Cleveland Clinic, section head of cardiovascular research at Cleveland Clinic Akron General, a university professor at the Cleveland Clinic Lerner College of Medicine (Associate Professor) and NEOMED (Adjunct Associate Professor), and founder of the non-profit startup, makeadent.org. He is director of Barry J. Maron Hypertrophic Cardiomyopathy Center in New Delhi, India. He is also the host of the cardiology podcast show, Parallax. He has presented late-breaking science at national and international scientific cardiovascular meetings, and has published over 200 scientific manuscripts in various peer-reviewed journals. Educated at Indira Gandhi Medical College (Shimla, India), he completed medical and cardiology training at the All India Institute of Medical Sciences (New Delhi, India), Cooper University Hospital (Camden, NJ), and Hennepin County Medical Center and Minneapolis Heart Institute (Minneapolis, MN). He served as a clinical and research fellow in interventional cardiology at Beth Israel Deaconess Medical Center, and a clinical fellow in medicine at Harvard Medical School (Boston, MA). He then completed a year of advanced interventional and structural cardiology fellowship at Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital (Houston, TX). Dr. Kalra is board-certified in Internal Medicine, Cardiovascular Disease and Interventional Cardiology from the American Board of Internal Medicine, and a Diplomate in Adult Comprehensive Echocardiography from the National Board of Echocardiography. He is also certified in patient safety, healthcare quality, health informatics and leadership from Harvard Medical School's 1-year Safety, Quality, Informatics and Leadership certification program. He is currently pursuing a Master of Science program in Health Economics, Outcomes and Management in Cardiovascular Sciences at the London School of Economics & Political Science in London, United Kingdom. He is also the author of the poetry book, "Ibadah" that was released on Amazon and Barnes & Noble, and launched in collaboration with Cleveland Clinic Arts and Medicine Institute on Valentine's Day, 2020. EHJ paper: https://academic.oup.com/eurheartj/article/38/23/1789/3867739 Non-profit startup, makeadent.org, and the poetry book, ibadahthebook.com

Dr. David Hilden of Hennepin County Medical Center joins Roshini to talk the latest, up to the minute COVID-19 news including, a lot of great vaccine information.  See omnystudio.com/listener for privacy information.

This week's topic is addiction. Dr. Hilden and Roshini are joined by special guest, Dr. Gavin Bart. Dr. Bart is Director of the Division of Addiction Medicine at Hennepin County Medical Center and Associate Professor of Medicine at the University of Minnesota. See omnystudio.com/listener for privacy information.

Curiosity about why one woman labored in a straightforward manner and a woman in a similar situation struggled much more led Gail Tully to ask why.  She dug in to understand not only the role of the pelvic bones in labor but also the soft tissues that can either create a good pathway or block baby’s progress through them.  Listen to her story and how she developed new techniques and reimagined some older ones to help birthing people create an easier path for their babies to emerge.   Gail Tully, CPM, is the Spinning Babies Lady and an expert in Fetal Positioning. A new paradigm emerged in 2001 with Spinning Babies® putting physiology first in labor progress to replace the high dependence on cesarean surgery. Previously a DONA International approved doula trainer, doula and homebirth midwife, Gail was a founding mother of the Childbirth Collective, one of the largest doula non-profits in the USA. She created the Hennepin County Medical Center’s Doula Project and led trainings for the Somali Doula Program and Turtle Women of St. Paul’s American Indian Family Center.   Gail Tully and her 14 Approved Trainers offer workshops and world speaking engagements.  Listen and Learn:  How curiosity, coupled with solid understanding of anatomy and physiology created the Spinning Babies program  The impact of gravity on the 30 muscles in the pelvis and how to work with these structures  The things birthing people can do to ease tension in pregnancy and create a good path for their baby when birthing time comes  The various training courses and who they are intended for  Why so many providers are becoming skilled in these techniques    Resources & Mentions:  https://spinningbabies.com/     Related Products from InJoy   Understanding Birth Curriculum Miracle of Birth 3: Five Birth Stories Miracle of Birth 4: Five Birth Stories    Pain Management for Childbirth – Vol. 1  

Curiosity about why one woman labored in a straightforward manner and a woman in a similar situation struggled much more led Gail Tully to ask why.  She dug in to understand not only the role of the pelvic bones in labor but also the soft tissues that can either create a good pathway or block baby’s progress through them.  Listen to her story and how she developed new techniques and reimagined some older ones to help birthing people create an easier path for their babies to emerge.   Gail Tully, CPM, is the Spinning Babies Lady and an expert in Fetal Positioning. A new paradigm emerged in 2001 with Spinning Babies® putting physiology first in labor progress to replace the high dependence on cesarean surgery. Previously a DONA International approved doula trainer, doula and homebirth midwife, Gail was a founding mother of the Childbirth Collective, one of the largest doula non-profits in the USA. She created the Hennepin County Medical Center’s Doula Project and led trainings for the Somali Doula Program and Turtle Women of St. Paul’s American Indian Family Center.   Gail Tully and her 14 Approved Trainers offer workshops and world speaking engagements.  Listen and Learn:  How curiosity, coupled with solid understanding of anatomy and physiology created the Spinning Babies program  The impact of gravity on the 30 muscles in the pelvis and how to work with these structures  The things birthing people can do to ease tension in pregnancy and create a good path for their baby when birthing time comes  The various training courses and who they are intended for  Why so many providers are becoming skilled in these techniques    Resources & Mentions:  https://spinningbabies.com/     Related Products from InJoy   Understanding Birth Curriculum Miracle of Birth 3: Five Birth Stories Miracle of Birth 4: Five Birth Stories    Pain Management for Childbirth – Vol. 1  

We all do better when we all do better Paul Wellstone More information can be found at www.socialchangeleaders.net As social change leaders work to be more inclusive and address structures and systems of racism and oppression in our communities, we take a look at one of the important ones to tackle - health care. This week we discuss bias, leadership and health equity with Dr. Veronica Svetaz. Dr. Svetaz is a physician at Hennepin County Medical Center (where she also works in the Center for Health Equity Leadership) and an Assistant Professor at the University of Minnesota. She is nationally recognized for her work as the Director of Aqui Para Ti youth development program and her extensive research and writings. Dr. Svetaz was recently named as one of the seven examples of local leadership by the Society for Adolescent Health and Medicine. In our conversation we: Listen to the story of Dr. Svetaz's journey that started in Latin America with a deep spirit of doing things together in community Hear about the impact of being a teenager under military government shaped Dr. Svetaz's ideas around democracy, advocacy and caring for each other Learn how Dr. Svetaz came to the United States and began working with adolescents and how that turned into a fellowship and residency Hear Dr. Svetaz discuss her experiences with the role of women in leadership and how that impacted her career choices Understand the connection she shared with Latino families and how she learned the importance of vicarious resilience and gratitude Learn about the difference between chronic conditions and chronic illness and how working with community in strength-based manner supported her in becoming an expert in the area of health equity Hear about the important role of leaders, but how leadership is one of the most difficult things to change Hear about inclusive spaces and how social change leaders can become more aware of structures and systems of oppression in the communities including understanding the bias, discrimination, stereotyping and racism experienced by marginalized communities Reflect on the transformative power of deeply listening and human sharing Understand how health equity is rooted in being aware of and starting work the social determinants of health Learn how Dr. Svetaz defines and supports activism and activation in patients In this episode we reference: Book, Promoting Health Equity Among Racially and Ethnically Diverse Adolescents More about Dr. Veronica Svetaz: Maria Veronica Svetaz, MD, MPH, FSAHM, FAAFP is a Faculty Family Practice and Adolescent Health Boarded physician at HCMC Department of Family and Community Medicine, and an Assistant Professor at the Department of Family and Community Medicine, University of Minnesota. From Argentina, Dr. Svetaz completed her medical school, Internal Medicine and Chief Residency at the University of Buenos Aries, Argentina. She came to the University of Minnesota in 1996 to join the Division of Pediatrics and Adolescent Health LEAH training program for a two-year fellowship. At the same time, she completed a Master in Public Health, Maternal, and Child Major and completed her Family Medicine Residency at Region's Hospital. She was a member of the National team that drafted the 2002 "Consensus Statement on Health Care Transitions for Young Adults with Special Needs," endorsed by AAP/AAFP/ACP/ASIN (published in Pediatrics, 2002). She had been the Medical Director of Aqui Para Ti/Here for You youth development program since its beginning in 2002. This program has received multiple National Awards, most importantly the 2014 Millar Award for Innovation in Adolescent Care, by the Society of Adolescent Health (SAHM). It is currently overseeing a system-wide initiative to make HCMC (safety Net Hospital) teen-friendly. Her research includes working with bilingual youth, chronic illness and youth, issues around parenting that youth, educating practitioners to better work with minority youth, on how to use CBPR (Community Based Participatory Research) and how to support Health Equity. She is currently the Chair of the Society of Adolescent Health and Medicine (SAHM) 's National Diversity Committee (authored 2 Position Papers on Health Equity) and is a National Alliance to Advance Adolescent Health's Board Member. She sits on the Health Equity Advisory Board at Minnesota Medical Association (MMA) and is also part of DHS Behavioral Health Homes' Advisory Committee.

We all do better when we all do better  Paul Wellstone  More information can be found at www.socialchangeleaders.net As social change leaders work to be more inclusive and address structures and systems of racism and oppression in our communities, we take a look at one of the important ones to tackle - health care. This week we discuss bias, leadership and health equity with Dr. Veronica Svetaz.  Dr. Svetaz is a physician at Hennepin County Medical Center (where she also works in the Center for Health Equity Leadership) and an Assistant Professor at the University of Minnesota. She is nationally recognized for her work as the Director of Aqui Para Ti youth development program and her extensive research and writings. Dr. Svetaz was recently named as one of the seven examples of local leadership by the Society for Adolescent Health and Medicine. In our conversation we: Listen to the story of Dr. Svetaz’s journey that started in Latin America with a deep spirit of doing things together in community Hear about the impact of being a teenager under military government shaped Dr. Svetaz’s ideas around democracy, advocacy and caring for each other   Learn how Dr. Svetaz came to the United States and began working with adolescents and how that turned into a fellowship and residency  Hear Dr. Svetaz discuss her experiences with the role of women in leadership and how that impacted her career choices   Understand the connection she shared with Latino families and how she learned the importance of vicarious resilience and gratitude Learn about the difference between chronic conditions and chronic illness and how working with community in strength-based manner supported her in becoming an expert in the area of health equity Hear about the important role of leaders, but how leadership is one of the most difficult things to change Hear about inclusive spaces and how social change leaders can become more aware of structures and systems of oppression in the communities including understanding the bias, discrimination, stereotyping and racism experienced by marginalized communities  Reflect on the transformative power of deeply listening and human sharing  Understand how health equity is rooted in being aware of and starting work the social determinants of health  Learn how Dr. Svetaz defines and supports activism and activation in patients   In this episode we reference: Book, Promoting Health Equity Among Racially and Ethnically Diverse Adolescents    More about Dr. Veronica Svetaz: Maria Veronica Svetaz, MD, MPH, FSAHM, FAAFP is a Faculty Family Practice and Adolescent Health Boarded physician at HCMC Department of Family and Community Medicine, and an Assistant Professor at the Department of Family and Community Medicine, University of Minnesota. From Argentina, Dr. Svetaz completed her medical school, Internal Medicine and Chief Residency at the University of Buenos Aries, Argentina. She came to the University of Minnesota in 1996 to join the Division of Pediatrics and Adolescent Health LEAH training program for a two-year fellowship. At the same time, she completed a Master in Public Health, Maternal, and Child Major and completed her Family Medicine Residency at Region's Hospital. She was a member of the National team that drafted the 2002 "Consensus Statement on Health Care Transitions for Young Adults with Special Needs," endorsed by AAP/AAFP/ACP/ASIN (published in Pediatrics, 2002). She had been the Medical Director of Aqui Para Ti/Here for You youth development program since its beginning in 2002. This program has received multiple National Awards, most importantly the 2014 Millar Award for Innovation in Adolescent Care, by the Society of Adolescent Health (SAHM). It is currently overseeing a system-wide initiative to make HCMC (safety Net Hospital) teen-friendly. Her research includes working with bilingual youth, chronic illness and youth, issues around parenting that youth, educating practitioners to better work with minority youth, on how to use CBPR (Community Based Participatory Research) and how to support Health Equity. She is currently the Chair of the Society of Adolescent Health and Medicine (SAHM) 's National Diversity Committee (authored 2 Position Papers on Health Equity) and is a National Alliance to Advance Adolescent Health's Board Member. She sits on the Health Equity Advisory Board at Minnesota Medical Association (MMA) and is also part of DHS Behavioral Health Homes' Advisory Committee. 

Anita White is an artist whom I first encountered several years ago while working locum tenens at Hennepin County Medical Center in Minneapolis, MN. I was so impressed with her work that I commissioned her for the cover of my latest book, "The Locum Life: A Physician's Guide to Locum Tenens." Anita began drawing daily while still a teenager. When her husband Josh developed a chronic illness requiring frequent trips to the hospital, she chronicled these visits in her sketchbook. Anita discovered that she could "draw my way through difficult situations" and helped her cope with the stress of her husband's deteriorating physical health. Even after her husband's death, Anita has continued to return to the hospital to draw. During our interview, Anita walks us through six fascinating pieces of her work. Please join us for this 20-minute journey into "The Art of Medicine." For more information on Anita and her work, please go to: 1. Hospitalfieldnotes.blogspot.com 2. https://hereforlife.blog/local-artist-illustrates-a-day-in-the-life-at-hennepin-healthcare-in-160-moments-over-24-hours 

From perusing old-fashioned blueprints to dealing with the COVID-19 crisis, Mortenson Construction’s Rich Bistodeau has pretty much done it all on a construction site. Now, after nearly 50 years with the company, he’s calling it a career. Bistodeau joined Mortenson in 1972 as a carpenter apprentice and rose through the ranks to become a superintendent. During that time, he worked on projects that include the Hennepin County Medical Center expansion in Minneapolis and other notable healthcare jobs. In the following interview, Bistodeau talks about what led him to a career in construction, how the industry has changed in the past 47 years, the increasing focus on safety, and his plans for retirement.

Our guest is Eric Weinhandl, an epidemiologist whose investigation of a JAMA paper on dialysis patients lead to its retraction, and subsequent republication. Eric discusses the steps leading to the paper's eventual retraction, and what this signals about the larger research enterprise. Eric also discusses the role of bias, conflicts of interest, big data and home dialysis, as well as some thoughts on the field of epidemiology during the COVID pandemic. GUEST: Eric is an epidemiologist with 14 years of research experience in kidney disease, mostly regarding dialysis and pharmaceuticals. Eric worked at the United States Renal Data System (USRDS) Coordinating Center between 2004 and 2015 and has conducted studies with Amgen, Baxter, DaVita, NxStage, Sigma Tau, and the Peer Kidney Care Initiative. He recently worked for Fresenius Medical Care, one of the major dialysis companies in the United States, and currently works with the chronic disease research group as part of the Hennepin County Medical Center.  https://twitter.com/eric_weinhandl?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor (Twitter) WATCH ON YOUTUBE: https://youtu.be/jNxULLscu0U (Watch the episode) on our YouTube channel SHOW NOTES: https://jamanetwork.com/journals/jama/article-abstract/2764714 (JAMA retracted and republished paper) https://t.co/Dpk1UiV3V2?amp=1 (JAMA research letter) SUPPORT THE SHOW https://www.patreon.com/accadandkoka (Make a small donation) on our Patreon page on and join our discussion group or receive a free book. Support this podcast

This week is an open phone lines week. Dr. Hilden and Denny Long open up the phone & text lines and take any and all questions you may having concerning health matters.

In this episode, we hear from Dr. Martha Nance, a neurologist, geneticist, and Director of the HDSA Center of Excellence at the Hennepin County Medical Center in Minneapolis, Minnesota. Dr. Nance covers a wide range of topics about the impact of HD on youth, and provides some valuable insights on genetic testing. Dr. Nance has some great stories to share, and this is a must-listen to kick off HSG 2019 week in Sacramento, as she serves as the chair of the Huntington Study Group's Family Education Committee.

Keith G. Lurie, MD Dr. Keith Lurie is a practicing cardiac electrophysiologist and resuscitation scientist who, over the past 30 years, has developed novel ways to resuscitate patients experiencing sudden cardiac arrest. As one of the leading innovators in the field, he has helped to develop new devices and methods that optimize cardiopulmonary resuscitation and improve the likelihood of survival following cardiac arrest. In addition, he is a respected thought leader in developing and implementing an internationally-recognized systems-based approach to managing and treating cardiac arrest. Some of his most notable contributions include the development and assessment of various resuscitative techniques such as the impedance threshold device (ITD), active compression-decompression (ACD) CPR, use of active intra-thoracic pressure regulation to modulate cerebral and systemic circulation in states of severe hypotension and head injury, and the development of devices to elevate the head and thorax during CPR. He has mentored scores of research and clinical fellows over the past 30 years and he actively collaborates with multiple scientific colleagues worldwide. A professor of Emergency Medicine and Internal Medicine at the University of Minnesota, Dr. Lurie also directs a NIH-funded research laboratory at Hennepin County Medical Center in Minneapolis and he is a co-founder and Chief Medical Officer for Advanced Circulatory Solutions. His scientific publications have been cited over 10,000 times in the medical literature. He previously founded and then sold Advanced Circulatory Systems Incorporated to ZOLL Medical in 2015.  

It's a special edition of Healthy Matters as we continue our two-hour program, "I'm Listening".  We discuss mental health, and suicide prevention during the start of national suicide prevention week.  Dr. Hilden and Denny Long are joined by Dr. Brent Walden, the Chief Clinical Psychologist at HCMC. 

This weeks topic is strokes. Doctors Tapan Thacker and Ivan Matos from Hennepin County Medical Center join Dr. Hilden and Steve Thomson to discuss.

Interview by Gary Gunderson   An emergency physician, healthcare executive, and entrepreneur, Larry McEvoy’s diverse perspective renders him an inspiring, design-oriented leader, strategist, advisor, facilitator, and speaker. His extensive track record of real-life strategic and operational results—and a unique facility with ecosystems, neuroscience, social intelligence, and human networks—helps you understand and capacitate entire systems, small and large, to optimize performance, adaptation, and vitality.  He has wide experience in shaping the challenges of our complex times into outstanding results, rapid learning, and energized professional cultures. Larry’s mission is to deepen the vigor, resilience, and sustainability of leaders, the people they lead, and the organizations they create. Particularly focused on the shared work between executives, clinicians, and clinical leaders, Larry’s experience as both a CEO and a clinician deepens his skill in facilitating dynamic shifts in mindset, method, and performance. His background as a strategic innovator and “designer-in-chaos” has led him to increasing work outside of health care as organizations and corporations seek to create value via both stability andrapid reconfiguration in environments of velocity and volatility. His career has comprised the renewal of multiple environments of distrust, stress, and dispirited dynamics.  He focuses on creating a practical approach to the acceleration of systemic shifts in results, adaptation, and professional vitality; the linkage between leadership evolution, stewardship ethic, and business value; and the activation of “positive epidemics” through the understanding and application of complexity principles, network science, and neuroscience.  As one of his clients puts it, “I learn more from him in an hour than I do from anyone else in a year.  His emotional intelligence is off the charts, and his strategic acumen is of the highest order.” From 2008 to 2012, Larry served as the CEO of Memorial Health System in Colorado Springs, CO, facilitating a $100 million turnaround, the emergence of a culture of collaboration and commitment, and Memorial’s transformation from an at-risk and unfunded municipal hospital to the threshold of its merger with the University of Colorado Health system. Prior to that he was a senior executive and emergency physician at the Billings Clinic in Billings, MT, from 1995 to 2008. He completed his training in emergency medicine at Hennepin County Medical Center in Minneapolis, MN, in 1995. After earning a BA in English Writing from Carroll College (MT) in 1987, Larry graduated from Stanford University Medical School in 1992. He serves as an Executive-in-Residence at the Center for Creative Leadership and as a Principal at Brenva Group. He is on the faculty of the American Association of Physician Leaders,The Governance Institute, and The Leadership Development Group, and has presented at the Conference Board, The Executive Development Roundtable, and the American Medical Group Association as well as at numerous health care organizations nationwide. He co-founded PracticingExcellence, a web-based professional collegial community which focuses on the clinician experience as the foundation of healthcare performance, patient experience, and meaning.   Most recently he has founded Epidemic Leadership, where he focuses on the executive work of creating organizations of exponential health and vigor—where performance, learning, and vitality rise in parallel and are abundant, infectious, sustained and sustaining.

In this podcast Dr. Stephen Dunlop, an emergency medicine physician with a certificate in tropical medicine and hygiene, addresses fever and other ailments in individuals returning from traveling. Objectives:    Upon completion of this podcast, participants will be able to: Identify what risk factors predispose towards certain tropical diseases/conditions. Apply appropriate differential diagnoses related to a patient with a fever who returned from traveling. Understand the basic work-ups needed in a patient experiencing fever who returned from traveling. CME credit is only offered to Ridgeview Providers for this podcast activity. Complete and submit the online evaluation form, after viewing the activity.  Upon successful completion of the evaluation, you will be e-mailed a certificate of completion within 2 weeks.  You may contact the accredited provider with questions regarding this program at  rmccredentialing@ridgeviewmedical.org. Click on the following link for your CME credit: CME Evaluation: Fever in the Returned Traveler (**If you are listening to the podcasts through iTunes on your laptop or desktop, it is not possible to link directly with the CME Evaluation for unclear reasons. We are trying to remedy this. You can, however, link to the survey through the Podcasts app on your Apple and other smart devices, as well as through Spotify, Stitcher and other podcast directory apps and on your computer browser at these websites. We apologize for the inconvenience.)  The information provided through this and all Ridgeview podcasts as well as any and all accompanying files, images, videos and documents is/are for CME/CE and other institutional learning and communication purposes only and is/are not meant to substitute for the independent medical judgment of a physician, healthcare provider or other healthcare personnel relative to diagnostic and treatment options of a specific patient's medical condition.”   FACULTY DISCLOSURE ANNOUNCEMENT  It is our intent that any potential conflict should be identified openly so that the listeners may form their own judgments about the presentation with the full disclosure of the facts. It is not assumed any potential conflicts will have an adverse impact on these presentations. It remains for the audience to determine whether the speaker’s outside interest may reflect a possible bias, either the exposition or the conclusions presented. Planning committee members and presenter(s) have disclosed they have no significant financial relationship with a pharmaceutical company and have disclosed that no conflict of interest exists with the presentation/educational event. Show Notes: Dr. Steve Dunlop is an emergency physician practicing at Hennepin County Medical Center. He trained at the University of Minnesota in med school, then did his emergency medicine residency at HCMC. Steve has his master's in public health and completed his certificate from the American Society of Tropical Medicine and Hygiene. He's widely published and is an assistant professor of emergency medicine at the University of Minnesota. He's quite the traveling man and is no stranger to sub Saharan Africa and many other parts of the world. Indeed he is an international physician of mystery and we're honored to have him join us to discuss fever in the return traveler. Today's talk will focus primarily on the process of assessing the return traveler and the big, bad uglies that we don't miss in these patients. So, buckle up and enjoy this tropical disease safari with Dr. Dunlop.   CHAPTER 1:     Malaria is a parasitic disease that is transmitted by the anopheles mosquito. Plasmodium falciparum malaria is the most common, and tends to be the most serious. Malaria has an interesting, somewhat complex life cycle and patients present with cyclical fevers, headache, body aches, nausea and other non-specific symptoms. There are over 200 million cases a year and up to 500,000 deaths per year. Up to 2000 cases per year in the United States are reported. After inoculation by an infected mosquito, there is an incubation period of 7-to 30-days.      We'll summarize this first segment with an overview of the general topic of fever in the return traveler as outlined by Dr. Dunlop. As we discussed, there are diagnoses that we in medicine are trained to think about, and while we consider them in our differential diagnosis, they are still considered "zebras" in medicine. These diagnoses happen, but for some reason, causes of febrile illness that would be considered "zebras" seem to be less apt to make it on that differential list, or are basically the, "come on, you're kidding, right?" diagnosis.      In the case of a disease like malaria, especially when it presents in the developed world, patients often are seen 3-times or more before the diagnosis is made.  Different diseases have varying incubation periods and latency periods. These unknowns make the diagnosis, let alone the awareness of these various so-called 'tropical diseases" all the more difficult. We first must ask the relevant questions, which should start with "have you traveled anywhere recently?", "When?", "For how long?", "Where?", and "What did you do there?".      Delusions of parasitosis are not always delusions. As Fred's example of the fish tape worm reveals, one should always perform a careful and detailed exam. With regards to some of the parasite illnesses, the latency periods can be months to years, and a continuous or oscillating fever is not always necessary.      With regard to malaria, for instance, a fever may not be present when the patient shows up with their other non-specific symptoms. Again, the latency period is variable with malaria, not to mention the various causes of malaria.      The topic of tropical diseases is important to Dr. Dunlop because of the realization that the world has become a smaller place. One can easily travel to the other side of the world in a day. Minnesota, for instance, has one of the highest immigrant refugee per capita rates in the country, and consequently one of the largest global health programs in the country. Minnesota alone has over 1-million border crossings per year. Therefore, it is all the more important for general practitioners and other front line providers to have a greater awareness of where these patients recently came from and/or have traveled back to lately.      Seeing and evaluating a refugee immigrant versus other immigrants also carries nuance. Refugees in general undergo a very robust pre-departure screening, treatment and vaccinations. Other migrants however, may not have had the same king of screenings and treatments as refugees.      People travel extensively now, and sometimes forget to tell us about some of the quick stop-over trips that are made in the course of a larger holiday. It's, therefore, important to also consider these extra "side-trips" in the course of the bigger trip and access our resources. Dr. Dunlop refers to the CDC Yellow Book. Specifically, the "clinician view" tab should be accessed. This site allows us to see the most updated travel medicine guidelines regarding vaccines and chemoprophylaxis. As Dr. Dunlop states, fresh water exposure history will clue us in to various parasitic illnesses, such as schistosomiasis. Food intake is also taken into consideration, but this can become murky, and of course can lead to a variety of GI illnesses. Vaccine preventable illnesses, such as Hepatitis A, Typhoid and Yellow Fever, depending on where you are traveling, may be advised. Regarding malaria prophylaxis in particular, chemoprophylaxis regimens need to be given before, during and after an abroad trip. This CDC Yellow Book resource advises specific advice for specific regions and cities in all countries. All the vaccines, chemoprophylaxis, precautions and other considerations are provided here.      Public health programs track various diseases, however, the data gathering is largely backed by wealthier governments. The CDC in particular has surveillance posts throughout the world which monitors health and disease phenomena. WHO [the World Health Organization] takes on the responsibility of disseminating this information, but the efforts do tend to be collaborative.        CHAPTER 2:      VFR travelers, or "visiting friends and relatives" comprise of the majority of malaria cases in our country. Many of these people. for reasons unclear, don't always adhere to chemoprophylaxis during their often extended visits to their home countries. As a side note, malaria was common in the United States until the mid-1800's, and was largely eradicated in the ensuing decades due to DDT. Good for the malaria, bad for the eagles, and a lot of other critters. A pesticide that unfortunately killed a lot of other organisms as well.      Dr. Dunlop presents a case, that Fred and I butcher our way through. Bear in mind, folks, this discussion is meant to be broad, and not super-granular in terms of each tropical illness, although our friendly Dr. Robotvoice that you've already met, will chime in periodically to give us some factoids about some of these diseases we should be considering. So, we have a 35-year old male, VFR traveler who goes back to Ghana. He returns with a fever. While home in Ghana, he stayed in his village; and basically while there, he lived like the locals - so to not stick out like a sore "Americanized" thumb amongst his friends and family. However, as Steve points out, and while we should be ever vigilant for malaria and still test for it, and still consider the other tropical diseases in this patient, it's still prudent to do the tests for the common illnesses. Influenza, pneumonia, strep, UTIs, etc.      How do we test for malaria now? Thick and thin blood smears are still the standard in diagnosis of malaria. But, those smears can also show other diseases, such as African Sleeping Sickness. However, the rapid malaria tests are even more commonly performed now, and will give you a quicker turnaround in the diagnosis. The sensitivity and specificity of the rapid malaria tests are good, and if the patient looks non-septic, perhaps improves with conservative care or some IV fluids, the test is sufficient. It's common to repeat the test several times if the patient continues with symptoms. The thick and thin smears are still warranted, though, in these cases as well. CDC can be helpful, however is not diagnostic of malaria.       In this same patient, if the malaria testing is negative, and other screening of common febrile causes is negative, then throw in some bone pain, joint pain, severe headache and a blanching rash - Dengue Fever is to be considered. Getting Dengue again further down the road can be much worse, such as Dengue Hemorrhagic Fever. Chikungunya is making itself known quite well in recent years too. While there is less likelihood of these and other viral diseases to cause severe illness, they are helpful to track from a public health standpoint. Sex tourism is quite common as well, and STIs must also be considered, such as HIV. In fact, some health systems are doing rapid HIV tests on all-comers. There is about a 0.1% positive rate at Hennepin Ed, for instance, and the significance here is that we're identifying the superinfected hosts who are at the highest likelihood of passing it to others. So, again, besides doing our basic work-ups like a chest x-ray, urinalysis, etc., the work-up for malaria is indicated as directed. A CDC and LFTs can also be helpful. Leukopenia, thrombocytopenia and transaminitis, a lot of vector borne illnesses will exhibit these findings. Rickettsial diseases are included in this.      There is a high incidence of gram negative sepsis with severe malaria, therefore, a comprehensive sepsis work-up and treatment plan with brad spectrum abx is appropriate; even in the setting of a positive malaria test or smear. IV quinidine is approved for use in the United States, although production of this is now an issue. There is hope that other drugs will go through the FDA process, although this is expensive. Artesunate is the IV med for malaria used elsewhere in the world, and the CDC has an investigative provision to use this drug when and if quinidine is not available. Malarone can be given PO or crushed and placed in an NG tube if IV preparations are temporarily unavailable. Doxycycline and Clindamycin do have some utility in malaria treatment as well. So, in the unlikely event that you are treating the sick malaria patient, these can be used as well in a pinch.        CHAPTER 3:      For respiratory patients who have traveled and you don't know the etiology, think respiratory isolation until you have a better sense of what's going on. Most likely, it is not something serious. However, there are serious respiratory illnesses endemic to certain countries and regions, such as MERS and SARS. Again, the Yellow Book can be helpful here. Personal protection including masks for patient and providers/care givers is recommended.      Diarrheal illnesses are also to be considered such as cholera. In general, abx are not always needed. The extreme cases of fever, abdominal pain and severe diarrhea is a different story, though, and abx can be given here. While some of the diarrheal etiologies for travelers are viral, many are bacterial. There is some resistance to certain antibiotics in campylobacter. Traveler's Diarrhea, for instance, does not require antibiotic therapy. Patients at higher risk are often on antacid meds at baseline. Situational needs may warrant antibiotics, such as the need to avoid a bathroom break next to a pride of lions, or a curious hippopotamus. Imodium is helpful, as is bismuth subsalicylate. Warn your patients about the black stools, though, too. Bismuth may be able to be used as prophylaxis as well. Imodium can be helpful for traveler's diarrhea, but it can lead to obstipation and it should be avoided in severe cases. Contacting the CDC for general questions about a tropical illness is an option. Steve also mentions that in the Hennepin service area, the option of contacting the Emergency Physician on duty is also an option. Again, look into the option of having a rapid malaria test available at your shop.      Dr. Dunlop discusses EMR systems, in this case, EPIC showing an improved ability to screen patients based on their demographics, country of origin, travel history, etc. of potential infectious considerations. For instance, what kind of malaria or other travel illnesses to consider based on what the patient's registration information provides.      Follow-up for most patients who have been diagnosed with a travel illness, especially something complex like malaria, it would be best to refer them to someone steeped in this field. As Dr. Dunlop mentions, it's prudent to look up ASTMH certified providers in your area. This information could be obtained from a travel medicine clinic, and would be a good place to start. Health care providers as patients tend to be some of the worst offenders in terms of compliance with travel medicine, chemoprophylaxis, etc. Utilizing a travel medicine clinic will be most prudent, and besides medications, many other topics can be addressed, including issues one wouldn't think of, like vaccinations - that may be problematic for older patients, insurance coverage for medications, etc.  

In this interesting podcast, Dr. Laurie Drill-Mellum, a Home Care/Hospice physician, discusses the incidence of incivility in health care, as well as the growing need to address it. Using studies and data-informed research from the malpractice and patient safety realms, listeners will gain an appreciation of some of the real risks created by tolerance of uncivil behavior, including: negative influence on patient and employee experience; decreased clinical performance and increased adverse outcomes; increased risk of liability.  Additionally, a framework to address incivility will be reviewed. Enjoy the podcast. Objectives: Upon completion of this CME event, program participants should be able to: Define incivility and list some of its impacts in healthcare environments. Explain the incidence of incivility in healthcare environments. Validate processes and tools to address incivility in our workplace(s). CME credit is only offered to Ridgeview Providers for this podcast activity. Complete and submit the online evaluation form, after viewing the activity.  Upon successful completion of the evaluation, you will be e-mailed a certificate of completion within 2-weeks.  You may contact the accredited provider with questions regarding this program at rmccredentialing@ridgeviewmedical.org. Click on the following link for your CME credit:  CME Evaluation: Incivility in Medicine (**If you are listening to the podcasts through iTunes on your laptop or desktop, it is not possible to link directly with the CME Evaluation for unclear reasons. We are trying to remedy this. You can, however, link to the survey through the Podcasts app on your Apple and other smart devices, as well as through Spotify, Stitcher and other podcast directory apps and on your computer browser at these websites. We apologize for the inconvenience.)  The information provided through this and all Ridgeview podcasts as well as any and all accompanying files, images, videos and documents is/are for CME/CE and other institutional learning and communication purposes only and is/are not meant to substitute for the independent medical judgment of a physician, healthcare provider or other healthcare personnel relative to diagnostic and treatment options of a specific patient's medical condition.” FACULTY DISCLOSURE ANNOUNCEMENT  It is our intent that any potential conflict should be identified openly so that the listeners may form their own judgments about the presentation with the full disclosure of the facts. It is not assumed any potential conflicts will have an adverse impact on these presentations. It remains for the audience to determine whether the speaker’s outside interest may reflect a possible bias, either the exposition or the conclusions presented. Planning committee members and presenter(s) have disclosed they have no significant financial relationship with a pharmaceutical company and have disclosed that no conflict of interest exists with the presentation/educational event.   Show Notes: Dr. Laurie Drill-Mellum is the chief medical officer of MMIC and vice president of patient safety solutions. She earned her medical degree from the University of Minnesota, as well as her MPH. She is an emergency physician by trade, graduating in 1991 from the Emergency medicine residency program at Hennepin County Medical Center. Dr. Drill-Mellum practiced at Ridgeview for the entirety of her emergency medicine practice, before changing to her current role at Midwest Medical Insurance company. Her passions lay in the realm of communication and it’s effect on patient and provider outcomes. She joined us on March 29, 2019 to discuss the elephant in the room topic of incivility in medicine.    CHAPTER 1:      Bullying and incivility in medicine has actually been well researched and published. It is a significant problem. A Cherokee legend describes a battle within. Two wolves, and one represents negative and evil thoughts and doings, the other represents care, compassion and kindness. The one that wins, according to the Cherokee chief telling the story to his grandson, is the one we choose to feed.      Some staggering statistics demonstrate tremendous loss of providers and nursing, choosing to leave bedside medicine within the first several years of their practice. Parker Palmer, an educator and philosopher, has written many books. He refers to a notion of “the tragic gap”. A hard reality around us, and what we know is possible.      Bullying is the repeated health harming mistreatment of one or more people by one or more other perpetrators. Healthcare has the highest incidence of this compared to any other work environment in the United States. Safety and quality patient care is directly impacted by this. And this is affirmed by the Joint Commission.      Depersonalization is happening in our work environments. Burnout and bullying directly impact this. 6 out of 10 Operative techs and surgical nurses experience bullying on a weekly basis according to an AORN publication in the fall of 2018. According to the existing data, and our own experiences, there is a chiasm between nurses and physicians, and this must be bridged. Similarly, a chiasm between nurses, physicians, physician assistants, nurse practitioners and administrators exists and this must also be bridged.      Dr. Drill-Mellum conducted a live survey for her audience. The survey sought to identify various modes and experiences of incivility and bullying in the healthcare workplace. The majority of audience members reported such experiences of being yelled at, gossiped about, public reprimand, negative comments about one’s intelligence and dismissed opinions.       CHAPTER 2:      Workplace surveys and other studies looking at intimidation and bullying in the nursing field, and interestingly, there is significant lateral bullying in this field, in other words, bullying amongst nurses. There are providers and nurses we are afraid to call for help or approach. As Laurie points out, there are many incidents that result in malpractice and severe outcomes for patients due to this impedance to communication with these personalities in medicine. Team member experience is, needless to say, negative and retention rate therefore suffers. Patient and family experience is ultimately affected, liability and legal risk is elevated in turn. Brand and negative advertisement ensues.      According to Dr. D-M, when claims are submitted to MMIC for instance, 40% of them are related to communication problems. Provider communication issues: poor professional rapport, not reading notes, not closing loops and hierarchical issues. Many of these are involved in communication errors with patients and families as well. Physician and provider bad behavior increases malpractice risk. A Vanderbilt study looking at hundreds of physicians in the 1990s demonstrated that more unsolicited complaints from patients were associated with higher risk of being sued. In Annals of Surgery last year, in the Harvard system, showed a decreased risk of being sued with certain behaviors. No big surprise that these were positive behaviors; almost all involved positive communication skills. Other studies demonstrating rude and disrespectful behaviors also had higher rates of poor surgical outcomes. The working notion is that these people tend to be difficult to approach and communicate with by others on the team and patients and families as well. The lists go on in terms of studies that demonstrate positive patient outcomes and lessened medicolegal risk when positive, constructive communication and team work is employed. Why should this come as a surprise? We all know how it feels to be treated rudely or to have our efforts and thoughts dismissed out rightly. How badly do we want to be on that team and consequently how well do we perform in these settings?      CHAPTER 3:     How do we solve this? How do we change this culture of incivility? First, recognize the issue exists. We Need to know that there is a problem in the first place.  Second, We need motivation to address the problem. How do we deal with the problem? Address it. External motivation may mean the threat of losing one’s job, which may effect change in behavior. Ideally, Internal motivation can happen and would involve the person’s desire to get along better with others, to actually have a better relationship with colleagues and patients. Sometimes that involves sending an individivdual to a coach or some kind of behavioral remediation training. 3. Accountability is necessary. Will the offending individual actual assume this and proceed with the appropriate steps to remediation. Obviously, this is a time consuming and expensive endeavor for healthcare systems.       The Institute of Medication safe practices involves specific steps which involve the following: Setting the stage. Establish a steering committee and engage system leaders and leadership. Leadership is vital. Someone to drive the agenda. Establish the “no retribution” policy. There must be a survey for employees as well. A “code of conduct” must also happen. A communication strategy of some sort should also be employed. SBAR, or similar types of communication procedures which allow for someone on the team to voice their concern that something bad or inappropriate is happening. All members need a voice at the table. Having Zero tolerance for certain behaviors is also critical. Turning a blind eye to this time after time is not an option. Staff training about these steps is also necessary to implement these policies. Teaching people the skills necessary to address bad behavior. A confidential reporting system that involves no retribution also needs to be put in place. Ultimately, fostering a positive work environment is critical. Connecting departments and individuals to bridge the chiasms in our communication and culture should be the goal.      Laurie references Amy Edmonson at Harvard who has researched healthcare extensively. She wrote a book called teaming. “Teaming” is teamwork on the fly essentially. Collaborating across boundaries in complex, unpredictable situations. And Healthcare is where this form of teamwork is mandatory, because this is our reality. Complex, unpredictable scenarios and clinical presentations. Feeling as though you can express your opinions without condemnation is termed psychological safety. Google did a study called, the Aristotle project, looking at teams and performance relating to strong business outcomes. Psychological safety ended up being the most predictive of better performance outcomes. Give us a chance to spitball, to ask the question. Remember the only stupid questions are the ones not asked. Permit your team members and subordinates to feel this level of comfort. Remember, what we say to others: our team members, patients, family members, and anyone we interact with in our work environments can NOT be taken back.      Culture is also what we do when no one is looking. Do we foster a positive environment regardless of the chaos we are practicing in. Dr. Drill-Mellum advises that addressing behaviors by someone who sees issues in shades of gray rather than black and white, as well as involving others in the leadership team to be a part of this process is very important. Sometimes bad behaviors are driven by complex histories, mental health, burnout and other motivations. Recognizing we are all human and fallible, and providing an opportunity for an offender to make necessary changes is also necessary in this process.      A special thanks to Dr. Drill-Mellum for bringing this issue to light and for reinforcing the need for healthcare teams to foster positive, affirming and non- condemning environments to work in. Taking care of people is our job. It is our duty. We can only do our job well if we are not made to feel less than capable or unworthy of this duty.

Dr. Uzma Samadani founded Oculogica in 2013, and her laboratory has developed the eye-tracking methodology and published six papers on its utility. She is currently the Rockswold Kaplan Endowed Chair for Traumatic Brain Injury at Hennepin County Medical Center and Associate Professor of Neurosurgery at the University of Minnesota. She serves on the American Association of Neurological Surgeons/Congress of Neurological Surgeons Executive Committee for Trauma and Critical Care and is Scientific Program Chair of the AANS/CNS National Neurotrauma Society Joint Satellite Meeting. Rosina Samadani is the CEO of Oculogica and has 20 years of experience with medical device companies, including 7 years with McKinsey & Company as a leader in their healthcare practice. She holds a PhD in Biomedical Engineering from Northwestern University and BS and MS in Mechanical Engineering from MIT. Oculogica a medical device company dedicated to developing breakthrough technology to fundamentally transform the diagnosis of concussions and Traumatic Brain Injuries with its non-invasive, fast, patent-protected and peer-reviewed technology.  www.oculogica.com 

Presented by Hennepin County Medical Center. Today's show is an open lines show.

Presented by Hennepin County Medical Center. Today's show is an open lines show.

Presented by Hennepin County Medical Center. Today, Dr. David Hilden welcomes Dr. Peter Polski and Robert Crane to discuss interventional therapy, including Robert's specialty of acupuncture.

Presented by Hennepin County Medical Center. Today's show is an open lines show live from the Minnesota State Fair.

Presented by Hennepin County Medical Center. Today's show topic is pain in older adults.

Presented by Hennepin County Medical Center. Today's show is an open lines show.

Presented by Hennepin County Medical Center. Today's show is an open lines show.

Presented by Hennepin County Medical Center. Today's show is an open lines show.

The host of WCCO Radio's "Healthy Matters" show, Dr. David Hilden is an Internist on the staff of Hennepin County Medical Center in downtown Minneapolis. Today's topic is seasonal injuries.

The host of WCCO Radio's "Healthy Matters" show, Dr. David Hilden is an Internist on the staff of Hennepin County Medical Center in downtown Minneapolis. Today's show is an open lines show.

The host of WCCO Radio's "Healthy Matters" show, Dr. David Hilden is an Internist on the staff of Hennepin County Medical Center in downtown Minneapolis. Today's topic is COPD

The host of WCCO Radio's "Healthy Matters" show, Dr. David Hilden is an Internist on the staff of Hennepin County Medical Center in downtown Minneapolis. Today's show is an open lines show.

The host of WCCO Radio's "Healthy Matters" show, Dr. David Hilden is an Internist on the staff of Hennepin County Medical Center in downtown Minneapolis. Today's show is an open lines show.

The host of WCCO Radio's "Healthy Matters" show, Dr. David Hilden is an Internist on the staff of Hennepin County Medical Center in downtown Minneapolis. Today's topic is falls in the elderly.

The host of WCCO Radio's "Healthy Matters" show, Dr. David Hilden is an Internist on the staff of Hennepin County Medical Center in downtown Minneapolis. Today's show is Ask A Pharmacist.

The host of WCCO Radio's "Healthy Matters" show, Dr. David Hilden is an Internist on the staff of Hennepin County Medical Center in downtown Minneapolis. Today is an open lines show.

The host of WCCO Radio's "Healthy Matters" show, Dr. David Hilden is an Internist on the staff of Hennepin County Medical Center in downtown Minneapolis. Today's topic is hearing loss.

The host of WCCO Radio's "Healthy Matters" show, Dr. David Hilden is an Internist on the staff of Hennepin County Medical Center in downtown Minneapolis. Today's topic is skin care.

The host of WCCO Radio's "Healthy Matters" show, Dr. David Hilden is an Internist on the staff of Hennepin County Medical Center in downtown Minneapolis. Today's show is an open lines show.

The host of WCCO Radio's "Healthy Matters" show, Dr. David Hilden is an Internist on the staff of Hennepin County Medical Center in downtown Minneapolis. Today's show is an open lines show.

The host of WCCO Radio's "Healthy Matters" show, Dr. David Hilden is an Internist on the staff of Hennepin County Medical Center in downtown Minneapolis. Today's topic is allergies.

In this Parent Town podcast, we focus on transgender children. We hear from Dr. Rhamy Magid who runs the Gender and Sexual Health clinic at Hennepin County Medical Center, along with parents Ali and Martha who are both raising transgender children in Minneapolis and St. Paul.

Since the late 1990’s there has been an explosion in the prescribing of opiate pain medication. As a result of advocacy programs such as treating pain as the “Fifth Vital Sign” and aggressive marketing by the pharmaceutical industry, the number of prescriptions has tripled from 76 million in 1991 to 219 million in 2011 (Vector One National). Listen as Chris Johnson, MD, walks you through his journey and experience with the opiate epidemic in the United States. Dr. Johnson works with the Institute for Clinical Systems Improvement on their Pain Management Work Group, which develops evidence-based guidelines for treating pain applicable to all specialties. He is also a member of the Minnesota Medical Association’s Board of Trustees. Chris Johnson received his medical training at the Medical College of Virginia in Richmond, VA, graduating in 2000 and completed his residency training in Emergency Medicine at Hennepin County Medical Center in 2003. He has been practicing in the Twin Cities for the last 13 years and is currently part of the Allina Health Care system. He has been involved in fighting the prescription opiate epidemic for over a decade and currently serves as Chairperson for the Dept. of Human Services Opioid Prescribing workgroup. In addition, he is a Board Member of the national organization Physicians for Responsible Opioid Prescribing and is a Board Member of the local advocacy group – the Steve Rummler Hope Foundation, whose mission is to raise awareness of the problem of chronic pain and opiate addiction. He works with the Institute for Clinical Systems Improvement on their Pain Management Work Group, which develops evidence-based guidelines for treating pain applicable to all specialties. He is also a member of the Minnesota Medical Association’s Board of Trustees. Dr. Johnson’s Articles: CNN: The other tragedy behind Prince’s death MN Physician’s Profession Update: Dying from prescription heroin: A perspective on the opiate epidemic

Ep #17 A Primer on Intrathoracic Pressure Regulation & The Physiology of CPR with Dr. Keith Lurie Happy #EMSWeek #EMSStrong #EMSNation   Sponsored by @PerfectCPR Apple Watch App with Audio and Haptic Feedback to Optimize Cardiac Arrest Training and Improve Quality of CPR PerfectCPR.com   Dr. Keith Lurie is a practicing cardiac electrophysiologist and resuscitation scientist who, over the past 25 years, has devoted himself to study novel ways to resuscitate patients experiencing sudden cardiac arrest.  Dr. Lurie earned his bachelors degree at Yale University and his medical degree at Stanford University. He studied cardiovascular medicine at the University of California in San Francisco and later joined the faculty there.  He has been on the faculty at the University of Minnesota since 1991. As one of the leading innovators in the field, he has helped to develop new devices and methods that optimize cardio-pulmonary resuscitation (CPR) and, in turn, improve survival chances following cardiac arrest. In addition, he has become a respected thought leader in developing and implementing a systems-based approach to managing and treating sudden cardiac death events. Some of his most notable contributions include the development and assessment of various resuscitative techniques such as the impedance threshold device (ITD), active compression-decompression (ACD) CPR and the use of intra-thoracic pressure regulation to modulate cerebral and systemic circulation in states of severe hypotension and head injury. He has also helped to develop devices to treat heart failure and abnormal heart rhythms. He has mentored scores of research and clinical fellows over the past 30 years and he actively collaborates with multiple scientist colleagues worldwide. A professor of Emergency Medicine and Internal Medicine at the University of Minnesota, Dr. Lurie also directs an NIH-funded research laboratory at Hennepin County Medical Center in Minneapolis and he is a consultant for Zoll Medical.   Selected Peer-Reviewed Publications (Selected from over 200 publications):   Lurie KG, Nemergut EC, Yannopoulos D, Sweeney M. The physiology of cardiopulmonary resuscitation. Anesth Analg. 11/2015 Kwon Y, Debaty G, Puertas L, Metzger A, Rees J, McKnite S, Yannopoulos D, Lurie K. Effect of regulating airway pressure on intrathoracic pressure and vital organ perfusion pressure during cardiopulmonary resuscitation: A non-randomized interventional cross-over study. Scandinavian journal of trauma, resuscitation and emergency medicine. 2015;23:83 Debaty G, Metzger A, Lurie K. Evaluation of zoll medical's resqcpr system for cardiopulmonary resuscitation. Expert review of medical devices. 2015;12:505-516 Smith G, Dwork N, O'Connor D, Sikora U, Lurie K, Pauly J, Ellerbee A. Automated, depth resolved estimation of the attenuation coefficient from optical coherence tomography data. IEEE transactions on medical imaging. 2015 Lurie KL, Gurjarpadhye AA, Seibel EJ, Ellerbee AK. Rapid scanning catheterscope for expanded forward-view volumetric imaging with optical coherence tomography. Optics letters. 2015;40:3165-3168 Debaty G, Metzger A, Rees J, McKnite S, Puertas L, Yannopoulos D, Lurie K. Enhanced perfusion during advanced life support improves survival with favorable neurologic function in a porcine model of refractory cardiac arrest. Crit Care Med. 2015;43:1087-1095 Salzman JG, Frascone RJ, Burkhart N, Holcomb R, Wewerka SS, Swor RA, Mahoney BD, Wayne MA, Domeier RM, Olinger ML, Aufderheide TP, Lurie KG. The association of health status and providing consent to continued participation in an out-of-hospital cardiac arrest trial performed under exception from informed consent. Acad Emerg Med. 2015;22:347-353 Metzger A, Rees J, Kwon Y, Matsuura T, McKnite S, Lurie KG. Intrathoracic pressure regulation improves cerebral perfusion and cerebral blood flow in a porcine model of brain injury. Shock. 2015;44 Suppl 1:96-102 Debaty G, Shin SD, Metzger A, Kim T, Ryu HH, Rees J, McKnite S, Matsuura T, Lick M, Yannopoulos D, Lurie K. Tilting for perfusion: Head-up position during cardiopulmonary resuscitation improves brain flow in a porcine model of cardiac arrest. Resuscitation. 2015;87:38-43 Bartos JA, Matsuura TR, Sarraf M, Youngquist ST, McKnite SH, Rees JN, Sloper DT, Bates FS, Segal N, Debaty G, Lurie KG, Neumar RW, Metzger JM, Riess ML, Yannopoulos D. Bundled postconditioning therapies improve hemodynamics and neurologic recovery after 17 min of untreated cardiac arrest. Resuscitation. 2015;87:7-13 Gold B, Puertas L, Davis SP, et al. Awakening after cardiac arrest and post resuscitation hypothermia: are we pulling the plug too early? Resuscitation. Feb 2014;85(2):211-214. Metzger A, Rees J, Segal N, et al. "Fluidless" resuscitation with permissive hypotension via impedance threshold device therapy compared with normal saline resuscitation in a porcine model of severe hemorrhage. The journal of trauma and acute care surgery. Aug 2013;75(2 Suppl 2):S203-209. Frascone RJ, Wayne MA, Swor RA, et al. Treatment of non-traumatic out-of-hospital cardiac arrest with active compression decompression cardiopulmonary resuscitation plus an impedance threshold device. Sep 2013;84(9):1214-1222. Yannopoulos D, Segal N, Matsuura T, et al. Ischemic post-conditioning and vasodilator therapy during standard cardiopulmonary resuscitation to reduce cardiac and brain injury after prolonged untreated ventricular fibrillation. Aug 2013;84(8):1143-1149. Sarraf M, Sharma A, Caldwell E, McKnite S, Aufderheide T, Lurie K, Neumar R, Riess M, Yannopoulos D. Postconditioning with inhaled sevoflurane at the initiation of cpr improves hemodynamics and mitigates post-cardiac arrest myocardial injury after 15 min of untreated ventricular fibrillation. Crit Care Med. 2012;40:1-328 Yannopoulos D, Segal N, McKnite S, Aufderheide TP, Lurie KG. Controlled pauses at the initiation of sodium nitroprusside-enhanced cardiopulmonary resuscitation facilitate neurological and cardiac recovery after 15 mins of untreated ventricular fibrillation. Crit Care Med. 2012;40:1562-1569 Segal N, Matsuura T, Caldwell E, Sarraf M, McKnite S, Zviman M, Aufderheide TP, Halperin HR, Lurie KG, Yannopoulos D. Ischemic postconditioning at the initiation of cardiopulmonary resuscitation facilitates functional cardiac and cerebral recovery after prolonged untreated ventricular fibrillation. Resuscitation. 2012;83:1397-1403 Convertino VA, Parquette B, Zeihr J, Traynor K, Baia D, Baumblatt M, Vartanian L, Suresh M, Metzger A, Gerhardt RT, Lurie KG, Lindstrom D. Use of respiratory impedance in prehospital care of hypotensive patients associated with hemorrhage and trauma: A case series. The journal of trauma and acute care surgery. 2012;73:S54-59 Yannopoulos D, Matsuura T, Schultz J, et al. Sodium nitroprusside enhanced cardiopulmonary resuscitation improves survival with good neurological function in a porcine model of prolonged cardiac arrest. Crit Care Med. Jun 2011;39(6):1269-1274. Yannopoulos D, Kotsifas K, Lurie KG. Advances in cardiopulmonary resuscitation. Heart Fail Clin. Apr 2011;7(2):251-268, ix. Lurie KG, Coffeen P, Shultz J, McKnite S, Detloff B, Mulligan K. Improving active compression-decompression cardiopulmonary resuscitation with an inspiratory impedance valve. Circulation 1995;91(6):1629-32. Plaisance P, Lurie KG, Vicaut E, Adnet F, Petit JL, Epain D, Ecollan P, Gruat R, Cavagna P, Biens J and others. A comparison of standard cardiopulmonary resuscitation and active compression-decompression resuscitation for out-of-hospital cardiac arrest. French Active Compression-Decompression Cardiopulmonary Resuscitation Study Group. N Engl J Med 1999;341(8):569-75. Lurie KG, Voelckel WG, Zielinski T, McKnite S, Lindstrom P, Peterson C, Wenzel V, Lindner KH, Samniah N, Benditt D. Improving standard cardiopulmonary resuscitation with an inspiratory impedance threshold valve in a porcine model of cardiac arrest. Anesth Analg 2001;93(3):649-55. Lurie KG, Zielinski T, McKnite S, Aufderheide T, Voelckel W. Use of an inspiratory impedance valve improves neurologically intact survival in a porcine model of ventricular fibrillation. Circulation 2002;105(1):124-9. Aufderheide TA, Sigurdsson G, Pirrallo RG, Yannopoulos D, McKnite S, van Briesen C, Sparks C, Conrad CJ, Provo CA, Lurie KG. Hyperventilation-induced hypotension during CPR. 2004;109:1960-65. Aufderheide TP, Pirrallo RG, Provo TA, Lurie KG. Clinical evaluation of an inspiratory impedance threshold device during standard cardiopulmonary resuscitation in patients with out-of-hospital cardiac arrest. Critical Care Medicine. 2005, Apr;33(4):734-40. Pirrallo RG, Aufderheide TP, Provo TA, Lurie KG. Effect of an inspiratory impedance threshold device on hemodynamics during conventional manual cardiopulmonary resuscitation. 2005 Jul;66(1):13-20. Aufderheide T, Alexander C, Lick C, Myers B, Romig L, Vartanian L, Stothert J, S. M, Matsuura T, Yannopoulos D and others. From laboratory science to six emergency medical services systems: New understanding of the physiology of cardiopulmonary resuscitation increases survival rates after cardiac arrest. Crit Care Med 2008;36(Suppl):S397-S404. Lurie KG, Yannopoulos D, McKnite SH, Herman ML, Idris AH, Nadkarni VM, Tang W, Gabrielli A, Barnes TA, Metzger AK. Comparison of a 10-breaths-per-minute versus a 2-breaths-per-minute strategy during cardiopulmonary resuscitation in a porcine model of cardiac arrest. Respir Care 2008;53(7):862-70. Metzger A, Yannopoulos D, Lurie KG. Instrumental Management of CPR. Severe Acute Heart Failure Syndromes:  A Practical Approach for Physicians. Mebazaa, A., Gheorghiade, M., Zannad, F., Parrillo, J.E. (eds.). Springer-Verlag, London Ltd. 2008, pp. 43-51. Metzger A, Lurie K. Harnessing Cardiopulmonary Interactions to Improve Circulation and Outcomes After Cardiac Arrest and Other States of Low Blood Pressure. In: Iaizzo PA, editor. Handbook of Cardiac Anatomy, Physiology, and Devices: Springer Science; 2009. p 583-604. Nichol G, Aufderheide TP, Eigel B, Neumar RW, Lurie KG, Bufalino VJ, Callaway CW, Menon V, Bass RR, Abella BS and others. Regional systems of care for out-of-hospital cardiac arrest: A policy statement from the American Heart Association. Circulation;121(5):709-29. Yannopoulos D, Matsuura T, McKnite S, Goodman N, Idris A, Tang W, Aufderheide TP, Lurie KG. No assisted ventilation cardiopulmonary resuscitation and 24-hour neurological outcomes in a porcine model of cardiac arrest. Crit Care Med;38(1):254-60.     Query us on Twitter: www.twitter.com/EMS_Nation Like us on Facebook: www.facebook.com/prehospitalnation   Wishing Everyone a safe tour! ~Faizan H. Arshad, MD @emscritcare www.emsnation.org  

Neonatal jaundice is predominantly a benign condition that affects 60%–80% of newborns worldwide but progresses to potentially harmful severe hyperbilirubinaemia in some. Despite the proven therapeutic benefits of phototherapy for preventing extreme hyperbilirubinaemia, acute bilirubin encephalopathy or kernicterus, several low-income and middle-income countries continue to report high rates of avoidable exchange transfusions, as well as bilirubin-induced mortality and neurodevelopmental disorders. A review recently published in ADC examines the contributory factors to the burden of severe hyperbilirubinaemia and kernicterus and provide strategies for improving care. ADC Global Health editor Nick Brown talks to co-author Tina Slusher, Department of Pediatrics, University of Minnesota & Hennepin County Medical Center, Minneapolis, to hear what they suggest. Read the full paper: http://goo.gl/7fO5h1

As cities respond to growing calls for safer streets and more open space, many have begun holding a series of Open Streets events where streets are closed to cars and opened to everyone else (people, bikes, skates and other non-motorized users). In most cases there is special programming including vendors, music, demonstrations and fun activities, but a few just put up some cones and let people have the street. And of course marathons, road races and charity walks are some examples of active use of streets and highways. For more info and a sampling of what different cities are doing, check out this Momentum Magazine article, the Wikipedia page and the Open Streets Project directory. Read all about the history of ciclovias (open streets) at Ciclovias Recreativas de las Américas. I took to Lyndale Avenue South on a beautiful Sunday in late June for Open Streets Minneapolis. This episode features "in the field" interviews with some of the organizations tabling as well as regular people trying out activities such and the pop-up cycle track and the slow race. Organizations represented are (in order): Metro Transit; Minneapolis Public Works Dept; Minneapolis Bicycle Coalition; Spokes community bike center; Bike Walk Twin Cities (Transit for Livable Communities, Non-motorized Transportation Pilot Program); Nice Ride bike sharing; Minneapolis Sculpture Garden; Hennepin County Medical Center; Bicycle Alliance of Minnesota. The morning event I spoke about is the Brompton US Championship (photos). Please send in your questions, comments and suggestions for future topics and guests to feedback@criticaltransit.com or via the contact page. Follow my work on Facebook and Twitter, and contact the people I interviewed for more information and inspiration.

Dr. Steven R. Goldsmith, Professor of Medicine at the University of Minnesota, Director of the Heart Failure Program at Hennepin County Medical Center, and Director of the Minnesota Heart Failure Consortium, explains the importance of congestion as a contributor to the pathophysiology of acute heart failure, describes the limits of current decongestive strategies and the promise of newer modalities and discusses emerging insights concerning the relationship between congestion and the cardiorenal syndrom in acute heart failure.

Monday, June 20, 2011 –Our incredible special guest tonight is Dr. Martha A. Nance, director of the HD Center of Excellence at Hennepin County Medical Center since 1991. She received her BS from Yale University and her MD from Medical College of Virginia. She completed training in Neurology and in Genetics from the University of Minnesota, and now is an Adjunct Professor in the Department of Neurology at the University of Minnesota Dr. Nance wrote The Juvenile HD Handbook and was a co-author of the recently revised Physician's Guide to HD, both published by HDSA. She has served on the Executive Committee of the Huntington Study Group, and as an investigator on a number of HSG clinical trials.  She frequently lectures about HD at local, regional, national, and international patient and professional conferences. She also serves as the Medical Director of the Struthers Parkinson's Center at Park Nicollet Clinic, a National Parkinson Foundation Center of Excellence, where she maintains an active clinical and research practice.  She graduated two years ago from a career as a soccer mom, and now has much more time to spend in her vegetable and flower gardens! Contact Information: Telephone:  612-873-2515 Email: Martha.Nance@ParkNicollet.com OR martha.nance@hcmed.org Websites: http://www.hcmc.org www.hdsa.org