Podcasts about Interventions

In the final episode of our series on the end of days, we delve into the age-old question: Are we living in the last generation? Join Jacob Fronczak and Daniel Lancaster as they explore historical and contemporary signs, from the ingathering of Israel's exiles to the global technology revolution, that suggest we might be on the brink of a new era. Discover how eschatology drives discipleship and what it means to live with the expectation of the Messiah's imminent return. Tune in for a thought-provoking discussion that challenges our understanding of prophecy and the times we live in.

Much of Angela Washko's work begins with a simple question: What if we took the media we consume every day — the video games, the reality shows, the online chatrooms — as seriously as we take traditional art spaces? What if we examined them not just as distractions or products but as public arenas where identity, power and belonging are actively negotiated?With a practice that spans performance, social engagement, video games and film, Angela has spent more than a decade doing just that. Her work doesn't just critique digital culture from the outside; it embeds itself within it, creating space for dialogue in places not usually known for nuance. Whether she's convening feminist councils in the fantasy worlds of online gaming or crafting interactive experiences from the textures of real life, her projects ask how we behave when no one — or everyone — is watching. In 2012 she launched The Council on Gender Sensitivity and Behavioral Awareness in World of Warcraft, an in-game social practice project that sparked multi-hour dialogues between initially hostile players. Later she created The Game: The Game, an RPG in which a player could try to negotiate a bar packed full of male pickup artists following the same seduction playbook. And just last year, fascinated by the allure and promises of reality television, she directed her first documentary, “Workhorse Queen,” about a few members of the tightknit drag community in Rochester, NY and their complicated relationship with “RuPaul's Drag Race” and the commerce of 21st century drag celebrity.In this interview, Angela, now a full professor and the MFA Program Director at the Stamps School of Art & Design at the University of Michigan, reflects on how she found her voice as an artist inside a male-dominated gaming culture, why she continues to work in and not against the media she critiques and how becoming a mother during a global crisis reshaped her ideas of creativity, care and time.https://angelawashko.com/home.html

Steven W. Evans, Ph.D., explains why youth with ADHD often have problems with academic and social functioning, and shares evidence-based approaches proven to help in these problematic areas at home and at school. Social Skills for Teens with ADHD: Additional Resources Free Download: Free Guide to Improving Your Students' Social Skills Read: The Social Executive Function Skills That Elude Kids with ADHD Read: Build Your Child's Social Skills in 7 Steps Read: 10 Ways to Improve Your Teen's Executive Skills Access the video and slides for podcast episode #568 here: https://www.additudemag.com/webinar/social-skills-for-teens-executive-function/ Thank you for listening to ADDitude's ADHD Experts podcast. Please consider subscribing to the magazine (additu.de/subscribe) to support our mission of providing ADHD education and support.

To pass the written ACLS exam and mega code, students need to be able to identify basic ECG dysrhythmias, including the two types of second-degree heart block.One method of ECG rhythm identification is to ask a series of questions such as:What's the rate (150);Is the rhythm regular or irregular;What's the shape, width, and frequency of P waves and QRS complexes; andWhat's the P-R interval and is it constant?ECG characteristics of a second-degree Mobitz type I (Wenckebach).Identification of unstable bradycardia and its treatment with Atropine.ECG characteristics of a second-degree Mobitz type II.Possible effect of using Atropine on patients with a second-degree type II AV block.Treatment of unstable bradycardic patients refractory to Atropine using TCP, Dopamine, or Epinephrine drip.Starting dose and titration of Dopamine and Epinephrine drips.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Free Prescription Discount Card - Get your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vip/savePass ACLS Web Site - Other ACLS-related resources: https://passacls.com@Pass-ACLS-Podcast on LinkedIn The Curious Clinicians: History of Doctor Wenckebach & Mobitzhttps://curiousclinicians.com/2022/07/06/episode-52-way-back-wenckebach/Practice ECGs with rationale at Dialed Medics:https://dialedmedics.com/

Dr. Hope Rugo and Dr. Kamaria Lee discuss the prevalence of financial toxicity in cancer care in the United States and globally, focusing on breast cancer, and highlight key interventions to mitigate financial hardship. TRANSCRIPT  Dr. Hope Rugo: Hello, and welcome to By the Book, a podcast series from ASCO that features engaging conversations between editors and authors of the ASCO Educational Book. I'm your host, Dr. Hope Rugo. I'm the director of the Women's Cancer Program and division chief of breast medical oncology at the City of Hope Cancer Center, and I'm also the editor-in-chief of the Educational Book. Rising healthcare costs are causing financial distress for patients and their families across the globe. Patients with cancer report financial toxicity as a major impediment to their quality of life, and its association with worse outcomes is well documented. Today, we'll be discussing how patients with breast cancer are uniquely at risk for financial toxicity. Joining me for this discussion is Dr. Kamaria Lee, a fourth-year radiation oncology resident and health equity researcher at MD Anderson Cancer Center and a co-author of the recently published article titled, "Financial Toxicity in Breast Cancer: Why Does It Matter, Who Is at Risk, and How Do We Intervene?" Our full disclosures are available in the transcript of this episode.  Dr. Lee, it's great to have you on this podcast. Dr. Kamaria Lee: Hey, Dr. Rugo. Thank you so much for having me. I'm excited to be here today. I also would like to recognize my co-authors, Dr. Alexandru Eniu, Dr. Christopher Booth, Molly MacDonald, and Dr. Fumiko Chino, who worked on this book chapter with me and did a fantastic presentation on the topic at ASCO this past year. Dr. Hope Rugo: Thanks very much. We'll now just jump into the questions. We know that rising medical costs contribute to a growing financial burden on patients, which has [GC1]  [JG2]  been documented to contribute to lower quality-of-life, compromised clinical care, and worse health outcomes. How are patients with breast cancer uniquely at risk for financial toxicity? How does the problem vary within the breast cancer population in terms of age, racial and ethnic groups, and those who have metastatic disease? Dr. Kamaria Lee: Breast cancer patients are uniquely at risk of financial toxicity for several reasons. Three key reasons are that breast cancer often requires multimodal treatment. So this means patients are receiving surgery, many receive systemic therapies, including hormonal therapies, as well as radiation. And so this requires care coordination and multiple visits that can increase costs. Secondly, another key reason that patients with breast cancer are uniquely at risk for financial toxicity is that there's often a long survivorship period that includes long-term care for toxicities and continued follow-ups, and patients might also be involved in activities regarding advocacy, but also physical therapy and mental health appointments during their prolonged survivorship, which can also add costs. And a third key reason that patients with breast cancer are uniquely at risk for financial toxicity is that the patient population is primarily women. And we know that women are more likely to have increased caregiver responsibilities while also potentially working and managing their treatments, and so this is another contributor. Within the breast cancer population, those who are younger and those who are from marginalized racial/ethnic groups and those with metastatic disease have been shown to be at an increased risk. Those who are younger may be more likely to need childcare during treatment if they have kids, or they're more likely to be employed and not yet retired, which can be disrupted while receiving treatment. And those who are racial/ethnic minorities may have increased financial toxicity due to reasons that exist even after controlling for socioeconomic factors. And some of these reasons have been shown to be increased risk of job or income loss or transportation barriers during treatment. And lastly, for those with metastatic breast cancer, there can be ongoing financial distress due to the long-term care that is needed for treatment, and this can include parking, transportation, and medications while managing their metastatic disease. Dr. Hope Rugo: I think it is really important to understand these issues as you just outlined. There has been a lot of focus on financial toxicity research in recent years, and that has led to novel approaches in screening for financial hardship. Can you tell us about the new screening tools and interventions and how you can easily apply that to clinical practice, keeping in mind that people aren't at MD Anderson with a bunch of support and information on this but are in clinical practice and seeing many, many patients a day with lots of different cancers? Dr. Kamaria Lee: You're exactly right that there is incredible nuance needed in understanding how to best screen for financial hardship in different types of practices. There are multiple financial toxicity tools. The most commonly used tool is the Comprehensive Score for Financial Toxicity, also known as the COST tool. In its full form, it's an 11-item survey. There's also a summary question as well. And these questions look at objective and subjective financial burden, and it uses a five-point Likert scale. For example, one question on the full form is, "I know that I have enough money in savings, retirement, or assets to cover the cost of my treatment," and then patients are able to respond "not at all" to "very much" with a threshold score for financial toxicity risk. Of course, as you noted, one critique of having an 11-item survey is that there's limited time in patient encounters with their providers. And so recently, Thom et al validated an abbreviated two-question version of the COST tool. This validation was done in an urban comprehensive cancer center, and it was found to have a high predictive value to the full measure. We note which two questions are specifically pulled from the full measure within the book chapter. And this is one way that it can be easier for clinicians who are in a busier setting to still screen for financial toxicity with fewer questions. I also do recommend that clinicians who know their clinic's workflow the best, work with their team of nurses, financial navigators, and others to best integrate the tool into their workflow. For some, this may mean sending the two-item survey as a portal message so that patients can answer it before consults. Other times, it could mean having it on the tablet that can be done in the clinic waiting room. And so there are different ways that screening can be done, even in a busy setting, and acknowledging that different practices have different amounts of resources and time. Dr. Hope Rugo: And where would people access that easily? I recognize that that information is in your chapter, or your article that's on PubMed that will be linked to this podcast, but it is nice to just know where people could easily access that online. Dr. Kamaria Lee: Yes, and so you should be able to Google ‘the COST measure', and then there is a website that also has the forms as well. So it's also beyond the book chapter, Googling ‘the COST measure', and then online they would be able to find access to the form. Dr. Hope Rugo: And how often would you do that screening? Dr. Kamaria Lee: So, I think it's definitely important that we are as proactive as possible. And so initially, I recommend that the screening happens at the time of diagnosis, and so if it's done through the portal, it can be sent before the initial consult, or again, however, is best in the workflow. So at the time of diagnosis and then at regular intervals, so throughout the treatment process, but then also into the follow-up period as well to best understand if there's still a financial burden even after the treatments have been completed. Dr. Hope Rugo: I wonder if in the metastatic setting, you could do it at the change of treatment, you know, a month after somebody's changed treatment, because people may not be as aware of the financial constraints when they first get prescribed a drug. It's more when you hear back from how much it's going to cost. And leading into that, I think it's, what do you do with this? So, you know, this cost conversation is really important. You're going to be talking to the patient about the cost considerations when you, for example, see that there are financial issues, you're prescribing treatments. How do we implement impactful structured cost conversations with our breast cancer patients, help identify financial issues, and intervene? How do we intervene? I mean, as physicians often we aren't really all that aware, or providers, of how to address the cost. Dr. Kamaria Lee: Yes, I agree fully that another key time when to screen for financial toxicity is at that transition between treatments to best understand where they're at based off of what they've received previously for care, and then to anticipate needs when changing regimens, such as like you said in the metastatic setting. As we're collecting this information, you're right, we screen, we get this information, and what do we do? I do agree that there is a lack of knowledge among us clinicians of how do we manage this information. What is insurance? How do we manage insurance and help patients with insurance concerns? How do we help them navigate out-of-pocket costs or even the indirect costs of transportation? Those are a lot of things that are not covered in-depth in traditional medical training. And so it can be overwhelming for a lot of clinicians, not only due to time limitations in clinic, but also just having those conversations within their visit. And so what I would say, a key thing to note, is that this is another area for multidisciplinary care. So just as we're treating patients in a multidisciplinary way within oncology as we work with our medical oncology, surgical colleagues across the board, it's knowing that this is another area for multidisciplinary care. So the team members include all of the different oncologists, but it also includes team members such as financial counselors and navigators and social workers and even understanding nonprofit partners who we have who have money that can be set aside to help reduce costs for certain different aspects of treatment. Another thing I will note is that most patients with breast cancer often say they do want to have these conversations still with their clinicians. So they do still see a clinician as someone that can weigh in on the costs of their treatment or can weigh in on this other aspect of their care, even if it's not the actual medication or the radiation. And so patients do desire to hear from their clinicians about this topic, and so I think another way to make it feel less overwhelming for clinicians like ourselves is to know that even small conversations are helpful and then being knowledgeable about within your institution or, like I said, outside of it with nonprofits, being aware of who can I refer this patient to for continued follow-up and for more detailed information and resources. Dr. Hope Rugo: Are those the successful interventions? It's really referring to financial navigators? How do people identify? You know, in an academic center, we often will sort of punt this to social workers or our nurse navigators. What about in the community? What's a successful intervention example of mitigating financial toxicity? Dr. Kamaria Lee: I agree completely that the context at which people are practicing is important to note. So as you alluded to, in some bigger systems, we do have financial navigators and this has been seen to be successful in providing applications and assisting with applications for things such as pharmaceutical assistance, insurance applications, discount opportunities.  Another successful intervention are financial toxicity tumor boards, which I acknowledge might not be able to exist everywhere. But where this is possible, multidisciplinary tumor boards that include both doctors and nurses and social workers and any other members of the care team have been able to effectively decrease patients' personal spending on care costs and decrease co-pays through having a dedicated time to discuss concerns as they arise or even proactively. Otherwise, I think in the community, there are other interventions in regards to understanding different aspects of government programs that might be available for patients that are not, you know, limited to an institution, but that are more nationally available, and then again, also having the nonprofit, you know, partnerships to see other resources that patients can have access to.  And then I would also say that the indirect costs are a significant burden for many patients. So by that, I mean even parking costs, transportation, childcare. And so even though those aren't interventions necessarily with someone who is a financial navigator, I would recommend that even if it's a community practice, they discuss ways that they can help offset those indirect costs with patients with parking or if there are ways to help offset transportation costs or at least educate patients on other centers that may be closer to them or they can still receive wonderful care, and then also making sure that patients are able to even have appointments scheduled in ways that are easier for them financially.  So even if someone's receiving care out in the community where there's not a financial navigator, as clinicians or our scheduling teams, sometimes there are options to make sure if a patient wants, visits are more so on one day than throughout the week or many hours apart that can really cause loss of income due to missed work. And so there are also kind of more nuanced interventions that can happen even without a financial navigation system in place. Dr. Hope Rugo: I think that those are really good points and it is interesting when you think about financial toxicity. I mean, we worry a lot when patients can't take the drugs because they can't afford them, but there are obviously many other non-treatment, direct treatment-related issues that come up like the parking, childcare, tolls, you know, having a working car, all those kinds of things, and the unexpected things like school is out or something like that that really play a big role where they don't have alternatives. And I think that if we think about just drug costs, I think those are a big issue in the global setting. And your article did address financial toxicity in the global setting. International financial toxicity rates range from 25% of patients with breast cancer in high-income countries to nearly 80% in low- and middle-income countries or LMICs. You had cited a recent meta-analysis of the global burnout from cancer, and that article found that over half of patients faced catastrophic health expenditures. And of course, I travel internationally and have a lot of colleagues who are working in oncology in many countries, and it is really often kind of shocking from our perspective to see what people can get coverage for and how much they have to pay out-of-pocket and how much that changes, that causes a lot of disparity in access to healthcare options, even those that improve survival. Can you comment on the global impact of this problem? Dr. Kamaria Lee: I am glad that you brought this up for discussion as well. Financial toxicity is something that is a significant global issue. As you mentioned, as high as 80% of patients with breast cancer in low- and middle-income countries have had significant financial toxicity. And it's particularly notable that even when looking at breast cancer compared to other malignancies around the world, the burden appears to be worse. This has been seen even in countries with free universal healthcare. One example is Sri Lanka, where they saw high financial toxicity for their patients with breast cancer, even with this free universal healthcare. But there were also those travel costs and just additional out-of-hospital tests that were not covered. Also, literature in low- and middle-income countries shows that patients might also be borrowing money from their social networks, so from their family and their friends, to help cover their treatment costs, and in some cases, people are making daily food compromises to help offset the cost of their care. So there is a really large burden of financial toxicity generally for cancer globally, but also specifically in breast cancer, it warrants specific discussion. In the meta-analysis that you mentioned, they identified key risk factors of financial toxicity globally that included people who had a larger family size, a lower income, a lack of insurance, longer disease duration, so again, the accumulation of visits and costs and co-pay over time, and those who had multiple treatments. And so in the global setting, there is this significant burden, but then I will also note that there is a lack of literature in low-income countries on financial toxicity. So where we suspect that there is a higher burden and where we need to better understand how it's distributed and what interventions can be applied, especially culturally specific interventions for each country and community, there's less research on this topic. So there is definitely an increased need for research in financial toxicity, particularly in the global setting. Dr. Hope Rugo: Yes, and I think that goes on to how we hope that financial toxicity researchers will have approaches to large-scale multi-institutional interventions to improve financial toxicity. I think this is an enormous challenge, but one of the SWOG organizations has done some great work in this area, and a randomized trial addressing cancer-related financial hardship through the delivery of a proactive financial navigation intervention is one area that SWOG has focused on, which I think is really interesting. Of course, that's going to be US-based, which is how we might find our best paths starting. Do you think that's a good path forward, maybe that being able to provide something like that across institutions that are independent of being a cancer only academic center, or more general academic center, or a community practice? You know, is finding ways to help patients with breast cancer and their families understand and better manage financial aspects of cancer care on a national basis the next approach? Dr. Kamaria Lee: Yes, I agree that that is a good approach, and I think the proactive component is also key. We know that patients that are coming to us with any cancer, but including breast cancer, some of them have already experienced a financial burden or have recently had a job loss before even coming to us and having the added distress of our direct costs and our indirect costs. So I think being proactive when they come to us in regards to the additional burden that their cancer treatments may cause is key to try to get ahead of things as much as we can, knowing that even before they've seen us, there might be many financial concerns that they've been navigating.  I think at the national level, that allows us to try to understand things at what might be a higher level of evidence and make sure that we're able to address this for a diverse cohort of patients. I know that sometimes the enrollment can be challenging at the national level when looking at financial toxicity, as then we're involving many different types of financial navigation partners and programs, and so that can maybe make it more complex to understand the best approaches, but I think that it can be done and can really bring our understanding of important financial toxicity interventions to the next level. And then the benefit to families with the proactive component is just allowing them to feel more informed, which can help decrease anticipation, anxiety related to anticipation, and allow them to help plan things moving forward for themselves and for the whole family. Dr. Hope Rugo: Those are really good points and I wonder, I was just thinking as you were talking, that having some kind of a process where you could attach to the electronic health record, you could click on the financial toxicity survey questions that somebody filled out, and then there would be a drop-down menu for interventions or connecting you to people within your clinic or even more broadly that would be potential approaches to manage that toxicity issue so that it doesn't impact care, you know, that people aren't going to decide not to take their medication or not to come in or not to get their labs because of the cost or the transportation or the home care issues that often are a big problem, even parking, as you pointed out, at the cancer center. And actually, we had a philanthropic donor when I was at UCSF who donated a large sum of money for patient assistance, and it was interesting to then have these sequential meetings with all the stakeholders to try and decide how you would use that money. You need a big program, you need to have a way of assessing the things you can intervene with, which is really tough. In that general vein, you know, what are the governmental, institutional, and provider-level actions that are required to help clinicians do our best to do no financial harm, given the fact that we're prescribing really expensive drugs that require a lot of visits when caring for our patients with breast cancer in the curative and in the metastatic setting? Dr. Kamaria Lee: At the governmental level, there are patient assistant programs that do exist, and I think that those can continue and can become more robust. But I also think one element of those is oftentimes the programs that we have at the government level or even institutional levels might have a lot of paperwork or be harder for people with lower literacy levels to complete. And so I think the government can really try to make sure that the paperwork that is given, within reason, with all the information they need, but that the paperwork can be minimized and that there can be clear instructions, as well as increased health insurance options and, you know, medical debt forgiveness as more broad just overall interventions that are needed. I think additionally, institutions that have clinical trials can help ensure that enrollment can be at geographically diverse locations. Some trials do reimburse for travel costs, of course, but sometimes then patients need the reimbursement sooner than it comes. And so I think there's also those considerations of more so upfront funds for patients involved in clinical trials if they're going to have to travel far to be enrolled in that type of care or trying to, again, make clinical trials more available at diverse locations.  I would also say that it's important that those who design clinical trials use what is known as the “Common Sense Oncology” approach of making sure that they're designed in minimizing the use of outcomes that might have a smaller clinical benefit but may have a high financial toxicity. And that also goes to what providers can do, of understanding what's most important to a particular patient in front of them, what outcomes and what benefit, or you know, how many additional months of progression-free survival or things like that might be important to a particular patient and then also educating them and discussing what the associated financial burden is just so that they have the full picture as they make an informed decision. Dr. Hope Rugo: As much as we know. I mean, I think that that's one of the big challenges is that as we prescribe these expensive drugs and often require multiple visits, even, you know, really outside of the clinical trial setting, trying to balance the benefit versus the financial toxicity can be a huge challenge. And that's a big area, I think, that we still need help with, you know. As we have more drugs approved in the early-stage setting and treatments that could be expensive, oral medications, for example, in our Medicare population where the share of cost may be substantial upfront, you know, with an upfront cost, how do we balance the benefits versus the risk? And I think you make an important point that discussing this individually with patients after we found out what the cost is. I think warning patients about the potential for large out-of-pocket cost and asking them to contact us when they know is one way around this. You know, patients feeling like they're sort of out there with a prescription, a recommendation from their doctor, they're scared of their cancer, and they have this huge share of cost that we didn't know about. That's one challenge, and I don't know if there's any suggestions you have about how one should approach that communication with the patient. Dr. Kamaria Lee: Yes, I think part of it is truly looking at each patient as an individual and asking how much they want to know, right? So we all know that patients, some who want more information, some want less, and so I think one way to approach that is asking them about how much information do they want to know, what is most helpful to them. And then also, knowing that if you're in a well-resourced setting that does have the social workers and financial navigators, also making sure it's integrated in the multidisciplinary setting and so that they know who they can go to for what, but also know that as a clinician, you're always happy for them to bring up their concerns and that if it's something that you're not aware of, that you will connect them to the correct multidisciplinary team members who can accurately provide that additional information. Dr. Hope Rugo: Do you have any other additional comments that you'd like to mention that we haven't covered? I think the idea of a financial toxicity screen with two questions that could be implemented at change of therapy or just periodically throughout the course of treatment would be a really great thing, but I think we do need as much information on potential interventions as possible because that's really what challenges people. It's like finding out information that you can't handle. Your article provides a lot of strategies there, which I think are great and can be discussed on a practice and institutional level and applied. Dr. Kamaria Lee: Yeah, I would just like to thank you for the opportunity to discuss such an important topic within oncology and specifically for our patients with breast cancer. I agree that it can feel overwhelming, both for clinicians and patients, to navigate this topic that many of us are not as familiar with, but I would just say that the area of financial toxicity is continuing to evolve as we gather more information on most successful interventions and that our patients can often inform us on, you know, what interventions are most needed as we see them. And so you can have your thinking about it as you see individual patients of, "This person mentioned this could be more useful to them." And so I think also learning from our patients in this space that can seem overwhelming and that maybe we weren't all trained on in medical school to best understand how to approach it and how to give our patients the best care, not just medically, but also financially. Dr. Hope Rugo: Thank you, Dr. Lee, for sharing your insights with us today. Our listeners will find a link, as I mentioned earlier, to the Ed Book article we discussed today in the transcript of this episode. I think it's very useful, a useful resource, and not just for providers, but for clinic staff overall. I think this can be of great value and help open the discussion as well. Dr. Kamaria Lee: Thank you so much, Dr. Rugo. Dr. Hope Rugo: And thanks to our listeners for joining us today. Please join us again next month on By the Book for more insightful views on topics you'll be hearing at Education Sessions from ASCO meetings and our deep dives into new approaches that are shaping modern oncology. Thank you. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Follow today's speakers:       Dr. Hope Rugo  @hope.rugo  Dr. Kamaria Lee @ lee_kamaria Follow ASCO on social media:       @ASCO on X (formerly Twitter)       ASCO on Bluesky      ASCO on Facebook       ASCO on LinkedIn       Disclosures:      Dr. Hope Rugo:   Honoraria: Mylan/Viatris, Chugai Pharma  Consulting/Advisory Role: Napo Pharmaceuticals, Sanofi, Bristol Myer  Research Funding (Inst.): OBI Pharma, Pfizer, Novartis, Lilly, Merck, Daiichi Sankyo, AstraZeneca, Gilead Sciences, Hoffman La-Roche AG/Genentech, In., Stemline Therapeutics, Ambryx    Dr. Kamaria Lee: No relationships to disclose  

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Happy Wednesday, Women of Strength! Today we are joined by our friend, Nichole, from Nevada who shares her SEVEN birth stories. Nichole has had a wild ride when it comes to birth. Every story is so different and so unique. This episode is jam-packed with things like placental abruption, NICU time, preeclampsia, a surprise HBA2C, induced VBA2C, changing providers, and two VBA3C stories. Her last birth, a 2VBA3C, sparks an important conversation about how interventions can sometimes be a necessary part of a successful VBAC. Knowing the general pros and cons of interventions is just the first step. We all then have to apply what we've learned to our specific situations, adapt, and do what feels best to us!Needed Website: Code VBAC20 for 20% OffCoterie Diapers - Use code VBAC20 for 20% OffThe Ultimate VBAC Prep Course for ParentsOnline VBAC Doula TrainingSupport this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

Lester Kiewit speaks to Colin Wardle, the communications lead for the Zero Dropout Campaign. They discuss whether truancy officers or school attendance officers still have a role to play in reducing high dropout rates, especially in provinces like the Northern Cape where 4000 learners dropped out in the first quarter of 2025. Good Morning Cape Town with Lester Kiewit is a podcast of the CapeTalk breakfast show. This programme is your authentic Cape Town wake-up call. Good Morning Cape Town with Lester Kiewit is informative, enlightening and accessible. The team’s ability to spot & share relevant and unusual stories make the programme inclusive and thought-provoking. Don’t miss the popular World View feature at 7:45am daily. Listen out for #LesterInYourLounge which is an outside broadcast – from the home of a listener in a different part of Cape Town - on the first Wednesday of every month. This show introduces you to interesting Capetonians as well as their favourite communities, habits, local personalities and neighbourhood news. Thank you for listening to a podcast from Good Morning Cape Town with Lester Kiewit. Listen live on Primedia+ weekdays between 06:00 and 09:00 (SA Time) to Good Morning CapeTalk with Lester Kiewit broadcast on CapeTalk https://buff.ly/NnFM3Nk For more from the show go to https://buff.ly/xGkqLbT or find all the catch-up podcasts here https://buff.ly/f9Eeb7i Subscribe to the CapeTalk Daily and Weekly Newsletters https://buff.ly/sbvVZD5 Follow us on social media CapeTalk on Facebook: https://www.facebook.com/CapeTalk CapeTalk on TikTok: https://www.tiktok.com/@capetalk CapeTalk on Instagram: https://www.instagram.com/ CapeTalk on X: https://x.com/CapeTalk CapeTalk on YouTube: https://www.youtube.com/@CapeTalk567 See omnystudio.com/listener for privacy information.

Today, I'm joined by Leo Grady, PhD, founder and CEO of Jona.   Jona uses metagenomic sequencing and machine learning to deliver personalized metabolic health insights, predicting how factors like diet and lifestyle affect the gut.   In this episode, we discuss upgrading microbiome testing with AI technology.   We also cover:   Why gut tests could outpace blood tests Building AI to read medical literature at scale Using digital twins to predict health outcomes   Subscribe to the podcast → insider.fitt.co/podcast Subscribe to our newsletter → insider.fitt.co/subscribe Follow us on LinkedIn → linkedin.com/company/fittinsider   Jona Health's Website: https://jona.health/  Jona Journal (Newsletter & Blog): https://jona.health/blogs/journal  Instagram: https://www.instagram.com/jonahealth/  X (Twitter): https://x.com/jona_health  Facebook: https://www.facebook.com/JonaHealth/  LinkedIn: https://www.linkedin.com/company/jona-health/    -   The Fitt Insider Podcast is brought to you by EGYM. Visit EGYM.com to learn more about its smart workout solutions for fitness and health facilities.   Fitt Talent: https://talent.fitt.co/  Consulting: https://consulting.fitt.co/  Investments: https://capital.fitt.co/    Chapters: (00:00) Introduction (00:20) Leo's Background (02:15) Why the Microbiome is the Perfect AI Application (06:10) Building AI to Read Medical Literature at Scale (09:55) From Testing to Interventions (13:30) Avoiding Supplement Sales for Credibility (15:25) Direct Consumer and Clinical Partnerships (17:25) Digital Twin Technology in Healthcare (21:15) Three Customer Types and Testing Frequency (23:00) Microbiome vs Blood Testing (27:25) Education and Category Building Challenges (29:25) Technology Applications Beyond Microbiome (32:10) Health Tracking Integrations (37:00) Regulatory Considerations and Future Diagnostics (37:45) 2025 Roadmap and New Features (39:15) Conclusion

Felix Lindberg, MD, PhD and Abdullah Al-Abcha, MD discuss revascularization strategies in ST-elevation myocardial infarction with multivessel disease - temporal trends, patient profiles, and outcomes.

Atsushi Sugiura, MD, PhD and Abdullah Al-Abcha, MD discuss transcatheter edge-to-edge repair in patients with primary tricuspid regurgitation.

Giuseppe Tarantini, MD, PhD and Mirza Umair Khalid, MBBS, MD, FACC discuss the Coronary Access After TAVI (CAvEAT) Study.

Mehdi H. Shishehbor, DO, MPH, PhD, FACC and F. Aaysha Cader, MBBS, MD, MSc, FACC discuss the analysis of 1-Year Outcomes of Transcatheter Arterialization of Deep Veins: PROMISE II and Pooled PROMISE Studies.

Divaka Perera, MD and F. Aaysha Cader, MBBS, MD, MSc, FACC discuss the SERIAL study, the first randomized comparison of Fractional Flow Reserve and Instantaneous Wave Free Ratio in serial coronary artery disease.

Divaka Perera, MD and F. Aaysha Cader, MBBS, MD, MSc, FACC discuss the SERIAL study, the first randomized comparison of Fractional Flow Reserve and Instantaneous Wave Free Ratio in serial coronary artery disease.

Giuseppe Tarantini, MD, PhD and Mirza Umair Khalid, MBBS, MD, FACC discuss the Coronary Access After TAVI (CAvEAT) Study.

Atsushi Sugiura, MD, PhD and Abdullah Al-Abcha, MD discuss transcatheter edge-to-edge repair in patients with primary tricuspid regurgitation.

Felix Lindberg, MD, PhD and Abdullah Al-Abcha, MD discuss revascularization strategies in ST-elevation myocardial infarction with multivessel disease - temporal trends, patient profiles, and outcomes.

Mehdi H. Shishehbor, DO, MPH, PhD, FACC and F. Aaysha Cader, MBBS, MD, MSc, FACC discuss the analysis of 1-Year Outcomes of Transcatheter Arterialization of Deep Veins: PROMISE II and Pooled PROMISE Studies.

View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter's Weekly Newsletter Eric Verdin is a physician-scientist and the CEO of the Buck Institute for Research on Aging whose career has centered on understanding how epigenetics, metabolism, and the immune system influence the aging process. In this episode, Eric traces his scientific journey from studying viruses and histone deacetylases (HDACs) to leading aging research at the Buck Institute, offering insights into how aging impairs immune and nervous system function—including thymic shrinkage, chronic inflammation, and reduced vaccine response—and how these changes impact lifespan. He explores the metabolic underpinnings of aging, such as oxidative stress and insulin and IGF-1 signaling, and he discusses practical tools like zone 2 cardio, ketogenic diets, and GLP-1 drugs. The conversation also covers declining NAD levels with age, the roles of NAD-consuming enzymes such as sirtuins and CD38, and what current NAD-boosting strategies (like NMN, NR, and IV NAD) can and can't accomplish. Eric weighs in on promising longevity interventions including rapamycin, growth hormone for thymic regeneration, and anti-inflammatory therapies, while also examining the promise and limitations of current biological age tests and the potential of combining epigenetic, proteomic, and organ-specific metrics with wearables to guide personalized longevity care. We discuss: Eric's scientific journey from virology to the field of geroscience [2:45]; How dysfunction in the immune system and central nervous system can drive aging throughout the body [5:00]; The role of metabolism and oxidative stress in aging, and why antioxidant strategies have failed to deliver clear benefits [8:45]; Other aspects of metabolism linked to aging: mitochondrial efficiency, fuel utilization, and glucose-modulating drugs [16:30]; How inefficient glucose metabolism drives insulin, IGF-1 signaling, and accelerates aging [21:45]; The metabolic effects of GLP-1 agonists, and the need to move beyond crude metrics like BMI in favor of more precise assessments of metabolic health [27:00]; The case for immune health as a “fifth horseman” [36:00]; How the innate and adaptive immune systems work together to build immune memory [39:45]; Why vaccines lose effectiveness with age: shrinking of the thymus gland and diminished T-cell diversity [44:15]; Exploring growth hormone, thymic regeneration, and the role of exercise in slowing immune aging [48:45]; The challenges of identifying reliable biomarkers for immune function, and the potential of rapamycin analogs to enhance vaccine response in older adults [57:45]; How rapamycin's effects on the immune system vary dramatically by dosage and frequency [1:03:30]; The limitations of mouse models in aging research and the need for cautious interpretation of rapamycin's benefits in humans [1:08:15]; NAD, sirtuins, and aging: scientific promise amid commercial hype [1:15:45]; How CD38 drives age-related NAD decline, influences immune function, and may impact longevity [1:23:45]; How NMN and NR supplementation interact with CD38 and NAD metabolism, and potential risks like homocysteine elevation and one-carbon cycle depletion [1:31:00]; Intravenous NAD: limited evidence and serious risks [1:37:00]; Interleukin-11 (IL-11) as a new target in immune aging, the dual role of chronic inflammation in aging, and the need for better biomarkers to guide interventions [1:43:00]; Biological aging clocks: types of clocks, promise, major limitations, and future outlook [1:48:30]; The potential of proteomics-based aging clocks for detecting organ-specific decline and frailty [2:00:45]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube

Amy Steel is a climate adaptation expert and PhD candidate with Adrift Lab at Curtin University, Western Australia. With over a decade of experience advising on decarbonisation and climate resilience, Amy is now focused on a vital question: should humans intervene to help ecosystems on the verge of collapse—and if so, how, where, and when?Amy's research centres on the Yowli (otherwise known as Flesh-footed Shearwaters) breeding on islands in the Recherche Archipelago off Kepa Kurl, Esperance. These seabirds face increasing and worsening threats from lightning-ignited wildfires during their peak breeding season, impacted by climate change. Working with the Esperance Tjaltjraak Rangers, Amy is exploring how Wudjari cultural burning can protect these fragile habitats. Amy also reflects on moving from high-level strategy to hands-on fieldwork, the importance of Indigenous knowledge, and what it means to protect ecosystems in a rapidly changing climate.In this episode, we discuss:Amy's diverse background and what led her from leadership roles in climate strategy to researchThe long-term impacts of heat stroke that ended her competitive netball career and influenced her pathJoining the Adrift Lab team and what inspired her to undertake a PhDWhy islands and seabirds like the Yowli are critical indicators of ecosystem healthThe increasing severity of wildfires and extreme weather, and their impacts on vulnerable speciesWhether seabirds and other wildlife can adapt to human-driven climate change, and if natural checks and balances are breaking downThe ethical and ecological questions around human intervention in collapsing ecosystemsWorking closely with the Esperance Tjaltjraak Rangers, and the role of Wudjari cultural burning in ecosystem resilienceThe importance of place-based policy and honouring Indigenous knowledge in climate responsesHow to communicate climate and conservation issues effectively, and create lasting change within communitiesStaying motivated in advocacy through collaboration and community actionThe role of athletes in climate conversations, and how to stay safe while being active in a changing climateWhat gives Amy hope as an environmental researcherTo view all the links to the websites and documents, visit the show notes on our website.Please support our work and enable us to deliver more content by buying us a coffee or becoming a member of Athletes for Nature.Follow us on Instagram, Facebook and Bluesky, subscribe to this podcast, and share this episode with your friends and family.

Episode #89 of the PhysioBib Podcast brings you another English-language episode — this time featuring a conversation with Dr. Marcelo de França Moreira, a physiotherapist from Brazil.We met at a Pain School hosted by EFIC – the European Pain Federation – in Verona last year, where we had some inspiring conversations about the use of mindfulness-based interventions in pain physiotherapy.Marcelo really encouraged me to explore meditation, tai chi, and qigong more deeply in my clinical work – and also to start a more dedicated qigong practice myself. I really appreciated his perspective, so we thought it would be great to share part of our exchange with you in this episode.Besides our main topic – mindfulness and mindfulness-based interventions in pain care – we also touched on what physiotherapy looks like in Brazil and how Marcelo integrates mindfulness into his daily life and clinical routine.

Throughout human history, there have been stories of mysterious figures who appear at the precise moment of crisis—only to vanish without a trace. Are these fleeting presences guardian angels? Celestial messengers? Or are they something else entirely, operating just beyond the veil of our understanding? In this deeply compelling episode of Phantoms & Monsters Radio, we explore a series of firsthand accounts that leave divine intervention seemingly undeniable.From near-death rescues to comforting strangers who shift the course of a person's life, tonight's broadcast features powerful testimonies that challenge our perception of reality. A six-year-old nearly drowns in a hotel hot tub—only to be pulled to safety by a silent, smiling old man who vanishes moments later. A nurse dressed in white disappears after tending to a dying motorcyclist. And a traumatized survivor of human trafficking is gently lifted from the brink of suicide by a loving, disembodied voice that offers purpose and peace.We'll also explore how these phenomena blur the lines between religious experiences and extraterrestrial encounters. One experiencer recounts a failed abduction halted by a booming voice of warning—an act of divine protection. Another recalls a UFO event that left their uncle transformed and spiritually awakened. Are these messengers truly "angels," or are they part of a larger cosmic intelligence that intervenes during moments of crisis and transformation?Join us as we delve into cases that suggest we are not alone—even in our darkest hour. Whether these beings are divine emissaries, higher-dimensional guides, or alien watchers, their presence leaves an undeniable imprint. These encounters remind us that in times of despair, help may arrive in the most unexpected forms.

Throughout human history, there have been stories of mysterious figures who appear at the precise moment of crisis—only to vanish without a trace. Are these fleeting presences guardian angels? Celestial messengers? Or are they something else entirely, operating just beyond the veil of our understanding? In this deeply compelling episode of Phantoms & Monsters Radio, we explore a series of firsthand accounts that leave divine intervention seemingly undeniable.From near-death rescues to comforting strangers who shift the course of a person's life, tonight's broadcast features powerful testimonies that challenge our perception of reality. A six-year-old nearly drowns in a hotel hot tub—only to be pulled to safety by a silent, smiling old man who vanishes moments later. A nurse dressed in white disappears after tending to a dying motorcyclist. And a traumatized survivor of human trafficking is gently lifted from the brink of suicide by a loving, disembodied voice that offers purpose and peace.We'll also explore how these phenomena blur the lines between religious experiences and extraterrestrial encounters. One experiencer recounts a failed abduction halted by a booming voice of warning—an act of divine protection. Another recalls a UFO event that left their uncle transformed and spiritually awakened. Are these messengers truly "angels," or are they part of a larger cosmic intelligence that intervenes during moments of crisis and transformation?Join us as we delve into cases that suggest we are not alone—even in our darkest hour. Whether these beings are divine emissaries, higher-dimensional guides, or alien watchers, their presence leaves an undeniable imprint. These encounters remind us that in times of despair, help may arrive in the most unexpected forms.

Sponsor: Use code THEBIRTHHOUR at Inito.com to save $60 and get the Inito starter pack for just $89 and start using this unique at-home fertility monitor. The Birth Hour Links: Know Your Options Online Childbirth Course (code 100OFF for $100 OFF!) Beyond the First Latch Course (comes free with KYO course) Access archived episodes and a private Facebook group via Patreon! 

Jamie Hartmann-Boyce and Nicola Lindson discuss emerging evidence in e-cigarette research and interview Elias Klemperer from the University of Vermont, USA. Associate Professor Jamie Hartmann-Boyce and Associate Professor Nicola Lindson discuss the new evidence in e-cigarette research and interview Dr Elias Klemperer behavioural scientist and licenced clinical psychologist, Department of Psychiatry, University of Vermont, USA. Elias works in the field of tobacco regulatory science and tobacco control. He has a special interest in long-term users of both cigarettes and e-cigarettes, dual users, a group who take in nicotine via two methods. In the July podcast Elias Klemperer discusses his recent 2 × 2 factorial trial randomized trial of nicotine replacement therapy (patches and lozenges) in 396 young adult dual users aged 18–29 (DOI: 10.1093/ntr/ntaf119). In a randomized factorial trial participants are randomly placed into different groups to test more than one treatment at the same time. The study was funded by the National Institute of General Medical Sciences, the Food and Drug Administration, the National Institute on Drug Abuse, and the National Cancer Institute, USA. Elias Klemperer and his team carried out this study as little is known regarding nicotine replacement therapy for young adult dual users, or whether to recommend quitting versus continuing e-cigarettes during smoking cessation treatment. The participants received 12 weeks of combination NRT compared to no NRT for stopping smoking, plus text-based treatment recommendations to quit or to continue using e-cigarettes. This advice was delivered via written material, an animated video they developed in-house, and text message support during the 12-week treatment period. The study looked at abstinence from cigarettes at 12 and 24 weeks. Their study found that NRT was effective in promoting early smoking cessation among young adult dual users. Their secondary findings indicated that pairing NRT with support to quit both products could enhance the effects on prolonged cigarette abstinence. This podcast is a companion to the electronic cigarettes Cochrane living systematic review and Interventions for quitting vaping review and shares the evidence from the monthly searches. Our search for the EC for smoking cessation review carried out on 1st July 2025 found six papers linked studies included in the review (10.1101/2025.05.06.25327053; 10.1016/j.jacadv.2025.101833; 10.1016/j.drugalcdep.2025.112740; 10.1186/s13722-025-00575-w; 10.1038/s41598-025-03904-w; 10.1136/bmjopen-2024-098005). Our search for our interventions for quitting vaping review up to 1st July 2025 found one new study by Klemperer et al discussed in this podcast (10.1093/ntr/ntaf119), one new ongoing study (10.1136/bmjopen-2024-096963), and two linked papers (10.1093/heapro/daaf085; 10.1016/j.jadohealth.2025.04.012). For further details see our webpage under 'Monthly search findings': https://www.cebm.ox.ac.uk/research/electronic-cigarettes-for-smoking-cessation-cochrane-living-systematic-review-1 For more information on the full Cochrane review of E-cigarettes for smoking cessation updated in January 2025 see: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010216.pub9/full For more information on the full Cochrane review of Interventions for quitting vaping published in January 2025 see: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD016058.pub2/full This podcast is supported by Cancer Research UK.

SHOW NOTES: I've talked before about so many medical interventions over the years and gone into detail about the pros and cons of them, and all of that info is relevant…but today I want to go a little deeper into the underlying reasons we as Christians should not be accepting so many medical interventions. Often we kind of separate faith from our health care, but everything we do as Christians is to be to the glory of God -- including how we seek and receive care for our bodies.   This is the newly rebranded podcast, formerly known as "Your Birth, God's Way". If you are pregnant, please look back on your podcast app for over 140 episodes dealing exclusively with pregnancy topics! Helpful Links: — BIBLE STUDY - FREE Bible Study Course - How To Be Sure Of Your Salvation - https://the-ruffled-mango-school.teachable.com/p/how-to-be-sure-of-your-salvation   -- COACHING - If you're tired of shallow, cheap, meaningless connections in pregnancy that leave you feeling passed over and confused, Virtual Prenatal Coaching might be for you. If you're ready to invest in coaching that will bring REAL results and REAL change, not only now but for the future of your family and your children's families, let's talk about how this 1-on-1 coaching might be just what you've been looking for! Go here to learn more - https://go.yourbirthgodsway.com/coachinginterest   -- If you are not pregnant, you're sick and tired of being sick and tired, and you're ready for something different - something to help you finally look and feel like yourself again, my 1:1 Concierge Wellness Coaching is for YOU! Learn more at morriswellnessservices.com!   — CHRISTIAN CHILDBIRTH EDUCATION - Sign up HERE for the Your Birth, God's Way Online Christian Childbirth Course! This is a COMPLETE childbirth education course with a God-led foundation taught by a certified nurse-midwife with over 20 years of experience in all sides of the maternity world! - https://go.yourbirthgodsway.com/cec   — HOME BIRTH PREP - Having a home birth and need help getting prepared?  Sign up HERE for the Home Birth Prep Course. — homebirthprep.com   — MERCH - Get Christian pregnancy and birth merch HERE - https://go.yourbirthgodsway.com/store   — RESOURCES & LINKS - All of Lori's Recommended Resources HERE - https://go.yourbirthgodsway.com/resources   Got questions?  Email lori@yourbirthgodsway.com Leave me a message -- https://www.speakpipe.com/yourbirthgodsway   Social Media Links: Follow Lori on Instagram! @lori_morris_cnm Subscribe to my YouTube channel - youtube.com/ifmamaainthealthy Join Lori's Facebook Page! facebook.com/lorimorriscnm Join Our Exclusive Online Christian Women's Wellness Community -- facebook.com/groups/yourbirthgodsway   Learn more about pregnancy at go.yourbirthgodsway.com! Learn how to reclaim your health at every season of motherhood at morriswellnessservices.com !   DISCLAIMER:  Remember that though I am a midwife, I am not YOUR midwife.  Nothing in this podcast shall; be construed as medical advice.  Listening to this podcast does not mean that we have entered into a patient-care provider relationship. While I strive to provide the most accurate information I can, content is not guaranteed to be 100% accurate.  You must do your research and consult other reputable sources, including your provider, to make the best decision for your own care.  Talk with your own care provider before putting any information here into practice.  Weigh all risks and benefits for yourself knowing that no outcome can be guaranteed.  I do not know the specific details about your situation and thus I am not responsible for the outcomes of your choices.    Some links may be affiliate links which provide me a small commission when you purchase through them.  This does not cost you anything at all and it allows me to continue providing you with the content you love.

Chaque jour, retrouvez le journal de 19h de la rédaction d'Europe 1 pour faire le tour de l'actu. Distribué par Audiomeans. Visitez audiomeans.fr/politique-de-confidentialite pour plus d'informations.

Chaque jour, retrouvez le journal de 19h de la rédaction d'Europe 1 pour faire le tour de l'actu. Distribué par Audiomeans. Visitez audiomeans.fr/politique-de-confidentialite pour plus d'informations.

Send us a text00:00 - Surf's Up, Season 6 Episode 8The conversation addresses three issues that are distinct, yet each is pivotal to the future of MASLD and MASH therapies. The first, from the Global Think-Tank on Steatotic Liver Disease, considers how personal and digital approaches can be combined to form the most effective strategy for patient management. In the second, Global Liver Institute President and CEO Larry Holden joins Roger Green to discuss the new challenges in Washington stemming from the Trump Administration and RFK Jr. The final section is the conclusion of our recent drug development roundtable, examining drug classes we did not previously discuss, along with a thought on where combination therapy is likely to lead. 00:04:57 - Global Think-Tank on SLD Roundtable, Part 2Behavior consultant Dr. Kristina Curtis joins Jörn Schattenberg, Louise Campbell and Roger Green to discuss issues related to patient-centered care. This discussion focuses on the elements of successful behavior change and the importance of real-time, actionable feedback. The group discusses the interplay of diagnostic test feedback, real-time personal exchanges and AI-based algorithms in what Kristina terms a "hybrid therapy."00:18:39 - Newsmaker: Larry HoldenGLI President and CEO Larry Holden addresses two issues related to current goings-on in Washington. First, he acknowledges that we are in for "dark times" under the current administration, and describes some of the decisions and challenges we face. Second, he suggests what individuals and organizations can do to create the best possible situation -- and even some "wins" -- for people living with liver disease. These suggestions reflect his experiences during a 30-year career on Capitol Hill, prior to his joining GLI.00:46:15 - Drug Development Roundtable, Part 4Sven Francque joins Jörn, Louise and Roger to share an up-to-date look at drug development. This discussion focuses on PPARs, genetic medicines, and other emerging drug classes. Sven uses the example of the pan-PPAR lanifibranor to explore the idea that drug therapies can have an impact on the liver independent of their effect on fibrosis regression. The group proceeds to discuss other emerging drugs in development and their modes of action. One theme: over time, we may see prescribers consider using different therapies to address metabolic vs. liver-specific effects, often in combination.01:00:47 - Business ReportThanks to our listeners, Jörn's vacation, Welcome Regeneron

In this episode, Dr Tsen Vei Lim talks to: Dr Marilyn Piccirillo from the Department of Psychiatry at Rutgers University-New Brunswick and Drs Katherine Walukevich-Dienst and Elizabeth Lehinger from the Department of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine. The interview covers their research report on the longer-term efficacy of brief, alcohol-focused personalised feedback interventions among young adults in two universities on the West coast of the US. Note for listeners: The acronym PFI is used throughout this episode, which stands for ‘personalised feedback intervention'.· What is an alcohol-focused personalised feedback intervention? [01:48]· An example of how one of these interventions would work in practice [03:03]· The importance of considering distress [03:46]· The key findings of the study [07:24]· Why ‘less is more' when it comes to alcohol interventions [12:19]· How the findings contribute to policy or practice [14:46]· The pioneers of personalised feedback interventions [17:41]About Marilyn Piccirillo: Dr Piccirillo is a licensed psychologist and an Assistant Professor in the Department of Psychiatry at Rutgers University-New Brunswick. She is also a Core Faculty member of the Rutgers Brain Health Institute and a member of the Rutgers Addiction Research Center. Dr Piccirillo uses person-centered frameworks to study motivating and maintenance factors for substance use problems, particularly for those experiencing co-occurring anxiety, trauma, and stress. She also examines how digital tools can be used to support treatment and recovery and optimise the design and delivery of treatments for substance use problems and addiction. About Katherine Walukevich-Dienst: Dr Walukevich-Dienst is a clinical psychologist and Assistant Professor in the Department of Psychiatry and Behavioral Sciences at the University of Washington. Her research focuses on developing and testing digital interventions to reduce substance use and improve mental health among young adults. She uses methods such as ecological momentary assessment to examine real-time behavior and intervention engagement. Dr Walukevich-Dienst has authored over 50 peer-reviewed publications and leads National Institutes of Health (NIH)-funded projects aimed at improving outcomes for cannabis and alcohol use through scalable, evidence-based approaches. About Elizabeth Lehinger: Dr Lehinger is an Acting Assistant Professor in the Department of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine. She has two primary areas of research: 1) college student alcohol prevention, and 2) trauma recovery for individuals with co-occurring substance use disorders. Her research focuses on reward processes underlying these research areas. The authors have no conflicts of interest to disclose. Original article: Examining the longer-term efficacy of brief, alcohol-focused personalized feedback interventions for individuals with internalizing distress: Secondary analysis of a randomized controlled trial. https://doi.org/10.1111/add.70044 The opinions expressed in this podcast reflect the views of the host and interviewees and do not necessarily represent the opinions or official positions of the SSA or Addiction journal. The SSA does not endorse or guarantee the accuracy of the information in external sources or links and accepts no responsibility or liability for any consequences arising from the use of such information. Hosted on Acast. See acast.com/privacy for more information.

Retrouvez la boutique LEGEND ➡️: https://shop.legend-group.fr/Merci à Thomas d'être passé nous voir chez LEGEND ! Thomas est ambulancier et urgentiste au SMUR depuis 10 ans. Il est venu partager avec nous ses anecdotes les plus marquantes.Il a vécu des interventions difficiles, comme sur une scène de crime où une mère avait tué ses deux enfants, ou encore ce jour où il a pris en charge une victime coupée en deux par un hachoir.Mais son métier, c'est aussi des moments plus légers, parfois même drôles, comme cette fois où il a dû intervenir sur le tournage d'un film X pour secourir des acteurs.Pour toutes demandes de partenariats : legend@influxcrew.comRetrouvez-nous sur tous les réseaux LEGEND !Retrouvez l'interview complète sur YouTube ➡️ https://youtu.be/ye5cVoc7hIcFacebook : https://www.facebook.com/legendmediafrInstagram : https://www.instagram.com/legendmedia/TikTok : https://www.tiktok.com/@legendTwitter : https://twitter.com/legendmediafrSnapchat : https://t.snapchat.com/CgEvsbWV Hébergé par Acast. Visitez acast.com/privacy pour plus d'informations.

Adequate nutrition is crucial during adolescence due to significant physical, mental, and emotional changes, yet in many adolescents poor dietary behaviors lead to inadequate nutrient intake and increased health risks. Peer-led interventions have shown promise in improving these behaviors. Join us this episode as  Editor-in-Chief Douglas Taren speaks with Daniale T Ekubagewargies, lead author of our featured article, as they discuss the effectiveness of Peer-led interventions in improving the dietary behaviors of adolescents.

In this episode of HSS Presents, pediatric orthopedic surgeon Dr. Shevaun Doyle is joined by pediatric physical therapist Dr. Magdalena Oledzka to explore congenital muscular torticollis (CMT)—a common condition in infants that, if left untreated, can lead to head tilting, facial asymmetry, and developmental delays. They discuss the early signs and causes of CMT, emphasize the importance of timely intervention, and share practical physical therapy strategies. The conversation also covers how to support families with home-based routines, when to consider further evaluation or surgical referral, and long-term outcomes. Listeners will gain valuable insights into the collaborative, multidisciplinary approach to managing CMT from infancy through early childhood. This episode is essential listening for pediatric providers, therapists, and parents alike.

Send us a textThis conversation is the opening segment of  SurfingMASH's coverage of the Global Think Tank on Steatotic Liver Diseases (#SLDThinkTank2025) held in Barcelona in June.  Co-hosts Louise Campbell and Roger Green are joined by Dr. Kristina Curtis, Managing Director of Applied Behaviour Change, a UK-based consultancy. This discussion starts with co-host Jörn Schattenberg discussing the history and evolution of the first four Global Think-Tanks as the focus shifts from educating medical professionals about liver disease to incorporating a broader group of stakeholders, including politicians and non-hepatologist MDs, to break down siloes and create broader awareness. Co-host Louise Campbell describes the breadth of stakeholders necessary to address this pandemic fully. She explains how her work with transient elastography and the MyLife365.me app constitutes a form of behavioral therapy. Jörn describes the test as a diagnostic and comments that the treatment is what health professionals do with the results. Kristina says that the behavioral change that results comes from well-delivered feedback. She describes "hybrid interventions, digital interventions with a human in the loop." Louise discusses results from the EASL late-breaker that support these findings and goes on to discuss the role AI can play in medical practices.

In this episode, we explore the intersection of ovarian health, menopause, and AI technology with Kiran, the founder of TimelessBioTech. The conversation delves into the importance of ovarian longevity for women's health, the predictive tools being developed to forecast menopause timing, and the various interventions that can support ovarian health. Kiran shares insights on hormonal balance, the role of lifestyle factors, and the future of personalized health strategies for women. The discussion emphasizes the need for targeted solutions and the potential for AI to revolutionize women's health care.Timeless Biotech WebsiteKiran's email for investors, clinics, and companies looking to invest in or work with Timeless: Kiiran@timelessbiotech.comThis episode is brought to you by OneSkin, the longevity scientists behind the first topical peptide scientifically proven to reverse skin aging—now bringing their expertise to your scalp. If you care about aging well, you can't ignore your hair. The health of your scalp directly impacts the strength, thickness, and lifespan of every strand. That's why OneSkin created their new OS-01 HAIR, the first scalp serum powered by a longevity peptide designed to optimize follicle health, balance the scalp, and extend the healthspan of your hair follicles. In their clinical study, OS-01 HAIR showed significant improvements in hair density, thickness, and overall scalp health—all by targeting follicle aging at the root. I've been using it myself and I'm genuinely impressed. It's lightweight, fragrance-free, and backed by science—not fluff. If you're serious about keeping your hair vibrant and resilient as you age, I highly recommend giving OneSkin's OS-01 HAIR a try. Head to oneskin.co/KAYLA  for 15% off your order. About KiranKiran Kumar is the Founder & CEO of Timeless Biotech, an early-stage ovarian longevity company that has prototyped the first-ever time-to-menopause predictor and ovarian age clock. Kiran is a Biotechnology Bioengineer from UC San Diego, and has contributed to research in ML-powered diagnostics.Kiran has worked in numerous longevity and wellness startups such as FOXO Technologies, OneSkin, and Timeline where she authored. research-backed contentKiran's work sits at the intersection of Physiology, AI, and Longevity.Chapters00:00 Introduction to Ovarian Longevity and AI Solutions02:44 The Importance of Ovarian Health in Longevity05:38 Understanding Menopause and Ovarian Aging08:48 Predictive Tools for Menopause Timing11:32 Interventions for Ovarian Longevity14:31 The Role of Hormones in Ovarian Health17:25 Innovative Approaches to Hormonal Balance20:14 The Future of Ovarian Health Technologies22:58 Personalized Health Strategies for Women25:31 Conclusion and Future Directions

OMB and DOGE have been clear about their intention to use federal data more smartly to evaluate programs and drive decisions. That's something data watchers have advocated for years. But how they do that matters for transparency and trust. Here with a front-row seat to the issues is President and CEO of the Data Foundation, Nick Hart.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Dr. Nora Fritz, PhD, PT, DPT, NCS, an expert in postural control and fall risk in people with multiple sclerosis, joins host J.J. Mowder-Tinney for a deep dive into reactive balance—why it matters, how it's measured, and what we can do about it. J.J. and Nora explore the latest research around sensory reweighting, backward walking, and compensatory stepping, connecting the science to real-world clinical applications across patient populations. Together, they discuss strategies to support your clients' safety and confidence through tailored interventions and meaningful conversations. Whether you're looking to sharpen your assessment approach or rethink fall prevention strategies, this episode offers insights you won't want to miss.Learning ObjectivesAnalyze the evidence around reactive postural control in persons with MSApply evidence-based, practical strategies to actionably address reactive balance control in persons with MSIncorporate measures of psychological functioning that may impact goal setting for reactive postural control in persons with MSTimestamps(00:00:00) Welcome(00:00:47) Introduction to reactive balance and multiple sclerosis (MS)(00:03:04) Understanding reactive balance mechanisms(00:06:50) Research insights on backward walking(00:11:55) Neural control of reactive balance(00:17:45) Applications across different diagnoses(00:20:57) Practical examples in therapy sessions(00:26:41) Assessing reactive balance in clinical settings(00:29:02) Understanding patient concerns and fear of falling(00:33:04) Interventions for improving reactive balance(00:35:24) Creative approaches to reactive balance training(00:38:44) Key takeaways for clinicians(00:40:34) Case studies and clinical insights(00:42:31) Research and future directions in balance trainingResources Mentioned in EpisodeAcademy of Neurologic Physical Therapy (ANPT) podcast episode that discusses the CAFFE Scale: DD SIG Episode 53: JNPT highlight: Concern About Falling and Fear of Falling in MS with Taylor TaklaBalance AssessmentsMini-BESTestPush and ReleaseABC ScaleFES-ICAFFE ScaleNeuro Navigators is brought to you by Medbridge. If you'd like to earn continuing education credit for listening to this episode and access bonus takeaway handouts, log in to your Medbridge account and navigate to the course where you'll find accreditation details. If applicable, complete the post-course assessment and survey to be eligible for credit. The takeaway handout on Medbridge gives you the key points mentioned in this episode, along with additional resources you can implement into your practice right away.To hear more episodes of Neuro Naviagators, visit ⁠⁠⁠https://www.medbridge.com/neuro-navigators⁠⁠⁠If you'd like to subscribe to Medbridge, visit ⁠⁠⁠https://www.medbridge.com/pricing/⁠⁠⁠IG: https://www.instagram.com/medbridgeteam/

Here's a prep guide for hospital births that will help you feel more confident, and empower you with information that could help you avoid unnecessary procedures that can result in trauma and/or injury.Our guest is HeHe Stewart, a birth doula and founder of The Birth Lounge, a non-judgmental, evidence-based childbirth education online platform known for helping parents navigate birth. HeHe also has her own podcast called the Birth Lounge. Here's some of what we discuss:how to avoid unnecessary C-sectionshow to confidently ask for optionswhat to do if things don't go as expectedcrucial information to prepare you for hospital birthFull show notes: fourthtrimesterpodcast.comConnect with HeHe Stewart Tranquility by HeHe | The Birth Lounge Education PlatformHeHe's Podcast The Birth Lounge PodcastLearn more The 10 Questions Every First-Time Parent Asks | Home Birth As An Alternative To The Hospital | How a Friend or Family Member Can Help You if You Don't Have a Doula (What is a Doula?)Resources HelloGaia Parenting Copilot | FREE DOWNLOAD Customizable Birth Plan | FREE DOWNLOAD Customizable Fourth Trimester Plan | Postpartum Soups and Stews CollectionConnect with Fourth Trimester Facebook | Instagram

Join @theradork aka Dr. Ellen Csepe as we discuss the obesity paradox and our role as clinicians in addressing this global health crisis while aligning with new medical Interventions    If you found this content helpful, go to https://PTonICE.com to check out our collection of Free Resources like the MMOA Digest our Bi-Weekly Research Email that goes out to thousands of clinicians.

In this special episode, host Chris Patil (VP-Media, BioAge) moderates a live panel discussion at the 25th Bay Area Aging Meeting at UCSF, bringing together six leading voices across the aging research ecosystem to tackle one of the field's most critical challenges: how to move promising discoveries from the laboratory to therapies that can benefit patients.The distinguished panel spans academia, industry, and scientific publishing, featuring Janine Sengstack (CEO, Junevity), Saul Villeda (Professor, UCSF), Jodi Nunnari (Director, Bay Area Institute of Science, Altos Labs), Sebastien Thuault (Chief Editor, Nature Aging), Anne Brunet (Professor, Stanford), and Nir Barzilai (Professor, Albert Einstein College of Medicine). Together, they explore the most promising research directions for clinical impact, the revolutionary tools enabling modern aging research, and the structural challenges that must be overcome to bring longevity therapies to market.Listeners will gain insights into the emerging science of cellular rejuvenation, the importance of systemic factors in aging, how to balance high-risk discovery with practical drug development, and the cultural shifts needed to better prepare the next generation of scientists for translational work. The panel also addresses the regulatory challenges of targeting aging itself as an indication and offers candid advice for young researchers navigating this rapidly evolving field.The Finer Details:Emerging research directions with the greatest clinical potential: cellular senescence, rejuvenation and repair, DNA methylation clocks, and understanding what makes aging biomarkers tickThe revolution in cellular and spatial resolution tools and how single-cell technologies are revealing cell-type-specific aging responsesSystemic factors and the remarkable plasticity remaining in aging organisms that can be unlocked through interventionsThe critical importance of starting with human data and working backward to validate targets and approachesChallenges unique to aging biotech: the need for aging-specific cellular assays, testing in older animal models, and genetic validationCultural and structural barriers between academia and industry, including the shift from mechanism-focused to mission-driven researchBalancing high-risk fundamental discovery with the practical needs of drug development and clinical translationThe regulatory landscape for aging interventions and potential pathways to FDA approval beyond traditional disease indicationsAdvice for young scientists: embracing rejection as part of the process, finding passion, working as teams, and considering diverse career paths in the growing longevity ecosystemQuotes:"Our goal as a company is to increase human health span, and the way I like to frame that more colloquially is we want to increase the number of happy, healthy years each person gets to spend on Earth." - Janine Sengstack"There is an exquisite amount of plasticity left in an aging organism, both within the tissues, within the cells. There is plasticity that we can actually tap into." - Saul Villeda"Burn bright, but don't burn out." - Jodi Nunnari"The challenge that we run into is that there are so many combinations that very quickly it would become intractable to line up enough test tubes to test them all." - Sebastien Thuault, on the complexity of aging interventions"We love our job. If not, we would not be doing it. I would do it again in a heartbeat... you get paid to play, to ask the questions that interest you, the approaches that interest you to play with who you want to—it is a fantastic job." - Saul Villeda"Our life is a life of rejection...and still, we're having fun and making an advance. So don't give up." - Nir Barzilai

In this episode of JACC This Week, Editor-in-Chief Dr. Harlan Krumholz summarizes key studies from the July 15 issue, focused on cardiovascular interventions. Topics include new insights on plaque vulnerability in acute coronary syndromes, virtual flow reserve after PCI, long-term data on FFR-guided revascularization, and stent thrombosis risk. This issue delivers high-impact, practice-relevant research for interventionalists, imaging specialists, and general cardiologists alike.

Max Keiser, Bitcoin OG and Sr. BTC Advisor to Presiden Bukele, is forecasting significant governmental intervention as Bitcoin approaches a valuation of $400,000. “At $400,000 Bitcoin, the global hash wars will be so intense the US invokes national security and seizes publicly traded companies like $MSTR $COIN $MARA $RIOT.” Learn more about your ad choices. Visit megaphone.fm/adchoices

Shannon and Mary chat with Dr. Katie Pace-Miles about MTSS and RTI, sharing practical tips for delivering effective reading interventions, choosing quality resources, and running efficient team meetings to support struggling readers.   Whether you're a classroom teacher trying to support struggling readers, a specialist designing intervention programs, or a parent advocating for your child, this conversation provides clear, actionable guidance for making literacy interventions both manageable and truly impactful.LINKS FOR RESOURCES MENTIONED IN THE EPISODE:Easy CBMMaking Words Stick by Katie Pace Miles and Molly Ness *Amazon affiliate link*our episode with Molly Ness from Season 6overview of MTSS/RTI from understood.orgmeeting normsFCRR Fast PhrasesWrights LawCaregiver Guide from Katie Pace MilesLetter Knowledge Guide from Katie Pace MilesThe Reading Institute websiteThe Reading Institute on IGThe Reading Institute (LinkedIn)The Reading Institute (Facebook)Katie Pace Miles' websiteConnect with Katie through LinkedInFind Katie on IGMcGraw Hill Science of Literacy Library:A free resource hub containing blogs, videos, research reports, and more— designed to connect teachers with practical classroom resources and Professional Learning tips.Bonus Episodes access through your podcast appBonus episodes access through PatreonFree Rubrics Guide created by usFinding Good Books Guide created by usSupport the showGet Literacy Support through our Patreon

By William Paz - God is the same, yesterday, today, and forever! He has, and even now working in the affairs of men to bring eternal salvation and glory to all who turn to HIM and his SON. We only need to look to scripture and more recent history as a witness and testimony of HIS miraculous interventions, being

In which stage of lymphedema will elevation of an extremity MOST particularly help reduce swelling? Find it all out in the podcast!  Be prepared for the NPTE so that you can pass with flying colors! Check out www.ptfinalexam.com/podcast for more information and to stay up-to-date with our latest courses and projects.  #Npte #PT #ptboards #crushtheNPTE #study #studygram #spt #ptstudent #ptlife #sptprobs #physicaltherapystudent #physicaltherapy #physio #physiotherapist #ptlife #ptstudentstudy

On Legal Docket, Supreme Court rules on treatment for gender transition; on Moneybeat, the Middle East risk; and on History Book, the start of the Korean War. Plus, the Monday morning newsSupport The World and Everything in It today at wng.org/donateAdditional support comes from WatersEdge Kingdom Investments — personal investments that build churches. 5.05% APY on a three-month term. WatersEdge.com/investWatersEdge Kingdom Investments - WatersEdge securities are subject to certain risk factors as described in our Offering Circular and are not FDIC or SIPC insured. This is not an offer to sell or solicit securities. WatersEdge offers and sells securities only where authorized; this offering is made solely by our Offering Circular.