Podcasts about IV

Share on
Share on Facebook
Share on Twitter
Share on Reddit
Copy link to clipboard
  • 5,674PODCASTS
  • 17,836EPISODES
  • 47mAVG DURATION
  • 8DAILY NEW EPISODES
  • Oct 13, 2021LATEST

POPULARITY

20112012201320142015201620172018201920202021


Best podcasts about IV

Show all podcasts related to iv

Latest podcast episodes about IV

The tastytrade network
Options Jive - October 13, 2021 - Skew and IV Correlation

The tastytrade network

Play Episode Listen Later Oct 13, 2021 13:25


Option skew can be intuitively thought of as the direction and magnitude of the underlying's velocity of risk. For equities, this risk is to the downside whereas commodities see their velocity of risk to the upside. The direction of the underlying's velocity of risk can be determined by either looking at the symmetry of the option chain, or by observing the correlation between the underlying's price and its IV.

The tastytrade network
Options Jive - October 13, 2021 - Skew and IV Correlation

The tastytrade network

Play Episode Listen Later Oct 13, 2021 12:34


Option skew can be intuitively thought of as the direction and magnitude of the underlying's velocity of risk. For equities, this risk is to the downside whereas commodities see their velocity of risk to the upside. The direction of the underlying's velocity of risk can be determined by either looking at the symmetry of the option chain, or by observing the correlation between the underlying's price and its IV.

LMU Grundkurs Zivilrecht 2020/21
BGB Schuldrecht AT - Folge 11: Unmöglichkeit: Schadensersatzansprüche

LMU Grundkurs Zivilrecht 2020/21

Play Episode Listen Later Oct 12, 2021 85:42


Noch § 9 Leistungsstörungen, Teil 3: Unmöglichkeit der Leistung und gleichgestellte Tatbestände: vom Vertretenmüssen abhängige Rechtsfolgen der Unmöglichkeit: Schadensersatz statt der Leistung: anfängliche Leistungsbefreiung (§ 311a II BGB), nachträgliche Leistungsbefreiung (§§ 275 IV, 280 I, III, 283 BGB), Inhalt des Schadensersatzanspruches: Surrogations- oder Differenztheorie

RADAR ECONÓMICO
EMISIÓN 9921 OCTUBRE 11 2021

RADAR ECONÓMICO

Play Episode Listen Later Oct 12, 2021 16:19


Temas en la mira del RadaR: Colombia está lista para recibir más inversión extranjera y confía en el sector privado como motor para la transformación social. Eso dijo el presidente Iván Duque ante la Cámara de Comercio de Estados Unidos. El mandatario se reunió con directivos del Banco Mundial y el Fondo Monetario Internacional. La importancia de la innovación en la cadena de valor. Sobre el tema habla Antoni Paz, director ejecutivo de Knowledge Innovation Market. También les tenemos datos de lo que adelanta el gobierno nacional en materia de innovación y cambio climático desde el Ministerio de Agricultura de Colombia. Ya viene Caribe Biz 2021, foro organizado por la Cámara de Comercio de Barranquilla. Patrocinadores: Gecelca, Air-e, Gases del Caribe, Promigas

Rebel Talk
RT 156: Maintain a high vibration state during challenging times

Rebel Talk

Play Episode Listen Later Oct 12, 2021 61:21


Meaningful and candid conversations about health and tapping into your intuitive self; this is the Rebel Talk podcast with Dr. Michelle Peris. This episode is brought to you by The Wild Collective. For more information, please see the bottom of this episode's show notes. Dr. Michelle Peris, ND is joined by Meghan Telpner, an author, speaker, nutritionist, and founder of the academy of culinary nutrition. She has written two best-selling books, UnDiet: Eat Your Way To Vibrant Health and the UnDiet Cookbook.  Meghan's success in cultivating a global community of UnDiet enthusiasts and culinary nutrition experts has garnered her a feature in Forbes and ranked her as one of the top 100 female entrepreneurs in Canada. We talk briefly about her journey into holistic nutrition and we talk about her most exciting new program. We just had a really great conversation about how to maintain a high vibration state during challenging times. This conversation is for anyone who is feeling numb or disconnected at this time; Meghan is an absolute joy. Sign up for Meghan's new program, called The Program: https://www.meghantelpner.com/theprogram/ Continue on your wild journey… Wild Collective link: https://join.the-wild-collective.com/start-today-1 This episode of the Rebel Talk Podcast is brought to you by The Wild Collective. The Wild Collective is our community health initiative that helps women understand the intersection of our physiology, how our body works, how our hormones, how our stress, how our lifestyle factors influence our ability to connect with our intuition. It is where like-minded individuals have high-level conversations and learn a curriculum that every woman has the right to know, that is in their best interest to understand so that they can take their health and their life to the next level. It is our deepest honor and privilege to be able to offer this here at the poppy clinic. If you have been curious to learn more about our sisterhood and how to leverage community as your superpower to take radical action in your life. Then I highly recommend that you connect with us in two ways. One, you join our five day free challenge via the link on our Instagram page and two, you join our upcoming masterclass. It is called the science of sisterhood, the ultimate women's health blueprint. We would love for you to join us.  www.poppyclinic.com Dr. Michelle Peris at Instagram  Dr. Michelle Peris at Facebook Designs for Health Have you ever heard of IV Vitamin Therapy? This is one of the treatments that are offered at the Poppy Clinic, you can receive it as a stand-alone treatment or as part of your holistic health care. IV stands for Intravenous. It is a 40-minute session during which you are administered a customized blend of vitamins intravenously, right into your bloodstream. The advantage of getting your vitamins this way is that the digestive tract is bypassed in order for you to absorb 100% of what you are getting, you are receiving the vitamins directly, and are able to get much higher doses of the vitamins than you would ever be able to get otherwise. Did you know that 1 of 3 people have a digestive compromise? This means that even if you are eating a great diet or taking all of your vitamins, you might not actually be digesting and absorbing everything. IV Vitamin Therapy is the treatment that helps you absorb 100% of vitamins into your system. Benefits of IV Vitamin Therapy: - Boost your immune system - Heal from chronic disease - Fight off infections - Boost your mood - Improve sleep quality - Calm your nervous system - Health optimization - Prevention of disease - Anti-aging and collagen production boost Reach out to the Poppy Clinic! You don't need a referral. We look forward to meeting you very soon!

Coronavirus 4 1 1  podcast
Coronavirus, COVID-19, coronavirus variants, and vaccine updates for 10-12-2021

Coronavirus 4 1 1 podcast

Play Episode Listen Later Oct 12, 2021 4:59


This is Coronavirus 411, the latest COVID-19 info and new hotspots for October 12th, 2021. Merck asked U.S. regulators yesterday to authorize the pill it has for treating COVID. If they hear what they want to hear from the FDA, and that could happen in a few weeks, that'd be the first pill shown to treat the illness. There are other drugs, but they require an IV or injection. Merck said earlier this month the pill cut hospitalizations and deaths by half among patients with early symptoms. Meanwhile AstraZeneca's antibody cocktail against COVID, already shown to work as a preventative shot in the non-infected, was also shown to save lives and prevent severe disease when used as treatment within a week of first symptoms. Two new studies indicate pregnant women who develop Covid symptoms risk emergency complications and additional problems, and the disease puts their babies at risk. Of the 100 Covid-positive moms who delivered babies between March and September of 2020 at one Texas hospital, 58% of those with symptomatic infections delivered in emergency circumstances. For those with an asymptomatic case, 46% did. It's a sure way to fight Covid…sue people. A parent in southern Wisconsin has sued their school district after her son got Covid-19 from a classmate. She's upset the board removed a student mask requirement and other Covid-19 mitigation measures in May. Her son, who was wearing a mask, sat next to a kid who had symptoms and was infected regardless. The suit calls for the district to comply with CDC guidelines. Do you habitually smoke weed? Never mind, you don't have to tell me. But you should know a study from an arm of the National Institutes of Health says the risk of getting a coronavirus breakthrough infection in the U.S. may be 7.8% higher among those who habitually smoke weed. The risk is also there, but a little lower, for those with tobacco use disorder. In the United States cases were down 19%, deaths are down 2%, and hospitalizations are down 21% over 14 days. The 7-day average of new cases has been trending down since September 13. There are 9,793,733 active cases in the United States. With not all states reporting daily numbers, the five states with the greatest increase in hospitalizations per capita: Michigan 21%, Minnesota 16%. Pennsylvania 15%. North Dakota 14%. And Montana 10%. The top 10 counties with the highest number of recent cases per capita according to The New York Times: Bethel Census Area, AK. Stark, ND. Lewis, KY. Kodiak Island Borough, AK. Whitley, KY. Knox, IN. Clay, TX. Custer, MT. McCreary, MT. And Big Horn, WY. There have been at least 713,770 deaths in the U.S. recorded as Covid-related. The top 3 vaccinating states by percentage of population that's been fully vaccinated: Vermont at 70.2%, Connecticut at 69.4%, and Rhode Island at 69.3%. The bottom 3 vaccinating states are West Virginia at 40.7%, and Wyoming and Idaho at 42.4%. The percentage of the U.S. that's been fully vaccinated is 56.4%. The five countries with biggest 24-hour increases in the number of fully vaccinated people: Oceana, Cambodia up 2%, and Saudi Arabia and India 1%. Globally, cases were down 12% and deaths were down 12% over 14 days, with the 7-day average trending down since August 26. There are 17,913,065 active cases around the world. The five countries with the most new cases: The U.K. 34,320. The United States 29,520. Russia 28,647. Turkey 28,370. And India 19,018. There have been at least 4,855,635 deaths reported as Covid-related worldwide. For the latest updates, subscribe for free to Coronavirus 411 on your podcast app or ask your smart speaker to play the Coronavirus 411 podcast. See acast.com/privacy for privacy and opt-out information.

Value School | Ahorro, finanzas personales, economía, inversión y value investing
Inversión en valor para un ciclo de crecimiento. Una conversación con Iván Martín.

Value School | Ahorro, finanzas personales, economía, inversión y value investing

Play Episode Listen Later Oct 11, 2021 61:40


«El mundo está al principio de un nuevo ciclo de crecimiento económico sincronizado como no se ha visto en muchos años». Iván Martín    A lo largo de este encuentro Iván Martín repasará con nosotros el comportamiento que han tenido durante el último año los fondos que gestiona en Magallanes Value Investors y responderá a las preguntas de la comunidad de Value School.   Si te ha gustado el programa, déjanos un comentario y danos una valoración alta en la plataforma donde lo hayas escuchado. No olvides darte de alta en www.valueschool.es para obtener información sobre nuestras actividades y acceder a todo nuestro material gratuito. Recuerda que también puedes seguirnos en Facebook, Twitter, Instagram y en nuestro canal de YouTube. Muchas gracias por tu atención. (Música: "Corporate Innovative" by Scott Holmes). http://www.scottholmesmusic.com 

The Gary Null Show
The Gary Null Show - 10.11.21

The Gary Null Show

Play Episode Listen Later Oct 11, 2021 58:37


Can low temperature-aged garlic enhance exercise performance? Korea Univesity & National Institute of Agricultural Sciences (South Korea), October 8, 2021 Scientists from South Korea's National Institute of Agricultural Sciences and Korea University looked at aged garlic to see whether it could help reduce fatigue. To do this, they conducted a study on mice fed with a special low-temperature-aged garlic (LTAG). Their findings were published in the Journal of Medicinal Food. Testing the fatigue-fighting effects of low temperature-aged garlic The researchers chose to use LTAG because it lacked the pungent odor and spicy flavor of regular garlic, making it easier to use for animal testing. To create the LTAG, the researchers stored garlic in a sealed container, aging at 60 C for 60 days. The resulting LTAG was then peeled and pulverized, before being added to 200 milliliters of 70 percent ethanol (EtOH), which was then subjected to ultrasonic extraction three times. This 70 percent EtOH and LTAG extract was then concentrated under a vacuum at 45 C and then lyophilized to create a dry LTAG residue. After the creation of the LTAG, the researchers then separated mice into six groups. The first group was given a low dose of LTAG extract; the second was fed a high dose of LTAG extract; the third was given a low dose of garlic extract; and the fourth was given a high dose of garlic extract. The fifth and sixth groups consisted of normal mice that were given phosphate-buffered saline (PBS) instead of garlic. One of these control groups was made to exercise while the other group was not. The mice in the five groups were forced to run on a treadmill for four weeks. With each passing week, the amount of exercise the mice would have to do on the treadmills would increase. This was done by increasing both the speed that the mice had to run, and the amount of time they had to spend running. (Related: How to alleviate fatigue with herbal medicine.) After 28 days of treatment, five mice from each group were subjected to a final, exhaustive treadmill test. This test increased the treadmill speed from 15 meters per minute (m/min) to 40 m/min every 3 minutes. During this test, the running time was monitored until each mouse failed to follow the increase in speed on three consecutive occasions and lag occurred. At this point, the mouse's total running time was recorded. The effect of the LTAG on the levels of glucose, lactate dehydrogenase (LDH), free fatty acid (FFA) and lactate in the mice's blood. Following the final exercise, the mice were killed and blood samples were collected from them. In addition, the mice's gastrocnemius muscles were also isolated and frozen in liquid nitrogen for testing. LTAG treated mice demonstrated less fatigue Following the exhaustive running tests, the researchers found that the mice treated with LTAG extract were able to run for much longer than the control mice. Meanwhile, looking at the blood tests, they noted that the mice treated with LTAG extract exhibited lower levels of glucose, LDH, FFA and lactate. More importantly, the LTAG treated mice had increased amounts of glycogen and creatine kinase (CK) in their muscles. Glycogen storage is an important source of energy during exercise. It serves a central role in maintaining the body's glucose homeostasis by supplementing blood glucose. Because of this, glycogen is seen as an accurate marker for fatigue, with increased glycogel levels closely associated with improved endurance and anti-fatigue effects. CK, on the other hand, is known to be an accurate indicator of muscle damage. During muscle degeneration, muscle cells are dissolved and their contents enter the bloodstream. As a result, when muscle damage occurs, muscle CK comes out into the blood. As such, fatigue tends to lead to lower muscle CK levels and higher blood CK levels. Higher levels of glycogen and muscle CK in the LTAG treated mice indicated that they experienced less fatigue than the other groups. Based on these findings, the researchers believe that LTAG has potential for use as an anti-fatigue agent.       Mindfulness meditation helps preterm-born adolescents University of Geneva (Switzerland), October 7, 2021 Adolescents born prematurely present a high risk of developing executive, behavioral and socio-emotional difficulties. Now, researchers from Geneva University Hospitals (HUG) and the University of Geneva (UNIGE) have revealed that practicing mindfulness may help improve these various skills. The study, published in the journal Scientific Reports, suggests using mindfulness as a means of clinical intervention with adolescents, whether prematurely born or not. Several studies have already shown that very preterm (VPT) children and adolescents are at higher risk of exhibiting cognitive and socio-emotional problems that may persist into adulthood. To help them overcome the difficulties they face, researchers from the HUG and UNIGE have set up an intervention based on mindfulness, a technique known to have beneficial effects in these areas. Mindfulness consists in training the mind to focus on the present moment, concentrating on physical sensations, on breathing, on the weight of one's body, and even on one's feelings and thoughts, completely judgment-free. The mindfulness-based interventions generally take place in a group with an instructor along with invitations to practice individually at home. To accurately assess the effects of mindfulness, a randomized controlled trial was performed with young adolescents aged 10 to 14, born before 32 weeks gestational weeks. Scientists quickly found that mindfulness improves the regulation of cognitive, social and emotional functions, in other worlds, our brain's ability to interact with our environment. Indeed, it increases the ability to focus on the present—on thoughts, emotions and physical sensations, with curiosity and non-judgment. Thanks to this practice, adolescents improve their executive functions, i.e. the mental processes that enable us to control our behavior to successfully achieve a goal. As a result, young people find it easier to focus, manage and regulate their behavior and emotions in everyday life. For eight weeks, the young teens spent an hour and a half each week with two mindfulness instructors. They were further encouraged to practice mindfulness daily at home. Parents were also involved in this study. They were asked to observe their child's executive functions, for example the ability to regulate their emotions and attentional control, their relationships with others and their behavior. The adolescents also underwent a series of computerized tasks to assess their reactions to events. A comparison of their test results with a control group that did not practice mindfulness shows a positive impact of the intervention on the adolescents' everyday life and on their ability to react to new events. "Each teenager is unique, with their own strenghts and difficulties. Through their involvement in this study, our volunteers have contributed to show that mindfulness can help many young people to feel better, to refocus and to face the world, whether they were born preterm born or not," agree Dr. Russia Hà-Vinh Leuchter, a consultant in the Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics at Geneva University Hospitals, and Dr. Vanessa Siffredi, a researcher at the Child Development Laboratory at the Department of Paediatrics, Gynaecology and Obstetrics at the UNIGE Faculty of Medicine, two of the authors of this work. "However, while the practice of meditation can be a useful resource, it is important to be accompanied by well-trained instructors", they specify. The adolescents who took part in the program are now between 14 and 18 years. Scientists are currently evaluating the long-term effects of mindfulness-based intervention on their daily attention and stress. Furthermore, to validate their clinical data with neurobiological measurements, researchers are currently studying the effects of mindfulness on the brain using magnetic resonance imaging (MRI).   Iron deficiency in middle age is linked with higher risk of developing heart disease University Heart and Vasculature Centre Hamburg (Germany) 6 October 2021 Approximately 10% of new coronary heart disease cases occurring within a decade of middle age could be avoided by preventing iron deficiency, suggests a study published today in ESC Heart Failure, a journal of the European Society of Cardiology (ESC).1 “This was an observational study and we cannot conclude that iron deficiency causes heart disease,” said study author Dr. Benedikt Schrage of the University Heart and Vasculature Centre Hamburg, Germany. “However, evidence is growing that there is a link and these findings provide the basis for further research to confirm the results.” Previous studies have shown that in patients with cardiovascular diseases such as heart failure, iron deficiency was linked to worse outcomes including hospitalisations and death. Treatment with intravenous iron improved symptoms, functional capacity, and quality of life in patients with heart failure and iron deficiency enrolled in the FAIR-HF trial.2 Based on these results, the FAIR-HF 2 trial is investigating the impact of intravenous iron supplementation on the risk of death in patients with heart failure. The current study aimed to examine whether the association between iron deficiency and outcomes was also observed in the general population. The study included 12,164 individuals from three European population-based cohorts. The median age was 59 years and 55% were women. During the baseline study visit, cardiovascular risk factors and comorbidities such as smoking, obesity, diabetes and cholesterol were assessed via a thorough clinical assessment including blood samples. Participants were classified as iron deficient or not according to two definitions: 1) absolute iron deficiency, which only includes stored iron (ferritin); and 2) functional iron deficiency, which includes iron in storage (ferritin) and iron in circulation for use by the body (transferrin). Dr. Schrage explained: “Absolute iron deficiency is the traditional way of assessing iron status but it misses circulating iron. The functional definition is more accurate as it includes both measures and picks up those with sufficient stores but not enough in circulation for the body to work properly.” Participants were followed up for incident coronary heart disease and stroke, death due to cardiovascular disease, and all-cause death. The researchers analysed the association between iron deficiency and incident coronary heart disease, stroke, cardiovascular mortality, and all-cause mortality after adjustments for age, sex, smoking, cholesterol, blood pressure, diabetes, body mass index, and inflammation. Participants with a history of coronary heart disease or stroke at baseline were excluded from the incident disease analyses. At baseline, 60% of participants had absolute iron deficiency and 64% had functional iron deficiency. During a median follow-up of 13.3 years there were 2,212 (18.2%) deaths. Of these, a total of 573 individuals (4.7%) died from a cardiovascular cause. Incidence coronary heart disease and stroke were diagnosed in 1,033 (8.5%) and 766 (6.3%) participants, respectively. Functional iron deficiency was associated with a 24% higher risk of coronary heart disease, 26% raised risk of cardiovascular mortality, and 12% increased risk of all-cause mortality compared with no functional iron deficiency. Absolute iron deficiency was associated with a 20% raised risk of coronary heart disease compared with no absolute iron deficiency, but was not linked with mortality. There were no associations between iron status and incident stroke. The researchers calculated the population attributable fraction, which estimates the proportion of events in 10 years that would have been avoided if all individuals had the risk of those without iron deficiency at baseline. The models were adjusted for age, sex, smoking, cholesterol, blood pressure, diabetes, body mass index, and inflammation. Within a 10-year period, 5.4% of all deaths, 11.7% of cardiovascular deaths, and 10.7% of new coronary heart disease diagnoses were attributable to functional iron deficiency. “This analysis suggests that if iron deficiency had been absent at baseline, about 5% of deaths, 12% of cardiovascular deaths, and 11% of new coronary heart disease diagnoses would not have occurred in the following decade,” said Dr. Schrage. “The study showed that iron deficiency was highly prevalent in this middle-aged population, with nearly two-thirds having functional iron deficiency,” said Dr. Schrage. “These individuals were more likely to develop heart disease and were also more likely to die during the next 13 years.” Dr. Schrage noted that future studies should examine these associations in younger and non-European cohorts. He said: “If the relationships are confirmed, the next step would be a randomised trial investigating the effect of treating iron deficiency in the general population.”     Consumption of a bioactive compound from Neem plant could significantly suppress development of prostate cancer National University of Singapore, September 29, 2021   Oral administration of nimbolide, over 12 weeks shows reduction of prostate tumor size by up to 70 per cent and decrease in tumor metastasis by up to 50 per cent   A team of international researchers led by Associate Professor Gautam Sethi from the Department of Pharmacology at the Yong Loo Lin School of Medicine at the National University of Singapore (NUS) has found that nimbolide, a bioactive terpenoid compound derived from Azadirachta indica or more commonly known as the neem plant, could reduce the size of prostate tumor by up to 70 per cent and suppress its spread or metastasis by half.   Prostate cancer is one of the most commonly diagnosed cancers worldwide. However, currently available therapies for metastatic prostate cancer are only marginally effective. Hence, there is a need for more novel treatment alternatives and options.   "Although the diverse anti-cancer effects of nimbolide have been reported in different cancer types, its potential effects on prostate cancer initiation and progression have not been demonstrated in scientific studies. In this research, we have demonstrated that nimbolide can inhibit tumor cell viability -- a cellular process that directly affects the ability of a cell to proliferate, grow, divide, or repair damaged cell components -- and induce programmed cell death in prostate cancer cells," said Assoc Prof Sethi.   Nimbolide: promising effects on prostate cancer   Cell invasion and migration are key steps during tumor metastasis. The NUS-led study revealed that nimbolide can significantly suppress cell invasion and migration of prostate cancer cells, suggesting its ability to reduce tumor metastasis. The researchers observed that upon the 12 weeks of administering nimbolide, the size of prostate cancer tumor was reduced by as much as 70 per cent and its metastasis decreased by about 50 per cent, without exhibiting any significant adverse effects.   "This is possible because a direct target of nimbolide in prostate cancer is glutathione reductase, an enzyme which is responsible for maintaining the antioxidant system that regulates the STAT3 gene in the body. The activation of the STAT3 gene has been reported to contribute to prostate tumor growth and metastasis," explained Assoc Prof Sethi. "We have found that nimbolide can substantially inhibit STAT3 activation and thereby abrogating the growth and metastasis of prostate tumor," he added.   The findings of the study were published in the April 2016 issue of the scientific journal Antioxidants & Redox Signaling. This work was carried out in collaboration with Professor Goh Boon Cher of Cancer Science Institute of Singapore at NUS, Professor Hui Kam Man of National Cancer Centre Singapore and Professor Ahn Kwang Seok of Kyung Hee University.   The neem plant belongs to the mahogany tree family that is originally native to India and the Indian sub-continent. It has been part of traditional Asian medicine for centuries and is typically used in Indian Ayurvedic medicine. Today, neem leaves and bark have been incorporated into many personal care products such as soaps, toothpaste, skincare and even dietary supplements.       Review looks at the efficacy of acupuncture in treating insulin resistance Guangzhou University of Chinese Medicine (China), October 8, 2021 In their report, researcherss from Guangzhou University of Chinese Medicine in China explored the role of acupuncture in treating insulin resistance. The study was published in the journal Complementary Therapies in Clinical Practice. Earlier studies have reported the effectiveness of acupuncture in treating insulin resistance and related conditions. The review looked at acupuncture and its effects on clinical outcomes. The researchers searched the following databases for randomized controlled trials involving insulin resistance patients treated with acupuncture: Cochrane Central Register of Controlled Trials Embase Medline (via OVID) China National Knowledge Infrastructure (CNKI) Wan Fang and China Science and Technology Journal Database (VIP) The studies show that homeostasis model assessment of insulin resistance significantly decreased with acupuncture treatment. Other significant decreases include fasting blood glucose, postprandial blood glucose and fasting insulin. Acupuncture increased insulin sensitivity with very few adverse effects. In sum, acupuncture is a safe and effective alternative treatment for insulin resistance.     Blueberries may improve attention in children following double-blind trial University of Reading (UK), October 10, 2021  Primary school children could show better attention by consuming flavonoid-rich blueberries, following a study conducted by the University of Reading. In a paper published in Food & Function, a group of 7-10 year olds who consumed a drink containing wild blueberries or a matched placebo and were tested on their speed and accuracy in completing an executive task function on a computer. The double blind trial found that the children who consumed the flavonoid-rich blueberry drink had 9% quicker reaction times on the test without any sacrifice of accuracy. In particular, the effect was more noticeable as the tests got harder. Professor Claire Williams, a neuroscience professor at the University of Reading said: "This is the first time that we have seen the positive impact that flavonoids can have on the executive function of children. We designed this double blind trial especially to test how flavonoids would impact on attention in young people as it's an area of cognitive performance that hasn't been measured before. "We used wild blueberries as they are rich in flavonoids, which are compounds found naturally in foods such as fruits and their juices, vegetables and tea. They have been associated with a range of health benefits including antioxidant and anti-inflammatory effects, and our latest findings continue to show that there is a beneficial cognitive effect of consuming fruit and vegetables, tea, coffee and even dark chocolate which all contain flavonoids." The children were then asked to pay attention to an array of arrows shown on a PC screen and press a key corresponding to the direction that the central arrow was facing. The task was repeated over a number of trials, where cognitive demand was manipulated by varying how quickly the arrows appeared, whether there were additional arrows appearing either side of the central arrow, and whether the flanking arrows were pointing in the same/different direction as the central arrow. Previous Reading research has shown that consuming wild blueberries can improve mood in children and young people, simple memory recall in primary school children, and that other flavonoid rich drinks such as orange juice, can also improve memory and concentration. The Wild Blueberry Association of North America provided a freeze-dried powder made from wild blueberries which was used in the study but did not provide any additional financial support and did not play a role in the design of the study. Wild blueberries are grown and harvested in North America, and are smaller than regular blueberries, and are higher in flavonoids compared to regular varieties. The double-blind trial used a flavonoid-rich wild blueberry drink, with a matched placebo contained 8.9g of fructose, 7.99g of glucose and 4 mg of vitamin C matching the levels of nutrients found in the blueberry drink. The amount of fructose is akin to levels found in a standard pear. This was an executive function task- requiring participants to pay attention to stimuli appearing on screen and responding correctly. The task was a simple one- responding to the direction of an arrow in the middle of a screen (by pressing left/right arrow key) but we then varied how quickly the stimuli appeared, whether there was additional arrows appearing either side of the stimuli and whether those flanking arrows were pointing in the same/different direction as they direction you had to respond. There are 6 main classes of flavonoids: Anthocyanins – found in berry fruits such as the blueberries used in this study and also in red wine. Flavonols - found in onions, leeks, and broccoli Flavones - found in parsley and celery, Isoflavones - found in soy and soy products, Flavanones - found in citrus fruit and tomatoes Flavanols—found in green tea, red wine, and chocolate     Nocebo effect: Does a drug's high price tag cause its own side effects? University Medical Center Hamburg (Germany), October 5, 2021  Pricey drugs may make people more vulnerable to perceiving side effects, a new study suggests—and the phenomenon is not just "in their heads." The study delved into the so-called "nocebo effect." It's the negative version of the well-known placebo effect, where people feel better after receiving a therapy because they expected good things. With the nocebo effect, patients' worries over treatment side effects make them feel sick. In this study, researchers found that people were more likely to report painful side effects from a fake drug when told it was expensive. But it wasn't just something people were "making up." Using brain imaging, the researchers traced the phenomenon to specific activity patterns in the brain and spine. "These findings are a strong argument against the perception of placebo and nocebo effects as being only 'fake' effects—created purely by imagination or delusions of the patient," said lead researcher Alexandra Tinnermann. She is with the University Medical Center Hamburg-Eppendorf, in Germany. Dr. Luana Colloca, a researcher at the University of Maryland in Baltimore, agreed. "This is not merely a reflection of people's biases," said Colloca, who wrote an editorial published with the study. "Expectations do modulate symptoms and patients' responses to treatment," she said. For the study, Tinnermann's team recruited 49 healthy volunteers and randomly assigned them to test one of two itch-relieving "medical creams." In reality, both creams were identical and contained no active ingredients. However, people in both groups were told that the products could have the side effect of making the skin more sensitive to pain. There was only one apparent difference between the two phony creams: One came in fancy packing with a high price tag; the other was cheap. After participants applied the creams to their forearms, the researchers had them undergo a standard test that measured their tolerance for heat-induced pain. It turned out that people who'd used the expensive cream were more sensitive to pain during the tests. On average, their pain rating hovered around a 15—within the "mild" pain range—whereas people using the cheap cream barely registered any discomfort. It's likely, Tinnermann said, that people expect a pricey medication to be potent—which could also make them expect more side effects. Colloca agreed. We are all "vulnerable" to such outside influences, she said, be it a drug's price or how it's given (by IV versus mouth, for instance). However, we are not just imagining those placebo or nocebo effects, both researchers noted. Using functional MRI brain scans, Tinnermann's team found specific patterns of nervous system activity in people who had a nocebo response to the pricey cream. That included a change in "communication" between certain brain structures and the spinal cord, Tinnermann said. According to Colloca, research like this can have practical uses. Doctors could, for instance, inform patients that drug prices or other factors can sway their expectations about a treatment's benefits and risks—and that, in turn, can influence whether they feel better or develop side effects. There is, however, no research into whether that kind of knowledge helps prevent patients from the nocebo effect, Tinnermann said. But, she added, health professionals can be aware that patients' expectations "play a huge role in medicine"—and be mindful of how they talk about a medication and its possible side effects. It's an important matter, Colloca said, because the nocebo effect can cause people to stop taking needed medications. Colloca pointed to the example of cholesterol-lowering statins. The potential for those medications to cause muscle pain has been widely reported. And one recent study found evidence that this knowledge can make statin users more likely to report muscle pain side effects. Other research, Colloca said, has shown that when people stop taking their statins, their risk of heart attack and stroke rises.

ProspectiveDoctor's MCAT Basics
Electron Transport Chain

ProspectiveDoctor's MCAT Basics

Play Episode Listen Later Oct 11, 2021 37:54


This MCAT Basics Podcast continues its series on metabolism, and in today's episode, Alex Starks talks about the Electron Transport Chain and ATP synthesis. The story continues with a look at how electrons flow through complexes I,II,III, and IV, as well as how it is coupled to the synthesis of ATP. Everything you need to know about this stage of metabolism is made clear and easy to understand so you can ace any metabolism question on the AAMC MCAT Exam. [03:10] The Purpose of the Electron Transport Chain [07:24] What is NADH Dehydrogenase [11:32] Coenzyme Q in the Electron Transport Chain [18:31] Why Oxygen is Called the Terminal Electron Acceptor [20:33] The Proton Motive Force [27:10] The Effects of Breaking the Electron Transport Chain [30:14] DNP: The "Miracle Weight-Loss Drug" [34:30] Fatty Acid Metabolism [34:58] Quiz and Important Takeaways Full show notes

Saving Lives: Critical Care w/eddyjoemd
Peripheral Intravenous (IV) vs. Intraosseous (IO) Access in Cardiac Arrest in < 1 minute (Journal Club-ish)

Saving Lives: Critical Care w/eddyjoemd

Play Episode Listen Later Oct 10, 2021 0:58


Cardiac arrest with no IV access: Should we place a peripheral IV or place an intraosseous (IO) access? Let's examine the data. #shorts Show Notes: https://eddyjoemd.com/io-or-iv Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom. Website: www.eddyjoemd.com Instagram: www.instagram.com/eddyjoemd Twitter: www.twitter.com/eddyjoemd Facebook: www.facebook.com/eddyjoemd Podcast: https://anchor.fm/eddyjoemd My Amazon store for resources you may find helpful: www.amazon.com/shop/eddyjoemd Citation: Schwalbach KT, Yong SS, Chad Wade R, Barney J. Impact of intraosseous versus intravenous resuscitation during in-hospital cardiac arrest: A retrospective study. Resuscitation. 2021 Sep;166:7-13. doi: 10.1016/j.resuscitation.2021.07.005. Epub 2021 Jul 14. PMID: 34273470. --- Support this podcast: https://anchor.fm/eddyjoemd/support

Por fin no es lunes
Gobernantes en la sombra: De Rasputín a Iván Redondo

Por fin no es lunes

Play Episode Listen Later Oct 9, 2021 10:07


Después de su entrevista en 'Lo de Évole', no queda muy claro si Iván Redondo era el presidente en la sombra de Pedro Sánchez como se decía. Por eso, en la Cápsula del Tiempo de Por fin no es lunes, recordamos algunos de los personajes históricos que llegaron a mandar que sus propios reyes o presidentes.

Moods & Modes
PAT METHENY PART 2

Moods & Modes

Play Episode Listen Later Oct 8, 2021 70:05


In part 2 of Alex's conversation with Pat Metheny, the two discuss some of Metheny's unconventional work, his association with musicians like Jaco Pastorius and Joni Mitchell, the evolution of his synthesizer sound, and why he thinks in visual terms. Pat shares his daily routine, what he does to keep learning after each gig, and explains the natural curiosity that keeps him going. Unlike almost any other modern musician, Pat Metheny remains uniquely unpredictable. His versatility is nearly without peer on any instrument. Metheny has won countless awards, including three gold records for Still Life (Talking), Letter from Home, and Secret Story. He has been nominated for 37 Grammy awards and is the winner of 20; he has also been nominated in 13 different Grammy categories, winning in 10 of them. His new album, SIDE-EYE NYC (V1.IV), an exciting, vibrant and energized new platform for Metheny, is available now.You can read the blog post that Alex references in the episode - "Art Imitating Music" - here, and listen to music from the episode on Spotify.Moods & Modes is presented by Osiris Media. Hosted and Produced by Alex Skolnick. Osiris Production by Kirsten Cluthe and Brad Stratton. Editing and mixing by Justin Thomas (Revoice Media). Music by Alex Skolnick. Artwork by Mark Dowd. To discover more podcasts that help you connect more deeply to the music you love, check out osirispod.com. If you like what you hear, please give us a rate and review on Apple Podcasts. See acast.com/privacy for privacy and opt-out information.

Cardionerds
153. Case Report: Ur-Ine for a Treat – A Case of Diuretic Resistance – The Johns Hopkins Hospital

Cardionerds

Play Episode Listen Later Oct 8, 2021 62:54


CardioNerds (Amit Goyal and Daniel Ambinder), join Dr. Anjali Wagle (Internal medicine resident, Johns Hopkins Hospital) and Dr. Nick Smith (Cardiology fellow, Johns Hopkins Hospital) for an important discussion involving a patient with non-ischemic dilated cardiomyopathy and biventricular heart failure who had developed diuretic resistance. They discuss the role for invasive hemodynamic assessment of volume overload, initial strategies in managing a patient with volume overload, the role of guideline directed therapy in the management of patients with recurrent volume overload, and advanced strategies for diuretic resistance. Dr. Nisha Gilotra (Director of the Cardiac Sarcoidosis Program and assistant professor of medicine, Johns Hopkins Hospital) provides the E-CPR for this episode. Audio editing and Approach to Diuretic Resistance infographic by Dr. Gurleen Kaur (Director of the CardioNerds Internship). This episode is made possible with support from Panacea Financial. Panacea Financial is a national digital bank built for doctors by doctors. Visit panaceafinancial.com today to open your free account and join the growing community of physicians nationwide who expect more from their bank. Panacea Financial is a division of Primis, member FDIC. Claim free CME just for enjoying this episode! Disclosures: NoneJump to: Patient summary - Case teaching - References CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Patient Summary - Diuretic Resistance A young woman in her 20s with non-ischemic dilated cardiomyopathy and NYHA class IV ACC stage D biventricular heart failure with an LV ejection fraction of 30-35% on palliative inotropic therapy complicated by cardiogenic cirrhosis and stage IIIb chronic kidney disease presented with acute decompensated heart failure with volume overload. During her hospitalization she exhibited profound signs of diuretic resistance with minimal improvement after increasing inotropes, increasing IV loop diuretics, adding IV thiazides, and trialing continuous IV furosemide. She was given high dose mineralocorticoids, IV acetazolamide, and hypertonic saline paired with IV furosemide and had a durable treatment response. Episode Teaching - Diuretic Resistance Pearls - Diuretic Resistance Diuretic resistance is a complex clinical problem defined as inadequate natriuresis despite an adequate diuretic regimen. However, the practitioner cannot overlook low output heart failure and/or insufficient renal perfusion as the causes for inadequate diuretic response. In cases of inadequate urine output due to low cardiac output, increased inotropic or mechanical support would be the first objective.Confirming adequate cardiac output to support renal perfusion and/or confirming high filling pressures may require invasive hemodynamic assessment.Sodium avidity is most effectively blunted by treating the patient with maximally tolerated guideline directed therapy. This includes but is not limited to a backbone of ARNI (or ACE or ARB), mineralocorticoid receptor antagonists, beta-blockers, and SGLT-2 inhibitors.In cases of advanced diuretic resistance, hypertonic saline paired with high dose IV furosemide can be an effective strategy.In cases of diuretic resistance combined with cirrhosis and heart failure there is a synergistic hyperaldosteronism that can be targeted with higher doses of mineralocorticoid receptors as is seen in the treatment of cirrhosis with ascites. Notes - Diuretic Resistance 1. What is the role for invasive hemodynamic assessment in acute decompensated heart failure? Cases where intracardiac filling pressures are in question: right heart catheterization (RHC) can give insight into the presence and degree of right versus left sided filling pressures.

Global Tennessee
TNWAC Conversation with Colombian Ambassador Pinzón | Oct 7

Global Tennessee

Play Episode Listen Later Oct 8, 2021 43:31


On October 7, 2021, TNWAC President Patrick Ryan talked with Ambassador of Colombia to the United States Juan Carlos Pinzón in Nashville for the Global Dialogue + Webinar/"Global Tennessee" series Podcast, about: U.S.-Colombian relations, regional issues, developments in Colombia, commercial relations with the U.S. and Tennessee, and the people to people connections between the countries. Join the Tennessee World Affairs Council (TNWAC.org/join) and support with your gift (TNWAC.org/donate) to ensure these quality programs continue. Thanks! Ambassador Juan Carlos Pinzón On July 26, 2021, President Iván Duque swore in Juan Carlos Pinzón as Ambassador of Colombia to the United States. ​Pinzón previously served as Colombia's Ambassador to Washington from 2015 to 2017. During his tenure, he oversaw the approval of “Peace Colombia or Plan Colombia II” ($450 million per year) that increased the U.S. funding package for security and development. Additionally, he helped establish the “CEO U.S.-Colombia Business Council” at the U.S. Chamber of Commerce and the Atlantic Council's "Colombia Task Force" with the report on the future of the U.S.-Colombia relationship. The accession of the avocado Hass to the U.S. market was an important highlight. While in office, the Colombian Embassy was recognized as the best diplomatic delegation in Washington by the World Affairs Council in Washington, DC. Prior to that, Ambassador Pinzón served as Minister of Defense of Colombia for nearly four years. Under his leadership, the Colombian Armed Forces dealt the most severe blows in history to terrorist organizations – FARC and ELN – and Criminal Bands, highly degrading their logistics, structure and leadership. Pinzón also strengthened all capabilities of the Colombian armed forces and established Colombia as a regional cooperation leader. By the end of his period, he left the Armed Forces at its historical peak in manpower, capabilities, welfare, technology and budget. ​ Throughout his career, Pinzón has been a leader in both the public and private sectors. Between 2018 and 2021, Pinzón was appointed President of the Foundation for the Progress of the Capital Region – ProBogotá, a private non-profit for the promotion of common good, public policy and long-term strategic projects for the capital region of Colombia. He is currently a member of several corporate advisory boards and NGOs. In July 2017, Ambassador Pinzón launched a bid for president with the support of the civic citizens' movement “Colombia Above All.” In March 2018, he became vice presidential candidate. ​ Additional previous positions include Chief of Staff to the President of Colombia; Deputy Minister of Defense; Senior Advisor to the Executive Director at the Board of the World Bank; Vice President of the Colombian Banking Association; Assistant Vice President of Investment Banking at Citigroup; Private Secretary and Chief of Staff for the Finance and Public Credit Ministry; and Economist for Colombia at Citigroup. Pinzón received an honorable mention for his outstanding academic performance while earning his Bachelor of Science degree in Economics from the Pontificia Universidad Javeriana in Bogotá. He also holds three Master degrees. A Master of Science in Economics from the Pontificia Universidad Javeriana. A Master in Public Policy from Princeton University (scholarship awarded). And a Master's degree (honoris causa) in Defense and National Security from Colombia's National War College. Pinzón also completed advanced courses in international relations and strategic studies at Johns Hopkins University, in science and technology policy at Harvard University, and smart cities at Nanyang Technological University-Singapore. Ambassador Pinzón was born in Bogotá on December 22, 1971. He is married to Pilar Lozano and has two children, Natalia and Juan Pablo.

Blunt Force Truth
Carona Fascism - An Interview with Alu Axelman

Blunt Force Truth

Play Episode Listen Later Oct 7, 2021 66:07


Today's show rundown: Chuck has heard all the back and forth with the Build Back Better...this is what we are up against - everyone who is lying to you, is claiming that you are lying. Has the MS Media re-defined the word lie? The Corona Virus bill for instance...10% of this bill is for Corona and true, but 90% of that bill is NOT about Corona, and a lie, how can this be? The perfect lie...just enough to "Billboard" the bill, 10%...but 90% is what they are really trying to do. Mark talks about Satan and lying...the Devil is most dangerous when he is the Angel of Light. Real lies have a little bit of truth in the lie, a little nugget. Biden has completely abandoned this...he is willing to look right into the camera and lie without ANY NUGGET of truth at all. Biden Twitter account - if he is posting these himself, he not only has dementia, but he has schizophrenia. Biden says Republicans are playing some dangerous game of chicken NOT supporting raising the debt limit. Government is just trying to make government larger by stripping private rights, and taking more control. We get to meet our guest today All Axelman. Mark introduces the book that All has written. We get Alu's thoughts on the government using the CDC as a tool to do whatever they want. If we allow the government the ability to take away all of our freedoms based on the word "Health" they are going to do the same thing again...global warming, gun violent, racism - these will be the NEXT Epidemics. ABOUT ALU AXELMAN Elliot “Alu” Axelman lives with his wonderful wife, Kate in southern New Hampshire. Though raised as a conservative, Alu became increasingly libertarian as he learned more about how government operates. As he became more involved in political analysis via his writing, podcasts, videos, and activism, Alu evolved into a voluntaryist – which means that he totally rejects the use of force against peaceful people, even by government agents. Outside of his full-time job (emergency medicine) and his full-time labor of love (supporting freedom), Alu enjoys power-lifting, boxing, BJJ, traveling, teaching, and recently began trying his hand at piano and saxophone. Professionally, Alu is a critical-care and flight certified paramedic, which is the highest level of certification that a pre-hospital medical provider could attain. He has worked in emergency medical services since 2011 and is a Field Training Officer and adjunct instructor for all levels of EMS students. Alu's experience includes service to a multitude of municipalities as the primary 911 ALS response ambulance, and service to a multitude of hospital systems as an inter-facility specialty care paramedic, often utilizing ventilators, IV pumps, advanced airways, and managing cardiac arrests. About the Guest's book: https://www.amazon.com/Corona-Fascism-Politicians-Eliminate-Themselves-Libertys/dp/1948035073/ref=sr_1_1?dchild=1&keywords=corona+fascism&qid=1633446818&sr=8-1 ABOUT CORONA-FASCISM How dangerous is the coronavirus really? How contagious is it? How have total death rates not increased if the virus is the deadliest disturbance in the history of humanity? Sociopaths in Washington DC and their cronies in the ‘private' sector, seized the opportunity that COVID presented and used that narrative to support their mission and accelerate their goals: destroy our freedom, eliminate our privacy, and enrich themselves and their allies. This book uses data and logical reasoning to destroy the mainstream talking points that cultivated the age of perpetual paranoia and the widespread acceptance of corona-fascism. https://worldmission.cc/donate-humanitarianoutreach/ https://libertyblock.com/ Give H2Max a try and let us know what you think: buyh2max.com Help...

Técnica Fórmula 1 · Podcast de F1
Episodio 472 · La previa al GP de Turquía

Técnica Fórmula 1 · Podcast de F1

Play Episode Listen Later Oct 6, 2021 50:29


Después de una semana de descanso, este fin de semana vuelve la F1 y lo hace en una pista, la de Estambul, que a los chicos del Podcast Técnica Fórmula 1 les gusta bastante. El año pasado ya hubo carrera en esa pista y demostró ser bastante deslizante, un defecto que seguramente haya sido corregido, al menos en parte para este año. Además, el fin de semana promete ser de lo más entretenido con la espectacular y reñida pelea entre Hamilton y Verstappen. ¿Aguantará el motor de Hamilton? Esa es otra cuestión que pone, si cabe, más emoción al asunto. En esta ocasión, Raúl Molina, Iván Fernández, John René Montes y Abel (que no está en directo pero ha podido aportar su granito de arena) harán una buena previa al Gran Premio, antes de pasar, en el segundo programa de la semana, a analizar el Rally de Finlandia. Turquía vuelve como sustituto a Singapur. Para el GP de Turquía, que se agregó al calendario este año para reemplazar a Singapur, Pirelli ha seleccionado los tres neumáticos de la zona media de la gama. Una decisión que es un paso más blanda que la del año pasado. Eso sí, el año pasado la carrera se celebró en noviembre (después de una ausencia de 9 años en el calendario de competición de la F1). La decisión de pasar a un nivel más bajo de dureza se debe a los datos obtenidos el año pasado, con una pista con niveles medios de abrasión y bajo agarre, que dejó una superficie extremadamente resbaladiza y que, sin embargo, mostró una rápida evolución. La pista había sido completamente reasfaltada justo antes del GP del año pasado y es probable que el asfalto haya mejorado un poco, por no hablar de que, además, se ha limpiado por completo con un chorro de agua a alta presión. Así que este año los pilotos deberían beneficiarse de un mejor agarre como consecuencia de todo lo anteriormente comentado: neumáticos más blandos, mayor rugosidad del asfalto y temperaturas más altas que las del año pasado, debido a las fechas. La curva más conocida en la pista, el Istanbul Park, es la curva 8, descrita como una de las grandes curvas de la F1. Es muy larga - el 12% de la vuelta completa - y se toma a alta velocidad. Además, es una curva de varios vértices que colocan fuerzas superiores a los 5G en los coches y los neumáticos. Pero hay otras curvas que también son exigentes con los neumáticos, como la curva 1 que se abordan con un descenso significativo antes de dirigirse hacia arriba. También la recta trasera contiene una curva cuesta arriba que se apoda “Faux Rouge”, en homenaje a Spa. En realidad todo el trazado de la pista aprovecha al máximo la elevación natural de la zona. En resumen, Turquía es una pista difícil para los neumáticos y los coches funcionan con gran carga aerodinámica, para ayudar a empujar a las gomas hacia el suelo. Y el clima será una incógnita: el año pasado el fin de semana fue pasado por agua, como lo fue la carrera donde Hamilton consiguió la victoria con una estrategia a una parada (lluvia extrema a intermedios en la vuelta 8) y también su séptimo campeonato. Un circuito muy técnico. Según los técnicos de Brembo, el Intercity Istanbul Park es un circuito de dificultad media para los frenos (3 sobre 5 en el índice de dificultad). Es muy técnico y tiene numerosos cambios de pendiente, lo que conlleva riesgos en los adelantamientos al entrar en la curva cuesta abajo o frenar demasiado fuerte en las curvas cuesta arriba. Los frenos son usados un 17% de la vuelta, el mismo porcentaje que en dos de los circuitos anteriores: Sochi y Zandvoort. Debido a la falta de rectas largas, la primera parte de la pista yurca no presenta mucha frenada. La segunda parte, al ser más retorcida, presenta tres secciones de frenado de menos de 4G que ponen a prueba a pilotos y sistemas. De las 9 zonas de frenado del GP de Turquía, sólo una se considera muy exigente con los frenos, tres son de dificultad media y cinco son ligeras. La más dura para el sistema de frenado es la curva 12, cuando los coches pasan de 313 km/h a 92 km/h en 125m. Horario de sesiones y de carrera. En la España con horario peninsular podremos ver el viernes las dos primeras sesiones de entrenamientos libres, a las 10:30 y a las 14:00h. El sábado veremos la segunda sesión de entrenamientos a las 11:00h, y la clasificación a las 14:00h. El domingo veremos la salida de la carrera a las 14:00h. Escucha el episodio completo en la app de iVoox, o descubre todo el catálogo de iVoox Originals

En Casa de Herrero
Las noticias de Herrero: La temporada de gripe llegará antes y puede ser más agresiva

En Casa de Herrero

Play Episode Listen Later Oct 6, 2021 23:00


Luis Herrero entrevista a Iván Sanz Muñoz, responsable científico del Centro Nacional de Gripe de Valladolid.

Es la Mañana de Federico
Federico Jiménez Losantos entrevista a Iván Espinosa de los Monteros

Es la Mañana de Federico

Play Episode Listen Later Oct 6, 2021 40:35


Federico entrevista al portavoz de Vox en el Congreso de los Diputados, Iván Espinosa de los Monteros.

The tastytrade network
Market Measures - October 5, 2021 - Is BPR Still the Worst Case Estimator?

The tastytrade network

Play Episode Listen Later Oct 5, 2021 10:14


In 2019, tastytrade studied the effectiveness of a short strangle's buying power reduction as an estimator for worst case loss. The reason for this conclusion is that before 2020, there was never a loss on a 16∆ strangle in SPY that exceeded the initial BPR, including 2008. Did the move in 2020 change this conclusion? In 2020, we saw three occurrences where the loss on a 16∆ SPY strangle exceeded the initial BPR. Note that individual stocks can experience different outcomes. In higher IV environments, the worst loss as % of BPR including 2020 was 75%. Going forward, the BPR still remains an estimator of the worst case scenario on an undefined risk trade.

The tastytrade network
Market Measures - October 5, 2021 - Is BPR Still the Worst Case Estimator?

The tastytrade network

Play Episode Listen Later Oct 5, 2021 9:24


In 2019, tastytrade studied the effectiveness of a short strangle's buying power reduction as an estimator for worst case loss. The reason for this conclusion is that before 2020, there was never a loss on a 16∆ strangle in SPY that exceeded the initial BPR, including 2008. Did the move in 2020 change this conclusion? In 2020, we saw three occurrences where the loss on a 16∆ SPY strangle exceeded the initial BPR. Note that individual stocks can experience different outcomes. In higher IV environments, the worst loss as % of BPR including 2020 was 75%. Going forward, the BPR still remains an estimator of the worst case scenario on an undefined risk trade.

La Hora de la Verdad
Entrevista a Iván Cancino

La Hora de la Verdad

Play Episode Listen Later Oct 5, 2021 9:08


El equipo de La Hora de la Verdad entrevista a Iván Cancino.

The Entrepology Podcast
241: Body: Become the Healthiest Version of Yourself Through Biohacking, Peptide Therapy, and Nootropics with Dr. Amber Krogsrud, ND

The Entrepology Podcast

Play Episode Listen Later Oct 5, 2021 41:51


I am super excited about today's subject matter because it is the ultimate manifestation of what entrepology is all about! My guest today, Dr. Amber Krogsrud, truly hangs out in the intersection of mindset, health, and entrepreneurship — which is what entrepology is all about!   Dr. Amber Krogsrud is a Naturopathic Doctor practicing in California. She is trained in regenerative medicine and something super cool called “peptide therapy.” If you haven't heard of peptide therapy already… you're in for a real treat this episode! We're going to be talking all things peptide therapy, biohacking, nootropics, entrepreneurship, and how to get ourselves (as high-performing women) responding and activating physiologically so that we can be our best possible selves every. Single. Day!   I know that you are absolutely going to love this conversation with Amber and I cannot wait for you all to tune in!   Key Takeaways: [1:29] About today's episode with Dr. Amber Krogsrud. [2:50] Welcoming Dr. Amber Krogsrud to the podcast! [3:15] Dr. Amber shares about who she is and how she got into naturopathic medicine. [6:20] Amber speaks about the busy women that she works with and the common elements she has noticed manifesting for many of them. [8:56] If estrogen is balanced, does cortisol become less of an issue for women? [10:04] Amber's recommendations on how we can begin to clear out unnecessary baggage and weight that is causing additional physiological stress on the body. [13:37] In Amber's practice, she leverages a therapeutic intervention called peptide therapy. She explains what it is and how she uses it. [16:15] Amber describes the different ways to experience peptide therapy. [18:23] How Amber would deploy peptides for those in a state of anxiety and overwhelm. [19:25] Why is peptide therapy not as common of a choice for practitioners? [20:13] How peptide therapy would fit into an overall picture of therapy and support. [23:52] Amber shares what the trajectory of care looks like once you begin peptide therapy. [25:18] How Amber, as a busy entrepreneur, supports herself physiologically to stay at her prime! [29:35] About Amber's business and her journey to how she's gotten to where she is today. [33:05] Dr. Amber's KPIs! [38:40] Where to connect with Dr. Amber and her work online! [39:35] Thanking Dr. Amber for joining the podcast! [39:44] Have you been finding value in The Entrepology Podcast? We'd love to read your five-star review over on Apple Podcasts!   Mentioned in This Episode: Dr. Amber Krogsrud Becoming Supernatural: How Common People Are Doing the Uncommon, by Dr. Joe Dispenza A Happy Pocket Full of Money, Expanded Study Edition: Infinite Wealth and Abundance in the Here and Now, by David Cameron Gikandi   More About Dr. Amber Krogsrud Dr. Amber is a Licensed Naturopathic Doctor at My Bright Wellness and Medical Director for KIYA Longevity and resides in Los Angeles, CA. She is trained in regenerative medicine, detoxification protocols, hormone testing and treatment, bioidentical hormone therapy, peptide therapy, and IV nutrient therapy. She also has a practice in Redondo Beach, CA where she specializes in bioidentical hormones and peptide therapy. Dr. Amber is a member of the International Peptide Society (IPS) and has completed peptide therapy certification training through the American Academy of Anti-aging (A4M).   Connect with my Guest: Websites: DrAmberND.com & PeptidePlaybook.com Social Media: Facebook, Instagram, Twitter & YouTube   If you enjoyed our conversation and would like to hear more: Please subscribe to The Entrepology Podcast on Stitcher or iTunes. We would also appreciate a review!   Come Join Your Community on The Entrepology Collective Facebook Page! They say that you're the product of the five people with whom you spend the most time. Imagine you could spend time with hundreds of fellow entrepreneurs and go-getters looking to up-level their business, body, and mindset! Come hang out with us on Facebook and let us collectively inspire and support you towards your vision of contribution, your commitment towards better health, and your journey of mindset mastery. We're in this together! Come join us today!   CALL TO ACTION Within the realm of natural health, there is a myriad of options that we all have access to! More than ever before, there are so many evidence-informed options that can address the root cause of what is ailing people with respect to their health. Today's conversation with Dr. Amber Krogsrud truly highlighted this.   What did you learn in this episode about peptide therapy? Did you hear any ideas that you may try incorporating into your everyday life? Let us know over on my Instagram @DrMeghanWalker or our free Facebook group, The Entrepology Collective!   Tweetables:   “Estrogen is a huge player in how a woman feels.” — Dr. Amber Krogsrud   “I really found myself in this difficult situation where my health wasn't where I wanted it to be and that's actually where I found the peptide therapy. It transformed my health … and I started utilizing it in my practice.” — Dr. Amber Krogsrud   “What peptide therapy can really do is support the normal signaling of some of these pathways that … fall off as we age, as we're injured, [and] as we have more stressors on the body.” — Dr. Amber Krogsrud   “The more I study medicine, the more I am understanding and drawn to … helping clients with [their] mind-body connection and the power of [their] thoughts [impacting their] physical health.” — Dr. Amber Krogsrud   “The reason I … pursued this journey of [becoming] a naturopathic doctor is because [I] love to help people transform their health. … There's this personal responsibility to become … the healthiest version of myself and then teach other[s] to do the same.” — Dr. Amber Krogsrud

Rebel Talk
RT 155: Sleep better with help from Dr. Leigha Saunders

Rebel Talk

Play Episode Listen Later Oct 5, 2021 37:47


Meaningful and candid conversations about health and tapping into your intuitive self; this is the Rebel Talk podcast with Dr. Michelle Peris. This episode is brought to you by The Wild Collective. For more information, please see the bottom of this episode's show notes. Dr. Peris would like you to stay awake for this episode as her guest today would like to put you to sleep. Dr. Leigha Saunders joins the podcast today to discuss sleep patterns including our body clock, natural rhythms, chronotype, how sleep is the ultimate gauge of your nervous system, and how important sleep is to your mindset and health. Dr. Saunders is opening up her online sleep program that involves habit-changing. Sign up here: https://thesleepfix.com/masterclass   Continue on your wild journey… Wild Collective link: https://join.the-wild-collective.com/start-today-1 This episode of the Rebel Talk Podcast is brought to you by The Wild Collective. The Wild Collective is our community health initiative that helps women understand the intersection of our physiology, how our body works, how our hormones, how our stress, how our lifestyle factors influence our ability to connect with our intuition. It is where like-minded individuals have high-level conversations and learn a curriculum that every woman has the right to know, that is in their best interest to understand so that they can take their health and their life to the next level. It is our deepest honor and privilege to be able to offer this here at the poppy clinic. If you have been curious to learn more about our sisterhood and how to leverage community as your superpower to take radical action in your life. Then I highly recommend that you connect with us in two ways. One, you join our five day free challenge via the link on our Instagram page and two, you join our upcoming masterclass. It is called the science of sisterhood, the ultimate women's health blueprint. We would love for you to join us.  www.poppyclinic.com Dr. Michelle Peris at Instagram  Dr. Michelle Peris at Facebook Designs for Health Have you ever heard of IV Vitamin Therapy? This is one of the treatments that are offered at the Poppy Clinic, you can receive it as a stand-alone treatment or as part of your holistic health care. IV stands for Intravenous. It is a 40-minute session during which you are administered a customized blend of vitamins intravenously, right into your bloodstream. The advantage of getting your vitamins this way is that the digestive tract is bypassed in order for you to absorb 100% of what you are getting, you are receiving the vitamins directly, and are able to get much higher doses of the vitamins than you would ever be able to get otherwise. Did you know that 1 of 3 people have a digestive compromise? This means that even if you are eating a great diet or taking all of your vitamins, you might not actually be digesting and absorbing everything. IV Vitamin Therapy is the treatment that helps you absorb 100% of vitamins into your system. Benefits of IV Vitamin Therapy: - Boost your immune system - Heal from chronic disease - Fight off infections - Boost your mood - Improve sleep quality - Calm your nervous system - Health optimization - Prevention of disease - Anti-aging and collagen production boost Reach out to the Poppy Clinic! You don't need a referral. We look forward to meeting you very soon!

Le Book Club
Cécile Coulon: sortir du gouffre

Le Book Club

Play Episode Listen Later Oct 5, 2021 24:48


Cécile Coulon est écrivaine. Son dernier roman, “Seule en sa demeure”, est paru en août aux éditions de l'Iconoclaste. Au sein de cette même maison, elle co-dirige l'iconopop, une collection de textes courts et poétiques. Dans ce nouvel épisode du Book Club, Cécile Coulon compare ses livres à “ses professeurs”, indispensables chez elle, semblables à des “lumières”. “Ma bibliothèque dit beaucoup de choses de moi puisqu'elle renferme tout ce qui me touche intimement, tout ce qui m'émeut, tout ce qui m'éduque”. Elle a choisi de nous parler d'un livre qui l'a particulièrement bouleversée alors qu'elle sortait de l'écriture de son roman "Trois saisons d'orage". Courte fable en huis clos, Le Puits, signé par l'écrivain espagnol Iván Repila, raconte l'histoire de deux frères, le Grand et le Petit, qui se retrouvent au fond d'un puits et essayent de s'en sortir. Ce conte cruel les observe sortir de l'enfance malgré eux, en découvrant les désirs de haine et de vengeance. Unis par leur fraternité, l'amour seul résiste à l'épreuve qu'ils doivent surmonter. En se replongeant dans cette lecture, l'écrivaine nous confie l'écho qu'a eu cette “œuvre complète” dans sa vie. “J'étais à une période où j'essayais de me hisser hors d'un lieu où je me sentais un petit peu pétrifiée et immobile, comme ces deux enfants dans le livre, essayent à de nombreuses reprises de se hisser hors de ce puits.” Une lecture physique et sensorielle qui a accompagné Cécile Coulon, dans un nouveau moment de vie. “Lorsque je l'ai terminé j'étais dans un état second. Je savais que je venais de lire un grand livre, un ouvrage important. Je savais que ce texte allait avoir des répercussions sur moi, sur ma façon d'écrire, sur ma façon de penser.”Le Book Club est un podcast présenté par Agathe Le Taillandier. Cécile Coulon répond aux questions de la journaliste Antonella Francini. Soukaïna Qabbal est à l'édition et à la coordination du Book Club. Marjolaine Roget a fait le montage de cet épisode et Jean-Baptiste Aubonnet a réalisé le mixage.Le Book Club est une création Louie Media aussi rendue possible grâce à Maureen Wilson, responsable éditoriale, Marion Girard, responsable de production, Charlotte Pudlowski, directrice éditoriale et Mélissa Bounoua, directrice des productions.Pour que les podcasts de Louie soient accessibles à toutes et tous, des retranscriptions écrites des épisodes sont disponibles sur notre site internet. Si celle de l'épisode que vous cherchez n'est pas encore disponible, vous pouvez nous écrire à hello@louiemedia.com See acast.com/privacy for privacy and opt-out information.

En Casa de Herrero
Tertulia de Herrero: Moncloa y el PSOE estallan contra Iván Redondo

En Casa de Herrero

Play Episode Listen Later Oct 4, 2021 51:40


Luis Herrero analiza junto a Marisol Hernández, Cristina de la Hoz y Carmen Tomás la entrevista a Iván Redondo.

Julia en la onda
Mesa de Redacción: In my opinion

Julia en la onda

Play Episode Listen Later Oct 4, 2021 53:28


La Mesa de Redacción, con Goyo Benítez, Marina Martínez Vicens y Guillem Zaragoza. Hoy hablamos de los anglicismos a raíz de la entrevista de Iván Redondo en el programa de Évole, de los coches del futuro y de Mbappé. 

The tastytrade network
Market Measures - October 4, 2021 - ROC in High vs Low IVR

The tastytrade network

Play Episode Listen Later Oct 4, 2021 7:52


We've looked at how various IV environments impact the risk associated with strangles, but how does it impact your return on capital (ROC)? As IVR increases, so does the initial credit we collect on our trades, but is this correlated with the ROC? Let's take a look at SPY strangles since 2005 to see if this is the case!

The tastytrade network
Market Measures - October 4, 2021 - ROC in High vs Low IVR

The tastytrade network

Play Episode Listen Later Oct 4, 2021 7:01


We've looked at how various IV environments impact the risk associated with strangles, but how does it impact your return on capital (ROC)? As IVR increases, so does the initial credit we collect on our trades, but is this correlated with the ROC? Let's take a look at SPY strangles since 2005 to see if this is the case!

WealthStyle Podcast
The World of Health Care Benefit Plans With Stefan Carpentieri

WealthStyle Podcast

Play Episode Listen Later Oct 4, 2021 29:54


When reviewing your health care benefit plan options, do you have the right information to make the best choice for you? In this episode, Iván Watanabe sits down with OPUS PC's benefits consultant, Stefan Carpentieri. Stefan explains everything you need to know about health insurance and employee benefits to help you select the optimal coverage. … Continue reading The World of Health Care Benefit Plans With Stefan Carpentieri →

Todd Durkin IMPACT Show
Intermittent Fasting, Fasted Cardio, Sports Nutrition, Supplementation, and MUST-DO Nutrition Hacks | Ep. 216 with Robert Yang

Todd Durkin IMPACT Show

Play Episode Listen Later Oct 4, 2021 78:56


Making his return on the IMPACT SHOW today is a world-renowned nutrition expert and good friend, Robert Yang. This episode is EPIC...I reached out to my podcast and Instagram listeners and asked for your top nutrition questions to ask Robert. We had over 50 questions come through on supplementation, sports nutrition, weight loss & weight gain, intermittent fasting, fasted cardio, top hacks for peak performance, and everything in between. This is a rapid-fire nutrition course in just one episode.    Specifically, this is what Robert and I cover in today's episode: - Gut Health & what to do about it - Intermittent Fasting and Fasted Cardio - Tips for longevity, happiness, and success with nutrition - Nutrition tips post-cancer - Sports nutrition for the youth athlete - Supplements - MCT Oil, Collagen Protein, and Magnesium - Nutrition tips for when things get in the way of healthy habits - Thoughts on Dairy - Weight loss and weight gain - Top Nutrition Hacks for Peak Performance & energy   Without further ado, let's go to the episode. Please be share today's episode with your family, friends, and colleagues. And be sure to share it on your social media! Tag us at: IG/Twitter: @ToddDurkin @robertyang FB: @ToddDurkinFQ10, @robertyang #ToddDurkinIMPACTShow #Nutrition   ---   1:59 - Sean Lake with BUBS Naturals with a special offer - www.bubsnaturals.com For 20% off your order, code is “impact” for the best MCT Oil Powder, Collagen, Protein, and Apple Cider Gummies on the planet!   3:57 - What's new in the world of Robert Yang? Working on a Gut program...Why is Gut health important   10:02 - Questions about Fasting sam_bidmer asks: Is Intermittent fasting healthy? What is the best way to do it?   Rhoop31 asks: A lot of discussions has been made about fasted cardio or training for the enthusiasts for fat loss. Is there a science to it?   Colby.schreckengost asks: It seems intermittent fasting and cell repair are all the rage now. Do you believe that fasting is the best way to heal your body from chronic inflammation? I'm a chronic Lyme disease patient. I have a flare-up typically when the seasons change, but this summer has been tough due to the heat and humidity on the east coast.   25:12 - Questions about diets. emeraldrealtync asks: Thoughts on dairy? What do you think of the “starch diet”?   emeraldrealtync asks: What's one of your best tips for longevity, happiness, and success when it comes to nutrition?   31:26 - Fiber… how much do we really need?  Kellys_bootcamp asks: Suggestions for real food fiber. It can be a challenge to get 25 to 35 grams a day, especially for those who are less carb tolerant.   32:49 - Nutrition and Cancer eringlynn8 asks: What are your thoughts for nutrition post-cancer? I did keto for 2 years with great success, but my cholesterol went up so high my Dr. was overly concerned. (I did a calcium score and tested 0). The premise was to starve the cancer cells from sugar – make them ‘sick' and improve the effects of the treatments.  Being on an estrogen blocker seems to really be affecting my weight loss efforts.  Resource: Dom D'agostino - “Fasting and Ketosis.”   35:30 - Nutrition for when life gets busy.  gwms12 asks: What are some solid habits/nutrition tips to embrace when life gets in the way and to help keep you from throwing hard work away?  A big struggle is that I know what to do but it's when life throws you curveballs and I just go back to the “easy” which is not always the most health-conscious decision.   38:15 - Nutrition for when you get older.  mamarusher365 asks: When's the best time of the day to eat fruits?  So many in natural sugars, that it seems a bowl of. Any combo wouldn't be so bad to have?   mamarusher365 asks: Do women over 55 need an extra something in our nutritional plan, that we might be losing in our body when working out? I work out 7 days a week, whether bodyweight or weights. Main goals are healthy on the inside, strong on the outside.   41:54 - Nutrition for high school athletes  Matthewsmithatc05 asks: How complex should nutrition be for high school athletes?   45:05 - Parents listen up...Special message for the kids from Todd and Robert.   47:52 - Nutritional Intake with Calorie Output  jimmillerjrnflagent asks: For 13/14-year-old female soccer players:  Suggested calorie intake and carb/protein/fat percentage? Some are doubling up on high school cross-country running or volleyball and then coming to our training session that runs 90 minutes. I am concerned they are not fueling properly for the output they are burning, and you know the high schools don't have a nutritionist on staff to help their athletes regulate.   52:10 - What is MCT Oil dianadeadlifts asks: What are the benefits of MCT Oil? Does the timing of creatine supplementation play a big role in how effectively your body will use it whether it's pre or post-exercise?   1:02:07 - Magnesium Benefits  shooten1st asks: How should magnesium be taken as a supplement? Any naturally occurring sources of food?  Lots of misinformation out there. Magnesium Glycinate by Albion   1:04:24 - What's the best diet for HPA Axis Syndrome polished_chick9 asks: Dr. Golightly diagnosed me with HPA Axis Syndrome. Not only are my adrenals shutting down, but my cholesterol also keeps rising.  I had been on keto then switched to plant-based for 8 months and it went up another 20 points! I am diligently following her supplement protocol but am at a loss as to what to eat.  I eat fruit, veggies, salmon, nuts, and now occasionally chicken and cut out all alcohol. Thoughts?   1:09:35 - How IV therapy affects performance  turnuptheheat66 asks: What's your take on IV therapy, specifically for performance base prior to competition and what recipe? How long prior to competition?   1:11:33 - Rapid fire questions for Robert.   - Best practices - What brings you the most joy - Best book or podcast you've read in the past month - Josh Waitzkin “The Art of Learning.”   - What are you most looking forward to in the future     1:15:16 - Parting words from Robert.   * Robert was also on Episode #44 of the IMPACT SHOW titled “Nutrition...Guts, Hormones, Gluten & Coffee” and this was one of our Top 10 listened to thus far out of 215 episodes. If you haven't listened to it already I highly recommend you go back and listen after listening to this episode.     ---   About Robert Yang:   Robert Yang earned a postgraduate degree in Human Nutrition from the University of Bridgeport.  He is a certified nutritionist and a certified strength and conditioning specialist.  With over 2 decades of experience, he has worked with an array of athletes from the NFL, MLB, NHL, X-Games, PGA & LPGA.  Robert is in high demand as a nutritionist and strength coach for professional athletes, golfers, and celebrities. His client roster includes the likes of Ken Block, Michelle Wie, Drew Brees, Russell Wilson, Steve Delabar, Pierre-Luc Gagnon, I.K. Kim, Carlota Ciganda, Belen Mozo, Rashaan Salaam, Andy Dalton, Rob Dyrdek, Ben Crane, just to name a few.   He specializes in resolving gut issues, hormonal imbalances, and achieving optimal performance. His integrative programs are based on a thorough health history evaluation and the use of laboratory testing to determine the individual needs of a client.   As an athlete, husband, and father Robert understands the needs of his clients and strives to stay on the cutting edge of training, supplementation, nutrition, rehabilitation, and performance enhancement. Robert is continually traveling, researching, and studying the best methods to help individuals achieve their ultimate goals.   Website: www.Robertyang.net    ---   Are you a Trainer, Coach, or Fitness Business Owner seeking to make even more IMPACT in your business & life?   You are only as good as the people you surround yourself with. Level up today with my “Best in Class” MASTERMIND program for fitness professionals. I invite you to connect, share, and grow with the top coaches, trainers, and entrepreneurs in the fitness industry. My MASTERMIND is for passionate and purpose-driven fitness professionals who want to create success & significance in their personal and professional lives. If that sounds like you, visit: ToddDurkinMastermind.com to enroll or apply today. If you do so within the next 24 hours, you will receive a FREE video of one of my recent “ALL MASTERMIND” coaching calls. There are so many lost souls right now that need “our” LIGHT.  Let's make a difference together, one life at a time!    ---   Please keep your questions coming so I can highlight you on the podcast!!    If you have a burning question and want to be featured on the IMPACT show, go to www.todddurkin.com/podcast, fill out the form, and submit your questions!    ---   Follow Todd… → Instagram & Twitter: @ToddDurkin → Youtube: https://www.youtube.com/user/ToddDurkinFQ10 → FB: @ToddDurkinFQ10   Don't forget that if you want more keys to unlock your potential and propel your success, you can order my book GET YOUR MIND RIGHT at www.todddurkin.com/getyourmindright or anywhere books are sold.   Get Your Mind Right now available on AUDIO: https://christianaudio.com/get-your-mind-right-todd-durkin-audiobook-download   Want more Motivation and Inspiration?? Sign up for my newsletter The TD Times that comes out on the 10th of every month full of great content  www.todddurkin.com   ---   ABOUT:   Todd Durkin is one of the leading coaches, trainers, and motivators in the world. It's no secret why some of the world's top athletes have trained with him for nearly two decades. He's a best-selling author, a motivational speaker, and owns the legendary Fitness Quest 10 in San Diego, CA, where he leads an amazing team of 42 teammates.   Todd is a coach on the Netflix show “STRONG” that is must-watch TV. He is a previous Jack LaLanne Award winner, a 2-time Trainer of the Year, and he runs his Todd Durkin Mastermind group of top trainers and fitness pros around the globe, coaching them with business, leadership, marketing, training, and personal growth mentorship.   Todd and his wife Melanie head up the Durkin IMPACT Foundation (501-c-3) that has raised over $250,000 since it started in 2013. 100% of all proceeds go back to kids and families in need. To learn more about Todd, visit www.ToddDurkin.com and www.FitnessQuest10.com.   Join his fire-breathing dragons' community and receive regular motivational and inspirational emails. Visit www.ToddDurkin.com and opt-in to receive his value-rich content.   Connect with Todd online in the following places: You can listen to Todd's podcast, The IMPACT Show, by going to www.todddurkin.com/podcast.

La ContraCrónica
Biden, Sanders y el conflicto fiscal

La ContraCrónica

Play Episode Listen Later Oct 3, 2021 39:28


El partido Demócrata, que tan unido estaba hace un año en torno a la figura de Joe Biden, se encuentra ahora muy dividido en el Congreso. La razón hay que ir a buscarla a un plan de subida de impuestos generalizada que la Casa Blanca necesita para sus proyectos de infraestructuras y programas sociales. El asunto comenzó hace unas semanas, cuando, con el apoyo de republicanos y demócratas, se sacó adelante en el Senado. Los republicanos están de acuerdo en asignar dinero público a infraestructuras, pero no a ir más allá. Los demócratas, por su parte, si quieren hacerlo. Biden tiene intención de expandir los servicios sociales tanto como pueda y combatir el cambio climático, pero eso cuesta mucho más dinero del que le ha aprobado el Senado, así que la cosa se ha complicado porque con el billón de dólares original no basta. Para atender a las nuevas necesidades hacen falta más de 3,5 billones de dólares que han de salir necesariamente del bolsillo de los contribuyentes, especialmente de la clase media y de las empresas. Ahí Biden ha tocado hueso porque no todos dentro de su partido quieren incrementar la carga fiscal. La presidenta de la Cámara de Representantes, Nancy Pelosi, ha tratado de hacer encaje de bolillos pasando primero uno y luego el otro, pero el sector izquierdista del partido Demócrata, el liderado por Bernie Sanders, ha visto el farol y se ha opuesto a los dos. O pasan juntos con su subida de impuestos incluida, o no pasa ninguno. Esto ha ocasionado un bloqueo en la cámara y un agrio enfrentamiento dentro de la bancada demócrata que está haciendo las delicias de sus oponentes. Los demócratas disidentes aseguran que se están limitando a promover el programa con el que Biden se presentó a las elecciones el año pasado. Ninguno de los dos quiere dar su brazo a torcer, pero muchos estadounidenses han empezado a palparse el bolsillo. Las curvas ya las tienen aquí, los impuestos no tardarán en llegar. En La ContraRéplica: - Debatir con Cao de Benós o Roberto Vaquero - La cumbre de la CELAC en México - La visita de Iván Duque a Madrid - La etnia vasca “La ContraHistoria de España. Auge, caída y vuelta a empezar de un país en 28 episodios”… https://amzn.to/3kXcZ6i Apoya La Contra en: · Patreon... https://www.patreon.com/diazvillanueva · iVoox... https://www.ivoox.com/podcast-contracronica_sq_f1267769_1.html · Paypal... https://www.paypal.me/diazvillanueva Sígueme en: · Web... https://diazvillanueva.com · Twitter... https://twitter.com/diazvillanueva · Facebook... https://www.facebook.com/fernandodiazvillanueva1/ · Instagram... https://www.instagram.com/diazvillanueva · Linkedin… https://www.linkedin.com/in/fernando-d%C3%ADaz-villanueva-7303865/ · Flickr... https://www.flickr.com/photos/147276463@N05/?/ · Pinterest... https://www.pinterest.com/fernandodiazvillanueva Encuentra mis libros en: · Amazon... https://www.amazon.es/Fernando-Diaz-Villanueva/e/B00J2ASBXM Escucha el episodio completo en la app de iVoox, o descubre todo el catálogo de iVoox Originals

Redeemer Presbyterian Church
Matthew 11:7-15 Believing John the Baptist

Redeemer Presbyterian Church

Play Episode Listen Later Oct 3, 2021 30:07


Who is John the Baptist, why did he come, and how does he help us understand Jesus? I. John is the prophet whom Jesus defends, vv7-9. II. John is the forerunner who prepares us for Jesus, vv9-10. III. John is ranked greatest but we're greater than him, v11. IV. John is the End of the Prophets and Law, vv12-13 . V. John is the Elijah who is to come, vv14-15

Weekly Poker Hand with Jonathan Little
WPH #375: How To EXECUTE A MASTERFUL RIVER BLUFF! Timoshenko vs De Wolfe on partypokerTV

Weekly Poker Hand with Jonathan Little

Play Episode Listen Later Oct 3, 2021 16:42


This is an amazing hand where Timoshenko demonstrates how sometimes we may need to turn a strong hand into a bluff! In this hand we look at the epic battle between Timoshenko & De Wolfe from the 2010 partypoker live premier league IV! A lot has changed in the world of poker since this hand … WPH #375: How To EXECUTE A MASTERFUL RIVER BLUFF! Timoshenko vs De Wolfe on partypokerTV Read More » The post WPH #375: How To EXECUTE A MASTERFUL RIVER BLUFF! Timoshenko vs De Wolfe on partypokerTV first appeared on Jonathan Little.

Downtown Church: Memphis, TN
Dirty Faith: James 3:1-12 Words - Weapons of War, or Instruments of Peace - Richard Rieves October 3, 2021

Downtown Church: Memphis, TN

Play Episode Listen Later Oct 3, 2021 31:06


James 3:1-12 I. Words have purpose. (Genesis. 1:1-3) “In Genesis 1, the world of communication was a world of peace, truth, and life. Words were never used as weapons. Truth was never used to tear down. Words were always spoken in love, and human communication never broke the bonds of peace.” Tripp, Paul David. War of Words: Getting to the Heart of Your Communication Struggles (p. 12). We were created to thrive on words of blessing, affirmation, and encouragement from God. We were also created to receive purpose and mission from God through His Words. (Genesis. 1:28-30) We were also created to have God speak law, boundaries, and words of warning. (Genesis. 2:16-17) We also were created for God to explain our deepest emotions and feelings. (Genesis. 2:18) We need God to speak to us to 1) Bless us, 2) put us on a purposeful mission, 3) give us directives that will protect our lives, 4) makes sense of our internal longings. (James 3:1-2) (Genesis. 3:1-6) When the serpent speaks, he speaks to deceive, pull hearers away from active listening to God, and the result is always death, confusion, skepticism and suspicion. II. Words have creative power. (Matthew 3:16-17) (Matthew 5:21-23) (James 3:8-10) (James: 5-6) (Proverbs 18:21) III. Words are a window to our heart. (James 3:6) (Luke 6:43 - 45) (Jeremiah 17:9) IV. The Word is our hope. (James 9-10) (John 1:14,16) (Matthew. 7:3-5) (Romans 5:20)

10% Happier with Dan Harris
Joy Vs. Happiness | Bonus Meditation with Sebene Selassie

10% Happier with Dan Harris

Play Episode Listen Later Oct 1, 2021 13:02


What if we told you that joy doesn't have to be an accident? Learn how to develop joy in this guided session from Sebene.About Sebene Selassie:Growing up, Sebene felt like a big weirdo. Born in Addis Ababa, Ethiopia and raised in white neighborhoods in Washington, D.C., she was a tomboy Black girl who loved Monty Python and UB40. She never believed she belonged. Thirty years ago, she began studying Buddhism as an undergraduate at McGill University where she majored in Comparative Religious Studies. Now, Sebene is a teacher, author, and speaker who teaches that meditation can help us remember our inherent sense of belonging, that our individual freedom affects absolutely everyone and everything, and that our collective freedom depends on each and every one of us. Sebene is a three-time cancer survivor of Stage III and IV cancer.To find this meditation in the Ten Percent Happier app, you can search for “Joy,” or click here: https://10percenthappier.app.link/content?meditation=8ab8948a-d112-423a-bf8b-78f1e6e2b291.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Con Intencion
056.LGBTQ+, matrimonio, liberación sexual y +

Con Intencion

Play Episode Listen Later Oct 1, 2021 61:52


Esta conversación con Iván Chanis Barahona, abogado y Presidente de la Fundación Iguales, como tantas otras, se fue poniendo progresivamente mejor en cuanto fuimos conversando. En este episodio Iván toca temas valiosísimos: Situación actual de leyes panameñas que protejan a la comunidad LGBTQ+ que es la lucha de su fundación. ¿Qué estamos protegiendo con nuestras decisiones como sociedad y a costa de qué? Cómo podemos ser agentes de cambio o aliados desde 3 perspectivas: individual, profesional y política. Cuestionar nuestras formas de expresión para generar un lenguaje inclusivo congruente con nuestros valores. El significado de las siglas LGBTQ+ La liberación sexual percibida como disruptiva para el orden del estado democrático. Ani además habla desde su lado más anarquista y debate sobre la institución del matrimonio y la inherencia del estado, ese debate fue como una montaña rusa de emociones con una reflexión valiosísima sobre decisiones. No hay segundo de desperdicio porque la conversa va en crescendo. Conoce más de Iván y todo el contenido que nos comparte en su Instagram personal y el de su fundación IG: https://www.instagram.com/ivanchanis/ (@ivanchanis) @https://www.instagram.com/fundacionigualespanama/ (fundacionigualespanama) Twitter: https://twitter.com/ivan_chanis (@ivan_chanis) _______________________________________ Puedes conocer más sobre mí:  Para adultos: https://my.captivate.fm/aniesk.com (aniesk.com) & https://my.captivate.fm/instagram.com/ani.esk (@ani.esk) Puedes agendar una primera entrevista para coaching conmigo en este https://calendly.com/aniesk/sesion-de-coaching (link). Para niños: https://my.captivate.fm/www.campwandu.com (www.campwandu.com )& https://my.captivate.fm/instagram.com/campwandu (@campwandu) y Pronto Cacao Camp

Losing a Child: Always Andy's Mom
Episode 107: Corey's Mom

Losing a Child: Always Andy's Mom

Play Episode Listen Later Sep 30, 2021 56:06


Nine years ago, when 6 week-old Corey was admitted to the hospital for generalized weakness, everyone assumed that he had some sort of infection. His mother, Stephanie, thought that he would get some medication, maybe some IV fluids and then she would be able to take her little boy home again. On the third day of his hospitalization, however, Stephanie overheard a few residents talking. She heard the use the term, 'SMA' for the first time. A young doctor started a sentence with the words, 'if he lives to 6 months' and 'if he lives to a year.'  Suddenly, Stephanie's life was turned up-side-down. Corey did indeed have SMA (Spinal Muscular Atrophy) and he actually did not live to see 6 months. When Corey was born, a diagnosis of SMA was a death sentence. Only months after Corey was born, clinical trials for a treatment for SMA were developed. Now, that medication is so successful in treating SMA that we are really nearing the day that these children will live with SMA and not die from it. Since Corey's death, Stephanie has done so much to support this cause. She was instrumental in getting SMA testing on the newborn screen in the state of Ohio. She speaks to groups nationally as well. I know that after losing a child, I want to do anything that I can to prevent another parent from feeling my same pain. Stephanie feels the same way and her work has truly helped prevent some many deaths. Today, we talk about her work in the Cure SMA organization, but we also discuss her personal grief journey as well. Stephanie talks about the pain of returning home without her baby boy in her arms. We discuss learning to help her then 5 year old daughter grieve in an open, honest way and the pain that comes with watching our children grieve. Now, so many years later, there are fewer and fewer people who remember baby Corey, and that makes some days even harder than in the beginning. It certainly make those who remember and understand the lasting pain all the more precious.

Precarious
Living is Harder Than Dying

Precarious

Play Episode Listen Later Sep 30, 2021 20:12


Sometimes I think living is harder than dying. At least that's what I've been struggling with since I completed another course of IV chemotherapy. Metaphorically speaking, living means staying open in the face of fear. Living means staying engaged in the midst of overwhelm. It's a courageous act to stay present when life feels like it's one big "sufferfest". Here's to every single one of you who are enduring some version of pain at this moment. You are my hero.

El Washington Post
Motín carcelario en Ecuador. Isabel Díaz Ayuso habla del catolicismo. "Volver la vista atrás"

El Washington Post

Play Episode Listen Later Sep 30, 2021 17:56


Sobre las cárceles en el Ecuador hablamos con Samantha Schmidt de "The Washington Post" y José Olmos de "El Universo". De lo que dijo Díaz Ayuso, con el historiador Iván Escamilla de la UNAM. Y llamamos a Juan Gabriel Vásquez

Nueva Vida 97.7FM
Iván Rodríguez y su Mariachi ¡en vivo!

Nueva Vida 97.7FM

Play Episode Listen Later Sep 30, 2021 10:59


Iván Rodríguez y su Mariachi ¡en vivo!

Técnica Fórmula 1 · Podcast de F1
Episodio 470 · El análisis del GP de Rusia (I)

Técnica Fórmula 1 · Podcast de F1

Play Episode Listen Later Sep 29, 2021 74:34


VÓTANOS, POR FAVOR, EN LOS PREMIOS DE IVOOX AQUÍ: https://es.surveymonkey.com/r/PremiosIvooxAudiencia2021 Como viene siendo ya una costumbre esta temporada, los, a priori, circuitos más aburridos de la temporada nos están dejando, en 2021, carreras memorables y más que entretenidas. Así ocurrió el fin de semana pasado en Sochi, donde se disputó el Gran Premio de Rusia 2021. En el primer episodio de esta semana los chicos de Podcast Técnica Fórmula (con Iván Fernández, Abel Caro e Ignacio Psijas) analizarán a fondo todo lo que dio de sí, no sólo la carrera, sino todo el fin de semana en Rusia. Un final de infarto. Aunque parezca empezar la casa por el tejado, no podemos menos de hablar de un final pasado por agua donde la lluvia fue la protagonista y dio un vuelco grandísimo a la carrera. Como tampoco podemos dejar de comentar que la victoria de Hamilton en la carrera le llevó, por fin, a sumar su centésima victoria en la categoría, cifra que llevaba acariciando desde hace muchos Grandes Premios. Una victoria que le pone, de nuevo, liderando el Mundial de pilotos, pero no con mucha ventaja, pues tiene a Verstappen a tan sólo 2,5 puntos tras él. Y, por supuesto, no nos olvidamos del sabor agridulce de no haber visto la primera victoria en F1 de Lando Norris, que hubiera sido bien merecida: la perdió en las 3 últimas vueltas, donde fallaron tanto él como su equipo en la toma de decisiones. Pero así son las carreras. Por otra parte, destacar el podio de Carlos Sainz, que hizo una carrera que sorprendió a todos y que no ha dejado a nadie indiferente, sobre todo en Italia. La carrera comenzó el sábado. Aunque debido a las previsiones de lluvias para el sábado se llevaba hablando desde el viernes de la posibilidad de que la clasificación no tuviera lugar hasta el domingo, finalmente la climatología dio una tregua y la clasificación tuvo lugar a la hora prevista. Y no pudo ser más animada y traer más alegrías a los protagonistas. Con Verstappen fuera de la ecuación, pues había cambiado la unidad de potencia ya que el circuito era, en principio, poco favorable a Red Bull y además arrastraba la penalización por el choque con Hamilton en la carrera anterior, parecía que en este circuito “Mercedes” el equipo alemán iba a llevarse la Pole, máxime con el buen fin de semana que estaba firmando Bottas, al que este circuito se le da muy bien. Pero no, ninguno de los dos pudo llevarse la Pole. Fue un increíble Norris el que la consiguió, la primera de su carrera en Fórmula 1, aunque durante unos instantes no estuvo claro si sería para él o para Sainz, que finalmente se quedó con el segundo puesto. Un segundo puesto que siempre se ha dicho que no es una buena posición de salida en Sochi. El tercer puesto se lo llevo Russell, que volvió, con un Williams, a calificar por delante de su futuro compañero en Mercedes. Y es que Hamilton perdió una valiosa oportunidad de lograr la Pole al quedarse con un intento menos: cometió un fallo en boxes y golpeó uno de los muros. ¿Está quizás el británico tan nervioso como dice que ve a Verstappen? La verdad es que en esta carrera no debiera haberlo estado, pues el holandés salía desde el fondo de la parrilla y en el equipo Mercedes habían tomado la “estratégica” decisión (en palabras de Wolff) de volver a cambiar partes del motor de Bottas para que este quedara al fondo de la parrilla pero por delante del de Red Bull y le parara… cosa que finalmente no sucedió. Una salida inimaginable. Con Norris en primera posición y Russell en tercera posición, parecía que Sainz tenía todas las papeletas para perder su posición rápidamente, bien, con Russell, bien con Hamilton, que salía por detrás de él y podía beneficiarse de su rebufo. Pero no fue así. Sainz consiguió colocarse rápidamente tras Norris, arrebatando el rebufo del de McLaren al Williams y terminó por pasarle y colocarse en la primera posición. Mientras, Hamilton hacía una salida muy cauta y era adelantado por Stroll y Alonso. Ya desde el inicio de la carrera algunos pilotos ganaron muchas posiciones y comenzaron a remontar, como es el caso de Leclerc (que había montado también una nueva unidad de potencia, la nueva evolución de Ferrari), Verstappen o Bottas. A pesar de todos esos movimientos, la primeras vueltas fueron tranquilas. En la vuelta 14, Norris pasó a Sainz, que no tenía velocidad ni ritmo respecto a su rival. Entonces Sainz hizo su parada y montón duros, mostrando una de las grandes carencias del coche italiano con las gomas. Russell también hizo su parada para defenderse de Stroll, pero en Williams hicieron una mala actuación y terminaron perdiendo la posición con el Aston Martin. En esos momentos, los McLaren iban primero y segundo, con un Ricciardo que esta semana ocupó el papel de defensa de su compañero, y de qué manera, contra Hamilton. Pero al hacer la parada también hubo un mal trabajo en el box de McLaren y Ricciardo terminó cayendo hasta el puesto 13º. Mientras, Pérez era cuarto sin poder tirarle el coche a Hamilton. Sube tus comentarios de audio o tus preguntas y te escucharás en el siguiente podcast. Puede hacerlo aquí: https://www.speakpipe.com/tecnicaformula1 No olvidéis seguirnos en nuestra redes sociales donde tendréis información extra: Twitter: @PodcastTecnica / @RaulMolinaRecio Facebook: https://www.facebook.com/PodcastTecnicaFormula1/ Escucha el episodio completo en la app de iVoox, o descubre todo el catálogo de iVoox Originals

True To You
Let's talk about sex with MaryFrances Barbisan

True To You

Play Episode Listen Later Sep 29, 2021 32:06


In this week's episode I am talking to Sex Coach MaryFrances Barbisan. MaryFrances has for over 30 years developed an expert wellness practise, renown for enlivening women to let go and embrace more vibrant health, wellness and sensuality, enticing more juicy pleasure and joy in life.MaryFrances is a Registered Nurse with an extensive background in medical IV therapy. She is a Registered Massage Therapist, CranioSacral Therapist, Reiki Master including other healing modalities, a Wellness and Sex Coach and yes, for the love of wine… even a Sommelier. Today we are chatting all about sex, why it's a taboo topic, how to liven up your sexual energy within yourself and feel more comfortable in your own body! To connect with MaryFrances go to https://maryfrances.ca/ ____________________________________________________________________________________________________________________________ October Health Coaching Early Bird Pricing on NOW: https://truetoyoulifestyle.com/shop/ols/products/12-week-group-health-coaching If you're ready to commit to your health and wellness, learn the tools to create new habits that align with your goals and then crush those goals join us this October for 12 weeks of coaching! SIGN UP BEFORE THE EARLY BIRD PRICING IS GONE! ____________________________________________________________________________________________________________________________ Jessica Derksen is a certified health and life coach and is passionate about you living a life you love while feeling amazing from the inside out. When we feel better we do better in life. This podcast is all about helping you level up your health and your life. New episodes released weekly! Have you checked out True To You apparel yet? Get your very own piece of clothing right here: https://truetoyoulifestyle.com/shop/ols/categories/clothing Follow us on facebook https://www.facebook.com/jessderksenhealthcoach/ Follow us on Instagram https://www.instagram.com/jessicaderksenhealthcoach/

Shrink Speak
The Future of Psychedelics: A Discussion with Rick Doblin & Steven Levine

Shrink Speak

Play Episode Listen Later Sep 29, 2021 64:08


In this episode, Dr. Jeffrey Lieberman is joined by pioneering psychedelics researchers, Drs. Rick Doblin and Steven Levine, to discuss the therapeutic applications of psychedelic drugs such as psilocybin, ketamine, LSD, MDMA, and ibogaine in treating mental health and addiction disorders, and the future path forward in legitimately harnessing their game changing potential. Dr. Rick Doblin is the Founder and Executive Director of MAPS (the Multidisciplinary Association for Psychedelic Studies), , a leading non-profit psychedelic drugs research and educational organization, with both domestic and international studies. Dr. Steven Levine is the Vice President of Patient Access at COMPASS Pathways, a leading psychedelics research organization conducting international clinical trials with psilocybin therapy for treatment-resistant depression. A pioneer in the clinical use of IV ketamine for treatment resistant depression, Dr. Levine is also the founder of Actify Neurotherapies, one of the largest networks of ketamine treatment centers in the US.  

The tastytrade network
Options Trading Concepts Live - September 28, 2021 - Trading Volatility After a Selloff

The tastytrade network

Play Episode Listen Later Sep 28, 2021 41:58


When the market sells off, IV% expands across the board, and volatility products tend to rally in a big way. The tastytrade crew explains why it's easier to wait for a pop and place a short vol trade, rather than trying to time a pop that may never happen. They also place a trade in MU for earnings!Tune in to learn more, with a live Q&A as well!

The tastytrade network
Options Trading Concepts Live - September 28, 2021 - Trading Volatility After a Selloff

The tastytrade network

Play Episode Listen Later Sep 28, 2021 41:08


When the market sells off, IV% expands across the board, and volatility products tend to rally in a big way. The tastytrade crew explains why it's easier to wait for a pop and place a short vol trade, rather than trying to time a pop that may never happen. They also place a trade in MU for earnings!Tune in to learn more, with a live Q&A as well!

MoneyBall Medicine
E-Patient Dave Says We Still Need Better Access to our Health Data

MoneyBall Medicine

Play Episode Listen Later Sep 28, 2021 50:52


The podcast is back with a new name and a new, expanded focus! Harry will soon be publishing his new book The Future You: How Artificial Intelligence Can Help You Get Healthier, Stress Less, and Live Longer. Like his previous book MoneyBall Medicine, it's all about AI and the other big technologies that are transforming healthcare. But this time Harry takes the consumer's point of view, sharing tips, techniques, and insights we can all use to become smarter, more proactive participants in our own health. The show's first guest under this expanded mission is Dave deBronkart, better known as "E-Patient Dave" for his relentless efforts to persuade medical providers to cede control over health data and make patients into more equal partners in their own care. Dave explains how he got his nickname, why it's so important for patients to be more engaged in the healthcare system, and what kinds of technology changes at hospitals and physician practices can facilitate that engagement. Today we're bringing you the first half of Harry and Dave's wide-ranging conversation, and we'll be back on October 12 with Part 2.Dave deBronkart is the author of the highly rated Let Patients Help: A Patient Engagement Handbook and one of the world's leading advocates for patient engagement. After beating stage IV kidney cancer in 2007, he became a blogger, health policy advisor, and international keynote speaker, and today is the best-known spokesman for the patient engagement movement. He is the co-founder and chair emeritus of the Society for Participatory Medicine, and has been quoted in Time, U.S. News, USA Today, Wired, MIT Technology Review, and the HealthLeaders cover story “Patient of the Future.” His writings have been published in the British Medical Journal, the Patient Experience Journal,  iHealthBeat, and the conference journal of the American Society for Clinical Oncology. Dave's 2011 TEDx talk went viral, and is one the most viewed TED Talks of all time with nearly 700,000 views.Please rate and review The Harry Glorikian Show on Apple Podcasts! Here's how to do that from an iPhone, iPad, or iPod touch:1. Open the Podcasts app on your iPhone, iPad, or Mac. 2. Navigate to The Harry Glorikian Show podcast. You can find it by searching for it or selecting it from your library. Just note that you'll have to go to the series page which shows all the episodes, not just the page for a single episode.3. Scroll down to find the subhead titled "Ratings & Reviews."4. Under one of the highlighted reviews, select "Write a Review."5. Next, select a star rating at the top — you have the option of choosing between one and five stars. 6. Using the text box at the top, write a title for your review. Then, in the lower text box, write your review. Your review can be up to 300 words long.7. Once you've finished, select "Send" or "Save" in the top-right corner. 8. If you've never left a podcast review before, enter a nickname. Your nickname will be displayed next to any reviews you leave from here on out. 9. After selecting a nickname, tap OK. Your review may not be immediately visible.That's it! Thanks so much.Full TranscriptHarry Glorikian: Hello. I'm Harry Glorikian. Welcome to The Harry Glorikian Show.You heard me right! The podcast has a new name. And as you're about to learn, we have an exciting new focus. But we're coming to you in the same feed as our old show, MoneyBall Medicine. So if you were already subscribed to the show in your favorite podcast app, you don't have to do anything! Just keep listening as we publish new episodes. If you're not a regular listener, please take a second to hit the Subscribe or Follow button right now. And thank you.Okay. So. Why are we rebranding the show?Well, I've got some exciting news to share. Soon we'll be publishing my new book, The Future You: How Artificial Intelligence Can Help You Get Healthier, Stress Less, and Live Longer. It's all about how AI and big data are changing almost everything we know about our healthcare.Now, that might sound a bit like my last book, MoneyBall Medicine. But I wrote that book mainly to inform all the industry insiders who deliver healthcare. Like people who work at pharmaceutical companies, hospitals, health plans, insurance companies, and health-tech startups.With this new book, The Future You, I'm turning the lens around and I'm explaining the impact of the AI revolution on people who consume healthcare. Which, of course, means everyone. That impact is going to be significant, and it's going to change everything from the way you interact with your doctors, to the kind of medicines you take, to the ways you stay fit and healthy.We want you to be prepared for this new world. So we're expanding the focus of the podcast, too. To go along with the new name, we're bringing you interviews with a new lineup of fascinating people who are changing the way patients experience healthcare. And there's nobody better to start out with than today's guest, Dave deBronkart.Dave is best known by the moniker he earned back in the late 2000s: E-Patient Dave. We'll talk about what the E stands for. But all you need to know going in is that ever since 2007, when he survived his own fight with kidney cancer, Dave has been a relentless, tireless advocate for the idea that the U.S. medical system needs to open up so that patients can play a more central role in their own healthcare. He's pushed for changes that would give patients more access to their medical records. And he hasn't been afraid to call out the institutions that are doing a poor job at that. In fact, some folks inside the business of healthcare might even call Dave an irritant or a gadfly. But you know what? Sometimes the world needs people who aren't afraid to shake things up.And what's amazing is that in the years since Dave threw himself into this debate, the world of healthcare policy has started to catch up with him. The Affordable Care Act created big incentives for hospitals and physician practices to switch over to digital recordkeeping. In 2016 the Twenty-First Century Cures Act prohibited providers from blocking access to patients' electronic health information. And now there's a new interface standard called FHIR that promises to do for medical records what HTML and HTTP did for the World Wide Web, and make all our health data more shareable, from our hospital records to our genomics data to the fitness info on our smartphones.But there's a lot of work left to do. And Dave and I had such a deep and detailed conversation about his past work and how patients experience healthcare today that we're going to break up the interview into two parts. Today we'll play the first half of our interview. And in two weeks we'll be back with Part 2. Here we go.Harry Glorikian: Dave, welcome to the show.Dave deBronkart: Thank you so much. This is a fascinating subject, I love your angle on the whole subject of medicine.Harry Glorikian: Thank you. Thank you. So, Dave, I mean, you have been known widely as what's termed as E-patient Dave. And that's like a nickname you've been using in public discussions for, God, at least a decade, as far as I can remember. But a lot of our listeners haven't heard about that jargon word E-patient or know what E stands for. To me, it means somebody who is assertive or provocative when it comes to managing their own health, you know, with added element of being, say, tech savvy or knowing how to use the Internet, you know, mobile, wearable devices and other digital tools to monitor and organize and direct their own care—-all of which happens to describe the type of reader I had in mind when I wrote this new book that I have coming out called The Future You. So how would you describe what E- patient [means]?Dave deBronkart: You know, it's funny because when you see an E-patient or talk with them, they don't stick out as a particularly odd, nerdy, unusual sort of person. But the the term, we can get into its origins back in the 90s someday if you want to, the term has to do with somebody who is involved. What today is in medicine is called patient engagement. And it's funny because to a lot of people in health care, patient engagement means getting the patient to do what they tell us to. Right. Well, tvhere's somebody who's actually an activated, thinking patient, like, I'm engaged in the sense that I want to tell you what's important to me. Right. And I don't just want to do what I'm told. I want to educate myself. That's another version of the E. In general, it means empowered, engaged, equipped, enabled. And these days, as you point out, naturally, anybody who's empowered, engaged and enabled is going to be doing digital things, you know, which weren't possible 20 years ago when the term patient was invented.Harry Glorikian: Yeah, and it's interesting because I was thinking like the E could stand for so many things like, you know, electronic, empowered, engaged, equipped, enabled, right. All of the above. Right. And, you know, I mean, at some point, you know, I do want to talk about access, right, to all levels. But just out of curiosity, right, you've been doing this for a long time, and I'm sure that people have reached out to you. How many E-patients do you think are out there, or as a proportion of all patients at this point?Dave deBronkart: You know, that depends a lot on demographics and stage of life. The, not surprisingly, digital natives are more likely to be actively involved in things just because they're so digital. And these days, by federal policy, we have the ability to look at parts of our medical information online if we want to. As opposed to older people in general are more likely to say just what the doctors do, what they want to. It's funny, because my parents, my dad died a few years ago. My mother's 92. We're very different on this. My dad was "Let them do their work." And my mother is just all over knowing what's going on. And it's a good thing because twice in the last five years, important mistakes were found in her medical record, you know. So what we're at here, this is in addition to the scientific and technological and data oriented changes that the Internet has brought along. We're also in the early stages of what is clearly going to be a massive sociological revolution. And it has strong parallels. I first had this idea years ago in a blog post, but I was a hippie in the 60s and 70s, and I lived through the women's movement as it swept through Boston. And so I've seen lots of parallels. You go back 100 years. I think the you know, we recently hit the 100th anniversary of the 19th Amendment, giving women the right to vote. There were skeptics when the idea was proposed and those skeptics opinions and the things they said and wrote have splendid parallels with many physicians' beliefs about patients.Dave deBronkart: As one example I blogged some years ago, I can send you a link about a wonderful flyer published in 1912 by the National Association Opposed to Women's Suffrage. And it included such spectacular logic as for, I mean, their bullets, their talking points, why we should not give women the vote, the first was "Most women aren't asking for it." Which is precisely parallel to "Most patients aren't acting like Dave, right? So why should we accommodate, why should we adjust? Why should we provide for that? The second thing, and this is another part, is really a nastier part of the social revolution. The second talking point was "Most women eligible to vote are married and all they could do is duplicate or cancel their husband's vote." It's like, what are you thinking? The underlying is we've already got somebody who's voting. Why do we need to bring in somebody else who could only muddy the picture? And clearly all they could do is duplicate or cancel their husband's vote. Just says that the women or the patients, all right, all I could do is get in the way and not improve anything. I bring this up because it's a real mental error for people to say I don't know a lot of E-patients. So it must not be worth thinking about. Harry Glorikian: Yeah, I mean, so, just as a preview so of what we're going to talk about, what's your high-level argument for how we could make it easier for traditional patients to become E-patients?Dave deBronkart: Well, several dimensions on that. The most important thing, though, the most important thing is data and the apps. Harry Glorikian: Yes.Dave deBronkart: When people don't have access to their information, it's much harder for them to ask an intelligent question. It's like, hey, I just noticed this. Why didn't we do something? What's this about? Right. And now the flip side of it and of course, there's something I'm sure we'll be talking about is the so-called final rule that was just published in April of this year or just took effect of this year, that says over the course of the next year, all of our data in medical records systems has to be made available to us through APIs, which means there will be all these apps. And to anybody middle aged who thinks I don't really care that much, all you have to do is think about when it comes down to taking care of your kids or your parents when you want to know what's going on with them. Harry Glorikian: Would you think there would be more E-patients if the health care system gave them easier access to their data? What are some of the big roadblocks right now?Dave deBronkart: Well, one big roadblock is that even though this final federal rule has come out now, the American Medical Group Management Association is pushing back, saying, "Wait, wait, wait, this is a bad idea. We don't need patients getting in the way of what doctors are already doing." There will be foot dragging. There's no question about that. Part of that is craven commercial interests. There are and there have been numerous cases of hospital administrators explicitly saying -- there's one recording from the Connected Health conference a few years ago, Harlan Krumholtz, a cardiologist at Yale, quoted a hospital president who told him, "Why wouldn't I want to make it a little harder for people to take their business elsewhere?"Harry Glorikian: Well, if I remember correctly, I think it was the CEO of Epic who said, “Why would anybody want their data?”Dave deBronkart: Yes. Well, first of all, why I would want my data is none of her damn business. Well, and but that's what Joe Biden -- this was a conversation with Joe Biden. Now, Joe has a, what, the specific thing was, why would you want to see your data? It's 10,000 pages of which you would understand maybe 100. And what he said was, "None of your damn business. And I'll find people that help me understand the parts I want."Harry Glorikian: Yeah. And so but it's so interesting, right? Because I believe right now we're in a we're in a state of a push me, pull you. Right? So if you look at, when you said apps, I think Apple, Microsoft, Google, all these guys would love this data to be accessible because they can then apps can be available to make it more understandable or accessible to a patient population. I mean, I have sleep apps. I have, you know, I just got a CGM, which is under my shirt here, so that I can see how different foods affect me from, you know, and glucose, insulin level. And, you know, I'm wearing my Apple Watch, which tracks me. I mean, this is all interpretable because there are apps that are trying to at least explain what's happening to me physiologically or at least look at my data. And the other day I was talking to, I interviewed the CEO of a company called Seqster, which allows you to download your entire record. And it was interesting because there were some of the panels that I looked at that some of the numbers looked off for a long period of time, so I'm like, I need to talk to my doctor about those particular ones that are off. But they're still somewhat of a, you know, I'm in the business, you've almost learned the business. There's still an educational level that and in our arcane jargon that gets used that sort of, you know, everybody can't very easily cross that dimension.Dave deBronkart: Ah, so what? So what? Ok, this is, that's a beautiful observation because you're right, it's not easy for people to absorb. Not everybody, not off the bat. Look, and I don't claim that I'm a doctor. You know, I still go to doctors. I go to physical therapists and so on and so on. And that is no reason to keep us apart from the data. Some doctors and Judy Faulkner of Epic will say, you know, you'll scare yourself, you're better off not knowing. Well, ladies and gentlemen, welcome to the classic specimen called paternalism. "No, honey, you won't understand." Right now paternal -- this is important because this is a major change enabled by technology and data, right -- the paternal caring is incredibly important when the cared-for party cannot comprehend. And so the art of optimizing and this is where MoneyBall thinking comes in. The art of optimizing is to understand people's evolving capacity and support them in developing that capacity so that the net sum of all the people working on my health care has more competence because I do. Harry Glorikian: Right. And that's where I believe like. You know, hopefully my book The Future You will help people see that they're, and I can see technology apps evolving that are making it easier graphically, making it more digestible so someone can manage themselves more appropriately and optimally. But you mentioned your cancer. And I want to go and at least for the listeners, you know, go a little bit through your biography, your personal history, sort of helping set the stage of why we're having this conversation. So you started your professional work in, I think it was typesetting and then later software development, which is a far cry from E-patient Dave, right? But what what qualities or experiences, do you think, predisposed you to be an E-patient? Is it fair to say that you were already pretty tech savvy or but would you consider yourself unusually so?Dave deBronkart: Well, you know, the unusually so, I mean, I'm not sure there's a valid reason for that question to be relevant. There are in any field, there are pioneers, you know, the first people who do something. I mean, think about the movie Lorenzo's Oil, people back in the 1980s who greatly extended their child's life by being so super engaged and hunting and hunting through libraries and phone calls. That was before there was the Internet. I was online. So here are some examples of how I, and I mentioned that my daughter was gestating in 1983. I took a snapshot of her ultrasound and had it framed and sitting on my office desk at work, and people would say, what's that? Nobody knew that that was going to be a thing now and now commonplace thing. In 1999, I met my second wife online on Match.com. And when I first started mentioning this in speeches, people were like, "Whoa, you found your wife on the Internet?" Well, so here's the thing, 20 years later, it's like no big deal. But that's right. If you want to think about the future, you better be thinking about or at least you have every right to be thinking about what are the emerging possibilities. Harry Glorikian: So, tell us the story about your, you know, renal cancer diagnosis in 2007. I mean, you got better, thank God. And you know, what experience it taught you about the power of patients to become involved in their decision making about the course of treatment?Dave deBronkart: So I want to mention that I'm right in the middle of reading on audio, a book that I'd never heard of by a doctor who nearly died. It's titled In Shock. And I'm going to recommend it for the way she tells the story of being a patient, observing the near fatal process. And as a newly trained doctor. In my case, I went in for a routine physical. I had a shoulder X-ray and the doctor called me the next morning and said, "Your shoulder is going to be fine, but the X-ray showed that there's something in your lung that shouldn't be there." And to make a long story short, what we soon found out was that it was kidney cancer that had already spread. I had five tumors, kidney cancer tumors in both lungs. We soon learned that I had one growing in my skull, a bone metastasis. I had one in my right femur and my thigh bone, which broke in May. I now have a steel rod in my in my thigh. I was really sick. And the best available data, there wasn't much good data, but the best available data said that my median survival. Half the people like me would be dead in 24 weeks. 24 weeks!Harry Glorikian: Yeah.Dave deBronkart: And now a really pivotal moment was that as soon as the biopsy confirmed the disease, that it was kidney cancer, my physician, the famous doctor, Danny Sands, my PCP, because he knew me so well -- and this is why I hate any company that thinks doctors are interchangeable, OK? They they should all fry in hell. They're doing it wrong. They should have their license to do business removed -- because he knew me he said, "Dave, you're an online kind of guy. You might like to join this patient community." Now, think how important this is. This was January 2007, not 2021. Right. Today, many doctors still say stay off the Internet. Dr. Sands showed me where to find the good stuff.Harry Glorikian: Right. Yeah, that's important.Dave deBronkart: Well, right, exactly. So now and this turned out to be part of my surviving. Within two hours of posting my first message in that online community, I heard back. "Thanks for the, welcome to the club that nobody wants to join." Now, that might sound foolish, but I'd never known anybody who had kidney cancer. And here I am thinking I'm likely to die. But now I'm talking to people who got diagnosed 10 years ago and they're not dead. Right? Opening a mental space of hope is a huge factor in a person having the push to move forward. And they said there's no cure for this disease. That was not good news. But the but there's this one thing called high dose Interleukin 2. That usually doesn't work. So this was the patient community telling me usually doesn't work. But if you respond at all, about half the time, the response is complete and permanent. And you've got to find a hospital that does it because it's really difficult. And most hospitals won't even tell you it exists because it's difficult and the odds are bad. And here are four doctors in your area who do it, and here are their phone numbers. Now, ladies and gentlemen, I assert that from the point of view of the consumer, the person who has the need, this is valuable information. Harry, this is such a profound case for patient autonomy. We are all aware that physicians today are very overworked, they're under financial pressure from the evil insurance companies and their employers who get their money from the insurance companies. For a patient to be able to define their own priorities and bring additional information to the table should never be prohibited. At the same time, we have to realize that, you know, the doctors are under time pressure anyway. To make a long story short, they said this this treatment usually doesn't work. They also said when it does work, about four percent of the time, the side effects kill people.Harry Glorikian: So here's a question. Here's a question, though, Dave. So, you know, being in this world for my entire career, it's my first question is, you see something posted in a club, a space. How do you validate that this is real, right, that it's bona fide, that it's not just...I mean, as we've seen because of this whole vaccine, there's stuff online that makes my head want to explode because I know that it's not real just by looking at it. How do you as as a patient validate whether this is real, when it's not coming from a, you know, certified professional?Dave deBronkart: It's a perfect question for the whole concept of The Future You. The future you has more autonomy and more freedom to do things, has more information. You could say that's the good news. The bad news is you've got all this information now and there's no certain source of authority. So here you are, you're just like emancipation of a teenager into the adult life. You have to learn how to figure out who you trust. Yeah, the the good news is you've got some autonomy and some ability to act, some agency, as people say. The bad news is you get to live with the consequences as well. But don't just think "That's it, I'm going to go back and let the doctors make all the decisions, because they're perfect," because they're not, you know, medical errors happen. Diagnostic errors happen. The overall. The good news is that you are in a position to raise the overall level of quality of the conversations.Harry Glorikian: So, you know, talk about your journey after your cancer diagnosis from, say, average patient to E-patient to, now, you're a prominent open data advocate in health care.Dave deBronkart: Yes. So I just want to close the loop on what happened, because although I was diagnosed in January, the kidney came out in March, and my interleukin treatments started in April. And by July, six months after diagnosis, by July, the treatment had ended and I was all better. It's an immunotherapy. When immunotherapy works, it's incredible because follow up scans showed the remaining tumors all through my body shrinking for the next two years. And so I was like, go out and play! And I started blogging. I mean, I had really I had pictured my mother's face at my funeral. It's a, it's a grim thought. But that's how perhaps one of my strengths was that I was willing to look that situation in the eye, which let me then move forward. But in 2008, I just started blogging about health care and statistics and anything I felt like. And in 2009 something that -- I'm actually about to publish a free eBook about that, it's just it's a compilation of the 12 blog posts that led to the world exploding on me late in 2008 -- the financial structure of the U.S. health system meant that even though we're the most expensive system in the world, 50 percent more expensive than the second place country, if we could somehow fix that, because we're the most expensive and we don't have the best outcomes, so some money's being wasted there somewhere. All right. If we could somehow fix that, it would mean an immense amount of revenue for some companies somewhere was going to disappear.Dave deBronkart: Back then, it was $2.4 trillion, was the US health system. Now it's $4 trillion. And I realized if we could cut out the one third that excess, that would be $800 billion that would disappear. And that was, I think, three times as much as if Google went out of business, Apple went out of business and and Microsoft, something like that. So I thought if we want to improve how the system works, I'm happy if there are think tanks that are rethinking everything, but for you and me in this century, we got to get in control of our health. And that had to start with having access to our data. All right. And totally, unbeknownst to me, when the Obama administration came in in early 2009, this big bill was passed, the Recovery Act, that included $40 billion of incentives for hospitals to install medical computers. And one of the rules that came out of that was that we, the patients, had to be able to look at parts of our stuff. And little did I know I tried to use to try to look at my data. I tried to use the thing back then called Google Health. And what my hospital sent to Google was garbage. And I blogged about it, and to my huge surprise, The Boston Globe newspaper called and said they wanted to write about it, and it wasn't the local newspaper, it was the Washington health policy desk. And they put it on Page One. And my life spun out of control.Harry Glorikian: Yeah, no, I remember I remember Google Health and I remember you know, I always try to tell people, medicine was super late to the digitization party. Like if it wasn't for that the Reinvestment and Recovery Act putting that in place, there would still be file folders in everybody's office. So we're still at the baby stage of digitization and then the analytics that go with it. And all I see is the curve moving at a ridiculous rate based on artificial intelligence, machine learning being applied to this, and then the digitized information being able to come into one place. But you said something here that was interesting. You've mentioned this phenomenon of garbage in, garbage out. Right. Can you say more about one of the hospitals that treated you? I think it was Beth Israel. You mentioned Google Health. What went wrong there and what were the lessons you took away from that?Dave deBronkart: Well, there were, so what this revealed to me, much to my amazement, much to my amazement, because I assumed that these genius doctors just had the world's most amazing computers, right, and the computers that I imagined are the computers that we're just now beginning to move toward. Right. RI was wrong. But the other important thing that happened was, you know, the vast majority of our medical records are blocks of text, long paragraphs of text or were back then. Now, it was in a computer then, it wasn't notes on paper, but it was not the kind of thing you could analyze, any more than you could run a computer program to read a book and write a book report on it. And so but I didn't know that. I didn't know what Google Health might do. The next thing that happened was as a result, since Google Health was looking for what's called structured data -- now, a classic example of structured data is your blood pressure. It's fill in a form, the high number, the low number, what's your heart rate? What's your weight, you know? The key value pairs, as some people call them. Very little of my medical history existed in that kind of form. So for some insane reason, what they decided to send Google instead was my insurance billing history.Dave deBronkart: Now, insurance data is profoundly inappropriate as a model of reality for a number of reasons. One of one reason is that insurance form data buckets don't have to be very precise. So at one point I was tested for metastases to the brain to see if I had kidney cancer tumors growing in my brain. The answer came back No. All right. Well, there's only one billing code for it. Metastases to the brain. And that's a legitimate billing code for either one. But it got sent to Google Health as metastases to the brain, which I never had. All right. Another problem is something called up-coding, where insurance billing clerks are trained you can bill for something based on the keywords that the doctors and nurses put in the computer. So at one point during my treatment, I had a CAT scan of my lungs to look for tumors. And the radiologist noted, by the way, his aorta is slightly enlarged. The billing clerk didn't care that they were only checking for kidney cancer tumors. The billing clerk saw aorta, enlarged, aneurysm, and billed the insurance company for an aneurysm, which I never had. Corruption. Corruption. People ask, why are our health care costs so high? It's this system of keyword-driven billing. But then on top of that, I had things that I never had anything like it. There was, when this blew up in the newspaper, the hospital finally released all my insurance billing codes. It turns out they had billed the insurance company for volvulus of the intestine. That's a lethal kink of the intestine that will kill you in a couple of days if it's not treated. Never had anything of the sort. Billing fraud.Harry Glorikian: Interesting.Dave deBronkart: Anyway, because a random patient had just tried to use Google Health and I knew enough about data from my day job to be able to say, "Wait a minute, this makes no sense, why is all this happening?" And I couldn't get a straight answer. You know, it's a common experience. Sometimes you ask a company, "I've got a problem. This isn't right." And sometimes they just blow you off. Well, that's what my hospital did to me. I asked about these specific questions and they just blew me off. So then once it was on the front page of the newspaper, the hospital is like, "We will be working with the E-patient Dave and his doctor." And there's nothing like publicity, huh?[musical interlude]Harry Glorikian: Let's pause the conversation for a minute to talk about one small but important thing you can do, to help keep the podcast going. And that's to make it easier for other listeners discover the show by leaving a rating and a review on Apple Podcasts.All you have to do is open the Apple Podcasts app on your smartphone, search for The Harry Glorikian Show, and scroll down to the Ratings & Reviews section. Tap the stars to rate the show, and then tap the link that says Write a Review to leave your comments. It'll only take a minute, but you'll be doing us a huge favor.And one more thing. If you like the interviews we do here on the show I know you'll   like my new book, The Future You: How Artificial Intelligence Can Help You Get Healthier, Stress Less, and Live Longer.It's a friendly and accessible tour of all the ways today's information technologies are helping us diagnose diseases faster, treat them more precisely, and create personalized diet and exercise programs to prevent them in the first place.The book comes out soon, so keep an eye out for the next announcement.Thanks. And now back to our show.[musical interlude]Harry Glorikian: One of your slogans is "Gimme my damn data," meaning, you know, your patient records. And so can you summarize first, the state of the art prior to this digital transformation? Why was it historically the case that patients didn't have easy access to charts from their doctor's office or their visits? Why has the medical establishment traditionally been reluctant or maybe even unable to share this data?Dave deBronkart: Well, first, I want to explain the origin of that of that term. Because the speech in September of that year that launched the global speaking had that title. What happened was that summer of 2009, my world was spinning out of control as I tried to answer people's questions and get involved in the blogging that was going on and health policy arguments in Washington and so on. And so a real visionary in Toronto, a man named Gunther Eisenbach, who had quite a history in pioneering in this area, invited me to give the opening keynote speech for his annual conference in Toronto that fall. And several times during the summer, he asked me a question I'd never been asked. I came to learn that it was normal, but it was "For our brochure, we need to know what do you want to call the speech? What's the title of the speech?" And I remember very well sitting in my office at work one day saying into the telephone, "I don't know, just call it 'Give me my damn data, because you guys can't be trusted." And much to my amazement, It stuck.Dave deBronkart: I want to be clear. Under the 1996 health information law called hip hop, you are entitled to a copy of every single thing they have about you. All right, and a major reason for that. Back in the beginning was to detect mistakes. So it's interesting because HIPAA arose from health insurance portability. 1996 was when it first became mandatory that you had to be able to take your insurance business elsewhere and therefore your records. And that's the origin of the requirement that anybody who holds your health information as part of your insurance or anything else has to be really careful about not letting it leak out. And therefore and it has to be accurate. Therefore, you have a right to look at it and get any mistakes fixed. But. Foot dragging, foot dragging, foot dragging. I don't want to. As we discussed earlier, there are some doctors who simply wanted to keep you captive. But there are also, the data was also handwritten garbage at times, just scribbles that were never intended to be read by anyone other than the person who wrote the note in the first place. Harry Glorikian: Well, but, you know, I'm not trying to necessarily defend or anything, but but, you know, as you found at Beth Israel Deaconess, and I talk about this in The Future You as well, part of the problem is most of these things that people look at as large electronic health record systems were are still are in my mind designed as accounting and billing systems, not to help the doctors or the patients. And that's still a major problem. I mean, I think until we have, you know, a Satya Nadella taking over Microsoft where he, you know, went down and started rewriting the code for Microsoft Office, you're not going to get to management of patients for the betterment of their health as opposed to let me make sure that I bill for that last Tylenol.Dave deBronkart: Absolutely. Well, and where I think this will end up, and I don't know if it'll be five years or 10 or 20, but where this will end up is, the system as it exists now is not sustainable as a platform for patient-centered care. The early stage that we're seeing now, there is an incredibly important software interface that's been developed in the last five or six years still going on called FHIR, F-H-I-R. Which is part of that final rule, all that. So all of our data increasingly in the next couple of years has to be available through an API. All right. So, yeah, using FHIR. And I've done some early work on collecting my own data from the different doctors in the hospitals I've gone to. And what you get what you get when you bring those all in, having told each of them your history and what medications you're on and so on, is you get the digital equivalent of a fax of all of that from all of them. That's not coordinated, right. The medication list from one hospital might not match even the structure, much less the content of the medication list. And here's where it gets tricky, because anybody who's ever tried to have any mistake fixed at a hospital, like "I discontinued that medicine two years ago," never mind something like, "No, I never had that diagnosis," it's a tedious process, tons of paperwork, and you've got to keep track of that because they so often take a long time to get them fixed. And I having been through something similar in graphic arts when desktop publishing took over decades ago. I really wonder, are we will we ultimately end up with all the hospitals getting their act together? Not bloody likely. All right. Or are we more likely to end up with you and me and all of us out here eventually collecting all the data and the big thing the apps will do is organize it, make sense of it. And here's a juicy thing. It will be able to automatically send off corrections back to the hospital that had the wrong information. And so I really think this will be autonomy enabled by the future, you holding your own like you are the master copy of your medical reality.Harry Glorikian: Yeah, I always you know, I always tell like what I like having as a longitudinal view of myself so that I can sort of see something happening before it happens. Right. I don't want to go in once the car is making noise. I like just I'd like to have the warning light go off early before it goes wrong. But. So you mentioned this, but do you have any are there any favorite examples of patient friendly systems or institutions that are doing data access correctly?Dave deBronkart: I don't want to finger any particular one as doing a great job, because I haven't studied it. Ok. I know there are apps, the one that I personally use, which doesn't yet give me a useful it gives me a pile of fax pages, but it does pull together all the data, it's it's not even an app, it's called My Patient Link. And anybody can get it. It's free. And as long as the hospitals you're using have this FHIR software interface, which they're all required to, by the way, but some still don't. As long as they do this, My Patient Link will go and pull it all together. Now it's still up to you to do anything with it. So we're just at the dawn of the age that I actually envisioned back in 2008 when I decided to do the Google Health thing and the world blew up in my face.Harry Glorikian: Yeah. I mean, I have access to my chart. And, you know, that's useful because I can go look at stuff, but I have to admit, and again, this is presentation and sort of making it easy to digest, but Seqster sort of puts it in a graphical format that's easier for me to sort of absorb. The information is the same. It's just how it gets communicated to me, which is half the problem. But but, you know, playing devil's advocate, how useful is the data in the charts, really? I mean, sometimes we talk as if our data is some kind of treasure trove of accurate, actionable data. But you've helped show that a lot of it could be, I don't want to say useless, but there's errors in it which technically could make it worse than useless. But how do you think about that when you when you think about this?Dave deBronkart: Very good. First note. First of all, you're right. It will...a lot of the actual consumer patient value will, and any time I think about that again, I think a lot of young adults, I think of parents taking care of a sick kid, you know, or middle aged people taking care of elders who have many declining conditions. Right. There's a ton of data that you really don't care about. All right, it's sort of it's like if you use anything like Quicken or Mint, you probably don't scrutinize every detail that's in there and look for obscure patterns or so on. But you want to know what's going on. And here's the thing. Where the details matter is when trouble hits. And what I guarantee we will see some time, I don't know if it'll be five years, 10, or 20, but I guarantee what we will see someday is apps or features within apps that are tuned to a specific problem. If my blood pressure is something I'm.... Six years ago my doctor said, dude, you're prediabetic, your A1C is too high. Well, that all of a sudden brings my focus on a small set of numbers. And it makes it really important for me to not just be tracking the numbers in the computer, but integrate it with my fitness watch and my diet app.Harry Glorikian: Right. Dave deBronkart: Yeah, I lost 30 pounds in a year. And then at the age of 65, I ran a mile for the first time in my life because my behavior changed. My behavior had changed to my benefit, not because of the doctor micromanaging me, but because I was all of a sudden more engaged in getting off my ass and doing something that was important to me.Harry Glorikian: well, Dave, you need to write a diet book, because I could use I could stand to lose like 10 or 20 pounds.Dave deBronkart: Well, no, I'm not writing any diet books. That's a project for another day. Harry Glorikian: That's it for this week's episode. Dave and I had a lot more to talk about, and we'll bring you the second part of the conversation in the next episode, two weeks from now.You can find past episodes of The Harry Glorikian Show and MoneyBall Medicine at my website, glorikian.com. Don't forget to go to Apple Podcasts to leave a rating and review for the show. You can find me on Twitter at hglorikian. And we always love it when listeners post about the show there, or on other social media. Thanks for listening, stay healthy, and be sure to tune in two weeks from now for our next interview. 

Anesthesia Guidebook
#48 – IV Induction Agents with Ashley Scheil, BSN, SRNA

Anesthesia Guidebook

Play Episode Listen Later Sep 27, 2021 52:11


This episode was originally published in April 2019 on From the Head of the Bed… a podcast for the anesthesia community. In this podcast, Ashley walks us through an overview of the most common IV anesthesia induction agents. We cover propofol, ketamine, etomidate, barbiturates (e.g. methohexital), dexmedetomidine and benzodiazepines (e.g. midazolam). A run down of […]

Ari Shaffir's Skeptic Tank
#441 Korea Was Hell with Chris Alan

Ari Shaffir's Skeptic Tank

Play Episode Listen Later Sep 27, 2021 162:24


Comedian and Air Force vet Chris Alan came over to tell me, famous draft dodger, about his time in the armed forces. It's waaaay different than what you see in movies. It was a funny and super interesting podcast about the gruntwork side of war.  Follow Chris: Instagram  Twitter  Listen to his new album, "Off Script" For more Ari: Upcoming tour dates: Follow on Instagram Patreon More   Thank you to our sponsors!  Go to BetterHelp.com/Ari for 10% off your first month. Order your liquid IV at LiquidIV.com and be sure to use code "Skeptic" for 25% off! Check out 3Chi.com and use promo code "Skeptic" for 5% off Delta 8 products. The Music: Jimmie Osborne - Thank God For Victory In Korea Cake - I Bombed Korea The Air Force Song Black Sabbath - War Pigs  

POLITICO Dispatch
Presenting Global Insider: Colombian President Iván Duque on protests, vaccines & Bezos

POLITICO Dispatch

Play Episode Listen Later Sep 26, 2021 14:53


On this special presentation of POLITICO's new podcast Global Insider, host Ryan Heath sits down with Colombia's leader Iván Duque. Subscribe to Global Insider Ryan Heath is the author of Global Insider, POLITICO's global newsletter and podcast, and previously authored POLITICO's U.N. Playbook, Brussels Playbook, and Davos Playbook. Ryan moderated the first presidential debate of the 2019 EU election, as part of a five-year stint in the POLITICO's European leadership team. He appears on CNN, NBC and BBC and is the author of two books on politics. Prior to POLITICO, Ryan wrote for the Sydney Morning Herald in Australia, and worked for the European Commission in Brussels as a presidential speechwriter and later as the Commission's spokesperson for digital issues. Olivia Reingold is the producer of Global Insider. Irene Noguchi is the Executive Producer of POLITICO Audio and edits Global Insider.

The Global Politico
UNGA Dispatch 3: Colombian President Iván Duque on protests, vaccines & Bezos

The Global Politico

Play Episode Listen Later Sep 23, 2021 14:53


 Ryan Heath sits down with Colombia's leader Iván Duque. What's on their minds? Deadly protests, lack of vaccines, climate change, refugees and… oh yeah, space travel with Jeff Bezos.  Also: if you have the time, we're trying to learn more about our listeners. We'd appreciate it if you're able to take our short survey.  Iván Duque is the president of Colombia.  Ryan Heath is the host of the "Global Insider" podcast and newsletter.  Olivia Reingold produces “Global Insider.”  Irene Noguchi edits “Global Insider” and is the executive producer of POLITICO Audio.