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Drs. Ted Morton and Christine Lockowitz join Dr. Ryan Moenster to discuss all things amoxicillin, particularly in our pediatric patients. Our guests answer common questions, such as, what formulations should be used for certain infectious conditions and/or organisms and how to dose amoxicillin to maximize PK/PD optimization without inducing potential adverse events. It is a must-listen for all! This episode also qualifies for 1 hour of BCIDP credit! How to Obtain BCIDP Recertification Credit for this Episode: Visit sidp.org/BCIDP for more information. References: Bradley JS, Garonzik SM, Forrest A, Bhavnani SM. Pharmacokinetics, pharmacodynamics, and Monte Carlo simulation: selecting the best antimicrobial dose to treat an infection. Pediatr Infect Dis J. 2010 Nov;29(11):1043-6. doi: 10.1097/INF.0b013e3181f42a53. PMID: 20975453. Craig WA. Pharmacokinetic/pharmacodynamic parameters: rationale for antibacterial dosing of mice and men. Clin Infect Dis. 1998 Jan;26(1):1-10; quiz 11-2. doi: 10.1086/516284. PMID: 9455502. Hakenbeck R, Grebe T, Zähner D, Stock JB. beta-lactam resistance in Streptococcus pneumoniae: penicillin-binding proteins and non-penicillin-binding proteins. Mol Microbiol. 1999 Aug;33(4):673-8. doi: 10.1046/j.1365-2958.1999.01521.x. PMID: 10447877. Bax R. Development of a twice daily dosing regimen of amoxicillin/clavulanate. Int J Antimicrob Agents. 2007 Dec;30 Suppl 2:S118-21. doi: 10.1016/j.ijantimicag.2007.09.002. Epub 2007 Nov 5. PMID: 17983732. Bielicki JA, Stöhr W, Barratt S, Dunn D, Naufal N, Roland D, Sturgeon K, Finn A, Rodriguez-Ruiz JP, Malhotra-Kumar S, Powell C, Faust SN, Alcock AE, Hall D, Robinson G, Hawcutt DB, Lyttle MD, Gibb DM, Sharland M; PERUKI, GAPRUKI, and the CAP-IT Trial Group. Effect of Amoxicillin Dose and Treatment Duration on the Need for Antibiotic Re-treatment in Children With Community-Acquired Pneumonia: The CAP-IT Randomized Clinical Trial. JAMA. 2021 Nov 2;326(17):1713-1724. doi: 10.1001/jama.2021.17843. Erratum in: JAMA. 2021 Dec 7;326(21):2208. doi: 10.1001/jama.2021.20219. PMID: 34726708; PMCID: PMC8564579.
Recent randomized controlled trials have shown that routine perioperative palliative care does not improve outcomes for patients undergoing curative-intent cancer surgery. No, that wasn't a typo. Regardless of how the data were analyzed, the findings remained consistent: perioperative palliative care DID NOT improve outcomes in the only two randomized controlled trials conducted in this area—the SCOPE and PERIOP-PC trials. Null trials like these often receive less attention in academic and clinical settings, but they can be profoundly practice-changing. Consider the Shannon Carson study on palliative care for chronically critically ill patients. While some have argued it "wasn't a palliative care study," I've always regarded it as one of the most significant studies for understanding not what works—but what doesn't—for palliative care in specific patient populations. The same holds true for the SCOPE and PERIOP-PC trials. Both were null, but their findings are deeply relevant to clinical practice. That's why we invited the lead authors, Rebecca Aslakson (PERIOP-PC) and Myrick "Ricky" Shinall (SCOPE), to share insights into what they did in their studies and why they think they got the results that they did. One key takeaway for me from this discussion was the idea that patients undergoing curative-intent surgery might simply be too early in their cancer trajectory to derive meaningful benefits from palliative care, and maybe the focus should be more on geriatrics. I especially appreciated the closing discussion about the future of research in this area: if routine perioperative palliative care doesn't improve outcomes, what should the next generation of studies focus on? Eric Widera Studies we talk about during the podcast Aslakson et al. Effect of Perioperative Palliative Care on Health-Related Quality of Life Among Patients Undergoing Surgery for Cancer: A Randomized Clinical Trial. JAMA Netw Open. 2023 Shinall et al. Effects of Specialist Palliative Care for Patients Undergoing Major Abdominal Surgery for Cancer: A Randomized Clinical Trial. JAMA Surg. 2023 Carson et al. Effect of Palliative Care–Led Meetings for Families of Patients With Chronic Critical Illness: A Randomized Clinical Trial. JAMA. 2016 Holdsworth et al. Patient Experiences of Specialty Palliative Care in the Perioperative Period for Cancer Surgery. JPSM. 2024 Williams et al. Patient Perceptions of Specialist Palliative Care Intervention in Surgical Oncology Care. Am J Hosp Palliat Care. 2025 Yefimova et al. Palliative Care and End-of-Life Outcomes Following High-risk Surgery. JAMA Surg. 2020
The Sex & Power Podcast: Truth-telling that liberates with Mike Steve Collins: The Anti-Civil Rights MovementMike Collins is the author of The Anti-Civil Rights Movement: Affirmative Action as Wedge and Weapon (University Press of Kansas, 2024), Understanding Etheridge Knight, updated edition (University of South Carolina Press, 2023), and The Traveling Queen (poems, Sheep Meadow Press, 2013). His essays have appeared in Harper's Magazine, The Oxford American, The Cambridge Companion to American Prison Writing and Mass Incarceration, Fight & Fiddle, Callaloo, PMLA, and elsewhere. His poems have appeared in New Letters, About Place, 32 Poems, The Rupture, JAMA, The American Journal of Poetry, and elsewhere. He teaches at Texas A & M University.https://kansaspress.ku.edu/9780700637140/ Our conversation today focuses on his recent book The Anti-Civil Rights Movement: Affirmative Action as Wedge and Weapon, where Mike examines how policies created to promote opportunity and fairness were slowly reshaped into tools that divided the very groups they were meant to empower.FIND MIKE on TikTok @mike.steve.collinsFIND JANICE SELBIE:Janice Selbie's best-selling book, Divorcing Religion: A Memoir and Survival Handbook, is available here. https://amzn.to/4mnDxuoRecordings from the Shameless Sexuality: Life After Purity Culture conference 2025 available here. https://www.shamelesssexuality.org/Religious Trauma Survivor Support Groups happen online Tuesdays and Thursdays at 5pm Pacific/8pm Eastern. Sign up here. https://www.divorcing-religion.com/servicesFor help with recovery from religious trauma, book a free 20-minute consultation with Janice here. https://www.divorcing-religion.com/servicesFollow Janice and Divorcing Religion on Social Media:linktr.ee/janiceselbieThe Divorcing Religion Podcast is for entertainment purposes only. If you need help with your mental health, please consult a qualified, secular, mental health clinician. The views expressed by guests are not necessarily held by the host.Support the show
On this week’s episode, we’re continuing our Guidelines Series exploring the 2022 ESC/ERS Guidelines for the diagnosis and treatment of Pulmonary Hypertension. If you missed our first episode in the series, give it a listen to hear about the most recent recommendations regarding Pulmonary Hypertension definitions, screening, and diagnostics. Today, we’re talking about the next steps after diagnosis. Specifically, we’ll be discussing risk stratification, establishing treatment goals, and metrics for re-evaluation. We’ll additionally introduce the mainstays of pharmacologic therapy for Pulmonary Hypertension. Meet Our Co-Hosts Rupali Sood grew up in Las Vegas, Nevada and made her way over to Baltimore for medical school at Johns Hopkins. She then completed her internal medicine residency training at Massachusetts General Hospital before returning back to Johns Hopkins, where she is currently a pulmonary and critical care medicine fellow. Rupali’s interests include interstitial lung disease, particularly as related to oncologic drugs, and bedside medical education. Tom Di Vitantonio is originally from New Jersey and attended medical school at Rutgers, New Jersey Medical School in Newark. He then completed his internal medicine residency at Weill Cornell, where he also served as a chief resident. He currently is a pulmonary and critical care medicine fellow at Johns Hopkins, and he’s passionate about caring for critically ill patients, how we approach the management of pulmonary embolism, and also about medical education of trainees to help them be more confident and patient centered. Key Learning Points 1) Episode Roadmap How to set treatment goals, assess symptom burden, and risk-stratify patients with suspected/confirmed pulmonary arterial hypertension (PAH). What tools to use to re-evaluate patients on treatment Intro to major PAH medication classes and how they map to pathways. 2) Case-based diagnostic reasoning Patient: 37-year-old woman with exertional dyspnea, mild edema, abnormal echo, telangiectasias + epistaxis → raises suspicion for HHT (hereditary hemorrhagic telangiectasia) and/or early connective tissue disease. Key reasoning move: start broad (Groups 2–5) and narrow using history/exam/testing. In a young patient without obvious left heart or lung disease, think more about Group 1 PAH (idiopathic/heritable/associated). HHT teaching point: HHT can cause PH in more than one way: More common: high-output PH from AVMs (often hepatic/pulmonary) Rare (1–2% mentioned): true PAH phenotype (vascular remodeling; associated with ALK1 in some patients), behaving like Group 1 PAH. 3) Functional class assessment WHO Functional Class: Class I: no symptoms with ordinary activity, only with exertion Class II: symptoms with ordinary activity Class III: symptoms with less-than-ordinary activity (can't do usual chores/shopping without dyspnea) Class IV: symptoms at rest Practical bedside tip they give: Ask if the patient can walk at their own pace or keep up with a similar-age peer/partner. If not, think Class II (or worse). 4) Risk stratification at diagnosis: why, how, and which tools Big principle: treatment choices are driven by risk, and the goal is to move patients to low-risk quickly. ESC/ERS approach at diagnosis (as described): Use a 3-strata model predicting 1-year mortality: Low: 20% ESC/ERS risk assessment variables (10 domains discussed): Clinical progression, signs of right heart failure, syncope WHO FC Biomarkers (NT-proBNP) Exercise capacity (6MWD) Hemodynamics Imaging (echo; sometimes cardiac MRI) CPET (peak VO₂; VE/VCO₂ slope) They note: even if you don't have everything, the calculator can still be useful with ≥3 variables. REVEAL 2.0: Builds on similar core variables but adds further patient context (demographics, renal function, BP, DLCO, etc.) Case result: both tools put her in intermediate risk (ESC/ERS ~1.6; REVEAL 2.0 score 8), underscoring that mild symptoms can still equal meaningful mortality risk. 5) Treatment goals and follow-up philosophy What they explicitly prioritize: Help patients feel better, live longer, and stay out of the hospital Use risk tools to communicate prognosis and to track improvement Reassess frequently (they mention ~every 3 months early on) until low risk is achieved “Time-to-low-risk” is an important treatment goal Also emphasized: The diagnosis is psychologically heavy; patients need clear counseling, reassurance about the plan, and connection to support groups. 6) Medication classes for the treatment of PAH Nitric oxide–cGMP pathway PDE5 inhibitors: sildenafil, tadalafil Soluble guanylate cyclase stimulator: riociguat Important safety point: don't combine PDE5 inhibitors with riociguat (risk of significant hypotension/hemodynamic effects) Endothelin receptor antagonists (ERAs) “-sentan” drugs: bosentan (less used due to side effects/interactions), ambrisentan, macitentan Teratogenicity emphasized Hepatotoxicity that requires LFT monitoring Can cause fluid retention and peripheral edema Prostacyclin pathway Prostacyclin analogs/agonists: Epoprostenol (potent; short half-life; IV administration) Treprostinil (IV/SubQ/oral/inhaled options) Selexipag (oral prostacyclin receptor agonist) 7) Sotatercept (post-guidelines) They note sotatercept wasn't in 2022 ESC/ERS but is now “a game changer” in practice: Mechanism: ligand trap affecting TGF-β signaling / remodeling biology Positioned as potentially more disease-modifying than pure vasodilators Still evolving: where to place it earlier vs later in regimens is an active question in the field 8) How risk category maps to initial treatment intensity General approach they outline: High risk at diagnosis: parenteral prostacyclin (IV/SubQ) strongly favored, often aggressive early Intermediate risk: at least dual oral therapy (typically PDE5i + ERA); escalate if not achieving low risk Low risk: at least one oral agent; many still use dual oral depending on etiology/trajectory For the case: intermediate-risk → start dual oral therapy (they mention tadalafil + ambrisentan as a typical choice), reassess in ~3 months; add a third agent (e.g., selexipag/prostacyclin pathway) if not low risk. References and Further Reading Humbert M, Kovacs G, Hoeper MM, Badagliacca R, Berger RMF, Brida M, Carlsen J, Coats AJS, Escribano-Subias P, Ferrari P, Ferreira DS, Ghofrani HA, Giannakoulas G, Kiely DG, Mayer E, Meszaros G, Nagavci B, Olsson KM, Pepke-Zaba J, Quint JK, Rådegran G, Simonneau G, Sitbon O, Tonia T, Toshner M, Vachiery JL, Vonk Noordegraaf A, Delcroix M, Rosenkranz S; ESC/ERS Scientific Document Group. 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J. 2022 Oct 11;43(38):3618-3731. doi: 10.1093/eurheartj/ehac237. Erratum in: Eur Heart J. 2023 Apr 17;44(15):1312. doi: 10.1093/eurheartj/ehad005. PMID: 36017548. Condon DF, Nickel NP, Anderson R, Mirza S, de Jesus Perez VA. The 6th World Symposium on Pulmonary Hypertension: what’s old is new. F1000Res. 2019 Jun 19;8:F1000 Faculty Rev-888. doi: 10.12688/f1000research.18811.1. PMID: 31249672; PMCID: PMC6584967. Maron BA. Revised Definition of Pulmonary Hypertension and Approach to Management: A Clinical Primer. J Am Heart Assoc. 2023 Apr 18;12(8):e029024. doi: 10.1161/JAHA.122.029024. Epub 2023 Apr 7. PMID: 37026538; PMCID: PMC10227272. Hoeper MM, Badesch DB, Ghofrani HA, Gibbs JSR, Gomberg-Maitland M, McLaughlin VV, Preston IR, Souza R, Waxman AB, Grünig E, Kopeć G, Meyer G, Olsson KM, Rosenkranz S, Xu Y, Miller B, Fowler M, Butler J, Koglin J, de Oliveira Pena J, Humbert M; STELLAR Trial Investigators. Phase 3 Trial of Sotatercept for Treatment of Pulmonary Arterial Hypertension. N Engl J Med. 2023 Apr 20;388(16):1478-1490. doi: 10.1056/NEJMoa2213558. Epub 2023 Mar 6. PMID: 36877098. Ruopp NF, Cockrill BA. Diagnosis and Treatment of Pulmonary Arterial Hypertension: A Review. JAMA. 2022 Apr 12;327(14):1379-1391. doi: 10.1001/jama.2022.4402. Erratum in: JAMA. 2022 Sep 6;328(9):892. doi: 10.1001/jama.2022.13696. PMID: 35412560.
Dr. Stacey Clardy talks with Dr. John Ney about the prevalence, disability burden, and societal impact of neurologic disorders in the U.S. Read the related article in JAMA. Disclosures can be found at Neurology.org.
We return for Part 2 of our Scott Galloway deep dive, where the vibes remain strong, the confidence unwavering, and the relationship with empirical evidence increasingly… decorative.Returning to our Modern Wisdom safari, we continue navigating the forbidden terrain of men, masculinity, and male suffering: a topic so dangerous that it requires constant ritual disclaimers, whispered caveats, and the occasional nervous glance around the bar to make sure we can take out the other men if necessary.We cover Scott's outline of his masculine Third Way: rejecting both the Right's “Bring Back the Fifties” masculinity and the Left's “Men Are the Problem” framework, in favour of a solution that might be described as Stern Dad Who's Also Nice About It. Prepare to thrill at proposals of mandatory national service, kindness as a masculine superpower, and the radical idea that young people might benefit from not being economically crushed.Things get spicier when we're told what women really want and learn about the adaptive skill check of the female orgasm. Chris Williamson unveils a prepared essay on What Men Want which proves to be a moving piece of therapeutic slam poetry that somehow manages to combine manosphere grievance mongering with woke therapy talk. We learn how what men really just want to be told is “you are enough" and should be kind for kindness sake, but also should optimise their friend group such that they can properly signal their high mate quality and train hard enough to take out all other males in the bar.Finally, we hit peak Decoding Mode as Scott's statistics begin to escalate: boys are ten times more likely to kill themselves, father absence turns sons into inmates, daughters into promiscuous approval-seekers, and nearly every claim is delivered with total confidence and minimal concern for effect sizes, confounds, or whether the study actually exists. Decorative scholarship is in full bloom.We do our best as two hyper-masculine men to separate reasonable concerns about boys, mentorship, and social policy from hyperbolic factoids, pop-psych inflation, and the familiar habit of smuggling moral arguments in under the banner of “what the science says.”Bring your hunting knife and stoic daily diary. Take your testosterone injection. And get ready for some man talk!LinksModern Wisdom: The War On Men Isn't Helping Anyone - Scott GallowayThe Diary of a CEO: Scott Galloway: We're Raising The Most Unhappy Generation In History! Hard Work Doesn't Build WealthAcademic papers/Sources ReferencedCulpin, I., Heuvelman, H., Rai, D., Pearson, R. M., Joinson, C., Heron, J., … Kwong, A. S. F. (2022). Father absence and trajectories of offspring mental health across adolescence and young adulthood: Findings from a UK-birth cohort. Journal of Affective Disorders, 314, 150–159.Dekker, M. C., Ferdinand, R. F., van Lang, N. D. J., Bongers, I. L., van der Ende, J., & Verhulst, F. C. (2007). Developmental trajectories of depressive symptoms from early childhood to late adolescence: Gender differences and adult outcome. Journal of Child Psychology and Psychiatry, 48(7), 657–666.Angelakis, I., Austin, J. L., & Gooding, P. (2020). Association of childhood maltreatment with suicide behaviors among young people: a systematic review and meta-analysis. JAMA network open, 3(8), e2012563-e2012563.Zhang, L., Wang, P., Liu, L., Wu, X., & Wang, W. (2026). Different roles of child abuse and neglect on emerging adult's nonsuicidal self-injury and suicidal ideation: sex difference through emotion regulation. Current...
Linda Brubaker, MD, and Christopher C. Muth, MD, Deputy Editors of JAMA, the Journal of the American Medical Association, discuss articles published from January 17-23, 2026.
Interview with Emily Baumrin, MD, MSCE, author of Discordance in Treatment Response Assessment Between Clinicians and Patients With Skin Chronic Graft-vs-Host Disease. Hosted by Adewole S. Adamson, MD. Related Content: Discordance in Treatment Response Assessment Between Clinicians and Patients With Skin Chronic Graft-vs-Host Disease
Join Thanks to our guest today, Jed Hansen, PhD, APRN, FNP-C, who is the Nebraska Rural Health Association's Executive Director. He and Libby Crockett, MD are discussing the Rural Health Transformation Fund which was established by HR1 (or the One Big Beautiful Bill Act) July 4, 2025. He serves as the Nebraska Hospital Associations's rural consultant. He is a native Nebraskan, growing up in the community of Minden. His academic background is focused on healthcare utilization facilitators and barriers in ambulatory care settings.Dr. Hansen leads projects focused on the rural emergency hospital model, improving veteran access to care, and innovative community-level health economic models. He also works diligently to improve interoperability and data flow in rural health care settings and increase workforce pipelining. Dr. Hansen is a fellow of the National Rural Health Association, the 2023 Rural Advocate of the Year and he recently published in JAMA on the impact of OBBA/HR1 on rural healthcare (read it here): https://pubmed.ncbi.nlm.nih.gov/40900579/Additional Background on HR1 (OBBA) Link to HR1 - One Big Beautiful Bill ActNE DHHS text of Application- click here and scroll down to find text of applicationhttps://www.cms.gov/priorities/rural-health-transformation-rht-program/overviewhttps://shvs.org/wp-content/uploads/2025/08/SHVS-Manatt-Rural-Health-Transformation-Fund-Discussion-8.28.25.pdfhttps://shvs.org/tracking-state-preparation-for-the-rural-health-transformation-program/Rural Health Association Links:https://nebraskaruralhealth.org/I Love Rural Health Program Link:https://iloveruralhealth.com/We rely on your donations to keep producing this podcast content and to support physician advocacy in Nebraska. If you would like to support Nebraska Alliance for Physician Advocacy, a 501(c)(3) organization in Nebraska please click to DONATE NOW. If you have questions or answers, please email us at contact@nebraskaallianceforphysicianadvocacy.org Please check out our website at: Nebraska Alliance for Physician Advocacy Follow on social media: @NEAllianceforPhysicianAdvocacy on Instagram https://www.facebook.com/neallianceforphysicianadvocacy on Facebook The views and opinions expressed on this podcast are solely those of the speakers and guests and do not necessarily reflect the official policy or position of their employers or any other organization or entity. This podcast is for informational and entertainment purposes only and does not constitute professional medical, legal, or financial advice. If you have a specific concern, please consult with a qualified professional.
Clippings: The Official Podcast of the Council for Nail Disorders
Nail Lichen Planus in 81 Patients: A Retrospective Study of Clinical Characteristics, Histopathological Features, and Long-Term Treatment Outcomes.He J, Weng T, Bai J, Zhu W, Huang X, Yang Y, Li C. The Journal of Dermatology. 2025 Nov;52(11):1629-37.Low-dose naltrexone use in biopsy-proven lichen planus of the nails.Bray ER, Morrison BW. JAMA dermatology. 2024 Dec 1;160(12):1334-7.
This week on the Faculty Factory Podcast, author Joshua Hartzell, MD, MS-HPEd, FACP, FIDSA, is back on the show, and we're taking a deep dive into feedback. We discuss how to give and receive feedback more effectively—a topic that we all should strive to improve in our professional lives. With 25 years of experience in military medicine, Dr. Hartzell is a retired army colonel as well as a practicing internist and infectious diseases physician. Feedback is meant to be a conversation, helping each other better understand where the other individual is coming from. After all, we're never sure what is going on in someone's life until we ask. How do we get better at feedback? Yes, you can read books and consume podcasts like this on it, but explicitly asking someone to give you feedback about yourself may be an even stronger starting point. Dr. Hartzell also encourages getting feedback on your feedback, as it takes practice. "When we give people feedback, it tells them whether their performance aligns with our expectations or not; it really clarifies our expectations. I think that's really important because, without that, it's sort of left up to people to decide: 'Am I doing a good job?'" he told us. Another crucial element surrounding this interview is the critically important notion that a lack of feedback is still a form of feedback so there are no doubt consequences of choosing silence and inaction. Explore Resources from this Podcast Dr. Hartzell's first appearance on our Faculty Factory Podcast, titled “A Comprehensive Look at Developing Excellent Leadership in Medicine” can be found here: https://facultyfactory.org/joshua-hartzell/ You can learn more about Dr. Hartzell's book, “A Prescription for Caring in Healthcare Leadership: Building a Culture of Compassion and Excellence”, here: https://www.amazon.com/Prescription-Caring-Healthcare-Leadership-Compassion/dp/B0DSQ4276K Disclaimer: The opinions and assertions expressed herein are those of the author and do not reflect the official policy or position of the Army, Navy, Air Force, the Uniformed Services University of the Health Sciences or the Department of War. References: Kim Scott, Radical Candor: Be a Kick-Ass Boss Without Losing Your Humanity (New York: St. Martin's Press, 2019). Ende J. Feedback in clinical medical education. JAMA. 1983 Aug 12;250(6):777-81.
Editor's Summary by Linda Brubaker, MD, and Preeti Malani, MD, MSJ, Deputy Editors of JAMA, the Journal of the American Medical Association, for articles published from January 10-16, 2026.
In this episode of The Valley Today Community Health series, host Janet Michael talks with Dr. Kevin Volkema, a board-certified family medicine physician at Valley Health Primary Care Greenwood, about the critical importance of primary care. From Chicago Suburbs to the Shenandoah Valley Dr. Kevin Volkema's journey into medicine began with a simple nudge. Growing up in Wheaton, Illinois, just outside Chicago, he received encouragement from two unlikely sources during high school: his own primary care physician and his chemistry teacher. Both pulled the 16-year-old aside and suggested he consider a career in medicine. Initially, Dr. Volkema didn't think much of their advice. However, during his sophomore year at the University of Illinois, he decided to take a leap of faith. He earned his EMT license and began volunteering at a clinic for the uninsured. That experience changed everything. "I really, really enjoyed that year," Dr. Volkema recalls. "Most importantly, I enjoyed working at that clinic for the uninsured. That's really where the foundation grew of this appreciation for community health and community service and this grassroots effort of making change for individuals." Today, Dr. Volkema serves as a board-certified family medicine physician at Valley Health Primary Care Greenwood. He splits his time between patient care and his role as regional medical director, bringing both clinical expertise and administrative insight to the growing Winchester community. He moved to the area this past summer with his wife, a neonatologist at Valley Health, after completing a stint in Charlottesville where she finished her fellowship. The Power of One: Understanding Primary Care's Impact When most people think of healthcare, they envision dramatic scenes from television—emergency rooms, operating theaters, intensive care units. Yet Dr. Volkema emphasizes that this high-stakes, acute care represents only a fraction of actual healthcare delivery. "The reality is that's not the majority of health or the majority of healthcare," he explains. Primary care, by contrast, serves as the quarterback, the home base, the front door to the healthcare system. The statistics backing this claim are remarkable. According to a major study published in JAMA, just one primary care physician for every 10,000 people produces measurable effects: decreased mortality, reduced hospitalization rates, fewer emergency room visits, lower healthcare costs, and improved chronic disease management. "One person could affect 10,000 lives," Dr. Volkema emphasizes. "That's a pretty huge impact." More Than Just Availability: The Three A's of Primary Care Dr. Volkema shares wisdom from one of his mentors, who told him that patients care about three things when choosing a primary care physician: they want someone who is able, affable, and available. Fail on any of these three, and success becomes impossible. Increasingly, availability has become the biggest challenge. This explains why many people default to urgent care facilities—they're open when patients need them. Nevertheless, urgent care cannot replace the continuity and comprehensive oversight that primary care provides. Valley Health has recognized this critical need and made substantial investments in primary care infrastructure. The organization has built new clinics, including the Greenwood location where Dr. Volkema practices, remodeled existing facilities, and aggressively recruited physicians to serve the growing community. Building Relationships That Save Lives Primary care thrives on continuity. Dr. Volkema particularly enjoys seeing entire families—parents, grandparents, and children—because understanding family dynamics provides crucial context for individual health. "Who you live with, how you sleep, if you're stressed, if you are eating a healthy diet, if you exercise—those are gonna influence everything," he notes. "But if I don't even understand the basics about who you are as a person or how your life works, how am I supposed to help you with your chronic medical conditions?" This relationship-building extends beyond physical health. Surprisingly, primary care serves as the largest provider of mental health services in the United States. When people experience depression, anxiety, or grief, they typically turn to their primary care physician first—not because PCPs are psychiatrists, but because patients trust them. "We've built that relationship. We've put in the effort to develop that connection with them so that when things do arise, they feel comfortable talking with us," Dr. Volkema explains. The Four Horsemen: Preventing Chronic Disease Dr. Volkema frames chronic disease management around four pillars, sometimes called "the four horsemen": cardiovascular disease, metabolic disease, neurodegenerative diseases, and cancer. Much of primary care's preventive focus centers on delaying or preventing these conditions from developing. Through lifestyle modifications and mindful attention to habits, patients can potentially push back diagnoses by a decade or more. Instead of developing a chronic condition at 55, thoughtful prevention might delay onset until 65 or 75. Importantly, Dr. Volkema stresses that it's never too late to start. Impressive research demonstrates that individuals 65 and older who begin exercise and weightlifting routines show measurable improvements in bone density, muscle mass, metabolic health, and overall function. "There's never a time that's too late to start," he assures patients of all ages. "It can always make a difference." Bridging the Gap Between Generalist and Specialist Primary care physicians sometimes face skepticism about their breadth of knowledge compared to specialists' depth. Dr. Volkema acknowledges this reality while highlighting two significant advantages primary care physicians possess. First, there's that crucial continuity of care. A specialist may know everything about one body system, but they lack the benefit of a 3-, 5-, or 15-year relationship with the patient. They don't understand the full context of someone's life, medical history, and individual circumstances. Second, primary care physicians identify and fill gaps in care. When Dr. Volkema sees patients who have only followed with specialists, he consistently discovers concerning omissions: missed cancer screenings, unknown medication interactions, and unassessed common medical conditions. "It's keeping an eye on all these different facets of an individual's life and an individual's care to make sure that there's not only a hyper fixation on one type of problem or one concern, and that all the other factors are still being addressed as well," he explains. Practical Access: Getting Care When You Need It Valley Health Primary Care Greenwood currently employs five providers—three physicians, one physician assistant, and one nurse practitioner. Three additional physicians will join the practice in 2026, with one starting in May and two more in July. All providers are accepting new patients, dispelling the common misconception that no one is taking new patients in the area. Patients can research providers at valleyhealthlink.com/primarycare or valleyhealthlink.com/findadoctor. The practice offers same-day appointments for urgent needs, though it's not a walk-in urgent care facility. Patients must call to schedule, but the practice holds multiple same-day slots specifically for this purpose. Additionally, a physician assistant dedicates her entire schedule to same-day patients, providing crucial access for both established and new patients. The Greenwood location also features a full-service lab open from 7:00 AM to 5:00 PM, Monday through Friday. Any Valley Health patient can have blood drawn there, regardless of which Valley Health physician ordered the tests. This convenience factor has proven particularly valuable for patients who work in different areas than where they live. When to Seek Care: Earlier Is Better Dr. Volkema emphasizes the importance of seeking care early in an illness. Treatments for conditions like influenza work most effectively when started soon after symptom onset. Tamiflu, for example, provides maximum benefit when begun early in the disease course—the same principle that applies to COVID antivirals like Paxlovid. The practice offers same-day testing for strep throat, influenza, and COVID-19, with results available in 15 to 20 minutes. This rapid turnaround helps patients get appropriate treatment quickly, especially important during seasons when multiple viruses circulate simultaneously. For individuals with complex medical needs who require immediate primary care—perhaps after a hospitalization or recent move to the area—Valley Health operates a transition clinic on Amherst Street near the hospital. This clinic provides bridge care while patients establish with a long-term primary care physician. The Path Forward As Winchester's Greenwood area continues its explosive growth—transforming from farmland into a bustling commercial district—Valley Health's investment in primary care infrastructure positions the community for better health outcomes. Dr. Volkema's message remains clear and hopeful: primary care access exists in the Shenandoah Valley, providers are accepting new patients, and establishing that crucial relationship with a primary care physician represents one of the most impactful health decisions anyone can make. Whether you're managing chronic conditions, seeking preventive care, or simply need someone who knows your complete health story, the door to primary care stands open. The question isn't whether you can find a primary care physician—it's whether you'll take that first step toward better health. After all, as the research shows, one physician really can change 10,000 lives. Perhaps it's time to let them change yours.
Interview with Arash Mostaghimi, MD, MPA, MPH, author of Advanced Practice Clinicians and Dermatology Drug Spending. Hosted by Adewole S. Adamson, MD. Related Content: Advanced Practice Clinicians and Dermatology Drug Spending Biologics Prescribing in Dermatology by Advanced Practice Clinicians—Trends in the Practice of Advanced Practice Clinicians in Dermatology
✓ Zašto se u Picburgu ne nose maske? ✓ Koji tip ličnosti su glavne sestre? ✓ Kako izgleda kombinacija gubitnika i sociopate?
Send us a textThis week on The Incubator Podcast, Ben and Daphna review several recent studies in neonatal care. They start with a JAMA trial comparing expectant versus active PDA management in preterm infants, noting a survival signal favoring expectant care and discussing how this fits within current practice. They then review outcomes of 21-week gestation infants from the University of Iowa, focusing on resuscitation strategies and survival at the limits of viability.The conversation continues with the ICAF trial, examining whether extending caffeine therapy through 41 weeks postmenstrual age meaningfully reduces intermittent hypoxia and for which infants this may matter. A large national cohort study on antenatal corticosteroids between 21 and 24 weeks gestation is also discussed, highlighting practice variation and implications for counseling.The episode closes with a Neo News segment on legal liability in the NICU following a recent $32 million NEC settlement. Ben, Daphna, and Eli consider informed consent around nutritional care and how evolving legal pressures may influence communication and clinical decision making.This compilation brings together research and policy discussions from the week in a single long-form episode.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!
Editor's Summary by Linda Brubaker, MD, and Preeti Malani, MD, MSJ, Deputy Editors of JAMA, the Journal of the American Medical Association, for articles published from January 3-9, 2026.
Send us a textIn this Journal Club episode, Ben and Daphna review a major randomized clinical trial published in JAMA comparing expectant management with active pharmacologic treatment of patent ductus arteriosus in preterm infants. They walk through the trial design, inclusion criteria, and outcomes, highlighting the unexpected survival difference favoring expectant management despite similar rates of bronchopulmonary dysplasia. The discussion explores the implications for bedside decision-making, the limitations of PDA-focused strategies, and the need for a more physiologic, patient-centered approach to ductal management in extremely preterm infants.----Expectant Management vs Medication for Patent Ductus Arteriosus in Preterm Infants: The PDA Randomized Clinical Trial. Laughon MM, Thomas SM, Watterberg KL, Kennedy KA, Keszler M, Ambalavanan N, Davis AS, Slaughter JL, Guillet R, Colaizy TT, Cotten CM, Dhawan MA, Bose CL, Talbert J, Smucny S, Benitz WE, Rysavy MA, Ohls RK, Baserga MC, DeMauro SB, Jaleel M, Jackson WM, Carlo WA, Puopolo KM, Hibbs AM, Katheria A, Sánchez PJ, D'Angio CT, Patel RM, Johnson BA, Chock VY, Bhatt AJ, Merhar SL, Moore R, Laptook AR, Ghavam S, Fuller J, Vyas-Read S, Kicklighter SD, Steinbrekera B, Anderson K, Reynolds AM, Wyckoff MH, Montoya C, Das A, Do B, Chang S, Higgins RD, Walsh MC; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network.JAMA. 2025 Dec 9:e2523330. doi: 10.1001/jama.2025.23330. Online ahead of print.PMID: 41364689Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!
蒼藍鴿使用的保健品牌「藥師健生活」: 輸入優惠碼「bluepig」享全品項95折優惠! 點我購買▶ https://www.phargoods.com/ --- ⟡ 支持蒼藍鴿產出Podcast ➤ https://open.firstory.me/join/bluepigeon0810 ⟡ 信箱 ➤ bluepigeonn@gmail.com --- 【各段重點】 00:00 AD 01:50 月中心得：我們如何評估與挑選月子中心 05:50 新生兒回家後一直哭？實際遇到的狀況與我們的應對方式 09:20 肺癌蟬聯癌王：台灣不吸菸族群罹患肺癌比例偏高 12:17 非吸菸者肺癌的常見原因解析：二手菸、氡氣、PM2.5、油煙 16:08 肺癌篩檢：低劑量電腦斷層 (LDCT) 18:00 總結 #新生兒回家 #月子中心 #肺癌 #月中生活 #新手爸媽 #新生兒照護 #育兒心得 #育兒日常 #親子生活 #爸媽必看 #醫學科普 #健康知識 #肺腺癌 #非吸菸者肺癌 #不吸菸也會得肺癌 #肺癌原因 #二手菸危害 #PM25 #室內空氣品質 #油煙危害 #氡氣 #癌症篩檢 #低劑量電腦斷層 #LDCT #健康檢查 #癌症預防 --- ⟡ 更多醫學知識： 蒼藍鴿著作 ➤ https://reurl.cc/WA7lpL Instagram ➤ https://reurl.cc/ygvba8 Youtube ➤ https://reurl.cc/gm6bb7 Powered by Firstory Hosting
Interview with Victoria A. Sanchez, AuD, PhD, and Yaël Bensoussan, MD, MSc, authors of Why Hearing Health Must Be Part of Voice Biomarker Research. Hosted by Paul C. Bryson, MD, MBA. Related Content: Why Hearing Health Must Be Part of Voice Biomarker Research
Editor's Summary by Kirsten Bibbins-Domingo, PhD, MD, MAS, Editor in Chief, and Preeti Malani, MD, MSJ, Deputy Editor of JAMA, the Journal of the American Medical Association, for articles published from December 20,2025, through January 2, 2026.
JAMA Deputy Editor Mary McDermott, MD, and JAMA Deputy Editor Kristin Walter, MD, MS, highlight their selections of top JAMA Clinical Reviews podcasts in 2025. Related Content: Managing Adverse Effects of Obesity Medications Diagnosis and Management of Hypothyroidism Type 2 Diabetes: Diagnosis and Current Guidelines for Treatment Managing Adverse Effects of Incretin-Based Medications for Obesity Hypothyroidism Diagnosis and Treatment of Type 2 Diabetes in Adults JAMA Editors' Choice 2024: Clinical Reviews Podcasts
蒼藍鴿使用的保健品牌「藥師健生活」: 輸入優惠碼「bluepig」享全品項95折優惠! 點我購買▶ https://www.phargoods.com/ --- ⟡ 支持蒼藍鴿產出Podcast ➤ https://open.firstory.me/join/bluepigeon0810 ⟡ 信箱 ➤ bluepigeonn@gmail.com --- 【各段重點】 00:00｜澳洲立法限制青少年社群使用 澳洲政府規劃限制 16 歲以下青少年使用社群媒體，引發對青少年大腦發展的討論。 01:56｜JAMA 醫學期刊：社群媒體與青少年認知功能 研究顯示長時間使用社群媒體，可能影響專注力與記憶力。 02:33｜為什麼滑手機會變笨？被動資訊接收 碎片化資訊降低深度思考與主動學習能力。 05:47｜ABCD Study：青少年大腦認知發展研究 大型長期研究分析科技使用與大腦發育的關聯。 #被動學習 #專注力下降 #手機成癮 #青少年大腦發展 #社群媒體影響 #滑手機變笨 #青少年認知功能 #大腦發育 #數位成癮 #記憶力影響 #社群媒體研究 #JAMA期刊 #ABCDStudy #兒童青少年健康 #青少年心理 #注意力訓練 #深度思考 #資訊碎片化 #醫學科普 #青少年政策 #社群媒體使用 #手機使用習慣 #腦科學 #行為科學 #家長必看 #健康教育 --- ⟡ 更多醫學知識： 蒼藍鴿著作 ➤ https://reurl.cc/WA7lpL Instagram ➤ https://reurl.cc/ygvba8 Youtube ➤ https://reurl.cc/gm6bb7 Powered by Firstory Hosting
In this episode, JAMA Editor in Chief Kirsten Bibbins-Domingo, PhD, MD, MAS, and Medical News Director Jennifer Abbasi discuss the journal's inaugural Research of the Year roundup. Related Content: Research of the Year 2025
In this episode, JAMA Editor in Chief Kirsten Bibbins-Domingo, PhD, MD, MAS, and Medical News Director Jennifer Abbasi discuss the journal's inaugural Research of the Year roundup. Related Content: Research of the Year 2025
In this episode, JAMA Editor in Chief Kirsten Bibbins-Domingo, PhD, MD, MAS, and Medical News Director Jennifer Abbasi discuss the journal's inaugural Research of the Year roundup. Related Content: Research of the Year 2025
In this episode of the Evolving Wellness Podcast, I delve into the complexities of vitamin D and melatonin, particularly during the winter months. I discuss the natural decline of vitamin D levels in winter, the critical role of melatonin, and how modern lifestyles disrupt these hormonal balances. The conversation covers the impact of stress, alcohol, and blue light on health, the importance of circadian rhythms, and the potential benefits and drawbacks of vitamin D supplementation. Links: Become a substack subscriber & get early access to podcasts + free courses - https://open.substack.com/pub/sarahkleinerwellness/p/uvbred-light-protocol?r=5eztl9&utm_campaign=post&utm_medium=web&showWelcomeOnShare=trueHoliday Sale - https://www.sarahkleinerwellness.com/SKW-holidayFree Webinar - https://www.sarahkleinerwellness.com/mycircadianapp-free-webinarTimestamps:00:00 Introduction to Vitamin D and Melatonin02:47 Understanding Seasonal Changes in Vitamin D Levels06:13 The Role of Melatonin in Winter Health09:00 Impact of Modern Lifestyle on Vitamin D and Melatonin11:51 The Effects of Stress and Alcohol on Hormonal Balance15:08 Circadian Rhythms and Their Importance17:51 The Dangers of Blue Light and Sleep Disruption21:07 Winter Infections and Their Impact on Vitamin D23:59 Pros and Cons of Vitamin D Supplementation27:13 Understanding Individual Variability in Vitamin D Metabolism29:52 Short-Term Vitamin D Supplementation: When Is It Appropriate?33:14 The Importance of Comprehensive Testing and Monitoring36:01 Conclusion and Future DirectionsReferences & further reading:Article: You've been warned about sunlight but not about supplements - http://sarahkleinerwellness.com/blog/you-ve-been-warned-about-sunlight-but-not-supplementsArticle - Can vitamin D supplements lower your melatonin? https://sarahkleinerwellness.substack.com/p/can-vitamin-d-supplements-lower-yourManson et al. VITAL primary outcomes. N Engl J Med. 2019. PMID: 30415629Sanders et al. Annual high-dose D ↑ falls/fractures. JAMA. 2010. PMID: 20157135Bischoff-Ferrari et al. Monthly high-dose D ↑ falls. JAMA Intern Med. 2016. PMID: 26747333Jackson et al. WHI Ca+D ↑ kidney stones. N Engl J Med. 2006. PMID: 16481635Slominski et al. Melatonin, mitochondria & skin photobiology. Cell Mol Life Sci. 2020.Hamblin MR. Anti-inflammatory photobiomodulation. AIMS Biophys. 2017.Deng et al. Magnesium, vitamin D status & mortality (NHANES). BMC Med. 2013.Holick et al. Translocation of cutaneous vitamin D₃. Endocrinology. 1994.This video is not medical advice & as a supporter to you and your health journey - I encourage you to monitor your labs and work with a professional!________________________________________Get all my free guides and product recommendations to get started on your journey!https://www.sarahkleinerwellness.com/all-free-resourcesCheck out all my courses to understand how to improve your mitochondrial health & experience long lasting health! (Use code PODCAST to save 10%) - https://www.sarahkleinerwellness.com/coursesSign up for my newsletter to get special offers in the future! -https://sarahkleinerwellness.kit.com/profile?_gl=1*1gs7n29*_gcl_aw*R0NMLjE3NjQwOTIxNjcuQ2owS0NRaUF4SlhKQmhEX0FSSXNBSF9KR2poSEZxTTl0blpDSEl4SjYyRHdpa1FuNGc3QXplVll4NVktSFhmSFZZamEwVDAtcU92YXlfQWFBbHp0RUFMd193Y0I.*_gcl_au*MTgwMTYwMTMxMi4xNzYzMzIwODkyLjYyODE4ODI3NC4xNzY1NTA5NjM3LjE3NjU1MDk2MzY.Free Guide to Building your perfect quantum day (start here) -https://www.sarahkleinerwellness.com/opt-in-9d5f6918-77a8-40d7-bedf-93ca2ec8387fMy free product guide with all product recommendations and discount codes:https://www.canva.com/design/DAF7mlgZpJI/xVyE4tiQFEWJmh_Xwx8Kbw/view?utm_content=DAF7mlgZpJI&utm_campaign=designshare&utm_medium=link2&utm_source=uniquelinks&utlId=h0782b52987
This episode breaks down the major misconceptions about ADHD treatment and clarifies what decades of research, major clinical guidelines, and leading experts actually recommend. Ryan and Mike explain why weekly talk therapy is not an evidence-based treatment for ADHD, why parent training and environmental structure are consistently shown to improve outcomes, and how parents can make informed decisions without getting pulled into common myths.Find Mike @ www.grownowadhd.com & on IGFind Ryan @ www.adhddude.com & on Youtube{{chapters}}[00:00:00] Start[00:02:21] What clinical guidelines actually recommend[00:05:27] Dr. Barkley's research on effective ADHD treatments[00:09:11] Evidence on CBT, DBT, and play therapy[00:19:21] Why office-based therapy doesn't translate to real-world behavior[00:22:29] Rumination and how talk-heavy approaches can backfire[00:31:19] Treatments with the strongest evidence (medication, parent training)Citations:1. AAP Guideline (Parent Training + Medication as First-Line)Wolraich, M. L., et al. (2019). Clinical practice guideline for ADHD in children and adolescents. Pediatrics, 144(4), e20192528.2. AACAP Treatment Parameter (Medication + Behavioral)Pliszka, S. R., & AACAP Work Group. (2007). Practice parameter for ADHD. JAACAP, 46(7), 894–921.3. Barkley: ADHD as Performance DisorderBarkley, R. A. (2012). Executive functions. Guilford Press.Barkley, R. A. (2015). ADHD: Handbook for diagnosis and treatment (4th ed.). Guilford Press.4. CBT Evidence (Adolescents/Adults, Not Young Children)Safren, S. A., et al. (2010). CBT vs relaxation for adults with ADHD. JAMA, 304(8), 875–880.Solanto, M. V. (2011). CBT for adult ADHD. Guilford Press.Langberg, J. M., et al. (2008). Organization skills intervention for adolescents. JCCP, 76(6), 967–982.5. DBT-Informed (Pilot Trials, Emotion Dysregulation)Murray, D. W., et al. (2022). DBT skills group for adolescents with ADHD. J Attention Disorders, 26(11), 1421–1430.6. Play Therapy (Insufficient Evidence)Hassan, R. A., & Shaker, N. S. (2014). CBPT for ADHD symptoms. Int J Psychology & Behavioral Sciences, 4(6), 221–229.7. EF Skills: Experience-Based, Not Language-BasedBarkley, R. A. (2012). Executive functions. Guilford Press.8. Rumination and ADHDOstojic, D., et al. (2021). Mind wandering and rumination in youth with ADHD. J Abnormal Child Psychology, 49, 1203–1216.Seymour, K. E., et al. (2014). Emotion regulation mediates ADHD-depression relationship. J Abnormal Child Psychology, 42, 611–621.9. Time Blindness/Temporal ProcessingToplak, M. E., & Tannock, R. (2005). Time perception deficits in ADHD. J Abnormal Child Psychology, 33(5), 639–654.Barkley, R. A., et al. (2008). ADHD in adults: What the science says. Guilford Press.10. Parent Behavior Training (Evidence-Based)Chronis, A. M., et al. (2006). Evidence-based treatments for children with ADHD. Clinical Psychology Review, 26(4), 486–502.Evans, S. W., et al. (2014). Evidence-based treatments for ADHD. JCCAP, 43(4), 527–551.11. Medication as First-LineFaraone, S. V., et al. (2021). Stimulant effectiveness and safety. World Psychiatry, 20(3), 314–329.Swanson, J. M., et al. (2017). MTA study long-term outcomes. JAACAP, 56(3), 228–240.
Broadcast from KSQD, Santa Cruz on 12-18-2025: Dr. Dawn opens by examining how market competition is actually working in the weight loss drug sector. Novo Nordisk's Ozempic and Wegovy compete against Eli Lilly's Monjaro and ZepBound, with prices dropping nearly 50% as companies launch direct-to-consumer websites. The main barriers remain needles and refrigeration, driving development of oral versions. Novo's Wegovy pill awaits FDA approval for early 2026 launch at $150 monthly. Next-generation drugs show remarkable results: Eli's retatrutide causes 24% weight loss in 48 weeks, while Novo's Cagrisema combines semaglutide with amylin to reduce muscle loss. Pfizer paid $10 billion for Metsera's once-monthly drug despite significant side effects. A quick fiber tip suggests adding plain psyllium to morning coffee for cardiovascular and microbiome benefits. Start with half a teaspoon and work up to two teaspoons (10 grams) over several weeks to avoid gas. The prebiotic fiber improves glucose tolerance and may reduce cancer risk. UC San Diego scientists discovered why cancers mutate so rapidly despite being eukaryotic cells with protected chromosomes. The answer is chromothripsis, a catastrophic event where the enzyme N4BP2 literally explodes chromosomes into fragments. These reassemble incorrectly, generating dozens to hundreds of mutations simultaneously and creating circular DNA fragments carrying cancer-promoting genes. One in four cancers show evidence of this mechanism, with all osteosarcomas and many brain cancers displaying it. This explains why the most aggressive cancers resist treatment. Research from 2013 shows any glucocorticoid use significantly increases venous thromboembolism risk, with threefold increases during the first month of use. The risk applies to new and recurrent clots, affecting both oral and inhaled steroids, though IV poses highest risk and topical the lowest. Joint injections fall somewhere between inhaled and oral. Anyone with prior blood clots should avoid steroids except for life-threatening situations like severe asthma attacks requiring ventilation. A meta-analysis of 20 randomized controlled trials shows creatine supplementation helps older adults (48-84) maintain muscle mass when combined with weight training two to three times weekly. The supplement provides no benefit without exercise. Recommended dosing starts at 2 grams and works up to 5 grams daily. Vegans benefit most since they consume little meat or fish. Important caveat: creatine throws off standard kidney function tests (creatinine), so users should request cystatin C testing instead for accurate renal health assessment. A new JAMA study suggesting risk-based mammogram screening is fatally flawed. First, researchers offered chemopreventative drugs like tamoxifen only to the high-risk group, contaminating the study design. Second, the demographics skewed heavily toward white college-educated women, missing the reality that Black women face twice the risk of aggressive breast cancer with 40% higher mortality. Third, wild-type humans failed to follow instructions—low-risk women continued getting annual mammograms anyway while high-risk women skipped recommended extra screenings. The conclusion of "non-inferior" outcomes is meaningless given poor adherence. Stick with annual mammograms, and consider alternating with MRIs for high-risk women. The EAT-Lancet report condemns red meat based purely on observational data showing correlations with heart disease, cancer, and mortality. But people who eat lots of red meat differ dramatically from low consumers: they weigh more, smoke more, exercise less, and eat less fiber. Studies can't control for sleep quality, depression, or screen time. Notably, heavy meat eaters also die more in accidents, suggesting a risk-taking lifestyle phenotype. The inflammatory marker TMAO is higher in meat eaters, but starch is also pro-inflammatory. Eating red meat instead of instant ramen might improve health. A balanced diet with limited amounts beats epidemiology-based blanket statements. Dr. Dawn grades Dr. Oz's performance as CMS administrator. Starting at minus one for zero relevant experience, he earns plus two for promoting diet, exercise, and gut health on his show. He studied intensively after nomination, calling all four previous CMS directors repeatedly and surrounding himself with experienced staff (plus one). He finalized Medicare rules favoring prevention over surgery and earned bipartisan praise as "a real scientist, not radical" (plus one). He divested healthcare holdings but kept some blind trust interests (minus 0.5). He's developing a CMS app and partnering with Google on a digital health ecosystem (plus one), but supports ending ACA subsidies that will raise premiums for millions (minus one). He correctly promoted COVID vaccines and contradicted Trump's Tylenol-autism claims (plus one). Final score: 3.5 out of 5 possible points, the only positive score for any Trump health administrator.
Punky reggae party avec Kiddus I, Camille Bazbaz et Jérôme « Tchiky » Perez #SessionLive ! (Rediffusion) The Salmon est le projet d'un trio légendaire de « soul men » réuni pour célébrer une longue amitié, la liberté musicale et la créativité. Inspirés par les sons originaux du reggae, de la country, du blues et de la soul, ils remontent la rivière tels des saumons, à contre-courant des clichés et des normes. Leur balade nous ravit et nous transporte vers des paysages lointains, apaisants qui nous reconnectent à l'essentiel : l'amour de la musique. Le groupe est composé de trois amis aux carrières bien remplies : Kiddus I, la légende du reggae à la voix envoûtante, « Last Crooner on Earth », héros du film Rockers sorti en 1977 et un des membres du projet Inna De Yard ; Bazbaz, pianiste auteur-compositeur-interprète français avec neuf disques à son actif ; et Tchiky, guitariste hors pair qui accompagne De La Soul depuis une dizaine d'années. Après un premier EP sorti en 2020 composé des titres « Enough is Enough » et « The Long Road », et une pandémie plus tard, The Salmon renaît finalement en janvier 2022 du haut des collines de Kingston, où le trio enfin réuni fera vibrer la Jamaïque aux côtés de musiciens chevronnés français comme jamaïcains tels que Delroy Wormbass, Viryane Say, Sly Dunbar, Christianne Prince, Pam Hall, Fabrice Colombani, Fonso, Yann Cléry, David Hadjadj, Flabba Holt et Style Scott. Leur premier album est un pur bijou franco-jamaïcain imprégné de la terre natale du reggae, et reflète la volonté du trio de revenir aux racines de leurs inspirations. Music is love… or is nothing ! ► Titres interprétés au grand studio - Wiggling Live RFI - The Salmon (Ska Version), extrait de l'album - Flowers Live RFI ► Line Up : Kiddus I (chant), Camille Bazbaz (claviers) et Jérôme « Tchiky » Perez (guitare) Son : Mathias Taylor, Benoît Letirant, Camille Roch. ► Album The Salmon (22D Music 2025). Bandcamp - Facebook. ► Playlist - The Specials – Gangsters 1979 - Bob Marley – Punky Reggae Party 1977 - Junior Murvin – Police and Thieves 1976 - Femi Kuti – Journey Through Life (Journey Through Life Bongo Joe 2025) - Sami Galbi – Casaflex (1er album YLH Bye Bye Bongo Joe 2025). Réalisation : Hadrien Touraud.
Punky reggae party avec Kiddus I, Camille Bazbaz et Jérôme « Tchiky » Perez #SessionLive ! (Rediffusion) The Salmon est le projet d'un trio légendaire de « soul men » réuni pour célébrer une longue amitié, la liberté musicale et la créativité. Inspirés par les sons originaux du reggae, de la country, du blues et de la soul, ils remontent la rivière tels des saumons, à contre-courant des clichés et des normes. Leur balade nous ravit et nous transporte vers des paysages lointains, apaisants qui nous reconnectent à l'essentiel : l'amour de la musique. Le groupe est composé de trois amis aux carrières bien remplies : Kiddus I, la légende du reggae à la voix envoûtante, « Last Crooner on Earth », héros du film Rockers sorti en 1977 et un des membres du projet Inna De Yard ; Bazbaz, pianiste auteur-compositeur-interprète français avec neuf disques à son actif ; et Tchiky, guitariste hors pair qui accompagne De La Soul depuis une dizaine d'années. Après un premier EP sorti en 2020 composé des titres « Enough is Enough » et « The Long Road », et une pandémie plus tard, The Salmon renaît finalement en janvier 2022 du haut des collines de Kingston, où le trio enfin réuni fera vibrer la Jamaïque aux côtés de musiciens chevronnés français comme jamaïcains tels que Delroy Wormbass, Viryane Say, Sly Dunbar, Christianne Prince, Pam Hall, Fabrice Colombani, Fonso, Yann Cléry, David Hadjadj, Flabba Holt et Style Scott. Leur premier album est un pur bijou franco-jamaïcain imprégné de la terre natale du reggae, et reflète la volonté du trio de revenir aux racines de leurs inspirations. Music is love… or is nothing ! ► Titres interprétés au grand studio - Wiggling Live RFI - The Salmon (Ska Version), extrait de l'album - Flowers Live RFI ► Line Up : Kiddus I (chant), Camille Bazbaz (claviers) et Jérôme « Tchiky » Perez (guitare) Son : Mathias Taylor, Benoît Letirant, Camille Roch. ► Album The Salmon (22D Music 2025). Bandcamp - Facebook. ► Playlist - The Specials – Gangsters 1979 - Bob Marley – Punky Reggae Party 1977 - Junior Murvin – Police and Thieves 1976 - Femi Kuti – Journey Through Life (Journey Through Life Bongo Joe 2025) - Sami Galbi – Casaflex (1er album YLH Bye Bye Bongo Joe 2025). Réalisation : Hadrien Touraud.
Editor's Summary by Kirsten Bibbins-Domingo, PhD, MD, MAS, Editor in Chief, and Preeti Malani, MD, MSJ, Deputy Editor of JAMA, the Journal of the American Medical Association, for articles published from December 13-19, 2025.
Depo-Provera was approved in 1992 by U.S. regulators. About 1 in 4 sexually active women in the United States have used the shot at some point, according to the U.S. Centers for Disease Control and Prevention (CDC). Meningiomas are common intracranial tumors with a female predominance. In fact, they are the most common primary brain tumor in women, with an incidence of approximately 12.76 per 100,000 in the general female population. The vast majority of these tumors are benign (World Health Organization [WHO] grade 1) while 15% to 20% of these tumors can behave atypically (WHO grade 2) and rarely, in 1% to 2% of cases, these tumors can be malignant (WHO grade 3). We covered the relationship between Depo-Provera, as a contraceptive agent, and brain meningiomas back in March 2024. With the increase in data, the ACOG released a patient centered counseling tool titled, “Counseling Patients on Birth Control Injection and Meningioma”. The most recent update on this story comes from the FDA, which has granted a medication label change to Depo-Provera (Pfizer) warning of this association. Even though association does not prove causation, the association between depo and meningiomas seems strong (with new data from the US). Does this warning extend to other progestins? Listen in for details. 1. https://podcasts.apple.com/us/podcast/dr-chapas-obgyn-clinical-pearls/id1412385746?i=10006508795722. ACOG's “Counseling Patients on Birth Control Injection and Meningioma” 3. https://www.statnews.com/pharmalot/2025/12/17/fda-pfizer-contraception-cancer-preemption-depoprovera/4. Xiao T, Kumar P, Lobbous M, et al. Depot Medroxyprogesterone Acetate and Risk of Meningioma in the US. JAMA Neurology. 2025;82(11):1094-1102. doi:10.1001/jamaneurol.2025.3011.5. de Dios E, Näslund O, Choudhry M, et al.Prevalence and Symptoms of Incidental Meningiomas: A Population-Based Study.Acta Neurochirurgica. 2025;167(1):98. doi:10.1007/s00701-025-06506-7.6. Schaff LR, Mellinghoff IK.Glioblastoma and Other Primary Brain Malignancies in Adults: A Review. JAMA. 2023;329(7):574-587. doi:10.1001/jama.2023.0023.7. BMJ 2024; 384 doi: https://doi.org/10.1136/bmj-2023-078078 (Published 27 March 2024) Cite this as: BMJ 2024;384:e078078
'n Politieke ontleder, Kenneth Mokgathle, sê terrorisme groei reg oor Afrika namate staatsgrepe, korrupsie en swak leierskap nasies blootstel. Volgens die Verenigde Nasies is die Sahel-streek tans verantwoordelik vir 19-persent van terroriste-voorvalle wêreldwyd. Mokgathle sê ekstremistiese organisasies, soos onder meer, Jama'at Nusrat al-Islam wal Muslimeen en die Islamitiese Staat in die Groter Sahara, trek voordeel uit die leemte wat dalende internasionale ondersteuning teen tereur skep:
From Freudian fashion to sumptuous saris, courtly courtesans to iconic opera costumes, we take you "behind the seams" of our recent fashion history-packed day tours of New York City spent at the Fashion Institute of Technology, The New York Historical Society, The Metropolitan Opera and the Metropolitan Museum of Art. Further learning: Valerie Steele's Dress, Dreams, and Desire at the Museum at FIT The New York Sari and The Gay Harlem Renaissance at the New York Historical Discounted tickets for The Metropolitan Opera Antonio Ratti Center Noel Catherine Vorlée 1783 and ca. 1804 at the Metropolitan Museum of Art Man's Jama with Poppies Want more Dressed: The History of Fashion? Our website and classes Our Instagram Our bookshelf with over 150 of our favorite fashion history titles Learn more about your ad choices. Visit megaphone.fm/adchoices
Obesity affects more than 1 billion people worldwide and is recognized by the World Health Organization as a chronic, relapsing disease. WHO recently published a guideline in JAMA on the use and indications of GLP-1 therapies for the treatment of #obesity in adults. Francesca Celletti, MD, PhD, and Ezekiel Emanuel, MD, PhD, join JAMA Editor in Chief Kirsten Bibbins-Domingo, PhD, MD, MAS, to discuss. Related Content: World Health Organization Guideline on the Use and Indications of Glucagon-Like Peptide-1 Therapies for the Treatment of Obesity in Adults
This episode centers on the critical gap in nutrition education within medical training and efforts to bridge it. Guest Akash Patel, a medical student who led a pilot nutrition curriculum, discusses why doctors receive little formal training in nutrition despite poor diet being a major driver of disease. With diet-related conditions (obesity, diabetes, cardiovascular disease, etc.) contributing heavily to morbidity and healthcare costs, the conversation highlights a pivotal push to better equip physicians in nutritional knowledge and counseling. Patel's work comes at a turning point: there are now calls for standardized nutrition competencies in medical education (e.g., a recent JAMA consensus) and a growing recognition that improving doctors' nutrition literacy could enhance patient care and public trust. But at the same time, medical programs already have a huge workload and little space is available for appropriate training. Others state that nutrition shouldn't fall within the remit of doctors. So how do we reconcile all this? While this episode focuses on the United States context, the concepts apply to other countries, as it outlines both the challenges and the emerging solutions for closing the nutrition training gap in medicine. Timestamps [03:21] Akash Patel's background and interests [05:22] Current state of nutrition education in medical schools [07:55] Akash's pilot program and initial findings [13:37] Challenges and considerations for curriculum integration [15:11] Effective curriculum design for nutrition education [23:38] Debating the role of nutrition education in medical training [29:00] Practical scenarios and the role of doctors [33:58] Advice for implementing nutrition education initiatives [38:15] Future directions in nutrition and medicine [43:07] Key ideas segment Links & Resources Go to episode page (with studies listed & linked) Join the Sigma email newsletter for free Subscribe to Sigma Nutrition Premium Enroll in the next cohort of our Applied Nutrition Literacy course Instagram: @withakashpatel @dannylennon_sigma @sigmanutrition
Welcome to Episode 51 of “The 2 View,” the podcast for EM and urgent care nurse practitioners and physician assistants! Segment 1 Rodríguez, M. Á., Quintana-Cepedal, M., Cheval, B., Thøgersen-Ntoumani, C., Crespo, I., & Olmedillas, H. (2025, October 7). Effect of exercise snacks on fitness and cardiometabolic health in physically inactive individuals: Systematic review and meta-analysis. British Journal of Sports Medicine. Advance online publication. https://doi.org/10.1136/bjsports-2025-110027 Rodgers, L. (2025, October 17). As pickleball continues to gain players, injuries are increasing. JAMA. https://doi.org/10.1001/jama.2025.18833 Segment 2 Baos, S., Lui, M., Walker-Smith, T., Pufulete, M., Messenger, D., Abbadi, R., Batchelor, T., Casali, G., Edwards, M., Goddard, N., Abu Hilal, M., Alzetani, A., Vaida, M., Martinovsky, P., Saravanan, P., Cook, T., Malhotra, R., Simpson, A., Little, R., Wordsworth, S., Stokes, E., Jiang, J., Reeves, B., Culliford, L., Collett, L., Maishman, R., Chauhan, N., McCullagh, L., McKeon, H., Abbs, S., Lamb, J., Gilbert, A., Hughes, C., Wynick, D., Angelini, G., Grocott, M., Gibbison, B., & Rogers, C. A. (2025). Gabapentin for pain management after major surgery: A placebo-controlled, double-blinded, randomized clinical trial (the GAP Study). Anesthesiology, 143(4), 851-861. https://doi.org/10.1097/ALN.0000000000005655 NEJM Journal Watch. (2024, December 30). Growing evidence of harms associated with gabapentinoid drugs. JWatch. https://www.jwatch.org/na58203/2024/12/30/growing-evidence-harms-associated-with-gabapentinoid-drugs Moeindarbari, S., Beheshtian, N., & Hashemi, S. (2022). Cerebral vein thrombosis in a woman using oral contraceptive pills for a short period of time: A case report. Journal of Medical Case Reports, 16, Article 260. https://doi.org/10.1186/s13256-022-03473-w Peckham, A. M., Evoy, K. E., Ochs, L., & Covvey, J. R. (2018). Gabapentin for off-label use: Evidence-based or cause for concern? Substance Abuse: Research and Treatment, 12, 1178221818801311. https://doi.org/10.1177/1178221818801311 The 2 View: Emergency Medicine PAs & NPs. (2025, January 22). 41 – RCVS and CVT, CPR care science, prehospital tourniquets, blood pressure [Audio podcast episode]. Fireside. https://2view.fireside.fm/41 Strahan, A. E., Rikard, S. M., Schmit, K. M., Zhang, K., Guy, G. P., Jr., & [Additional Authors]. (2025). Trends in dispensed gabapentin prescriptions in the United States, 2010 to 2024. Annals of Internal Medicine. Advance online publication. https://doi.org/10.7326/ANNALS-25-01750 Segment 3 Brown, R. F., Lopez, K., Smith, C. B., & Charles, A. (2025). Diverticulitis: A review. JAMA, 334(13), 1180-1191. https://doi.org/10.1001/jama.2025.10234 Carr, S., & Velasco, A. L. (2024, July 25). Colon diverticulitis. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK541110/ Bob Tubbs on Emergency Radiology: https://youtu.be/Jg1JG67eoJQ Our social media: TikTok: https://www.tiktok.com/@ccmecourses Instagram: https://www.instagram.com/ccmecourses Facebook: https://www.facebook.com/CenterForMedicalEducation LinkedIn: https://www.linkedin.com/in/rickbukata Our podcasts: The 2 View Podcast (Free): Subscribe on Apple Podcasts https://apple.co/3rhVNZw Subscribe on Google Podcasts: http://bit.ly/2MrAHcD Subscribe On Spotify: http://spoti.fi/3tDM4im Risk Management Monthly Podcast (Paid CME): https://www.ccme.org/riskmgmt ** The information in this video is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/health professional. emergencymedicine #cme
In this episode, Michael speaks with attorney Shane Pennington, a leading expert on cannabis rescheduling, about reports that President Trump is preparing an executive order to reclassify marijuana from Schedule I to Schedule III. Pennington explains what a reclassification would mean for consumers, the legal cannabis industry, medical research, criminal justice, and state–federal power. Michael also explores the contrasting New York Times and JAMA analysis questioning the medical benefits of cannabis—and hears from listeners whose real-world experiences tell a different story. A fast-moving, deeply informative conversation about federal drug policy, politics, and the shifting landscape of cannabis in America. Hosted by Simplecast, an AdsWizz company. See https://pcm.adswizz.com for information about our collection and use of personal data for advertising.
TCW Podcast Episode 248 - An Act of Control We look at Japan's Act on Control and Improvement of Amusement Business and its impact on the arcade industry in Japan. In the late 1970s and early 1980s, video games became increasingly popular in Japan, drawing public concern over how much time and money players were spending in game centers. With little cultural context for games as entertainment, many assumed there must be some form of gambling or prize element involved, leading to growing moral panic. These concerns culminated in a 1985 amendment to an existing law that brought game centers under strict regulation. We examine the role of industry trade groups during this period, including the NRO, an operators organization that supported regulation under the belief it would disadvantage large arcades while leaving smaller venues such as department store rooftops and grocery stores unaffected. That assumption proved incorrect. At the same time, JAMA, representing manufacturers, organized its own operator segment to counter the NRO's influence. Because the law was written broadly, regulators were left to define what qualified as a controlled amusement, resulting in a chilling effect on arcades across Japan. These regulations reshaped the industry and pushed many companies to shift their focus toward home consoles and other markets. TCW 008 - Birth of the Japanese Game Center: https://podcast.theycreateworlds.com/e/birth-of-the-japanese-game-center/ Act on Control and Improvement of Amusement Business: https://www.japaneselawtranslation.go.jp/en/laws/view/4234/en Abroad in Japan - Pachinko - Japan's Biggest Gaming Obsession: https://www.youtube.com/watch?v=-tBy2jemw4s Masumi Akagi - "It Started with Pong": https://www.amazon.co.jp/%E3%81%9D%E3%82%8C%E3%81%AF%E3%80%8C%E3%83%9D%E3%83%B3%E3%80%8D%E3%81%8B%E3%82%89%E5%A7%8B%E3%81%BE%E3%81%A3%E3%81%9F-%E3%82%A2%E3%83%BC%E3%82%B1%E3%83%BC%E3%83%89TV%E3%82%B2%E3%83%BC%E3%83%A0%E3%81%AE%E6%88%90%E3%82%8A%E7%AB%8B%E3%81%A1-%E8%B5%A4%E6%9C%A8%E7%9C%9F%E6%BE%84/dp/4990251202 Rotamint - "Royal Super": https://www.youtube.com/watch?v=KRPBQ2cwAas Rotomint - Jackpot: https://www.youtube.com/watch?v=RgrmntnQfP4 TCW 077 - Invading Taito Part 1: https://podcast.theycreateworlds.com/e/invading-taito-part-1/ TCW 078 - Invading Taito Part 2: https://podcast.theycreateworlds.com/e/invading-taito-part-2/ TCW 195 - Finding Video Game Copyright: https://podcast.theycreateworlds.com/e/finding-video-game-copyright Sun Electronics - The Guiness: www.youtube.com/watch?v=zsJHEJHTU1M Fred Rogers Congress Public Funding: https://www.youtube.com/watch?v=fKy7ljRr0AA New episodes are on the 1st and 15th of every month! TCW Email: feedback@theycreateworlds.com Twitter: @tcwpodcast Patreon: https://www.patreon.com/theycreateworlds Alex's Video Game History Blog: http://videogamehistorian.wordpress.com Alex's book, published Dec 2019, is available at CRC Press and at major on-line retailers: http://bit.ly/TCWBOOK1 Intro Music: Josh Woodward - Airplane Mode - Music - "Airplane Mode" by Josh Woodward. Free download: http://joshwoodward.com/song/AirplaneMode Outro Music: RoleMusic - Bacterial Love: http://freemusicarchive.org/music/Rolemusic/Pop_Singles_Compilation_2014/01_rolemusic_-_bacterial_love Copyright: Attribution: http://creativecommons.org/licenses/by/4.0/
In this episode, JAMA Editor in Chief Kirsten Bibbins-Domingo, PhD, MD, MAS, and Medical News Director Jennifer Abbasi discuss the journal's inaugural Research of the Year roundup. Related Content: Research of the Year 2025
Editor's Summary by Kirsten Bibbins-Domingo, PhD, MD, MAS, Editor in Chief, Preeti Malani, MD, MSJ, Deputy Editor, and Christopher W. Seymour, MD, MSc, Associate Editor of JAMA, the Journal of the American Medical Association, for articles published from December 6-12, 2025.
In this episode, Dr. Zanotti discusses the role of Procalcitonin in the ICU. He is joined by Dr. Simran Gupta, an infectious disease specialist at Brigham & Women's Hospital in Boston. Dr. Gupta has additional training in Clinical Research, Transplant, and Infectious Disease. She recently published an article on reassessing the role of Procalcitonin in critically ill patients with sepsis. Additional resources: Reassessing Procalcitonin-Guided Antibiotic Therapy in Critically Ill Patients with Sepsis: Lessons from the ADAPT-Sepsis Trial. S. Gupta, et al. Clinical Infectious Disease 2025: https://pubmed.ncbi.nlm.nih.gov/40579227/ Biomarker-Guided Antibiotic Duration for Hospitalized Patients With Suspected Sepsis: The ADAPT-Sepsis Randomized Clinical Trial. JAMA 2025: https://pubmed.ncbi.nlm.nih.gov/39652885/ Procalcitonin-guided antibiotic therapy may shorten the length of treatment and may improve survival- a systematic review and meta-analysis. M Papp, et al. Crit Care 2023: https://pubmed.ncbi.nlm.nih.gov/37833778/ Books and entertainment mentioned in this episode: Shantaram: A Novel. By Gregory David Roberts: https://bit.ly/4ovVHKX SHANTARAM – Apple TV series: https://tv.apple.com/us/show/shantaram/umc.cmc.atxsrive40xli3zh3uxjimut
Interview with Molly N. Huston, MD, and William A. Strober, MD, MSCI, authors of Biofeedback vs Respiratory Retraining for Inducible Laryngeal Obstruction: A Randomized Clinical Trial. Hosted by Paul C. Bryson, MD, MBA. Related Content: Biofeedback vs Respiratory Retraining for Inducible Laryngeal Obstruction
In this high-impact solo episode, Darin strips away the noise, hacks, and hype to deliver a clear, no-BS roadmap for transforming your body, brain, energy, and direction in life. This is a straight-talk breakdown of the 5 foundational habits that matter most — the habits backed by science, ancient wisdom, and Darin's decades-long experience living this work every day. Expect practical steps, micro-experiments, timing rules, and the mindset needed to reclaim sovereignty in a world full of distraction. If you're ready to build a stronger, clearer, more powerful version of yourself… this is the episode. What You'll Learn 00:00 – Welcome to SuperLife How this podcast helps you build sovereignty through real habits, real truth, and real practices. 03:07 – Why this episode is different Darin lays out the mission: habits, hacks, hard truths — without dogma or fluff. 03:44 – The 5 foundational moves that change your biology A preview of the metabolic, physical, mental, and behavioral levers that create huge shifts. 1. METABOLIC EDGE — Eat Like You're Building a Future 04:03 – Terrain theory + why your food timing matters How altering the internal environment of your cells changes everything. 05:02 – The two levers that unlock metabolic health Time-restricted eating + plant-forward whole foods. 05:23 – Compressing your eating window Why 8–10 hours is ideal, how it improves glucose, insulin, weight, and inflammation. 06:18 – Practical weekly ramp-up Week 1: 12 hours. Week 2: 8–10 hours. Simple, sustainable, achievable. 07:10 – Darin's personal eating window 10 a.m. to 6 p.m. — and why eating earlier aligns with digestive fire. 2. MOVEMENT THAT MATTERS — Strength Is Survival 11:04 – Why strength training is non-negotiable Muscle protects metabolism, bone density, insulin sensitivity, and longevity. 11:51 – What the evidence says Huge cohort studies show strength training reduces all-cause mortality. 12:23 – The perfect weekly formula 3x/week compound lifts + daily movement + micro-bursts every hour. 13:06 – Real-life practicality Darin's routine of walking, sprinting dogs, mountain biking, and breaking up the day with movement. 3. SLEEP — The Ultimate Biological Reset 16:26 – The truth everyone ignores You cannot out-supplement or out-biohack poor sleep. 16:40 – The real impact of chronic sleep loss Cognition, memory, hormones, emotional regulation — all decline. 17:37 – The universal rule: consistent timing Same bedtime ± 30 minutes, every night. 17:52 – 60-minute wind-down protocol Screens off, light down, nervous system softening. 18:32 – Using sauna as a down-regulation tool Infrared benefits + why Darin does it twice a day in winter. 4. MINDSET & CONSCIOUSNESS — Your Attention Is Your Power 20:00 – Why optimization fails without attention training You can master food, workouts, and sleep — but scattered attention destroys progress. 20:48 – Darin's morning protocol Water → elixir → infrared pad → meditation → visualization → journaling. Every day. Everywhere. 21:01 – Meta-analysis proof Meditation reduces anxiety, depression, stress — and rewires your brain. 21:23 – The perfect 10-minute breathwork formula 5–5–5–5 or 4–4–4–4 cycles for nervous system reset. 21:56 – Journaling as medicine Stream-of-consciousness to activate clarity and emotional release. 5. WEALTH — Treat Your Time Like Capital 22:36 – Redefining wealth It's not money — it's your magnetism, output, relationships, and purpose. 23:16 – The compounding effect of tiny decisions Time batching, micro-actions, and protecting your attention from the social media attention economy. 24:02 – Mini productivity framework 90 seconds → 3 important calls. Every Friday → 1 paragraph on what scaled this week. 25:14 – Darin's post-meditation rule No scrolling — replace with proactive actions: reading, outreach, Patreon replies. FINAL TAKEAWAYS 26:02 – The master checklist: • Time-restricted eating • Plant-focused meals • Resistance training • Daily meditation • Consistent sleep • Sauna recovery • Treating time like capital 26:11 – The real danger Chasing hacks before mastering fundamentals leads to burnout, confusion, and stress. 27:58 – Your power is in the basics These are simple, accessible, and life-changing. 28:04 – Closing message "Have your best Super Life Day ever." Thank You to Our Sponsors Our Place: Toxic-free, durable cookware that supports healthy cooking. Go to their website at fromourplace.com/darin and get 35% off sitewide in their largest sale of the year. Manna Vitality: Go to mannavitality.com/ and use code DARIN12 for 12% off your order. Join the SuperLife Community Get Darin's deeper wellness breakdowns — beyond social media restrictions: Weekly voice notes Ingredient deep dives Wellness challenges Energy + consciousness tools Community accountability Extended episodes Join for $7.49/month → https://patreon.com/darinolien Find More from Darin Olien: Instagram: @darinolien Podcast: SuperLife Podcast Website: superlife.com Book: Fatal Conveniences Key Takeaway "Your biology changes when your decisions change. Nail your sleep, nail your strength, honor your attention, and treat your time like capital — and you will build a Super Life from the ground up." Bibliography Time-restricted eating (human RCTs / reviews) — Wilkinson et al., 10-hour TRE reduced weight and improved cardiometabolic markers (2019). PMC Intermittent fasting / metabolic health review — comprehensive reviews showing metabolic switching benefits. PMC+1 Plant-forward/vegetarian diets & cardiometabolic outcomes — BMJ/Nutrition reviews and JAMA network evidence showing improved CVD risk markers and metabolic benefits. BMJ Nutrition+1 Sleep and cognition / brain health — Nature/Harvard coverage & meta-analyses: short sleep impairs cognition and links to amyloid processes. Nature+1 Resistance training & mortality / physical function — systematic and cohort evidence that muscle-strengthening activity lowers risk and preserves function. British Journal of Sports Medicine+1 Mindfulness & mental health meta-analysis — Goyal et al. 2014 and subsequent meta-analyses showing reductions in anxiety/stress. PubMed+1 Sauna bathing and cardiovascular outcomes — JAMA Internal Medicine / Mayo Clinic Proceedings reviews on sauna and lower CVD risk signals.
Christmas is a time of celebration, when friends and family gather to enjoy meals together. However, many of us overindulge, which leaves us feeling tired, bloated, and guilty. What actually happens to our bodies when we overeat, drink more, and swap fibre for sugar? And is there a way to enjoy the season's pleasures without starting January full of regret? In this episode, ZOE's Head Nutritionist, Dr Federica Amati, joins Jonathan to explore how festive food traditions shape our health and how to navigate them without guilt or restriction. Dr Federica shares practical suggestions for gut-friendly food swaps, festive traditions worth reviving, and the one ingredient she always includes on her own Christmas table. This episode is full of helpful advice on how to care for your body in a season that often asks us to do the opposite. Unwrap the truth about your food
Send us a Text Message (please include your email so we can respond!)Episode 79! We talk all about perfusion with arterial lines in EVERDAC and personalized resuscitation with ANDROMEDA SHOCK 2! EVERDAC: https://pubmed.ncbi.nlm.nih.gov/41159885/EVERDAC (NEJM): https://www.nejm.org/doi/10.1056/NEJMoa2502136ANDROMEDA SHOCK 2: https://pubmed.ncbi.nlm.nih.gov/41159835/ANDROMEDA SHOCK 2(JAMA): https://jamanetwork.com/journals/jama/fullarticle/2840823If you enjoy the show be sure to like and subscribe, leave that 5 star review! Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!
Since Democrats decided to shut down the government over Affordable Care Act subsidies, now's a good time for a deep dive into what they're even talking about. John Hopkins professor Dr. Ge Bai walks us through the ACA subsidies, the hidden mechanics behind the Affordable Care Act, and its illusion of "affordability." Dr. Bai shows us how regulations and subsidies have quietly reshaped the healthcare market - and how the free market can make it work for patients again. Ge Bai, PhD, CPA is a Professor of Accounting at Johns Hopkins Carey Business School and Professor of Health Policy & Management (joint) at Johns Hopkins Bloomberg School of Public Health. An expert on health care accounting, finance, and policy, Dr. Bai has testified before the House Ways and Means Committee and the Senate HELP Committee, written for the Wall Street Journal and the Washington Post, and published her studies in leading academic journals such as the New England Journal of Medicine, JAMA, and Health Affairs. Find her on X at @GeBaiDC and read her recent WSJ oped here: https://www.wsj.com/opinion/let-the-obamacare-enhanced-premium-subsidies-expire-16ef7e1b
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