Podcasts about jama internal medicine

What does it mean if you have a rotator cuff tear on your MRI? Listen to our latest podcast as we break down the latest JAMA Internal Medicine article, "Incidental Rotator Cuff Abnormalities on Magnetic Resonance Imaging."

Is fasting really the best way to lose fat — or is there a smarter, more strategic approach? In this masterclass episode, Vanessa introduces a powerful new concept: Protein Fasting — a structured approach using PSMF (Protein-Sparing Modified Fast) days to optimize fat loss, suppress appetite naturally, protect muscle, and potentially tap into fasting-like cellular signaling.

In this episode, Annika Theodoulou speaks to Professor Jonathan Bricker, a Professor of Public Health at the Fred Hutchinson Cancer Research Center and Affiliate Professor of Psychiatry at the University of Washington in Seattle, Washington, US. The interview covers Jonathan's research article covering intersectionality in cigarette smoking cessation using a latent class analysis to predict 12-month cessation in a randomized controlled trial.Intersectionality and why it is important to explore in smoking cessation [01:19]Six factors that are well-known predictors of smoking [03:20]The aim of a latent class analysis [04:55]The key findings of the study [07:09]The differences found between smartphone apps used in the trial [11:02]The implications of the findings for policy and practice [14:49]About Annika Theodoulou: Annika is a researcher at the Nuffield Department of Primary Care Health Sciences at the University of Oxford. Her work focuses on health behaviours, including smoking cessation and weight management, with an emphasis on evidence synthesis. Annika's doctoral research, funded by the Society for the Study of Addiction (SSA) and The Rotary Foundation, examined socioeconomic inequalities in smoking cessation behaviours and outcomes using quantitative and qualitative methods. She is an Associate Editor of Nicotine & Tobacco Research. Annika holds a Bachelor of Health Sciences and a Master of Clinical Science from the University of Adelaide.About Jonathan Bricker: Jonathan is an expert in the field of health behavior change interventions. He is a Full Professor of Public Health at the Fred Hutchinson Cancer Research Center and Affiliate Professor of Psychiatry at the University of Washington in Seattle, Washington. Dr. Bricker is founder and leader of the Health and Behavioral Innovations in Technology (“HABIT”) Research Group. The HABIT research group focuses on developing and testing innovative theory-based behavioral interventions for tobacco cessation and weight loss, especially those delivered in widely disseminable technology platforms. He and his team have developed a novel health behavior change intervention model based on the principles of Acceptance and Commitment Therapy (“ACT”). The principal investigator of over $35 million US dollars in research grants, he has been leading ten NIH R01 randomized trial grants, as well as led or collaborated on multiple other Federal and private research grants. His current grants focus on testing a machine learning natural language processing chatbot for quitting smoking, several smartphone applications for tobacco cessation in the general population, among cancer patients, American Indians & Alaska Natives, Hispanics, and adolescents, and a weight loss telephone coaching program based on ACT. His “iCanQuit” smartphone app based on ACT was proven more effective than a leading National Cancer Institute smartphone app based on the US Clinical Practice Guidelines in a large, randomized trial published in JAMA Internal Medicine. iCanQuit is now publicly available. He has published over 150 peer-reviewed research articles on addictions, behavioral interventions, and technologies. Currently, he serves as a Senior Editor of the journal Addiction. Original article: Intersectionality in cigarette smoking cessation: A latent class analysis to predict 12-month cessation in a randomized controlled trial https://doi.org/10.1111/add.70185Digital Object Identifier (DOI)The opinions expressed in this podcast reflect the views of the host and interviewees and do not necessarily represent the opinions or official positions of the SSA or Addiction journal.The SSA does not endorse or guarantee the accuracy of the information in external sources or links and accepts no responsibility or liability for any consequences arising from the use of such information. Hosted on Acast. See acast.com/privacy for more information.

Interview with Thomas Ibounig, MD, author of Incidental Rotator Cuff Abnormalities on Magnetic Resonance Imaging and Brian T. Feeley, MD, author of Magnetic Resonance Imaging Abnormalities and Incidental Age-Related Changes. Hosted by Eve Rittenberg, MD. Related Content: Incidental Rotator Cuff Abnormalities on Magnetic Resonance Imaging Magnetic Resonance Imaging Abnormalities and Incidental Age-Related Changes

A JAMA Network Open consensus guide standardizes adult UTI triage for telehealth and in-person care. Nonpregnant women with classic cystitis symptoms and no resistance risks may receive empiric antibiotics without testing; men and higher-risk women require urinalysis with culture before treatment. Urine color or odor alone does not justify testing, and urgent evaluation is advised for suspected complicated infection or sepsis. A Danish registry study in JAMA Internal Medicine found SGLT2 inhibitors offer greater kidney protection than GLP-1 receptor agonists in type 2 diabetes. Long-term ASPREE follow-up in JAMA Oncology showed low-dose aspirin did not lower cancer incidence and increased cancer-related mortality in older adults.

Interview with Katherine Majzoub Morgan, MD, MPP, author of Primary Care Clinicians Available for New Patient Visits, and Ishani Ganguli, MD, MPH, author of A Different Lens on the Primary Care Workforce Shortage—Who Is Accepting New Patients? Hosted by Eve Rittenberg, MD. Related Content: Primary Care Clinicians Available for New Patient Visits A Different Lens on the Primary Care Workforce Shortage—Who Is Accepting New Patients? Changes in Physician Work Hours and Implications for Workforce Capacity and Work-Life Balance, 2001-2021

Episode Notes Join DASON Liaison Jeannette Bouchard as she speaks about a hot off the press article from JAMA Internal Medicine titled 'Antibiotic De-Escalation in Adults Hospitalized for Community-Onset Sepsis”. The article can be viewed here: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2842980

Warum ist es so wichtig, Esoterik und Spiritualität zu unterscheiden? In dieser Folge erklärt Anna Schaub, warum viele auf dem geheimen Weg der Esoterik steckenbleiben und wie du stattdessen den bewussten, klaren Weg der Spiritualität gehst. Mit konkreten Beispielen erfährst du, wie du mystische Denkfallen erkennst, deine Glaubenssätze überprüfst und innere Klarheit findest. Für echte Selbsterkenntnis statt Selbsttäuschung.Impulse für dichWarum es wichtig ist Esoterik und Spiritualität zu unterscheiden.Wie du erkennst, ob dein Glaube dich weiterbringt oder dich blockiert.Warum Achtsamkeit bedeutet nicht alles zu glauben was man denkt UND fühlt. Wie du Spiritualität für deine persönliche Weiterentwicklung nutzen kannst.Warum echte Spiritualität nichts mit Magie, sondern mit Bewusstsein zu tun hat.

Police Addicted to Drugs And His Amazing Recovery, Special Episode. Police Officer Attacked, Multiple Surgeries, Forced Retirement, Addiction, and an Inspiring Recovery. This special episode is streaming for free on the Law Enforcement Talk Radio Show and Podcast website, on Apple Podcasts, Spotify, YouTube, and most every major Podcast platform Brock Bevell never imagined that a single violent moment would change the entire trajectory of his life. A retired Mesa, Arizona police officer, Brock dedicated his career to public service, until a targeted act of violence ended his time on the job and set him on a painful, unexpected journey through addiction and recovery. Look for The Law Enforcement Talk Radio Show and Podcast on social media like their Facebook , Instagram , LinkedIn , Medium and other social media platforms. “She threw the truck into reverse and hit me,” Brock recalls. “In an instant, everything changed.” Supporting articles about this and much more from Law Enforcement Talk Radio Show and Podcast in platforms like Medium , Blogspot and Linkedin . A Career Cut Short by Violence While serving with the Mesa Police Department, Brock was seriously injured during a violent incident involving a vehicle. The attack caused devastating, career-ending injuries and required multiple surgeries. What followed was a long and grueling rehabilitation process, one familiar to many injured officers across the country. Police Addicted to Drugs And His Amazing Recovery, Special Episode. Available for free on their website and streaming on Apple Podcasts, Spotify, Youtube and other podcast platforms. To manage the intense pain, Brock was prescribed opioid pain medication. Like countless patients recovering from serious injuries, he trusted the prescriptions meant to help him heal. Instead, they quietly became the beginning of a much deeper struggle. From Recovery to Addiction During months of surgeries and physical therapy, Brock developed a severe dependence on opioid painkillers. What started as medically prescribed relief slowly evolved into addiction. “I didn't recognize myself anymore,” Brock says. “My world became smaller and darker. I was surviving, not living.” Brock openly shares how addiction affected every part of his life, his relationships, his identity, and his sense of purpose after forced retirement from policing. His story reflects a reality many first responders face but few openly discuss. Police Addicted to Drugs And His Amazing Recovery, Special Episode. The Law Enforcement Talk Radio Show and Podcast episode is available for free on their website , Apple Podcasts , Spotify and most major podcast platforms. The Science Behind the Crisis Research underscores just how common Brock's experience is. A major study published in JAMA Internal Medicine by researchers at the Stanford University School of Medicine found that patients undergoing 11 common surgeries faced an increased risk of becoming chronic opioid users. Lead author Eric Sun, MD, PhD, explained: “For a lot of surgeries, there is a higher chance of getting hooked on painkillers.” The study defined chronic opioid use as filling 10 or more prescriptions or receiving more than a 120-day supply within a year after surgery. Patients undergoing knee surgery faced the highest risk, nearly five times that of nonsurgical patients, followed by gallbladder surgery. Importantly, the study did not suggest avoiding surgery, but emphasized the need for careful monitoring and alternative pain management strategies. Police Addicted to Drugs And His Amazing Recovery, Special Episode. The interview can be found on The Law Enforcement Talk Radio Show and Podcast website, on Apple podcasts, Spotify, Youtube and on LinkedIn, Facebook, Instagram, and across most podcast platforms where listeners will find authentic law enforcement stories. Trauma, Policing, and Substance Use Law enforcement officers face unique occupational hazards, including repeated exposure to trauma. Studies show that substance use disorders, including alcohol and drug dependence, occur at higher rates among officers, particularly those experiencing psychological distress. In nationally representative data, more than half of men with lifetime PTSD also had a history of alcohol abuse or dependence. For police officers, these risks are compounded by work stress, injuries, and the cultural stigma surrounding mental health and asking for help. “We wear the uniform, but we're human,” Brock says. “And sometimes the damage doesn't show until it's almost too late.” The full podcast episode is streaming now on their website, on Apple Podcasts, Spotify, Youtube and across Facebook, Instagram, and LinkedIn. Hitting Bottom and Choosing Recovery Brock's turning point came when he realized addiction had taken everything it could from him. With professional help, support, and unwavering determination, he entered recovery and committed to sobriety. “Recovery didn't give me my old life back,” he says. “It gave me a new one, one with purpose.” Police Addicted to Drugs And His Amazing Recovery, Special Episode. Today, Brock uses his experience to help others struggling with addiction, trauma, and life after law enforcement. His message is clear: recovery is possible, even after profound loss. Healing Beyond the Badge In the aftermath of violence and trauma, communities often look to police officers as symbols of strength. Yet officers themselves must also heal. Proactive wellness programs, mental health resources, and open conversations about addiction are critical, not just for officers, but for the communities they serve. You can find the show on Facebook, Instagram, Pinterest, X (formerly Twitter), and LinkedIn, as well as read companion articles and updates on Medium, Blogspot, YouTube, and even IMDB. Mesa, located just east of Phoenix, is known for its deep history, from the ancient Hohokam culture to the modern city Brock once patrolled. It is also where his story originated, one of resilience, accountability, and hope. Listen to Brock's Story Brock Bevell's journey is featured in this Special Episode of the Law Enforcement Talk Radio Show and Podcast available for free on their website, also on Platforms like Apple Podcasts, Spotify, YouTube and most major podcast platforms. His story is also being shared across their Facebook, Instagram, LinkedIn, and other Social Media and News outlets. Listen to Brock's inspiring account of what happened, how prescribed opioids led to addiction, and how recovery helped him rebuild his life, and helps others do the same. Police Addicted to Drugs And His Amazing Recovery, Special Episode. Because sometimes, the most powerful stories of policing aren't about arrests or badges, but about survival, healing, and redemption. You can help contribute money to make the Gunrunner Movie . The film that Hollywood won't touch. It is about a now Retired Police Officer that was shot 6 times while investigating Gunrunning. He died 3 times during Medical treatment and was resuscitated. You can join the fight by giving a monetary “gift” to help ensure the making of his film at agunrunnerfilm.com . Background song Hurricane is used with permission from the band Dark Horse Flyer. You can contact John J. “Jay” Wiley by email at Jay@letradio.com , or learn more about him on their website . Stay connected with updates and future episodes by following the show on Facebook, Instagram, LinkedIn, their website and other Social Media Platforms. Find a wide variety of great podcasts online at The Podcast Zone Facebook Page , look for the one with the bright green logo. Be sure to check out our website . Be sure to follow us on X , Instagram , Facebook, Pinterest, Linkedin and other social media platforms for the latest episodes and news. Listeners can tune in on the Law Enforcement Talk Radio Show website, on Apple Podcasts, Spotify, YouTube, and most every major Podcast platform and follow updates on Facebook, Instagram, and other major News outlets. You can find the show on Facebook, Instagram, Pinterest, X (formerly Twitter), and LinkedIn, as well as read companion articles and updates on Medium, Blogspot, YouTube, and even IMDB. Police Addicted to Drugs And His Amazing Recovery, Special Episode. Attributions Stanford Medical IACP NIH Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Interview with Robert Goulden, MBBS author of Magnesium Supplementation and Tachyarrhythmias:A Nonrandomized Clinical Trial and Jason H. Wasfy, MD, MPhil author of Evidence for Clinical Treatment Decisions Without Randomized Data. Hosted by Ilana Richman, MD MHS. Related Content: Magnesium Supplementation and Tachyarrhythmias Evidence for Clinical Treatment Decisions Without Randomized Data

I denne episoden guider jeg, Annette Løno, deg gjennom en kort og nærende meditasjon som hjelper kroppen inn i dypere ro.Dette er en 8 minutters mikropause du kan bruke når som helst i løpet av dagen for å lande, puste og regulere nervesystemet.I meditasjonen får du både en myk guiding gjennom kroppen – med kroppsskanning og rolig pust – og en visualisering der du tas med på en liten tur i naturen. Du får besøke et sted som er helt ditt; et sted uten forventninger, der du kan være deg selv og møte et varmt, stille lys inni deg. Et lys som symboliserer indre trygghet, egenverd og vissheten om at du er god nok.Vi jobber med å hjelpe kroppen inn i dyp ro, nedregulere nervesystemet, aktivere vagusnerven og senke hjernestress, slik at både kropp og sinn kan hente seg inn.Forskning viser at mikropauser og regelmessig meditasjon kan gi flere helsefordeler, blant annet:Redusert stress og lavere fysiologiske stressmarkører:En studie publisert i Journal of Psychiatric Research (2017) viste at kortvarige puste- og meditasjonsøkter kan redusere kortisol og dempe kroppens stressrespons.Bedre emosjonell regulering:En systematisk oversikt i Clinical Psychology Review fant at meditasjon kan redusere symptomer på angst og depresjon og øke følelsesmessig balanse.Økt konsentrasjon og oppmerksomhet:Forskning i Neuroscience Letters (2018) viser at selv korte meditasjonsøkter over tid kan forbedre mental klarhet og kognitiv kontroll.Forbedret søvnkvalitet:En oversikt fra JAMA Internal Medicine (2015) dokumenterte at mindfulness-basert meditasjon kan gi bedre søvn, spesielt ved uro og høyt stress.Støtte for immunfunksjon:En metaanalyse i Psychoneuroendocrinology (2023) fant at meditasjon kan påvirke immunmarkører positivt og bidra til lavere inflammasjon.Denne meditasjonen er laget som en liten hvilestund du kan vende tilbake til når som helst.Lytt. Pust. Land i kroppen din.Passer for ungdommer og voksne.I Helsetipspodden deler jeg jevnlig ulike lydfiler du kan bruke for å hjelpe kroppen og hjernen inn i hvile. Forskning viser tydelig at regelmessig meditasjonspraksis kan gi både kortsiktige og langsiktige helsefordeler.Du finner også en egen spilleliste med alle Helsetipspoddens meditasjoner på Spotify – perfekt når du ønsker små pauser gjennom dagen. Reklame:Rabattkode Helsetipspodden på rødlysterapiapparatet FlexBeam. Jeg bruker ofte FlexBeam mens jeg mediterer. Rabattkode Nervus i helsekostbutikken Superstate. Mine favoritter er Magnesium Breakthrough, Magnesium L-threonate, Cymbiotika Vitamin D3 + K2 + CoQ10, Synergy B12 og Salte elektrolytter.Vagus & Mindfulness Retreat i Spania 22-27 mai 2026

A new JAMA Internal Medicine study reveals that Trump's NIH funding cuts have abruptly halted nearly 400 clinical trials, leaving more than 74,000 patients — especially those in underserved communities — without essential care and research options. Subscribe to our newsletter to stay informed with the latest news from a leading Black-owned & controlled media company: https://aurn.com/newsletter Learn more about your ad choices. Visit megaphone.fm/adchoices

Interview with Giselle Corbie, MD, MSc, Associate Editor of JAMA Internal Medicine, and Lynda H. Powell, PhD, author of Lifestyle Intervention for Sustained Remission of Metabolic Syndrome: A Randomized Clinical Trial. Hosted by Eve Rittenberg, MD. Related Content: Lifestyle Intervention for Sustained Remission of Metabolic Syndrome

Interview with Giselle Corbie, MD, MSc, Associate Editor of JAMA Internal Medicine, and Lynda H. Powell, PhD, author of Lifestyle Intervention for Sustained Remission of Metabolic Syndrome: A Randomized Clinical Trial. Hosted by Eve Rittenberg, MD. Related Content: Lifestyle Intervention for Sustained Remission of Metabolic Syndrome

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers goals of care conversations.Our guest for this episode is Dr. Tavis Apramian, a clinician-investigator in the Department of Family & Community Medicine (DFCM) at the University of Toronto and scientist in the Office of Education Scholarship. He works as a palliative care physician at St. Michael's Hospital and at Kensington Hospice. His largely qualitative program of research is focused on advance care planning; workplace-based learning and assessment; palliative care in family medicine; medical assistance in dying; and inequity in end-of-life care. His primary focus is on telling rich stories of learner and patient experiences to spark conversation about socioculturally complex educational and clinical problems in serious illness.The learning objectives for this episode are as follows:Describe a palliative approach to care and its relevance across different contextsDemonstrate a structured and compassionate approach to goals of care conversationsApply effective communication strategies to build therapeutic alliance, navigate difficult conversations, and involve multiple actors in the palliative contextRecognize and manage challenges in goals of care conversationsGuest: Dr. Tavis ApramianHosts: Dr. Daamoon Ghahari (PGY2) and Dr. Angad Singh (PGY2)Audio editing: Dr. Angad Singh (PGY2)Timestamps:(1:07) - Journey to palliative care(5:07) - What is palliative care(14:47) - Understanding patient values(33:47) - Structuring goals of care conversations(44:16) - Communication strategies(57:05) - Navigating family meetings(77:25) - Reflections on MAiD for sole mental illnessResources:Roth, H. (2024). Hearing the unspoken. Canadian Family Physician, 70(10), 642-642. https://pmc.ncbi.nlm.nih.gov/articles/PMC11477260/pdf/0700642.pdfReferences:Bernacki, R. E., & Block, S. D. (2014). Communication about serious illness care goals: a review and synthesis of best practices. JAMA internal medicine, 174(12), 1994-2003.Gross, J., & Koffman, J. (2024). Examining how goals of care communication are conducted between doctors and patients with severe acute illness in hospital settings: A realist systematic review. PLoS One, 19(3), e0299933.Scheunemann, L. P., Ernecoff, N. C., Buddadhumaruk, P., Carson, S. S., Hough, C. L., Curtis, J. R., ... & White, D. B. (2019). Clinician-family communication about patients' values and preferences in intensive care units. JAMA internal medicine, 179(5), 676-684.You, J. J., Downar, J., Fowler, R. A., Lamontagne, F., Ma, I. W., Jayaraman, D., ... & Canadian Researchers at the End of Life Network (CARENET). (2015). Barriers to goals of care discussions with seriously ill hospitalized patients and their families: a multicenter survey of clinicians. JAMA Internal Medicine, 175(4), 549-556.For more PsychEd, follow us on Instagram (⁠@psyched.podcast⁠),  Facebook (⁠PsychEd Podcast⁠), X (⁠@psychedpodcast⁠), and Bluesky (⁠@psychedpodcast.bsky.social‬⁠). You can email us at ⁠psychedpodcast@gmail.com⁠ and visit our website at⁠ ⁠⁠psychedpodcast.org⁠.

Interview with Sammy Saab, MD, MPH, author of Targeting MASLD and MASH in the US Hispanic/Latino Population: A Review. Hosted by Eve Rittenberg, MD. Related Content: Targeting MASLD and MASH in the US Hispanic/Latino Population

A large meta-analysis in The Lancet found clopidogrel superior to aspirin for long-term secondary prevention in coronary artery disease, reducing major cardiovascular events by 14% without added bleeding risk. The REBOOT trial in NEJM showed no benefit of beta-blockers in post-MI patients with preserved ejection fraction, and even potential harm in women on high doses, prompting reevaluation of routine use. Finally, a phase 2 trial in JAMA Internal Medicine showed daily azelastine nasal spray reduced COVID-19 incidence by 67% and shortened illness duration, though larger studies are needed to confirm its prophylactic role.

Interview with Robert Bals, MD, PhD, author of Azelastine Nasal Spray for Prevention of SARS-CoV-2 Infections: A Phase 2 Randomized Clinical Trial, and Dan H. Barouch, MD, PhD, author of A Novel Approach for Preventing Respiratory Virus Infections. Hosted by Eve Rittenberg, MD. Related Content: Azelastine Nasal Spray for Prevention of SARS-CoV-2 Infections A Novel Approach for Preventing Respiratory Virus Infections

Send us a textOrganic food often sounds like a smarter, healthier choice—but is it really worth the extra cost? In this episode, we dig into the scientific evidence behind organic foods, pesticide risks, and whether you're buying better health or just paying for a better-sounding label.We begin by breaking down the steep price differences between organic and conventional food. According to the USDA, Americans spend roughly $1 trillion annually on food at home, averaging over $3,100 per person. Organic options can increase grocery bills by 50% or more, as LendingTree reports in this price comparison analysis. My own market trip found Fuji apples nearly double in price, and wild-caught salmon more than twice as expensive.But do organics deliver better health outcomes? Most organic foods contain lower pesticide residues, which 85% of Americans cite as a concern. Yet research shows these lower levels don't clearly translate to better health. Rodent studies show harm at extremely high pesticide doses, far above what's found in conventional produce. Human risk data mostly comes from farm workers, not everyday consumers.A 2023 meta-analysis of 50 studies found that organic diets reduced blood pesticide levels and increased plant-derived phenolics, but showed inconsistent results for antioxidants. Cancer data is also mixed. One observational study found no clear differences across 15 cancer types. Another study of 68,000 participants linked organic food with perhaps a  0.6% lower risk of cancer incidence (JAMA Internal Medicine). However, organic eaters also are more likely health oriented (perhaps exercise more, sleep better), so lifestyle may explain the difference—not the food alone.I ran the numbers: avoiding one case of cancer might require 150 people to eat organic, costing about $300,000 in additional food expenses to avoid 1 cancer. And since organic prices may lead families to buy less produce overall, there's a tradeoff. We know from a meta-analysis that increasing fruit and vegetable intake (organic or not) is linked to a 13% reduction in mortality and a 35% drop in cancer risk. That's a far more impactful move.If you're looking for a middle ground, consider using the Environmental Working Group's Dirty Dozen and Clean 15 lists. While not a neutral source, their rankings can help prioritize which foods might be worth buying organic. Washing produce also helps reduce, but not eliminate, pesticide residues.Takeaways:Organic foods have lower pesticide levels but no clear, consistent health advantage.The biggest health gain comes from eating more fruits and vegetables—regardless of whether they're organic.If organic costs limit your produce intake, stick with conventional and focus on volume, variety, and other wellness investments like better sleep or exercise.As always, I'd love to hear what you think. Does this shift how you shop? Let me know—and share this episode with someone navigating the same choice.

Interview with Alison J. Huang, MD, MAS, and Stephanie Faubion, MD, MBA, authors of Nonhormonal Treatment of Menopausal Vasomotor Symptoms. Hosted by Eve Rittenberg, MD. Related Content: Nonhormonal Treatment of Menopausal Vasomotor Symptoms

JAMA Internal Medicine fellows Jerard Z. Kneifati-Hayek, MD, MS, Ilana B. Richman, MD, MHS, and Nathan Stall, MD, PhD, discuss their experiences learning how to work as members of the editorial team at a leading, widely read, high-impact internal medicine journal. They explore key elements including how the fellowship enhanced their teamwork, writing, critical appraisal, and research skills. Hosted by Ilana B. Richman, MD, MHS. Related Content: Introducing the Expanded JAMA Internal Medicine Editorial Fellowship

JAMA Internal Medicine fellows Jerard Z. Kneifati-Hayek, MD, MS, Ilana B. Richman, MD, MHS, and Nathan Stall, MD, PhD, discuss their experiences learning how to work as members of the editorial team at a leading, widely read, high-impact internal medicine journal. They explore key elements including how the fellowship enhanced their teamwork, writing, critical appraisal, and research skills. Hosted by Ilana B. Richman, MD, MHS. Related Content: Introducing the Expanded JAMA Internal Medicine Editorial Fellowship

Interview with Connor Prosty, MD, author of Prophylactic Antibiotics for Upper Gastrointestinal Bleeding in Patients With Cirrhosis: A Systematic Review and Bayesian Meta-Analysis, and Catherine Mezzacappa, MD, MPH, author of Antibiotic Prophylaxis in Variceal Hemorrhage—Time to Stop? Hosted by Ilana Richman, MD. Related Content: Prophylactic Antibiotics for Upper Gastrointestinal Bleeding in Patients With Cirrhosis Antibiotic Prophylaxis in Variceal Hemorrhage—Time to Stop?

How would you encourage sustainable behaviour?  You might assume logical messages work best.  Stuff like “the average three-hour flight creates ~250–400 kg of CO₂”.  But today's guest on Nudge has tested logical messages.  And they don't work.  Today on Nudge, Toby Park from the Behavioural Insights Team explains how renaming a meat-free dish doubled its sales. Why targeting home-movers made Americans 400% more likely to cycle. How social norms can increase sales by 20%. And the reframing led the majority of Brits to choose energy-efficient fridges.  ---  Watch the bonus episode: https://nudge.kit.com/27720ca0ad Connect with Toby on LinkedIn: https://www.linkedin.com/in/toby-park-67773279/  Read Toby's Net Zero Report: https://shorturl.at/Wy8RP How to Build a Net Zero Society: https://shorturl.at/0PcRk Sign up for my newsletter: https://www.nudgepodcast.com/mailing-list  Connect on LinkedIn: https://www.linkedin.com/in/phill-agnew-22213187/  Watch Nudge on YouTube: https://www.youtube.com/@nudgepodcast/  --- Sources:  Das, G., Spence, M. T., & Agarwal, J. (2021). Social selling cues: The dynamics of posting numbers viewed and bought on customers' purchase intentions. International Journal of Research in Marketing, 38(4), 994–1016. Kirkman, E. (2019). Free riding or discounted riding? How the framing of a bike share offer impacts redemption. Journal of Behavioral Public Administration, 2(2), 1–10. Park, T., Whincup, E., Parker, F., & Bhura, A. (2024). Net Zero communications, marketing and public engagement: Why we need it, and what we can learn from past case studies [Report]. Behavioural Insights Team. Shotton, R. (2018). The Choice Factory: 25 behavioural biases that influence what we buy. Harriman House. Sparkman, G., & Walton, G. M. (2017). Dynamic norms promote sustainable behavior, even if it is counternormative. Psychological Science, 28(11), 1663–1674. Turnwald, B. P., Boles, D. Z., & Crum, A. J. (2017). Association Between Indulgent Descriptions and Vegetable Consumption: Twisted Carrots and Dynamite Beets. JAMA Internal Medicine, 177(8), 1216–1218. Vennard, D., Park, T., & Attwood, S. (2019). Encouraging Sustainable Food Consumption By Using More-Appetizing Language.

Welcome to Ozempic Weightloss Unlocked, your source for the latest news, science, and lived experiences around Ozempic – and how it's transforming the landscape of weight management and health. Semaglutide, the active ingredient in Ozempic, began as a treatment for type two diabetes but quickly made waves for its powerful effect on weight loss. According to Yale University, Ozempic works by slowing stomach emptying and interacting with the brain's appetite regulation centers, naturally decreasing hunger and helping you feel fuller longer. Major clinical trials, as reported by the New England Journal of Medicine, found that people using Ozempic lost on average fifteen percent of their body weight over a sixty-eight-week period. That's a significant shift in the fight against obesity and has inspired a wave of success stories in 2025.Take Maria, a forty-two-year-old mother of two who, after years of struggling with different diets, lost thirty-five pounds in six months after her doctor prescribed Ozempic. She combined her medication with healthy foods and daily walks, gaining more energy and renewed self-confidence. John, a long-time executive living with type two diabetes, lost forty pounds and enjoyed not only improved blood sugar but the feeling of having his life back. Their stories, shared on Yale's health campus, point to the idea that consistency, a holistic approach, and strong support from healthcare professionals and family make all the difference.Ozempic doesn't just bring physical changes. Dr. Daniel Drucker, who helped develop GLP-1 medicines like Ozempic, told Toronto Life that the drug's success has helped validate obesity as a biological, not just behavioral, condition. For many, it's become proof that medical science can help overcome a complex health challenge – not just willpower alone.Globally, Ozempic and its sister drug, Wegovy, are reshaping national health systems like the NHS in the United Kingdom. NHS reports show over three million prescriptions for Ozempic issued annually, a testament to its popularity and potential. Wegovy, which is a higher-dose version designed specifically for weight loss, became available through specialist services in 2024. Healthcare leaders stress, however, that medications like Ozempic should support, not replace, good nutrition and regular activity. A combined approach delivers the best outcomes, and ongoing monitoring is essential to managing both progress and any possible side effects.Speaking of side effects, most users report mild-to-moderate gastrointestinal issues, especially at the start. There are still open questions about the long-term risks, and health authorities caution against unlicensed or cosmetic providers offering Ozempic outside proper medical supervision.In the competitive field of weight loss drugs, new challengers are emerging. According to Drugs.com and recent publications in JAMA Internal Medicine, Mounjaro, which combines GLP-1 and another gut hormone, has shown even greater weight loss than Ozempic in large studies. Nearly eighty-two percent of people using Mounjaro lost at least five percent of their body weight, compared to about sixty-seven percent for Ozempic. There's also a promising newcomer: a once-monthly shot called MariTide, which recent phase two trials show may rival or even exceed Ozempic's results, though it is not yet widely available.Looking ahead, Ozempic and its competitors are not just for type two diabetes or general obesity. A June 2025 study reported by Live Science found Ozempic's active ingredient may even help people with type one diabetes manage blood sugar and lose weight, hinting at a broader impact on medicine in the years to come.That wraps up this episode of Ozempic Weightloss Unlocked. Thank you for tuning in and remember to subscribe so you never miss an update. This has been a Quiet Please production, for more check out quietplease dot ai. Some great Deals https://amzn.to/49SJ3QsFor more check out http://www.quietplease.ai

Last December, The BMJ published an investigation into the 2009 PLATO trial - exposing serious problems with that study's data analysis and reporting.  Our follow up investigation has shown that those data problems extend to other key supporting evidence in AstraZeneca's initial application to regulators. Peter Doshi, senior editor in the BMJ's Investigations unit, and Rita Redberg, cardiologist and Professor of Medicine at UCSF and former editor of JAMA Internal Medicine, join us to explain what this means for scientific integrity, and trust in the FDA's approval processes.   Also in this episode. A group of international authors are arguing that weightloss advice given in primary care might actually be doing more harm than good - it's ineffective and potentially reinforces damaging stigma.  To explain why they came to that conclusion we're joined by Juan Franco editor in chief of BMJ EBM, and a practicing GP in Germany, and Emma Grundtvig Gram, from the Centre for General Practice at the University of Copenhagen Reading list Doubts over landmark heart drug trial: ticagrelor PLATO study Ticagrelor doubts: inaccuracies uncovered in key studies for AstraZeneca's billion dollar drug Beyond body mass index: rethinking doctors' advice for weight loss

Contributor: Alec Coston, MD Educational Pearls: For patients presenting to the emergency room with hypertension, clinicians should determine if it is isolated and uncomplicated, or involves comorbidities with more complex underlying pathophysiology.  For uncomplicated and isolated hypertension, first-line treatment is thiazide diuretics.  How do thiazide diuretics work to treat hypertension? Thiazide diuretics work by blocking sodium and chloride resorption in the kidneys.  “Where sodium goes, water follows,” thus promoting diuresis and lowering blood pressure. Examples of thiazide diuretics and their benefits? Hydrochlorothiazide (HCTZ): First-line medication in uncomplicated and chronic hypertensive states. Cheaper and fewer significant adverse effects compared to chlorthalidone. HCTZ can be associated with decreased risk of stroke and myocardial infarction. However, for more complicated hypertension, especially in the setting of heart failure, Angiotensin Converting Enzyme (ACE) Inhibitors should be considered.  How do ACE Inhibitors manage blood pressure? The body's kidneys drive the Renin-Angiotensin-Aldosterone-System (RAAS) to regulate blood pressure. It is easiest to understand RAAS as being pro-hypertensive as a response to decreased renal perfusion. As renal perfusion decreases, renin is released and activates angiotensin I, which is converted by ACE to Angiotensin II, which causes release of aldosterone. ACE Inhibitors prevent the conversion of Angiotensin I to Angiotensin II, thus decreasing the kidneys' production of Angiotensin II and Aldosterone levels. Why, in the context of heart failure, are ACE Inhibitors preferred? In heart failure, especially left-sided or left-ventricular heart failure, a vicious cycle can develop wherein the left ventricle fails to perfuse the kidneys due to over-dilation. The kidneys are hypoperfused and activate RAAS to try to retain volume and increase peripheral vasoconstriction, promoting renal perfusion. The increase in blood pressure puts further strain on the heart, thereby further decreasing cardiac output. The cycle develops, and extremely elevated blood pressures can develop. ACE Inhibitors can directly block this cycle, hence their preference in heart failure. Big takeaway? In uncomplicated hypertensive patients, consider thiazide diuretics. When comorbidities, especially heart failure, are introduced, then consider ACE Inhibitors. References Carey RM, Moran AE, Whelton PK. Treatment of Hypertension: A Review. JAMA. 2022;328(18):1849-1861. doi:10.1001/jama.2022.19590 Fan M, Zhang J, Lee CL, Zhang J, Feng L. Structure and thiazide inhibition mechanism of the human Na-Cl cotransporter. Nature. 2023;614(7949):788-793. doi:10.1038/s41586-023-05718-0 Hripcsak G, Suchard MA, Shea S, et al. Comparison of Cardiovascular and Safety Outcomes of Chlorthalidone vs Hydrochlorothiazide to Treat Hypertension. JAMA Internal Medicine. 2020;180(4):542-551. doi:10.1001/jamainternmed.2019.7454 Yu D, Li JX, Cheng Y, et al. Comparative efficacy of different antihypertensive drug classes for stroke prevention: A network meta-analysis of randomized controlled trials. PLoS One. 2025;20(2):e0313309. doi:10.1371/journal.pone.0313309 Summarized by Dan Orbidan, OMS2 | Edited by Dan Orbidan & Jorge Chalit, OMS4 Donate: https://emergencymedicalminute.org/donate/  

Interview with Adrian D. Haimovich, MD, PhD, author of National Trends in Prolonged Emergency Department Length of Stay Among Older Adults: 2017-2024 and Maura Kennedy, MD, MPH author of Addressing the Hospital Boarding Crisis in the US—Time to Act: Addressing the Hospital Boarding Crisis in the US. Hosted by Eve Rittenberg, MD. Related Content: Addressing the Hospital Boarding Crisis in the US—Time to Act Prolonged Emergency Department Stays for Older US Adults

In S6 E5 I am delighted to welcome Dr Colin West MD PhD to the podcast. Dr West is a practising physician, educator, biostatistician and he is globally renowned for his research in professional and organisational wellbeing in healthcare. He has been deeply embedded in research work in this area with colleagues at Mayo Clinic for over two decades to advance and inform healthcare organisational and clinician wellbeing leadership, strategy and evidence-informed system and work unit interventions to promote physician wellbeing and reduce distress. Dr West is the inaugural program director for physician wellbeing at Mayo Clinic. He is the recipient of multiple awards for his research and education work and collaborates extensively with scientists and groups within and outside Mayo Clinic. External collaborations include members of leadership in the American Medical Association. His work with colleagues including Dr Tait Shanafelt has  been published in multiple top-tier journals, including the Lancet, the Journal of the American Medical Association, Annals of Internal Medicine, and JAMA Internal Medicine.   In this conversation we discuss the evolution of his work over the past two decades. We learn how the combination of unique skills, intellectual curiosity and a deep investment and sense of purpose led to a critical coalition of colleagues who have helped to advance and build evidence-informed road maps and organisational blueprints  to promote physician wellbeing and professional satisfaction and reduce burnout and distress. I was particularly keen to explore some of the key intervention studies including the COMPASS trail ( Colleagues Meeting to Promote and Sustain Satisfaction) and the research about leadership capability and coaching/development. This episode is full of both the science and practical wisdom Dr West brings as a clinical expert in this field and yet still scratches the surface of his work.  A lot of his efforts today centre on attention to the MVPs ( meaning values and purpose )of professional wellbeing for his colleagues and the work they do in turn for their patients. He finishes with a powerful call to action at this juncture and critical inflection point for healthcare and clinicians globally. This is fundamentally important work and I am grateful to Colin and colleagues for continuing to advance our knowledge and applied practice. Links/References/ResourcesDr West's Wellbeing Wednesday Thread https://www.linkedin.com/posts/colin-west-57821b82_colin-west-colinwestmdphd-on-x-activity-7252370843236749312-1WMg/https://www.mayo.edu/research/faculty/west-colin-p-m-d-ph-d/bio-00027800https://edhub.ama-assn.org/steps-forward/pages/professional-well-beingThe COMPASS Trial https://pubmed.ncbi.nlm.nih.gov/34366134/Register for the Australasian Doctors' Health conference to continue to the conversation in 2025:https://adhc.org.au/The Mind Full Medic Podcast is proudly sponsored by the MBA NSW-ACT Find out more about their service or donate today at www.mbansw.org.auDisclaimer: The content in this podcast is not intended to constitute or be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your doctor or other qualified health care professional. Moreover views expressed here are our own and do not necessarily reflect those of our employers or other official organisations.

Today's episode focuses on a recent article in JAMA Internal Medicine regarding maternal mental health in the United States. I'll explain and summarize the study and results, and discuss the most appropriate next steps. Since I'm presenting the information in summary form, please read the article for yourself by clicking the link in the Resources section for this episode.  Show Highlights: The findings of this study are sobering and validating. Scope and value of research findings like this to “fill the gap” in maternal mental health The details of the study subjects: 198,000+ US mothers from 2016-2023 who self-reported their physical and mental health The key findings: The percentage of mothers reporting a rating of “excellent” mental health dropped dramatically during the time frame, the percentage reporting “fair” or “poor” mental health increased, and the trend of declining maternal mental health crosses through all socio-economic groups. The key factors contributing to maternal mental health conditions  Results of the study show that we need more investment into the underlying causes of mental health decline, especially for lower socio-economic status moms. Moms are suffering under the weight of silence, stigma, shame, and societal expectations. Studies like this one are vital to break down barriers to care and support. Learning to identify your needs, choose rest when needed, and prioritize self-compassion What we can do to help: offer screenings at multiple points, effect policy change, and find positive ways to support the entire family system. Resources: Read the JAMA article, “Trends and Disparities in Maternal Self-Reported Mental and Physical Health.” Click here. Call the National Maternal Mental Health Hotline at 1-833-TLC-MAMA or visit cdph.ca.gov Please find resources in English and Spanish at Postpartum Support International, or by phone/text at 1-800-944-4773. There are many free resources available, including online support groups, peer mentors, a specialist provider directory, and perinatal mental health training for therapists, physicians, nurses, doulas, and anyone who wants to become more supportive in offering services.  You can also follow PSI on social media: Instagram, Facebook, and most other platforms Visit www.postpartum.net/professionals/certificate-trainings/ for information on the grief course.   Visit my website, www.wellmindperinatal.com, for more information, resources, and courses you can take today! If you are a California resident looking for a therapist in perinatal mental health, email me about openings for private pay clients! Learn more about your ad choices. Visit podcastchoices.com/adchoices

Most of us are familiar with the idea that you need to take 10 thousand steps per day to stay healthy but getting to this magic number is not that easy. The 10,000-step target first became popular in Japan in the 1960s. A clockmaker capitalising on people's new interest in fitness following the 1964 Tokyo Olympic Games made a pedometer with a name that, when written in Japanese characters, resembled a walking man and coincidentally translated as “10,000-steps metre.” A study of over 78,000 people in the UK between 2013 and 2015 using wearable trackers was published in the journals JAMA Internal Medicine and JAMA Neurology. Where did we get the number 10 thousand from? Does that mean that we do not need to take 10 steps? So how many steps should I be aiming for per day? In under 3 minutes, we answer your questions! To listen to the last episodes, you can click here: ⁠Can you eat eggs everyday?⁠ ⁠What is Lucky Girl syndrome, this new method that is all the rage on Tik Tok?⁠ ⁠Which type of wine is best for your health?⁠ A podcast written and realised by Amber Minogue. First broadcast: 19/1/2023 Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode of Quality Talks With Peggy O'Kane, NCQA President Peggy O'Kane sits down with Dr. Rita Redberg, a cardiology pioneer and fierce advocate for evidence-based care. Dr. Redberg, who famously served as Editor-in-Chief of JAMA Internal Medicine for 14 years, shares her "Less is More" philosophy — a perspective that challenges the view that "more" care is always better.Join Peggy and Rita as they explore:The Problem with "More": Why a health care culture focused on technology and volume over patient needs leads to runaway costs and poor results.The Stent Story: How a widely adopted procedure in cardiology gained traction without initial evidence of patient benefit, and the uphill battle to integrate rigorous clinical trials.Mary Caldwell's Odyssey: A cautionary tale illustrating the dangerous cascade of unnecessary testing and interventions, based on a desire for reassurance rather than clinical need.Re-evaluating Statins: Rita's unconventional view on the use of statins in asymptomatic people. She advocates lifestyle changes over medication when the evidence of benefit is thin.Rebuilding Trust: How the fee-for-service payment model erodes the patient-doctor relationship and how regulatory reforms can shift incentives towards patient wellbeing.Rita reminds us that health care quality isn't about more tests or interventions. It's about thoughtful, patient-centered decisions and a commitment to "first, do no harm." This episode is a must-listen for anyone curious about improving health outcomes and reducing waste in health care.Key Quote:Most statins are prescribed for people that have not already had a heart attack or have established coronary disease. In that higher risk group, there is some benefit to taking statins. It's not huge but there is some benefit.But most people I see, and most people taking statins, are not in that category. They're healthy people that want to prevent a heart attack and want to live longer. They definitely are not going to feel better. Rita Redberg, MDTime Stamps:(02:09) Misconceptions in Medicine(10:01) Mary Caldwell: A Cautionary Tale(13:35) Choosing Wisely Campaign: A Step Towards Better Care(16:32) Debating the Use of Statins(21:31) Trust, Incentives and the High Cost of US Care(27:05) Technology, Teams and Trust Links:JAMA Internal Medicine “Less is More”Choosing WiselyConnect with Rita

CT scans are quick, painless, non-invasive tests that can identify everything from brain tumors to injuries from an accident. But a new study published in the journal JAMA Internal Medicine shows a link between the radiation exposure from the imaging tool and cancer. Ali Rogin spoke with Dr. Rebecca Smith-Bindman, the study's lead author, to learn more. PBS News is supported by - https://www.pbs.org/newshour/about/funders

CT scans are quick, painless, non-invasive tests that can identify everything from brain tumors to injuries from an accident. But a new study published in the journal JAMA Internal Medicine shows a link between the radiation exposure from the imaging tool and cancer. Ali Rogin spoke with Dr. Rebecca Smith-Bindman, the study's lead author, to learn more. PBS News is supported by - https://www.pbs.org/newshour/about/funders

In this episode, Dr. Zanotti discusses the science of hope. He's joined by Dr. Stephen Trzeciak, a physician-scientist, the Edward D. Viner Endowed Chief of Medicine at Cooper University Health Care, and Professor and Chair of Medicine at Cooper Medical School of Rowan University in Camden, New Jersey. Dr. Trzeciak is a practicing intensivist and a clinical researcher with more than 100 publications in the scientific literature. In addition, he is co-author of two excellent books: Wonder Drug: 7 Scientifically Proven Ways That Serving Others Is the Best Medicine for Yourself (2022) and Compassionomics: The Revolutionary Scientific Evidence that Caring Makes a Difference (2019). Additional resources: Recovery Expectations and Long-term Prognosis of Patients with Coronary Heart Disease Barefoot JC, et al. JAMA Internal Medicine 2011: https://pubmed.ncbi.nlm.nih.gov/21357800/ Optimism and Rehospitalization After Coronary Artery Bypass Graft Surgery. Scheler MF, et al. JAMA Int Med 1999: https://pubmed.ncbi.nlm.nih.gov/10219928/ The median is not the message. By Jay Gould: https://journalofethics.ama-assn.org/sites/joedb/files/2018-05/mnar1-1301.pdf Books mentioned in this episode: Man's Search for Meaning. By Viktor E. Frankl: https://bit.ly/3SqsNyt Wonder Drug: 7 Scientifically Proven Ways That Serving Others Is the Best Medicine for Yourself. By Stephen Trzeciak and Anthony Mazzarelli: https://bit.ly/4kiyA5q Compassionomics: The Revolutionary Scientific Evidence that Caring Makes a Difference. By Stephen Trzeciak and Anthony Mazzarelli: https://bit.ly/43ul5IE

Join our Patreon and get access to monthly bonus episodes and more nutriton content!Can fasting really slow aging? Does calorie restriction work for humans, or just for mice and yeast? And how much protein do you actually need to age well? This week on Your Diet Sucks, we break down the evidence behind the most talked-about interventions in the longevity space, what holds up under scrutiny, what doesn't, and why you might not need a supplement stack to live longer, and enjoy life. We dig into:The actual science on calorie restriction, fasting, and supplements—and where the evidence stopsWhat inflammation, oxidative stress, and telomeres have to do with how we ageThe best-researched dietary patterns for living longer (hint: it's not sexy, but it might include red wine)Why protein becomes more important as we ageThe difference between lifespan and healthspan, and why quality of life needs to be part of the conversation

Interview with Tricia M. Leahey, PhD, author of Patient-Delivered Continuous Care for Weight Loss Maintenance: A Randomized Clinical Trial, and Kathryn M. Ross, PhD, MPH, author of Mentor and Peer Support for Long-Term Weight Loss Maintenance: You've Got a Friend in Me. Hosted by Eve Rittenberg, MD. Related Content: Patient-Delivered Continuous Care for Weight Loss Maintenance Mentor and Peer Support for Long-Term Weight Loss Maintenance

Our main focus today was on nudging critical care clinicians to consider a more palliative approach to care.  Our guests are all trained in critical care: Kate Courtright, Scott Halpern, and Jaspal Singh.  Kate and Scott have additional training in palliative medicine.  To start. we review: What is a nudge? Also called behavioral interventions, heuristics, and cognitive biases. Prior podcasts on the ethics of nudging, and a different trial conducted by Kate and Scott in which the default for hospitalized seriously ill patients was to receive a palliative care consult. What is sludge?  I'd never heard the term, perhaps outside of Eric's pejorative reference to my coffee after adding copious creamers, flavoring, and sweeteners.  Sludge is apparently when you create barriers or extra work for someone.  For example, putting the healthy food at the back of the grocery store is sludge; making an applicant for health insurance climb the flight of stairs to the office - weeding out those less fit - is also sludge.  Prior-auth forms? Sludge. Examples of nudges, some based in health care, others in coffee.  This specific study, published in JAMA Internal Medicine, was conducted in 17 ICUs in North Carolina. Many were community hospitals.  Participants were critically ill and intubated.  Clinicians were randomized to 4 groups: Usual care Prognosis nudge - EHR prompt asking, do you think your patient will be alive in 6 months? This is called a focusing effect Comfort care nudge - EHR prompt asking if they'd offered comfort-focused care. This is called accountable justification - an appeal to standards of care for critically ill patients endorsed by multiple professional societies. Both the prognosis and comfort care nudge. A few key points of discussion: Is an EHR prompt a nudge or sludge?   The intervention was a negative study for the primary outcome, hospital length of stay.  Why?  The prognosis nudge did nothing.  What to make of that? Would you think an EHR nudge to consider prognosis might move the needle, at least on some outcomes? The nudge toward offering comfort care led to more hospice and early comfort-care orders.  Is this due to chance alone, given the multiplicity of secondary outcomes examined?  Or is it a tantalizing finding that suggests a remarkably low cost EHR based nudge might, on a population level, lead to critical care clinicians offering comfort care and hospice more frequently?  Imagine!    -Alex Smith  

Lisa S. Rotenstein, MD, MBA, MSc, Seth Berkowitz, MD, MPH, and Elizabeth Dzeng, MD, PHD, MPH, each sit down one on one with JAMA Internal Medicine Associate Editor Ishani Ganguli, MD, MPH, to discuss the work they are presenting at the 2025 Society of General Internal Medicine Annual Meeting. Related Content: Incomplete Team Staffing, Burnout, and Work Intentions Among US Physicians JAMA Internal Medicine at the 2025 Society of General Internal Medicine Annual Meeting

Interview with Itai Danovitch, MD, author of Hospital Addiction Consultation Service and Opioid Use Disorder Treatment: The START Randomized Clinical Trial, and Michael A. Incze, MD, MSEd, author of Mortality Among Veterans With Opioid Use Disorder After Medical Hospitalization. Hosted by Eve Rittenberg, MD. Related Content: Hospital Addiction Consultation Service and Opioid Use Disorder Treatment Mortality Among Veterans With Opioid Use Disorder After Medical Hospitalization When Usual Care Is Subpar Care for Hospitalized Patients With Opioid Use Disorder

Interview with Anand S. Iyer, MD, MSPH, author of A Person-Centered Approach to Supplemental Oxygen Therapy in the Outpatient Setting: A Narrative Review. Hosted by Eve Rittenberg, MD, and Jerard Z. Kneifati-Hayek, MD, MS. Related Content: A Person-Centered Approach to Supplemental Oxygen Therapy in the Outpatient Setting

A study published in JAMA Internal Medicine found that statin use in patients with chronic liver disease was associated with a lower risk of liver cancer and hepatic decompensation, suggesting potential protective effects beyond lipid management. Surveys by the Annenberg Public Policy Center revealed widespread misinformation about the risks of consuming raw milk, highlighting the need for public education on the importance of pasteurization. New research links red meat allergy (alpha-gal syndrome) to bites from deer ticks and western black-legged ticks, expanding the geographic risk area and emphasizing the need for clinicians to consider this diagnosis in patients with unexplained allergic symptoms following tick bites.

A pragmatic trial evaluates the effectiveness of a treatment or intervention in “real-world” clinical practice.  Outcomes are typically assessed from available records.  Eligibility in pragmatic trials are often broad, and don't have the exclusions of efficacy studies, which examine treatment effects under highly controlled conditions in highly select populations. Today we are delighted to welcome Jennifer Wolff, Sydney Dy, and Danny Scerpella, who conducted a pragmatic trial of advance care planning (ACP) in primary care practices; and Jasmine Santoyo-Olsson, who wrote an accompanying commentary in JAMA Internal Medicine. We spend the last portion of the podcast discussing the surprising finding of the study.  In the primary care practices that received the advance care planning intervention, rates of advance care planning were higher (about double). Shockingly, rates of potentially burdensome intervention (intubation, CPR, etc) were also higher in the advance care planning intervention group.  What?!?  Not a typo. We spend some time unpacking and contextualizing the potential reasons for this surprising finding, including: Disconnect between relatively low rates of new advance directives (12% in intervention arm vs 7% control) and higher rates of potentially burdensome treatment among decedents (29% in intervention arm vs 21% control).  Only 5% of intervention patients received the facilitator led component of the intervention (there were other components, facilitator-led was the most engaged component). Was there really a causal connection between the intervention, new advance directives, and higher rates of potentially burdensome interventions? Potential that care received, though potentially burdensome, was in fact aligned with goals, and might represent goal concordant care. Potential that documenting advance directives without a robust conversation about prognosis might have led to these findings.  My goals will differ if I think I probably have 2 years to live vs 10 years. Comparison to a trial Yael Shenker discussed in our podcast on AAHPM/HPNA plenary abstracts (also used the Respecting Choices intervention, outcome differed). Implications for the larger discussion over the value of advance care planning, and additional research into advance care planning.  As I say on the podcast, I'm sure Sean Morrison would be delighted to point to these findings as evidence that advance care planning doesn't work, and in fact may be harmful. And I got to sing in Spanish for the second time. I hope my pronunciation is better than my Urdu, or French! -Alex Smith  

Interview with Ishani Ganguli, MD, MPH, and David Cutler, PhD, authors of Telemedicine Adoption and Low-Value Care Use and Spending Among Fee-for-Service Medicare Beneficiaries. Hosted by Eve Rittenberg, MD. Related Content: Telemedicine Adoption and Low-Value Care Use and Spending Among Fee-for-Service Medicare Beneficiaries

En este episodio de Doctor Mau Informa, descubre cómo el sauna puede mejorar tu salud física y mental con respaldo de evidencia médica. ¡Esto es lo que necesitas saber! #drmauinforma #doctormauinforma Suscríbete a mi boletín informativo en: www.drmauriciogonzalez.com/ Redes sociales: ⁣ YouTube: /@doctormauinforma Instagram: www.instagram.com/dr.mauriciogonzalez TikTok: www.tiktok.com/@drmauriciogonzalez Twitter: www.twitter.com/DrMauricioGon CONTACTO ► booking@drmauriciogonzalez.com ¡Nos escuchamos pronto!⁣ Fuentes: Tomasz, Dudzik., Łucja, Dudzik., Aleksandra, Kozieł., Igor, Domański. (2024). The Impact of Sauna on Health. Journal of Education, Health and Sport, doi: 10.12775/jehs.2024.69.49430 Jörgen, Sandell., Mark, Davies. (2023). Benefits of sauna on lung capacity, neurocognitive diseases, and heart health. World Journal Of Advanced Research and Reviews, 17(1):057-062. doi: 10.30574/wjarr.2023.17.1.1414 Laukkanen, J. A., & Laukkanen, T. (2018). "Sauna bathing and risk of sudden cardiac death, fatal coronary heart disease, and fatal cardiovascular disease." JAMA Internal Medicine, 178(4), 630–637. Laukkanen, J. A., et al. (2015). "Sauna bathing and mortality: A prospective cohort study." JAMA Internal Medicine, 175(4), 542–548. Hypothalamic Menin regulates systemic aging and cognitive decline Leng L, Yuan Z, Su X, Chen Z, Yang S, et al. (2023 )Hypothalamic Menin regulates systemic aging and cognitive decline. PLOS Biology 21(3): e3002033.https://doi.org/10.1371/journal.pbio.3002033 Learn more about your ad choices. Visit megaphone.fm/adchoices

Surrogate decision making has some issues.  Surrogates often either don't know what patients would want, or think they know but are wrong, or make choices that align with their own preferences rather than the patients.  After making decisions, many surrogates experience regret, PTSD, and depressive symptoms.  Can we do better? Or, to phrase the question for 2024, “Can AI do better?” Follow that path and you arrive at a potentially terrifying scenario: using AI for surrogate decision making.  What?!?  When Teva Brender and Brian Block first approached me about writing a thought piece about this idea, my initial response was, “Hell no.”  You may be thinking the same.  But…stay with us here…might AI help to address some of the major issues present in surrogate decision making? Or does it raise more issues than it solves? Today we talk with Teva, Dave Wendler, and Jenny Blumenthal-Barby about: Current clinical and ethical issues with surrogate decision making The Patient Preferences Predictor (developed by Dave Wendler) or Personalized Patient Preferences Predictor (updated idea by Brian Earp) and commentary by Jenny Using AI to comb through prior recorded clinical conversations with patients to play back pertinent discussions; to predict functional outcomes; and to predict patient preferences based on prior spending patterns, emails, and social media posts (Teva's thought piece) A whole host of ethical issues raised by these ideas including the black box nature, the motivations of private AI algorithms run by for profit healthcare systems, turning an “is” into an “ought”, defaults and nudges, and privacy. I'll end this intro with a quote from Deb Grady in an editor's commentary to our thought piece in JAMA Internal Medicine about this topic: “Voice technology that creates a searchable database of patients' every encounter with a health care professional? Using data from wearable devices, internet searches, and purchasing history? Algorithms using millions of direct observations of a person's behavior to provide an authentic portrait of the way a person lived? Yikes! The authors discuss the practical, ethical, and accuracy issues related to this scenario. We published this Viewpoint because it is very interesting, somewhat scary, and probably inevitable.” -@alexsmithmd.bsky.social  

Last week, we heard a former U.S. ambassador describe Russia's escalating conflict with the U.S. Today, we revisit a 2019 episode about an overlooked front in the Cold War — a “farms race” that, decades later, still influences what Americans eat. SOURCES:Anne Effland, former Senior Economist for the Office of Chief Economist in the U.S.D.A.Shane Hamilton, historian at the University of York.Peter Timmer, economist and former professor at Harvard University.Audra Wolfe, writer, editor, and historian. RESOURCES:Freedom's Laboratory: The Cold War Struggle for the Soul of Science, by Audra Wolfe (2018).Supermarket USA: Food and Power in The Cold War Farms Race, by Shane Hamilton (2018).“Association of Higher Consumption of Foods Derived From Subsidized Commodities With Adverse Cardiometabolic Risk Among US Adults,” by Karen R. Siegel, Kai McKeever Bullard, K. M. Narayan, et al. (JAMA Internal Medicine, 2016).The Rise and Fall of American Growth: The U.S. Standard of Living Since the Civil War, by Robert J. Gordon (2016).“How the Mechanical Tomato Harvester Prompted the Food Movement,” by Ildi Carlisle-Cummins (UC Davis Department of Plant Sciences Newsletter, 2015). EXTRAS:"Is the U.S. Sleeping on Threats from Russia and China?" by Freakonomics Radio (2024).

Think back to the last time you went to the doctor's office. Chances are, at the start of the visit, they took your temperature, pulse, and blood pressure—your “vitals.”But how did they take your blood pressure? The medical literature that describes safe blood pressure ranges is all based on readings taken with the patient sitting with feet flat on the floor, legs uncrossed, back supported, and the testing arm supported by a desk at mid-heart level. But if the blood pressure is measured with the person in a different position—say, perched on the edge of an exam table, legs dangling, and an arm hanging at the side—the readings given by a blood pressure monitor can be distorted. In a recent study published in the journal JAMA Internal Medicine, researchers found that arm position could account for as much as a 7mmHg difference in pressure readings. That difference could be enough to incorrectly classify some people as hypertensive.Dr. Tammy Brady, medical director of the Pediatric Hypertension Program at Johns Hopkins University, joins Ira to talk about the art of blood pressure measurement, how to better track your own blood pressure, how to find blood pressure monitors that have been properly validated, and the importance of advocating for yourself in medical settings.Transcript for this segment will be available after the show airs on sciencefriday.com. Subscribe to this podcast. Plus, to stay updated on all things science, sign up for Science Friday's newsletters.