Podcasts about jama internal medicine

Die Themen in den Wissensnachrichten: +++ Unsere Galaxie wird eventuell doch nicht mit Andromeda kollidieren +++ Ausgestorbene Riesen-Säugetiere bestimmen - dabei hilft Kollagen +++ Die Generation Ü-65 konsumiert in den USA immer mehr Cannabis +++**********Weiterführende Quellen zu dieser Folge:No certainty of a Milky Way–Andromeda collision, Nature Astronomy, Juni 2025Collagen peptide markers for three extinct Australian megafauna species, Frontiers, Juni 2025Ensuring Older Adults Using Cannabis Are Not Left High and Dry, Jama Internal Medicine, Juni 2025Traditional water structures in villages support amphibian populations within a protected landscape, Ecosphere, Mai 2025Google users hit with dubious ads: 6 tips for better online searches, Mai 2025Alle Quellen findet ihr hier.**********Ihr könnt uns auch auf diesen Kanälen folgen: TikTok und Instagram .

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

Voici l’essentiel de l’épisode du 17 avril 2025 pour l’émission La commission: Les médias de droite comme Rebel News et True North ne sont pas passés inaperçus mercredi lors du débat francophone des chefs. Mercredi après-midi, des dizaines d’élèves de l’école secondaire de Westmount ont débrayé pour protester contre le laxisme de l’école face aux plaintes d’agressions sexuelles et d’intimidation. Pourquoi c’est si compliqué pour les écoles d’intervenir lorsque des élèves se font intimider et agresser? Les scanneurs pourraient être responsables, aux États-Unis, de 100 000 cancers par année, soit 5% des cas diagnostiqués dans le pays, selon une étude publiée par des chercheurs américains dans la revue Jama Internal Medicine. De quoi devrions-nous être inquiets? Est-ce que les mammographies comptent, parmi ces scanneurs responsables de cancer? On le sait, on tente d’améliorer le service du transport en commun dans le Grand Montréal. Aujourd’hui, EXO présente son rapport annuel 2024. Est-ce que le service s’améliore? Voir https://www.cogecomedia.com/vie-privee pour notre politique de vie privée

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

  With the influx of sports betting websites and the ease of gambling apps in the app store, we are seeing some repercussions. JAMA Internal Medicine reported a twenty three percent increase in people searching the terms "Am I addicted to gambling?". Dave and Debbie speak with Bran Hedin, Executive Director of Renaissance Ranch about how to know when a hobby like gambling turns into an addiction.  

Send us a textSpannendes Thema diese Woche im HAINS Talk Journal Club - die Arbeit von Homberg et al. aus JAMA Internal Medicine zur Frage nach Abbruchkriterien bei der innerklinischen Reanimation: Holmberg MJ, Granfeldt A, Moskowitz A, et al. Termination of Resuscitation Rules for In-Hospital Cardiac Arrest. JAMA Intern Med. Published online January 27, 2025. doi:https://doi.org/10.1001/jamainternmed.2024.7814Mit im Studio dabei - Michael Ziller, wissenschaftlicher Mitarbeiter der Klinik für Anästhesiologie am UKHD

Interview with John W. Ayers, PhD, MA, author of Growing Health Concern Regarding Gambling Addiction in the Age of Sportsbooks. Hosted by Eve Rittenberg, MD, and Nathan Stall, MD, PhD. Related Content: Growing Health Concern Regarding Gambling Addiction in the Age of Sportsbooks Gambling Harms in the Era of Legal Gambling Expansion—A Growing Health Problem

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. This week we look at three new pieces of research. First, we have a paper in the BMJ exploring arterial thrombosis risk with modern hormonal contraceptives including newer treatments such as the combined patch and ring. Second, we have a BJGP paper looking at which type of safety net advice is the most effective. Finally, a new paper in JAMA Internal Medicine collates trials on anti-virals for influenza. Can any of them provide genuine benefit? And don't forget our NB Plus offer - £25 discount on an annual subscription until the 17th of February.ResourcesBMJBJGPJAMAHealthier Together patient infowww.nbmedical.com/podcast

Introducing Mountain to Molehill: A Mindfulness and Meditation Newsletter Mental Health Melissa Llarena Why Stressed Professionals Quit Meditation (And How Not To) Meditating is a good alternative to that third glass of wine at night – and might even serve as a replacement for psych meds for the most restless, stressed-out marketers, sales professionals, and ad executives dealing with the unpredictability of their virtual lives, workplace, home life, and everything else that gets logged in your head as stressful mountains to climb when in reality you're looking at a molehill you can simply hop over. Q: Why did I write this article encouraging you to return to meditation instead of relying on quicker fixes for stress? A: I know firsthand how psych meds play out. I've been an unwitting observer of a personal longitudinal study as the daughter of a mom who has been on them since 1982. My thinking is simple: if you can avoid them, do. I don't say this as a psychiatrist – I say it as a witness who has watched decades of science experiments performed on my single parent, from my toddler years through today, when the impact of this four-decade-long chemical warfare is irreversible. This deeply personal experience is why I'm committed to my mental health, and why I believe adopting and keeping a meditation practice is a powerful approach to life's realities. A consistent practice will increase your capacity to bear any weight you may be carrying – something we all need, don't you agree? Now, I know it's hard to adopt a practice from scratch, so I decided to focus on those of you who once meditated and might secretly wish to return. Let's start with the top reasons for this kind of "quiet" quitting. Notice the pun? I'll try to keep you chuckling throughout this read. But first, let's look at some serious stats... According to the Journal of Alternative and Complementary Medicine, approximately 60% of people who start a meditation practice discontinue within the first year. The primary reasons include: 1.     Perceived lack of time 2.     Difficulty maintaining consistent practice 3.     Feeling they're "not doing it right" 4.     Not seeing immediate results Let's explore doable workarounds for these four reasons, considering our modern omnichannel lives. Interestingly, this study aligns perfectly with a recent LinkedIn survey I conducted, asking mid-career professionals what they wanted me to cover. Time emerged as the top concern, so let's start there. Perceived Lack of Time Let's talk about time – or the common excuse of not having enough of it. Let's dispel the idea that you're too busy to drop in and pay attention to your breath for five minutes a day. Where can you steal these five minutes? Let's start with the low-hanging fruit. According to the Harvard Business Review, professionals spend an average of 28% of their workweek managing email. That's about 3.1 hours per day reading, writing, and responding to emails, with an estimated 25% of those being unnecessary or unproductive. Take my librarian email saga, for example. I received a ridiculously long email about a book renewal that could have been summarized in three sentences. Instead, this well-meaning librarian wrote paragraphs explaining a simple process. I thought to myself: she could have meditated in the time it took to write this novel of an email. Seriously, couldn't you shave five minutes from your 3.1 hours of daily email writing for a relaxing breathing session? I have full confidence you can steal some time from email writing to meditate. It can be that simple – or perhaps meditation can become your pre-meeting ritual? My pandemic meditation journey was ritualistic. I needed a tool to reliably catch my breath and return to my three sons as the calmest version of myself; the stakes were staring me in the face. I'd drag my son's bean bag out to my wrap-around balcony – my "lanai" in honor of the Golden Girls – and sit under the sun. The benefits were two-fold: it gave me something to do during lockdowns, and I returned refreshed enough to homeschool three sons. Ultimately, I returned to my teaching post with greater patience, not totally "unsnappable," but feeling more able to relax. Pro Tip: You can always find time when a boss drops a last-minute request. Somehow, you'll complete other assignments, shorten your timeframe, stay up later, or wake up earlier. Imagine treating meditation as vitally as that urgent work assignment. This is just your way into starting a practice – not necessarily how you'll have to make it stick – which brings me to the second reason for quitting. Difficulty Maintaining Consistent Practice Willpower is overrated. There, I said it. If I had unlimited willpower, I wouldn't have half a bottle of wine in my fridge or pair my glass with partially dry Manchego cheese at six p.m. when I nestle in my corner of the sofa before my sons fight me to the death to take over the TV. This is why I endeavor to do as much as possible before 9 am every single day – it's not because I want to challenge myself but because I don't trust myself as the day gets later. There's science to back this up, which is why I apply simple heuristics to maintain a consistent meditation practice. My decision-making process is brutally simple: ·       Question: Do I plan to eat today? ·       Answer: Yes. ·       Action: Then I guess I'll go to the gym, walk 10K steps, and meditate before starting my workday. Don't think you need to do these things before meditating or before 9 am like me. Instead, use my question to spark your own chain of daily habits. Yours can be as simple as: ·       Question: Do I plan to breathe today? ·       Answer: Yes. ·       Action: Then I'll take 5 minutes to pay attention to some of those breaths. This decision tree below is for those of us who've been trained to overthink... just follow the nodes. I've found that thinking is often what gets in our way. Arnold Schwarzenegger shared the same sentiment about his workouts in his Netflix documentary: he said he could think after his workouts. Same goes for meditating. Think later. See Substack. https://open.substack.com/pub/melissallarena/p/why-stressed-professionals-quit-meditation?r=fetqt&utm_campaign=post&utm_medium=web&showWelcomeOnShare=true My meditation practice looks different every day. Sometimes I'll light a candle, drop on my carpeted floor with earbuds, and hum along to a guru telling me: "I am not my body. I am not my mind." Let's call this my "scruffy, get it done" meditation. Other times I've meditated with my eyes open during a commute. I believe in habit stacking – pairing one existing habit with a new one. Not Seeing Immediate Results On Halloween 2023, I self-published my book "Fertile Imagination." My goal was to become an Amazon bestseller. While my three boys were putting on Halloween costumes, I was copy/pasting/pitching/praying. My ranking wasn't moving despite my efforts. I had two choices: toss my laptop out the window and curse Bezos, or maintain unwavering belief in the process. I kept going. When I woke up at 5 am, I was number one in two categories. Sure, I was just a good night's rest away from seeing my goal come true – but writing the book had taken two years, securing early readers required 35 outbound emails a day for months, and Amazon needed 24 hours to update their stats. A LOT went into it behind the scenes. This experience mirrors the practice of meditation. It requires consistent effort, even when you don't see immediate results. You must trust that the benefits will manifest over time, just as I trusted my book would eventually rise in the ranks. It's about cultivating a deep-seated belief in the power of the practice, even when your mind whispers doubts. Feeling They're "Not Doing It Right" The internet paints a picture of meditation that's a bit... idealized. You know the image: serene folks, Lululemon-clad, perched on fancy meditation pillows, humming along to some ethereal YouTube guru. That's not exactly my reality. This morning, I was planning to meditate, but my phone battery died. So, I grabbed my timer and dropped onto the carpet, aiming for those 25 minutes of blissful silence. But let's just say, my meditation practice looked a little different. If I'd meditated any longer, my husband might have gotten out the masking tape to document a crime scene. Let me explain. If you could have seen me, I was definitely not dressed for a yoga retreat – just my usual work attire: brown boots, ripped jeans, and a cashmere sweater. Picture it: a perfectly respectable professional, now sprawled on their living room floor, looking like a crime scene victim. Pause for a second to see how Canva's image-generating AI "Dream Lab" doesn't care about doing things "right." Let's learn from it. The first try is so wacky and wrong. See Substack for images. https://open.substack.com/pub/melissallarena/p/why-stressed-professionals-quit-meditation?r=fetqt&utm_campaign=post&utm_medium=web&showWelcomeOnShare=true The image below is closer to my original description, but it's still not "quite right" – like many AI-generated images. So give yourself some grace and aim for "good enough right now" rather than "perfect." See Substack for images. https://open.substack.com/pub/melissallarena/p/why-stressed-professionals-quit-meditation?r=fetqt&utm_campaign=post&utm_medium=web&showWelcomeOnShare=true Side note: if you had a second to take that pause, then you have time to meditate. ;) No side-eye from me – just pointing this out. Here's the truth: There's no right way to meditate. You can meditate in a closet, on a Trader Joe's line, or in a nursery room. Simply be present. Here's the easiest way to begin your meditation practice: Wear your work clothes. Perfect. Find a comfortable spot: A bed, sofa, or even a random rug. Even better. Set a timer for 10 minutes. Focus on your breath. Your thoughts will arise — that's normal. Gently guide your attention back to your breath. Give yourself a mental high-five when you return to breathing. Commit to finding your own meditation style. Meditation has two-fold benefits when it comes to managing stress. Harvard Health Publishing confirms that meditation activates your body's relaxation response, which helps you navigate stressful situations with a sense of calm. Additionally, a JAMA Internal Medicine meta-analysis found that mindfulness meditation significantly reduces perceived stress. So, whether you have to climb a mountain, you'll feel more capable of doing so. Or perhaps you can quickly shift your perception of a mountain and see it for what it really is: a surmountable molehill. You'll want to adapt or bring back your meditation practice if you wish to see more molehills than mountains and feel resourced if it's a real mountain you must climb up or down to get to the other side. So, are you ready to give it a try? Conclusion Meditation is a practice, not a magical solution to stop thinking altogether. Be patient with yourself, and remember that even a few minutes of mindful presence can make a difference. A brief pause can give you space to reconsider a knee-jerk reaction or simply feel more capable of a tough conversation. I hope this article has provided helpful insights and encouragement. If you're struggling to establish, maintain, or restart a consistent meditation practice, please reach out via email melissa .llarena [at] gmail.com or leave a comment on the platform of your liking Substack, Medium or LinkedIn. I can offer support as a mindfulness and meditation practitioner dedicated to finding solutions that can increase your ability to navigate life's challenges and opportunities. Remember, your mental and emotional well-being is as vital as your physical health. They are interconnected, as I've observed in my research and personal experience. A healthy mind in an unhealthy body will likely experience discomfort, and an unhealthy mind can manifest in physical symptoms. Prioritize this empowering form of self-care and explore the many benefits of meditation. Your family and those you work with will appreciate it.   My Story – Melissa Llarena   I'm a meditation practitioner and #1 Amazon bestselling author who has spent years peering into the minds of marketers and executives, both as one of them and as their trusted guide. My articles in ForbesWomen have reached over 4 million readers, but what really lights me up is the deep work I do with people who, like me, have spent years shape-shifting to succeed.  My own journey through the corporate world – 10 years at powerhouses like Ogilvy (working on IBM) and P&G (yes, even Charmin!) – taught me firsthand about wearing different hats across 14+ business functions. For the past 13 years, I've had the privilege of coaching over 200 marketing and advertising executives worldwide, having raw, honest conversations about what it really costs us to morph ourselves every single day.    When I'm hosting the Mom Founder Imagination Hub podcast, I get to dive deep with remarkable leaders like Beth Comstock and GaryVee, exploring how to tap into our most overlooked superpower: imagination. My psychology degree from NYU, Dartmouth MBA, and Transformational Coaching certification gave me the foundation, but it was the pandemic that showed me – and my clients – that we needed something more.    In 2021, when ambition felt impossible and imagination seemed out of reach, I realized we were all exhausted from trying to power through. That's when I took a leap – pausing my coaching practice to write a book filled with soul-searching questions, while earning my meditation certification from the Jack Kornfield organization.     Now, I blend all these pieces – my corporate insider experience, thousands of honest conversations, and meditation wisdom – into workshops, sessions, and immersions that truly connect. Using imaginative meditation, mindfulness practices that even the most restless executives love, and revealing journaling exercises, I help people find their way back to themselves. Because here's what I know: when we stop losing ourselves every time life or business throws us a curveball, we can finally use our energy for what really matters – creating the impact we're meant to make.     

¿Deberías dejar el café? ☕ Descubre si esta popular bebida está ayudando o perjudicando tu salud. En este video, exploramos los beneficios y riesgos del café respaldados por la ciencia, y al final te damos recomendaciones prácticas para saber si deberías reducir su consumo o dejarlo por completo. Hablaremos de: ✅ Cómo el café afecta tu rendimiento físico y mental. ✅ Los beneficios antioxidantes y sus posibles riesgos ocultos. ✅ Ansiedad, insomnio y otros efectos de la cafeína en exceso. ✅ Alternativas saludables al café para quienes quieren reducirlo. Mira hasta el final para descubrir todo lo que necesitas saber sobre esta bebida tan popular. ¡Este video podría cambiar tu forma de consumir café para siempre!

Content Warning This episode addresses mental health issues, including research and personal narratives on suicide. Please take care while engaging with it and only proceed if you feel safe doing so. If you, or someone you love, is having thoughts of suicide, please contact 988. Help is available. Interviewer Dr. Lisa Meeks Interviewees John Ruddell Jennifer Ruddell Narrator Dr. Joseph Murray Transcript Link:  [https://docs.google.com/document/d/1aH2bYIfs63VeVnABRj4NrhpwffUjGmRSB3qaP9-bm4U/edit?usp=sharing] Keywords Suicide Prevention Medical Education Mental Health Postvention Grief and Healing Wellness in Medicine Advocacy Systemic Reform Burnout Depression Anxiety Disabilities in Medical Training Culture  Description of Series  DWDI Special Series: Suicidality in Medical Training dives into the critical conversations around mental health, well-being, support systems, and the intense pressures faced during medical training. Through the power of storytelling, the series intertwines these broader themes with the deeply personal story of Dr. Jack Ruddell, a promising medical student who tragically died by suicide. Jack's journey—his strengths, struggles, and the complexities leading to his untimely death—forms the emotional core of this five-part series, giving voice to the loved ones often excluded from these conversations. Alongside Jack's story, the series incorporates expert insights and data from the literature, offering a human perspective on burnout, depression, and suicide among medical trainees. With a commitment to improving mental health awareness and reducing the stigma around seeking help, the series presents a novel approach by centering personal narratives alongside expert analysis. It also explores actionable strategies for improving medical training environments and highlights the importance of institutional responses after a loss by suicide. Our mission is to reduce shame, encourage help-seeking among medical students struggling with depression, and ensure that every medical school is aware of the postvention resources offered by the American Foundation for Suicide Prevention (AFSP). Experts for the Series  Christine Moutier, MD – Chief Medical Officer, American Foundation for Suicide Prevention Jessi Gold, MD – Chief Wellness Officer, University of Tennessee System; Author of How Do You Feel? David Muller, MD – Director, Institute for Equity and Justice in Health Sciences Education; Dean Emeritus, Icahn School of Medicine at Mt. Sinai; Author of the NEJM essay, Kathryn Srijan Sen, MD, PhD – Director, Eisenberg Family Depression Center; PI of the Intern Health Study Justin Bullock, MD, MPH – Fellow, University of Washington; Author of the NEJM article, Suicide, Rewriting My Story Stuart Slavin, MD, MEd – Vice President for Well-Being, ACGME Episode Release Schedule: September 17: Episode 102 – Honoring Dr. Jack Ruddell: A Story of Joy, Compassion, and Mental Health in Medical Training. September 17: Episode 103 – Suicide and Suicidality in Medical Training: Understanding the Crisis and its Causes.  September 24: Episode 104 – Silent Struggles: Mental Health and Medical Education. September 26: Episode 105 – Repairing the System: How Do We Create Safe Environments? September 30: Episode 106 – Responding to Loss: Postvention and Support After a Suicide. Executive Producers: Lisa Meeks Rylee Betchkal John Ruddell Jennifer Ruddell Sound production: Jacob Feeman Mark Koha Next Day Podcast Consult Psychiatrist Joseph Murray, MD Resources:  24/7 Suicide & Crisis Hotline Call or text 988 or chat 988lifeline.org.    The American Foundation for Suicide Prevention https://afsp.org   Intern Health Study https://www.internhealthstudy.org https://www.srijan-sen-lab.com/intern-health-study   How are you? By Jessi Gold https://www.drjessigold.com/how-do-you-feel-book-by-jessi-gold-md/   Make the Difference: Preventing Medical Trainee Suicide https://www.youtube.com/watch?app=desktop&v=I9GRxF9qEBA&feature=youtu.be   Time to Talk About It: Physician Depression and Suicide” Video/Discussion Session for Interns, Residents, and Fellows https://www.mededportal.org/doi/10.15766/mep_2374-8265.10508   Action Collaborative on Clinician Well-Being and Resilience   National Academy of Medicine https://nam.edu/action-collaborative-on-clinician-well-being-and-resilience-network-organizations/   Jennifer and Jack Ruddell Essay in JAMA Internal Medicine  https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2829194   Dr. Lotte Dyrbye Invited Commentary responding to the Ruddell's essay https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2829200        

Show Notes for Episode 41 of “The 2 View” – reversible cerebral vasoconstriction syndrome, cerebral venous thrombosis, cardiopulmonary resuscitation and emergency cardiovascular care science, prehospital tourniquets, blood pressure, and more. Segment 1 – Reversible cerebral vasoconstriction syndrome and cerebral venous thrombosis Ropper AH, Klein JP. Cerebral Venous Thrombosis. N Engl J Med. Published June 30, 2021. https://www.nejm.org/doi/full/10.1056/NEJMra2106545 Spadaro A, Scott KR, Koyfman A, Long B. Reversible cerebral vasoconstriction syndrome: A narrative review for emergency clinicians. Am J Emerg Med. ScienceDirect. Published December 2021. https://www.sciencedirect.com/science/article/abs/pii/S0735675721008093 Segment 2 – Cardiopulmonary resuscitation and emergency cardiovascular care science, Prehospital tourniquets, and more Greif R, Bray JE, Djärv T, et al. 2024 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations: Summary from the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; And First Aid Task Forces. Circulation. AHA | ASA Journals. Published November 14, 2024. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001288?utmcampaign=sciencenews24-25&utmsource=science-news&utmmedium=phd-link&utmcontent=phd-11-14-24 Roberts M, Sharma M. The Center for Medical Education. 36 - Marijuana, Sunburns, Pulse Oximetry, Lower UTI's. 2 View: Emergency Medicine PAs & NPs. Published May 31, 2024. https://2view.fireside.fm/36 Roberts M, Sharma M. The Center for Medical Education. The 2 View: Episode 2. 2 View: Emergency Medicine PAs & NPs. Published February 3, 2021. https://2view.fireside.fm/2 Smith AA, Ochoa JE, Wong S, et al. Prehospital tourniquet use in penetrating extremity trauma: Decreased blood transfusions and limb complications. J Trauma Acute Care Surg. NIH: National Library of Medicine: National Center for Biotechnology Information. PubMed. Published January 2019. https://pubmed.ncbi.nlm.nih.gov/30358768/ STB home page. Stop the Bleed. American College of Surgeons. https://www.stopthebleed.org/ Teixeira PGR, Brown CVR, Emigh B, et al. Civilian Prehospital Tourniquet Use Is Associated with Improved Survival in Patients with Peripheral Vascular Injury. J Am Coll Surg. NIH: National Library of Medicine: National Center for Biotechnology Information. PubMed. Published May 2018. https://pubmed.ncbi.nlm.nih.gov/29605726/ Segment 3 – Blood Pressure Bress AP, Anderson TS, Flack JM, et al. The Management of Elevated Blood Pressure in the Acute Care Setting: A Scientific Statement From the American Heart Association. Hypertension. NIH: National Library of Medicine: National Center for Biotechnology Information. PubMed. Published August 2024. https://pubmed.ncbi.nlm.nih.gov/38804130/ Liu H, Zhao D, Sabit A. Arm Position and Blood Pressure Readings: The ARMS Crossover Randomized Clinical Trial. Jamanetwork.com. JAMA Network. JAMA Internal Medicine. Published October 7, 2024. https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2824754 Recurring Sources Center for Medical Education. Ccme.org. http://ccme.org The Proceduralist. Theproceduralist.org. http://www.theproceduralist.org The Procedural Pause. Emergency Medicine News. Lww.com. https://journals.lww.com/em-news/blog/theproceduralpause/pages/default.aspx The Skeptics Guide to Emergency Medicine. Thesgem.com. http://www.thesgem.com Trivia Question: Send answers to 2viewcast@gmail.com Be sure to keep tuning in for more great prizes and fun trivia questions! Once you hear the question, please email us your guesses at 2viewcast@gmail.com and tell us who you want to give a shout-out to. Be sure to listen in and see what we have to share!

Interview with Liselotte N. Dyrbye, MD, MHPE, author of From Tragedy to Action—How to Collectively Move Forward. Hosted by Ilana B. Richman, MD, and Eve Rittenberg, MD. Related Content: From Tragedy to Action—How to Collectively Move Forward

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

Interview with Stephanie E. Cohen, MD, author of Doxycycline Postexposure Prophylaxis and Sexually Transmitted Infection Trends, and guest discussant JAMA Deputy Editor Preeti Malani, MD, MSJ. Hosted by Eve Rittenberg, MD. Related Content: Doxycycline Postexposure Prophylaxis and Sexually Transmitted Infection Trends

Interview with Laura M. Dember, MD, author of Pain Coping Skills Training for Patients Receiving Hemodialysis: the HOPE Consortium Randomized Clinical Trial. Hosted by Eve Rittenberg, MD. Related Content: Pain Coping Skills Training for Patients Receiving Hemodialysis

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

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).

Is Robert F. Kennedy, Jr., just a big crank? Well, yes. But is he nevertheless correct in his specific claims about the harms of water fluoridation? It's long been argued that it's no longer necessary, and that it might have the scary adverse effect of lowering children's IQs. In this episode of The Studies Show, Tom and Stuart look at the evidence.While they're at it, Tom and Stuart ask whether there's evidence for several other dentistry-related claims. Regular check-ups; flossing; fillings; fluoride toothpaste—is your dentist just b**********g you about any or all of these?[This podcast was recorded just before Donald Trump selected RFK Jr. as his candidate for US Health Secretary, but that makes the episode even more relevant].The Studies Show is brought to you by Works in Progress magazine. If you're an optimist who enjoys reading about how things have gotten better in the past, and how we might make them better in the future—then it's the magazine for you. Find it at worksinprogress.co. Show notes* RFK Jr.'s tweet about how the new Trump administration will remove fluoride from the US water supply* US National Research Council's 2006 report on fluoridation* 2023 meta-analysis on water fluoridation and IQ* Letter co-authored by Stuart, criticising a bad study on fluoride and IQ in pregnant women and their babies* The original study* Review of fluoridation and cancer risk* 2000 UK NHS review of fluoridation and cancer risk* 2022 UK Government report on the link of water fluoridation to various different medical conditions* 2024 Cochrane Review on fluoridation and preventing tooth decay* Review of guidelines from the Journal of the American Dental Association* 2020 randomised controlled trial on fillings in children's teeth* The Cochrane Library on the evidence for specific intervals between dental appointments (e.g. 6 months)* The American Dental Association guidelines on flossing, and the NHS ones* 2019 Cochrane review of RCTs of flossing* The ADA and NHS guidelines on brushing with fluoride toothpaste* 2019 Cochrane review on brushing and fluoride* Claims about cardiac health being related to dental health* Study of 1m people in Korea on cardiac health and tooth loss* 2020 meta-analysis of cardiac and dental health* The study included in the meta-analysis by Chen, Chen, Lin, and Chen* Claims about dental health and cancer* 2020 review of the literature* 2024 Ars Technica story on dentists over-selling their services* 2019 Atlantic piece: “Is Dentistry a Science?”* 2013 piece in the Washington State Dental News magazine on “creative diagnosis”* Articles in the British Dental Journal and JAMA Internal Medicine both arguing that evidence-based medicine has left dentistry behindCredits The Studies Show is produced by Julian Mayers at Yada Yada Productions. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.thestudiesshowpod.com/subscribe

Send us a textIn this episode, Jessica Hochman MD and Pieter Cohen MD discuss melatonin use in children! Dr Cohen recently authored a study on melatonin use in children,  and the study revealed significant discrepancies in the labeling of melatonin supplements. They explore the safety concerns, regulatory issues, and the need for better quality control in the supplement industry.Dr. Pieter Cohen, a graduate of Yale School of Medicine, is an associate professor of Medicine at Harvard Medical School and a practicing internist at Cambridge Health Alliance (Somerville, Massachusetts).  His area of research is the safety of dietary supplements.  Along with analytic chemistry colleagues, he has spent more than a decade exploring the boundaries between drugs and supplements.  His work has been published in the New England Journal of Medicine, JAMA, JAMA Internal Medicine, American Journal of Public Health and Annals of Internal Medicine.   Read his article on melatonin gummies here:https://pmc.ncbi.nlm.nih.gov/articles/PMC101Dr Jessica Hochman is a board certified pediatrician, mom to three children, and she is very passionate about the health and well being of children. Most of her educational videos are targeted towards general pediatric topics and presented in an easy to understand manner. For more content from Dr Jessica Hochman:Instagram: @AskDrJessicaYouTube channel: Ask Dr JessicaWebsite: www.askdrjessicamd.com-For a plant-based, USDA Organic certified vitamin supplement, check out : Llama Naturals Vitamin and use discount code: DRJESSICA20-To test your child's microbiome and get recommendations, check out: Tiny Health using code: DRJESSICA Do you have a future topic you'd like Dr Jessica Hochman to discuss? Email Dr Jessica Hochman askdrjessicamd@gmail.com.The information presented in Ask Dr Jessica is for general educational purposes only. She does not diagnose medical conditions or formulate treatment plans for specific individuals. If you have a concern about your child's health, be sure to call your child's health care provider.

Interview with Chloe I. Bloom, BSc, MSc, PhD, author of Antidiabetic Medication and Asthma Attacks, and Katherine N. Cahill, MD, author of Borrowing From the Type 2 Diabetes Armamentarium for Asthma. Hosted by Eve Rittenberg, MD. Related Content: Antidiabetic Medication and Asthma Attacks Borrowing From the Type 2 Diabetes Armamentarium for Asthma

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.

Dupilimab received FDA approval as the first biologic treatment for adults with uncontrolled COPD, reducing exacerbations significantly in clinical trials. A study in JAMA Internal Medicine demonstrated that improper arm positioning during blood pressure measurements can lead to overestimated readings, potentially causing misdiagnosis. Another study in Atherosclerosis, Thrombosis, and Vascular Biology linked COVID-19 to long-term risks of major adverse cardiac events (MACE), with increased risks for patients hospitalized with COVID-19 and those with non-O blood types. These findings underscore the need for attention to proper clinical practices and long-term monitoring of cardiovascular health post-COVID-19.

Interview with Jerry H. Gurwitz, MD, author of High-Risk Medications in Persons Living With Dementia: A Randomized Clinical Trial, and Ariel R. Green, MD, PhD, MPH, author of Start Upstream, Leverage the Team—Deprescribing in Patients With Dementia. Hosted by Eve Rittenberg, MD. Related Content: High-Risk Medications in Persons Living With Dementia Start Upstream, Leverage the Team—Deprescribing in Patients With Dementia

Interview with Fasiha Kanwal, MD, MSHS, author of GLP-1 Receptor Agonists and Risk for Cirrhosis and Related Complications in Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease. Hosted by Eve Rittenberg, MD, and Grace Yuan Zhang, MD Related Content: GLP-1 Receptor Agonists and Risk for Cirrhosis and Related Complications in Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease

Anti-Asian hate incidents rose dramatically during COVID, likely fueled by prominent statements about the “Chinese virus.”  VIewed through the wider lens of history, this was just the latest in a long experience of Anti-Asian hate, including the murder of Vincent Chin, the Chinese Exclusion Act, and the internment of Japanese Americans during WWII.  For those who think that anti-Asian hate has receded as the COVID has “ended,” just two days prior to recording this episode a Filipino woman was pushed to her death on BART in San Francisco. These incidents are broadcast widely, particularly in Asian News outlets. Today we talk about the impact of anti-Asian hate on the health and well being of older adults with Russell Jeung, sociologist, Professor of Asian Studies at San Francisco State, and co-founder of Stop AAPI-Hate, Lingsheng Li, geriatrician/palliative care doc and T32 fellow at UCSF, and Jessica Eng, medical director of On Lok, a PACE, and Associate Professor in the UCSF Division of Geriatrics.  We discuss: What is considered a hate incident, how is it tracked, what do we know about changes over time The wider impact of Anti-Asian hate on older Asians, who are afraid to go out, leading to anxiety, social isolation, loneliness, decreased exercise, missed appointments and medications. Lingsheng (and I) recently published studies on this in JAMA Internal Medicine, and JAGS. Ongoing reports from patients about anti-Asian hate experiences  Should clinicians screen for Anti-Asian hate? Why? Why not? Proposing the clinicians ask a simple follow up question to the usual “do you feel safe at home?” question used to screen for domestic violence.  Add to this, “do you feel safe outside the home?” This question, while providing an opportunity to talk about direct and indirect experiences, can be asked of all patients, and opens the door to conversations about anti-semitism, islamophobia, or anti-Black racism. See also guides for how to confront and discuss anti-Asian hate in these articles in the NEJM and JGIM. And to balance the somber subject, Lingsheng requested the BTS song Dynamite, which was the group's first English language song, and was released at the height of the COVID pandemic.  I had fun trying to make a danceable version with electronic drums for the audio-only podcast.  Maybe we'll get some BTS followers to subscribe to GeriPal?!?   -@AlexSmithMD  

We delve into the implications of the recent study published in JAMA Internal Medicine, exposing how older risk models overestimate cardiovascular risk by about 50%. This overestimation has profound implications for primary statin use, insurer policies, and regulatory practices. Our discussion highlights the need for updated guidelines that reflect the most current evidence, ensuring better patient care and aligning clinical practice with the latest scientific findings. The GameChangerAdopting the PREVENT equations could significantly refine statin prescriptions, ensuring millions of adults receive appropriate cardiovascular risk management. HostJen Moulton, BSPharmPresident, CEimpactGuestsGeoff Wall, PharmD, BCPS, FCCP, BCGPProfessor of Pharmacy Practice, Drake UniversityInternal Medicine/Critical Care, UnityPoint HealthJake Galdo, PharmD, MBA, BCPS, BCGPCEOSeguridadReferenceAtherosclerotic Cardiovascular Disease Risk Estimates Using the Predicting Risk of Cardiovascular Disease Events EquationsPharmacists, REDEEM YOUR CPE HERE!CPE is available to Health Mart franchise members onlyTo learn more about Health Mart, click here: https://join.healthmart.com/CPE InformationLearning ObjectivesUpon successful completion of this knowledge-based activity, participants should be able to:1. Discuss the impact of the PREVENT equations on statin prescription recommendations for cardiovascular disease prevention.2. Explain clinical implications and practice changes from integrating the PREVENT equations into cardiovascular risk guidelines.0.05 CEU/0.5 HrUAN: 0107-0000-24-245-H01-PInitial release date: 08/12/2024Expiration date: 08/12/2025Additional CPE details can be found here.

We delve into the implications of the recent study published in JAMA Internal Medicine, exposing how older risk models overestimate cardiovascular risk by about 50%. This overestimation has profound implications for primary statin use, insurer policies, and regulatory practices. Our discussion highlights the need for updated guidelines that reflect the most current evidence, ensuring better patient care and aligning clinical practice with the latest scientific findings. The GameChangerAdopting the PREVENT equations could significantly refine statin prescriptions, ensuring millions of adults receive appropriate cardiovascular risk management. GuestsGeoff Wall, PharmD, BCPS, FCCP, BCGPProfessor of Pharmacy Practice, Drake UniversityInternal Medicine/Critical Care, UnityPoint HealthJake Galdo, PharmD, MBA, BCPS, BCGPCEOSeguridadReferenceAtherosclerotic Cardiovascular Disease Risk Estimates Using the Predicting Risk of Cardiovascular Disease Events EquationsPrevious GameChangers on PREVENT score Pharmacist Members, REDEEM YOUR CPE HERE! Not a member? Get a Pharmacist Membership & earn CE for GameChangers Podcast episodes! (30 mins/episode)CPE Information Learning ObjectivesUpon successful completion of this knowledge-based activity, participants should be able to:1. Discuss the impact of the PREVENT equations on statin prescription recommendations for cardiovascular disease prevention.2. Explain clinical implications and practice changes from integrating the PREVENT equations into cardiovascular risk guidelines.0.05 CEU/0.5 HrUAN: 0107-0000-24-245-H01-PInitial release date: 08/12/2024Expiration date: 08/12/2025Additional CPE details can be found here.Follow CEimpact on Social Media:LinkedInInstagram

Gender bias in the workplace should come as no surprise to KeyLIME-ers.  Yet, many do not realize how pervasive sexism can be in the assessment of trainees in our residency programs. Jon's selection showcases the significant issue of gender bias in the academic environment and the hosts attempt to understand the scope of the problem.  Authors: Dayal A, O'Connor DM, Qadri U, Arora VM.  Publication details: Comparison of Male vs Female Resident Milestone Evaluations by Faculty During Emergency Medicine Residency Training.  JAMA Internal Medicine. 2017. March 6. [ePub ahead of print] PubMed Link

Interview with Emily Lupton Lupez, MD, MPH, author of Health, Access to Care, and Financial Barriers to Care Among People Incarcerated in US Prisons, and Benjamin A. Howell, MD, author of Harming Health by Imposing In-Prison Co-Payments. Hosted by Eve Rittenberg, MD. Related Content: Health, Access to Care, and Financial Barriers to Care Among People Incarcerated in US Prisons Harming Health by Imposing In-Prison Co-Payments

Interview with Kelly C. Young-Wolff, PhD, MPH, author of Prenatal Cannabis Use and Maternal Pregnancy Outcomes, and Jamie O. Lo, MD, MCR, author of Associations Between Prenatal Cannabis Use and Maternal Health Outcomes. Hosted by Eve Rittenberg, MD. Related Content: Prenatal Cannabis Use and Maternal Pregnancy Outcomes Associations Between Prenatal Cannabis Use and Maternal Health Outcomes

Significant variations in medical treatments, even within the same state, challenge the belief that medical care is primarily based on science. In this episode, Dr. Rita Redberg, a Professor of Medicine at UCSF Health, examines the belief that medical care is based primarily on science by discussing significant variations in treatment practices and advocating for evidence-based medicine. In her "Less is More" series in JAMA Internal Medicine, she aims to improve test readability and effectiveness. Throughout this interview, Dr. Redberg discusses the US Preventive Services Task Force's controversial mammography guidelines and the potential harms of over-testing, underscoring the importance of high-quality, unbiased evidence and rigorous FDA approval processes for new medical devices and drugs. She also addresses issues like unnecessary procedures motivated by fear of litigation or financial incentives and strongly calls for removing conflicts of interest from scientific trials and enhancing NIH funding to promote independent research.  Tune in and learn about the importance of evidence-based practices in health care and the steps needed to ensure safer, more effective patient care! Learn more about your ad choices. Visit megaphone.fm/adchoices

What are the effective solutions to prevent burnout and promote wellness for clinicians?  Jon presents a systematic review that attempts to answer that problem. (All three hosts wanted to present this paper but Jon was the quickest to grab it!) His own specialty (Emergency Medicine) consistently ranks high in several studies on burnout.  Authors: Panagioti M, Efharis Panagopoulou E, Peter Bower P, Lewith G, Kontopantelis E, Chew-Graham C, Dawson S, van Marwijk H, Geraghty K, Esmail A. Publication details: Controlled Interventions to Reduce Burnout in Physicians: A Systematic Review and Meta-analysis. JAMA Internal Medicine. 2016 Dec. [ePub ahead of print] PubMed Link

Interview with Priti Bandi, PhD, author of Lung Cancer Screening in the US, 2022, and Ilana B. Richman, MD, MHS, author of Progress in Lung Cancer Screening Adoption. Hosted by Eve Rittenberg, MD. Related Content: Lung Cancer Screening in the US, 2022 Progress in Lung Cancer Screening Adoption

If you don't already know dozens of reasons that make exercise essential for menopause health, you may after this episode. I want to share with you 5 powerful quotes directly from the American Journal of Lifestyle Medicine. Then I'll tie this to the physiology of menopause. 1 If any pill or surgical procedure had the same positive effects of exercise, it would be the most widely prescribed medicine in the world. 2 “In fact, it would be malpractice not to prescribe it to every patient, every visit, regardless of medical specialty.” 3 “It is recommended that physical activity be recorded as a vital sign, just as other modifiable risk factors are routinely assessed (eg, blood pressure, weight, smoking)” 4 While other determinants of health (genetics, environment, and medical care) influence health outcomes, by far the most important factor contributing to health outcomes is individual lifestyle and behavior. 5 A 2015 article from JAMA Internal Medicine states, “There is no medication treatment that can influence as many organ systems in a positive manner as can physical activity.” This science wasn't written based on menopause. It was based on the obesity and physical inactivity “pandemic.” Not the one in 2020 but the one that began about the time Snackwells experienced its birth. Yet everything in this (and other research studies) applies to menopause. This is a point in time you're either going to choose to get and stay healthier or by not exercising properly, you're at risk of accelerating the rate of aging and disease. The Right Exercise Essential for Menopause Health These are all quotes directly from the American Journal of Lifestyle Medicine and it cited numerous papers published in 2007 and 2009 related to this Exercise is Medicine™ joint project between two prestigious organizations. In the first 5 years, platforms were built. Likely millions were spent. But still not much has happened. Here we are with less than 20% of all women lifting weights at least twice weekly. For women in menopause, strength training properly could significantly impact at least 7 of the most common symptoms experienced by midlife women. Muscle is an endocrine organ. Only 32% of patients receive advice from their physician or other health care professional to exercise or to continue being physically active during their visit with a physician. Only 12% of medical doctors were required to take any course related to exercise during their medical education. The answers are there. But no one is coming… to help a doctor have more time in an appointment, to help a fitness trainer develop a relationship with a doctor so they can be trusted and used as a referral. It's up to us. To you. To me. We've done much harder things. Advocate for yourself. It's right there. You are just one workout away. Reference: Source: PMID: 32922236 Resources: 10-Day Hot Not Bothered Challenge: https://www.flippingfifty.com/hnb-challenge STRONGER: https://www.flippingfifty.com/getstronger Other Episodes You Might Like: Menopause Exercise Intensity for Optimal Aging for Women Over 50 - https://www.flippingfifty.com/menopause-exercise-intensity/ 21 Ways to Optimize Your WORKOUT After 40, 50, 60 or 70 - https://www.flippingfifty.com/optimize-your-workout/ 21 Reasons Weight Training Should Be Mandatory Exercise After 50 - https://www.flippingfifty.com/weight-training-should-be-mandatory/

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: 19/01/2023 Learn more about your ad choices. Visit megaphone.fm/adchoices

Interview with Daniel Grossman, MD, author of Mail-Order Pharmacy Dispensing of Mifepristone for Medication Abortion After In-Person Screening, and Emily M. Godfrey, MD, MPH, author of Primary Care's Role in Prescribing Mail-Order Mifepristone. Hosted by Eve Rittenberg, MD. Related Content: Mail-Order Pharmacy Dispensing of Mifepristone for Medication Abortion After In-Person Screening Primary Care's Role in Prescribing Mail-Order Mifepristone Mifepristone–Science, Abortion Care, and Politics

Interview with Chintan V. Dave, PharmD, PhD, author of Antihypertensive Medication and Fracture Risk in Older Veterans Health Administration Nursing Home Residents, and Muna Thalji Canales, MD, MS, author of Blood Pressure Management and Falls in Nursing Home Residents—A Matter of Balance. Hosted by Eve Rittenberg, MD. Related Content: Antihypertensive Medication and Fracture Risk in Older Veterans Health Administration Nursing Home Residents Blood Pressure Management and Falls in Nursing Home Residents—A Matter of Balance

One of the things I love about Liz Dzeng's work is the way in which it draws upon, echoes, and advances our understanding of the influence of culture on the end of life experience.  This field is not new. In his book The Hour of our Death Philip Aries described a long evolution in western civilization of cultural attitudes towards dying.  More recently Sharon Kaufman 's book And a Time to Die described the ways in which physicians, nurses, hospital systems, and payment mechanisms influenced the hour and manner of patient's deaths. Similarly Jessica Zitter, an intensivist and palliative care doctor analogized the inevitable clinical momentum toward highly aggressive intensive care in US hospitals as a conveyor belt. Today Liz Dzeng discusses her journey towards studying this issue in detail. Having trained in different institutions within the United States and in the United Kingdom, and as both a sociologist and a hospitalist physician, Liz brings a unique perspective and set of skills to this issue. On this podcast we talk about her paper in JAMA Internal Medicine which studied three hospitals that varied in the intensity of care they provided to seriously ill patients. We discuss the moral distress that clinicians felt including, as one physician put it, a sense of your soul being ripped out. At the end we also pay tribute to Randy Curtis, senior author on this paper and mentor to Liz. Eric and I are joined today on this podcast by Anne Kelly palliative care social worker to discuss these issues with Liz. -@alexsmithMD   Additional links: From Liz: “policies that are too restrictive can actually have an opposite of hindering ethically and clinically appropriate practices whereas policies that allow for flexibility and transparency to act ethically can promote high quality end-of-life care” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8883558/   Other papers that are relevant:  JAMA IM 2015: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2212265 JPSM LAT France paper: https://www.jpsmjournal.com/article/S0885-3924(21)00399-7/pdf ICM paper policies: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8883558/ JPSM aggressive care: https://www.jpsmjournal.com/article/S0885-3924(17)30425-6/fulltext BMJ QS moral distress ethical climate: https://qualitysafety.bmj.com/content/27/10/766.long