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Real-talk nutrition with Jenny Smith—simple, practical, no-nonsense. Go tubeless with Omnipod 5 or Omnipod DASH * Eversense CGM Tandem Mobi ** twiist AID System Free Juicebox Community (non Facebook) Medtronic Diabetes Drink AG1.com/Juicebox Use code JUICEBOX to save 40% at Cozy Earth CONTOUR NextGen smart meter and CONTOUR DIABETES app Dexcom G7 Get your supplies from US MED or call 888-721-1514 Touched By Type 1 Take the T1DExchange survey Apple Podcasts> Subscribe to the podcast today! The podcast is available on Spotify, Google Play, iHeartRadio, Radio Public, Amazon Music and all Android devices The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here or buy me a coffee. Thank you! *The Pod has an IP28 rating for up to 25 feet for 60 minutes. The PDM is not waterproof. Brown et al. Diabetes Care (2021). Sherr et al. Diabetes Care (2022). Pasquel FJ, et al. JAMA Network Open (2025). Single-arm studies comparing 3 months of Omnipod 5 use to standard therapy in 240 people aged 6–70 years and 80 people aged 2–5.9 years with type 1 diabetes and 305 people aged 18–75 years with type 2 diabetes. ** t:slim X2 or Tandem Mobi w/ Control-IQ+ technology (7.9 or newer). RX ONLY. Indicated for patients with type 1 diabetes, 2 years and older. BOXED WARNING:Control-IQ+ technology should not be used by people under age 2, or who use less than 5 units of insulin/day, or who weigh less than 20 lbs. Safety info: tandemdiabetes.com/safetyinfo Disclaimer - Nothing you hear on the Juicebox Podcast or read on Arden's Day is intended as medical advice. You should always consult a physician before making changes to your health plan.
We have covered menopause on this show on various occasions. That's fitting and non-surprising as we are a women's health education podcast! While vaginal dryness and hot flashes get most of the attention in menopause, and they should, less attention often is given to skin changes. Nonetheless, these dermal manifestations of perimenopause and menopause can be just as disturbing to those affected. Estrogen helps skin produce oil and hold onto water, so extremely dry skin during menopause is common. Plus, according to the American Academy of Dermatology, collagen production drops 30% in the first 5 years of menopause and approximately 2% each year for about the next 20 years. Collagen gives skin its plumpness and structure. The direct-to-consumer market is replete with a variety of over-the-counter estrogen containing products, formulated as facial creams, which are meant to fight the battle of skin aging. But is topical estrogen applied to the face effective? What are the data? You'd be surprised to learn that there is published data on this- even level I data. Are there any safety concerns? We will summarize it in this episode. PLUS, as a “two-for one” special, we will also briefly highlight a brand new publication in the journal JAMA Network Open regarding antenatal corticosteroid dose to delivery interval and fetal benefits.
Send us a textHave you ever been told that food doesn't make a difference when it comes to endometriosis pain? Well, today's episode is here to flip that script! We'll dive into the latest findings from the largest-ever international survey on diet and endometriosis, sharing hopeful insights that empower you to take charge of your wellness journey.Here's what you'll hear in today's episode:A brand new study involving over 2,500 endometriosis sufferers and what it reveals about dietary changes and symptom reliefDiscussion of the foods most linked to improved painSpecific statistics from the research, showing the real impact dietary shifts can have (including which foods provided the most relief for participants!)Why certain foods can trigger inflammation—and how this may affect your pain, even if you don't have digestive issuesHow gut bacteria and your microbiome fit into the endometriosis puzzle—and what you can eat to support a healthy gutImportant perspective on "elimination diets" vs. nourishing and supporting your body without restrictionReal-life stories about the difference dietary changes can makeActionable steps: how to get started with dietary changes, what to add to your plate, and how to experiment in a way that works for YOULinks mentioned:Ep. 80 The JAMA Network Open article on diet and endometriosis Article on this study in The GuardianIf you're feeling frustrated by "standard advice" and want practical, down-to-earth guidance on easing Endo pain through food, this episode is for you!Tune in, feel empowered, and as always—take what resonates to nourish your unique body. Thanks for listening! Join the upcoming free workshop: The Endo Relief Blueprint Subscribe to The Endo Belly Girl Podcast: Apple | SpotifyConnect w/ Alyssa: Instagram Website Work w/ Alyssa: Free Endo Diet Guide Work with me 1:1 Join the EndoWellness Initiative Learn more about AlyssaDisclaimer: This podcast is for educational purposes only. This may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here.
Megan Georges, MS; Elizabeth Pino, PhD; and David Wiley of the Boston Medical Center continue their conversation on rehabilitation access disparities for patients with violent injuries, sharing steps that individual clinicians can take to help close gaps. Their findings were recently published in JAMA Network Open. Let us know what you thought of this week's episode on Twitter: @physicianswkly Want to share your medical expertise, research, or unique experience in medicine on the PW podcast? Email us at editorial@physweekly.com! Thanks for listening!
Megan Georges, MS; Elizabeth Pino, PhD; and David Wiley of the Boston Medical Center describe how survivors of community violence face disproportionately high rates of rehab denials compared with patients injured in motor vehicle crashes. Their findings were recently published in JAMA Network Open. Let us know what you thought of this week's episode on Twitter: @physicianswkly Want to share your medical expertise, research, or unique experience in medicine on the PW podcast? Email us at editorial@physweekly.com! Thanks for listening!
I'm joined by board-certified general surgeon Dr. Lee Howard, who walked away from traditional medicine. Why he feels traditional medicine doesn't really help its patients plus we cover what supplements are good for everyone to take, how to navigate allergy season with kids, what the heck the MTHFR gene is, how we should be approaching our kids' health, why were gonna start to hear more and more about creatine, ways we can help the aging process, plus perimenopause and menopause- how to minimize symptoms and recognize when we start to enter that stage. And we cover once and for all what those silly eye twitches are from. Clip 3: Low Testosterone and Alzheimer's RiskMost people think of testosterone as a hormone that just affects sex drive or muscle mass. But the brain is actually one of its biggest targets. A massive 2023 study from the University of Sydney looked at older men and found something shocking: men with low testosterone had a 26% higher risk of developing Alzheimer's disease. And we're not talking about late-stage life—these patterns start decades earlier. Testosterone helps regulate inflammation in the brain, supports memory circuits, and even promotes the growth of new neural connections. When levels drop too low, especially without being noticed, the brain becomes more vulnerable to decline. Here's the kicker: most men never get their levels checked. And if they do, the 'normal range' is often outdated or way too broad. What's normal for a 75-year-old is not what you want at 45. I've had women come in concerned about their partner's mood, irritability, even motivation—and it turns out his testosterone was tanked. If you're in a long-term relationship and your partner is acting like a different person, you're not imagining it. And getting his hormones evaluated might be the missing link to helping him feel like himself again—and preventing cognitive decline down the line.Study source: University of Sydney & Neuroscience Research Australia (2023)https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.1252Clip 5: Gut Health and MoodThere's a direct, two-way communication line between your gut and your brain—and researchers now believe that the gut may play just as much of a role in mental health as the brain itself. A major review from 2024 showed that people with poor gut diversity were significantly more likely to suffer from depression and anxiety, even when diet and lifestyle were controlled. Why? Because 90% of your serotonin is actually made in your gut. If your microbiome is inflamed or out of balance, your body literally has fewer raw materials to make feel-good brain chemicals. On top of that, gut inflammation sends stress signals to your brain—keeping you in a low-level “fight or flight” state, even when nothing's wrong. And if you've ever felt brain fog, irritability, or sadness after a weekend of sugar and alcohol… this is why. What's exciting is how quickly you can make a shift. Just increasing your fiber, adding fermented foods, or taking the right probiotic can make a measurable difference in just a few weeks. This isn't woo. This is the future of psychiatry. And if you've done therapy, made lifestyle changes, but still don't feel right—check your gut. It might be where your healing needs to start.Study source: Review from the Polish Society of Gastroenterology (2024)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811453Clip 8: Hormone Imbalances and MarriageYou'd be shocked how many couples come into my office thinking they have a communication problem—when what they really have is a hormone problem. He's irritable, unmotivated, maybe withdrawing. She's exhausted, anxious, snapping at small things. They think they've grown apart. They think the spark is gone. But when we test their hormones—testosterone, cortisol, DHEA, thyroid—what we find is that their biochemistry is off. And once we start restoring balance, everything shifts. The mood improves. The intimacy returns. The little things don't feel so overwhelming. We now have solid evidence that hormonal health directly impacts emotional regulation, sexual desire, and even empathy. And if both partners are dysregulated, it can feel like the marriage is falling apart—when really, it's just that their physiology is out of sync. This isn't a relationship failure. It's a hormone crisis. And once you name it, you can fix it. I've seen couples on the brink of divorce completely turn things around—because we stopped blaming each other and started healing their bodies.Study source: APA + American Journal of Men's Health (2023–24)https://journals.sagepub.com/doi/10.1177/15579883231166518Clip 11: Whole Milk in Schools Might Actually Be SmarterFor decades, schools have pushed low-fat or skim milk, based on outdated beliefs about fat and weight. But new evidence is flipping that script. A growing body of research now shows that children who drink whole milk are actually less likely to be overweight than those drinking low-fat milk. Why? Because fat makes food more satisfying. It helps with blood sugar regulation and keeps kids fuller longer—so they're less likely to snack on junk later. In 2025, there's increasing pushback from pediatricians and nutrition researchers against the one-size-fits-all low-fat approach. Some school districts are already considering bringing whole milk back, and they're seeing better nutrition outcomes. Whole milk also contains essential nutrients like vitamin D and calcium in more bioavailable forms, especially when paired with fat. It's time we stop fearing fat—especially when the data shows that cutting it hasn't actually reduced childhood obesity. In fact, we may have made things worse. So if your kid likes whole milk, don't feel guilty. It might just be the more nourishing option after all.Study source: Associated Press report (2025)https://apnews.com/article/e4868fdc2dc4e85aeb9375edcd27da49Clip 13: Hormone Fluctuations and Depression in WomenOne of the biggest blind spots in women's health is how powerful hormone fluctuations are—especially on mood. A 2025 study published in Biomedical Reports found that estrogen and progesterone shifts during puberty, pregnancy, postpartum, and perimenopause play a massive role in rates of depression. This isn't just anecdotal. These hormonal changes alter brain chemistry, sensitivity to stress, and even how the body processes trauma. In puberty, many girls who were previously confident begin to struggle with mood and self-esteem—but instead of checking hormones, we tell them to tough it out. In postpartum, we're finally starting to talk about depression more—but the hormonal crash that happens after birth still catches most women off guard. And in perimenopause, where mood swings and anxiety often resurface, women are still too often told it's “just part of aging.” It's not. It's biology. And the good news is, once you understand that hormones are a major player, you can treat the root cause instead of just masking symptoms. Whether it's bioidentical therapy, lifestyle shifts, or targeted nutrients, women deserve to know that their brains and their hormones are on the same team—and that relief is possible.Study source: Biomedical Reports (2025)https://pubmed.ncbi.nlm.nih.gov/40083602Clip 14: Social Media Changes Teen Brain WiringWe now have MRI data showing that the more often a teen checks social media, the more their brain becomes wired for external validation. In a study from UNC Chapel Hill, researchers found that teens who compulsively checked platforms like Instagram or Snapchat showed measurable changes in the brain's reward centers. These areas lit up more intensely over time, meaning their brains were becoming increasingly sensitive to likes, comments, and digital attention. This isn't just about being distracted. It's about a neurological shift in what they find rewarding—and that shift can impact everything from self-worth to emotional regulation. The researchers even found that this pattern predicts increased anxiety and depression, especially in girls. And it makes sense—when your self-esteem is tied to a number on a screen, even a small drop in engagement feels like social rejection. So what can parents do? First, understand that this isn't just 'teen stuff.' This is brain development. Second, set tech boundaries that prioritize boredom, creativity, and real-life interaction. Even a two-week break can reset the system. Social media isn't going away—but we have to teach kids how to use it without letting it rewire them.Study source: UNC-Chapel Hill (2023)https://www.unc.edu/posts/2023/01/03/study-shows-habitual-checking-of-social-media-may-impact-young-adolescents-brain-developmenClip 16: Screen Time and Toddlers' SleepSleep is how toddlers consolidate memory, regulate mood, and grow both physically and neurologically. But more and more research is showing that screen exposure—even if it's 'educational'—can seriously disrupt toddler sleep. A study published in JAMA Pediatrics found that children ages 2 to 5 who used screens within an hour of bedtime had shorter total sleep and more fragmented rest. Blue light delays melatonin production. Fast-paced content overstimulates the nervous system. And passive consumption before bed blunts their natural wind-down process. We think of it as relaxing—but their brains don't. What's worse is that these disruptions don't just affect nighttime. They carry over into the next day—affecting focus, mood, and even immune function. That's why experts now recommend at least 60 minutes of screen-free time before lights out—especially for young kids. Replace it with a bath, a book, a calm routine. These rituals help their circadian rhythm sync naturally. Sleep isn't just a health pillar—it's a developmental requirement. And screens may be the single biggest obstacle we're overlooking.Study source: JAMA Pediatrics (2024)https://jamanetwork.com/journals/jamapediatrics/fullarticle/282519Clip 18: Hormone-Disrupting Chemicals = Global Health RiskA sweeping review by the Endocrine Society in 2024 called endocrine-disrupting chemicals a 'global health threat.' These are substances—often found in plastics, pesticides, cosmetics, and even receipts—that can mimic, block, or interfere with your body's hormones. They've been linked to everything from infertility to obesity to neurological conditions and cancer. And they're everywhere. Prenatal exposure can affect fetal brain development. Chronic exposure is associated with thyroid dysfunction and metabolic syndrome. And it's not about one product—it's about cumulative load. What's scary is how underregulated many of these substances are in the U.S. compared to Europe. But what's hopeful is that you *can* reduce your exposure. Swap plastic for glass. Say no to fragrance. Wash produce well. Choose organic when you can. Each swap reduces total burden. This isn't alarmist. This is modern environmental medicine. And it affects every system in your body.Study source: Endocrine Society Global Consensus Statement (2024)https://www.endocrine.org/news-and-advocacy/news-room/2024/latest-science-shows-endocrine-disrupting-chemicals-in-pose-health-threats-globallyClip 19: Gut-Brain Axis and Mental HealthWe used to think the brain controlled everything. Now we know the gut plays just as big a role—especially in mental health. The gut-brain axis is a communication superhighway that links your microbiome to your nervous system. And studies show that disruptions in gut health are strongly linked to anxiety, depression, and even neurodevelopmental conditions like ADHD. Certain gut bacteria help produce neurotransmitters like serotonin and GABA. Others regulate inflammation, which directly impacts mood. A 2025 review of over 50 studies found that targeted probiotics improved symptoms of depression in many patients—sometimes as effectively as medication. What you eat, how you digest, and what lives in your gut may affect your mind more than your therapist knows. That doesn't mean meds aren't useful—but it means we have to zoom out. If your gut is inflamed, your brain is inflamed. And no amount of mindset work can override a body that's chemically out of balance. Heal the gut. Watch what changes.Study source: PubMed Meta-Review on Gut-Brain Axis (2025)https://pubmed.ncbi.nlm.nih.gov/3963000Perimenopause: Recognizing and Addressing Early SymptomsDid you know that up to 90% of women experience symptoms of perimenopause years before menopause actually begins? Despite that, most women are either dismissed by doctors or told they're too young to be entering that phase. Perimenopause can start as early as your mid-30s, and it's not just hot flashes—it's insomnia, anxiety, irritability, brain fog, and cycle irregularities. A study from Stanford's Center for Lifestyle Medicine in 2025 emphasized that when women are supported with hormone therapy earlier—during perimenopause, not just postmenopause—they report significantly better mental clarity, energy, and quality of life. But here's the problem: most conventional providers aren't trained to spot this transition, and women are left thinking it's just stress, parenting, or age catching up with them. When really, it's hormones shifting. Estradiol begins to fluctuate, progesterone declines, and the nervous system takes the hit. Women deserve to know what's happening inside their bodies—and what they can do about it. Simple steps like tracking symptoms, checking hormone levels through saliva or urine testing, and considering targeted bioidentical support can change everything. This isn't about vanity—it's about function, clarity, and reclaiming your life before things spiral. If you've ever thought, 'I just don't feel like myself anymore,' and your labs came back 'normal,' this is your sign to dig deeper. You're not crazy. You're not weak. You're likely perimenopausal. And you deserve care that actually sees you.Study source: Stanford Lifestyle Medicine (2025)https://longevity.stanford.edu/lifestyle/2025/03/06/menopause-hormone-therapy-is-making-a-comeback-is-it-safe-and-right-for-you/Menopause and Muscle Mass: The Critical Role of Resistance TrainingMuscle loss during and after menopause is one of the most overlooked drivers of weight gain, fatigue, and metabolic decline in women. In fact, women can lose up to 10% of their muscle mass in the first five years post-menopause. That's not just a cosmetic issue—it's a health crisis. Loss of muscle means decreased insulin sensitivity, weaker bones, and lower resting metabolic rate. But the good news? It's reversible. A landmark 2025 study from the University of Exeter showed that menopausal women who engaged in just 12 weeks of resistance training experienced a 21% improvement in lower body flexibility and significant increases in strength and mobility. What's even more promising is that these improvements came from just two to three sessions a week using basic strength exercises. Muscle is your metabolic engine. And during menopause, when estrogen drops, protecting that muscle becomes your superpower. This isn't about getting shredded or spending hours at the gym—it's about lifting enough weight to send your body the message that it's still needed. Because when your body doesn't get that message, it starts letting muscle go. This leads to increased fat gain, inflammation, and risk of chronic disease. If you're entering menopause or already postmenopausal and you're not lifting weights, you're missing one of the most effective, protective tools for your long-term health.Study source: University of Exeter (2025)https://news.exeter.ac.uk/faculty-of-health-and-life-sciences/first-of-its-kind-study-shows-resistance-training-can-improve-physical-function-during-menopause/The Importance of Sexual Activity as We AgeHere's something most people don't expect: research shows that sexual satisfaction actually improves with age. A 2025 study published in Social Psychology revealed that older adults reported higher levels of emotional intimacy, comfort, and fulfillment during sex—especially when partnered with someone long-term. It turns out that fewer distractions, better communication, and reduced self-consciousness all contribute to more satisfying experiences in later years. But biology still plays a role. Hormonal shifts—like lower estrogen or testosterone—can affect desire, arousal, and comfort. The good news? These challenges are highly treatable. We now have non-invasive, low-risk treatments like vaginal DHEA, testosterone therapy, or pelvic floor physical therapy that can radically improve function and satisfaction. And here's the key: sexual health isn't just about sex. It's about cardiovascular health, immune health, sleep, and mood. An active sex life improves oxytocin levels, reduces stress, and strengthens the emotional bond between partners. Unfortunately, a lot of providers still don't ask about it. And many people are too embarrassed to bring it up. But this is a health issue—and you deserve support. So if intimacy has changed, bring it into the conversation. Because aging doesn't have to mean disconnect—it can actually mean rediscovery.Study source: PsyPost (2025)https://www.psypost.org/sexual-satisfactions-link-to-marital-happiness-grows-stronger-with-age/Preventing Alzheimer's and Type 2 Diabetes: Blood Sugar and Brain HealthThere's a reason Alzheimer's is now being called 'Type 3 Diabetes.' A 2024 study published in JAMA Network Open found that people with Type 2 Diabetes who kept their A1C in the target range significantly lowered their risk of developing Alzheimer's disease. In fact, risk was reduced by up to 60%. Why? Because insulin resistance doesn't just affect your pancreas—it affects your brain. High insulin impairs memory centers like the hippocampus, increases inflammation, and accelerates plaque formation. That means your morning bagel and soda aren't just spiking your blood sugar—they may be spiking your dementia risk. The solution isn't extreme dieting. It's metabolic awareness. Simple tools like continuous glucose monitors, strength training, walking after meals, and eliminating ultra-processed carbs can dramatically stabilize blood sugar. Add in sleep and stress management, and you've got a recipe for brain protection. Most people wait until symptoms start. But prevention is where the power is. If you have a family history of Alzheimer's or Type 2 Diabetes, take this seriously. Your future brain is being built right now by the food on your plate.Study source: JAMA Network Open (2024)https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2821878Testosterone and Aging: It's Not Just About Sex DriveMost people hear 'testosterone' and immediately think of sex drive. But this hormone does way more than that. Testosterone plays a critical role in muscle maintenance, bone density, energy, focus, and mood. A 2025 review from the HE Clinics found that testosterone levels in men start declining around age 30—and continue to drop about 1% per year. That might sound gradual, but by your late 40s or 50s, it's enough to cause noticeable issues: brain fog, irritability, fatigue, and loss of motivation. What's even more concerning is that low testosterone has now been linked to a 26% higher risk of developing Alzheimer's. The brain literally needs testosterone to function well. The challenge is, many men go undiagnosed because they don't get tested—or they get told their levels are 'normal for their age.' But 'normal' doesn't mean optimal. And restoring optimal levels, especially with bioidentical therapies under medical supervision, has been shown to improve mood, clarity, libido, and physical performance. This isn't about bodybuilder doses or quick fixes—it's about reversing a gradual decline that's robbing men of their edge. If you or your partner feels like something is off, it's worth investigating. Because aging doesn't have to mean decline. It can mean recalibration.Study source: HE Clinics (2025)https://heclinics.com/testosterone-therapy-in-older-men-recent-findings/Why Functional Medicine Is Gaining Ground Over Conventional CareIf you've ever felt dismissed in a 7-minute doctor's appointment, you're not alone. Traditional primary care is built for volume—not personalization. That's where functional medicine comes in. A 2019 study published in JAMA Network Open found that patients receiving care through a functional medicine model saw a 30% greater improvement in health-related quality of life than those in conventional care. Why? Because functional medicine is built around asking better questions, running more comprehensive labs, and looking for root causes—not just masking symptoms. Instead of saying 'your labs are normal,' we ask, 'are you thriving?' We look at hormones, nutrition, sleep, gut health, toxin exposure, and genetics as pieces of a bigger picture. This approach is proactive—not reactive. It focuses on reversing disease, not just managing it. More and more people are turning to this kind of care because they're tired of feeling unseen. If you've been told everything is fine but you still feel off, functional medicine might be the approach you need. You deserve care that listens longer, digs deeper, and treats the whole you.Study source: JAMA Network Open (2019)https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2753520A word from my sponsors:Quince - Get cozy in Quince's high-quality wardrobe essentials. Go to Quince.com/honest for free shipping on your order and 365-day returns. LMNT - Get your free LMNT Sample Pack with any purchase at drinklmnt.com/HONEST. Ritual - Support a balanced gut microbiome with Ritual's Synbiotic+. Get 25% off your first month at Ritual.com/BEHONEST. Happy Squatting. Primal Kitchen - primalkitchen.com/honest to save 20% off your next order with code HONEST at checkout.Fatty15 - You can get an additional 15% off their 90-day subscription Starter Kit by going to fatty15.com/HONEST and using code HONEST at checkout.Bilt Rewards - Start earning points on rent you're already paying by going to joinbilt.com/HONEST. For more Let's Be Honest, follow along at:@kristincavallari on Instagram@kristincavallari and @dearmedia on TikTokLet's Be Honest with Kristin Cavallari on YouTubeProduced by Dear Media.This episode may contain paid endorsements and advertisements for products and services. Individuals on the show may have a direct, or indirect financial interest in products, or services referred to in this episode.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Né poco né troppo: parliamo di sonno. Secondo uno studio pubblicato su JAMA Network Open, la giusta durata del sonno protegge la nostra salute, in particolare la salute del cuore. Ne parliamo con il prof. Francesco Fanfulla, Past Presidente dell’Associazione Italiana di Medicina del Sonno e direttore dell’U.O. di Medicina del Sonno, Istituti Clinici Scientifici Maugeri di Pavia.
In a conversation with CancerNetwork®, Oluwadamilola “Lola” Fayanju, MD, MA, MPHS, FACS, discussed the key findings from a study she published in JAMA Network Open, which demonstrated that most patients with inflammatory breast cancer do not receive all available types of guideline-concordant care they are eligible for. Additionally, data showed disparities regarding receipt of modality-specific therapy among patients who were Black, Asian, Hispanic, or other racial minority populations. Based on these findings, Fayanju highlighted potential next steps for mitigating these gaps in care for certain patients with breast cancer. These strategies included revising stringent inclusion criteria for clinical trial enrollment, which may disproportionately exclude racial minority populations who have higher rates of diabetes or other medical conditions. Fayanju also emphasized educating clinicians across different oncology specialties to recognize how different populations present with inflammatory breast cancer and better understand the context in which patients receive treatment. “I hope [the study] makes some people angry…Frustration can be a wonderful fuel,” Fayanju stated regarding her research. “[By] recognizing that there isn't as much guideline-concordant care receipt amongst all people as there should be and the hope that's provided when we achieve concordant care, we can mitigate and eliminate racial disparities. I hope [that] will motivate people to think about how we can get more guideline-concordant care to more people and how we can incorporate diverse populations in the development of guidelines for concordant care at the beginning. Then, how can we also develop treatments that achieve efficacious results across diverse populations?” Fayanju is the Helen O. Dickens Presidential Associate Professor, chief in the Division of Breast Surgery at Penn Medicine, surgical director of Rena Rowan Breast Center, director of Health Equity Innovation at Penn Center for Cancer Care Innovation (PC3I), and senior fellow at Leonard Davis Institute of Health Economics (LDI), Perelman School of Medicine at the University of Pennsylvania. Reference Tadros A, Diskin B, Sevilimedu V, et al. Trends in guideline-concordant care for inflammatory breast cancer. JAMA Netw Open. 2025;8(2):e2454506. doi:10.1001/jamanetworkopen.2024.54506
Send us a textIn this Journal Club episode, Ben and Daphna review several impactful studies shaping neonatal care. They begin with a secondary analysis of the ETTNO trial, which examined whether liberal transfusion thresholds reduce intermittent hypoxemia or improve neurodevelopmental outcomes in extremely low birth weight infants. Despite prior concerns, the study found no benefit to liberal thresholds, supporting current restrictive practices. A JAMA Network Open study follows, revealing that late preterm infants are least likely to receive mother's own milk at 12 weeks, underscoring an overlooked group in breastfeeding support efforts. Dr. David Rube joins the show to discuss a two-year follow-up of the IN-RECSURE trial, which investigated whether lung recruitment before surfactant administration leads to improved long-term outcomes—ultimately showing no difference in death or disability. The hosts also explore a meta-analysis on umbilical cord blood therapy for children with cerebral palsy, highlighting benefits in motor function for younger children with milder CP when treated at higher doses. Additional topics include the association between funisitis and cerebral palsy in extremely preterm infants and the AZTEC trial's conclusion that azithromycin does not reduce BPD. The episode concludes with a review of best practices for discussing autopsy with families in the NICU setting. As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!
Diabetic retinopathy remains a leading cause of preventable blindness worldwide, and AI may facilitate screening, if such models continue to perform well when they are deployed in the real world. Coauthors Arthur Brant, MD, of Stanford University, and Sunny Virmani, MS, of Google join JAMA+ AI Editor in Chief Roy H. Perlis, MD, MSc, to discuss a new study published in JAMA Network Open. Related Content: Diabetic Retinopathy Is Massively Underscreened—an AI System Could Help Performance of a Deep Learning Diabetic Retinopathy Algorithm in India
Chi mangia bene invecchia meglio. Uno studio pubblicato sulla rivista Jama Network Open evidenzia l’importanza della salute metabolica sull’invecchiamento del cervello. A Obiettivo Salute il commento del prof. Piero Barbanti, neurologo all'Università Istituto Scientifico San Raffaele di Roma.
Tezę, że tempo chodzenia pozwala przewidzieć tempo starzenia, przedstawiono na łamach portalu naukowego JAMA Network Open. Szybko stała się wiralem. I ważną prozdrowotną wskazówką. Autorka: Anna Augustyn-Protas Artykuł przeczytasz pod linkiem: https://www.vogue.pl/a/im-szybciej-chodzisz-tym-wolniej-sie-starzejesz-oto-co-mowia-najnowsze-badania
Send us a textIn this packed episode of Neo News, Eli, Ben, and Daphna dive into the headlines impacting neonatology and public health. The trio starts with the controversial confirmation of Robert F. Kennedy Jr. as head of HHS, analyzing his actions around the CDC, NIH, vaccine policy, and the implications of promoting “informed consent” messaging in place of public health advocacy. Drawing from reporting by The New York Times, STAT News, and Science Magazine, the team unpacks how these shifts could affect vaccine uptake in the NICU.Next, they examine the threat to birthright citizenship in the U.S., based on analysis from The New York Times, and how immigration policy may directly impact NICU families' access to care and trust in healthcare systems.They also discuss a Wall Street Journal article detailing the erosion of trust in physicians post-pandemic and the fallout from a recent JAMA Pediatrics study on therapeutic hypothermia in late preterms, which raised questions about research transparency.Other highlights include studies from Scientific Reports, JAMA Network Open, and The New York Times on air pollution, paternity leave, language-concordant care, and breastfeeding. The show ends with a call to action from Dr. Shadel Shah's op-ed advocating for the continuation of the PREEMIE Act. As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!
DDFA | aerobinen kynnys | anaerobinen kynnys | Miten sykevälivaihtelusta saadaan määritettyä kynnysarvot? Mitkä ovat tämän Suunnon sykemittareissa olevan menetelmän heikkoudet ja vahvuudet? Mitä liikuntalabralaisten tulisi huomioida käyttäessään tätä menetelmää?Muun muassa näihin kysymyksiin kuulet tässä jaksossa vastaukset. Tarjolla on taas todella tuhti tutkittuun tietoon perustuva paketti fysiikkavalmennuksesta ja erityisesti kestävyysfysiologiasta kiinnostuneille.Vieraana on fyysikko ja väitöskirjatutkija Matias Kanniainen Tampereen yliopistosta ja aiheena sykevälivaihteluun perustuvat kynnysarvot kestävyysurheilussa. Jos työskentelet fysiikkavalmentajana, liikunnanohjaajana, kestävyysvalmentajana, fysioterapeuttina, olet liikunta- tai terveysalan opiskelija tai haluat tietää lisää sykevälivaihteluun, et voi jättää tätä podcastia väliin. Podcastin kuulet Spotifyssa, ITunesissa ja blogissa.
Efeito fim de semana. Estudo americano publicado no Jama Network Open, revela que cirurgias antes do fim de semana aumentam risco de morte: Uma das razões está nas equipas médicas mais pequenas durante o fim de semana.
durée : 00:01:56 - Le vrai ou faux - Une étude américaine publiée dans la revue médicale Jama Network Open alerte sur la désinformation médicale. Dans son viseur : les publications d'influenceurs qui incitent les internautes à aller se faire tester pour détecter d'éventuelles futures maladies ou cancers, sans alerter sur les conséquences éventuellement nocives.
AI can play a role in addressing language barriers in health care. In a recent Editorial in JAMA Network Open, Pilar Ortega, MD, MGM, of the University of Illinois College of Medicine, and coauthors emphasized the urgent need for integrating language equity into digital health solutions. Dr Ortega joins JAMA and JAMA+ AI Associate Editor Yulin Hswen, ScD, MPH, to discuss. Related Content: Researcher Proposes New Framework for Language Equity in Health Technology Language Equity in Health Technology for Patients With Non–English Language Preference Challenges to Video Visits for Patients With Non–English Language Preference
Die Themen in den Wissensnachrichten: +++ Kurzsichtig durch zu viel Bildschirmzeit? +++ Lieblingsfarbe Gelb bei Hunden? +++ Fellwechsel bei Grauhörnchen wegen Verkehrsunfällen? +++**********Zusätzliche InformationenDigital Screen Time and Myopia - A Systematic Review and Dose-Response Meta-Analysis, JAMA Network Open, 21.2.2025Ready, set, yellow! color preference of Indian free-ranging dogs, Animal Cognition, 4.2.2025No evidence for Peto's paradox in terrestrial vertebrates, PNAS, 24.2.2025A computational perspective on the dynamics of early architecture. Archaeological Research in Asia, März 2025New fish migrations into the Panama Canal increase likelihood of interoceanic invasions in the Americas, Current Biology, 21.2.2025Road mortality contributes to the evolution of an urban-rural cline in squirrel coat color, 11.2.2025**********Ihr könnt uns auch auf diesen Kanälen folgen: TikTok auf&ab , TikTok wie_geht und Instagram .
The NACE Journal Club with Dr. Neil Skolnik, provides review and analysis of recently published journal articles important to the practice of primary care medicine. In this episode Dr. Skolnik and guests review the following publications:1. Brain Function Outcomes of Recent and Lifetime Cannabis Use. JAMA Network Open 2025. Discussion by: Guest:Maija Adourian, DOResident– Family Medicine Residency Program Jefferson Health – Abington2. Tirzepatide for Heart Failure with Preserved Ejection Fraction and Obesity. New England Journal of Medicine. Discussion by:Guest:Christopher M. Kramer, MD George A. Beller/Lantheus Medical Imaging Distinguished Professor of Cardiovascular Medicine Chief of the Cardiovascular Division UVA Health3. Screening for Osteoporosis to Prevent FracturesUS Preventive Services Task Force Recommendation Statement. Discussion by:Guest: Anupriya Grover-Wenk, DOFaculty– Family Medicine Residency ProgramJefferson Health – AbingtonMedical Director and Host, Neil Skolnik, MD, is an academic family physician who sees patients and teaches residents and medical students as professor of Family and Community Medicine at the Sidney Kimmel Medical College, Thomas Jefferson University and Associate Director, Family Medicine Residency Program at Abington Jefferson Health in Pennsylvania. Dr. Skolnik graduated from Emory University School of Medicine in Atlanta, Georgia, and did his residency training at Thomas Jefferson University Hospital in Philadelphia, PA. This Podcast Episode does not offer CME/CE Credit. Send us a text about this episode. Please visit http://naceonline.com to engage in more live and on demand CME/CE content.
A recent study in JAMA Network Open evaluates the use of machine learning algorithms to assess the management of urinary tract infection (UTI). Author Sanjat Kanjilal, MD, MPH, professor in the Department of Population Medicine at Harvard Medical School and Harvard Pilgrim Healthcare Institute, joins JAMA Associate Editor Yulin Hswen, ScD, MPH, to discuss this topic and more. Related Content: Researchers Use Machine Learning to Put Older Clinical Guidelines to the Test Use of Machine Learning to Assess the Management of Uncomplicated Urinary Tract Infection
Fitness mit M.A.R.K. — Dein Nackt Gut Aussehen Podcast übers Abnehmen, Muskelaufbau und Motivation
Vielleicht hast Du Dir vorgenommen, deinen Körperfettanteil zu senken, vielleicht wünschst Du Dir eine noch knackigere Figur. Oder Du möchtest einfach gesünder und fitter sein, ohne abzunehmen. Prima! Du hast richtig gute Freunde, die dich bei deinem Plan tatkräftig unterstützen können. Wer das sein soll? Na, deine Muskeln! Solange Du bereit bist, wenigstens 60 Minuten pro Woche – also gerade mal die Dauer einer Folge Deiner Lieblingsserie – ins Training zu investieren, sage ich Dir: Wir bekommen das hin. Hier sind die Basics für Dein Training – und wie Du Deine verfügbare Zeit so ins Training investierst, das Du möglichst viel für Dich herausholst. ____________ *WERBUNG: AG1 (by Athletic Greens): Als FMM-Hörer bekommst Du zur ersten Bestellung kostenlos 5 Travelpacks, eine Flasche Vitamin D3+K2 plus das Willkommenspaket mit Shaker und schicker Edelstahldose. ____________ Vielen Dank für Dein Vertrauen. Hier sind ein paar weitere Wege, wie ich Dich unterstützen kann. Kostenlos: Email: #DRNBLBR Newsletter (jeden Sonntagmorgen) Instagram: @fitnessmitmark Ebook: Ratgeber Nahrungsergänzung Kostenpflichtig: Buch: Dranbleiben! Buch: Looking Good Naked Workouts: #DRNBLBR Bodyweight Circle Persönliche Betreuung: MarathonFitness Online-Coaching _____________
Sugar-sweetened beverages, the epidemiology of driving after an ICD, BP measurements, and massive EBM lesson in EVT for acute stroke are the topics John Mandrola, MD, discusses in today's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Sugar-Sweetened Beverages Sugary Drinks Fuel Millions of Diabetes and CVD Cases https://www.medscape.com/viewarticle/sugary-drinks-fuel-millions-diabetes-and-cvd-cases-2025a10002wr Nature Medicin;e Epidemiologic Study https://www.nature.com/articles/s41591-024-03345-4 JAMA-Network Open; Beverage Tax Observational Study https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2829505 Lancet Regional Health; Beverage Tax Philadelphia EHR 10.1016/j.lana.2024.100906 II. Driving With an ICD JACC Electrophysiology paper https://doi.org/10.1016/j.jacep.2024.12.002 Earlier HEART paper https://heart.bmj.com/content/110/24/1401 III. Blood Pressure Measurements and Simple RCTs BP Readings in Noisy Market as Good as Quiet Office? https://www.medscape.com/viewarticle/bp-readings-noisy-market-good-quiet-office-2025a10002z0 Annals of Internal Medicine Study https://www.acpjournals.org/doi/10.7326/ANNALS-24-00873 IV. A Big Shake-up in Interventional Stroke Care Endovascular Therapy Fails to Show Benefit in Distal Occlusion Stroke https://www.medscape.com/viewarticle/endovascular-therapy-fails-show-benefit-distal-occlusion-2025a100035u ESCAPE-MeVO https://www.nejm.org/doi/full/10.1056/NEJMoa2411668 DISTAL trial https://www.nejm.org/doi/full/10.1056/NEJMoa2408954 J. Mocco Editorial https://www.nejm.org/doi/full/10.1056/NEJMe2500492 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net
Digital health technologies, including patient portals, are widely used by older adults, as described in a recent study published in JAMA Network Open. Author Cornelius James, MD, of the University of Michigan joins JAMA+ AI Editor in Chief Roy H. Perlis, MD, MSc, to discuss the study and how it fits with his own experience in the clinic. Related Content: Study Finds Most Older Adults Use Digital Health Technologies, Plus Some Surprises Use of Digital Health Technologies by Older US Adults
What are psychedelics? How do they impact your brain? Are they safe? Parker and Emma unpack the current research and legality of psychedelics and discuss the ethical implications of psychoactive drugs. Sources: Cheung, K., Earp, B. D., Patch, K., & Yaden, D. B. (2025). Distinctive But Not Exceptional: The Risks of Psychedelic Ethical Exceptionalism. The American Journal of Bioethics, 25(1), 16–28. Tiwari, P., Davoudian, P. A., Kapri, D., Vuruputuri, R. M., Karaba, L. A., Sharma, M., … Vaidya, V. A. (2024). Ventral hippocampal parvalbumin interneurons gate the acute anxiolytic action of the serotonergic psychedelic DOI. Neuron, 112(22), 3697-3714. Wang, E., Mathai, D. S., Gukasyan, N., Nayak, S., & Garcia-Romeu, A. (2024). Knowledge, attitudes, and concerns about psilocybin and MDMA as novel therapies among U.S. Healthcare Professionals. Scientific Reports, 14(1), 28022. Davis, A. K., Bates, M., Lund, E. M., Sepeda, N. D., Levin, A. W., Armstrong, S. B., … Yehuda, R. (2024). The Epidemiology of Psychedelic Use Among United States Military Veterans. Journal of Psychoactive Drugs, 1–14. Published Online. September 12, 2024. Ehrenkranz, R., Agrawal, M., Nayak, S. M., & Yaden, D. B. (2024). Adverse events should not be surprising in psychedelic research. Psychedelic Medicine. Published Online. September 4, 2024. Hinkle, J. T., Graziosi, M., Nayak, S. M., & Yaden, D. B. (2024). Adverse events in studies of classic psychedelics. JAMA Psychiatry, 81(12), 1225-1235. Yaden, D. B., Goldy, S. P., Weiss, B., & Griffiths, R. R. (2024). Clinically relevant acute subjective effects of psychedelics beyond mystical experience. Nature Reviews Psychology, 3(9), 606–621. Goldy, S. P., Hendricks, P. S., Keltner, D., & Yaden, D. B. (2024). Considering distinct positive emotions in psychedelic science. International Review of Psychiatry, 1–12. Published Online. September 2, 2024. Heller, N. H. & Barrett, F. S. (2024). Teaching a new dog old tricks: bringing rigor, grounding, and specificity to psychedelic neuropsychopharmacology. Neuropsychopharmacology. Published Online. August 26, 2024. Yaden, D. B., Mathai, D., Bogenschutz, M., & Nichols, D. E. (2024). The pharmacology of hallucinogens. In: Miller et al. (Eds.). Principles of Addiction Medicine. American Society of Addiction Medicine. Yaden, D. B., Nayak, S. M., Griffiths, R. R. (2024). Belief change and agnostic frames in psychedelic research and clinical contexts. In: C. Letheby (Ed.). Philosophy and the psychedelic renaissance. Oxford University Press, New York. DiRenzo, D., Barrett, F. S., Perin, J., Darrah, E., Christopher-Stine, L., & Griffiths, R. R. (2024). Impact of psilocybin on peripheral cytokine production. Psychedelic Medicine, 2(2). Cheung, K., Propes, C., Jacobs, E., Earp, B. D., & Yaden, D. B. (2024). Psychedelic group-based integration: Ethical assessment and initial recommendations. International Review of Psychiatry, 1–11. Tiwari, P., Ehrenkranz, R., & Yaden, D. B. (2024). Psychiatric Applications of Psychedelics: Neurobiological Foundations for Treatments of Depression, Anxiety, and Obsessive-Compulsive Disorder. Advances in Psychiatry and Behavioral Health. McGuire, A. L., Cohen, I. G., Sisti, D., Baggott, M., Celidwen, Y., Devenot, N., Gracias, S., Grob, C., Harvey, I., Kious, B., Marks, M., Mithoefer, M., Nielson, E., Öngür, D., Pallas, A., Peterson, A., Schenberg, E. E., Summergrad, P., Waters, B., Williams, M. T., & Yaden, D. B. (2024). Developing an Ethics and Policy Framework for Psychedelic Clinical Care: A Consensus Statement. JAMA Network Open, 7(6), e2414650.
How do patients feel about the quality of AI-generated responses to their messages to clinicians? Author Eleni Linos, MD, DrPH, of Stanford joins JAMA+ AI Editor in Chief Roy H. Perlis, MD, MSc, to discuss her recent study in JAMA Network Open that characterized satisfaction with these messages. Related Content: Study Finds People Prefer AI Over Clinician Responses to Questions in the Electronic Medical Record Perspectives on Artificial Intelligence–Generated Responses to Patient Messages
A study in NEJM shows that abelacimab, a fully human monoclonal antibody targeting factor XI, significantly reduces bleeding risk compared to rivaroxaban in atrial fibrillation patients, suggesting a safer alternative for stroke prevention. Data from JAMA Health Forum reveals growing consolidation of primary care practices by hospitals and private equity firms, driving up healthcare costs without clear quality improvements. The largest U.S. tuberculosis outbreak in Kansas underscores the importance of vigilance and rapid response by healthcare providers, while a study in JAMA Network Open finds women, particularly nonmenopausal females aged 40–54, at higher risk for long COVID, emphasizing the need for tailored prevention and treatment strategies.
The burden of responding to clinician inbox messages may be a contributor to burnout. Eden English, MD, of UCHealth joins JAMA+ AI Editor in Chief Roy H. Perlis, MD, MSc, to discuss her recent study published in JAMA Network Open, which examined the use of large language models to reply to patient messages. Related Content: Researchers Tested an AI Tool That Drafts Responses to Patient Messages—Here's What They Found Utility of Artificial Intelligence–Generative Draft Replies to Patient Messages Are Artificial Intelligence–Generated Replies the Answer to the Electronic Health Record Inbox Problem?
Die Themen in den Wissensnachrichten: +++ Mögliche Magmakammern in der Eifel +++ Pizza-Stein-Material verhält sich gegen Hitze-Regeln +++ Eine Giftspinnen-Art sind eigentlich drei +++**********Weiterführende Quellen zu dieser Folge:Seismic Reflection Imaging of Fluid-Filled Sills in the West Eifel Volcanic Field, Germany, Geophysical Research Letters, 22.12.2024Evolution of the iodine cycle and the late stabilization of the Earth's ozone layer, PNAS, 06.01.2025Anomalous thermal expansion of cordierite, Mg2Al4Si5O18, understood through lattice simulations, Matter, 10.01.2025Cannabis Laws and Utilization of Medications for the Treatment of Mental Health Disorders, JAMA Network Open, 05.09.2024The world's most venomous spider is a species complex: systematics of the Sydney funnel-web spider (Atracidae: Atrax robustus), BMC Ecology and Evolution, 13.01.2025**********Ihr könnt uns auch auf diesen Kanälen folgen: TikTok auf&ab , TikTok wie_geht und Instagram .
American Indian and Alaska Native communities have higher rates of suicide than any other racial or ethnic group in the US. A recent study published in JAMA Network Open describes an AI-based suicide screening tool investigated in an American Indian community. Author Emily Haroz, PhD, of Johns Hopkins Bloomberg School of Public Health, joins JAMA and JAMA+ AI Associate Editor Yulin Hswen, ScD, MPH. Related Content: How AI Could Help Clinicians Identify American Indian Patients at Risk for Suicide Performance of Machine Learning Suicide Risk Models in an American Indian Population
Do remote and hybrid managers need different skills to those who work in-person? If so, what are those skills and how do we develop them? In this first episode of The Mindtools L&D Podcast for 2025, Ross Dickie and Ross Garner are joined by return guest Gary Cookson, author of Making Hybrid Working Work. We discuss: The ‘sensory loss' that takes place when managers move to a hybrid environment The digital signals that help managers understand their teams Strategies for building hybrid management capability. Gary's book, Making Hybrid Working Work, is available now from Kogan Page. During the discussion, we referenced a few other episodes of our podcast: 271 — Jobcraft Country 406 — Revisiting 70:20:10: Theory into practice 407 — Revisiting 70:20:10: From learning to performance 421 — Good managers balance care with results Ross Garner also discussed ‘context-dependent memory effect'. In ‘What I Learned This Week', we each shared a paper: Ross G: Vences, M., Köhler, J., Hutter, C. R., Preick, M., Petzold, A., Rakotoarison, A., ... & Scherz, M. D. (2024). Communicator whistles: A Trek through the taxonomy of the Boophis marojezensis complex reveals seven new, morphologically cryptic treefrogs from Madagascar (Amphibia: Anura: Mantellidae). Vertebrate Zoology, 74, 643-681. Gary: Veronese, N., Stubbs, B., Noale, M., Solmi, M., Vaona, A., Demurtas, J., ... & Fontana, L. (2017). Fried potato consumption is associated with elevated mortality: an 8-y longitudinal cohort study. The American journal of clinical nutrition, 106(1), 162-167. Goh, E., Gallo, R., Hom, J., Strong, E., Weng, Y., Kerman, H., ... & Chen, J. H. Large Language Model Influence on Diagnostic Reasoning. JAMA Network Open, 7(10). For more from us, including details of our new Manager Skill Builder, visit mindtools.com. There, you'll also find details of our award-winning performance support toolkit, our off-the-shelf e-learning, and our custom work. For more from Gary, see EpicHR.co.uk Connect with our speakers If you'd like to share your thoughts on this episode, connect with us on LinkedIn: Ross Garner Ross Dickie Gary Cookson
How can hospitals use early warning score tools to risk stratify patients without adding to alarm fatigue? Dana Edelson, MD, MS, of the University of Chicago joins JAMA+ AI Editor in Chief Roy H. Perlis, MD, MSc, to discuss a recent study published in JAMA Network Open that she coauthored, comparing 6 early warning scores designed to recognize clinical deterioration in hospitalized patients. Related Content: Researchers Compared Hospital Early Warning Scores for Clinical Deterioration—Here's What They Learned Early Warning Scores With and Without Artificial Intelligence
Chatbots may have a role in enhancing clinical care, but the best way to apply them remains a work in progress. Jonathen Chen, MD, PhD, and Ethan Goh, MD, MS, of Stanford, join JAMA and JAMA+ AI Associate Editor Yulin Hswen, ScD, MPH, to discuss their randomized clinical trial published in JAMA Network Open investigating the use of chatbots in clinical practice. Related Content: An AI Chatbot Outperformed Physicians and Physicians Plus AI in a Trial—What Does That Mean? Large Language Model Influence on Diagnostic Reasoning
Dr. Emily Eshleman discusses the #4 article of 2023, “Management of de Quervain Tenosynovitis,” which was originally published in JAMA Network Open in October 2023. Dr. Jeremy Schroeder serves as the series host. Dr. Eshleman is a member of the AMSSM Top Articles Subcommittee, and this episode is part of an ongoing mini journal club series highlighting each of the Top Articles in Sports Medicine from 2023, as selected for the 2024 AMSSM Annual Meeting. Management of de Quervain Tenosynovitis: A Systematic Review and Network Meta-Analysis https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2811119
In this episode of Walk, Don't Run to the Doctor, Miles Hassell MD explores the complex and often controversial topic of alcohol consumption and its impact on health. From historical context to modern studies, he provides a balanced look at the potential benefits and risks of alcohol, encouraging viewers to make informed decisions based on evidence rather than emotion. Summary: Dr. Hassell discusses the nuanced role of alcohol in health and lifestyle. While heavy drinking poses clear dangers—such as liver disease, cardiovascular issues, and societal harm—low to moderate consumption might have benefits in certain contexts. Evidence from large studies suggests reduced risks of cardiovascular disease, type 2 diabetes, and some forms of dementia for moderate drinkers, particularly when paired with a healthy lifestyle. Key Takeaways: Moderation is Key: Up to 7 drinks per week for women and 10-14 for men may provide benefits, but heavy drinking is harmful. Context Matters: Alcohol's benefits are most evident in a healthy lifestyle, alongside good nutrition and regular exercise. Potential Benefits: Includes improved heart health, reduced type 2 diabetes risk, and enhanced cognitive function. Risks to Consider: Alcohol can still pose risks, including cancer, dependence, and societal harm, even at low levels. Preferred Choice: Red wine may offer additional health benefits due to its antioxidants. For more insights and advice on reducing dependence on medications through lifestyle changes, make sure to subscribe to Walk, Don't Run to the Doctor. More references can be found at www.GreatMed.org Would you like Dr. Hassell to answer your question on the air? Contact us! Phone/text: 503-773-0770 e-mail: info@GreatMed.org Write us a letter. We love to hear from you. This podcast is sponsored by our generous listeners. Send questions, comments, and support to: 4804 NW Bethany Blvd., Suite I-2, #273 Portland OR 97229 References: Buljeta, I., et al. (2023). Beneficial effects of red wine polyphenols on human health: comprehensive review. Current Issues in Molecular Biology, 45(2), 782–798. https://doi.org/10.3390/cimb45020052 Yoo, J. E., et al. (2022). Association between changes in alcohol consumption and cancer risk. JAMA Network Open, 5(8), e2228544. https://doi.org/10.1001/jamanetworkopen.2022.28544 Yoo JE, et al. Association between changes in alcohol consumption and cancer risk (supplemental data, tables e1 and e2). JAMA Netw Open. 2022;5(8):e2228544. doi:10.1001/jamanetworkopen.2022.28544 CDC.gov. (2024). About moderate alcohol use. U.S. Centers for Disease Control and Prevention. https://www.cdc.gov/alcohol/about-alcohol-use/moderate-alcohol-use.html#:~:text=to%20not%20drinking.-,Moderate%20drinking,or%20less%20in%20a%20day Pierre-Louis, T., et al. (2020). Effects of alcohol consumption in general, and wine in particular, on the risk of cancer development: a review. Oeno One, 54(4). https://doi.org/10.20870/oeno-one.2020.54.4.3569 Hong, S., et al. (2020). Alcohol consumption and the risk of prostate cancer: a dose-response meta-analysis. Nutrients, 12(8), 2188. https://doi.org/10.3390/nu12082188 Zhang, X., et al. (2021). Alcohol consumption and risk of cardiovascular disease, cancer and mortality: a prospective cohort study. Nutrition Journal, 20(1), 13. https://doi.org/10.1186/s12937-021-00671-y Ortola, R., et al. (2024). Alcohol consumption patterns and mortality among older adults with health-related or socioeconomic risk factors. JAMA Network Open, 7(8), e2424495. https://doi.org/10.1001/jamanetworkopen.2024.24495 Lofterod, T., et al. (2020). Exploring the effects of lifestyle on breast cancer risk, age at diagnosis, and survival: the EBBA-Life study. Breast Cancer Research and Treatment, 182(1), 215–227. https://doi.org/10.1007/s10549-020-05679-2 Tamimi, R. M., et al. (2016). Population attributable risk of modifiable and nonmodifiable breast cancer risk factors in postmenopausal breast cancer. American Journal of Epidemiology, 184(12), 884–893. https://doi.org/10.1093/aje/kww145 Cancer.gov. (2021, July 14). Alcohol and Cancer Risk. National Cancer Institute. https://www.cancer.gov/about-cancer/causes-prevention/risk/alcohol/alcohol-fact-sheet#how-does-alcohol-affect-the-risk-of-cancer Colditz, G. (2024). Overview of Cancer Prevention. UpToDate.com https://www.uptodate.com/contents/overview-of-cancer-prevention AICR.org. (2024, July 5). New study finds AICR/WCRF's cancer prevention recommendations are associated with reduced mortality risk from all causes, cancer and heart disease. American institute for Cancer Research. https:// www.aicr.org/news/new-study-finds-aicr-wcrfs-cancer-prevention-recommendations-are-associated-with-reduced-mortality-risk-from-all-causes-cancer-and-heart-disease/
We all know that the effects of tobacco on the human body are devastating. The World Health Organisation says that it kills more than 8 million people each year, making it one of the biggest public health threats the world has ever seen. It's hardly surprising when you consider that cigarettes contain over 4,000 chemical substances, and at least 50 of them are carcinogens, meaning they are linked to an increased risk of cancer. Many people will attempt to quit smoking as part of their New year's resolutions, and we're here to provide some information on the best ways to do so. It seems so, at least according to the most recent large-scale study on the subject which was published by Jama Network Open in October 2022. If I give up, will my body ever fully recover? What different methods are out there? In under 3 minutes, we answer your questions ! To listen to the latest episodes, click here: What is the olive theory from Tiktok? How does the vagus nerve affect your health? What is climate shadow, the newest way to measure your impact on global warming? A Bababam Originals podcast, written and produced by Joseph Chance. In partnership with upday UK. First Broadcast: 31/12/2022 Learn more about your ad choices. Visit megaphone.fm/adchoices
In this episode of the Friends for Life Podcast, we dive into recent research that reveals a striking rise in autism diagnoses across the United States, up by 175% over the last decade. This increase spans all age groups, but some groups are experiencing even higher rates, especially young adults and minority children. The study, published in JAMA Network Open, shows autism prevalence has more than doubled since 2011, underscoring the need for better awareness and support systems. Lead researcher Luke Grosvenor suggests that while universal developmental screenings may account for part of this rise, the diversity in diagnosis rates across age, gender, and ethnicity points to a more complex picture. As the adult autism population continues to grow, the healthcare system faces the challenge of adapting to meet the unique needs of autistic adults, from employment support to mental health resources. In today's conversation, we explore the implications of these findings and discuss the urgent need for inclusive healthcare solutions that offer lifelong support for autistic individuals. Join us as we take a closer look at the changing landscape of autism diagnoses and what it means for the future of care.
Episode 179: Impact of intermittent fasting Impact on T2DMFuture Dr. Carlisle explains the physiology of fasting and how it can help revert type 2 diabetes. Dr. Arreaza adds details on how to do intermittent fasting. Written by Cameron Carlisle, MSIV, Ross University School of Medicine. Comments and edits by Hector Arreaza, MD, FAAFP.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.What is type 2 Diabetes Mellitus (T2DM)?-Type 2 Diabetes Mellitus (T2DM) is a metabolic disorder characterized by insulin resistance and impaired glucose regulation. -This impaired regulation can lead to hyperglycemia, contributing to complications in a myriad of organs: heart, kidneys, eyes, nerves, etc. (target organs). According to the CDC, more than 38 million Americans have T2DM (about 1/10 people). -Multiple mechanisms are believed to contribute to insulin resistance in obese patients with T2DM, such as increased lipid deposition throughout the body and systemic inflammation.What is Intermittent Fasting (IF)? Intermittent fasting (IF) has recently gained popularity as a dietary approach for health benefits, but it has been around for thousands of years. IF is an eating pattern that alternates between eating and fasting (no calories consumed) over a specific period of time. When you are fasting, you are allowed and encouraged to keep drinking water and non-caloric drinks, like coffee, tea, and even homemade bone broth.-According to the International Food Information Council Foundation (IFIC), 10% of Americans engage in IF daily. -According to Mark Mattson, a neuroscientist and IF expert for over 25 years, a mechanism called “metabolic switching” is seen with IF. This is when your body runs out of glucose and starts burning fat (i.e., fatty oxidation). These metabolic changes can help protect your organs and reduce the risk of chronic conditions, like T2DM. Common IF methods: Time-restricted eating: Most common method, involves eating within a specific time frame (e.g., the 16:8, 18:6, 12:12 method is also common. [16:8 means you have 16 hours of fasting and 8 hours of eating.]Alternate-day fasting: Alternating between fasting days and normal eating days. [Find more info in The Complete Guide to Fasting, by Jason Fung, who is a nephrologist, he explains that alternate-day is basically eating every other day, which would give 36 hours of fasting, but if you are a beginner you can try a 24 hours fasting, in short, not eating breakfast any day of the week and having lunch 4 days a week, and dinner every night.]5:2 diet (aka periodic fasting): Maintaining a normal diet for 5 days, with 2 days (usually non-consecutive) of caloric restriction (25% of normal caloric intake; e.g., 500 calorie meal). IF is strongly believed to improve metabolic health in individuals with T2DM by reducing insulin resistance via increasing insulin sensitivity, promoting weight loss (patients with obesity and DM… AKA patients with diabesity), and enhancing lipolysis via fat oxidation.While fasting, the body goes through several phases that affect how energy is metabolized. Between 0 and 4 hours after eating, the body enters a feeding state, using glucose as its main energy source. After fasting for 12-16 hours, the body enters ketosis and starts to use fat for energy. Within 24-36 hours, autophagy begins, a process that recycles damaged cells and allows for cellular repair. This process can have great benefits for people with T2DM, such as improved insulin sensitivity and glucose regulation. Pathophysiology of Implementing IF in T2DM. -IF is thought to increase insulin sensitivity by decreasing fatty tissue in the body (i.e., visceral adipose tissue), which is correlated to insulin resistance. Insulin resistance is defined as higher than normal circulating insulin levels needed for a glucose lower response, which is thought to be the culprit for the generation of T2DM. It means you need high levels of insulin to keep glucose normal. -Obesity is an important risk factor for T2DM. Visceral adipose tissue functions as an organ via the secretion of adipokines (cytokines or cellular messengers produced by adipose tissue): leptin and adiponectin. Leptin: proinflammatory, leading to chronic inflammation. Patients with higher BMI levels and increased insulin resistance were found to have increased leptin levels.[Leptin is a good hormone at normal levels, but there is leptin resistance] Adiponectin: anti-inflammatory and antidiabetic effects. Higher adiponectin levels result in decreased hepatic gluconeogenesis, enhanced glucose absorption, and enhanced skeletal muscle and hepatic fatty acid oxidation. Levels drop as visceral fat increases. -Dr. López-Jaramillo, a Colombian endocrinologist and researcher, and colleagues published a review in 2014 examining the imbalance in the levels of leptin and adiponectin in individuals with metabolic syndrome. This imbalance (increase in leptin and decrease in adiponectin) is linked to obesity and insulin resistance, which has been shown to increase the risk of T2DM. It has been shown that IF has resulted in the reduction of leptin levels and increased levels of adiponectin, which leads to decreased insulin resistance and increased insulin sensitivity. -IF allows pancreatic beta-cells to rest by not having to secrete insulin constantly. This allows the beta-cells of the pancreas to improve in function over time. In addition, IF has been shown to lead to noticeable weight loss and loss in body fat, both of which play an important contribution in managing T2DM. Research demonstrates that this weight loss increases insulin sensitivity and decreases the need for insulin therapy, making IF a powerful approach for improving metabolic health. AMP-Activated Protein Kinase (AMPK) and Its Role in IF and T2DM Recent research has highlighted an important enzyme seen in IF, AMP-activated protein kinase (AMPK), which plays a vital role as an important energy sensor in cells. It is activated when cellular energy levels are low, such as during IF. A 2020 research study in Nature Reviews Endocrinology explains that activation of AMPK aids in suppressing gluconeogenesis and stimulates fatty acid oxidation, leading to optimal energy balance and reduction of visceral adipose tissue accumulation, a major contributor to insulin resistance and T2DM progression. AMPK is upregulated during fasting, which enhances glucose metabolism and reduces insulin resistance. This is imperative in managing T2DM, as it counters the effects of insulin resistance associated with T2DM.Exercise, which also promotes AMPK activation, complements IF and can promote a synergistic effect in improving insulin sensitivity and promoting fat burning, New Research Findings on IF and T2DM -The EARLY (Exploration of Treatment of Newly Diagnosed Overweight/Obese Type 2 Diabetes Mellitus) study is a randomized clinical trial published in JAMA Network Open (2024). Findings In this randomized clinical trial study found that a time-restricted eating window significantly improved fasting glucose levels and HbA1c levels in individuals with T2DM. The study examined the effect of a 16-week 5:2 meal replacement (5:2 MR) fasting plan that consisted of five days of normal eating and 2 days, nonconsecutive of restricted diet (500-600 calories). This group was examined alongside a group of patients who took metformin 0.5 g BID and empagliflozin 10 mg QD. The study wanted to investigate the changes in HbA1c in Chinese adults with early T2DM.-The study was a randomized clinical trial of 405 adults, and a study showed that the 5:2 MR approach led to better glycemic control at 16 weeks compared to the counter treatments with metformin and empagliflozin. The 5:2 MR group had the greatest reduction in HbA1c (-1.9%), followed by metformin (-1.6%), and empagliflozin (-1.5%). The 5:2 MR plan also revealed the greatest weight loss (-9.7 kg), followed by empagliflozin (-5.8 kg), and metformin (-5.5 kg). -This research suggests IF, such as 5:2 MR, can be a powerful tool in the management of T2DM and improving metabolic health. This study can potentially open doors for healthcare providers to provide the 5:2 MR approach for individuals as an effective initial lifestyle intervention. However, follow-up studies are needed to assess the effectiveness and durability of the 5:2 MR.Safety and Risks of IF in T2DM. -IF when combined with glucose-lowering medications (e.g., insulin, sulfonylureas, GLP-1 agonists) can increase the risk of hypoglycemia. Also, prolonged fasting can lead to nutrient deficiencies if not planned carefully. Patients should be counseled on maintaining a balanced, nutritious diet during non-fasting days. -IF is not suitable for everyone. Children under the age of 18 should not try IF due to needing proper calories for adequate development and proper growth. Also, it is recommended that pregnant or breastfeeding women do not undergo IF. It is advised that people with eating disorders should not try IF. -Individuals with certain medical conditions, such as kidney stones or gastroesophageal disease should speak with their doctor before trying IF. Also, patients on insulin or other glucose-lowering medications should adjust their dose and talk with their healthcare providers to prevent hypoglycemia during fasting. It is recommended that each person speak with their doctor to discuss the safety and risks of IF and see if it would benefit the individual before starting IF. -Many studies have explored the benefits of IF at the micro level revealing its cellular benefits and on a macro level of the body as a whole. However, more research is needed to confirm the long-term effects of IF on glycemic control and its sustainability as a therapeutic approach for T2DM. Conclusion:-IF shows potential for improving glycemic control, promoting weight loss, and enhancing metabolic health in individuals with T2DM. Despite its benefits, IF may present with risks, such as hypoglycemia, nutrition deficiencies, or dehydration in certain patients. Therefore, it may not be suitable for all individuals. It's important to monitor patients who engage in IF, especially for patients with T2DM. Patients should follow up with their doctor for individualized IF plans in patients with T2DM. ______________This week we thank Hector Arreaza and Cameron Carlisle. Audio editing by Adrianne Silva.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:Albosta, Michael, and Jesse Bakke. “Intermittent Fasting: Is There a Role in the Treatment of Diabetes? A Review of the Literature and Guide for Primary Care Physicians - Clinical Diabetes and Endocrinology.” BioMed Central, BioMed Central, 3 Feb. 2021, doi.org/10.1186/s40842-020-00116-1.Blumberg, Jack, et al. “Intermittent Fasting: Consider the Risks of Disordered Eating for Your Patient - Clinical Diabetes and Endocrinology.” BioMed Central, BioMed Central, 21 Oct. 2023, https://clindiabetesendo.biomedcentral.com/articles/10.1186/s40842-023-00152-7.De Cabo, Rafael, and Mark P. Mattson. “Effects of intermittent fasting on health, aging, and disease.” New England Journal of Medicine, vol. 381, no. 26, 26 Dec. 2019, pp. 2541–2551, https://doi.org/10.1056/nejmra1905136.Guo, Lixin, et al. “A 5:2 intermittent fasting meal replacement diet and glycemic control for adults with diabetes.” JAMA Network Open, vol. 7, no. 6, 21 June 2024, https://doi.org/10.1001/jamanetworkopen.2024.16786.Herz, Daniel, et al. “Efficacy of Fasting in Type 1 and Type 2 Diabetes Mellitus: A Narrative Review.” Nutrients, U.S. National Library of Medicine, 10 Aug. 2023, www.ncbi.nlm.nih.gov/pmc/articles/PMC10459496/. Herzig, S., & Shaw, R. J. (2018). AMPK: Guardian of metabolism and mitochondrial homeostasis. Nature Reviews Molecular Cell Biology, 19(2), 121-135.Longo, V. D., & Mattson, M. P. (2014). Fasting: Molecular mechanisms and clinical applications. Cell Metabolism, 19(2), 181-192. https://doi.org/10.1016/j.cmet.2013.12.008López-Jaramillo P, Gómez-Arbeláez D, López-López J, et al. The role of leptin/adiponectin ratio in metabolic syndrome and diabetes. Hormone Molecular Biology and Clinical Investigation. 2014;18(1):37–45.Mattson, Mark P., et al. “Impact of intermittent fasting on health and disease processes.” Ageing Research Reviews, vol. 39, Oct. 2017, pp. 46–58, https://doi.org/10.1016/j.arr.2016.10.005. Patikorn, Chanthawat, et al. “Intermittent fasting and obesity-related health outcomes.” JAMA Network Open, vol. 4, no. 12, 17 Dec. 2021, https://doi.org/10.1001/jamanetworkopen.2021.39558.Sharma, Suresh K, et al. “Effect of Intermittent Fasting on Glycaemic Control in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.” TouchREVIEWS in Endocrinology, U.S. National Library of Medicine, May 2023, www.ncbi.nlm.nih.gov/pmc/articles/PMC10258621/#:~:text=In%20IF%2C%20eating%20habits%20are,the%20risk%20of%20developing%20T2DM.Xiaoyu, Wen, et al. “The effects of different intermittent fasting regimens in people with type 2 diabetes: A network meta-analysis.” Frontiers in Nutrition, vol. 11, 25 Jan. 2024, https://doi.org/10.3389/fnut.2024.1325894. Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/.
Acetaminophen overdose is one of the most common medication concerns we see in the ED. It is important to know when to be concerned and when to treat as true overdoses can cause liver failure and death. UC Davis medical toxicologist, Dr. Hoan Nguyen, joins us in this episode to discuss a new consensus statement published in JAMA Network Open in August 2023: Managing of Acetaminophen Poisoning in the US and Canada. We discuss the updated approach and walk through as hypothetical case. At the end of this episode, you'll be able to identify high risk patients, know what labs to draw, when to start NAC, transfer, and call your local toxicologist. Do these updated guidelines change your practice? Hit us up on social media @empulsepodcast or at ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Guests: Dr. HoanVu Nguyen, Military Emergency Physician and Medical Toxicologist at UC Davis. Resources: Dart RC, Mullins ME, Matoushek T, et al. Management of Acetaminophen Poisoning in the US and Canada: A Consensus Statement. JAMA Netw Open. 2023 Aug 1;6(8):e2327739. doi: 10.1001/jamanetworkopen.2023.27739. Erratum in: JAMA Netw Open. 2023 Sep 5;6(9):e2337926. doi: 10.1001/jamanetworkopen.2023.37926. PMID: 37552484. ***** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.
It's In the News! A look at the top diabetes stories and headlines happening now. Top stories this week: The FTC sues PBMs over insulin pricing, a new CGM is approved in Europe, more news about GLP-1s but some research says it may not work as well for one population, diabetes camps are invited to apply for grants, and more! Find out more about Moms' Night Out Please visit our Sponsors & Partners - they help make the show possible! Learn more about Gvoke Glucagon Gvoke HypoPen® (glucagon injection): Glucagon Injection For Very Low Blood Sugar (gvokeglucagon.com) Omnipod - Simplify Life Learn about Dexcom Edgepark Medical Supplies Check out VIVI Cap to protect your insulin from extreme temperatures Learn more about AG1 from Athletic Greens Drive research that matters through the T1D Exchange The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Sign up for our newsletter here Here's where to find us: Facebook (Group) Facebook (Page) Instagram Twitter Check out Stacey's books! Learn more about everything at our home page www.diabetes-connections.com Reach out with questions or comments: info@diabetes-connections.com Episode transcription with links: Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and every other Friday I bring you a short episode with the top diabetes stories and headlines happening now. XX The U.S. Federal Trade Commission sued the country's three largest pharmacy benefit managers on Friday, accusing them of steering diabetes patients towards higher priced insulin in order to reap millions of dollars in rebates from pharmaceutical companies. The case accuses UnitedHealth Group Inc's (UNH.N), opens new tab Optum unit, CVS Health Corp's (CVS.N), opens new tab CVS Caremark and Cigna Corp's (CI.N), opens new tab Express Scripts of unfairly excluding lower cost insulin products from lists of drugs covered by insurers. The three companies said in statements that the suit was baseless and defended their business practices, saying that they had lowered insulin prices for businesses, unions and patients. https://www.reuters.com/business/healthcare-pharmaceuticals/us-ftc-sues-drug-gatekeepers-over-high-insulin-prices-2024-09-20/ XX A new study finds metformin, may slow aging. Previous studies on "lower order" species have found that it can delay the onset of age-related diseases. Gotta say, this is only in animal studies right now, not people, human trials are next. https://www.cbsnews.com/boston/news/diabetes-drug-metformin-aging/ XX New research from the Case Western Reserve University School of Medicine identifies a potential new approach to address the opioid overdose epidemic—which has devastated families and communities nationally. The study, published in the journal JAMA Network Open, suggests semaglutide is linked to lower opioid overdoses in people with opioid-use disorder (OUD) and type 2 diabetes (T2D). Semaglutide, a glucagon-like peptide receptor (GLP-1R) molecule that decreases hunger and helps regulate blood sugar in T2D, is also the active component in the diabetes and weight-loss drugs Wegovy and Ozempic. The research team—led by biomedical informatics professor Rong Xu—analyzed six years of electronic records of nearly 33,000 patients with OUD who also had T2D. The researchers used a statistical approach that mimics a randomized clinical trial. They found patients prescribed semaglutide had a significantly lower risk for opioid overdose, compared to those who had taken any of eight other anti-diabetic medications, including other types of GLP-1R-targeting medications. About 107,500 people died from drug overdoses nationally in 2023, mostly from opioids, according to the CDC. Despite effective medications to prevent overdoses from OUD, the CDC estimates only a quarter of those with OUD receive them and about half discontinue treatment within six months. https://medicalxpress.com/news/2024-09-popular-diabetes-weight-loss-drug.html XX New research analyzing the effects of two drugs used to treat type 2 diabetes indicates a consistent lack of cardiovascular and renal benefits in Black populations. The drugs, called sodium-glucose co-transporter 2 inhibitors (SGLT2-Is) and glucogen-like peptide 1 receptor agonists (GLP1-RAs), are some of the newer treatments prescribed to lower blood sugar levels in people with type 2 diabetes. The research findings, published in the Journal of the Royal Society of Medicine, show that for White and Asian populations, SGLT2-Is and GLP1-RAs have beneficial effects on blood pressure, weight control and renal function, and significantly reduce the risk of severe heart problems and kidney disease. However, the research shows no evidence of these beneficial effects in Black populations. ""Whether the differences are due to issues with under-representation of Black populations and low statistical power, or to racial/ethnic variations in the way the body and these drugs interact with each other needs further investigation," said Professor Seidu. "It is therefore important that prescribers don't hasten to deny these newer treatments to Black populations on the back of this research." https://www.news-medical.net/news/20240923/Research-reveals-disparities-in-diabetes-drug-efficacy-for-Black-populations.aspx XX If a woman is already in a "prediabetic" state in her teen or college years, her odds for a serious complication of pregnancy later in life rises, new research shows. Ignoring prediabetes in teenagers "may represent a missed opportunity to avert pregnancy-related complications" later, said study lead author Katharine McCarthy. She's an assistant professor of population health science and policy, and obstetrics, gynecology and reproductive science at the Icahn School of Medicine at Mount Sinai in New York City. Her team published its findings Sept. 24 in the journal JAMA Network Open. Prior research has found that rates of prediabetes have tripled among Americans ages 12 to 19 over the past decade. In the new study, the Mount Sinai team tracked rates of prediabetes (using blood sugar tests) among a group of 14,000 New York City residents ages 10 to 24. None of these individuals had full-blown diabetes at the time they were tested. Having prediabetes in youth was linked to a doubling of risk of gestational diabetes -- new-onset diabetes while pregnant. Tracking blood levels of hemoglobin A1c, a measure of a person's average blood sugar level over the prior three months, was very predictive of whether or a not a woman would get gestational diabetes, the team found. Prediabetes in youth was also linked to an 18% rise in the risk for hypertensive disorders during pregnancy, such as gestational hypertension and preeclampsia, or preterm delivery. Measuring a teen girl's blood for signs of prediabetes might help protect her against trouble in a later pregnancy, McCarthy's group said. https://www.usnews.com/news/health-news/articles/2024-09-24/prediabetes-in-teens-could-raise-odds-for-complicated-pregnancies-later XX Is there a link between IBD and type 1? In a recent and very large study, researchers looked at more than 630-thousdan people and found that irritable bowel disease seemed to significantly increase the risk of type 1 diabetes and vice versa. Interestingly, patients with IBD were found to have a significantly higher probability of formerly having contracted T1D, validating the bidirectional associations between these comorbidities. The highest risk was observed in patients with ulcerative colitis (aHR = 2.02), highlighting a stronger association with this IBD subtype. Additionally, over 70% of the study cohort was followed for more than ten years, reinforcing the robustness of these findings. https://www.news-medical.net/news/20240919/IBD-increases-type-1-diabetes-risk-revealing-a-bidirectional-link-between-the-two-conditions.aspx XX Roche plans to launch its first continuous glucose monitor (CGM) in Europe “in the coming weeks,” The Accu-Chek Smartguide has European approval for adults with Type 1 or Type 2 diabetes. Roche will roll out the CGM in the Netherlands, Switzerland and Germany. Accu-Chek Smartguide can be worn for 14 days, and features predictive algorithms that Roche hopes will differentiate it from competitors Abbott and Dexcom. However, it also must be calibrated at first using a finger stick, which the other brands don't require. Roche developed the CGM with three different prediction tools: A feature to predict the risk of low blood glucose within 30 minutes, a feature to forecast glucose levels over the next two hours, and a feature to predict hypoglycemia risk at night. Pau Herrero, an algorithm and decision support tech lead at Roche, said the device provides a different picture than the trend arrows other CGMs use, which typically forecast glucose levels over the next 20 minutes. The predictions are based on multiple days of patient data using machine learning models. The company is in “active discussions” with the Food and Drug Administration on bringing Accu-Chek Smartguide to the U.S., Moreiras said, adding that he “cannot commit to any timelines.” https://www.medtechdive.com/news/roche-cgm-launch-europe/726863/ XX Exciting news! iLet users can now invite friends and family to join their Bionic Circle to see their diabetes data and receive alerts. By accepting the invite and downloading our new Bionic Circle App, loved ones can monitor an iLet user's CGM values, meal announcements, insulin doses, and alerts from anywhere. To learn how to invite followers and accept an invite, visit: https://lnkd.in/ghigJKMt XX Diabetes Canada has unveiled the key findings of a first-of-its-kind national survey on how widespread stigma, judgement and discrimination is for those who live with diabetes and the impact of those social experiences on the quality of life for people with diabetes. The survey shows that diabetes can not only negatively impact a person's physical health but can also negatively affect their personal relationships, work or studies, leisure activities, financial situation, and emotional well-being. In fact, nearly 90% of people living with type 1 diabetes and 70% of people living with type 2 diabetes experience shame and blame for having diabetes. “As someone who lives with type 2 diabetes, I know first-hand how stigma can negatively impact the quality of life for people living with this condition in Canada,” says Laura Syron, President & CEO of Diabetes Canada. “We need to change the conversation around diabetes—the values, beliefs and language—so that people living with this condition can feel more accepted and understood. These feelings can dramatically improve the likelihood that people living with diabetes can receive the support and care they need to better their health outcomes and their quality of life.” In the survey, key findings show how people living with diabetes must deal with unfair assumptions about what they can and cannot do, judgements if they consume specific foods, and being blamed for having diabetes. 40% of people with T1D never or rarely ask for support to help manage their diabetes when they need it. 56% of people with T2D never or rarely ask for support to help manage their diabetes when they need it. https://finance.yahoo.com/news/diabetes-canada-releases-first-kind-101300695.html?guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAAJIrWwjdye-ehrLNDt-LIGb5qTXaKDTIa8NWwiT7fKwFFgjDMN2nnINis6YfFePWP2ZA2DVYWXEIZQqRlQ4aKLFrYWgvw1jdI-t1n9kO6NIzdBCMXQNNCVl_S-75lDNip2SysHDJQmyqSc4wLjfDya3v9wwTWU-KgE_OqrPCTnlu XX Edgepark commercial XX This is National Glucose Awareness Week. Dexcom and Beyond Type 2 are teaming up for the new designation to encourage people to learn about the importance of glucose and its significant impact on overall health, especially for people with diabetes. The news release says: National Glucose Awareness Week will feature a variety of educational resources about the importance of glucose health and information about new, cutting-edge glucose biosensing technology. That technology is CGM.. now available over the counter as Dexcom's Stelo. Get moving: Participate in a nationwide step challenge (invitation code: glucose) from Sept. 30 to Oct. 13 to help improve your glucose health.† Step challenge participants can register to participate from Sept. 23-29, 2024 and will have the chance to compete for prizes. Get resources: Close the glucose knowledge gap with key educational resources from Beyond Type 2. https://www.businesswire.com/news/home/20240923896101/en/Dexcom-Beyond-Type-2-and-Retta-Establish-National-Glucose-Awareness-Week-to-Close-the-Glucose-Knowledge-Gap?utm_campaign=shareaholic&utm_medium=copy_link&utm_source=bookmark XX Attention diabetes camp organizers! You're invited to apply for financial support for your need based scholarships. This is the Type 1 Diabetes Camps Project: 2025-2027 Campership Initiative The initiative will also provide limited funds for selected camps to expand their revenue development efforts, funds for professional development and funds for low-income camper recruitment efforts and indirect costs. The initiative is supported by $6 million in grant funding from The Leona M. and Harry B. Helmsley Charitable Trust and $900 thousand in funding from Eli Lilly and Company over the next three years. For more information about the RFP, please login and navigate to the publicly available RFPs: https://newventurefund.force.com/login XX Join us again soon!
Interviewer: Lisa Meeks Interviewees John Ruddell Jennifer Ruddell Roja (friend of Jack Ruddell) Dr. Stuart Slavin Dr. Christine Moutier Dr. Srijan Sen Dr. David Muller Dr. Justin Bullock Dr. Jessi Gold Narrator Dr. Joseph Murray Transcript Keywords: Mental health, Medical training, Stress, Well-being, Jack Ruddell, Depression, Suicidality, Financial counseling, Career counseling, Transferable skills, Medical errors, Medical culture, Opt-Out, Trust, Vulnerability, Open Discussions, Sharing Stories Description In this episode, we address the urgent issue of suicidality in medical training, reflecting on the personal and systemic challenges that contribute to this crisis. Building on episodes 102, 103, and 104, we continue to explore the deep impact of these challenges. We begin by examining the need to address both individual and systemic factors, emphasizing the importance of cultural shifts within medical environments and advocating for meaningful systems change. As the episode concludes, our experts highlight actionable steps medical schools can take to better support mental health, including fostering open dialogue, ensuring accessible resources, and creating a culture of vulnerability. In memory of Dr. Jack Rudell, we close with a piece of his music—a poignant reminder of the personal nature of this issue and the critical need to keep every trainee's light shining. 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/ References: Hogan, W. B., Del Re, A. M., & Daniels, A. H. (2021). A Voice, Singing: Reflections on Losing a Colleague to Suicide. Rhode Island Medical Journal, 104(6), 68-69. Knaak, S., Mantler, E., & Szeto, A. (2017, March). Mental illness-related stigma in healthcare: Barriers to access and care and evidence-based solutions. In Healthcare management forum (Vol. 30, No. 2, pp. 111-116). Sage CA: Los Angeles, CA: SAGE Publications. Malone, T. L., Zhao, Z., Liu, T. Y., Song, P. X., Sen, S., & Scott, L. J. (2021). Prediction of suicidal ideation risk in a prospective cohort study of medical interns. PLoS One, 16(12), e0260620. Meeks, L. M., Cleary, J., Horwitz, A., Pereira-Lima, K., Zhao, Z., Fang, Y., & Sen, S. (2022). Analysis of depressive symptoms and perceived impairment among physicians across intern year. JAMA Network Open, 5(1), e2144919-e2144919. Slavin, S. J., & Chibnall, J. T. (2016). Finding the why, changing the how: improving the mental health of medical students, residents, and physicians. Academic Medicine, 91(9), 1194-1196. Tandon MD, H. K., Kratochvil, M. D., Taylor, J., Keiser, M. S., LIMHP, K. L., Kent BS, N. J., ... & Gold, J. P. (2024). UNMC Quick Checks: An “Opt-Out” Model for Health Profession Student Appointments with Mental Health Counseling Services. Innovations in Health Sciences Education Journal, 2(1), 2.
Date: September 18, 2024 Reference: Dillon et al. Naloxone and Patient Outcomes in Out-of-Hospital Cardiac Arrests in California. JAMA Network Open. August 20, 2024 Guest Skeptic: Dr. Chris Root is an emergency medicine and emergency medicine service (EMS) physician at the University of New Mexico, Albuquerque. Before attending medical school, he was a New York […] The post SGEM#453: I Can't Go For That – No, No Narcan for Out-of-Hospital Cardiac Arrests first appeared on The Skeptics Guide to Emergency Medicine.
Warning: This content addresses mental health issues, including research and 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 Lisa Meeks Interviewees John Ruddell Jennifer Ruddell Roja (friend of Jack Ruddell) Dr. Christine Moutier Dr. Jessi Gold Narrator Dr. Joseph Murray Description In this deeply moving episode, host Lisa Meeks introduces a special series dedicated to exploring the mental health crisis among medical trainees, with a focus on the tragic story of Dr. Jack Ruddell. Joined by Jack's parents, John and Jennifer Ruddell, and his close friend Roja, we delve into Jack's life, his struggles with depression and anxiety, and the immense pressures faced by medical students. Dr. Joseph Murray, a psychiatrist at Weill Cornell Medical College, provides expert insights into the high rates of burnout, depression, and suicide in the medical field. We also hear from Dr. Christine Moutier, Chief Medical Officer of the American Foundation for Suicide Prevention, and Dr. Jessie Gold, a respected psychiatrist and author, who discuss the unique challenges and cultural issues within medical training that contribute to mental health struggles. This episode aims to reduce the stigma surrounding mental health issues, encourage medical learners to seek help, and advocate for systemic changes in medical education to foster a more supportive and compassionate environment. 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 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. Transcript Keywords: Suicide, Death, Mental health, Jack Ruddell, Medical training, Depression, Suicidality, Burnout, Anxiety, Medical trainees, American Foundation for Suicide Prevention, Tourette's, Disabilities, Medical education, Medical school, Discrimination, Academic pressure, Clinical practice, Imposter syndrome, Perfectionism, Shame, Mental disability, Learning challenges, Accommodations, High-stakes testing, Inclusivity, Stigma Resources: 24/7 Suicide & Crisis Hotline, call or text 988 or chat 988lifeline.org. How are you? By Jessi Gold National Office for Suicide Prevention: Language and suicide The American Foundation for Suicide Prevention References Johnson KM, Slavin SJ, Takahashi TA. Excellent vs Excessive: Helping Trainees Balance Performance and Perfectionism. J Grad Med Educ. 2023 Aug;15(4):424-427. doi: 10.4300/JGME-D-23-00003.1. PMID: 37637342; PMCID: PMC10449346. Bynum WE 4th, W Teunissen P, Varpio L. In the "Shadow of Shame": A Phenomenological Exploration of the Nature of Shame Experiences in Medical Students. Acad Med. 2021 Nov 1;96(11S):S23-S30. doi: 10.1097/ACM.0000000000004261. PMID: 34348391. Jain, Neera R. PhD, MS1; Stergiopoulos, Erene MD, MA2; Addams, Amy3; Moreland, Christopher J. MD, MPH4; Meeks, Lisa M. PhD, MA5. “We Need a Seismic Shift”: Disabled Student Perspectives on Disability Inclusion in U.S. Medical Education. Academic Medicine ():10.1097/ACM.0000000000005842, August 8, 2024. | DOI: 10.1097/ACM.0000000000005842 Meeks LM, Jain NR. Accessibility, Inclusion, and Action in Medical Education: Lived Experiences of Learners and Physicians with Disabilities. Washington, DC: Association of American Medical Colleges; 2018. Retrieved on September 14, 2024 from: https://store.aamc.org/accessibility-inclusion-and-action-in-medical-education-lived-experiences-of-learners-and-physicians-with-disabilities.html. Meeks, L. M., Pereira‐Lima, K., Plegue, M., Jain, N. R., Stergiopoulos, E., Stauffer, C., ... & Moreland, C. J. (2023). Disability, program access, empathy and burnout in US medical students: A national study. Medical education, 57(6), 523-534. Recommended Readings: Almutairi, H., Alsubaiei, A., Abduljawad, S., Alshatti, A., Fekih-Romdhane, F., Husni, M., & Jahrami, H. (2022). Prevalence of burnout in medical students: A systematic review and meta-analysis. International Journal of Social Psychiatry, 68(6), 1157-1170. Enns MW & Cox B. (2002) The Nature and Assessment of Perfectionism: A Critical Analysis. In: Flett GL, Hewitt PL, eds. Perfectionism: Theory, Research, and Treatment. American Psychological Association, 33-62. Goldman, M. L., Shah, R. N., & Bernstein, C. A. (2015). Depression and suicide among physician trainees: recommendations for a national response. JAMA psychiatry, 72(5), 411-412. Johnson, K. M., Slavin, S. J., & Takahashi, T. A. (2023). Excellent vs excessive: helping trainees balance performance and perfectionism. Journal of Graduate Medical Education, 15(4), 424-427. Meeks, L. M., Conrad, S. S., Nouri, Z., Moreland, C. J., Hu, X., & Dill, M. J. (2022). Patient And Coworker Mistreatment Of Physicians With Disabilities: Study examines mistreatment of physicians with disabilities. Health Affairs, 41(10), 1396-1402. Mirza, A. A., Baig, M., Beyari, G. M., Halawani, M. A., & Mirza, A. A. (2021). Depression and anxiety among medical students: a brief overview. Advances in Medical Education and Practice, 393-398. Pereira-Lima, K., Meeks, L. M., Ross, K. E., Marcelin, J. R., Smeltz, L., Frank, E., & Sen, S. (2023). Barriers to disclosure of disability and request for accommodations among first-year resident physicians in the US. JAMA Network Open, 6(5), e239981-e239981. Meeks LM, Ramsey J, Lyons M, Spencer AL, Lee WW. Wellness and work: mixed messages in residency training. J Gen Intern Med. 2019;34(7):1352-1355. PMID: 30924087 Meeks LM, Stergiopoulos E, Petersen KH. Institutional Accountability for Students With Disabilities: A Call for Liaison Committee on Medical Education Action. Acad Med. 2021 Oct. PMID: 34670236
Okay, it's time to finally answer the question: is drinking booze good or bad? Is there really a “J-curve”, such that it's bad to drink zero alcohol, good to drink a little, and then bad to drink any more than that? What exactly is the “safe level” of alcohol consumption, and why do the meta-analyses on this topic all seem to tell us entirely different things?In this episode of The Studies Show, Tom and Stuart get very badly intoxicated—with statistics.We're sponsored by Works in Progress magazine. There's no better place online to find essays on the topic of “Progress Studies”—the new field that digs deep into the data on how scientific and technological advances were made in the past, and tries to learn the lessons for the future. Check them out at worksinprogress.co.Show notes* Media reports say alcohol is good! Oh no wait, it's bad. Oh, sorry, it's actually good! No, wait, actually bad. And so on, ad infinitum* The three conflicting meta-analyses:* 2018 in The Lancet (“no safe level”)* 2022 in The Lancet (the J-curve returns)* 2023 in JAMA Network Open (using “occasional drinkers” as the comparison)* Some of the press coverage about the J-curve age differences* David Spiegelhalter's piece comparing the two Lancet meta-analyses* Tom's piece on the idea of “safe drinking”CreditsThe Studies Show is produced by Julian Mayers at Yada Yada Productions. We're very grateful to Sir David Spiegelhalter for talking to us about this episode (as ever, any errors are ours alone). 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
The Psychology of Self-Injury: Exploring Self-Harm & Mental Health
Emotion Regulation Individual Therapy for Adolescents (ERITA) and its internet-delivered version (IERITA) is just one of a couple of treatments developed specifically to address nonsuicidal self-injury (NSSI) among adolescents. In this episode, Dr. Johan Bjureberg from the Karolinska Institute in Stockholm, Sweden walks us through in detail each of the 11 sessions of IERITA and IERITA's 6 parallel sessions for parents.Learn more about Dr. Bjureberg's work here, and follow the Bjureberg Research Lab and their projects and publications at https://bjureberglab.se/. Below are links to his research on ERITA/IERITA referenced in this episode:Bjureberg, J., Ojala, O., Hesser, H., Häbel, H., Sahlin, H., Gratz, K. L., Tull, M. T., Knutsson, E. C., Hedman-Lagerlöf, E., Ljótsson, B., & Hellner, C. (2023). Effect of internet-delivered Emotion Regulation Individual Therapy for Adolescents with Nonsuicidal Self-Injury Disorder: A randomized clinical trial. JAMA Network Open, 6(7), e2322069.Bjureberg, J., Sahlin, H., Hedman-Lagerlof, E., Gratz, K. L., Tull, M. T., Jokinen, J., Hellner, C., & Ljotsson, B. (2018). Extending research on emotion regulation individual therapy for adolescents (ERITA) with nonsuicidal self-injury disorder: Open pilot trial and mediation analysis of a novel online version. BMC Psychiatry, 18, 326.Bjureberg, J., Sahlin, H., Hellner, C., Hedman-Lagerlof, E., Gratz, K. L., Bjarehed, J., Jokinen, J., Tull, M. T., & Ljotsson, B. (2017). Emotion regulation individual therapy for adolescents with nonsuicidal self-injury disorder: A feasibility study. BMC Psychiatry, 17, 411.Want to have a bigger role on the podcast?:Should you or someone you know be interviewed on the podcast? We want to know! Please fill out this Google doc form, and we will be in touch with more details if it's a good fit.Want to hear your question and have it answered on the podcast? Please send an audio clip of your question (60 seconds or less) to @DocWesters on Instagram or Twitter/X, or email us at thepsychologyofselfinjury@gmail.comWant to be involved in research? Send us a message at thepsychologyofselfinjury@gmail.com and we will see if we can match you to an active study.Want to interact with us through comments and polls? You can on Spotify!Follow Dr. Westers on Instagram and Twitter/X (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter/X (@ITripleS).The Psychology of Self-Injury podcast has been rated as one of the "10 Best Self Harm Podcasts" and "20 Best Clinical Psychology Podcasts" by Feedspot and one of the Top 100 Psychology Podcasts by Goodpods. It has also been featured in Audible's "Best Mental Health Podcasts to Defy Stigma and Begin to Heal." Goodpods Top 100 Parents Podcasts Listen now to The Psychology of Self-Injury: ExploringSelf-Harm & Mental Health podcast Goodpods Top 100 Research Podcasts Listen now to The Psychology of Self-Injury: ExploringSelf-Harm & Mental Health podcast
RSV season is just around the corner (Fall and Winter months). Newborns are 16x more likely to be hospitalized with serious RSV lung infection than the flu. On August 21, 2023, the FDA approved the first RSV vaccine, Abrysvo, for use in pregnant individuals to protect newborns and infants against severe RSV disease in the first 6 months after birth. The FDA approved the vaccine to be administered between 32 and 36 weeks and 6 days of gestation. Then, on September 22, 2023, the CDC's Advisory Committee on Immunization Practices (ACIP) voted to recommend a single dose of maternal RSV vaccination for pregnant people at 32 through 36 weeks of gestation, using seasonal administration, to prevent RSV lower respiratory tract infection (LRTI) in infants.This resulted in the ACOG's endorsement, also in September 2023, of Abrysvo in pregnancy. However, the clinical trial resulting in the vaccine's FDA approval noted “a numerical imbalance” for preterm birth occurrence (1% more) in vaccine recipients. Because of this, there was a call for additional “real world outcomes“ to see if this finding would be replicated outside of the trial. In this episode, we will summarize a brand new (July 8, 2024) publication from JAMA Network Open which provides this data, although some noteworthy study limitations must be acknowledged. Listen in for details!
A substantial collection of evidence indicates that the fallopian tube serves as the primary site of origin for a large portion of high-grade serous ovarian cancers. As a result, clinical practice guidelines (including from the ACOG) recommend salpingectomy for permanent contraception- when necessary- rather than simple tubal ligation. But an August 2023 publication, in JAMA Network Open, stated that women who undergo a salpingectomy are no more or less at risk of ovarian cancer compared to traditional tubal ligation. Why? In this episode, we will summarize this controversial publication and contrast that to a systematic review the following month, in September 2023 in JAMA Surgery, which provides an alternative conclusion. Should we still perform opportunistic salpingectomies (OS) rather than tubal ligations in the average-risk patient? We'll explain the data and provide clinical pearls for practice at the end of the episode. Thank you, Bret, for this clinical conundrum as a podcast episode recommendation! You ask…we do!
(Here's a WONDERFUL QI Project for this New Residency Academic Year) With 70.8% of pregnancies among adolescents being unintended, there is a clear need for increased access to contraceptive services. Many adolescents use the emergency department (ED) as their primary healthcare source, highlighting the importance of providing comprehensive sexual health services in this setting. The risk of pregnancy is high among adolescents seeking ED care, indicating an opportunity to expand pregnancy prevention services in this setting. ED clinicians are in a unique position to address pregnancy prevention among adolescents. Novel ED staff training tools kits do exist for brief contraceptive counseling interventions during the ED visit for interested adolescents who present for any chief complaint. Talking to teens about contraceptives in the ED is feasible, acceptable, and allows ED staff to reach youth that may not have access or choose not to access medical care in any other setting. In this episode, we will summarize striking data from a recent publication (June 28, 2024), in JAMA Network Open, which revealed gaps in addressing contraceptive needs among vulnerable adolescent females and gaps in provisions of EC when needed. Additionally, we will propose an easy to adopt strategy to better equip Emergency Department staff for having these conversations.
Anxiety disorders are the most common mental health issue in the United States, affecting nearly 1 in 5 adults, or 40 million people. Another 19 million adults – 8% of the population – has depression. Prenatal mood disturbances are known to affect the fetal brain, and endocrine system. Left amygdalar volumes were smaller in newborns whose mothers had high psychological distress during the COVID-19 pandemic, a small cross-sectional study suggested. Infants of mothers with elevated maternal distress during the pandemic had median reductions in white matter, right hippocampal, and left amygdala volumes compared with neonates whose mothers had low distress levels, this is according to research from the Children's National Hospital in Washington, D.C. This was published in JAMA Network Open on June 20, 2024 and is making the medical headlines. This is fascinating data. BUT, this is NOT new news. In this episode, we will review the concerning effect that maternal mood and stress has on the developing fetal brain, and how maternal stress may even be leading to changes in the child's puberty! Listen in for details.
View the Show Notes For This EpisodeGet Free Weekly Health Tips from Dr. HymanSign Up for Dr. Hyman's Weekly Longevity JournalGet Ad-free Episodes & Dr. Hyman+ Audio ExclusivesToday, we're zooming in on a groundbreaking study that comes from Stanford University and was recently published in JAMA Network Open. The researchers put a vegan diet head-to-head with an omnivorous diet in twenty-two pairs of identical twins. The buzz around this study has been immense, sparking conversations everywhere—from social media to professional circles. Adding to the excitement, this research forms the basis of a new Netflix documentary called "You Are What You Eat: A Twin Experiment." In this episode of my Health Bites series, I discuss the many conflicts of interest, funding sources, and hidden agendas that were not fully disclosed but could have had a major hand in clouding the study's conclusions and real-world applications. We'll also get into the Netflix docuseries itself—what they got right vs. what they got wrong, as well as the Functional Medicine approach to diet and how we can feed our bodies to create health while taking care of the planet in a healthy, sustainable, and ethical way.This episode is brought to you by Rupa Health, Momentous, and Happy Egg.Streamline your lab orders with Rupa Health. Access more than 3,000 specialty lab tests and register for a FREE live demo at RupaHealth.com.Head over to livemomentous.com/mark for 20% off creatine, collagen, and all of their best-in-class products.Shopping for better eggs shouldn't be confusing. Look for the yellow carton at your local grocery store or visit happyegg.com/farmacy to find Happy Egg near you.In this episode, I discuss (audio version / Apple Subscriber version):Why nutrition research is so confusing (7:26 / 5:36)Overview of the Stanford study design and findings (11:57 / 10:07)Issues with the study design (27:10 / 24:10)Conflicts of interest and ethical considerations with this study (38:19 / 35:19)Other research on vegan diets (44:44 / 41:44)What the Netflix documentary got right and wrong (1:00:23 / 57:23)How to eat for your health and the environment (1:08:43 / 1:05:43) Hosted on Acast. See acast.com/privacy for more information.