Podcasts about mra

In this episode, Dana Walker discusses the Michigan Retailers Association (MRA) with Vic Veda and Burke Sage. They explore the benefits of MRA membership, including legislative advocacy, merchant services, and community engagement through initiatives like the Buy Nearby campaign. The conversation highlights the importance of supporting local businesses, especially in the face of challenges like e-commerce and gift card fraud. The episode concludes with a call to action for listeners to shift their spending towards local businesses and to utilize the resources provided by MRA.

Episode 212: Managing HFpEFHyo Mun and Jordan Redden (medical students) explain how to manage HFpEF with medications and touch some basics about nonpharmacologic treatments. Dr. Arreaza asks insightful questions to guide the discussion. Written by Hyo Mun, MSIV, American University of the Caribbean; and Jordan Redden, MSIV, Ross University School of Medicine. Comments by Hector Arreaza, MD.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.Treatment of HFpEFArreaza: Mike, if you had to name the one therapy everyone with HFpEF should be on, what is it?Mike: That's easy! SGLT-2 inhibitors. This is the one slam-dunk we have in HFpEF. Empagliflozin (Jardiance) or dapagliflozin (Farxiga) should be started in essentially every patient with HFpEF, and it doesn't matter if they have diabetes or not.Jordan: And that's worth repeating, because people still think of these as “diabetes drugs.” They're not anymore. In HFpEF, SGLT-2 inhibitors reduce heart-failure hospitalizations, improve symptoms, improve quality of life, and even reduce cardiovascular death.Dr. Arreaza: They're also simple. Empagliflozin 10 mg daily or dapagliflozin 10 mg daily. No titration, no drama. The effectiveness of these meds was established around 2019 with DAPA-HF and later with DELIVER. These were trials thatdemonstrated that dapagliflozin reduces worsening heart failure and cardiovascular events across the full spectrum of heart failure, from reduced to preserved ejection fraction, independent of diabetes status.Mike: And the number needed to treat is about 28 to prevent one heart-failure hospitalization. That's excellent for a disease where we historically had almost nothing that worked.Jordan: They're also safe in chronic kidney disease down to an eGFR of about 25, which makes them even more useful in this population.Dr. Arreaza: Alright. We got SGLT-2 inhibitor, what's next?Mike: Volume management. Loop diuretics are still the backbone of symptom control in HFpEF. If the patient is volume overloaded, you diurese, and you diurese aggressively.Jordan: The goal is euvolemia. Dry weight, no edema, no orthopnea, no waking up gasping for air. A lot of these patients end up needing chronic oral loop diuretics to stay there.Dr. Arreaza: Something to remember: HFpEF patients don't tolerate congestion well, and being “a little wet” is not benign. Let's move into RAAS inhibition. Where do ARBs and ACE inhibitors fit in?Mike: Between ARBs and ACE inhibitors, ARBs are the winners in HFpEF. They actually reduce heart failure hospitalizations—drugs like candesartan, losartan, valsartan. ACE inhibitors? Not so much. They showed minimal benefit in older HFpEF patients, which is why we go with ARBs instead.Jordan: But a lot of clinicians get nervous about ACE inhibitors and ARBs because of kidney function, so it's worth talking through how these drugs actually work in the kidney.Dr. Arreaza: Yes, misunderstanding may lead to unnecessary drug discontinuation.Jordan: Under normal conditions, the afferent arteriole brings blood into the glomerulus, and the efferent arteriole is constricted by angiotensin II. That constriction keeps pressure high in the glomerulus and maintains filtration.Mike: Here's what happens with an ACE inhibitor: you block angiotensin II, the efferent arteriole relaxes, glomerular pressure drops, and GFR dips slightly. Creatinine bumps up a little, and that scares people, but that's actually the whole point—that's how you get kidney protection long-term.Jordan: High intraglomerular pressure causes hyperfiltration injury and scarring over time. Lowering that pressure protects the kidney long-term. The short-term GFR drop is the price you pay for long-term benefits.Dr. Arreaza: So let's talk about CKD, because this is where people panic.Mike: Right. ACE inhibitors and ARBs are not contraindicated in chronic kidney disease. In fact, they're recommended even in advanced stages. They reduce progression to kidney failure by about a third.Jordan: The key is how you use them. Start low. Check creatinine and potassium one to two weeks after starting, then periodically. A creatinine rise up to 30% from baseline is acceptable. That's not kidney injury, that's physiology.Dr. Arreaza: And what about potassium creeping up?Mike: You adjust the dose or add a potassium binder. You don't just automatically stop the drug.Dr. Arreaza: Now there is one absolute contraindication everyone needs to know about! (board exam test)Jordan: Bilateral renal artery stenosis. This is the big one. In these patients, the kidneys are completely dependent on angiotensin II–mediated efferent constriction to maintain GFR. Take that away, and GFR collapses.Mike: Creatinine can jump dramatically within days. If you see a creatinine rise of 20% or more shortly after starting an ACE inhibitor, you should be thinking about bilateral renal artery stenosis and stopping the drug immediately.Dr. Arreaza: After revascularization, though, many patients can tolerate ACE inhibitors again, so this isn't always permanent. What about cardiorenal syndrome? That's where things get uncomfortable.Mike: It is uncomfortable, but cardiorenal syndrome isn't a contraindication. These patients have severe heart failure and kidney disease, and their mortality is actually higher than patients with heart failure alone.Jordan: ACE inhibitors still reduce mortality and slow kidney disease progression in this group. Studies show that stopping ACE inhibitors during acute heart-failure admissions increases in-hospital mortality three- to four-fold.Dr. Arreaza: So we are cautious, but we don't avoid it.Mike: Exactly. Start low, titrate slowly, monitor labs closely, accept up to a 30% creatinine rise. You only stop if kidney function keeps worsening, or potassium gets dangerously high.Dr. Arreaza: Alright. Let's move on. What about mineralocorticoid receptor antagonists… MRA?Jordan: Spironolactone or eplerenone might reduce hospitalizations in HFpEF, but the data is mixed. This is more of a “select patients” situation.Mike: And you have to watch potassium and kidney function carefully, especially if they're already on an ACE inhibitor or ARB.Dr. Arreaza: What about sacubitril-valsartan, also known as Entresto®?Mike: Entresto may help patients with mildly reduced EF roughly in the 45 to 57% range. It's not first-line for HFpEF, but in select patients, it's reasonable.Dr. Arreaza: Now let's clarify one of the biggest sources of confusion: beta blockers.Jordan: Beta blockers are not a treatment for HFpEF itself. They're only indicated if the patient has another reason to be on them, like coronary disease or atrial fibrillation.Mike: And timing really matters here. You absolutely do not start beta blockers during acute decompensated heart failure. Their negative inotropic effects can make things worse when patients are volume overloaded.Jordan: But, and this is critical, you also don't stop them if the patient is already taking one. Abrupt withdrawal causes a sympathetic surge and dramatically increases mortality.Dr. Arreaza: If a patient is admitted on a beta blocker, what do we do?Mike: Continue it at the same dose or reduce it slightly if they're really unstable. Once they're euvolemic and stable, you can carefully titrate up.Jordan: And watch for chronotropic incompetence. HFpEF patients often rely on heart-rate response to exercise, and beta blockers can worsen exercise intolerance.Dr. Arreaza: Beyond medications, HFpEF is really about treating comorbidities. Aerobic activity can be an initial strategy to improve exercise intolerance and has evidence of improving aerobic function and quality of life. Sodium restriction: improves symptoms, does not decrease risk of death or hospitalizations.Mike: Hypertension control is huge. For diabetes, the SGLT-2 inhibitors will perform double duty. For obesity, weight loss improves symptoms, and GLP-1 agonists like semaglutide are absolute gamechangers.Jordan: Don't forget sleep apnea, atrial fibrillation, and lifestyle. Exercise improves the quality of life, even if it doesn't change hard outcomes. Lifestyle is the main treatment. Dr. Arreaza: And when should you refer to cardiology?Mike: You should refer when the diagnosis isn't clear; symptoms are not responding to treatment, difficult volume management, end-organ dysfunction, or if you are concerned about advanced heart failure.Dr. Arreaza: So, it has been a great discussion. What is the takeaway?Mike: HFpEF treatment isn't about one magic drug -- it's about volume control, SGLT2 inhibitors, smart use of RAAS blockade, and aggressive management of comorbidities.Jordan: And it's understanding the physiology, so you don't withhold life-saving therapies out of fear.Dr. Arreaza: Well said. If you found this helpful, share it with a friend or colleague and rate us wherever you listen. This is Dr. Arreaza, signing off.Jordan/Mike: Thanks! 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:Barzin A, Barnhouse KK, Kane SF. Heart Failure With Preserved Ejection Fraction. Am Fam Physician. 2025;112(4):435-440.Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure. Circulation. 2022;145(18):e895-e1032.Kittleson MM, Panjrath GS, Amancherla K, et al. 2023 ACC expert consensus decision pathway on management of heart failure with preserved ejection fraction. J Am Coll Cardiol. 2023;81(18):1835-1878.Anker SD, Butler J, Filippatos G, et al. Empagliflozin in heart failure with a preserved ejection fraction. N Engl J Med. 2021;385(16):1451-1461.Solomon SD, McMurray JJV, Claggett B, et al. Dapagliflozin in heart failure with mildly reduced or preserved ejection fraction. N Engl J Med. 2022;387(12):1089-1098.Pitt B, Pfeffer MA, Assmann SF, et al. Spironolactone for heart failure with preserved ejection fraction. N Engl J Med. 2014;370(15):1383-1392.Yusuf S, Pfeffer MA, Swedberg K, et al. Effects of candesartan in patients with chronic heart failure and preserved left-ventricular ejection fraction. Lancet. 2003;362(9386):777-781.Solomon SD, McMurray JJV, Anand IS, et al. Angiotensin-neprilysin inhibition in heart failure with preserved ejection fraction. N Engl J Med. 2019;381(17):1609-1620.Kosiborod MN, Abildstrøm SZ, Borlaug BA, et al. Semaglutide in patients with heart failure with preserved ejection fraction and obesity. N Engl J Med. 2023;389(12):1069-1084.Xie Y, Xu E, Bowe B, Al-Aly Z. Long-term cardiovascular outcomes of COVID-19. Nat Med. 2022;28(3):583-590.Puntmann VO, Carerj ML, Wieters I, et al. Outcomes of cardiovascular magnetic resonance imaging in patients recently recovered from COVID-19. JAMA Cardiol. 2020;5(11):1265-1273.Basso C, Leone O, Rizzo S, et al. Pathological features of COVID-19-associated myocardial injury. Eur Heart J. 2020;41(39):3827-3835.Nalbandian A, Sehgal K, Gupta A, et al. Post-acute COVID-19 syndrome. Nat Med. 2021;27(4):601-615.Badve SV, Roberts MA, Hawley CM, et al. Effects of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in adults with estimated GFR less than 60 mL/min per 1.73 m². Ann Intern Med. 2024;177(8):953-963.Navis G, Faber HJ, de Zeeuw D, de Jong PE. ACE inhibitors and the kidney: a risk-benefit assessment. Drug Saf. 1996;15(3):200-211.Textor SC, Novick AC, Tarazi RC, et al. Critical perfusion pressure for renal function in patients with bilateral atherosclerotic renal vascular disease. Ann Intern Med. 1985;102(3):308-314.Hackam DG, Spence JD, Garg AX, Textor SC. Role of renin-angiotensin system blockade in atherosclerotic renal artery stenosis and renovascular hypertension. Hypertension. 2007;50(6):998-1003.Ronco C, Haapio M, House AA, et al. Cardiorenal syndrome. J Am Coll Cardiol. 2008;52(19):1527-1539.Prins KW, Neill JM, Tyler JO, et al. Effects of beta-blocker withdrawal in acute decompensated heart failure. JACC Heart Fail. 2015;3(8):647-653.Jondeau G, Neuder Y, Eicher JC, et al. B-CONVINCED: Beta-blocker CONtinuation Vs. INterruption in patients with Congestive heart failure hospitalizED for a decompensation episode. Eur Heart J. 2009;30(18):2186-2192.Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/.

Dr. Alanna Morris-Simon, Senior Medical Director for US Medical Affairs at Bayer, describes the symptoms and diagnostics used to classify heart failure and the key at-risk populations for this condition. The rapidly evolving landscape of heart failure treatments now includes the Bayer drug KERENDIA, a non-steroidal MRA approved to reduce cardiovascular death and heart failure in adults with an ejection fraction of 40% or more. This drug is part of an emerging trend to treat multiple related conditions simultaneously  and could prevent the onset of heart failure and treat established heart failure. Alanna explains, "At a basic level, heart failure is a clinical syndrome, and that's important. I'm actually a heart failure cardiologist as well. And so this is important because patients have to have signs and symptoms. And those signs and symptoms really result from the heart being unable to either fill with blood properly or squeeze that blood out in a way that meets the body's demands. Either way, patients experience the same symptoms, and those include symptoms like swelling and weight gain, shortness of breath, either at rest or with activity, fatigue, abdominal swelling and bloating, loss of appetite, as well as other symptoms."   "If a doctor or a clinician suspects a diagnosis of heart failure, 99.99% of the time, they'll start by ordering an echocardiogram or a heart ultrasound. Of course, the guidelines tell us to get a chest X-ray, get labs, those sorts of things. But really, we make the diagnosis for the most part based on the results of an echocardiogram because that echocardiogram allows us to visualize how the heart is pumping. It allows us to classify the type of heart failure so that if we see that the squeeze of the heart is impaired, we call that heart failure with reduced ejection fraction. And that's when the ejection fraction or EF is 40% or less. If the EF is in the 41 to 49% range, we classify that as heart failure with mildly reduced ejection fraction. And if patients have an ejection fraction of 50% or greater, we call that heart failure with preserved ejection fraction or HFpEF."   "And we were excited that the FDA actually granted a priority review for KERENDIA because this really only occurs when the FDA recognizes that a treatment can fill a significant unmet need for a disease or a population of patients. And lo and behold, in July of 2025, finerenone was approved by the FDA under the trade name KERENDIA to reduce the risk of cardiovascular death, hospitalization for heart failure, and urgent heart failure visits in adults with an ejection fraction of 40% or more." #Bayer #Finerenone #Pharma #HeartFailure #HFpEF #HFmrEF #MRA #UnmetNeed #Cardiology #KERENDIA #FDA #CardiovascularHealth #MedicalBreakthrough #PatientCare #Innovation Bayer.com Download the transcript here

Dr. Alanna Morris-Simon, Senior Medical Director for US Medical Affairs at Bayer, describes the symptoms and diagnostics used to classify heart failure and the key at-risk populations for this condition. The rapidly evolving landscape of heart failure treatments now includes the Bayer drug KERENDIA, a non-steroidal MRA approved to reduce cardiovascular death and heart failure in adults with an ejection fraction of 40% or more. This drug is part of an emerging trend to treat multiple related conditions simultaneously  and could prevent the onset of heart failure and treat established heart failure. Alanna explains, "At a basic level, heart failure is a clinical syndrome, and that's important. I'm actually a heart failure cardiologist as well. And so this is important because patients have to have signs and symptoms. And those signs and symptoms really result from the heart being unable to either fill with blood properly or squeeze that blood out in a way that meets the body's demands. Either way, patients experience the same symptoms, and those include symptoms like swelling and weight gain, shortness of breath, either at rest or with activity, fatigue, abdominal swelling and bloating, loss of appetite, as well as other symptoms."   "If a doctor or a clinician suspects a diagnosis of heart failure, 99.99% of the time, they'll start by ordering an echocardiogram or a heart ultrasound. Of course, the guidelines tell us to get a chest X-ray, get labs, those sorts of things. But really, we make the diagnosis for the most part based on the results of an echocardiogram because that echocardiogram allows us to visualize how the heart is pumping. It allows us to classify the type of heart failure so that if we see that the squeeze of the heart is impaired, we call that heart failure with reduced ejection fraction. And that's when the ejection fraction or EF is 40% or less. If the EF is in the 41 to 49% range, we classify that as heart failure with mildly reduced ejection fraction. And if patients have an ejection fraction of 50% or greater, we call that heart failure with preserved ejection fraction or HFpEF."   "And we were excited that the FDA actually granted a priority review for KERENDIA because this really only occurs when the FDA recognizes that a treatment can fill a significant unmet need for a disease or a population of patients. And lo and behold, in July of 2025, finerenone was approved by the FDA under the trade name KERENDIA to reduce the risk of cardiovascular death, hospitalization for heart failure, and urgent heart failure visits in adults with an ejection fraction of 40% or more." #Bayer #Finerenone #Pharma #HeartFailure #HFpEF #HFmrEF #MRA #UnmetNeed #Cardiology #KERENDIA #FDA #CardiovascularHealth #MedicalBreakthrough #PatientCare #Innovation Bayer.com Listen to the podcast here

Da li je predsednik Srbije postao TikToker? U 223. epizodi Njuz Podkasta analiziramo nadrealni "duel" između Aleksandra Vučića i Bake Praseta. Dok predsednik pokušava da osvoji mlađu publiku na TikToku, mi se pitamo: da li je ovo promocija kocke i rijaliti kulture na državnom nivou? Osim viralnog spoja Vučića i Bake Praseta, bavimo se i drugim gorućim temama: Zašto RTS nije prenosio finale Novaka Đokovića i da li je Nole postao neprijatelj režima? Istražujemo i skandal u Petoj gimnaziji (slučaj "Dronka"), kontroverzni "Mrdićev zakon" koji preti pravosuđu, kao i aferu sa "kolačarom" iz redova SNS-a.

Dr. Mary Newport shares groundbreaking research analyzing cholesterol profiles across 40 years of studies, challenging conventional wisdom about saturated fat and heart health. We discuss her findings on MCT oil for brain health, the 288 caregiver reports showing cognitive improvements, and practical protocols for using coconut oil and ketones.Dr. Mary Newport, physician and Alzheimer's researcher, joins us to discuss her latest research that challenges decades of assumptions about coconut oil and saturated fat. In this interview, we explore: • Her comprehensive analysis of 26 studies spanning 40 years (984 lipid profiles) showing coconut oil's unexpected effects on cholesterol • The 288 caregiver reports documenting improvements in memory, cognition, and daily function • How medium-chain triglycerides (MCTs) may provide an alternative fuel source for aging brains • Practical protocols for incorporating coconut oil and MCT oil into your diet • The controversial history of dietary fat guidelines and the trans fat problem • Why the medical establishment has been slow to acknowledge ketone research Dr. Newport's work began with her husband Steve's dramatic response to coconut oil after his early-onset Alzheimer's diagnosis. Her research has since expanded to include hundreds of case reports and comprehensive lipid analysis.

Stroke risk doesn't begin suddenly it builds silently through inflammation and vascular damage. In Part 2, Dr. Ana Rosa explains why inflammation, insulin resistance, and unstable plaque are the true drivers of stroke risk, and why blockage percentage alone doesn't tell the full story. Learn how doctors use imaging like carotid ultrasound, MRI, and MRA to identify dangerous soft plaque early and how daily lifestyle habits can slow, stop, or even reverse vascular damage before it leads to stroke.

Hostem Press klubu byla předsedkyně senátorského klubu ANO Jana Mračková Vildumetzová. Romana Navarová s ní probírala taky aktuální téma - hlasování o důvěře vládě. Narozdíl od části poslanců, Mračková Vildumetzová novému kabinetu věří. Podle ní jsou ministři připraveni pracovat. Poslechněte si celý rozhovor.See omnystudio.com/listener for privacy information.

Friend of the pod Weeza AKA Australia's First Attractive Comedian AKA Elouise Eftos is back!! What better pair to talk about insecure men, and to break down some cooked r/MensRights posts? Babe, you're in for a treat. LINKS Vote for Dancing2 in the Hottest 100 https://www.abc.net.au/triplej/countdown/hottest100 Follow Elouise Eftos on IG @weezasqueeza See Elouise live https://linktr.ee/elouise Check out @itsalotpod on IG at https://bit.ly/itsalot-instagram Review the podcast on Apple Podcasts https://bit.ly/ial-review Follow LiSTNR Entertainment on IG @listnrentertainment Follow LiSTNR Entertainment on TikTok @listnrentertainment Get instructions on how to access transcripts on Apple podcasts https://bit.ly/3VQbKXY CREDITS Host: Abbie Chatfield @abbiechatfield Guest: Elouise Eftos @weezasqueeza Executive Producer and Editor: Amy Kimball @amy.kimballDigital and Social and Video Producer: Oscar Gordon @oscargordon Social and Video Producer: Justin Hill @jus_hillIt's A Lot Social Media Manager: Julia ToomeyManaging Producer: Sam Cavanagh Find more great podcasts like this at www.listnr.com/See omnystudio.com/listener for privacy information.

Download the Guide here: https://cdfinancial.com FREE 15-minute call: https://calendly.com/charlesdzama/complimentary-15-minute-phone-call-youtubeAre you truly ready to retire? This episode of the CD Financial Podcast dives into key questions about eligibility and financial management, helping you to understand the path to getting ready for retirement. We discuss essential aspects of retirement planning to ensure your financial planning is robust.Newsletter: https://cdfinancial.com/newsletterSocials:Instagram: https://instagram.com/cdfinancial.llc/Facebook: https://facebook.com/cdfinancialLinkedIn: https://linkedin.com/company/cd-financial

 Ted speaks with J. Irons of Miovic Reinhardt Associates, a Seattle-based design-build firm known for its deep commitment to craftsmanship, sustainability, and client-centered building. J. reflects on his early love of design, his path through Berkeley and the University of Washington, and how curiosity led him from architecture into business development and leadership.They explore the unique design culture of the Pacific Northwest — from biophilic buildings and civic responsibility to the influence of Seattle's natural beauty on the region's architectural identity. J. discusses the values that drive today's homeowners, including the desire for meaningful spaces, outdoor living, and wellness-focused environments.Ted and J. also examine how construction has evolved, the impact of rising costs, and why permitting delays remain one of the industry's biggest frustrations. J. offers perspective on improving efficiency, managing client expectations during long timelines, and how MRA approaches cost planning rather than cost cutting.The episode closes with a thoughtful discussion on AI: its misconceptions, its potential to enhance efficiency, and why human creativity, curiosity, and connection remain irreplaceable in the building process.TOPICS DISCUSSED01:30 Early Career & Path Into Architecture04:20 Curiosity, Sales & Becoming a Rainmaker08:10 Understanding Clients Through Deep Listening10:00 Childhood Creativity & Design Foundations14:00 Seattle's Design Culture & Regional Inspiration17:10 West Coast Mindset & Sense of Place21:00 Wellness, Balance & Human-Centered Spaces23:00 What Clients Value in Their Homes25:30 Outdoor Living & Modern Landscaping28:30 Evolution of Residential Construction30:10 Costs, Efficiency & Permitting Delays & System Challenges37:00 AI Misconceptions & Practical Uses47:20 Creativity, Curiosity & Human Value48:45 Human Connection & The Role of Sales CONNECT WITH GUESTJ. IronsWebsiteLinkedInInstagramKEY QUOTES FROM EPISODE"Alignment gives people the space to connect""People are yearning for connection""Engagement is about creating opportunities"

Novo Nordisk, the pharmaceutical company behind popular GLP-1 medications like Wegovy and Ozempic, recently announced that its phase 3, two-year trial examining GLP-1 medications for Alzheimer's failed to produce a significant reduction in disease progression.While these results are discouraging, they may have revealed something vital about Alzheimer's treatment.In this video, Dr. Bret Scher breaks down the recent failure of Novo Nordisk's evoke and evoke+ trials and what it teaches us about the limitations of a drug-only approach to Alzheimer's treatment.Key topics covered:Why GLP-1s may not be enough for Alzheimer'sThe link between glucose metabolism and brain energy failureHow ketones offer an alternative fuel for the brainEarly research on ketogenic therapy for cognitive impairmentWhy nutritional interventions deserve more scientific attentionWith Alzheimer's affecting millions and costing billions, it's time to shine a light on metabolic strategies that directly support brain energy, reduce inflammation, and improve cognitive function.

Tim and Guy are up against it. It's only the second watch and Guy fears the pair are in too deep a water already. That is a scary prospect for two men looking down the barrel of 12 more watches in just 4 short days. Let us gaze upon the beautiful cinematography and excellent acting of Joker 2 and marvel at how it stills somehow manages to be a really stinky film. Tim offers advice for his friends in the MRA community and swears to all Holy powers above that David Bowie most probably played The Sims.Support us, and watch these episodes early, ad-free and in video form (plus bonus content) at twioat.substack.com Hosted on Acast. See acast.com/privacy for more information.

Alpská ves, strmě stoupající v prudkém slunci, v pozadí s průsmykem, do jehož oparu lanovka vyklápěla stříbrné a zlaté záblesky. Mračná modrošedá clona je vzápětí o pár metrů vedle vyfukovala nazpět. Lesky obloukem pomalu klesaly do údolí. Výjev působil poklidně: průsmyk nad vesnicí se nacházel ve vzdálenosti, kam lidské oko dohlédlo, tenké mraky se skal dotýkaly ohleduplně a kabiny lanovky odrážející paprsky se oběma směry posunovaly zvolna a důkladně.

Alpská ves, strmě stoupající v prudkém slunci, v pozadí s průsmykem, do jehož oparu lanovka vyklápěla stříbrné a zlaté záblesky. Mračná modrošedá clona je vzápětí o pár metrů vedle vyfukovala nazpět. Lesky obloukem pomalu klesaly do údolí. Výjev působil poklidně: průsmyk nad vesnicí se nacházel ve vzdálenosti, kam lidské oko dohlédlo, tenké mraky se skal dotýkaly ohleduplně a kabiny lanovky odrážející paprsky se oběma směry posunovaly zvolna a důkladně.Všechny díly podcastu Ranní úvaha můžete pohodlně poslouchat v mobilní aplikaci mujRozhlas pro Android a iOS nebo na webu mujRozhlas.cz.

In a small mining town in the Colorado Rockies, a man and his dog walked into the mountains and never returned. Less than a year later, another man working in the exact same location took interest in the disappearance from the year before. Soon he would follow the same trail and he too would vanish.  One mountain, two men, countless theories.SourcesFRNWH Unsolved Strange Outdoors CBSNEWS Chicago Tribune Historic Mysteries Colorado.gov MRA.orgSupport us on Patreon for as little as $1 a month, with benefits starting at the $3 tier!Follow us on Instagram at offthetrailspodcastFollow us on Facebook at Off the Trails PodcastIf you have your own outdoor misadventure (or adventure) story that you'd like us to include in a listener episode, send it to us at offthetrailspodcast@gmail.com  Please take a moment to rate and review our show, and a big thanks if you already have!**We do our own research and try our best to cross-reference reliable sources to present the most accurate information we can. Please reach out to us if you believe we have mispresented any information during this episode, and we will be happy to correct ourselves in a future episode.

In this listener mailbag episode, SLP grad students, clinicians, and private practice owners call the Minivan Meltdown line to share what's really happening behind the scenes in our field.First, a grad student with a repaired bilateral cleft lip and palate describes a supervisor who told her she “can't be a good SLP” because of her speech difference. Dr. Jeanette Benigas and Preston Lewis, SLP, break down discrimination in training, how CCC standards exclude disabled and Deaf clinicians, and why difference is not disorder.Next, a medical SLP who accidentally dropped her CCC in 2008 shares what happened when she kept her state license and kept working. We talk shame culture, confusion around the CCC, mutual recognition agreements, and why so many CCC “rules” fall apart under scrutiny.Finally, a private practice owner in Kentucky explains how pediatric F-codes (like F80) were treated as “mental health” diagnoses, triggering visit caps, mass denials, and 12–18 month reimbursement delays. We unpack F-code chaos, the Mental Health Parity Act, and why small practices shouldn't be the ones stuck fighting insurers.If you've ever been gaslit by a supervisor, confused by the CCC, or crushed by insurance games, this episode is your reminder: you're not the problem. The system is.Stop paying to track ASHA-approved CEUs. Save your money and set up for a FREE CEU/PDH tracker with Speech Therapy PD. While you are there, get $10 off a professional subscription with the code FixSLP10!

Pulsatile tinnitus — the perception of a rhythmic sound in sync with the heartbeat — can be a key indicator of underlying vascular or structural pathology. In this episode, JNIS new Editor-in-Chief Dr. Michael Chen speaks with Dr. Madhavi Duvvuri and Dr. Matthew Robert Amans, authors of Non-invasive imaging modalities for diagnosing pulsatile tinnitus: a comprehensive review and recommended imaging algorithm. They are both from the University of California San Francisco, USA. They discuss the current evidence base, highlight the strengths and limitations of non-invasive imaging techniques such as MRI, MRA, CT, and CTA, and outline a practical algorithm for streamlining diagnosis.    Please subscribe to the JNIS podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/4aZmlpT) or Spotify (https://spoti.fi/3UKhGT5). We'd love to hear your feedback on social media - @JNIS_BMJ.

Specijalna epizoda sa specijalnom gošćom! U goste nam je konačno stigla Iva Parađanin Lalić ( @tamponzona , Joj majko), a sa njom i priče o majčinstvu bez filtera, nerealnim očekivanjima i zašto se o teškim stranama roditeljstva premalo govori. Ali to nije sve! Spremili smo vam preporuke za svako raspoloženje: od "feel-good" serija koje će vam vratiti veru u život, do verovatno najmračnije i najteže drame koju smo ikada gledali. Prisetili smo se i naše opsesije španskim serijama iz '90-ih (Kralj stočara, seća li se ko?).

Heart failure remains a leading cause of hospitalization, prompting ongoing research into treatment strategies that improve outcomes for patients. A recent study explores the potential of combining an MRA agent and SGLT2 inhibitor, showing meaningful clinical benefit while also reinforcing the need for thoughtful patient selection and safety monitoring. Tune in to explore how this evidence may shape pharmacist-driven care and contribute to more confident, individualized treatment decisions.HOSTJoshua Davis Kinsey, PharmDVP, EducationCEimpactGUESTZachary Cox, PharmDProfessorLipscomb University College of PharmacyJoshua Davis Kinsey has no relevant financial relationships to disclose. Zachary Cox is a consultant for Roche, Reprieve Cardiovascular, Abiomed, Vectorious, Kestra Medical Technologies, and WhiteSwell. He was also a consultant for Lexicon Pharmaceuticals (ended 2025) and conducted research for AstraZeneca (ended 2024). All relevant financial relationships have been mitigated.  Pharmacists, REDEEM YOUR CPE HERE!CPE is available to Health Mart franchise members onlyTo learn more about Health Mart, click here: https://join.healthmart.com/CPE INFORMATION Learning ObjectivesUpon successful completion of this knowledge-based activity, participants should be able to:1. Describe the clinical evidence supporting the use of multiple drug classes in combination therapy for heart failure.2. Identify pharmacist considerations for evaluating patient-specific factors related to efficacy and safety of combination treatment approaches.0.05 CEU/0.5 HrUAN: 0107-0000-25-299-H01-PInitial release date: 10/20/2025Expiration date: 10/20/2026Additional CPE details can be found here.

Heart failure remains a leading cause of hospitalization, prompting ongoing research into treatment strategies that improve outcomes for patients. A recent study explores the potential of combining an MRA agent and SGLT2 inhibitor, showing meaningful clinical benefit while also reinforcing the need for thoughtful patient selection and safety monitoring. Tune in to explore how this evidence may shape pharmacist-driven care and contribute to more confident, individualized treatment decisions.HOSTJoshua Davis Kinsey, PharmDVP, EducationCEimpactGUESTZachary Cox, PharmDProfessorLipscomb University College of PharmacyJoshua Davis Kinsey has no relevant financial relationships to disclose. Zachary Cox is a consultant for Roche, Reprieve Cardiovascular, Abiomed, Vectorious, Kestra Medical Technologies, and WhiteSwell. He was also a consultant for Lexicon Pharmaceuticals (ended 2025) and conducted research for AstraZeneca (ended 2024). All relevant financial relationships have been mitigated.  Pharmacist Members, REDEEM YOUR CPE HERE! Not a member? Get a Pharmacist Membership & earn CE for GameChangers Podcast episodes! (30 mins/episode)CPE INFORMATIONLearning ObjectivesUpon successful completion of this knowledge-based activity, participants should be able to:1. Describe the clinical evidence supporting the use of multiple drug classes in combination therapy for heart failure.2. Identify pharmacist considerations for evaluating patient-specific factors related to efficacy and safety of combination treatment approaches.0.05 CEU/0.5 HrUAN: 0107-0000-25-299-H01-PInitial release date: 10/20/2025Expiration date: 10/20/2026Additional CPE details can be found here.Follow CEimpact on Social Media:LinkedInInstagram

On this episode of Together We Win, your hosts, President Steve Clark and VP Kerry Miller, sit down with Chef Eric Leblanc, MRA 2025 Chef of the Year and Culinary Director of Burtons Grill & Bar and Red Heat Tavern. From his early days in the kitchen to leading major restaurant operations, Eric's career is a masterclass in what a passion for the culinary world can achieve. He shares some of his favorite experiences along the way and gives us a behind-the-scenes look at exciting upcoming projects, including the opening of Burtons Grill & Bar's 24th location. You won't want to miss it!

Dubrovnik koji je postao kulisa, umiveno ustaštvo na ulicama Zagreba, potrošnja koja nadomješta ljudskost, majčinstvo o kakvom nije pristojno govoriti, banke kao sablasni stupovi naših života, emocije kakve ne viđamo u reklamama, a osjećamo ih tako snažno... To je svijet koji Maša Kolanović istražuje u svojoj novoj zbirci priča "Poštovani kukci". Autorica tekstom i crtežima oblikuje onaj sablasni i teško izrecivi višak materijalne strane ljudske egzistencije, dok smještanje priča u razdoblje tranzicije u Hrvatskoj dodatno pojačava njihov jezivi efekt. "Poštovane kukce" žanrovski bi se moglo opisati kao tranzicijsku gotiku, postsocijalističku zonu sumraka, jezivo stvarnosnu prozu… Mračno i apsurdne, a opet duboko intimne, snažne i društveno osjetljive priče. Nagrada Europske unije za književnost 2020. i Godišnja nagrada Vladimir Nazor 2020. Redateljica: Stephanie Jamnicky, dramatizacija: Kristina Kegljen

CME credits: 1.00 Valid until: 24-09-2026 Claim your CME credit at https://reachmd.com/programs/cme/tbd/37671/ Patients with chronic kidney disease (CKD) and heart failure with reduced ejection fraction (HFrEF) will achieve improved benefits from optimized use of guideline directed medical therapy, however healthcare providers may not be utilizing renin–angiotensin aldosterone system inhibitors (RAASi) and mineralocorticoid receptor antagonists (MRA) use due to hyperkalemia concerns. Using a multidisciplinary approach, experts in cardiology and nephrology address the clinical implications of suboptimal RAASi and MRA use, compare real-world data on the efficacy and safety of oral potassium binders, and developing evidence-based treatment strategies that incorporate potassium binders to improve outcomes in patients with CKD and HF who are at risk for or experiencing hyperkalemia.

CME credits: 1.00 Valid until: 24-09-2026 Claim your CME credit at https://reachmd.com/programs/cme/tbd/37670/ Patients with chronic kidney disease (CKD) and heart failure with reduced ejection fraction (HFrEF) will achieve improved benefits from optimized use of guideline directed medical therapy, however healthcare providers may not be utilizing renin–angiotensin aldosterone system inhibitors (RAASi) and mineralocorticoid receptor antagonists (MRA) use due to hyperkalemia concerns. Using a multidisciplinary approach, experts in cardiology and nephrology address the clinical implications of suboptimal RAASi and MRA use, compare real-world data on the efficacy and safety of oral potassium binders, and developing evidence-based treatment strategies that incorporate potassium binders to improve outcomes in patients with CKD and HF who are at risk for or experiencing hyperkalemia.

CME credits: 1.00 Valid until: 24-09-2026 Claim your CME credit at https://reachmd.com/programs/cme/tbd/37676/ Patients with chronic kidney disease (CKD) and heart failure with reduced ejection fraction (HFrEF) will achieve improved benefits from optimized use of guideline directed medical therapy, however healthcare providers may not be utilizing renin–angiotensin aldosterone system inhibitors (RAASi) and mineralocorticoid receptor antagonists (MRA) use due to hyperkalemia concerns. Using a multidisciplinary approach, experts in cardiology and nephrology address the clinical implications of suboptimal RAASi and MRA use, compare real-world data on the efficacy and safety of oral potassium binders, and developing evidence-based treatment strategies that incorporate potassium binders to improve outcomes in patients with CKD and HF who are at risk for or experiencing hyperkalemia.

CME credits: 1.00 Valid until: 24-09-2026 Claim your CME credit at https://reachmd.com/programs/cme/tbd/36194/ Patients with chronic kidney disease (CKD) and heart failure with reduced ejection fraction (HFrEF) will achieve improved benefits from optimized use of guideline directed medical therapy, however healthcare providers may not be utilizing renin–angiotensin aldosterone system inhibitors (RAASi) and mineralocorticoid receptor antagonists (MRA) use due to hyperkalemia concerns. Using a multidisciplinary approach, experts in cardiology and nephrology address the clinical implications of suboptimal RAASi and MRA use, compare real-world data on the efficacy and safety of oral potassium binders, and developing evidence-based treatment strategies that incorporate potassium binders to improve outcomes in patients with CKD and HF who are at risk for or experiencing hyperkalemia.

CME credits: 1.00 Valid until: 24-09-2026 Claim your CME credit at https://reachmd.com/programs/cme/the-critical-interplay-ckd-hf-and-hyperkalemia/36193/ Patients with chronic kidney disease (CKD) and heart failure with reduced ejection fraction (HFrEF) will achieve improved benefits from optimized use of guideline directed medical therapy, however healthcare providers may not be utilizing renin–angiotensin aldosterone system inhibitors (RAASi) and mineralocorticoid receptor antagonists (MRA) use due to hyperkalemia concerns. Using a multidisciplinary approach, experts in cardiology and nephrology address the clinical implications of suboptimal RAASi and MRA use, compare real-world data on the efficacy and safety of oral potassium binders, and developing evidence-based treatment strategies that incorporate potassium binders to improve outcomes in patients with CKD and HF who are at risk for or experiencing hyperkalemia.

CME credits: 1.00 Valid until: 24-09-2026 Claim your CME credit at https://reachmd.com/programs/cme/tbd/37672/ Patients with chronic kidney disease (CKD) and heart failure with reduced ejection fraction (HFrEF) will achieve improved benefits from optimized use of guideline directed medical therapy, however healthcare providers may not be utilizing renin–angiotensin aldosterone system inhibitors (RAASi) and mineralocorticoid receptor antagonists (MRA) use due to hyperkalemia concerns. Using a multidisciplinary approach, experts in cardiology and nephrology address the clinical implications of suboptimal RAASi and MRA use, compare real-world data on the efficacy and safety of oral potassium binders, and developing evidence-based treatment strategies that incorporate potassium binders to improve outcomes in patients with CKD and HF who are at risk for or experiencing hyperkalemia.

CME credits: 1.00 Valid until: 24-09-2026 Claim your CME credit at https://reachmd.com/programs/cme/tbd/37673/ Patients with chronic kidney disease (CKD) and heart failure with reduced ejection fraction (HFrEF) will achieve improved benefits from optimized use of guideline directed medical therapy, however healthcare providers may not be utilizing renin–angiotensin aldosterone system inhibitors (RAASi) and mineralocorticoid receptor antagonists (MRA) use due to hyperkalemia concerns. Using a multidisciplinary approach, experts in cardiology and nephrology address the clinical implications of suboptimal RAASi and MRA use, compare real-world data on the efficacy and safety of oral potassium binders, and developing evidence-based treatment strategies that incorporate potassium binders to improve outcomes in patients with CKD and HF who are at risk for or experiencing hyperkalemia.

CME credits: 1.00 Valid until: 24-09-2026 Claim your CME credit at https://reachmd.com/programs/cme/tbd/37674/ Patients with chronic kidney disease (CKD) and heart failure with reduced ejection fraction (HFrEF) will achieve improved benefits from optimized use of guideline directed medical therapy, however healthcare providers may not be utilizing renin–angiotensin aldosterone system inhibitors (RAASi) and mineralocorticoid receptor antagonists (MRA) use due to hyperkalemia concerns. Using a multidisciplinary approach, experts in cardiology and nephrology address the clinical implications of suboptimal RAASi and MRA use, compare real-world data on the efficacy and safety of oral potassium binders, and developing evidence-based treatment strategies that incorporate potassium binders to improve outcomes in patients with CKD and HF who are at risk for or experiencing hyperkalemia.

CME credits: 1.00 Valid until: 24-09-2026 Claim your CME credit at https://reachmd.com/programs/cme/tbd/37675/ Patients with chronic kidney disease (CKD) and heart failure with reduced ejection fraction (HFrEF) will achieve improved benefits from optimized use of guideline directed medical therapy, however healthcare providers may not be utilizing renin–angiotensin aldosterone system inhibitors (RAASi) and mineralocorticoid receptor antagonists (MRA) use due to hyperkalemia concerns. Using a multidisciplinary approach, experts in cardiology and nephrology address the clinical implications of suboptimal RAASi and MRA use, compare real-world data on the efficacy and safety of oral potassium binders, and developing evidence-based treatment strategies that incorporate potassium binders to improve outcomes in patients with CKD and HF who are at risk for or experiencing hyperkalemia.

SLP fear is real, but facts are louder. In this Fix SLP Podcast episode, Dr. Jeanette Benigas, SLP, and Preston Lewis, MS/SLP, unpack the top fears heard daily: Praxis retakes, reinstating the ASHA CCC, supervision requirements, getting overlooked by misinformed employers, whether CCC status affects international portability via the Mutual Recognition Agreement (MRA) with the UK, Canada, Ireland, Australia, and New Zealand, and how employer education, not court battles, drives SLP autonomy and better jobs.This episode shows how to turn fear into facts: evaluating your local job market, approaching HR about removing CCC requirements, clarifying supervision rules, and proving that patient outcomes, not extra letters, define true competence in the field.Thank you to our sponsor, ⭐️ Informed Jobs, ⭐️ connecting SLPs with meaningful job opportunities and career resources to keep you informed and empowered. Explore more at informedslp.com. Just click the menu, then select "Jobs"!

Dr. Jeff Maki discusses current considerations for contrast enhanced MRA exams as well as liver imaging Claim your Credit Here This MR iCast episode is supported by Bracco Diagnostics Inc. through an unrestricted educational grant.

U najnovijoj epizodi Njuz Podkasta EP203 zaranjamo u epicentar haosa: otkriven je tajni plan Aleksandra Vučića za gašenje N1 i Nove S! Detaljno analiziramo ekskluzivni snimak koji je objavio KRIK i pitamo se da li je ovo kraj slobodnih medija u Srbiji. Pored toga, vraćamo se na uzavreli avgust i proteste "Srbija protiv nasilja". Komentarišemo najbizarnije trenutke – od Vučićeve povrede na staklu i tuče naprednjaka u Veterniku, do viralnih scena sa momkom sa fajtalicom. Zaranjamo u fenomen "Ćacilenda", analiziramo hapšenje Tome Mone i Vesićevu bolest, i ne zaobilazimo sramotu sa pismom Gardijanu. Na kraju, bavimo se opasnim napadom vlasti na Univerzitet i Filozofski fakultet i Đukinom idejom o pobedi "stranačke pešadije".

Inštitut za slovensko kulturo v Benečiji je kulturno in jezikovno središče zamejskih Slovencev v Italiji, ki prebivajo od Kanalske doline in Rezije do Terskih in Nadiških dolin. Ustanovljen je bil leta 2006 z namenom, da kot močna krovna organizacija omogoči bolj učinkovito uveljavljanje in ohranjanje slovenskega jezika in kulture v krajih, kjer je pripoved zgodovine v odnosu do Slovencev težka in mračna. “Prišel sem z dežja pod kap.” To preprosto reklo zgovorno označuje razmere v Benečiji takoj po drugi svetovni vojni. S temi besedami se začne knjiga Mračna leta Benečije, ki sta jo pod psevdonimom NAZ napisala duhovnika Marino Qualizza in Božo Zuanella. Knjiga o delovanju tajnih organizacij v Benečiji je izšla v italijanščini leta 1996 v Čedadu, slovenski prevod pa je Cankarjeva založba v Ljubljani objavila dve leti pozneje. Duhovnika sta bila za svoje delo preganjana na sodišču, pogum, s katerim sta prekinila molk, dolg desetletja, pa naj bi vplival tudi na njuni profesionalni karieri. Oba sta v visoki starosti umrla maja 2025. Ravno tisti mesec pa je Inštitut za slovensko kulturo v Benečiji izvolil novo vodstvo sedmih posameznic različnih generacij, vseh izredno dejavnih na raznih področjih življenja slovenske manjšine v Benečiji. Prvi večji dogodek so članice novega vodstva posvetile ravno umrlima duhovnikoma in lokalno skupnost pozvale k skupnemu branju njunih besed. Besedilo je bilo na voljo tako v slovenščini kot v italijanščini, branje pa je spodbudilo tudi marsikatero zgodbo starejših generacij, ki so ji lahko prisluhnili mladi, ki teh časov niso doživeli. Predstavnice vodstva smo povabili k pogovoru o tem, kako vidijo vlogo Inštituta za slovensko kulturo v regiji in širše ter položaju slovenske manjšine v sedanjih časih.

CME credits: 0.50 Valid until: 30-07-2026 Claim your CME credit at https://reachmd.com/programs/cme/addressing-ckm-mortality-morbidity-in-patients-with-ckd-and-t2d-the-role-of-combined-ns-mra-sglt2i-therapy/29907/ This three-part panel series explores how emerging evidence from the CONFIDENCE trial is shaping the future of cardio-kidney-metabolic (CKM) care. In Chapter 1, the experts discuss the additive benefits and safety of combining a nonsteroidal MRA and an SGLT2 inhibitor. Chapter 2 focuses on patient selection and individualized strategies for initiating combination therapy. Chapter 3 shifts to real-world implementation, highlighting multidisciplinary collaboration and strategies to improve adherence and continuity of care. Together, this series provides a roadmap to optimize outcomes in patients with CKD and T2D.=

Send us a textGeorge Adams is in his 7th year as the Head Strength and Conditioning Coach at Madison-Ridgeland Academy. Adams oversees all aspects of the MRA athletics strength and conditioning program. Since arriving at MRA, Adams has been a part of eight state championships (three football, three boys' & girls' track and field, and two boys' basketball). He has served on the NHSSCA Mississippi Advisory Board since 2020, was named the 2022 Mississippi State Coach of the Year, and is now the Mississippi State Director for the association. Coach Adams has also served as a strength and conditioning coach with the Minnesota Vikings and at the following college athletic programs: Methodist University, Southern Miss, Marshall University, University of Georgia, Embry-Riddle Aeronautical University, and the University of Georgia. Periodization for high school sportsSpeed and agility drillsInjury prevention for teen athletesCoaching high school athletesWeightlifting technique youthStrength benchmarks for athletesIn-season vs offseason liftingAthletic performance podcastHigh school football trainingYouth performance traininghttps://youtube.com/@platesandpancakes4593https://instagram.com/voodoo4power?igshid=YmMyMTA2M2Y=https://voodoo4ranch.com/To possibly be a guest or support the show email Voodoo4ranch@gmail.comhttps://www.paypal.com/paypalme/voodoo4ranch

Join us on the Fireside Chat as we speak with Guy. He has been an MRA for a long time done a few small bits of advocacy here and there, wrote an article for AVFM and fancies himself as a social scientist but totally unqualified, kinda like a male version of Allison in that regard.

In this month's episode of Together We Win, MRA's President Steve Clark and VP Kerry Miller sit down with Kathi Turner, CEO of Turner's Seafood Grill & Market and the newest Chair of the Massachusetts Restaurant Association Board. Together, they discuss the evolution of the hospitality industry and the enduring importance of customer connection in an increasingly digital world. From embracing new technologies to staying rooted in people-first values, Kathi shares insights from her years of leadership and offers a thoughtful look at where the industry is headed. Whether you're leading a team or greeting guests at the door, this episode is a powerful reminder that success in hospitality still starts with human connection.

In this podcast, Ty J. Gluckman, MD, MHA, discusses the pivotal phase III FINEARTS-HF trial and how the treatment landscape is evolving for patients with heart failure (HF) with mildly reduced or preserved ejection fraction, including:The emerging role of mineralocorticoid receptor antagonists in HF careFinerenone's efficacy in reducing composite cardiovascular death and worsening HF events Why safety must be monitored, especially considering hyperkalemia riskWhere HF guideline recommendations lack compared with the current evidence PresenterTy J. Gluckman, MD, MHAMedical Director, Center for Cardiovascular Analytics, Research, and Data Science (CARDS)Providence Heart InstituteProvidence Health SystemPortland, OregonProgram page: https://bit.ly/448XcH0

Zatímco oficiální ekonomické ukazatele jako HDP nebo inflace reagují na vývoj s určitým zpožděním, existuje celá řada neoficiálních, často až bizarních indikátorů, které se snaží předpovědět blížící se hospodářské problémy s větším předstihem. Některé z nich – jako prodeje mražené pizzy, rtěnek nebo spodního prádla – si už vysloužily své místo v populárním ekonomickém folklóru.Jak ale říká ekonom Dominik Stroukal, má to své opodstatnění: „Ve chvíli, kdy chudneš, tak začneš kupovat věci, kterým říkáme podřadné statky. Mražená pizza je typicky podřadný statek – čím jsi chudší, kupuješ si ho víc,“ uvedl v podcastu Ve vatě.Zkušenosti z minulosti, například z velké finanční krize nebo pandemie, naznačují, že rostoucí prodej levného jídla či kosmetiky koreluje s poklesem ekonomické aktivity. „Viděli jsme to v roce 2009, ale to už jsme věděli, že jsme v krizi. Takže kdyby ten ukazatel přišel dřív, třeba v roce 2007, bylo by to mnohem zajímavější,“ říká ekonom Stroukal z Metropolitní univerzity Praha.Dalším z populárních ukazatelů je tzv. „lipstick index“ – hypotéza, podle které se v době nejistoty zvyšuje prodej rtěnek. Stroukal vysvětluje: „Když je na trhu práce těsno, ženy více investují do svého vzhledu.“ Rtěnka je levnější než nový outfit, ale pořád výrazná změna. Takže dává smysl, že její prodej v předkrizových dobách roste.I muži mění své nákupní chování, když se blíží recese. Slavný „index spodního prádla“, jehož autorství je přisuzovánu Alanu Greenspanovi, někdejšímu šéfovi americké centrální banky, tvrdí, že muži v krizi omezí nákupy nových trenýrek. „Je to věc, kterou nikdo nevidí, takže na ní můžeš šetřit, aniž by sis zhoršil šance třeba u pohovoru,“ uvažuje Stroukal.*****Ve vatě. Podcast novinářky Markéty Bidrmanové. Poslechněte si konkrétní rady investorů a odborníků na téma investic, inflace, úvěrů a hypoték. Finanční „kápézetka“ pro všechny, kterým nejsou peníze ukradené.Vychází každý čtvrtek. Poslouchejte na Seznam Zprávách, Podcasty.cz nebo ve všech podcastových aplikacích.V podcastu vysvětlujeme základní finanční pojmy a principy, nejde ale o investiční poradenství.O čem byste chtěli poslouchat příště? Co máme zlepšit? A co naopak určitě neměnit? Vaše připomínky, tipy i výtky uvítáme na adrese audio@sz.cz.

Barron's Deputy Editor Ben Levisohn and Associate Editor Al Root are joined by MRA technical analyst John Kolovos to discuss the week's earnings, Tesla's robotaxi deadline, and what the charts say about the market right now. Learn more about your ad choices. Visit megaphone.fm/adchoices

On this week's episode, I'm discussing the Federal Employees Retirement System, or FERS, a program that covers nearly all civilian federal workers. If you're a federal employee curious about when you're eligible to retire, how your pension is calculated, what the Thrift Savings Plan offers, or how special early retirement and survivor benefits work, this episode is your go-to resource.  We're breaking down the three key components of FERS: your  Basic Benefit Plan (a pension), Social Security, and the Thrift Savings Plan, as well as important details like cost-of-living adjustments and tax considerations. Whether you're just starting your federal career or planning your retirement right now, you'll get practical insights to help you make the most of your retirement benefits. You will want to hear this episode if you are interested in... [00:00] I share an overview of how FERS provides federal employees' retirement benefits. [05:02] Your basic benefit plan is calculated using the highest average salary over three consecutive years, often the final service years. [09:52] Federal employees retiring at 55-57 receive a FERS supplement until age 62, calculated by years of service/40 times the estimated Social Security benefit. [11:41] Benefits include cost-of-living adjustments for those 62+ or in special roles, aligned with consumer price index increases. [14:52] FERS survivor benefits are available if the deceased had at least 10 years of service. What is FERS, and Who Does It Cover? As one of the most significant employment sectors in the United States, the federal government supports over 3 million workers, the majority of whom participate in the Federal Employees Retirement System (FERS). If you're a federal employee, understanding FERS is vital to planning a comfortable and financially secure retirement. The Federal Employees Retirement System (FERS) is the primary retirement plan for U.S. civilian federal employees hired after 1983. According to the Office of Personnel Management, FERS provides retirement income from three sources:   1. The Basic Benefit Plan (a pension). 2. Social Security. 3. The Thrift Savings Plan (TSP), similar to a private sector 401(k). FERS covers different federal professionals, from law enforcement and firefighters to engineers, analysts, and other administrative roles. Special provisions exist for high-risk positions such as air traffic controllers and certain law enforcement officers, which affect their benefit calculations and retirement age. When Can You Retire Under FERS? Retirement eligibility under FERS primarily depends on age and years of credible service. The key term here is Minimum Retirement Age (MRA), which varies based on birth year, from 55 for those born before 1948 to 57 for workers born in 1970 or later. Retirement options include:   Age 62 with 5 years of service. Age 60 with 20 years of service.  MRA with 30 years of service. MRA with 10 years of service (MRA+10), though benefits are reduced by 5% for each year under age 62. Early retirement is available in some situations, such as involuntary separations or major agency reorganizations. In those cases, eligibility can be as early as age 50 with 20 years of service or at any age with 25 years of service. Calculating Your Basic Pension Benefit The FERS pension is calculated using your “high-3” average salary, the highest three consecutive years of basic pay, usually your last three years. The formula generally provides 1% of your high-3 salary for each year of government service (increases to 1.1% if you retire at 62 or older with 20+ years). Special categories, like federal law enforcement or air traffic controllers, receive 1.7% for the first 20 years and 1% thereafter. For example: If you retire at 57 with 30 years of service and your high-3 average is $165,000:   - 30 years x 1% = 30%   - $165,000 x 30% = $49,500 annual pension The FERS Supplement Since some federal employees retire before they're eligible for Social Security (age 62), FERS includes a Special Retirement Supplement. This bridges the income gap until you can claim Social Security, calculated as:   Years of service ÷ 40 x age-62 Social Security benefit For example, with 30 years of service and a projected Social Security benefit of $2,500 per month, the supplement would be $1,875 per month from retirement until age 62. Understanding FERS is essential for federal workers considering retirement. Regularly reviewing your retirement strategy, estimating future benefits, and taking advantage of financial planning resources can help you maximize your retirement security.  Resources Mentioned Retirement Readiness Review Subscribe to the Retire with Ryan YouTube Channel Download my entire book for FREE  US Office of Personnel Management (OPM) FERS Information  Connect With Morrissey Wealth Management  www.MorrisseyWealthManagement.com/contact   Subscribe to Retire With Ryan  

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Thank you for your wonderful and helpful videos on postponed retirement. The one question I have remaining is - I understand that if I retire at MRA and 10 that I cannot take my annuity without penalty until I am 62. Is there an option to continue with health benefits at time of resignation and not collect annuity until age 62 or do you have to start both at the same time? - Nancy  https://zurl.co/yidsG

Listener feedback, resistant hypertension, K-binders for MRA use in heart failure, nutritional epidemiology, and a positive study for vitamin D are the topics John Mandrola, MD, discusses in this week'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 Listener Feedback Califf editorial https://www.jacc.org/doi/10.1016/j.jaccas.2020.01.003 II Resistant HTN Positive Topline Results for Lorundrostat in Hypertension https://www.medscape.com/viewarticle/positive-topline-results-lorundrostat-hypertension-2025a100062e III K-Binding REALIZE K Trial https://doi.org/10.1016/j.jacc.2024.11.014 Packer Editorial https://doi.org/10.1016/j.jacc.2025.01.011 Diamond Trial EHJ https://doi.org/10.1093/eurheartj/ehac401 REALIZE K Commentary https://www.medscape.com/viewarticle/realize-k-new-potassium-binder-help-keep-spiro-board-2024a1000m2c IV Butter vs Plant-based Oils and Mortality JAMA-IM Study https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2831265 Is Red Meat Healthy? Multiverse Analysis Has Lessons Beyond Meat https://www.medscape.com/viewarticle/red-meat-healthy-multiverse-analysis-has-lessons-beyond-meat-2024a10008qv Cookbook Review https://doi.org/10.3945/ajcn.112.047142 V Vitamin D Impact Factor https://www.medscape.com/viewarticle/rare-win-vitamin-d-this-time-ms-2025a10005ul D-Lay trial https://jamanetwork.com/journals/jama/fullarticle/2831270 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