Podcasts about national academies

What happens when organizations racing to survive suddenly scrub "equity" and "justice" from their websites—without asking the communities they serve? Dr. Philip Alberti, founding director of the AAMC Center for Health Justice, joins host Corey Dion Lewis for a powerful conversation about the real cost of changing language without changing process.In this episode, Philip breaks down why speed matters, how community engagement isn't optional, and what it really means to build health equity for ALL communities—yes, including white ones. From navigating existential threats to imagining cross-racial movements for justice, this conversation challenges health equity professionals to hold the line on values while adapting to a hostile landscape.Whether you're a health equity champion feeling the squeeze, a leader struggling with messaging, or someone who believes thriving communities are possible for everyone, this episode offers both validation and a roadmap forward.Show NotesIn This Episode:[00:00] Introduction - The LinkedIn post that started it all: "The more our organizations change their language, the less their communities trust them"[03:10] The real existential threats facing health equity work—and the hidden cost of quick compliance[05:29] Why the speed of institutional language changes sent the wrong message to communities[08:18] The "health equity tourists" who jumped ship—and why that might not be all bad[09:09] If health equity benefits everyone, why is it so divisive in 2025? Where did we lose the thread?[11:25] Addressing the elephant in the room: health equity for ALL communities, including white ones[13:10] Unpacking the false narrative that health equity creates winners and losers[16:30] Why Black and Brown champions shouldn't have to build bridges—and Philip's fantasy nonprofit "The Daves"[18:09] What's truly non-negotiable when it comes to language and messaging[19:00] The 10 core principles of authentic community engagement from the National Academies model[22:01] How to actually start building community partnerships (spoiler: just listen first)[24:43] The organizational infrastructure changes that make community engagement possible[27:57] What gives Philip hope: surprising public opinion data showing cross-ideological agreement[31:49] Real-world example: Community Works and building relationships across political divides[32:14] Health justice as both aspiration and operational framework—making the process the productKey Resources Mentioned:AAMC Center for Health Justice: AAMCHealthJustice.orgAAMC Principles of Trustworthiness ToolkitAAMC CHARGE (Collaborative for Health Equity Act Research Generate Evidence) - free to join, 1,800+ membersDr. Philip Alberti's article: "Health Equity Benefits All Communities" National Academies model of assessing meaningful engagementDr. Sarah Gollust's communication research on population health equityCommunity Works organization featured in The NationThe Vital Conditions for Health and Well-beingGuest Bio:Dr. Philip Alberti is the founding director of the AAMC Center for Health Justice, where he leads work at the intersection of community engagement, health equity research, and policy change. A community-engaged scientist and practitioner by training, Philip brings experience from public health departments and a commitment to building trustworthy partnerships that center community wisdom. As a gay white man, he entered this work thinking about class-based and LGBTQ+ inequities, and now champions a tent big enough for all communities to thrive.Connect with Dr. Philip Alberti:AAMC Center for Health Justice: AAMCHealthJustice.orgJoin AAMC CHARGE (free membership): Visit website for detailsStay Connected & Support the Show:Want to keep up with conversations like this that challenge the status quo and center community voices? Sign up for The Healthy Project newsletter at www.healthyproject.co for exclusive insights, resources, and updates you won't want to miss.Love what you're hearing? Support independent podcasting that prioritizes truth over trends. Join THP+ for just $5/month and get bonus content, early access to episodes, and the satisfaction of knowing you're fueling more conversations that matter.Visit www.healthyproject.co to subscribe and support today. ★ Support this podcast ★

In schools across the United States, active shooter drills have been common for years and yet we don't know all that we could about the effect of such drills on students and educators. On this episode, we talk with two members of a National Academies of Sciences, Engineering, and Medicine Consensus Study focused on this phenomenon: Melissa Brymer of the UCLA–Duke National Center for Child Traumatic Stress and Sonali Rajan of Columbia University.

Send us a textEdward You is recently coming off an amazing career at the U.S. Federal Bureau of Investigation (FBI) where most recently he served in roles as Supervisory Special Agent, National Counterintelligence Task Force, Counterintelligence Division, as well as a Supervisory Special Agent in the FBI's Weapons of Mass Destruction Directorate.  He was also previously simultaneously detailed as a Liaison Officer at the Department of Health and Human Services, Office of National Security, and as a National Counterintelligence Officer for Emerging and Disruptive Technologies, in the Office of the Director of National Intelligence (ODNI).Mr. You was responsible for creating programs and activities to coordinate and improve FBI and interagency activities to identify, assess, and respond to biological threats or incidents.  He supported FBI initiatives to build partnerships with the life sciences community, domestically and internationally, and lead efforts to identify and address potential security challenges in advanced biotechnology. His overall goal was to safeguard the scientific community, the life science research enterprise, and the U.S. bioeconomy.  Before being promoted to the Weapons of Mass Destruction Directorate, Mr. You served as a member of the FBI Los Angeles Field Office Joint Terrorism Task Force and the FBI Hazardous Evidence Response Team. Mr. You has also been directly involved in policy-making efforts with a focus on biosecurity.  He served as an active Working Group member of the White House National Security Council Policy Coordinating Committee on Countering Biological Threats and represented the FBI as an Ex Officio member of the National Institutes of Health National Science Advisory Board for Biosecurity.  He also served on two National Academies of Sciences, Engineering, and Medicine Committees, the Institute of Medicine's Forum on Microbial Threats and the Committee on Science, Technology, and Law's Forum on Synthetic Biology.  He is currently a Senior Fellow for the Scowcroft Institute of International Affairs at the Bush School of Government and Public Service at Texas A&M University.Prior to joining the FBI, Mr. You had extensive experience in academic research having worked for three years in autoimmune disease research at the Cedars-Sinai Medical Center and six years in human gene therapy and retrovirology at the University of Southern California, Keck School of Medicine, where he received his Master of Science (M.S.), Biochemistry and Molecular Biology.  Just prior to joining the FBI, Mr. You worked for three years in the commercial biotechnology sector conducting cancer research and assay development at AMGEN, Inc.Mr. You recently set up EHY Consulting LLC, dedicated to consulting activities focused on safeguarding science and innovation at the intersection of biotechnology, artificial intelligence, and national security.#EdwardYou #FederalBureauOfInvestigation #WeaponsOfMassDestructionDirectorate #FBI #SupervisorySpecialAgent #Biosecurity #Bioeconomy #Biohackers #DualUse #Anthrax #Ricin #FBIHazardousEvidenceResponseTeam #JointTerrorismTaskForce #AutoimmuneDisease #MolecularBiology #GeneTherapy #Angiogenesis #WMDCoordinator #Chemical #Biological #CBRN #UnitedNationsInterregionalCrimeAndJusticeResearchInstitute #UNICRI #NationalAcademies #NationalCounterintelligenceAndSecurityCenter #OfficeOfTheDirectorOfNationalIntelligence #ProgressPotentialAndPossibilities #IraPastor #Podcast #Podcaster #ViralPodcast #STEM #Innovation #Technology #Science #ResearchSupport the show

We live in an age where truth twists into confusion, opinion drowns out data, and it's increasingly difficult to figure out whose expertise we can trust.Where did our mistrust in expertise come from? Its roots stretch back to deliberate misinformation campaigns beginning in the 1950s spread by the likes of Big Tobacco, Big Oil, and conservative church movements. Then social media poured gasoline on the fire, accelerating the spread of misinformation and making sowing division highly profitable.Misinformation campaigns take advantage of our brains' natural tendency to protect the familiar and mistrust outgroups. And they capitalize on the very real betrayals people have experienced at the hands of corporations, governments, schools, and healthcare systems.Our challenge now isn't just knowing the facts, it's interrogating our own beliefs, asking where our evidence comes from, and resisting the pull of certainty. As leaders, we need to discern who we give our attention to, practice critical thinking, resist manufactured controversy, and platform voices committed to both truth and connection.Today's guest is a neuroscientist and author of Why Brains Need Friends, who works to make science accessible, relational, and rooted in respect. He doesn't focus on winning arguments or shaming people into submission. He focuses on bridging divides, building trust, and reminding us that our brains–and our lives–are wired for connection.Ben Rein, PhD is an award-winning neuroscientist and science communicator. He serves as the Chief Science Officer of the Mind Science Foundation, an Adjunct Lecturer at Stanford University, and a Clinical Assistant Professor at SUNY Buffalo. He has published over 20 peer-reviewed papers on the neuroscience of social behavior, and is the author of Why Brains Need Friends: The Neuroscience of Social Connection. In addition, Rein educates an audience of more than 1 million social media followers and has been featured on outlets including Entertainment Tonight, Good Morning America and StarTalk with Neil DeGrasse Tyson. He has received awards for his science communication from the National Academies of Science, Engineering, and Medicine, the Society for Neuroscience, and elsewhere.Listen to the full episode to hear:How an especially vivid nightmare redirected Ben's path to neuroscienceWhy the division and isolation of modern life is so bad for our brains and overall healthHow engaging with strangers isn't as awkward as we often think it is, and why we should do it moreHow small social interactions build our sense of belonging, community, and wellbeingWhy we need to recognize and then override our gut reactions to those we perceive as belonging to outgroupsHow social media sound bites vastly oversimplify the complex and unknown systems in our brainsWhy Ben's primary mission to to help people understand the value of looking to data and evidence rather than personalities and experiencesWhy we all have to get better at fact-checking and questioning why we're ready to believe somethingLearn more about Dr. Ben Rein:WebsiteInstagram: @dr.benreinWhy Brains Need Friends: The Neuroscience of Social ConnectionLearn more about Rebecca:rebeccaching.comWork With RebeccaThe Unburdened Leader on SubstackSign up for the weekly Unburdened Leader EmailResources:Golden Holocaust: Origins of the Cigarette Catastrophe and the Case for Abolition, Robert N Proctor"Assessing ExxonMobil's climate change communications (1977–2014),” Geoffrey Supran and Naomi Oreskes, 2017 Environmental Research Letters 12 084019The Creationists: From Scientific Creationism to Intelligent Design, Ronald L. Numbers"Misinformation and Its Correction Continued Influence and Successful Debiasing,” Stephan Lewandowsky et al., 2012 Psychological Science in the Public Interest, 13(3)The Logic of Scientific Discovery, Karl PopperSciSpaceSapiens: A Brief History of Humankind, Yuval Noah HarariDune, Frank HerbertThe Poisoner's Handbook: Murder and the Birth of Forensic Medicine in Jazz Age New York, Deborah BlumTory Lanez - Gangland x Fargentina 4EVR (feat. Wolfgang Peterson & Kai)Hard Knocks: Training CampCourage the Cowardly Dog

EELP's Hannah Perls speaks with environmental justice pioneer Charles Lee, former director of EPA's Office of Environmental Justice and principal author of the landmark 1987 report, Toxic Wastes and Race in the United States, and now a visiting scholar at Howard University School of Law, and Sean Moriarty, former deputy commissioner with the New Jersey Department of Environmental Protection. They discuss the growing field of cumulative impacts analysis and how states are increasingly using this tool in permitting and other programs to advance meaningful protections for overburdened communities across the country. Transcript: https://eelp.law.harvard.edu/wp-content/uploads/2025/10/CleanLaw_EP109-Transcript.pdf Toxic Wastes and Race in the United States: https://www.ucc.org/what-we-do/justice-local-church-ministries/efam/environmental-justice/environmental-ministries_toxic-waste-20/ New Jersey Department of Environmental Protection's Environmental Justice Archives: https://dep.nj.gov/ej/archive/#meeting-20210624 EELP's EJ Tracker page on EPA's cumulative impacts efforts: https://eelp.law.harvard.edu/tracker/epa-released-interim-framework-for-advancing-consideration-of-cumulative-impacts/ National Academies of Sciences, Engineering, and Medicine's State-of-the-Science and the Future of Cumulative Impact Assessment report: https://www.nationalacademies.org/our-work/state-of-the-science-and-the-future-of-cumulative-impact-assessment The New School Tishman Environment and Design Center's Cumulative Impacts Dashboard map of EJ laws: https://www.tishmancenter.org/cumulativeimpacts

In this episode of The VetMed Mind, Bob Murtaugh joins Shawn McVey and Rachel Teichberg to reflect on his remarkable 40+ year journey in veterinary medicine. From academic leadership to executive positions, he shares the pivotal moments, hard-earned lessons, and shifting perspectives that have defined his impactful career and lasting contributions to the field.Bob Murtaugh, DVM, MS, DACVIM, DACVECC, FCCM, has over 40 years of experience in veterinary medicine, with leadership roles at Tufts University, VCA Animal Hospitals, and Thrive Pet Healthcare. He has played a key role in expanding veterinary services nationwide and currently serves as Chair of Veterinary Medicine at the National Academies of Practice. A passionate advocate for accessible care, Bob is committed to advancing the profession through innovation, collaboration, and bold systemic change.To learn more about Bob Murtaugh's passions in life and work:Follow on LinkedIn - https://www.linkedin.com/in/drbobmurtaugh/Follow on FaceBook - https://www.facebook.com/murtdvmFollow on Twitter - https://twitter.com/MurtDVMCheck out his website - https://www.murtdvm.com/The VetMed Mind is a podcast project about sharing inspirational stories, lessons, and successes from the fantastic people of the veterinary industry.

An avalanche of information besets us on what to eat. It comes from the news, from influencers of every ilk, from scientists, from government, and of course from the food companies. Super foods? Ultra-processed foods? How does one find a source of trust and make intelligent choices for both us as individuals and for the society as a whole. A new book helps in this quest, a book entitled Food Intelligence: the Science of How Food Both Nourishes and Harms Us. It is written by two highly credible and thoughtful people who join us today.Julia Belluz is a journalist and a contributing opinion writer for the New York Times. She reports on medicine, nutrition, and public health. She's been a Knight Science Journalism Fellow at MIT and holds a master's in science degree from the London School of Economics and Political Science. Dr. Kevin Hall trained as a physicist as best known for pioneering work on nutrition, including research he did as senior investigator and section chief at the National Institutes of Health. His work is highly regarded. He's won awards from the NIH, from the American Society of Nutrition, the Obesity Society and the American Physiological Society. Interview Transcript Thank you both very much for being with us. And not only for being with us, but writing such an interesting book. I was really eager to read it and there's a lot in there that people don't usually come across in their normal journeys through the nutrition world. So, Julia, start off if you wouldn't mind telling us what the impetus was for you and Kevin to do this book with everything else that's out there. Yes, so there's just, I think, an absolute avalanche of information as you say about nutrition and people making claims about how to optimize diet and how best to lose or manage weight. And I think what we both felt was missing from that conversation was a real examination of how do we know what we know and kind of foundational ideas in this space. You hear a lot about how to boost or speed up your metabolism, but people don't know what metabolism is anyway. You hear a lot about how you need to maximize your protein, but what is protein doing in the body and where did that idea come from? And so, we were trying to really pair back. And I think this is where Kevin's physics training was so wonderful. We were trying to look at like what are these fundamental laws and truths. Things that we know about food and nutrition and how it works in us, and what can we tell people about them. And as we kind of went through that journey it very quickly ended up in an argument about the food environment, which I know we're going to get to. We will. It's really interesting. This idea of how do we know what we know is really fascinating because when you go out there, people kind of tell us what we know. Or at least what they think what we know. But very few people go through that journey of how did we get there. And so people can decide on their own is this a credible form of knowledge that I'm being told to pursue. So Kevin, what do you mean by food intelligence? Coming from a completely different background in physics where even as we learn about the fundamental laws of physics, it's always in this historical context about how we know what we know and what were the kind of key experiments along the way. And even with that sort of background, I had almost no idea about what happened to food once we ate it inside our bodies. I only got into this field by a happenstance series of events, which is probably too long to talk about this podcast. But to get people to have an appreciation from the basic science about what is going on inside our bodies when we eat. What is food made out of? As best as we can understand at this current time, how does our body deal with. Our food and with that sort of basic knowledge about how we know what we know. How to not be fooled by these various sound bites that we'll hear from social media influencers telling you that everything that you knew about nutrition is wrong. And they've been hiding this one secret from you that's been keeping you sick for so long to basically be able to see through those kinds of claims and have a bedrock of knowledge upon which to kind of evaluate those things. That's what we mean by food intelligence. It makes sense. Now, I'm assuming that food intelligence is sort of psychological and biological at the same time, isn't it? Because that there's what you're being told and how do you process that information and make wise choices. But there's also an intelligence the body has and how to deal with the food that it's receiving. And that can get fooled too by different things that are coming at it from different types of foods and stuff. We'll get to that in a minute, but it's a very interesting concept you have, and wouldn't it be great if we could all make intelligent choices? Julia, you mentioned the food environment. How would you describe the modern food environment and how does it shape the choices we make? It's almost embarrassing to have this question coming from you because so much of our understanding and thinking about this idea came from you. So, thank you for your work. I feel like you should be answering this question. But I think one of the big aha moments I had in the book research was talking to a neuroscientist, who said the problem in and of itself isn't like the brownies and the pizza and the chips. It's the ubiquity of them. It's that they're most of what's available, along with other less nutritious ultra-processed foods. They're the most accessible. They're the cheapest. They're kind of heavily marketed. They're in our face and the stuff that we really ought to be eating more of, we all know we ought to be eating more of, the fruits and vegetables, fresh or frozen. The legumes, whole grains. They're the least available. They're the hardest to come by. They're the least accessible. They're the most expensive. And so that I think kind of sums up what it means to live in the modern food environment. The deck is stacked against most of us. The least healthy options are the ones that we're inundated by. And to kind of navigate that, you need a lot of resources, wherewithal, a lot of thought, a lot of time. And I think that's kind of where we came out thinking about it. But if anyone is interested in knowing more, they need to read your book Food Fight, because I think that's a great encapsulation of where we still are basically. Well, Julie, it's nice of you to say that. You know what you reminded me one time I was on a panel and a speaker asks the audience, how many minutes do you live from a Dunkin Donuts? And people sort of thought about it and nobody was more than about five minutes from a Dunkin Donuts. And if I think about where I live in North Carolina, a typical place to live, I'm assuming in America. And boy, within about five minutes, 10 minutes from my house, there's so many fast-food places. And then if you add to that the gas stations that have foods and the drug store that has foods. Not to mention the supermarkets. It's just a remarkable environment out there. And boy, you have to have kind of iron willpower to not stop and want that food. And then once it hits your body, then all heck breaks loose. It's a crazy, crazy environment, isn't it? Kevin, talk to us, if you will, about when this food environment collides with human biology. And what happens to normal biological processes that tell us how much we should eat, when we should stop, what we should eat, and things like that. I think that that is one of the newer pieces that we're really just getting a handle on some of the science. It's been observed for long periods of time that if you change a rat's food environment like Tony Sclafani did many, many years ago. That rats aren't trying to maintain their weight. They're not trying to do anything other than eat whatever they feel like. And, he was having a hard time getting rats to fatten up on a high fat diet. And he gave them this so-called supermarket diet or cafeteria diet composed of mainly human foods. And they gained a ton of weight. And I think that pointed to the fact that it's not that these rats lacked willpower or something like that. That they weren't making these conscious choices in the same way that we often think humans are entirely under their conscious control about what we're doing when we make our food choices. And therefore, we criticize people as having weak willpower when they're not able to choose a healthier diet in the face of the food environment. I think the newer piece that we're sort of only beginning to understand is how is it that that food environment and the foods that we eat might be changing this internal symphony of signals that's coming from our guts, from the hormones in our blood, to our brains and the understanding that of food intake. While you might have control over an individual meal and how much you eat in that individual meal is under biological control. And what are the neural systems and how do they work inside our brains in communicating with our bodies and our environment as a whole to shift the sort of balance point where body weight is being regulated. To try to better understand this really intricate interconnection or interaction between our genes, which are very different between people. And thousands of different genes contributing to determining heritability of body size in a given environment and how those genes are making us more or less susceptible to these differences in the food environment. And what's the underlying biology? I'd be lying to say if that we have that worked out. I think we're really beginning to understand that, but I hope what the book can give people is an appreciation for the complexity of those internal signals and that they exist. And that food intake isn't entirely under our control. And that we're beginning to unpack the science of how those interactions work. It's incredibly interesting. I agree with you on that. I have a slide that I bet I've shown a thousand times in talks that I think Tony Sclafani gave me decades ago that shows laboratory rats standing in front of a pile of these supermarket foods. And people would say, well, of course you're going to get overweight if that's all you eat. But animals would eat a healthy diet if access to it. But what they did was they had the pellets of the healthy rat chow sitting right in that pile. Exactly. And the animals ignore that and overeat the unhealthy food. And then you have this metabolic havoc occur. So, it seems like the biology we've all inherited works pretty well if you have foods that we've inherited from the natural environment. But when things become pretty unnatural and we have all these concoctions and chemicals that comprise the modern food environment the system really breaks down, doesn't it? Yeah. And I think that a lot of people are often swayed by the idea as well. Those foods just taste better and that might be part of it. But I think that what we've come to realize, even in our human experiments where we change people's food environments... not to the same extent that Tony Sclafani did with his rats, but for a month at a time where we ask people to not be trying to gain or lose weight. And we match certain food environments for various nutrients of concern. You know, they overeat diets that are higher in these so-called ultra-processed foods and they'd spontaneously lose weight when we remove those from the diet. And they're not saying that the foods are any more or less pleasant to eat. There's this underlying sort of the liking of foods is somewhat separate from the wanting of foods as neuroscientists are beginning to understand the different neural pathways that are involved in motivation and reward as opposed to the sort of just the hedonic liking of foods. Even the simple explanation of 'oh yeah, the rats just like the food more' that doesn't seem to be fully explaining why we have these behaviors. Why it's more complicated than a lot of people make out. Let's talk about ultra-processed foods and boy, I've got two wonderful people to talk to about that topic. Julia, let's start with your opinion on this. So tell us about ultra-processed foods and how much of the modern diet do they occupy? So ultra-processed foods. Obviously there's an academic definition and there's a lot of debate about defining this category of foods, including in the US by the Health and Human Services. But the way I think about it is like, these are foods that contain ingredients that you don't use in your home kitchen. They're typically cooked. Concocted in factories. And they now make up, I think it's like 60% of the calories that are consumed in America and in other similar high-income countries. And a lot of these foods are what researchers would also call hyper palatable. They're crossing these pairs of nutrient thresholds like carbohydrate, salt, sugar, fat. These pairs that don't typically exist in nature. So, for the reasons you were just discussing they seem to be particularly alluring to people. They're again just like absolutely ubiquitous and in these more developed contexts, like in the US and in the UK in particular. They've displaced a lot of what we would think of as more traditional food ways or ways that people were eating. So that's sort of how I think about them. You know, if you go to a supermarket these days, it's pretty hard to find a part of the supermarket that doesn't have these foods. You know, whole entire aisles of processed cereals and candies and chips and soft drinks and yogurts, frozen foods, yogurts. I mean, it's just, it's all over the place. And you know, given that if the average is 60% of calories, and there are plenty of people out there who aren't eating any of that stuff at all. For the other people who are, the number is way higher. And that, of course, is of great concern. So there have been hundreds of studies now on ultra-processed foods. It was a concept born not that long ago. And there's been an explosion of science and that's all for the good, I think, on these ultra-processed foods. And perhaps of all those studies, the one discussed most is one that you did, Kevin. And because it was exquisitely controlled and it also produced pretty striking findings. Would you describe that original study you did and what you found? Sure. So, the basic idea was one of the challenges that we have in nutrition science is accurately measuring how many calories people eat. And the best way to do that is to basically bring people into a laboratory and measure. Give them a test meal and measure how many calories they eat. Most studies of that sort last for maybe a day or two. But I always suspected that people could game the system if for a day or two, it's probably not that hard to behave the way that the researcher wants, or the subject wants to deceive the researcher. We decided that what we wanted to do was bring people into the NIH Clinical Center. Live with us for a month. And in two two-week blocks, we decided that we would present them with two different food environments essentially that both provided double the number of calories that they would require to maintain their body weight. Give them very simple instructions. Eat as much or as little as you'd like. Don't be trying to change your weight. We're not going to tell you necessarily what the study's about. We're going to measure lots of different things. And they're blinded to their weight measurements and they're wearing loose fitting scrubs and things like that, so they can't tell if their clothes are getting tighter or looser. And so, what we did is in for one two-week block, we presented people with the same number of calories, the same amount of sugar and fat and carbs and fiber. And we gave them a diet that was composed of 80% of calories coming from these ultra-processed foods. And the other case, we gave them a diet that was composed of 0% of calories from ultra-processed food and 80% of the so-called minimally processed food group. And what we then did was just measured people's leftovers essentially. And I say we, it was really the chefs and the dieticians at the clinical center who are doing all the legwork on this. But what we found was pretty striking, which was that when people were exposed to this highly ultra-processed food environment, despite being matched for these various nutrients of concern, they overate calories. Eating about 500 calories per day on average, more than the same people in the minimally processed diet condition. And they gained weight and gained body fat. And, when they were in the minimally processed diet condition, they spontaneously lost weight and lost body fat without trying in either case, right? They're just eating to the same level of hunger and fullness and overall appetite. And not reporting liking the meals any more or less in one diet versus the other. Something kind of more fundamental seemed to have been going on that we didn't fully understand at the time. What was it about these ultra-processed foods? And we were clearly getting rid of many of the things that promote their intake in the real world, which is that they're convenient, they're cheap, they're easy to obtain, they're heavily marketed. None of that was at work here. It was something really about the meals themselves that we were providing to people. And our subsequent research has been trying to figure out, okay, well what were the properties of those meals that we were giving to these folks that were composed primarily of ultra-processed foods that were driving people to consume excess calories? You know, I've presented your study a lot when I give talks. It's nice hearing it coming from you rather than me. But a couple of things that interest me here. You use people as their own controls. Each person had two weeks of one diet and two weeks of another. That's a pretty powerful way of providing experimental control. Could you say just a little bit more about that? Yeah, sure. So, when you design a study, you're trying to maximize the efficiency of the study to get the answers that you want with the least number of participants while still having good control and being able to design the study that's robust enough to detect a meaningful effect if it exists. One of the things that you do when you analyze studies like that or design studies like that, you could just randomize people to two different groups. But given how noisy and how different between people the measurement of food intake is we would've required hundreds of people in each group to detect an effect like the one that we discovered using the same person acting as their own control. We would still be doing the study 10 years later as opposed to what we were able to do in this particular case, which is completed in a year or so for that first study. And so, yeah, when you kind of design a study that way it's not always the case that you get that kind of improvement in statistical power. But for a measurement like food intake, it really is necessary to kind of do these sorts of crossover type studies where each person acts as their own control. So put the 500 calorie increment in context. Using the old fashioned numbers, 3,500 calories equals a pound. That'd be about a pound a week or a lot of pounds over a year. But of course, you don't know what would happen if people were followed chronically and all that. But still 500 calories is a whopping increase, it seems to me. It sure is. And there's no way that we would expect it to stay at that constant level for many, many weeks on end. And I think that's one of the key questions going forward is how persistent is that change. And how does something that we've known about and we discuss in our books the basic physiology of how both energy expenditure changes as people gain and lose weight, as well as how does appetite change in a given environment when they gain and lose weight? And how do those two processes eventually equate at a new sort of stable body weight in this case. Either higher or lower than when people started the program of this diet manipulation. And so, it's really hard to make those kinds of extrapolations. And that's of course, the need for further research where you have longer periods of time and you, probably have an even better control over their food environment as a result. I was surprised when I first read your study that you were able to detect a difference in percent body fat in such a short study. Did that surprise you as well? Certainly the study was not powered to detect body fat changes. In other words, we didn't know even if there were real body fat changes whether or not we would have the statistical capabilities to do that. We did use a method, DXA, which is probably one of the most precise and therefore, if we had a chance to measure it, we had the ability to detect it as opposed to other methods. There are other methods that are even more precise, but much more expensive. So, we thought that we had a chance to detect differences there. Other things that we use that we also didn't think that we necessarily would have a chance to detect were things like liver fat or something like that. Those have a much less of an ability. It's something that we're exploring now with our current study. But, again, it's all exploratory at that point. So what can you tell us about your current study? We just wrapped it up, thankfully. What we were doing was basically re-engineering two new ultra-processed diets along parameters that we think are most likely the mechanisms by which ultra-processed meals drove increased energy intake in that study. One was the non-beverage energy density. In other words, how many calories per gram of food on the plate, not counting the beverages. Something that we noticed in the first study was that ultra-processed foods, because they're essentially dried out in the processing for reasons of food safety to prevent bacterial growth and increased shelf life, they end up concentrating the foods. They're disrupting the natural food matrix. They last a lot longer, but as a result, they're a more concentrated form of calories. Despite being, by design, we chose the overall macronutrients to be the same. They weren't necessarily higher fat as we often think of as higher energy density. What we did was we designed an ultra-processed diet that was low in energy density to kind of match the minimally processed diet. And then we also varied the number of individual foods that were deemed hyper palatable according to kind of what Julia said that crossed these pairs of thresholds for fat and sugar or fat and salt or carbs and salt. What we noticed in the first study was that we presented people with more individual foods on the plate that had these hyper palatable combinations. And I wrestle with the term terminology a little bit because I don't necessarily think that they're working through the normal palatability that they necessarily like these foods anymore because again, we asked people to rate the meals and they didn't report differences. But something about those combinations, regardless of what you call them, seemed to be driving that in our exploratory analysis of the first study. We designed a diet that was high in energy density, but low in hyper palatable foods, similar to the minimally processed. And then their fourth diet is with basically low in energy density and hyper palatable foods. And so, we presented some preliminary results last year and what we were able to show is that when we reduced both energy density and the number of hyper palatable foods, but still had 80% of calories from ultra-processed foods, that people more or less ate the same number of calories now as they did when they were the same people were exposed to the minimally processed diet. In fact they lost weight, to a similar extent as the minimally processed diet. And that suggests to me that we can really understand mechanisms at least when it comes to calorie intake in these foods. And that might give regulators, policy makers, the sort of information that they need in order to target which ultra-processed foods and what context are they really problematic. It might give manufacturers if they have the desire to kind of reformulate these foods to understand which ones are more or less likely to cause over consumption. So, who knows? We'll see how people respond to that and we'll see what the final results are with the entire study group that, like I said, just finished, weeks ago. I respond very positively to the idea of the study. The fact that if people assume ultra-processed foods are bad actors, then trying to find out what it is about them that's making the bad actors becomes really important. And you're exactly right, there's a lot of pressure on the food companies now. Some coming from public opinion, some coming from parts of the political world. Some from the scientific world. And my guess is that litigation is going to become a real actor here too. And the question is, what do you want the food industry to do differently? And your study can really help inform that question. So incredibly valuable research. I can't wait to see the final study, and I'm really delighted that you did that. Let's turn our attention for a minute to food marketing. Julia, where does food marketing fit in all this? Julia - What I was very surprised to find while we were researching the book was this deep, long history of calls against marketing junk food in particular to kids. I think from like the 1950s, you have pediatrician groups and other public health professionals saying, stop this. And anyone who has spent any time around small children knows that it works. We covered just like a little, it was from an advocacy group in the UK that exposed aid adolescents to something called Triple Dip Chicken. And then asked them later, pick off of this menu, I think it was like 50 items, which food you want to order. And they all chose Triple Dip chicken, which is, as the name suggests, wasn't the healthiest thing to choose on the menu. I think we know obviously that it works. Companies invest a huge amount of money in marketing. It works even in ways like these subliminal ways that you can't fully appreciate to guide our food choices. Kevin raised something really interesting was that in his studies it was the foods. So, it's a tricky one because it's the food environment, but it's also the properties of the foods themselves beyond just the marketing. Kevin, how do you think about that piece? I'm curious like. Kevin - I think that even if our first study and our second study had turned out there's no real difference between these artificial environments that we've put together where highly ultra-processed diets lead to excess calorie intake. If that doesn't happen, if it was just the same, it wouldn't rule out the fact that because these foods are so heavily marketed, because they're so ubiquitous. They're cheap and convenient. And you know, they're engineered for many people to incorporate into their day-to-day life that could still promote over consumption of calories. We just remove those aspects in our very artificial food environment. But of course, the real food environment, we're bombarded by these advertisements and the ubiquity of the food in every place that you sort of turn. And how they've displaced healthy alternatives, which is another mechanism by which they could cause harm, right? It doesn't even have to be the foods themselves that are harmful. What do they displace? Right? We only have a certain amount the marketers called stomach share, right? And so, your harm might not be necessarily the foods that you're eating, but the foods that they displaced. So even if our experimental studies about the ultra-processed meals themselves didn't show excess calorie intake, which they clearly did, there's still all these other mechanisms to explore about how they might play a part in the real world. You know, the food industry will say that they're agnostic about what foods they sell. They just respond to demand. That seems utter nonsense to me because people don't overconsume healthy foods, but they do overconsume the unhealthy ones. And you've shown that to be the case. So, it seems to me that idea that they can just switch from this portfolio of highly processed foods to more healthy foods just doesn't work out for them financially. Do you think that's right? I honestly don't have that same sort of knee jerk reaction. Or at least I perceive it as a knee jerk reaction, kind of attributing malice in some sense to the food industry. I think that they'd be equally happy if they could get you to buy a lot and have the same sort of profit margins, a lot of a group of foods that was just as just as cheap to produce and they could market. I think that you could kind of turn the levers in a way that that would be beneficial. I mean, setting aside for example, that diet soda beverages are probably from every randomized control trial that we've seen, they don't lead to the same amount of weight gain as the sugar sweetened alternatives. They're just as profitable to the beverage manufacturers. They sell just as many of them. Now they might have other deleterious consequences, but I don't think that it's necessarily the case that food manufacturers have to have these deleterious or unhealthy foods as their sole means of attaining profit. Thanks for that. So, Julia, back to you. You and Kevin point out in your book some of the biggest myths about nutrition. What would you say some of them are? I think one big, fundamental, overarching myth is this idea that the problem is in us. That this rise of diet related diseases, this explosion that we've seen is either because of a lack of willpower. Which you have some very elegant research on this that we cite in the book showing willpower did not collapse in the last 30, 40 years of this epidemic of diet related disease. But it's even broader than that. It's a slow metabolism. It's our genes. Like we put the problem on ourselves, and we don't look at the way that the environment has changed enough. And I think as individuals we don't do that. And so much of the messaging is about what you Kevin, or you Kelly, or you Julia, could be doing better. you know, do resistance training. Like that's the big thing, like if you open any social media feed, it's like, do more resistance training, eat more protein, cut out the ultra-processed foods. What about the food environment? What about the leaders that should be held accountable for helping to perpetuate these toxic food environments? I think that that's this kind of overarching, this pegging it and also the rise of personalized nutrition. This like pegging it to individual biology instead of for whatever the claim is, instead of thinking about how did environments and don't want to have as part of our lives. So that's kind of a big overarching thing that I think about. It makes sense. So, let's end on a positive note. There's a lot of reason to be concerned about the modern food environment. Do you see a helpful way forward and what might be done about this? Julia, let's stay with you. What do you think? I think so. We spent a lot of time researching history for this book. And a lot of things that seem impossible are suddenly possible when you have enough public demand and enough political will and pressure. There are so many instances and even in the history of food. We spend time with this character Harvey Wiley, who around the turn of the century, his research was one of the reasons we have something like the FDA protecting the food supply. That gives me a lot of hope. And we are in this moment where a lot of awareness is being raised about the toxic food environment and all these negative attributes of food that people are surrounded by. I think with enough organization and enough pressure, we can see change. And we can see this kind of flip in the food environment that I think we all want to see where healthier foods become more accessible, available, affordable, and the rest of it. Sounds good. Kevin, what are your thoughts? Yes, I just extend that to saying that for the first time in history, we sort of know what the population of the planet is going to be that we have to feed in the future. We're not under this sort of Malthusian threat of not being able to know where the population growth is going to go. We know it's going to be roughly 10 billion people within the next century. And we know we've got to change the way that we produce and grow food for the planet as well as for the health of people. We know we've got to make changes anyway. And we're starting from a position where per capita, we're producing more protein and calories than any other time in human history, and we're wasting more food. We actually know we're in a position of strength. We don't have to worry so acutely that we won't be able to provide enough food for everybody. It's what kind of food are we going to produce? How are we going to produce it in the way that's sustainable for both people and the planet? We have to tackle that anyway. And for the folks who had experienced the obesity epidemic or finally have drugs to help them and other kinds of interventions to help them. That absolve them from this idea that it's just a matter of weak willpower if we finally have some pharmaceutical interventions that are useful. So, I do see a path forward. Whether or not we take that is another question. Bios Dr. Kevin Hall is the section chief of Integrative Physiology Section in the Laboratory of Biological Modeling at the NIH National Institute of Diabetes and Digestive and Kidney Diseases. Kevin's laboratory investigates the integrative physiology of macronutrient metabolism, body composition, energy expenditure, and control of food intake. His main goal is to better understand how the food environment affects what we eat and how what we eat affects our physiology. He performs clinical research studies as well as developing mathematical models and computer simulations to better understand physiology, integrate data, and make predictions. In recent years, he has conducted randomized clinical trials to study how diets high in ultra-processed food may cause obesity and other chronic diseases. He holds a Ph.D. from McGill University. Julia Belluz is a Paris-based journalist and a contributing opinion writer to the New York Times, she has reported extensively on medicine, nutrition, and global public health from Canada, the US, and Europe. Previously, Julia was Vox's senior health correspondent in Washington, DC, a Knight Science Journalism fellow at the Massachusetts Institute of Technology in Cambridge, and she worked as a reporter in Toronto and London. Her writing has appeared in a range of international publications, including the BMJ, the Chicago Tribune, the Economist, the Globe and Mail, Maclean's, the New York Times, ProPublica, and the Times of London. Her work has also had an impact, helping improve policies on maternal health and mental healthcare for first responders at the hospital- and state-level, as well as inspiring everything from scientific studies to an opera. Julia has been honored with numerous journalism awards, including the 2016 Balles Prize in Critical Thinking, the 2017 American Society of Nutrition Journalism Award, and three Canadian National Magazine Awards (in 2007 and 2013). In 2019, she was a National Academies of Sciences, Engineering, and Medicine Communications Award finalist. She contributed chapters on public health journalism in the Tactical Guide to Science Journalism, To Save Humanity: What Matters Most for a Healthy Future, and was a commissioner for the Global Commission on Evidence to Address Societal Challenges.

My Conversation with Mann and Hotez begins at 36 mins Stand Up is a daily podcast. I book,host,edit, post and promote new episodes with brilliant guests every day. This show is Ad free and fully supported by listeners like you! Please subscribe now for as little as 5$ and gain access to a community of over 750 awesome, curious, kind, funny, brilliant, generous souls In this “well-researched guide,” two of the world's most respected scientists reveal the forces behind the dangerous anti-science movement—and offer “powerful ideas about how to fight back” (Bill McKibben, author of Here Comes the Sun) “Science is indeed under siege, and that's not good for any of us. Here, Peter Hotez and Michael Mann name names...It's not too late to do something; it's time to get things done. Read on” (Bill Nye, science educator) From pandemics to the climate crisis, humanity faces tougher challenges than ever. Whether it's the health of our people or the health of our planet, we know we are on an unsustainable path. But our efforts to effectively tackle these existential crises are now hampered by a common threat: politically and ideologically motivated opposition to science. Michael E. Mann and Peter J. Hotez are two of the most respected and well-known scientists in the world and have spent the last twenty years on the front lines of the battle to convey accurate, reliable, and trustworthy information about science in the face of determined and nihilistic opposition. In this powerful manifesto, they reveal the five main forces threatening science: plutocrats, pros, petrostates, phonies, and the press. It is a call to arms and a road map for dismantling the forces of anti-science. Armed with the information in this book, we can be empowered to promote scientific truths, shine light on channels of dark money, dismantle the corporations poisoning the planet, and ultimately avert disaster. Peter J. Hotez, MD, PhD, is the founding dean of The National School of Tropical Medicine at Baylor College of Medicine in Houston, Texas, as well as director of the Texas Children's Hospital Center for Vaccine Development. He is an elected member of the Institute of Medicine of National Academies as well as the American Academy of Arts and Sciences. A pediatrician and an expert in vaccinology and tropical disease, Hotez has authored hundreds of peer-reviewed articles and editorials as well dozens of textbook chapters. www.peterhotez.org Dr. Michael E. Mann is Presidential Distinguished Professor in the Department of Earth and Environmental Science at the University of Pennsylvania, with a secondary appointment in the Annenberg School for Communication. He is director of the Penn Center for Science, Sustainability, and the Media (PCSSM). Dr. Mann received his undergraduate degrees in Physics and Applied Math from the University of California at Berkeley, an M.S. degree in Physics from Yale University, and a Ph.D. in Geology & Geophysics from Yale University. His research involves the use of theoretical models and observational data to better understand Earth's climate system. Dr. Mann was a Lead Author on the Observed Climate Variability and Change chapter of the Intergovernmental Panel on Climate Change (IPCC) Third Scientific Assessment Report in 2001 and was organizing committee chair for the National Academy of Sciences Frontiers of Science in 2003. He has received a number of honors and awards including NOAA's outstanding publication award in 2002 and selection by Scientific American as one of the fifty leading visionaries in science and technology in 2002. He contributed, with other IPCC authors, to the award of the 2007 Nobel Peace Prize. He was awarded the Hans Oeschger Medal of the European Geosciences Union in 2012 and was awarded the National Conservation Achievement Award for science by the National Wildlife Federation in 2013. He made Bloomberg News' list of fifty most influential people in 2013. In 2014, he was named Highly Cited Researcher by the Institute for Scientific Information (ISI) and received the Friend of the Planet Award from the National Center for Science Education. He received the Stephen H. Schneider Award for Outstanding Climate Science Communication from Climate One in 2017, the Award for Public Engagement with Science from the American Association for the Advancement of Science in 2018 and the Climate Communication Prize from the American Geophysical Union in 2018. In 2019 he received the Tyler Prize for Environmental Achievement and in 2020 he received the World Sustainability Award of the MDPI Sustainability Foundation. He was elected to the U.S. National Academy of Sciences in 2020. He is a Fellow of the American Geophysical Union, the American Meteorological Society, the Geological Society of America, the American Association for the Advancement of Science, and the Committee for Skeptical Inquiry. He is also a co-founder of the award-winning science website RealClimate.org. Dr. Mann is author of more than 200 peer-reviewed and edited publications, numerous op-eds and commentaries, and five books including Dire Predictions: Understanding Climate Change, The Hockey Stick and the Climate Wars: Dispatches from the Front Lines, The Madhouse Effect: How Climate Change Denial is Threatening our Planet, Destroying Our Politics, and Driving Us Crazy, The Tantrum that Saved the World and The New Climate War: The Fight to Take Back Our Planet. Pete on Blue Sky Pete on Threads Pete on Tik Tok Pete on YouTube  Pete on Twitter Pete On Instagram Pete Personal FB page Stand Up with Pete FB page All things Jon Carroll  Follow and Support Pete Coe Buy Ava's Art  Hire DJ Monzyk to build your website or help you with Marketing Gift a Subscription https://www.patreon.com/PeteDominick/gift

This week, we zoom out to the broader intellectual themes that shaped Decouple's origins five years ago. I'm joined by Jesse Ausubel, a visionary in sustainability and biodiversity research and the Director of the Program for the Human Environment at The Rockefeller University in New York City. In his long career, Ausubel pioneered the modern study of decarbonization and dematerialization in the late 1980s and early 1990s. He helped organize the first UN World Climate Conference in 1979 and spent the 1980s at the National Academies formulating U.S. and global climate research programs. In parallel, he has led major biodiversity initiatives including the decade-long Census of Marine Life, the DNA Barcode of Life project, and continues surveying ocean biodiversity using environmental DNA.In this conversation, Ausubel shows how the simple framework of logistic S-curves can illuminate fundamental trends across complex systems, including energy systems. Through this lens, we discuss the “environmental trifecta” of land-sparing, decarbonization, and dematerialization, and we explore whether apparent counter-trends challenge Ausubel's framework. Suffusing the interview is Ausubel's belief in the wisdom of long-term thinking and objectivity: simple, insightful frameworks are a starting point for admitting much-needed complexity into our worldviews. Join us in this rare examination of the mental models that claim to predict our environmental future.

Send us a text with your feedback from this session! Session 154Care Coordination Makes Our Profession Highly ValuedWe sit down and chat on the value of the Athletic Training and Therapy profession; how and where it fits and can be valued based on what we actually do! Anthony Breitbach has used over 20 years of clinical and sideline experience to inform his empowering and powerful current work in driving our profession forward. Dr. Anthony Breitbach is a Professor and Director of Interprofessional Education atSaint Louis University. He is a Distinguished Fellow and President of the NationalAcademies of Practice (NAP) representing NAP at the National Academies of Sciences, Engineering and Medicine Global Forum on Innovation in Health Professional Education. He is an Association of Schools Advancing Health Professions (ASAHP) Fellow, chairing their Interprofessional Committee and represents them on Interprofessional Education Collaborative (IPEC); also serving as Deputy Chair of the Interprofessional Global Board. Dr. Breitbach is an Associate Editor for the Journal of Interprofessional Care and the Journal of Interprofessional Education and Practice.

In this special Tick Boot Camp Podcast episode recorded live at Project Lab Coat during New York Fashion Week (NYFW), we sit down with Colonel Nicole Malachowski, USAF (Ret.). Col. Malachowski, the first female pilot of the USAF Thunderbirds and a Lyme patient advocate, walked the runway with us at Project Lab Coat and served as the sole patient representative on the National Academies of Sciences, Engineering, and Medicine committee that authored the landmark report on Lyme infection-associated chronic illness (Lyme IACI). She shares her perspective on why this recognition is a historic milestone for the Lyme community. What You'll Learn in This Episode Why the term Lyme IACI (infection-associated chronic illness) matters and how it creates an inclusive umbrella for persistent symptoms after Lyme infection. How the National Academies report represents the first time the U.S. government has officially recognized Lyme IACI. What it was like for Col. Malachowski to serve as the sole patient representative on the committee alongside scientists and clinicians. Why the report calls for running treatment trials in parallel with biomarker discovery so patients are not left waiting. How collaboration with long COVID and ME/CFS communities can accelerate solutions and strengthen advocacy. The role of AI and machine learning in analyzing patient data, biobanks, and surveys to identify new diagnostics and repurposed therapies. Why visibility at NYFW Project Lab Coat signals growing mainstream recognition of Lyme disease. About Col. Nicole Malachowski Col. Malachowski is a retired U.S. Air Force fighter pilot, the first woman selected to fly with the USAF Thunderbirds, and a National Women's Hall of Fame inductee. After contracting a tick-borne illness and being medically retired, she became a nationally recognized speaker and advocate for Lyme patients. She served as the sole patient voice on the National Academies committee that authored the landmark report on Lyme IACI, commissioned with support from the Steven & Alexandra Cohen Foundation. About Project Lab Coat at New York Fashion Week Project Lab Coat was a groundbreaking event held on September 13, 2025, during New York Fashion Week (NYFW). The show brought together prominent celebrities, researchers, doctors, and advocates who were invited to walk the runway to spotlight Lyme disease and raise funds for Lyme disease research. For the first time, the global visibility of NYFW was used to highlight one of the fastest-growing infectious diseases in the world. Tick Boot Camp co-founders Matt Sabatello and Rich Johannesen, together with Dr. Tal, walked the runway at Project Lab Coat, joining leaders from medicine, science, entertainment, and advocacy. Project Lab Coat demonstrated the power of mainstream platforms to bring awareness, credibility, and resources to the fight against Lyme disease. Key Takeaways Federal recognition matters – Lyme IACI in a National Academies report marks a turning point in credibility and urgency. Patients at the center – clinical trials must include patients from design through reporting. Collaboration is key – linking Lyme, long COVID, ME/CFS, and other infection-associated conditions strengthens progress. Do both now – pursue biomarkers and cures while also running treatment studies to help patients immediately. Technology accelerates hope – AI and machine learning can unlock insights from existing patient data. Resources and Links Read the full National Academies of Sciences, Engineering, and Medicine report on Lyme IACI Read our recap of Project Lab Coat at New York Fashion Week (NYFW)

Charles Duhigg reviews his communication techniques for finding common ground in any conflict.— YOU'LL LEARN — 1) The three-step looping method for making others feel heard2) The secret principle for keeping conversations aligned3) How to uncover what people really want in a conversationSubscribe or visit AwesomeAtYourJob.com/ep1097 for clickable versions of the links below. — ABOUT CHARLES — Charles Duhigg is a Pulitzer Prize–winning investigative journalist and the author of Supercommunicators, The Power of Habit, and Smarter Faster Better. A graduate of Harvard Business School and Yale University, he is a winner of the National Academies of Sciences, National Journalism, and George Polk awards. He writes for The New Yorker and The New York Times Magazine, and was the founding host of the Slate podcast How To! with Charles Duhigg.• Book: Supercommunicators: How to Unlock the Secret Language of Connection• Book: The Power of Habit: Why We Do What We Do in Life and Business• Substack: "The Science of Better"• Website: CharlesDuhigg.com— RESOURCES MENTIONED IN THE SHOW — • Study: Granovetter study on The Strength of Weak Ties— THANK YOU SPONSORS! — • Strawberry.me. Claim your $50 credit and build momentum in your career with Strawberry.me/Awesome• LinkedIn Jobs. Post your job for free at linkedin.com/beawesome• Quince. Get free shipping and 365-day returns on your order with Quince.com/AwesomeSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Presented by Lauren S. Hughes, MD, MPH, MSc, MHCDS, University of ColoradoSTFM Conference on Practice & Quality Improvement 2025 Opening Session | Monday, September 8, 2025As value-based care (VBC) continues to reshape the health care landscape, it is critical that family medicine residency programs prepare the next generation of physicians to not only adapt to policy changes but to lead them. This session explores how physician engagement at the state and federal levels can directly influence primary care transformation—and how those lessons can be brought back to the clinic and the classroom.Drawing on firsthand experience from launching the Pennsylvania Rural Health Model, a multi-payer global budget model focused on rural and frontier hospitals, and co-chairing the National Academies of Sciences, Engineering, and Medicine (NASEM) Standing Committee on Primary Care, Dr Hughes will share insights on how to drive high-impact policy change through coalition building, data-driven decision making, and visionary leadership. These experiences will be directly tied to strategies for training future family physicians to navigate and influence the evolving world of VBC.Special attention will be given to the implications of VBC in rural and underserved communities, where innovation leverages robust community partnerships, deep knowledge of local health care needs, and a strong commitment to well-being. The talk will also explore how the current federal administration's policy directions may influence VBC and graduate medical education – and how training programs can remain agile and proactive in this shifting environment.Attendees will leave better equipped to train, support, and inspire future family physician leaders, those who can bridge the gap between policy and practice to deliver high-quality, equitable primary care.Learning ObjectivesUpon completion of this session, participants should be able to:Describe how physician leaders can influence health policy at the state and federal levels by exploring examples focused on rural health and primary care.Identify effective strategies to teach residents about the evolving value-based care landscape, especially in rural and underserved communities.Discuss the potential impact of the current federal administration's policies on value-based care initiatives and residency training.Copyright © Society of Teachers of Family Medicine, 2025Lauren S. Hughes, MD, MPH, MSc, MHCDSLauren S. Hughes, MD, MPH, MSc, MHCDS, FAAFP, is the state policy director of the Farley Health Policy Center and associate professor of family medicine, both at the University of Colorado, where she researches how to strengthen primary care infrastructure, transform rural health care delivery, and advance behavioral health integration. Dr Hughes previously served as deputy secretary for health innovation in the Pennsylvania Department of Health, where she launched the state's Prescription Drug Monitoring Program and the Pennsylvania Rural Health Model, a new payment and delivery model co-designed with the CMS Innovation Center that transitions rural hospitals from fee-for-service to multi-payer global budgets.Dr Hughes is a former chair of the American Board of Family Medicine and an alumna of the Robert Wood Johnson Foundation Clinical Scholars Program. She currently serves as chair of the Rural Health Redesign Center Organization Board of Directors and is a member of the Primary Care Payment Reform Collaborative convened by the Colorado Division of Insurance. In 2018, she was selected as a presidential leadership scholar by former US Presidents Bill Clinton and George Bush Jr., and in 2023, she was named as the co-chair of the National Academies of Sciences, Engineering, a

Charles Duhigg⁠ is a Pulitzer Prize–winning investigative journalist and the bestselling author of three books: The Power of Habit, Smarter Faster Better and his latest, Supercommunicators, which was published this year. Charles is a winner of the National Academies of Sciences, National Journalism, and George Polk awards, and he currently writes for The New Yorker and several other publications. On this classic episode, Charles joined host Robert Glazer on ⁠the Elevate Podcast⁠ to talk about habit formation, how to become an excellent communicator, and much more. Thank you to the sponsors of The Elevate Podcast Shopify: ⁠⁠⁠⁠⁠⁠⁠shopify.com/elevate⁠⁠⁠⁠⁠⁠⁠ Indeed: ⁠⁠⁠⁠⁠⁠⁠indeed.com/elevate⁠⁠⁠⁠⁠⁠ Headway: ⁠⁠makeheadway.com/elevate⁠⁠ (Promo Code: Elevate) Learn more about your ad choices. Visit megaphone.fm/adchoices

Flying in the U.S. is still exceptionally safe, but the system relies on outdated tech and is under tremendous strain. Six experts tell us how it got this way and how it can (maybe) be fixed. (Part one of a two-part series.) SOURCES:Dorothy Robyn, senior fellow at I.T.I.F.Ed Bastian, C.E.O. of Delta Airlines.John Strong, professor of finance and economics at the William and Mary School of Business.Kenneth Levin, retired air traffic controller.Polly Trottenberg, former deputy secretary of the U.S. Department of Transportation. RESOURCES:"Brand New Air Traffic Control System Plan," (Federal Aviation Administration, 2025).The Air Traffic Controller Workforce Imperative: Staffing Models and Their Implementation to Ensure Safe and Efficient Airspace Operations, by the National Academies of Sciences, Engineering, and Medicine (2025)."Annual Aviation Infrastructure Report: 2025," by Marc Scribner (Reason Foundation, 2025)."New air traffic academy died in Congress despite dire need for more staff," by Lori Aratani (The Washington Post, 2025)."The Real Problem With the FAA," by Dorothy Robyn (The Atlantic, 2025)."How Much Do Jet Aircraft Pay into the Airport and Airway Trust Fund to Fly from Dallas to D.C.?" by Ann Henebery, (Eno Center for Transportation, 2018).Managing the Skies, by John Strong and Clinton Oster (2016). EXTRAS:"Freakonomics Radio Takes to the Skies," series by Freakonomics Radio (2023)."In Praise of Maintenance," by Freakonomics Radio (2016).

Dr. Laura welcomes Dr. Esther Sternberg, M.D., a Professor, Research Director, Speaker, and Author of the books Well at Work, Healing Spaces, and The Balance Within, to the podcast to talk about wellness at work and how workplace environments impact employees. Dr. Sternberg shares her career journey from her start in medical family practice through to becoming the Research Director at the Andrew Weil Center of Integrative Medicine. She and Dr. Laura talk about what factors impact health and overall wellness at work and how these can be improved.Dr. Sternberg delves into the insights in her book Well at Work and explains the seven domains of integrative health as defined by the Andrew Weil Center for Integrative Medicine. Sleep, resilience, environment, movement, relationships, spirituality, and nutrition are the seven domains, and they include things like how quickly we bounce back from stress, how clean our air is, and access to nature. Dr. Laura and Dr. Sternberg examine how office design, environmental location, common spaces that encourage relationships, and even temperature all play a key role in our workplace health. The conversation sheds light on how work isn't simply a place to invest time into productivity, but can positively or negatively impact our overall lives, and how redefining workplaces is a vital part of future discussions. “... if you're feeling too stressed or too activated, you want to do something that will tone down that stress response so you can perform at peak... If you're too stressed, you freeze, you're unable to focus. You're unable to do the job, the task at hand. So what helps you to move that stress response from the extreme danger zone back to performing at peak is places where you can go offline a little bit, where you can effectively meditate even though you're not sitting there with crossed legs in a lotus position in a yoga studio, although having spaces where some people can do that is is also beneficial. But a space, for example, [like] the gardens. To just walk in the gardens, to just take your brain off the computer for a while and focus on the green, on the plants.” - Dr. Esther SternbergAbout Dr. Esther Sternberg, M.D.:Dr. Esther Sternberg is internationally recognized for her discoveries in the science of the mind-body interaction in illness and healing, and the role of place in wellbeing. She is a pioneer and major force in collaborative initiatives on mind-body-stress-wellness and environment interrelationships. A dynamic speaker, she engages her audience with passion for her subject and compassion as a physician. Through stories, she provides listeners with many take-home tips to help them cope with stress and thrive, and to create wellbeing spaces wherever they work or live. Dr. Sternberg's three popular, highly readable, informative, and scientifically based books are inspirations for lay persons and professionals alike, seeking answers to the complexities and 21st-century frontiers of stress, place, healing, and wellness. Her award-winning book, WELL at WORK: Creating Wellbeing in Any Workspace (Little, Brown Spark, 2023) was named a Top Ten Lifestyle Book for Fall 2023 by Publishers Weekly and received the OWL (Outstanding Works of Literature) Longlist Award. Her two previous science-for-the-lay public books, Healing Spaces: The Science of Place and Well-Being and The Balance Within: The Science Connecting Health and Emotions, are landmark in its field. Healing Spaces was recognized by the President of the American Institute of Architects as an inspiration for launching the AIA's Design and Health Initiative and has inspired the implementation of healing spaces in hospitals across the country and around the world. Currently, Research Director, Andrew Weil Center for Integrative Medicine and Founding Director of the University of Arizona Institute on Place, Wellbeing & Performance, she holds the Inaugural Andrew Weil Chair for Research in Integrative Medicine and is a Research Professor of Medicine with joint appointments as Professor in Psychology, Architecture, and Planning & Landscape Architecture, and in the College of Agriculture and Life Sciences, School of Nutritional Sciences and Wellness. As Senior Scientist and Section Chief, National Institutes of Health (1986-2012), she directed the NIH Integrative Neural Immune Program, Co-Chaired the NIH Intramural Program on Research on Women's Health, and chaired a subcommittee of the NIH Central Tenure Committee. Dr. Sternberg has advised the World Health Organization; the U.S. National Academies of Sciences, Engineering and Medicine; the International WELL Building Institute; the Royal Society, London; the Vatican, where she was presented to Pope Benedict XVI; and has briefed high-level U.S. Federal Government officials, including the Surgeon General, National Institutes of Health leadership, and the Department of Defence. Her two decades-long research with the U.S. General Services Administration, using wearable devices to track health and wellbeing in the built office environment, is informing healthy design standards and COVID re-entry across the federal government and the private sector.Among other honors, she moderated a panel with the Dalai Lama, was recognized by the National Library of Medicine as one of the women who “Changed the Face of Medicine,” served as a member and Chair of NLM's Board of Regents, and received an Honorary Doctorate in Medicine from Trinity College, Dublin, on its 300th Anniversary. She has authored over 240 scholarly articles, edited 10 technical books on the topic of brain-immune connections and design and health, and writes a monthly blog for Psychology Today, it has garnered tens of thousands of readers on subjects including stress and illness, gratitude and wellness, and place and wellbeing. She co-created and hosted the PBS Television Special, The Science of Healing with Dr. Esther Sternberg, and is frequently interviewed in the lay press and media, including NPR, BBC, CBC radio; PBS, ABC, CBS 60 Minutes, Overtime television, the Washington Post, LA Times, U.S. News and World Report, Reader's Digest, Prevention Magazine, The Oprah Magazine, and numerous podcasts, among others. She received her M.D. from McGill University, and trained in rheumatology at the Royal Victoria Hospital, Montreal, Canada.Resources:Website: EstherSternberg.comBook: “Well at Work: Creating Wellbeing in any Workspace” by Esther M. Sternberg, MDInstagram: @dresternbergLinkedInLearn more about Dr. Laura on her website: https://drlaura.liveFor more resources, look into Dr. Laura's organizations: Canada Career CounsellingSynthesis Psychology

The Food and Drug Administration or FDA regulates roughly 78% of the US food supply. This includes packaged products, food additives, infant formula, ultra-processed foods, and lots more. However, an analysis by the Environmental Working Group found that 99% of new food ingredients enter our food supply through a legal loophole that skirts FDA oversight and seems, to me at least, to be incredibly risky. Today we're speaking with two authors of a recent legal and policy analysis published in the Journal Health Affairs. They explain what this loophole is and its risks and suggest a new user fee program to both strengthen the FDA's ability to regulate food ingredients and address growing concerns about food safety. Our guests are Jennifer Pomeranz Associate Professor of Public Health Policy and Management at New York University School of Global Public Health and Emily Broad, director of Harvard Law School Center for Health Law and Policy Innovation. Interview Summary So Jennifer, let's start with you, help our listeners understand the current situation with food ingredient oversight. And what is this legal loophole that allows food companies to add new ingredients without safety reviews. Sure. So, Congress passed the Food Additives Amendment in 1958, and the idea was to divide food additives and generally recognized as safe ingredients into two different categories. That's where the GRAS term comes from generally recognized as safe? ‘Generally Recognized As Safe' is GRAS. But it circularly defines food additives as something that's not GRAS. So, there's not actually a definition of these two different types of substances. But the idea was that the food industry would be required to submit a pre-market, that means before it puts the ingredient into the marketplace, a pre-market petition to the FDA to review the safety. And then the FDA promulgates a regulation for safe use of a food additive. GRAS ingredients on the other hand, initially thought of as salt, pepper, vinegar, are things like that would just be allowed to enter the food supply without that pre-market petition. The problem is the food industry is the entity that decides which category to place each ingredient. There's no FDA guidance on which category they're supposed to ascribe to these ingredients. What has happened is that the food industry has now entered into the food supply an enormous amount of ingredients under what we call the GRAS loophole, which is allowing it to just bring it to the market without any FDA oversight or even knowledge of the ingredient. So, in essence, what we're having now is that the food industry polices itself on whether to submit this pre-market petition for a food additive or just include it in its products without any FDA knowledge. When you said ‘enormous number of such things,' are we talking dozens, hundreds, thousands? Nobody knows, but the environmental working group did find that 99% of new ingredients are added through this loophole. And that's the concerning part. Well, you can look at some ultra-processed foods and they can have 30 or 40 ingredients on them. That's just one food. You can imagine that at across the food supply, how many things there are. And there are these chemicals that nobody can pronounce. You don't know what's going on, what they are, what they're all about. So, what you're saying is that the food industry decides to put these things in foods. There's some processing reason for putting them in. It's important that the public be protected against harmful ingredients. But the food industry decides what's okay to put in and what's not. Are they required to do any testing? Are there criteria for that kind of testing? Is there any sense that letting the industry police itself amounts to anything that protects the public good? Well, the criteria are supposed to be the same for GRAS or food additives. They're supposed to be meeting certain scientific criteria. But the problem with this is that for GRAS ingredients, they don't have to use published data and they can hold that scientific data to themselves. And you mentioned food labels, the ingredient list, right? That doesn't necessarily capture these ingredients. They use generic terms, corn oil, color additive, food additive whatever. And so, the actual ingredient itself is not necessarily listed on the ingredient list. There is no way to identify them and it's unknown whether they're actually doing the studies. They can engage in these, what are called GRAS panels, which are supposed to be experts that evaluate the science. But the problem is other studies have found that 100% of the people on these GRAS panels have financial conflicts of interest. Okay, so let me see if I have this right. I'm a food company. I develop a new additive to provide color or flavor or fragrance, or it's an emulsifier or something like that. I develop a chemical concoction that hasn't really been tested for human safety. I declare it safe. And the criteria I use for declaring it set safe is putting together a panel of people that I pay, who then in a hundred percent of cases say things are. That's how it works? I can't say that in a hundred percent of cases they say it's safe, but a hundred percent of the people have financial conflicts of interest. That's one of the major concerns there. Well, one can't imagine they would continue to be paid... Exactly. This sounds like a pretty shaky system to be sure. Emily: I wanted to add a couple other really quick things on the last discussion. You were saying, Kelly, like they're using a panel of experts, which indeed are paid by them. That would be best case in some cases. They're just having their own staff say, we think this is generally recognized as safe. And I think there's some examples we can give where there isn't even evidence that they went to even any outside people, even within industry. I think that the takeaway from all of that is that there's really the ability for companies to call all the shots. Make all the rules. Not tell FDA what they're doing. And then as we talked about, not even have anything on the label because it's not a required ingredient if it's, used as part of a processing agent that's not a substance on there. So I was feeling pretty bad when Jennifer is talking about these panels and the heavy conflict... Even worse. Of interest, now I feel worse because that's the best case. Totally. And one other thing too is just you kind of warmed this up by talking about this loophole. When we put an earlier article out that we wrote that was about just this generally recognized as safe, the feedback we got from FDA was this isn't a loophole. Why are you calling this a loophole? And it's pretty clear that it's a loophole, you know? It's big enough to drive thousands of ingredients through. Yes, totally. Emily, you've written about things like partially hydrogenated vegetable oils, trans fats, and red dye number three in particular. Both of which FDA has now prohibited in food. Can you walk us through those cases? You asked about partially hydrogenated oils or trans-fat, and then red dye three, which are two examples that we talk about a little bit in our piece. Actually, one of those, the partially hydrogenated oils was allowed in food through the generally recognized as safe definition. And the other was not. But they are both really good examples of another real issue that FDA has, which is that not only are they not doing a good job of policing substances going into food on the front end, but they do an even worse job of getting things out of food on the backend, post-market once they know that those substances are really raising red flags. And you raised two of the prime examples we've been talking about. With partially hydrogenated oils these are now banned in foods, but it took an extremely long time. Like the first evidence of harm was in the mid-nineties. By 2005, the Institute of Medicine, which is now the National Academies, said that intake of trans fat, of partially hydrogenated oils, should be as low as possible. And there was data from right around that time that found that 72,000 to 228,000 heart attacks in the US each year were caused by these partially hydrogenated oils. And on FDA's end, they started in early 2000s to require labeling. But it wasn't until 2015 that they passed a final rule saying that these substances were not generally recognized as safe. And then they kept delaying implementation until 2023. It was basically more than 20 years from when there was really clear evidence of harm including from respected national agencies to when FDA actually fully removed them from food. And red dye number three is another good example where there were studies from the 1980s that raised concerns about this red dye. And it was banned from cosmetics in 1990. But they still allowed it to be added to food. And didn't ban it from food until early this year. So early 2025. In large part because one of the other things happening is states are now taking action on some of these substances where they feel like we really need to protect consumers in our states. And FDA has been doing a really poor job. California banned red dye about 18 months before that and really spurred FDA to action. So that 20-year delay with between 72,000 and 228,000 heart attack deaths attributable to the trans fats is the cost of delay and inaction and I don't know, conflicts of interest, and all kinds of other stuff that happened in FDA. So we're not talking about something trivial by any means. These are life and death things are occurring. Yes. Give us another example, if you would, about something that entered the food supply and caused harm but made it through that GRAS loophole. The example that I've talked about both in some of the work we've done together and also in a perspective piece in the New England Journal of Medicine that really focused on why this is an issue. There was this substance added to food called tara flour. It came on the scene in 2022. It was in food prepared by Daily Harvest as like a protein alternative. And they were using it from a manufacturer in South America who said we have deemed this generally recognized as safe. Everything about that is completely legal. They deemed it generally recognized as safe. A company put it into food, and they sold that. Up until that point, that's all legal. What happened was very quickly people started getting really sick from this. And so there were, I think, about 400 people across 39 states got sick. Nearly 200 people ended up in the hospital, some of them with liver failure because of this toxicity of tara flour. And so FDA followed the thread they did help work with the company to do a voluntary recall, but it then took them two years, until May, 2024, to declare tara flour not generally recognized as safe. So I think, in some ways, this is a great example because it shows how it's so immediate, the impact of this substance that, again, was legally added to food with no oversight. In some ways it's a misleading example because I think so many of the substances in food, it's not going to be so clear and so immediate. It's going to be year over year, decade over decade as part of a full diet that these are causing cardiovascular risk, thyroid disease, cancer risk, those kinds of things. I'd love to hear from either of you about this. Why is FDA falling down on the job so badly? Is it that they don't have the money to do the necessary testing? Do they not have the authority? Is there not the political will to do this? Is there complete caving into the food industry? Just let them do what they want and we're going let it go? Jennifer: All of the above? Everything you just said? It's all of the above. Emily: Jen, do you wanna talk about the money side? Because that sort of gets to the genesis of the article we worked on, which was like maybe there's a creative solution to that piece. Yes, I'd love to hear about that because I thought that was a very creative thing that you guys wrote about in your paper. That there would be an industry user fee to help produce this oversight. Tell us what you had in mind with that. And then then convince me that FDA would appropriately use this oversight and do its job. So, the idea in the paper was proposing a comprehensive user fee program for the food branch of the FDA. The FDA currently collects user fees for all of human drugs, animal drugs, medical devices, etc. With Tobacco, it's a hundred percent funded by user fees. But food, it only gets 1% of its funding through user fees. And it's important to note user fees fund processes. They don't fund outcomes. It's not like a bribe. And the idea behind user fees and why industry sometimes supports them is actually to bring predictability to the regulatory state. It brings efficiency to reviews. And then this all allows the industry to anticipate timelines so they can bring products to market and know when they're going be able to do it. In the food context, for example, the FDA is required to respond to those food additives petitions that we talked about within 180 days. But they can't respond in time. And they have a lot of timelines that are required of them in the food context that they can't meet. They can't meet their timelines because they're so underfunded. So, we proposed a comprehensive user fee. But one of the main reasons that we think a user fee is important is to address the pre-market issues that I talked about and the post-market issues that Emily talked about. In order to close that GRAS loophole, first of all, FDA needs to either reevaluate its authorities or Congress needs to change its authorities. But it would need resources to be able to do something pre-market. Some of the ideas we had was that the user fee would fund some type of either pre-market review, pre-market notification, or even just a pre-market system where the FDA determines whether a proposed ingredient should go through the GRAS avenue, or through food additive petition. So at least that there will be some type of pre-market oversight over all the ingredients in the food supply. And then also the FDA is so severely lacking in any type of comprehensive post-market into play, they would have the resources to engage in a more comprehensive post-market review for all the ingredients. Could you see a time, and I bring this up because of lawsuits against the food industry for some of these additives that are going on now. The state attorney's generals are starting to get involved, and as you said, Emily, the some states are taking legislative action to ban certain things in the food supply. Do you think there could come a time when the industry will come to government pleading to have a user fee like this? To provide some standardization across jurisdictions, let's say? So, there's two things. The first is Congress has to pass the user fee, and historically, actually, industry has done exactly what you said. They have gone to Congress and said, you know what? We want user fees because we want a streamlined system, and we want to be able to know when we're bringing products to market. The problem in the context of food for the issues we're talking about is that right now they can use the GRAS loophole. So, they have very little incentive to ask for user fees if they can bring all their ingredients into the market through the GRAS loophole. There are other areas where a user fee is very relevant, such as the infant formula 90 day pre-market notification, or for different claims like health claims. They might want user fees to speed those things up, but in terms of the ingredients, unless we close the GRAS loophole, they'd have little incentive to actually come to the table. But wouldn't legal liability change that? Let's say that some of these lawsuits are successful and they start having to pay large settlements or have the State Attorneys General, for example, come down on them for these kinds of things. If they're legally liable for harm, they're causing, they need cover. And wouldn't this be worth the user fee to provide them cover for what they put in the food supply? Yes, it's great to have the flexibility to have all these things get through the loophole, but it'd be great as well to have some cover so you wouldn't have so much legal exposure. But you guys are the lawyers, so I'm not sure it makes sense. I think you're right that there are forces combining out in the world that are pushing for change here. And I think it's hard to disentangle how much is it that industry's pushing for user fees versus right now I think more willing to consider federal regulatory changes by either FDA or by Congress. At the state level this is huge. There's now becoming a patchwork across states, and I think that is really difficult for industry. We were tracking this year 93 bills in 35 states that either banned an additive in the general public, banned it in schools. Banned ultra-processed foods, which most of the states, interestingly, have all defined differently. But where they have had a definition, it's been tied to various different combinations of additives. So that's going on. And then I think you're right, that the legal cases moving along will push industry to really want clear and better standards. I think there's a good question right now around like how successful will some of these efforts be? But  what we are seeing is real movement, both in FDA and in Congress, in taking action on this. So interestingly, the Health Affairs piece that we worked on was out this spring. But we had this other piece that came out last fall and felt like we were screaming into the void about this is a problem generally recognized as safe as a really big issue. And suddenly that has really changed. And so, you know, in March FDA said they were directed by RFK (Robert F. Kennedy), by HHS (Health and Human Services) to really look into changing their rule on generally recognized as safe. So, I know that's underway. And then in Congress, multiple bills have been introduced. And I know there are several in the works that would address additives and specifically, generally recognized as safe. There's this one piece going on, which is there's forces coalescing around some better method of regulation. I think the question's really going to also be like, will Congress give adequate resources? Because there is also another scenario that I'm worried about that even if FDA said we're going now require at least notification for every substance that's generally recognized as safe. It's a flood of substances. And they just, without more resources, without more staff devoted to this, there's no way that they're going to be able to wade through that. So, I think that either the resources need to come from user fees, or at least partially from user fees, from more appropriations and I think, In my opinion, they are able to do that on their own. Even given where current administrative law stands. Because I think it's very clear that the gist of the statute is that FDA should be overseeing additives. And I think a court would say this is allowing everything to instead go through this alternative pathway. But I really think FDA's going to need resources to manage this. And perhaps more of a push from Congress to make sure that they really do it to the best of their ability. I was going to say there's also an alternative world where we don't end up spending any of these resources, and they require the industry just to disclose all the ingredients they've added to food and put it on a database. This is like low hanging fruit, not very expensive, doesn't require funding. And then the NGOs, I hope, would go to work and say, look at this. There is no safety data for these ingredients. You know, because right now we just can't rely on FDA to do anything unless they get more funding to do something. So, if FDA doesn't get funding, then maybe this database where houses every ingredient that's in the food supply as a requirement could be a low resource solution. Jennifer, I'll come back to you in a minute because I'd like to ask how worried should we be about all this stuff that's going into food. But Emily, let me ask you first, does FDA have the authority to do what it needs to do? Let's say all of a sudden that your wish was granted and there were user fees would it then be able to do what needs to be done? I think certainly to be able to charge these user fees in almost all areas, it right now doesn't have that authority, and Congress would need to act. There's one small area which is within the Food Safety Modernization Act for certain types of like repeat inspections or recalls or there's a couple other. FDA isn't charging fees right now because they haven't taken this one step that they need to take. But they do have the authority if they just take those steps. But for everything else, Congress has to act. I think the real question to me is because we now know so many of these substances are going through this GRAS pathway, the question is really can they do everything they need to do on their own to close that loophole? And again, my opinion is Congress could make it clear and if Congress were to act, it would be better. Like they could redefine it in a way that was much more clear that we are drawing a real line. And most things actually should be on the additive side of the line rather than the generally recognized as safe side of the line. But even with their current authority, with the current definition, I think FDA could at least require notification because they're still drawing a line between what's required for additives, which is a very lengthy pre-market process with, you know, a notice and comment procedure and all of these things. My take is FDA do what you can do now. Let's get the show on the road. Let's take steps here to close up the loophole. And then Congress takes time. But they definitely can even strengthen this and give a little more, I think, directives to FDA as to how to make sure that this loophole doesn't recur down the line. In talks that I've given recently, I've shown an ingredient list from a food that people will recognize. And I ask people to try to guess what that food is from its ingredient list. This particular food has 35 ingredients. You know, a bunch of them that are very hard to pronounce. Very few people would even have any idea at all what those ingredients do. There's no sense at all about how ingredient number 17 would interact with ingredient 31, etc. And it just seems like it's complete chaos. And I don't want to take you guys outside your comfort zone because your backgrounds are law. But Jennifer, let me ask you this. You have a background in public health as well. There are all kinds of reasons to be worried about this, aren't there? There are the concerns about the safety of these things, but then there's a concern about what these ultra-processed ingredients do to your metabolism, your ability to control your weight, to regulate your hunger and things like that. It sounds this is a really important thing. And it's affecting almost everybody in the country. The percentage of calories that are now coming from ultra-processed foods is over 50% in both children and adults. So it sounds like there's really reason to worry. Would you agree? Yes. And also, the FDA is supposed to be overseeing the cumulative effects of the ingredients and it doesn't actually enforce that regulation. Its own regulation that it's supposed to evaluate the cumulative effects. It doesn't actually enforce this. So by cumulative effects do you mean the chronic effects of long term use? And, having these ingredients across multiple products within one person's consumption. Also, the FDA doesn't look at things like the effect on the gut microbiome, neurotoxicity, even cancer risk, even though they're supposed to, they say that if something is GRAS, they don't need to look at it because cancer risk is relegated only to food additives. So here we're at a real issue, right? Because if everything's entering through the GRAS loophole, then they're not looking at carcinogen effects. So, I think there is a big risk and as Emily had said earlier, that these are sometimes long-term risks versus that acute example of tara flour that we don't know. And we do know from the science, both older and emerging science, that ultra-processed food has definite impact on not only consumption, increased consumption, but also on diet related diseases and other health effects. And by definition what we're talking about here are ultra-processed foods. These ingredients are only found in ultra-processed foods. So, we do know that there is cause for concern. It's interesting that you mentioned the microbiome because we've recorded a cluster of podcasts on the microbiome and another cluster of podcasts on artificial sweeteners. Those two universes overlap a good bit because the impact of the artificial sweeteners on some of them, at least on the microbiome, is really pretty negative. And that's just one thing that goes into these foods. It really is pretty important. By the way, that food with 35 ingredients that I mentioned is a strawberry poptart. Jennifer: I know that answer! Emily: How do you know that? Jennifer: Because I've seen Kelly give a million talks. Yes, she has. Emily: I was wondering, I was like, are we never going to find out? So the suspense is lifted. Let me end with this. This has been highly instructive, and I really appreciate you both weighing in on this. So let me ask each of you, is there reason to be optimistic that things could improve. Emily, I'll start with you. So, I've been giving this talk the past few months that's called basically like Chronic Disease, Food Additives and MAHA, like What Could Go Right and What Could Go Wrong. And so, I'm going give you a very lawyerly answer, which is, I feel optimistic because there's attention on the issue. I think states are taking action and there's more attention to this across the political spectrum, which both means things are happening and means that the narrative changing, like people are getting more aware and calling for change in a way that we weren't seeing. On the flip side, I think there's a lot that could go wrong. You know, I think some of the state bills are great and some of them are maybe not so great. And then I think this administration, you have an HHS and FDA saying, they're going to take action on this in the midst of an administration that's otherwise very deregulatory. In particular, they're not supposed to put out new regulations if they can get rid of 10 existing ones. There are some things you can do through guidance and signaling, but I don't think you can really fix these issues without like real durable legislative change. So, I'm sorry to be one of the lawyers here. I think the signals are going in the right direction, but jury is out a little bit on how well we'll actually do. And I hope we can do well given the momentum. What do you think, Jennifer? I agree that the national attention is very promising to these issues. The states are passing laws that are shocking to me. That Texas passing a warning label law, I would never have thought in the history of the world, that Texas would be the one to pass a warning label law. They're doing great things and I actually have hope that something can come of this. But I am concerned at the federal level of the focus on deregulation may make it impossible. User fees is an example of where they won't have to regulate, but they could provide funding to the FDA to actually act in areas that it has the authority to act. That is one solution that could actually work under this administration if they were amenable to it. But I also think in some ways the states could save us. I worry, you know, Emily brought up the patchwork, which is the key term the industry uses to try to get preemption. I do worry about federal preemption of state actions. But the states right now are the ones saving us. California is the first to save the whole nation. The food industry isn't going to create new food supply for California and then the rest of the country. And then it's the same with other states. So, the states might be the ones that actually can make some real meaningful changes and get some of the most unsafe ingredients out of the food supply, which some of the states have now successfully done. Bios Emily Broad Leib is a Clinical Professor of Law, Director of Harvard Law School Center for Health Law and Policy Innovation, and Founding Director of the Harvard Law School Food Law and Policy Clinic, the nation's first law school clinic devoted to providing legal and policy solutions to the health, economic, and environmental challenges facing our food system. Working directly with clients and communities, Broad Leib champions community-led food system change, reduction in food waste, food access and food is medicine interventions, and equity and sustainability in food production. Her scholarly work has been published in the California Law Review, Wisconsin Law Review, Harvard Law & Policy Review, Food & Drug Law Journal, and Journal of Food Law & Policy, among others. Professor Jennifer Pomeranz is a public health lawyer who researches policy and legal options to address the food environment, obesity, products that cause public harm, and social injustice that lead to health disparities. Prior to joining the NYU faculty, Professor Pomeranz was an Assistant Professor at the School of Public Health at Temple University and in the Center for Obesity Research and Education at Temple. She was previously the Director of Legal Initiatives at the Rudd Center for Food Policy and Obesity at Yale University. She has also authored numerous peer-reviewed and law review journal articles and a book, Food Law for Public Health, published by Oxford University Press in 2016. Professor Pomeranz leads the Public Health Policy Research Lab and regularly teaches Public Health Law and Food Policy for Public Health.

In this episode of Stanford Legal, host Professor Pamela Karlan interviews her Stanford Law School colleague Professor Lisa Larrimore Ouellette about actions by the Trump administration that Ouellette says are undermining scientific research and jeopardizing America's longstanding global leadership in medicine and innovation. Drawing on an essay she penned for Just Security, Ouellette explains how decades of bipartisan support for federally funded science—an engine of American innovation since World War II—is now at risk. From canceling grants already approved through peer review, to capping essential “indirect cost” reimbursements, she details how these moves threaten not just labs and universities but also patients, whose clinical trials are being abruptly halted.  Ouellette also highlights a second front in her current scholarship: how drug development policy can be better aligned with public health needs. As a member of a National Academies committee, she recently co-authored a report showing that both private investment and federal funding often fail to prioritize diseases causing the greatest suffering. Links:Lisa Larrimore Ouellette >>> Stanford Law pageThe Trump Administration's Multi-Front Assault on Federal Research Funding  >>> Just Security pageStanford Law's Lisa Ouellette Helps Shape New Report on Drug Development Reform  >>> Stanford Lawyer online featureConnect:Episode Transcripts >>> Stanford Legal Podcast WebsiteStanford Legal Podcast >>> LinkedIn PageRich Ford >>>  Twitter/XPam Karlan >>> Stanford Law School PageStanford Law School >>> Twitter/XStanford Lawyer Magazine >>> Twitter/X(00:00) Research Funding (05:01) The Competitive Grant Process (15:01) Addressing Disease Burden (20:00) Impacts of Stopped Clinical Trials (25:01) The Role of Federal Investment in Innovation 

You can find all the wonderful links on the linktree: https://linktr.ee/allts   Havana Syndrome is the name given to a series of mysterious health incidents that first came to public attention in late 2016, when U.S. diplomats and intelligence officers in Havana, Cuba, began reporting sudden, unexplained symptoms. The affected individuals described strange experiences—sometimes preceded by hearing a piercing, high-pitched sound or feeling pressure in their heads—followed by a range of medical issues, such as dizziness, headaches, nausea, hearing loss, vision problems, difficulty concentrating, and even cognitive impairment. The first wave occurred among personnel at the U.S. and Canadian embassies in Cuba, leading to strained diplomatic relations between the U.S. and Cuba. Over the following years, reports of similar incidents spread to U.S. diplomats, spies, and other officials stationed in places like China, Russia, Europe, and even Washington, D.C. The U.S. government called the episodes "anomalous health incidents" (AHIs). From the start, theories about the cause varied widely: Directed Energy Weapons: One of the earliest and most sensational explanations was that a hostile power was using microwave or ultrasonic devices to target U.S. personnel, possibly for espionage or harassment. Sonic or Acoustic Devices: Early Cuban incidents led some to suspect hidden sound-based weapons, though experts quickly noted that most sound frequencies capable of causing physical harm would be unlikely to travel through walls and over distances without being obvious. Environmental Factors: Some scientists proposed that toxins, pesticides, or natural phenomena could have caused the symptoms. Mass Psychogenic Illness: Others suggested that stress, anxiety, and suggestion among closely knit groups could explain the spread of symptoms without a single physical cause. Medical Conditions: A few cases may have been unrelated illnesses that were misattributed to a larger pattern. Despite years of investigation—including from the FBI, CIA, CDC, and National Academies of Sciences—the cause remains disputed. In 2023, the U.S. intelligence community released an assessment stating that most cases could be explained by medical conditions, environmental factors, or stress responses, and that there was no credible evidence of a sustained foreign attack. However, some affected individuals and scientists remain unconvinced, pointing to the severity and clustering of symptoms as evidence of something more deliberate. The Havana Syndrome debate has since become part of both diplomatic security policy and modern espionage lore—half genuine medical mystery, half geopolitical intrigue. If you want, I can also map out the timeline of incidents to show how it spread from Havana to other parts of the world. That's where the story gets especially strange.

Medicine stands at the threshold of a new era, where artificial intelligence and systems biology are working hand in hand to make care more personal, predictive, and precise than ever before. AI is already improving diagnostic accuracy, automating administrative tasks, and uncovering patterns in data—like retinal scans or genomics—that humans often miss. Rather than replacing doctors, AI enhances their ability to deliver more informed, precise, and efficient care. At the same time, individuals are gaining tools—from at-home diagnostics to wearable biosensors—that empower them to track and optimize their own health. This shift marks a move from reactive, disease-centered care to a proactive, data-driven model of scientific wellness. In this episode, I talk with Dr. Eric Topol, Dr. Nathan Price, Dr. Leroy Hood, Dr. Vijay Pande, and Daisy Wolf about how artificial intelligence, personalized data, and wearable technology are converging to radically transform medicine. Dr. Eric Topol is Executive Vice President of Scripps Research and founder/director of its Translational Institute, recognized as one of the top 10 most cited researchers in medicine with over 1,300 publications. A cardiologist and author of several bestselling books on the future of medicine, he leads major NIH grants in precision medicine and shares cutting-edge biomedical insights through his Ground Truths newsletter and podcast. Dr. Nathan Price is Chief Scientific Officer at Thorne HealthTech, author of The Age of Scientific Wellness, and a National Academy of Medicine Emerging Leader. He also serves on the Board on Life Sciences for the National Academies and is Affiliate Faculty in Bioengineering and Computer Science at the University of Washington. Dr. Leroy Hood is CEO and founder of Phenome Health, leading the Human Phenome Initiative to sequence and track the health of one million people over 10 years. A pioneer in systems biology and co-founder of 17 biotech companies, he is a recipient of the Lasker Prize, Kyoto Prize, and National Medal of Science. Dr. Vijay Pande is a General Partner at Andreessen Horowitz and founder of a16z Bio + Health, managing over $3 billion in life sciences and healthcare investments at the intersection of biology and AI. An Adjunct Professor at Stanford, he is known for his work in computational science, earning honors like the DeLano Prize and a Guinness World Record for Folding@Home. Daisy Wolf is an investing partner at Andreessen Horowitz, specializing in healthcare AI, consumer health, and healthcare-fintech innovation. She previously worked at Meta and in various startups, holds a JD from Yale Law, an MBA from Stanford, and a BA from Yale, and is based in New York City. This episode is brought to you by BIOptimizers. Head to bioptimizers.com/hyman and use code HYMAN10 to save 10%. Full-length episodes can be found here: Can AI Fix Our Health and Our Healthcare System? The Next Revolution In Medicine: Scientific Wellness, AI And Disease Reversal The Future of Healthcare: The Role of AI and Technology

It is not manifestly obvious that universities should be where most scholarly research is performed. One could imagine systems that separated out the tasks of "teaching students" and "generating new knowledge." But it turns out that combining them yields spectacular synergies, both from letting students experience cutting-edge research and from keeping researchers inspired by interacting with bright young minds. Today we talk to Elizabeth Mynatt, Dean of Computer Science at Northeastern, both about her own research in "human-centered computing," and about the bigger-picture issues of why basic research is important, and why universities are such good places to do it.Blog post with transcript: https://www.preposterousuniverse.com/podcast/2025/08/11/324-elizabeth-mynatt-on-universities-and-the-importance-of-basic-research/Support Mindscape on Patreon.Elizabeth Mynatt received a Ph.D. in computer science from the Georgia Institute of Technology. She is currently Dean of the Khoury College of Computer Sciences at Northeastern University. She is a senior investigator with Emory's Cognitive Empowerment Program and co-PI for the NSF AI-CARING Institute. She is a fellow of the Association for Computing Machinery and the American Association for the Advancement of Science, and a member of the American Academy of Arts and Sciences. She was lead author on the National Academies report, "Information Technology Innovation: Resurgence, Confluence, and Continuing Impact."Web pageGoogle Scholar publicationsWikipediaSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

The National Academies of Sciences, Engineering, and Medicine is developing a framework for assessing drought in a changing climate. It's a difficult task, as what's considered drought is often situational.

Jonny Dyer is the Co-Founder and CEO of Muon Space, an end-to-end space systems provider that designs, builds, and operates LEO satellite constellations that deliver mission-critical data. Prior to Muon, Jonny held technical leadership roles at Google Maps and Lyft, and was the Chief Engineer at Skybox Imaging.  On this episode of the Defense Tech Underground, Jonny discusses his background at Skybox Imaging and his experience building Muon Space. He describes Muon's approach to building satellite constellations end to end, and highlights the role of the FireSat constellation to provide operational guidance on the mitigation of wildfires. Jonny shares lessons learned from leading Muon, and explains how he has thought through pivotal moments in Muon's journey, such as their recent acquisition of Starlight Engines.  This episode is hosted by Helen Phillips and Bryan Harvey.    Full Bio:  Jonny Dyer is Co-Founder & CEO of Muon Space, with a remarkable career spanning aerospace, geospatial technology, and complex systems engineering across industry-shaping companies. As Chief Engineer at Skybox Imaging, he led development of the largest high-resolution satellite constellation ever deployed before the company's $500M acquisition by Google in 2014. At Google, he headed Maps' data collection team developing Street View cars and aircraft platforms, then served as Senior Director at Lyft's Level 5 Autonomous Vehicle group leading vehicle platform design and deployment. Currently an Operating Partner at Space Capital and advisor to Ubiquity.vc, Jonny also serves as a founding member of EDF's MethaneSat Technical Advisory Group and has served on multiple National Academies studies and committees. He holds MS and BS degrees in Mechanical Engineering from Stanford University and has authored widely-cited research spanning thermodynamics, radiation effects, and imaging systems.  

Story at-a-glance A specific type of fiber called beta-glucan, found in oats and barley, was shown to reduce levels of harmful PFAS chemicals in the blood within just four weeks Participants who consumed beta-glucan experienced significant drops in legacy PFAS compounds like PFOA and PFOS, which are linked to cancer and hormone disruption The fiber group was the only one to show a meaningful reduction in the seven most high-risk PFAS chemicals identified by the National Academies of Sciences, including those that raise your risk for thyroid disease, cancer and ulcerative colitis In a follow-up study using mice, animals exposed to high PFAS levels but fed beta-glucan had lower blood PFAS, improved fat metabolism and less liver stress compared to controls The key to beta-glucan's effect is its gel-forming action in your gut, which traps PFAS and interrupts their reabsorption cycle, allowing your body to eliminate them through stool

In this forward-looking episode of Practical Significance, co-hosts Donna LaLonde and Ron Wasserstein sit down with a powerhouse panel to explore where statistics is headed over the next decade. Kathy Ensor (Rice University), Lance Waller (Emory University), and Brittany Segundo (National Academies) dive into a major National Academies consensus study: Frontiers of Statistics in Science and Engineering: 2035 and Beyond. Ensor (chair) and Waller (vice chair) are […]

Hello, and welcome to season six of Looking at Lyme! We're thrilled to be kicking off this season talking with contributors of an important new research report from the National Academies of Sciences, Engineering and Medicine, which studied current gaps in research and treatments for Lyme Infection-Associated Chronic Illnesses.Dr. Kent Kester is board certified in both internal medicine and infectious diseases, is the chair of the publication committee, and is the vice chair of the National Academy of Medicine Forum on Microbial Threats. During his 24-year career in the U.S. Army, Kent led multiple research platforms at the biggest and most diverse lab with the Department of Defense, with a significant emphasis on emerging infectious diseases, and later led that institution as its commander.Nicole Malachowski is a retired air force fighter pilot, National Women's Hall of Famer, Keynote speaker, and Tick Borne Illness Patient Advocate. She lives and works in Colorado and she represents the patient perspective on the NASEM committee that produced this important new research.Their new publication is called “Charting a Path Toward New Treatments for Lyme Infection-Associated Chronic Illness”. (https://doi.org/10.17226/28578) We spoke with these two about their experiences putting together this report, and what impact they hope it will have moving forward.

In this forward-looking episode of Practical Significance, co-hosts Donna LaLonde and Ron Wasserstein sit down with a powerhouse panel to explore where statistics is headed over the next decade. Kathy Ensor (Rice University), Lance Waller (Emory University), and Brittany Segundo (National Academies) dive into a major National Academies consensus study: Frontiers of Statistics in Science and Engineering: 2035 and Beyond. Ensor (chair) and Waller (vice chair) are leading the committee working on this ambitious study. They share what drove them to tackle such a monumental project and why statistics is more ... The post Practical Significance | Episode 55: Forward Stats—Frontiers of Statistics in Science and Engineering: 2035 and Beyond first appeared on Amstat News.

Episode Summary:In this transformative episode of Secrets of Survival, Dr. Susan Rashid unpacks the intersection of clinical care and the Social Determinants of Health (SDOH) through the lens of the CMS Accountable Health Communities Health-Related Social Needs (HRSN) Screening Tool. Amid the pressures of time-limited visits and documentation burdens, this episode argues for a paradigm shift—one where asking the right questions becomes a form of clinical justice.Segment by segment, Dr. Rashid walks listeners through the five core domains—housing instability, food insecurity, transportation barriers, utility needs, and interpersonal safety—and introduces supplemental domains including financial strain, employment, community support, education, physical activity, substance use, mental health, and disability. With clarity and compassion, she demonstrates how these structured questions serve as clinical windows into hidden vulnerabilities—revealing the context behind medication non-adherence, chronic illness exacerbation, and missed appointments.The episode emphasizes that screening is not merely data collection—it is clinical witnessing. The ability to ask, listen, and respond with actionable referrals is presented not as a luxury, but as a clinical imperative. Citing national guidelines and landmark evidence from CMS, the National Academies, and leading scholars, Dr. Rashid reframes SDOH as the modern foundation of primary care.From medical education to healthcare system design, listeners are called to envision a future where healing is not confined to prescriptions, but extended through structurally aware care, community partnerships, and institutional accountability. This episode is both a masterclass in clinical application and a compelling call to action for medical educators, health system leaders, and frontline clinicians.

Linda S. Birnbaum, Ph.D., D.A.B.T., A.T.S. is the former Director of the National Institute of Environmental Health Sciences (NIEHS) of the National Institutes of Health, and the National Toxicology Program (NTP). After retirement, she was granted scientist emeritus status and still maintains a laboratory. As a board-certified toxicologist, Birnbaum served as a federal scientist for 40 years. Prior to her appointment as NIEHS and NTP Director in 2009, she spent 19 years at the U.S. Environmental Protection Agency (EPA), where she directed the largest division focusing on environmental health research. Birnbaum has received many awards and recognitions. In 2016, she was awarded the North Carolina Award in Science. She was elected to the Institute of Medicine of the National Academies, one of the highest honors in the fields of medicine and health. She was also elected to the Collegium Ramazzini, an independent, international academy comprised of internationally renowned experts in the fields of occupational and environmental health and received an honorary Doctor of Science from the University of Rochester and a Distinguished Alumna Award from the University of Illinois. She has also received Honorary Doctorates from the University of Rhode Island, Ben-Gurion University, Israel, and Amity University, India; the Surgeon General's Medallion 2014; and 14 Scientific and Technological Achievement Awards, which reflect the recommendations of EPA's external Science Advisory Board, for specific publications. Dr. Birnbaum recently received the Winslow Award, the highest honor from the Yale School of Public Health and was elected an AAAS Fellow. She has also received numerous awards from professional societies and citizen's groups. Birnbaum is an active member of the scientific community. She was vice president of the International Union of Toxicology, the umbrella organization for toxicology societies in more than 50 countries, and former president of the Society of Toxicology, the largest professional organization of toxicologists in the world. She is the author of more than 1000 peer-reviewed publications, book chapters, abstracts, and reports. Birnbaum's own research focuses on the pharmacokinetic behavior of environmental chemicals, mechanisms of action of toxicants including endocrine disruption, and linking of real-world exposures to health effects. She is an adjunct professor at the University of Queensland in Australia, the School of Public Health of Yale University, the Gillings School of Global Public Health, the Curriculum in Toxicology, and the Department of Environmental Sciences and Engineering at the University of North Carolina at Chapel Hill, as well as in the Integrated Toxicology and Environmental Health Program at Duke University where she is also a Scholar in Residence. A native of New Jersey, Birnbaum received her M.S. and Ph.D. in microbiology from the University of Illinois at Urbana-Champaign.

The U.S. investments in nanotechnology science over the past two decades positioned us as a global leader in this foundational discipline. But a new report from the National Academies of Science warns that, without continued investment, we're at risk of ceding our leadership to other countries, to the detriment of our innovative industries. The Chair of that report, Dean of the LSU College of Engineering and the Bert S. Turner chair, Dr. Vicki Colvin is here to discuss the report and its implications.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

In this edition of Between Two Nerds Tom Uren and The Grugq talk about cyber's ‘hard problems' and why they are intractable. This episode is also available on Youtube. Show notes Cyber Hard Problems, from the National Academies of Sciences

Dr. Joel Berg is joined by cariology expert Dr. Brian Novy for a discussion on all there's still to learn about dental caries. Dr. Novy delves into the importance for practitioners to understand the science of cariology, particularly when working with patients and families that may be opposed to traditional treatments, like fluoride. He also shares his personal path in evidence-based dentistry research and how this work has improved his approach to educating the future generation of dentists. Guest Bio: Often described as “The tenth dentist,” Dr. Brian B. Nový has faculty appointments at Virginia Commonwealth University and Harvard School of Dental Medicine. He served on the American Dental Association Council of Scientific Affairs from 2010-2014, and in 2016 was appointed the consumer representative to the United States Food & Drug Administration Dental Products Panel. His papers are published in various journals including the Journal of the American Dental Association, the Journal of Dental Research, the Journal of Evidence Based Dentistry, Dentistry Today, Inside Dentistry, Dental Economics, Compendium, the National Academies of Medicine, and the International Journal of Equity in HealthSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Do you pay attention to information printed on food labels? From eye-catching designs companies use to entice you to buy a product to nutrition facts panels to the tiny dates printed on packages. There's a lot going on to be sure. For policymakers, they hope that refining date labels on food packaging will help reduce the amount of uneaten food ending up in landfills. Food Waste is a major contributor to greenhouse gas emissions. The Food and Drug Administration and the Food Safety and Inspection Service recently asked for public input on food date labels. So, we decided to gather some experts together to talk about this important policy tool. Roni Neff is a professor in the Johns Hopkins Bloomberg School of Public Health and Senior Advisor at the School's Center for a Livable Future. Her research looks at the intersection of food waste policy, climate change, and food system resilience. Brian Roe is a professor at the Ohio State University Department of Agricultural, Environmental and Developmental Economics. His work focuses on issues including agricultural marketing, information policy, behavioral economics, and product quality. Ruiqing Miao is an associate professor of agricultural economics and rural sociology at Auburn University's College of Agriculture. His research emphasizes sustainability, innovation, and decision making. Interview Summary Brian, let's begin with you and let's make sure everyone's on the same page. Can you talk to us a little bit about what date labels are and where they are on packaging. And what is industry required to include in terms of these date labels? Yes, so date labels, we see them anytime we pick up a food package. Most packages are going to have some type of date label on them. Oddly, federal law doesn't regulate these or really require these other than the exception of infant formula, which is the only federal requirement domain out there. But in the absence of federal regulation, states have kind of done their own thing. About 40 different states require date labels on at least some food products. And about 20 states prohibit or restrict the sale or donation of food past the label date. And even though states that require date labels, manufacturers can still choose the dates. There are no real regulations on them. So, recognizing that confusion over date labels can lead to unnecessary food waste, Government and industry actors have made, you know, some efforts to try to standardize date labeling language. But nothing terribly authoritative. Now, some states have introduced bills that seek to standardize date labels, with the motivation to try to get rid of and reduce food waste. California being perhaps the most recent of these. In 2024, they passed a bill that prohibits the use of any date label other than 'Best if Used By,' the phrase that goes along with foods where the date represents kind of a quality indicator. And then the phrase 'Use By,", if that date has some implications for product safety. The bill doesn't go into effect until July of '26, so we're going to see if this is going to create a domino effect across other states, across the food manufacturing center or even bubble up and be dealt with at the federal legislation level. Now, industries tried to do things before. Back in 2017, the Food Marketing Institute and the Grocers Manufacturers Association had a standardized date labeling suggestion that some firms bought into. FDA has given out some guidance about preferring 'Best if Used By' on certain food products to indicate quality. But again, we're all kind of waiting to see if there might be a federal legislation that kind of brings these state labels into check. Thanks, Brian. And it's really important to know about the policy landscape and the fact that there hasn't been a federal policy across all foods. And it's interesting to see the efforts of, say, in California. I think this begs the question; how do consumers actually process the information of date labels? This fascinated us too. A very clever person at Ohio State that I work with, Dr. Aishwarya Badiger, led a study I was part of. We enlisted consumers to come into the Consumer Evaluation Lab that we have here on campus and evaluate samples of milk. They were presented with the label of each milk. We gave them a little glass with a nose full of the milk that they could sniff. So, they're looking at the date label, they're given the sample they could smell, and then we kind of asked them, Hey, if this were in your fridge, would you keep it or toss it? But the entire time we actually had them fitted with special glasses that precisely track their eye movements so we could understand kind of which information they were looking at while they went through the whole process of evaluating and then making their decision. Consumers overwhelmingly looked at the date itself on the package and largely ignored the phrase or the words that go along with the date. In fact, for more than half of the evaluations, the consumer's eyes never went anywhere near the phrase. This is important. And actually, we'll talk about that a little bit more with some of our other guests. So, what are the implications of date label policies? So the eye tracking research really drove home to me that dates are much more salient than phrases. Although all the policies largely deal with the phrases. Dates give you actionable information. People can look at the date on the label, look at the calendar, and man, that's something they can do something about. They can act based upon that. The phrases are a little bit more ambiguous as Roni will talk about later. I think that people have a hard time interpreting what those phrases really mean. That doesn't mean we should not try to unify those phrases, but rather this is going to be a longer-term investment in educational infrastructure that until those phrases really become salient and actionable to consumers. And then become more of a critical component of the policies. But right now, policies are generally silent on dates. And dates seem to be the real action mover. Yeah. So why don't we just get rid of all of this? What would be the implications? Yes. We did this experiment too. Same kind of setup. Had people come in, they had the jug of the milk in front of them. They had a glass of milk that they could sniff. Same thing. And we had a bunch of different milks. We had some that were only like 15 days post pasteurization. Some that went out to like 40 days past pasteurization. So, the youngest or the freshest had about three days, quote unquote, left on its date label. The 40-day old milk was like two or three weeks past the date. And we did two things. We had them evaluate the milk with the dates on the jugs, and then we had ones where we took the dates and the labels off the milk. Not surprisingly, when they did not have the dates on the milk, they were much more likely to say that they would keep the milk. Even that 40-day old milk, about half of them said, yeah, I'd drink this. I'd keep this if it were in my fridge. But it wasn't a slam dunk. So, our youngest and freshest milk had an odd flavor note. You know, sometimes as the seasons change, feed sources change for cattle, you get an odd flavor note. It's not spoilage, it's just a slightly different note. And when people have the date label, they were much more willing to give that milk a second chance and say that they would keep it. But if the date label wasn't on there, they took that odd flavor note and said, I'm going to toss this milk. So, it's really kind of a nuanced thing. And if you would take those off, I think you're going to get some consumers who are going to kind of freak out without any guidance. And they might have kind of an itchy trigger finger when it comes to throwing away that milk or other products. So, it's compelling. We've seen England, the UK, do this; take dates off of certain products. But I would probably want to see a little more example of how consumers are responding to that before I fully endorse that as kind of a policy movement forward. Brian, thank you for that. And I have got to say, I was not expecting to have a conversation about the bouquet of a glass of milk. But this is really an interesting finding, and it does help us understand some other things that we're going to talk about. Roni, I want to turn our attention to you. And I know you are someone who's been involved in understanding date labels for a while. And I really appreciate it and I've said it before, but you're the reason I got into this work. I want to understand a little bit more about what are important things to understand about the misconceptions that consumers may have about food date labels? And why does it matter for policymakers? Well, I'll start with just saying that conceptions are what we know rationally. And it's not the whole picture because as Brian was alluding to a lot of our decision making is going on in our emotions. And like I can tell my son all day long the fact that that milk is okay, he's going to toss it because he doesn't trust it. There's a lot more going on than conceptions. But I want to talk about two misconceptions. The first one is that despite what Brian just said about the fact that these date labels other than infant formula aren't federally regulated, about two in five people think that they are. We just did a national consumer survey in January 2025, and this is one of the findings. And I did that along with Emily Broad Lieb from the Harvard Food Law and Policy Project and Akif Khan also from there, and then Dana Gunders from ReFED. And in addition to this idea that they're federally regulated, I'll say that these kinds of beliefs were most common among those who were 18 to 34, parents with children under age 18, and black and Hispanic consumers. Our earlier work also found that those who think that food date labels are federally regulated are more likely to discard food based on them. All this speaks to a real challenge. And, you know, it kind of makes sense, like if you see something and you trust it, that it's from the federal government. And of course, we all trust the federal government these days. If you trust it, then you're going to respond to it. So that's an implication for food policy. And then the next thing we did also is that we tested understanding of five different food date label phrases: a date with no text, and then two of those phrases accompanied by icon images. And since none of these actually have a federally recognized meaning the correct answer for all of them in terms of the meaning is like other. But we also accepted answers that were aligned with that voluntary industry standard, just to kind of see how people were perceiving it. And, across all of these labels, only an average of 53% of people answered correctly about what these labels meant. Now, consumers were pretty good at identifying 'Best if Used By' as a quality label. But the real challenge comes in with 'Use By' which under the voluntary industry standards should be a safety label. And more people thought it was a quality label than thought it was a safety label; 44% versus 49%. And so, we need to clear up these misconceptions in support of food safety, in support of food waste prevention. But in order to do that, we need to be able to tell people clearly what the labels mean. And we can't really do that if there's no standardized meaning of what they mean. So, we really need a national standard, and that is the policy implication. Thank you for that. And I know Ruiqing and I have done some work in this space and in part learning from what you all have done. I'm interested because you mentioned the 2025 survey, but of course you also mentioned the 2016 survey. Are there any big shifts or anything that you want to tell us about changes that you see from those two different surveys? We asked a number of the same or almost identical questions in those two surveys. And since that time, we've adopted a voluntary industry standard and there's been a lot of education and communication about wasted food. And yet in our survey we actually found that things were going in the wrong direction. Consumer misunderstandings of date labels increased. Those who quote always or usually discard food based on the label: in 2016, that was 37%, and this year it was 43%. And then in terms of belief that these are federally regulated: in 2016 it was 36% and now it's 44%. We're going in the wrong direction despite all these activities, and I don't know why. I think for those who are looking for future research questions, this would be a really interesting one. This is really disturbing because all of the information that's come out about date labels. I thought people would understand this. And that this is where we would be in a different place. So, this work is really important. So, how did people's response to date labels vary by food item? Did you see any differences? Because this is something that comes up often that people may be more responsive to some food products versus others? Yeah, indeed. We asked about five different foods, and we showed a bunch of different labels for each food. And the responses did vary both based on the item and based on what label was on it. And I'll start with where caution is needed. Deli meats are one example of where we really want people to pay attention to that label. And while there's no federal standard that label's the best piece of information people has, so they should use it. And we found that only 65% would throw out the deli meat before, on, or just after the 'Use By' label. And the number of people that would respond to it reduced with other labels that were used, and older adults were most likely to disregard those labels. And they may be particularly vulnerable in terms of foodborne illness. So that's when lack of caution leads to risk. On the other hand, when caution leads to waste, we looked at raw chicken, pasteurized milk, lettuce, and breakfast cereal. And for all of those there, like the label is really only telling you about quality, and consumers should use their senses to decide, and knowledge of how that was, stored to decide whether to eat it. And so, the most common out of all five foods, including the deli, the one that they responded the strongest to was raw chicken. And that chicken can be contaminated as we know, but if you cook it, you're killing those bacteria, so it's okay. And averaging across all those different date labels, we found 54% would discard these four foods based on the date. And the piece that was most striking to me was that for breakfast cereal, 43% said they were discarded based on the date. So, we've got some education to do. Yeah. In the earlier paper I did with colleagues at Cornell, we used breakfast cereal and we were surprised to see how much people willing to throw away breakfast cereal if it were passed to date. There is confirmation and we see this happen in many other products. And we'll definitely talk about some of those product differences with Ruiqing. The last question I'd like to ask you is you found that many consumers thought they knew the meanings of the various food date labels, but they were incorrect. And in some of the work that you've done in the past, you found that many people answered incorrectly even after viewing information about the labels. So even when you educated folks or gave people information, they still made incorrect choices. Why do you think this is, and what should we do about it? And some people's responses do improve when you show them the information, but it was striking in that study that seconds after having read the definition, according to the voluntary industry standard, people were giving the wrong answer. Even though they had previously said that they thought they understood it. So, to me, this suggests that they already think they know the answer and so they're not tuning in. And this speaks to a real challenge that we're going to have when we do standardize these date labels. How are we going to reach people and capture their attention. Like, if we just change the policy, that does nothing. We've got to reach people and we've got to do it in a sophisticated and well-planned way. And I think the education should also emphasize that misunderstandings are common because that might be something that would help wake people up. But beyond that, we've got to capture their attention. So, you know, dancing clowns, whatever it is that wakes people up. I have a fear of clowns, so I'm not sure if I want that as a policy recommendation. However... For the deli meats we want you to be afraid, so it's okay. Yes, I agree. I agree. One of the things that this conversation has helped us see is that there's some real concerns around whether or not people are paying attention to the label. Or there may be paying more attention to the dates. And even when people are taught or encouraged to think about the dates, there seems to be a mismatch. And Ruiqing, I want to now turn to you because one of the things in the study that we were a part of, there's some questions about differences among people. So, in the paper that we recently published on the relationship between date labels and anticipated food waste, and people's individual orientation to risk and loss, can you tell us a little bit about what some of the key findings of that paper are? Right. So, the paper is published recently in Applied Economics Perspective Policy. It's one of the official journals of Agricultural and Applied Economics Association (AAEA). Norbert is the leading author. So, this paper built on the framework of prospect theory and is based on the data from a series of experiments we conducted in Alabama and also the state of New York. We find that consumers do adjust their anticipated food waste by date labels and by how much they tolerate risk and losses. In the experiment, we particularly measured their tolerance to risk and losses. We found that the 'Use By' date labels tend to lead to more anticipated food waste than 'Best Buy'. Maybe this echo what Roni has said. So, people may tend to link 'Use By' with quality and food safety. We also found that the consumers with low tolerance to losses and are associated with higher anticipated foot waste regardless of date labels and the products. So, we can see a heterogeneity of the responses of different consumers to date labels and food items based on their tolerance to losses and risks. Thank you for that. And I think this is a really important aspect of looking at this set of studies because we see that people are different. They respond differently. And they have different ideas about how they handle losses. This idea that it can be worse to lose a hundred dollars versus to gain a hundred dollars. Or the way we understand how we'll negatively respond versus how positively we respond. Using this economic framework of prospect theory, something that is drawn from actually the psychology literature to better understand how people react to food labels while shopping. What are some key features of this approach to explaining people's behaviors and why do you think it's a good choice? Why do you think it's important to do this? One of the key features of prospect theory is it divides the possible outcomes of a risky event into two domains. One is a gain domain and one is a loss domain. So, in terms of the food consumption, probably the most likely status quo is do not eat the food items. So, the gain domain might be gaining nutrition from the food item. The loss domain might be the loss of health if the food item is bad. So, I think this framework fits particularly well to describe the consumer's trade off in their mind when they face a food item with a date label that is maybe one day or two days past the expiration date. So, one possibility is you consume this food. If it is good, you get nutrition and if it is bad, you potentially get lost health or lose one day of work or so on. So, I think this model can capture the trade off or the decision-making procedure in a consumer's mind pretty well. And experiments data support the theoretical prediction that loss aversion may affect people's food waste decisions. Thank you for that. And I think what's one of the sort of take home messages that I've learned out of this process is this heterogeneity, the fact that people are different and may respond differently to these date labels, really does put the onus upon policymakers to think critically what date labels, if we were to use them, or if we think they have an effect, which are the right ones. And so I actually want to open up the question to all of you. In your view, what next steps make sense for date labels to help address the food waste challenges that we see in this country? Let's start with you, Brian. Ooh, yeah. So, to me a compelling issue that needs to be addressed is how do we get 'Use By' to really translate to be people to be about safety? Is it a different color? I know we don't want to mess with the phrases, but do we just call this safety date and put it in red or put a clown by it if that scares you. Something along those lines to make that stand out. And then on the relevance side, I think it might be out of policy, but perhaps, industry collaboration to really push printed dates to the end of that quality horizon. So that everybody has confidence that they're not going to get undercut by somebody else having an earlier date printed for cereals or for canned goods or something like that. To have a kind of a truce among commercial interests to say, okay, typically canned beans, has this type of 180 days or 360 days. Let's push it to the end of that acceptable horizon so that we don't have unwarranted waste happening as often. Those are two ideas that I've kind of chewed on a lot and think could be positive steps forward. But I'm fascinated to hear what others think. Thank you, Brian and I really don't like the idea of putting clowns anywhere near this. I want to go to you, Roni. All right, well first, I'll a thousand percent echo everything that Brian just said. And I'll note also in terms of the 'Use By' date, the label that was most commonly associated with food safety was 'Expires On' by consumers. But that isn't part of what has been under [policy] discussion. But anyway, in addition to echoing that, I'll just say we do need a standardized policy and it has to be accompanied by a well-designed education campaign. And this policy change, it's just a no-brainer. It's not controversial. It's fairly minimal cost. And given the high food prices and the struggles that consumers are having right now, they need every tool that they can to save money and food, and this is one of them. Great. Thank you, Roni. I'll give the last word to you, Ruiqing. Yeah. I will echo what Brian and Roni said. So, a well-designed policy and public education campaign. Particularly for the education campaign. I think regardless of if there is a policy change or not, I think it is time to do a public education campaign. Norbert, we have done the research on food waste for almost nine years, right? So, I learned a little bit about the date label's meaning. But still, I cannot change my wife's opinion. When she sees sell by yesterday for the milk, she would suggest we throw it away. But I said this is not for us, this is for sellers. But she wouldn't believe so because I cannot persuade her. But maybe an education campaign from more authoritative institutional federal government can change people's mind as a researcher or like even husband cannot change. Roni - And can I just add to that, just please. I think that the economics and psychology expertise that all of you have can really contribute to that. Because I think that's a really important point that you're making. And it's not just factual, it's emotional too. And so how do we, you know, get in there and change what people do beyond their knowledge? Bios Roni Neff is a Professor at the Johns Hopkins Bloomberg School of Public Health's Department of Environmental Health & Engineering and the Johns Hopkins Center for a Livable Future, an academic center focused on food systems and public health. Her research focuses on wasted food through the lens of equity and public health. She is a co-Director of the RECIPES national food waste research network, and she recently served on the National Academies of Science and Medicine consensus panel on consumer food waste. Brian Roe is the Van Buren Professor in the Department of Agricultural, Environmental and Development Economics at Ohio State University. Roe has worked broadly in the areas of agricultural and environmental economics focusing on issues including agricultural marketing, information policy, behavioral economics and product quality. He was recently named as a fellow of the Agricultural and Applied Economics Association and has previously served as an editor for the Association's flagship journal, the American Journal of Agricultural Economics. He currently leads the Ohio State Food Waste Collaborative, a collection of researchers, practitioners, and students working together to promote the reduction and redirection of food waste as an integral part of a healthy and sustainable food system, and co-leads the RECIPES Network, a National Science Foundation Sustainable Regional System's Research Network focused on increasing food system sustainability, resilience and equity by addressing the issue of food waste.  In addition to research on food waste, his other recent research includes a USDA funded project focused on local foods and school lunch programs and participation in an NSF-funded multidisciplinary team seeking to understand human-ecosystem feedbacks in the Western Lake Erie basin, including understanding how farms and agribusinesses respond to voluntary environmental programs and how Ohio residents respond to different options to manage Lake Erie water quality. Ruiqing Miao is an agricultural economist at Auburn University. Miao is interested in sustainability, innovation, and decision-making. His research focuses on the interaction between agricultural production and its environment, aiming to understand and quantify 1) agriculture's impact on land use, water use, water quality, and biodiversity, and 2) how agricultural production is affected by farmers' behaviors, public policies, agricultural innovation, technology adoption, and climate change.

Kelvin Droegemeier, a longtime leader in science policy, joins host Megan Nicholson for this installment of Science Policy IRL. Droegemeier began his career as a research meteorologist and went on to serve in many different leadership roles in state and federal government. He directed the White House Office of Science and Technology Policy from 2019–2021, served on the National Science Board from 2004–2016, and served on the Oklahoma Governor's Science and Technology Council from 2011–2019. He is currently a professor and Special Advisor to the Chancellor for Science and Policy at the University of Illinois at Urbana-Champaign. On this episode, Droegemeier shares what it's like to work on science policy at the state and federal levels, discusses what he sees as the pressing science policy issues of our time, and reflects on his leadership roles in academia and government. Resources:Read Kelvin Droegemier's book, Demystifying the Academic Research Enterprise: Becoming a Successful Scholar in a Complex and Competitive Environment, to gain a better understanding of how the academic research enterprise works. Check out the National Academies of Sciences, Engineering, and Medicine project on Improving the Regulatory Efficiency and Reducing Administrative Workload to Strengthen Competitiveness and Productivity of US Research. Read Science, the Endless Frontier by Vannevar Bush and Issues's project marking the anniversary of that report, The Next 75 Years of Science Policy, to learn more about the structure of scientific research in the United States. The National Science Board's Science and Engineering Indicators provide important metrics to understand the current state of science and engineering. What is the future of American science and technology? Check out Vision for American Science and Technology (VAST) for a potential roadmap. 

Alan speaks with Dr. Guru Madhavan at the National Academy of Sciences in Washington, DC, as we continue our series marking 250 years of American innovation. Guru, a leader at the National Academy of Engineering, explores the Academy's Civil War origins, its lasting role in advising the U.S. government, and its influence on everything from compass design to pandemic response. He discusses how innovation must balance bold ideas with long-term systems like sanitation and maintenance. Calling for a “deep time” perspective, Guru urges us to value resilience, inclusivity, and the often-unseen foundations that truly sustain progress.     Guest Bio Dr. Guru Madhavan is the Norman Augustine Senior Scholar and Senior Director of Programs at the National Academy of Engineering. With a background in biomedical engineering (MS, PhD) and an MBA from the State University of New York, he previously led innovations in the medical device industry before turning his focus to national science and engineering policy. He is the acclaimed author of Applied Minds: How Engineers Think and Wicked Problems: How to Engineer a Better World. A valued member of AMSE's National Advisory Committee, Guru was honored with the 2024 AMSE Foundation National Excellence Award for his outstanding contributions.     Show Highlights (1:54) An introduction to the National Academy of Sciences (7:59) Lincoln's impact on the sciences in the United States (11:06) How Vannevar Bush's principles from Science: The Endless Frontier are implemented (19:30) The impact the arts are having on STEM (20:13) How the National Academies have supported and encouraged innovation (24:10) Guru's list of most important American innovations (30:23) The frameworks and institutions that have supported America's innovations (37:51) The United States and the ideology of innovation (43:27) Using deep time to gain perspective on innovation     Links Referenced Applied Minds: How Engineers Think: https://www.amazon.com/Applied-Minds-how-Engineers-Think/dp/039335301X Wicked Problems: How to Engineer a Better World: https://www.amazon.com/Wicked-Problems-Engineer-Better-World/dp/0393651460  

Dr. John Sweetenham, Dr. Larry Shulman, and Dr. Rebecca Maniago discuss the integration of clinical pathways and decision support tools into the cancer center workflow, challenges to implementation at the point of care, and the promise of AI to further unlock these tools for clinicians. TRANSCRIPT Dr. John Sweetenham: Hello, I'm Dr. John Sweetenham, the host of the ASCO Daily News Podcast. Over the last decade or so, there has been a great deal of work and a lot of discussion about the implementation of oncology clinical care pathways at the point of care, which are designed to reduce variability in care, reduce costs, and improve the quality of care and outcomes. Although clinical pathways aim to guide treatment decisions, current data suggests that the utilization of these pathways at the point of care is very low. There are many reasons for this, which we will get into on the episode today.   My guests today are Dr. Larry Shulman and Rebecca Maniago. Dr. Shulman is a professor of medicine at the University of Pennsylvania Abramson Cancer Center. He's also the immediate past chair of the Commission on Cancer and serves on the National Cancer Policy Forum of the National Academies of Sciences, Engineering and Medicine. Rebecca Maniago is the director of clinical oncology at Flatiron Health, a technology platform that collects and analyzes real-world clinical data from electronic health records to facilitate decision making and research.  Our full disclosures are available in the transcript of this episode. Larry and Rebecca, welcome to the ASCO Daily News Podcast and many thanks for being here.  Dr. Larry Shulman: Thank you, John.  Rebecca Maniago: Thank you for having me.  Dr. John Sweetenham: Larry, I'm going to start out, if I may, with a question for you. You and I, in a previous podcast, have discussed some of these issues regarding pathway implementation before. But to start out with, it's certainly, I think, helpful for the listeners to remind us all of what are the benefits of oncology clinical pathways and why are we still talking about this 10 years or more on.  Dr. Larry Shulman: Yeah, and that's a great question, John. I think the good news is, and all of us who live in the oncology sphere know this, that there's been tremendous progress in cancer therapies over the last decade. But what that has entailed is the introduction of many new therapies. Their complexity is becoming really very tough for people to manage.  And so what we have are oncologists who are really trying to do their best to deliver care to patients that will give them the best chance for survival and quality of life. But it's really, really hard to keep up with everything that's happening in oncology in the context of what we all know is a very busy clinic schedule. Lots of patients coming through and decisions need to be made quickly. Pathways really could help us to guide us into recommending and delivering the best therapies for our patients for a particular disease. You know, cancer is complicated. There are many different types and there are many different therapies. It's just a lot to deal with without some assistance from pathways or pathway tools.  Dr. John Sweetenham: Thanks, Larry. So, knowing that's the case and knowing that these tools reduce variability, improve costs, improve quality of care as well. Starting with you again, Larry, if I may, why do you think it's been so difficult for so many oncologists to use these pathways effectively at the point of care?  Dr. Larry Shulman: So, I just wanted to step back a little bit. There are very extensive guidelines that tell us what the best therapies are for really all of the cancers. These guidelines come from the National Comprehensive Cancer Network or NCCN and the American Society of Clinical Oncology or ASCO and other professional organizations. And they're there. They're there, in free information off their websites.  But the problem is how to translate those pretty dense documents into something that will work in the clinic for a patient, for the physician who's working in the electronic health record. And the tools that are available, and there are a number of tools that can integrate with electronic health records, are expensive. You need to purchase them from the vendor and there are yearly fees.  And they're also difficult to implement. You need to work with the vendor to integrate them into your own rendition of your electronic health record. And there's a lot of customization that needs to be done. So, it's a financial challenge and it's also a time challenge for people to integrate these tools into their workflow, into their electronic health records.  Dr. John Sweetenham: Thanks, Larry. So speaking from my own past experience of pathway implementation, it certainly has been a major challenge for the reasons that you mentioned and also because of the, I think resistance may or may not be too strong a word, of many of the clinicians to use these for a number of reasons, part of which are the time it takes, part of which many of them feel that the pathways aren't really changing decisions that they might make anyway. So, you know, the uptake of pathway utilization, even in those centers which have been successful in getting something installed and plugged into their EHR, on the whole, hasn't been as good as it could have been. So maybe I'll turn to you, Rebecca, because I know that this is something that you've worked on a lot.  And it's a kind of double-barreled question. I think the first part of it is, you know, what do you think are the major roadblocks to high physician uptake in the use of these pathways platforms? And maybe you could talk a little bit about what the various software platforms do to make them more physician-friendly and to enhance utilization right on the front line.  Dr. Rebecca Maniago: Yeah, that's a great question. And so, you know, I've worked with a number of customers and physicians over the past five and a half years on implementing these pathways. And the number one pushback is really about the time it takes in the workflow. So, if I had a dollar for every time I heard “every click counts,” I'd be a rich person and it does come down to clicks. And so, you know, as a software vendor, we really have to focus on how do we reduce that friction?  How do we make sure that the clicks we are asking for are the ones that actually matter? And how do we continue to streamline that process? And so, you know, while there is a fine balance, because as part of a Pathways platform, at the end of the day, we do need to understand some data about that patient. You need to understand the clinical scenario so you can surface the right treatment recommendation, which means there is some amount of data capture that has to happen. In some circumstances, you know, we can pull some of that data in from the EHR.  But unfortunately, the reality is that a lot of that data is messy and it's sort of stuck in documents and unstructured places. And so it doesn't easily flow in, which means we rely on the provider to give us that information. And oftentimes they've already entered it other places. So what's more frustrating than entering data twice? But, you know, I do see a great opportunity here. And this is certainly where software companies are focused is with AI.  So, know, for, especially for this data aggregation, a lot of these AI tools can actually scan through the chart instead of relying on the physician to sort of manually skim through and aggregate and find all that pertinent information. That's what AI is really good at. And almost instantaneously, it can find the messy data that lives in those unstructured documents. And wouldn't it be nice if that was automatically populated within these applications so that really all we're asking of the clinician is to validate that that information is accurate. And then choose the treatment that cuts down on the number of clicks, it cuts down on frustration. You know, again, the physician will be the one that needs to make that decision. AI is not there to replace that, but it certainly has a great opportunity to reduce some of this manual documentation and the things that physicians find the most frustrating, especially as it relates to using these pathways tools.  Dr. John Sweetenham: One of the pretty common pushbacks that I heard during my time in a couple of institutions was, “Well, you know, I'm sitting here at the point of care with my patients and I already know what I want to do and how I'm going to treat that patient if it's not in the context of a clinical trial. So I don't need to go through, you know, X number of clicks to get me to where I know I'm going to be anyway.”  Does either of you have any thoughts about that? I think you've sort of partially answered it, but what do you think, Rebecca? Do you think that this is something that is more easily overcome-able, if that's even a word, than it was a few years back?  Rebecca Maniago: Yeah, I do. And I think this is where the customization comes into play. So while they may know what an appropriate treatment for their patient is, there are more options now than ever, which means at a local level, there may be multiple options that are clinically equivalent. And so when you think about things like payer pathways or drug margins as an organization, they have to drive some of that from within. But having the capability to do so can then start to sort of sell the value to the provider that, yes, you may know what you want to order for your patient, but would you consider something else if it was clinically equivalent, but it had other benefits to either the patient or the organization?  Dr. Larry Shulman: The other thing I would add to that, John, if I can jump in here is that the data is the data and the data shows us that guideline concordant care is not always prescribed to the US. And in fact, in some circumstances, the gaps between what should be prescribed and what is being prescribed are quite wide. So, you know, people feel like they're always doing the best job and making the best recommendations. And I think, you know, I think I am. But, you know, like many of my colleagues at academic cancer centers, I'm highly specialized. I only see patients with breast cancer. But many oncologists throughout the country are more generalists. They're seeing patients with multiple diseases. And it's harder for them to be completely on top of what the current recommendations are in any particular circumstance. Our diseases are complicated. They're getting more complicated all the time with molecular and genomic testing and subcategorizations of different cancers. So, I don't think that we can be too cocky about it, quite frankly. I think we ought to use technology that Rebecca describes for the tools and for AI to really help us. I think if we turn our backs on that, I think we're making a big mistake. You just got to look at the data. The data is pretty convincing.  Dr. John Sweetenham: You know ever since we started looking seriously at decision support through pathways a number of years ago, the word has always been around the payers role in this and the day will come where we are going to get reimbursed based on pathway and concordance and I'm not sure that that day has arrived. So I have a question for both of you in this regard actually. And the first of those is maybe I'll start with you for this part of it, Larry. Where do you think we are in that regard? And are you hearing more and more of payers starting to look at pathway compliance? And then on the other end of that, and maybe I'll ask Rebecca about this, is one of the other pushback issues that I used to experience from physicians I worked with was they may go through the pathways platform and come up with a treatment recommendation. The best example of this I can think might be that the recommendation might be a biosimilar. Let's just use that as an example. But the next stage in the process would be to find out whether the patient's insurance would actually cover that particular biosimilar, which opened up a whole new can of worms. So there are two kinds of payer aspects of that. Maybe Larry, I'll ask you to start off by talking about that kind of coverage issue. And then I'll ask Rebecca, if you have any thoughts about the flow the other way in terms of getting drugs approved and what we can do to help from an insurance perspective.  Dr. Larry Shulman: Sure, that's really an important point, John. Our current state of affairs with the payers and their attempt to be sure that we're providing responsible, guideline concordant care is the use of prior authorization processes, which are incredibly costly, both for the oncology practices and for the payers.  They have an army of nurses sitting at the phone talking to us in the oncology practices to decide whether they're going to pay for something. And frankly, generally, the payers will pay for things that are part of either the NCCN or ASCO or other professional organizations' guidelines. But you need to prove to them over the phone that in fact the patient qualifies for that.  We have actually had some experiments with some of the payers to prove that to them in different ways by auto transmission of data. And this would be a big savings for them and for us, it would take away some of the delays in therapy while we're waiting for prior authorizations to go through. And we shouldn't have to do this by phone.   The EHR and the pathway tools should aggregate the data, aggregate the potential treatment and be able to transmit those data to the payer. And if in fact it meets the appropriate criteria for guideline concordant care would be approved. Right now, it's a terrible, costly, timely manual process that they should be able to fix.  Dr. John Sweetenham: Thanks, Larry. And have you, you know, from a broader perspective, so not thinking necessarily about individual patients and specific issues around prior authorization, have you seen any movement among the payers to kind of get more aggressive about this and say, okay, you know, we are going to want to see your numbers, we want to know how many of your physicians are now using their pathways platform and so on. Are you seeing any word that that might be happening? Because certainly a few years back, that was the word on the street, as it were, that this day was coming.  Dr. Lawrence Shulman: And that's the proposal that we've made to several of our payers. Let us give you the aggregate data. If our guideline concordance is above a certain level, give us a gold card, give us a pass, and we won't need to do pre-authorizations. We've actually done that at my institution in radiology. Aggregate data gives individual physicians that pass if their guideline concordance was appropriate. I got to pass. So I don't need to go through those radiology pre-authorizations for my patients. And I think we can do the same thing with therapeutics. It's been a little bit more cumbersome to do it, and there's some detailed reasons why that is. But that's really what they want to know. And the payers want to know that patients are getting guideline concordant care, but they also realize it's not going be 100%. There are always a few outlier patients who require some variation from the guidelines. But if we get above 80% guideline concordant care, I think many of the payers would be happy to accept that as long as we continue to feed them the data. And that's the case in our radiology process with one of the payers is, you know, I get a gold card, but they continue to look at my data. And if I don't continue to perform well, they'll take that away.  Dr. John Sweetenham: Thanks, Larry. And Rebecca, just returning to you, this issue of prior authorization and facilitating life for the physician at the point of care in terms of knowing, you know, which specific treatment might be covered for a patient. Do you have any thoughts or maybe you could give us some insights on what software vendors are doing to facilitate that part of the process, the communication back to the payers to take some of that burden off the physician and the physician staff?  Rebecca Maniago: Yeah, absolutely. And this is a problem we've been trying to tackle for years. And it's not easy. We've tackled it in a couple ways. So first, we try to sort of link up to the payer portal where the information that was being attested to within the application could then be automatically sent. Because at the end of the day, the data points that are being collected to surface treatment recommendations ultimately are the same data points that the payer wants.  Unfortunately, there are a lot of data interoperability challenges within that space. So that was not something that was going to be sustainable. However, in current state, because as I mentioned, the customization is key for these products, focusing more on how can we allow practices to embed payer pathways within the application. So again, you kind of start with the backbone of your standard guidelines but then having the capability of adding in a payer pathway that will only show up as that preferred option for a patient who has that insurance, at least at the point of care, the provider sees what the insurer would then approve. So while it's not automatically assuring authorization, we are at least steering the decision in a direction where we think most likely this is going to be approved based upon the pathway that they have access to. So that sort of current state, I agree. We've been talking about this idea of gold carding for years.  Presumably the data is there today, right? Like we are able to capture structured data with every order placed to recognize concordance to Larry's point. All those reports are available to provide to payers. I just haven't seen a lot of practices have a lot of success when they tackle it on their own from that direction.  Dr. John Sweetenham: Right, thanks. Larry, you and I were at the NCCN annual meeting recently and I know that you've been quite heavily involved in the policy program and in the policy forums and so on at NCCN. Are you able to share anything from this year's meeting in terms of care pathways implementation and what you think might happen next in that regard?  Dr. Larry Shulman: NCCN, in my own opinion, has really led the way in defining what guideline concordant care is through their guidelines, which are very extensive, covering basically every cancer and every situation with every cancer. And it's really an astounding amount of amazing work that all of us use and the payers largely use as well. But they've increasingly understood that there's a gap between their guidelines and the implementation of their guidelines. And they are working on some things. They are working on the digitalization of their guidelines to make them more accessible, but also thinking about ways that they may, in fact, fit into the work processes that all of us have when we go to clinic.  They're acutely aware that the country is not where it needs to be in regard to a translation, if you will, of their guidelines in the practice. And I think we're all thinking really hard about whether there are things that we can team up to do, if you will, to try to close those gaps.  Dr. John Sweetenham: Great, thank you. Just switching gears a little bit back to you, if I can, Rebecca. I think you've said a little bit about this already. What do you think are the next steps that we need to take to more effectively implement these tools in the clinic? I think we've discussed a little bit some of the roadblocks to that. But where do you think we need to go next in terms of getting better use of these pathways?  Rebecca Maniago: Yeah, I will say one thing that we haven't really touched on is the pharmacy team. So the biggest blocker that I see is actually the pre-implementation. So there's a lot of focus on how do we get physicians to use this? How do we increase adoption? But often the first barrier is the regimen library. So no matter what the pathways platform is, the backbone of it will be those regimens. And so, really helping organizations and we partner with pharmacies, they're doing all the backend configuration. And so how can we make that piece of the technology easier for them to implement because that's really the lead up and there's a ton of cleanup and maintenance. You know, as a pharmacist, I empathize, but really that's where it all begins. And so I think, you know, continuing to focus on not only the front end user and the physician, but everybody that's going to be involved in order to make a pathway program successful needs to be, you know, at the table in the beginning, helping set up those processes and, and buying into the why this is important.  Dr. John Sweetenham: That's a great point.  Dr. Larry Shulman: So could I just jump in one quickly here, John? So pathways, as we've discussed, the tools are expensive. There is a person cost, as Rebecca is just describing, about customization and implementation. But there are very good data in the literature to show that when you follow pathways, care is less costly. Survival is better, which is obviously our primary goal, but also cost is less. And the payers can benefit from that. And the question is, can they figure out ways to use that to help to fund the purchase and maintenance of pathway products that will give their patients better care, but also less costly care? And so I think that is a potential solution. I've had that conversation with some payers as well. And it would be great to see that happen. I think that would be a huge step.  Rebecca Maniago: Yeah, we have some, if they're able to set it up in the right way and really optimize, you know, from the pharmacy perspective, we have practices who the application is more than, you know, paying for itself just by way of using it to the fullest potential that it has.  Dr. John Sweetenham: Yeah, that's a really great point. A couple of other more general questions. I'm going to start with you, Rebecca, and Larry ask you to respond as well. Are you hearing anything from patients around this issue? Are they aware or becoming more aware that pathways are being used in the clinic when they're seen by their physicians? And do they have a say, are there patient advocates involved in this part of the process? Rebecca, maybe you could start.  Rebecca Maniago: I haven't had as much exposure to that side of it. So, you know, I would love to hear what Larry thinks because most of my exposure is at the physician level, which of course they are the ones who are making the decision with the patient. So my assumption is that there is at least some level of understanding that there are options and that, you know, together let's decide on the best one for you. But again, I would love to hear what Larry has to say.  Dr. Larry Shulman: Yeah, so that's a really interesting question. I actually was discussing that at the cancer center last week, particularly around the utilization of AI in this process. And, you know, right now, as you know, if you submit a journal article or, you know, many other things, ask you whether you used AI to generate it. If in fact we use tools that include AI, we're not.  Are we obligated to tell the patient that you're making this recommendation together with computer assist, if you will, that helps you to make the recommendation you are making to them? Ultimately, I think it's the physician who's responsible for the choice, but should we disclose it? I have to tell you personally, I haven't thought about doing that. But I think it's a really, really good question is whether we should upfront tell the patients that we've had assistance in making the recommendations that we have.  Dr. John Sweetenham: Right, very interesting point. To close it out, one more question for both of you and again, it's the same one. Rebecca, to start with, we've all been, as I said right up front, talking and, you know, working on this issue for more than 10 years now. In 10 years from now, how would you like it to look and how do you think it might look?  Rebecca Maniago: Great question. I think we may get to where I would like to see it quicker than 10 years. I think AI provides a lot of opportunity and excitement. I'd love to turn a corner where physicians no longer see tools like this as a hindrance, rather they rely on them, they trust them, they help them get through their day. They continue to improve quality of care and reduce costs and patient burden. Obviously, that's the pipe dream, but I think we may get there before 10 years, given what I think AI is going to enable.  Dr. Larry Shulman: Yeah, I want to add to Rebecca's comments. One of the things that I worry about, and ASCO worries about a lot, is the oncology workforce, which is progressively strained in their attempts to care for all the cancer patients in the US. And for all of us who practice oncology, for many reasons, it's become more and more inefficient, whether it's use of the EHR, pre-authorization work, and so on.  And we really need to turn that around. We need to make practice not only better, which I think these tools can do, including AI, as Rebecca says, but make it much more efficient because that's going to allow us to both deliver more high-quality care to our patients, but also to care for more patients and have them benefit from our expertise and what we have to offer. So I think this is really an obligation on our part. I think it's an imperative that we move in this direction for both quality reasons and efficiency reasons.  Dr. John Sweetenham: Thanks, Larry. Well, I've really enjoyed the conversation today and I think, you know, it's been great to think about some of the challenges that we still have in this regard. But it's also great to hear what I'm sensing is quite a lot of optimism about how things may play out over the next few years. And it does sound as if there's a lot of hard work going on to bring us to a point where the clinical decision support tools are going to truly support what our oncologists are doing and no longer be seen as an obstruction. So, I want to thank you both for sharing your insights with us today on the ASCO Daily News Podcast.  Dr. Larry Shulman: Thank you so much, John.  Rebecca Maniago: Thank you so much.  Dr. John Sweetenham: And thank you to our listeners for your time today. If you value the insights that you hear on the ASCO Daily News Podcast, please take a moment to rate, review and subscribe wherever you get your podcasts.  Disclaimer:   The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity or therapy should not be construed as an ASCO endorsement.   Find out more about today's speakers:  Dr. John Sweetenham  Dr. Lawrence Shulman  Rebecca Maniago  Follow ASCO on social media:  @ASCO on Twitter  @ASCO on Bluesky  ASCO on Facebook  ASCO on LinkedIn        Disclosures:  Dr. John Sweetenham:  No relationships to disclose    Dr. Lawrence Shulman:  Consulting or Advisory Role: Genetech     Rebecca Maniago:   No relationships to disclose.     

In this Future Series episode, Kris Osborn and Captain William Ostendorff discuss the critical aspects of nuclear deterrence, focusing on warhead modernization, technological advancements, and the importance of reliability in nuclear weapons. Captain Ostendorff shares insights from his extensive experience in the Navy and his roles in various nuclear security programs, emphasizing the complexities of today's geopolitical landscape and the need for a robust nuclear strategy. The discussion also highlights the role of digital engineering and advanced computing in enhancing weapon performance and reliability, as well as the integration of non-nuclear components in nuclear systems.Captain William Ostendorff served as Principal Deputy Administrator of the National Nuclear Security Administration from 2007 to 2009 and as a commissioner of the United States Nuclear Regulatory Commission from 2010 to 2016.Captain Ostendorff is an advisory council member for the Institute for Nuclear Power Operations, a member of the Board of Directors for Information Systems Laboratories, Chairman of the Energy Solutions Decommissioning Nuclear Safety Review Board for Three Mile Island Unit 2, Independent Manager on the Board of Global Laser Enrichment LLC and Co-Chair of the Committee of Risk of Nuclear War and Nuclear Terrorism of the National Academies of Sciences, Engineering and Medicine.He graduated the U.S. Naval Academy with a Bachelor of Science in systems engineering and was an officer in the U.S. Navy from 1976 until his retirement in 2002. During his naval career, he served as Commanding Officer of the USS Norfolk, Director of the Submarine Force Commanding Officer School, Commander of Submarine Squadron Six and finally Director of the U.S. Naval Academy Math and Science Division. He returned to the Naval Academy as Distinguished Visiting Professor of National Security from 2016 to 2021.As counsel for the House Armed Services Committee from 2003 to 2007, Captain Ostendorff was staff director of the Strategic Forces Subcommittee, with oversight responsibilities for the Department of Energy's Atomic Energy Defense Activities and the Department of Defense's Missile Defense, Space and Intelligence Programs which totaled more than $50 billion in the annual defense authorization bill. He also worked as Director of the Committee on Science, Engineering and Public Policy and Director of the Board on Global Science and Technology from 2009 to 2010 and research staff member for Institute for Defense Analyses from 2002 to 2003.Socials:Follow on Twitter at @NucleCastFollow on LinkedIn: https://linkedin.com/company/nuclecastpodcastSubscribe RSS Feed: https://rss.com/podcasts/nuclecast-podcast/Rate: https://podcasts.apple.com/us/podcast/nuclecast/id1644921278Email comments and topic/guest suggestions to NucleCast@anwadeter.org

About this episode: A new report on misinformation and disinformation from the National Academies of Science, Engineering, and Medicine is helping to define what misinformation is and how it starts and how to combat it. In this episode: a conversation about the findings, and how to get away from misinformation as a name-calling contest. Guest: Vish Viswanath is the Lee Kum Kee Professor of Health Communication at the Harvard TH Chan School of Public Health and chaired the blue ribbon panel examining misinformation about science. Host: Dr. Josh Sharfstein is vice dean for public health practice and community engagement at the Johns Hopkins Bloomberg School of Public Health, a faculty member in health policy, a pediatrician, and former secretary of Maryland's Health Department. Show links and related content: Science Misinformation, Its Origins and Impacts, and Mitigation Strategies Examined in New Report; Multisector Action Needed to Increase Visibility of, Access to High-Quality Science Information—National Academies of Science, Engineering, and Medicine The Anatomy of Deception: Conspiracy Theories, Distrust, and Public Health In America—Public Health On Call (October 2024) Transcript information: Looking for episode transcripts? Open our podcast on the Apple Podcasts app (desktop or mobile) or the Spotify mobile app to access an auto-generated transcript of any episode. Closed captioning is also available for every episode on our YouTube channel. Contact us: Have a question about something you heard? Looking for a transcript? Want to suggest a topic or guest? Contact us via email or visit our website. Follow us: @‌PublicHealthPod on Bluesky @‌JohnsHopkinsSPH on Instagram @‌JohnsHopkinsSPH on Facebook @‌PublicHealthOnCall on YouTube Here's our RSS feed

“The world's leading alien hunter” —New York Times MagazineFrom acclaimed Harvard astrophysicist and bestselling author of Extraterrestrial comes a mind-expanding new book explaining why becoming an interstellar species is imperative for humanity's survival and detailing a game plan for how we can settle among the stars.In the New York Times bestseller Extraterrestrial, Avi Loeb, the longest serving Chair of Harvard's Astronomy Department,presented a theory that shook the scientific community: our solar system, Loeb claimed, had likely been visited by a piece of advanced alien technology from a distant star.This provocative and persuasive argument opened millions of minds internationally to the vast possibilities of our universe and the existence of intelligent life beyond Earth. But a crucial question remained: now that we are aware of the existence of extraterrestrial life, what do we do next? How do we prepare ourselves for interaction with interstellar extraterrestrial civilization? How can our species become interstellar?Now Loeb tackles these questions in a revelatory, powerful call to arms that reimagines the idea of contact with extraterrestrial civilizations. Dismantling our science-fiction fueled visions of a human and alien life encounter, Interstellar provides a realistic and practical blueprint for how such an interaction might actually occur, resetting our cultural understanding and expectation of what it means to identify an extraterrestrial object.From awe-inspiring searches for extraterrestrial technology, to the heated debate of the existence of Unidentified Aerial Phenomena, Loeb provides a thrilling, front-row view of the monumental progress in science and technology currently preparing us for contact. He also lays out the profound implications of becoming—or not becoming—interstellar; in an urgent, eloquent appeal for more proactive engagement with the world beyond ours, he powerfully contends why we must seek out other life forms, and in the process, choose who and what we are within the universe.Combining cutting edge science, physics, and philosophy, Interstellar revolutionizes the approach to our search for extraterrestrial life and our preparation for its discovery. In this eye-opening, necessary look at our future, Avi Loeb artfully and expertly raises some of the most important questions facing us as humans, and proves, once again, that scientific curiosity is the key to our survival.Abraham (Avi) Loeb is the Frank B. Baird, Jr., Professor of Science at Harvard University, the longest-serving chair of Harvard's Department of Astronomy, the founding director of Harvard's Black Hole Initiative, and the current director of the Institute for Theory and Computation (ITC) within the Harvard-Smithsonian Center for Astrophysics. He also heads the Galileo Project, chairs the Advisory Committee for the Breakthrough Starshot Initiative, and is former chair of the Board on Physics and Astronomy of the National Academies. Author of eight books and more than a thousand scientific papers, Loeb is an elected fellow of the American Academy of Arts and Sciences, the American Physical Society, and the International Academy of Astronautics. In 2012, Time selected Loeb as one of the twenty-five most influential people in space. He lives near Boston, Massachusetts.Become a supporter of this podcast: https://www.spreaker.com/podcast/earth-ancients--2790919/support.

More than half of US states have legalized cannabis for recreational or medical use. Regulations on cultivation, production, and marketing vary from state to state, and most of these policies were developed without a robust public health strategy. Because it is not federally legal, Washington has provided only limited guidance to states on how to control the variety of cannabis products on the market. What's more, the dazzling arrays of gummies, vapes, and chocolates are available with much higher concentrations of THC (the psychoactive component of cannabis) than have been previously available.A recent National Academies of Sciences, Engineering, and Medicine report, Cannabis Policy Impacts Public Health and Health Equity, examines the connections between public health and marijuana legalization. On this episode, host Sara Frueh talks to Yasmin Hurd, vice-chair of the report committee, Ward-Coleman Chair of Translational Neuroscience, and director of the Addiction Institute at  Mount Sinai. They discuss the research on the complex landscape of modern cannabis products, what's known about their public health impacts, and strategies policymakers could use to minimize harms. ResourcesRead the National Academies' report, Cannabis Policy Impacts Public Health and Health Equity.Visit the Hurd Lab and Addiction Institute websites to learn more about Yasmin Hurd's work on addiction.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-422 Overview: Conflicting data on alcohol's health effects leave clinicians uncertain about patient guidance. In this episode, we review the PREDIMED trial's findings on wine and cardiovascular outcomes, explore objective biomarkers for intake, and examine the National Academy of Sciences' recent report to clarify the risks and benefits of moderate consumption, giving you confidence in counseling patients. Episode resource links: Inés Domínguez-López, Rosa M Lamuela-Raventós, Cristina Razquin, et al. Urinary tartaric acid as a biomarker of wine consumption and cardiovascular risk: the PREDIMED trial, European Heart Journal, 2024;, ehae804, https://doi.org/10.1093/eurheartj/ehae804     National Academies of Sciences, Engineering, and Medicine. 2025. Review of Evidence on Alcohol and Health. Washington, DC: The National Academies Press. https://doi.org/10.17226/28582   Guest: Robert A. Baldor MD, FAAFP Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-422 Overview: Conflicting data on alcohol's health effects leave clinicians uncertain about patient guidance. In this episode, we review the PREDIMED trial's findings on wine and cardiovascular outcomes, explore objective biomarkers for intake, and examine the National Academy of Sciences' recent report to clarify the risks and benefits of moderate consumption, giving you confidence in counseling patients. Episode resource links: Inés Domínguez-López, Rosa M Lamuela-Raventós, Cristina Razquin, et al. Urinary tartaric acid as a biomarker of wine consumption and cardiovascular risk: the PREDIMED trial, European Heart Journal, 2024;, ehae804, https://doi.org/10.1093/eurheartj/ehae804   National Academies of Sciences, Engineering, and Medicine. 2025. Review of Evidence on Alcohol and Health. Washington, DC: The National Academies Press. https://doi.org/10.17226/28582   Guest: Robert A. Baldor MD, FAAFP Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  

Tara sits down with one of her mentors, Dr. Daved Rosensweet, to have an important conversation about hormone replacement therapy (HRT) and why so many women are left in the dark when it comes to their options. Dr. Rosensweet has been at the forefront of bioidentical hormone therapy for years, and in this episode, he shares his deep expertise on how to approach HRT safely and effectively. They break down the fears and misconceptions that have prevented countless women from getting the support they need and discuss why personalized hormone therapy should be the standard—not the exception. Whether you're currently using HRT, considering it, or just want a better understanding of your options, this episode is a must-listen.   Key Talking Points Why hormones matter—they're not just about reproductive health, but essential for brain function, bone strength, and overall vitality. The shocking truth about declining hormone levels—they start dropping in your 20s and never stop. How misinformation about hormone therapy has kept women suffering needlessly. The Women's Health Initiative study—how it wrongly created fear around hormones and what the real science says. Bioidentical vs. synthetic hormones—why the form of hormones you use makes a massive difference. When to start hormone therapy—(hint: the earlier, the better). The importance of individualized dosing—why one-size-fits-all approaches don't work. How to find a knowledgeable provider who truly understands hormone therapy.   Dr. Rosensweet:  Daved Rosensweet, MD is the Founder of The Institute of BioIdentical Medicine and The Menopause Method, as well as the author of three books on the subject including his latest "Happy Healthy Hormones".  Early in his career, Dr. Rosensweet trained the first nurse practitioners in the United States and was in charge of health promotion for the State of New Mexico. With over 30 years of experience specializing in Andropause and Menopause treatment, he is a nationally known lecturer and presenter at The American Academy of Anti-Aging Medicine (A4M), The American College for Advancement in Medicine (ACAM), The Age Management Medicine Group (AMMG), and more. In 2019, he was called to Washington to speak in front of The National Academies of Science Engineering and Medicine (NASEM) on "The Safety and Efficacy of Bioidentical Hormones." Through The Menopause Method and The Institute of BioIdentical Medicine, Dr. Rosensweet is training medical professionals to master cBHRT using the most advanced and modern tools. His protocol has been used to treat more than 12,000 women. CUSTOMIZE TREATMENT PROGRAMS: The Menopause Method DOWNLOAD DR ROSENSWEET'S BOOK FOR FREE:  Happy Healthy Hormones     Mentioned in this episode: HRT Made Simple™ - Learn how to confidently speak to your doctor about the benefits of hormone replacement therapy so you can set yourself up for symptom-free, unmedicated years to come without feeling confused, dismissed, or leaving the medical office minus your HRT script. Hair Loss Solutions Made Simple™ – This course will teach you the best natural, highly effective, and safe solutions for your hair loss so you can stop it, reverse it, and regrow healthy hair without turning to medications. The Hormone Balance Solution™ – My signature 6-month comprehensive hormonal health program for women in midlife who want to get solid answers to their hormonal health issues once and for all so they can kick the weight gain, moodiness, gut problems, skin issues, period problems, fatigue, overwhelm, insomnia, hair/eyebrow loss, and other symptoms in order to get back to the woman they once were. [FREE] The Ultimate Midlife Perimenopause Handbook - Grab my free guide and RECLAIM your confidence, your mood, your waistline and energy without turning to medications or restrictive diets (or spending a fortune on testing you don't need!). BOOK A 30-MINUTE SESSION WITH TARA HERE   You might also like these episodes:   EPISODE 55: All about HRT including rhythmic dosing, Estradiol vs. Bi-Est & more with Dr. Felice Gersh PART 1 EPISODE 79: Do you need HRT if you don't have symptoms? What if you don't have hot flashes & you're still cycling regularly?  

Forester Dr. Lauren Oakes joins in today to talk about the urgent need for effective reforestation efforts and the complexities of understanding the state of the world's forests. Plus, we talk about the dual narrative of loss and growth in forest ecosystems, emphasizing the importance of preserving existing forests while also working on reforestation efforts. About our guest:Dr. Lauren Oakes makes environmental science accessible to non-scientists. She writes about forests, climate, and our complex relationships with nature. Her craft blends science communications and reporting through narrative.She earned her Ph.D. from the Emmett Interdisciplinary Program for Environment and Resources at Stanford University. By training, she is an ecologist and land change scientist, committed to facilitating more sustainable land use practices in communities across the world. She has always been intrigued by our human footprint on the natural world and concerned about the ways environmental degradation affects the lives of people and other species.Her writing has appeared in The New York Times, Scientific American, Emergence Magazine, Nautilus and other media outlets. Her first book, In Search of the Canary Tree, was selected as one of Science Friday's Best Science Books of 2018. In 2019, it won second place for the Rachel Carson Environment Book Award and was a finalist for the National Academies of Sciences, Engineering, and Medicine Communication Award. The Alfred P. Sloan Foundation supported research and reporting for Treekeepers, her most recent book about the global reforestation movement.

Charles Duhigg is a Pulitzer Prize–winning investigative journalist and the bestselling author of three books: The Power of Habit, Smarter Faster Better and his latest, Supercommunicators, which was published this year. Charles is a winner of the National Academies of Sciences, National Journalism, and George Polk awards, and he currently writes for The New Yorker and several other publications. Charles joined host Robert Glazer on the Elevate Podcast to talk about habit formation, how to become an excellent communicator, and much more. Learn more about your ad choices. Visit megaphone.fm/adchoices

On this episode of "Dimensions of Diversity," host Lloyd Freeman is joined by Dr. Chantal Hailey, an assistant professor in the Department of Sociology at the University of Texas at Austin and a National Academies of Education Spencer Postdoctoral Fellow. Together, they explore Dr. Hailey's groundbreaking research on how race and racism influence American schooling and contribute to patterns of inequality.Dr. Hailey shares her personal experiences growing up in Dallas, Texas, where her daily commutes across racial and economic divides opened her eyes to the systemic inequities in education. She provides an in-depth look at her research on New York City's school choice system, revealing how perceptions of safety and racial biases affect decision-making and contribute to segregation.A central focus of the discussion is the concept of "Black belonging," which emphasizes the need for culturally relevant educational spaces that include Black teachers, strong extracurricular programs and supportive Black student communities. Dr. Hailey stresses the importance of addressing systemic racism and racial biases in order to create equitable educational experiences. She calls for a broader understanding of what defines a "good school" by centering the voices and needs of Black families.Dimensions of Diversity is a podcast created by Buchanan Ingersoll & Rooney, highlighting diversity in the workplace. Hosted by Lloyd Freeman, Chief Diversity & Inclusion Officer, the podcast features meaningful conversations with industry and community leaders working to advance D&I. 

In this episode we're diving deep into the fascinating world of carbon recycling with a trailblazer who's reshaping how we think about waste and sustainability. Our guest is Dr. Jennifer Holmgren, CEO of LanzaTech—a company on a mission to transform our biggest environmental challenge into an economic opportunity. LanzaTech is pioneering a process that takes industrial emissions—the kind of harmful gases that typically contribute to climate change—and recycles them into valuable products like fuels, fabrics, and everyday consumer goods. The concept might sound like science fiction, but it's already science fact. LanzaTech's technology captures carbon emissions from sources like steel mills, refineries, and even municipal solid waste, then feeds those emissions to specially engineered microbes. These microbes act like tiny factories, converting carbon pollution into useful materials. Imagine jet fuel made from industrial waste or yoga pants created from captured carbon—it's not just possible; it's happening. In fact, at the very end of 2024, LanzaTech received a holiday gift from the federal government: a $200 million award from the Dept. of Energy. In this episode, Jennifer and I discuss the path LanzaTech took, including raising $400 million and taking 13 years prior to commercializing its first product. We also touch on her personal journey from her birth in Colombia to her taking the helm at LanzaTech. As you'll hear, this isn't just about reducing emissions; it's about completely rethinking the role of waste in our economy. LanzaTech's vision is one where carbon is no longer a liability but an asset—a resource that can be reused and recycled, over and over again. It's a powerful example of how businesses can align profitability with purpose, and it's precisely the kind of story that inspires hope in these challenging times. So, whether you're an entrepreneur, an environmentalist, or just someone curious about the future of our planet, this is a conversation you won't want to miss.  Discussed in this episode Jennifer recommends reading Quiet by Susan Cain. LanzaTech awarded up to $200 million in federal cash from the DOE LanzaTech is backed by Khosla Ventures. More about Jennifer Holmgren, PhD Dr. Jennifer Holmgren is CEO of LanzaTech. Under her guidance, LanzaTech is developing a variety of platform chemicals and fuels, including the world's first alternative jet fuel derived from industrial waste gases. Given her integral role in the development of this alternative jet fuel, she is also a Director and the Chair of the LanzaJet Board of Directors.  Prior to LanzaTech, Jennifer was VP and General Manager of the Renewable Energy and Chemicals business unit at UOP LLC, a Honeywell Company. While at UOP, she was a key driver of UOP's leadership in low carbon aviation biofuels, and under her management, UOP technology became instrumental in producing nearly all the initial fuels used by commercial airlines and the military for testing and certification of alternative aviation fuel. Jennifer is the author or co-author of 50 U.S. patents and more than 30 scientific publications, and is a member of the National Academy of Engineering. In 2003, she was the first woman awarded the Malcolm E. Pruitt Award from the Council for Chemical Research (CCR). In 2010, she was the recipient of the Leadership Award from the Civil Aviation Alternative Fuels Initiative (CAAFI). In 2015, Jennifer and her team at LanzaTech were awarded the U.S. Environmental Protection Agency Presidential Green Chemistry Award, and she was awarded the BIO Rosalind Franklin Award for Leadership in Industrial Biotechnology. Jennifer was named as #1 of the 100 most influential leaders in the Bioeconomy in 2017 and received the Global Bioenergy Leadership Award in 2018, and the 2020 William C. Holmberg Award for Lifetime Achievement in the Advanced Bioeconomy. In 2021, she received the Edison Achievement Award and the Prix Voltaire Award. In 2022, she was included in ICIS's Top 40 Power Players ranking. Jennifer also has an honorary doctorate from Delft University of Technology. Jennifer is on the Governing Council for the Bio Energy Research Institute in India. The institute was set up by the DBT (Department of Biotechnology, Indian Government) and IOC (Indian Oil Corporation).  She also sits on the Advisory Council for the Andlinger Center for Energy and the Environment at Princeton University, the National Academies' Board on Energy and Environmental Systems (BEES), the External Advisory Committee for the Advanced Energy Technologies Directorate (AET) at Argonne National Laboratory, the Advisory Council for the Pacific Northwest National Laboratory (PNNL), the Halliburton Labs Advisory Board, the Universiti Teknologi PETRONAS International Advisory Council, and the Founder Advisory for The Engine, a venture capital fund built by MIT that invests in early-stage science and engineering companies.  Jennifer holds a B.Sc. degree from Harvey Mudd College, a Ph.D. from the University of Illinois at Urbana-Champaign and an MBA from the University of Chicago.

Dr. Gee returns to the discussion of his involvement in a university report on the Black Community Experience at the University of Wisconsin–Madison. In episode 188 he discussed the upcoming report with UW-Madison Chancellor Jennifer Mnookin and now that the report is public, he is joined by fellow board members on the ad hoc committee. Dr. Angela Byers-Winston and Ray Allen discuss the difference between good intentions and intentionality, when it comes to identifying and creating real change? The ad hoc study group worked to present their critical findings and strategic recommendations aimed at addressing the long-standing challenges faced by Black students, faculty, and staff on university campus. They discuss the question, “What is the systemic inertia to follow through on the recommendations?” Hear the unfiltered conversation about the report conducted by the UW by those that served on the board. All three speak honestly about the process, offering what made them angry or frustrated, and the hopes they have for change. They talk about how creating programs only can't change the DEI issues, but it takes institutional and organizational change. Also, be sure to catch a double portion of the Black Ice Breakers segment. Dr. Angela Byars-Winston is a tenured faculty member in the Division of General Internal Medicine within the Department of Medicine. She is also the inaugural Chair of the University of Wisconsin Institute for Diversity Science, associate director in the Collaborative Center for Health Equity, and faculty lead in the Center for the Improvement of Mentored Experiences in Research. Dr. Byars-Winston has received numerous awards for her research on advancing diversity goals and mentorship in STEM fields. In 2011, Dr. Byars-Winston was selected as a Champion of Change by the White House through President Obama's Winning the Future initiative for her research efforts to diversify science fields. In 2022, she was the recipient of the Innovation in Mentorship Research award from the Association of Clinical and Translational Research. Dr. Byars-Winston chaired the National Academies of Sciences' 2019 consensus study report, The Science of Effective Mentorship in STEMM. She is an elected Fellow in the American Psychological Association and is currently an appointed member of the NIH National Advisory General Medical Sciences Council. Over a career spanning nearly 50 years, Ray Allen has worked at the John Deere Company and served in a number of leadership roles in state government, including Secretary of the Wisconsin Department of Workforce Development. He was elected to three terms on the Madison School Board from 1995 to 2004, has served as chair of the Madison Area Technical College Board, and is the former publisher and owner of weekly newspaper The Madison Times. In 2016 Allen was honored with the Outstanding Alumni of Color Award from the UW–Madison Division of Diversity, Equity & Educational Achievement. He currently serves on more than 10 corporate and community boards, including 100 Black Men, the Overture Center, UMOJA Magazine's board of directors, United Way of Dane County, American Red Cross, Downtown Madison Inc., and Madison College. Read the Report: Black Community Experience on the University of Wisconsin – Madison Campus- AD Hockey Study Group alexgee.com Support the Show: patreon.com/blacklikeme Join the Black Like Me Listener Community Facebook Group

My special guest tonight is Satki who works with people to rid themselves of entities that pick can pick up in various ways including sexually. Visit her website. Parapsychology Main article: Parapsychology Participant of a Ganzfeld experiment which proponents say may show evidence of telepathy. Experimental investigation of the paranormal has been conducted by parapsychologists. J. B. Rhine popularized the now famous methodology of using card-guessing and dice-rolling experiments in a laboratory in the hopes of finding evidence of extrasensory perception.[20] However, it was revealed that Rhine's experiments contained methodological flaws and procedural errors. In 1957, the Parapsychological Association was formed as the preeminent society for parapsychologists. In 1969, they became affiliated with the  American Association for the Advancement of Science.[24] Criticisms of the field were focused in the creation (in 1976) of the  Committee for the Scientific Investigation of Claims of the Paranormal (now called the Committee for Skeptical Inquiry) and its periodical, the Skeptical Inquirer.[25] Eventually, more mainstream scientists became critical of parapsychology as an endeavor, and statements by the National Academies of Science and the National Science Foundation cast a pall on the claims of evidence for parapsychology. Today, many cite parapsychology as an example of a pseudoscience. Parapsychology has been criticized for continuing investigation despite being unable to provide convincing evidence for the existence of any psychic phenomena after more than a century of research. By the 2000s, the status of paranormal research in the United States had greatly declined from its height in the 1970s, with the majority of work being privately funded and only a small amount of research being carried out in university laboratories. In 2007, Britain had a number of privately funded laboratories in university psychology departments.[30]Publication remained limited to a small number of niche journals.