Podcasts about national heart

Discover all of the podcasts in our network, search for specific episodes, get the Optimal Living Daily workbook, and learn more at: OLDPodcast.com. Episode 3012: Dr. Neal breaks down the role of genetics in cholesterol levels and explains how even those with a family history of heart disease can benefit from targeted lifestyle changes. From diet tweaks to exercise strategies, his practical tips empower listeners to take control of their heart health, no matter their DNA. Quotes to ponder: "HDL actually helps the body clear LDL from the arteries, which is why it's good." "One of the most effective ways to lower blood cholesterol and blood pressure quickly is weight loss." "Fiber is so helpful because it helps bind to cholesterol and helps the body get rid of it." Episode references: Omega-3 Fatty Acids (NIH Office of Dietary Supplements): https://ods.od.nih.gov/factsheets/Omega3FattyAcids-Consumer USDA FoodData Central: https://fdc.nal.usda.gov/ National Heart, Lung, and Blood Institute: https://www.nhlbi.nih.gov Learn more about your ad choices. Visit megaphone.fm/adchoices

Discover all of the podcasts in our network, search for specific episodes, get the Optimal Living Daily workbook, and learn more at: OLDPodcast.com. Episode 3012: Dr. Neal breaks down the role of genetics in cholesterol levels and explains how even those with a family history of heart disease can benefit from targeted lifestyle changes. From diet tweaks to exercise strategies, his practical tips empower listeners to take control of their heart health, no matter their DNA. Quotes to ponder: "HDL actually helps the body clear LDL from the arteries, which is why it's good." "One of the most effective ways to lower blood cholesterol and blood pressure quickly is weight loss." "Fiber is so helpful because it helps bind to cholesterol and helps the body get rid of it." Episode references: Omega-3 Fatty Acids (NIH Office of Dietary Supplements): https://ods.od.nih.gov/factsheets/Omega3FattyAcids-Consumer USDA FoodData Central: https://fdc.nal.usda.gov/ National Heart, Lung, and Blood Institute: https://www.nhlbi.nih.gov Learn more about your ad choices. Visit megaphone.fm/adchoices

Chronic obstructive pulmonary disease, referred to as COPD, is a progressive disease which can, over time, limit your ability to do basic activities such as walking, cooking or taking care of yourself. According to the National Heart, Lung and Blood Institute, it is the sixth leading cause of death in the U.S. and is two times more common in rural areas than it is in large cities. Tushi Singh, M.D., Texas Tech Physicians pulmonologist, is our guest for this episode. Dr. Singh explains to us what causes COPD, what treatments are available and what we can do to protect ourselves from developing COPD. 

On this MADM, Sean Coady with the National Heart, Lung, and Blood Institute is sharing about the importance of heart health & beyond in rural communities. Listen & share. Sponsor: The SIMRP

On tonight's show, I have Sean Coady with National Heart, Lung, and Blood Institute (NHLBI) & Chef Jamie Gwen!

Our February episode kicks off with a great interview with Barbara Sullivan – Executive Director of the Village to Village Network (VtV Network). You will learn about this movement in aging in place to help keep older loved ones living in their homes longer as we celebrate National Village Day February 15. We are also focusing on National Caregivers Day February 21 and the recent studies on why caregivers are so burned out and what they need to relieve that stress. Also, February is Heart Health Month and National Cancer Awareness Month and we share some tips from Sherri's book, ME TIME MONDAY, on how to stay healthy and how to prevent your risk for heart disease and many cancers. February is also National Library Month and Sherri talks about how this observance matches up with a new wellness trend called “Social Re-Wilding.” What is it? Stay tuned… As well Sherri covers the latest trends in well home design from the recent KBIS Show in Las Vegas and why Sherri's “Snug Home” was a trendsetting blog (and the topic of her next book) at the beginning of a new growing home design trend called “The Snug.” Sherri also shares another trend in senior living called the Cozy Home Communities. (3:16) In CAREGIVER WELLNESS NEWS, Sherri talks about how caregivers are care managers, care researcgers, are coordinators and what will help them most on their caregiving journey with a shout-out to National Caregivers Day Feb 21. Also, she lists national organizations that help caregivers and explains how National Library Month fits into the new trend in “social re-wilding.” Sherri also talks about what to know about heart health for National Heart Health Awareness Month and a cancer screening and Cancer Prevention Quiz for National Cancer Awareness Month. (25:57) Barbara Sullivan – Executive Director of the Village to Village Network (VtV Network) – How to help older parents stay living in their homes longer with a little help. (55:29) For WELL HOME DESIGN NEWS, Sherri talks about the new Cozy Home Communities being built – an alternative to senior living for those in their 60s and 70s. She shares the trends coming out of the KBIS Show for universal design in the home and how Sherri's “Snug Home” blog and upcoming book were ahead of the curve in the new home design trend of having a “snug” at home. Take Care and Stay Well! Find out more at: caregivingclub.com/podcast/

On tonight's show, I'll have Sean Coady, Deputy Branch Chief in the Epidemiology Branch of the Division of Cardiovascular Sciences, at the National Heart, Lung, and Blood Institute to talk about heart health in rural areas and Lance Taylor with CEI Bookstore / Truth Publications to share about their progress after a tornado destroyed their business location in Athens.

On this MADM, I have Sean Coady, Deputy Branch Chief in the Epidemiology Branch of the Division of Cardiovascular Sciences, at the National Heart, Lung, and Blood Institute to talk about heart health in rural areas. Sponsor: Green's Dependable Hardware Russellville, AL

drdaltonsmith.com Staying Busy is Easy. Staying Well Rested and Avoiding Burnout— Now There's a Challenge. We are a society that praises being busy, the more that one can cram into a day and the fewer hours you need to sleep the more productive and successful you seem, but are you and at what cost? According to the National Heart, Lung and Blood Institute, NIH (June 7, 2017) "Sleep plays an important role in your physical health. For example, sleep is involved in healing and repair of your heart and blood vessels. Ongoing sleep deficiency is linked to an increased risk of heart disease, kidney disease, high blood pressure, diabetes, and stroke." How can you keep your energy, happiness, creativity, and relationships fresh and thriving in the midst of never-ending family demands, career pressures, the stress of everyday life, and Burnout? In Sacred Rest: Recover Your Life, Renew Your Energy, Restore Your Sanity, Dr. Saundra Dalton-Smith, a board-certified internal medicine doctor, reveals why rest can no longer remain optional. Dr. Dalton-Smith shares seven types of rest she has found lacking in the lives of those she encounters in her clinical practice and research-physical, mental, spiritual, emotional, sensory, social, creative-and why a deficiency in any one of these types of rest can have unfavorable effects on your health, happiness, relationships, creativity, and productivity. In Sacred Rest: Recover Your Life, Renew Your Energy, Restore Your Sanity, Dr. Dalton-Smith discusses the seven types of rest using the R-E-S-T method: Recognize your risk Evaluate your current position Science and research Today's application Sacred Rest: Recover Your Life, Renew Your Energy, Restore Your Sanity combines the science of rest, the spirituality of rest, the gifts of rest, and the resulting fruit of rest. It shows rest as something sacred, valuable, and worthy of our respect. SACRED REST gives the weary permission to embrace rest, set boundaries, and seek sanctuary without any guilt, shame, or fear. Media Highlights Sacred Rest Suggested Interview Questions Rest seems like a simple process. Why then do so many people struggle with fatigue, Insomina, and Burnout? What is the distinction between sleep and rest and how does it connect with Burnout? In your book Sacred Rest, you describe seven types of rest. What are they? We can get a sense of what these are just from the names, but to gain a better understanding, can you briefly define each type of rest? When you mentioned emotional rest, you said that it's when you no longer feel the need to perform. Can you say more about this? Your book has lots of teaching stories in it. Do you have a favorite? What are the long-term effects of focusing only on work and omitting regular periods of rest? Is this when burnout happens? What effect does work environment have on rest and burnout? Give us some examples of ways we can add rest in the middle of a busy work day? In the book you mention the gifts of rest, what's does that mean? You offer a unique resource for your readers called “The Rest Quiz”. Can you talk a bit about “The Rest Quiz”? Many people think of rest as a luxury. What would you say to them? Sample TV Segment Focused Questions (3-5 minutes) Rest seems like a simple process. Why then do so many people struggle with fatigue and insomnia? In your book Sacred Rest, you describe seven types of rest. What are they?

Dr. Cynthia "Cindy" Dunbar is National Institutes of Health (NIH) Distinguished Investigator and Chief of the Translational Stem Cell Biology Branch at the National Heart, Lung, and Blood Institute of the NIH. She talks about using macaques to study hematopoiesis and aging, and the challenges and considerations for using these models. She also discusses her collaborative study transplanting iPSC-derived cardiomyocytes into rhesus macaques, as well as the NIH's unique research environment and her musical talents outside of the lab.

There are dangers lurking in our food that affect your health and the health of our entire society, and you should know about them. In this episode, get the highlights from two recent Congressional events featuring expert testimony about the regulation of our food supply, as well as testimony from the man who is soon likely to be the most powerful person in our national health care system. Please Support Congressional Dish – Quick Links Contribute monthly or a lump sum via Support Congressional Dish via (donations per episode) Send Zelle payments to: Donation@congressionaldish.com Send Venmo payments to: @Jennifer-Briney Send Cash App payments to: $CongressionalDish or Donation@congressionaldish.com Use your bank's online bill pay function to mail contributions to: Please make checks payable to Congressional Dish Thank you for supporting truly independent media! Background Sources Joe Rogan Episodes The Joe Rogan Experience. The Joe Rogan Experience. The Joe Rogan Experience. The Joe Rogan Experience. Ron Johnson Scott Bauer. January 3, 2023. AP News. Robert F. Kennedy, Jr. Daniel Cusick. October 28, 2024. Politico. Rachel Treisman. August 5, 2024. NPR. Susanne Craig. May 8, 2024. The New York Times. Department of Health and Human Services U.S. Department of Health and Human Services. FDA “Generally Recognized as Safe” Approach Paulette M. Gaynor et al. April 2006. U.S. Food and Drug Administration. Paulette Gaynor and Sebastian Cianci. December 2005/January 2006. U.S. Food and Drug Administration. Glyphosate September 20, 2023. Phys.org. Lobbying and Conflicts of Interest OpenSecrets. OpenSecrets. OpenSecrets. LinkedIn. Shift from Democrats to Republicans Will Stone and Allison Aubrey. November 15, 2024. NPR. Helena Bottemiller Evich and Darren Samuelsohn. March 17, 2016. Politico. Audio Sources September 25, 2024 Roundtable discussion held by Senator Ron Johnson Participants: , Author, Good Energy; Tech entrepreneur, Levels , Co-founder, Truemed; Advocate, End Chronic Disease , aka the Food Babe, food activist Jillian Michaels, fitness expert, nutritionist, businesswoman, media personality, and author Dr. Chris Palmer, Founder and Director, Metabolic and Mental Health Program and Director, Department of Postgraduate and Continuing Education, McLean Hospital; Assistant Professor of Psychiatry, Harvard Medical School Brigham Buhler, Founder & CEO, Ways2Well Courtney Swan, nutritionist, real food activist, and founder of the popular platform "Realfoodology" , Founder and CEO, HumanCo; co-founder, Hu Kitchen Dr. Marty Makary, Chief of Islet Transplant Surgery, Professor of Surgery, and Public Policy Researcher, Johns Hopkins University Clips Robert F. Kennedy, Jr: When discussing improvements to US healthcare policy, politicians from both parties often say we have the best healthcare system in the world. That is a lie. Robert F. Kennedy, Jr: Every major pillar of the US healthcare system, as a statement of economic fact, makes money when Americans get sick. By far the most valuable asset in this country today is a sick child. The pharma industry, hospital industry, and medical school industry make more money when there are more interventions to perform on Americans, and by requiring insurance companies to take no more than 15% of premiums, Obamacare actually incentivized insurance companies to raise premiums to get 15% of a larger pie. This is why premiums have increased 100% since the passage of Obamacare, making health care the largest driver of inflation, while American life expectancy plummets. We spend four times per capita on health care than the Italians, but Italians live 7.5 years longer than us on average. And incidentally, Americans had the highest life expectancies in the world when I was growing up. Today, we've fallen an average of six years behind our European neighbors. Are we lazier and more suicidal than Italians? Or is there a problem with our system? Are there problems with our incentives? Are there problems with our food? 46:15 Robert F. Kennedy, Jr: So what's causing all of this suffering? I'll name two culprits, first and worst is ultra processed foods. 47:20 Robert F. Kennedy, Jr: The second culprit is toxic chemicals in our food, our medicine and our environment. Robert F. Kennedy, Jr: The good news is that we can change all this, and we can change it very, very, very quickly, and it starts with taking a sledgehammer to corruption, the conflicts in our regulatory agencies and in this building. These conflicts have transformed our regulatory agencies into predators against the American people and particularly our children. 80% of NIH grants go to people who have conflicts of interest, and these scientists are allowed to collect royalties of $150,000 a year on the products that they develop at NIH and then farm out to the pharmaceutical industry. The FDA, the USDA and CDC are all controlled by giant for-profit corporations. Their function is no longer to improve and protect the health of Americans. Their function is to advance the mercantile and commercial interests of the pharmaceutical industry that has transformed them and the food industry that has transformed them into sock puppets for the industry they're supposed to regulate. 75% of FDA funding does not come from taxpayers. It comes from pharma. And pharma executives and consultants and lobbyists cycle in and out of these agencies. Robert F. Kennedy, Jr: Money from the healthcare industry has compromised our regulatory agencies and this body as well. The reality is that many congressional healthcare staffers are worried about impressing their future bosses at pharmaceutical companies rather than doing the right thing for American children. Today, over 100 members of Congress support a bill to fund Ozempic with Medicare at $1,500 a month. Most of these members have taken money from the manufacturer of that product, a European company called Novo Nordisk. As everyone knows, once a drug is approved for Medicare, it goes to Medicaid, and there is a push to recommend Ozempic for Americans as young as six, over a condition, obesity, that is completely preventable and barely even existed 100 years ago. Since 74% of Americans are obese, the cost of all of them, if they take their Ozempic prescriptions, will be $3 trillion a year. This is a drug that has made Novo Nordisk the biggest company in Europe. It's a Danish company, but the Danish government does not recommend it. It recommends a change in diet to treat obesity and exercise. Virtually Novo Nordisk's entire value is based upon its projections of what Ozempic is going to sell to Americans. For half the price of Ozempic, we could purchase regeneratively raised organic agriculture, organic food for every American, three meals a day and a gym membership for every obese American. Why are members of Congress doing the bidding of this Danish company instead of standing up for American farmers and children? Robert F. Kennedy, Jr: For 19 years, solving the childhood chronic disease crisis has been the central goal of my life, and for 19 years, I have prayed to God every morning to put me in a position to end this calamity. I believe we have the opportunity for transformational, bipartisan change to transform American health, to hyper-charge our human capital, to improve our budget, and I believe, to save our spirits and our country. 1:23:10 Sen. Ron Johnson (R-WI): Our next presenter, Dr. Marty Makary also bears a few scars from telling the truth during COVID. Dr. Makary is a surgeon and public policy researcher at Johns Hopkins University. He writes for The Washington Post and The Wall Street Journal, and is the author of two New York Times best selling books, Unaccountable and The Price We Pay. He's been an outspoken opponent of broad vaccine mandates and some COVID restrictions at schools. Dr. Makary holds degrees from Bucknell University, Thomas Jefferson University and Harvard University. Dr. Marty Makary: I'm trained in gastrointestinal surgery. My group at Johns Hopkins does more pancreatic cancer surgery than any hospital in the United States. But at no point in the last 20 years has anyone stopped to ask, why has pancreatic cancer doubled over those 20 years? Who's working on that? Who's looking into it? We are so busy in our health care system, billing and coding and paying each other, and every stakeholder has their gigantic lobby in Washington, DC, and everybody's making a lot of money, except for one stakeholder, the American citizen. They are financing this giant, expensive health care system through their paycheck deduction for health insurance and the Medicare excise tax as we go down this path, billing and coding and medicating. And can we be real for a second? We have poisoned our food supply, engineered highly addictive chemicals that we put into our food, we spray it with pesticides that kill pests. What do you think they do to our gut lining and our microbiome? And then they come in sick. The GI tract is reacting. It's not an acute inflammatory storm, it's a low grade chronic inflammation, and it makes people feel sick, and that inflammation permeates and drives so many of our chronic diseases that we didn't see half a century ago. Who's working on who's looking into this, who's talking about it? Our health care system is playing whack a mole on the back end, and we are not talking about the root causes of our chronic disease epidemic. We can't see the forest from the trees. Sometimes we're so busy in these short visits, billing and coding. We've done a terrible thing to doctors. We've told them, put your head down. Focus on billing and coding. We're going to measure you by your throughput and good job. You did a nice job. We have all these numbers to show for it. Well, the country is getting sicker. We cannot keep going down this path. We have the most over-medicated, sickest population in the world, and no one is talking about the root causes. Dr. Marty Makary: Somebody has got to speak up. Maybe we need to talk about school lunch programs, not just putting every kid on obesity drugs like Ozempic. Maybe we need to talk about treating diabetes with cooking classes, not just throwing insulin at everybody. Maybe we need to talk about environmental exposures that cause cancer, not just the chemo to treat it. We've got to talk about food as medicine. Sen. Ron Johnson (R-WI): So, Dr Makary, I've got a couple questions. First of all, how many years have you been practicing medicine? Dr. Marty Makary: 22 years. Sen. Ron Johnson (R-WI): So we've noticed a shift from decades ago when 80% of doctors are independent to now 80% are working for some hospital association. First of all, what has that meant in terms of doctors' independence and who they are really accountable too? Dr. Marty Makary: The move towards corporate medicine and mass consolidation that we've witnessed in our lifetime has meant more and more doctors are told to put their heads down, do your job: billing and coding short visits. We've not given doctors the time, research, or resources to deal with these chronic diseases. 1:32:45 Sen. Ron Johnson (R-WI): Dr. Casey Means is a medical doctor, New York Times Best Selling Author, tech entrepreneur at Levels, an aspiring regenerative gardener and an outdoor enthusiast. While training as a surgeon, she saw how broken and exploitative the health care system is, and led to focus on how to keep people out of the operating room. And again, I would highly recommend everybody read Good Energy. It's a personal story, and you'll be glad you did. Dr. Casey Means: Over the last 50 years in the United States, we have seen rapidly rising rates of chronic illnesses throughout the entire body. The body and the brain, infertility, obesity, type 2 diabetes and pre-diabetes, Alzheimer's, dementia, cancer, heart disease, stroke, autoimmune disease, migraines, mental illness, chronic pain, fatigue, congenital abnormalities, chronic liver disease, autism, and infant and maternal mortality all going up. Americans live eight fewer years compared to people in Japan or Switzerland, and life expectancy is going down. I took an oath to do no harm, but listen to these stats. We're not only doing harm, we're flagrantly allowing harm. While it sounds grim, there is very good news. We know why all of these diseases are going up, and we know how to fix it. Every disease I mentioned is caused by or worsened by metabolic dysfunction, a word that it is thrilling to hear being used around this table. Metabolic dysfunction is a fundamental distortion of our cellular biology. It stops our cells from making energy appropriately. According to the American College of Cardiology, metabolic dysfunction now affects 93.2% of American adults. This is quite literally the cellular draining of our life force. This process is the result of three processes happening inside our cells, mitochondrial dysfunction, a process called oxidative stress, which is like a wildfire inside our cells, and chronic inflammation throughout the body and the gut, as we've heard about. Metabolic dysfunction is largely not a genetic issue. It's caused by toxic American ultra processed industrial food, toxic American chemicals, toxic American medications, and our toxic sedentary, indoor lifestyles. You would think that the American healthcare system and our government agencies would be clamoring to fix metabolic health and reduce American suffering and costs, but they're not. They are deafeningly silent about metabolic dysfunction and its known causes. It's not an overstatement to say that I learned virtually nothing at Stanford Medical School about the tens of thousands of scientific papers that elucidate these root causes of why American health is plummeting and how environmental factors are causing it. For instance, in medical school, I did not learn that for each additional serving of ultra processed food we eat, early mortality increases by 18%. This now makes up 67% of the foods our kids are eating. I took zero nutrition courses in medical school. I didn't learn that 82% of independently funded studies show harm from processed food, while 93% of industry sponsored studies reflect no harm. In medical school, I didn't learn that 95% of the people who created the recent USDA Food guidelines for America had significant conflicts of interest with the food industry. I did not learn that 1 billion pounds of synthetic pesticides are being sprayed on our food every single year. 99.99% of the farmland in the United States is sprayed with synthetic pesticides, many from China and Germany. And these invisible, tasteless chemicals are strongly linked to autism, ADHD, sex hormone disruption, thyroid disease, sperm dysfunction, Alzheimer's, dementia, birth defects, cancer, obesity, liver dysfunction, female infertility and more, all by hurting our metabolic health. I did not learn that the 8 billion tons of plastic that have been produced just in the last 100 years, plastic was only invented about 100 years ago, are being broken down into micro plastics that are now filling our food, our water, and we are now even inhaling them in our air. And that very recent research from just the past couple of months tells us that now about 0.5% of our brains by weight are now plastic. I didn't learn that there are more than 80,000 toxins that have entered our food, water, air and homes by industry, many of which are banned in Europe, and they are known to alter our gene expression, alter our microbiome composition and the lining of our gut, and disrupt our hormones. I didn't learn that heavy metals like aluminum and lead are present in our food, our baby formula, personal care products, our soil and many of the mandated medications, like vaccines and that these metals are neurotoxic and inflammatory. I didn't learn that the average American walks a paltry 3500 steps per day, even though we know based on science and top journals that walking, simply walking 7000 steps a day, slashes by 40-60% our risk of Alzheimer's, dementia, type two diabetes, cancer and obesity. I certainly did not learn that medical error and medications are the third leading cause of death in the United States. I didn't learn that just five nights of sleep deprivation can induce full blown pre-diabetes. I learned nothing about sleep, and we're getting about 20% less sleep on average than we were 100 years ago. I didn't learn that American children are getting less time outdoors now than a maximum security prisoner. And on average, adults spend 93% of their time indoors, even though we know from the science that separation from sunlight destroys our circadian biology, and circadian biology dictates our cellular biology. I didn't learn that professional organizations that we get our practice guidelines from, like the American Diabetes Association and American Academy of Pediatrics, have taken 10s of millions of dollars from Coke, Cadbury, processed food companies, and vaccine manufacturers like Moderna. I didn't learn that if we address these root causes that all lead to metabolic dysfunction and help patients change their food and lifestyle patterns with a united strong voice, we could reverse the chronic disease crisis in America, save millions of lives, and trillions of dollars in health care costs per year. Instead, doctors are learning that the body is 100 separate parts, and we learn how to drug, we learn how to cut and we learn how to bill. I'll close by saying that what we are dealing with here is so much more than a physical health crisis. This is a spiritual crisis we are choosing death over life. We are we are choosing death over life. We are choosing darkness over light for people and the planet, which are inextricably linked. We are choosing to erroneously believe that we are separate from nature and that we can continue to poison nature and then outsmart it. Our path out will be a renewed respect for the miracle of life and a renewed respect for nature. We can restore health to Americans rapidly with smart policy and courageous leadership. We need a return to courage. We need a return to common sense and intuition. We need a return to awe for the sheer miraculousness of our lives. We need all hands on deck. Thank you. Sen. Ron Johnson (R-WI): I'm not letting you off that easy. I've got a couple questions. So you outlined some basic facts that doctors should know that truthfully, you could cover in one hour of an introductory class in medical school, yes. So why aren't we teaching doctors these things? Dr. Casey Means: The easy thing to say would be, you know, follow the money. That sounds sort of trite, but frankly, I think that is the truth, but not in the way you might think that, like doctors are out to make money, or even medical schools. The money and the core incentive problem, which is that every institution that touches our health in America, from medical schools to pharmaceutical companies to health insurance companies to hospitals offices, they make more money when we are sick and less when we are healthy. That simple, one incentive problem corrodes every aspect of the way medicine is thought about. The way we think about the body, we talked about interconnectedness. It creates a system in which we silo the body into all these separate parts and create that illusion that we all buy into because it's profitable to send people to separate specialties. So it corrodes even the foundational conception of how we think about the body. So it is about incentives and money, but I would say that's the invisible hand. It's not necessarily affecting each doctor's clinical practice or the decision making. It's corroding every lever of the basics of how we even consider what the human body is and what life is. Sen. Ron Johnson (R-WI): In your book, you do a really good job of describing how, because of the specialization of medicine, you don't see the forest for the trees. The fact is, you do need specialized medicine. I mean, doctors can't know it all. So I think the question is, how do we get back to the reward for general practitioners that do focus on what you're writing about? Dr. Casey Means: I have huge respect for doctors, and I am incredibly grateful for the American health care system, which has produced miracles, and we absolutely need continue to have primary care doctors and specialists, and they should be rewarded highly. However, if we focused on what everyone here is talking about, I think we'd have 90% less throughput through our health care system. We would be able to have these doctors probably have a much better life to be honest. You know, because right now, doctors are working 100 hours a week seeing 50, 60, 70 patients, and could actually have more time with patients who develop these acute issues that need to be treated by a doctor. But so many of the things in the specialist office are chronic conditions that we know are fundamentally rooted in the cellular dysfunction I describe, which is metabolic dysfunction, which is created by our lifestyle. So I think that there's always going to be a place for specialists, but so so many, so much fewer. And I think if we had a different conception for the body is interconnected, they would also interact with each other in a very different way, a much more collaborative way. And then, of course, we need to incentivize doctors in the healthcare system towards outcomes, not throughput. 1:46:25 Sen. Ron Johnson (R-WI): Our next presenter is Dr. Chris Palmer. Dr. Palmer is a Harvard trained psychiatrist, researcher and author of Brain Energy, where he explores a groundbreaking connection between metabolic health and mental illness. He is a leader in innovative approaches to treating psychiatric conditions, advocating for the use of diet and metabolic interventions to improve mental health outcomes. Dr. Palmer's work is reshaping how the medical field views and treats mental health disorders. Dr. Chris Palmer: I want to build on what Dr. Means just shared that these chronic diseases we face today. Obesity, diabetes, fatty liver, all share something in common. They are, in fact, metabolic dysfunction. I'm going to go into a little bit of the science, just to make sure we're all on the same page. Although most people think of metabolism as burning calories, it is far more than that. Metabolism is a series of chemical reactions that convert food into energy and building blocks essential for cellular health. When we have metabolic dysfunction, it can drive numerous chronic diseases, which is a paradigm shift in the medical field. Now there is no doubt metabolism is complicated. It really is. It is influenced by biological, psychological, environmental and social factors, and the medical field says this complexity is the reason we can't solve the obesity epidemic because they're still trying to understand every molecular detail of biology. But in fact, we don't need to understand biology in order to understand the cause. The cause is coming from our environment, a toxic environment like poor diet and exposure to harmful chemicals, and these are actually quite easy to study, understand, and address. There is no doubt food plays a key role. It provides the substrate for energy and building blocks. Nutritious foods support metabolism, while ultra processed options can disrupt it. It is shocking that today, in 2024, the FDA allows food manufacturers to introduce brand new chemicals into our food supply without adequate testing. The manufacturer is allowed to determine for themselves whether this substance is safe for you and your family to eat or not. Metabolism's impact goes beyond physical health. I am a psychiatrist. Some of you are probably wondering, why are you here? It also affects mental health. Because guess what? The human brain is an organ too, and when brain metabolism is impaired, it can cause symptoms that we call mental illness. It is no coincidence that as the rates of obesity and diabetes are skyrocketing, so too are the rates of mental illness. In case you didn't know, we have a mental health crisis. We have all time prevalence highs for depression, anxiety, bipolar disorder, deaths of despair, drug overdoses, ADHD and autism. What does the mental health field have to say for this? Well, you know, mental illness is just chemical imbalances, or maybe trauma and stress that is wholly insufficient to explain the epidemic that we are seeing. And in fact, there is a better way to integrate the biopsychosocial factors known to play a role in mental illness. Mental Disorders at their core are often metabolic disorders impacting the brain. It's not surprising to most people that obesity and diabetes might play a role in depression or anxiety, but the rates of autism have quadrupled in just 20 years, and the rates of ADHD have tripled over that same period of time. These are neuro developmental disorders, and many people are struggling to understand, how on earth could they rise so rapidly? But it turns out that metabolism plays a profound role in neurodevelopment, and sure enough, parents with metabolic issues like obesity and diabetes are more likely to have children with autism and ADHD. This is not about fat shaming, because what I am arguing is that the same foods and chemicals and other drivers of obesity that are causing obesity in the parents are affecting the brain health of our children. There is compelling evidence that food plays a direct role in mental health. One study of nearly 300,000 people found that those who eat ultra processed foods daily are three times more likely to struggle with their mental health than people who never or rarely consume them. A systematic review found direct associations between ultra processed food exposure and 32 different health parameters, including mental mental health conditions. Now I'm not here to say that food is the only, or even primary driver of mental illness. Let's go back to something familiar. Trauma and stress do drive mental illness, but for those of you who don't know, trauma and stress are also associated with increased rates of obesity and diabetes. Trauma and stress change human metabolism. We need to put the science together. This brings me to a key point. We cannot separate physical and mental health from metabolic health. Addressing metabolic dysfunction has the potential to prevent and treat a wide range of chronic diseases. Dr. Chris Palmer: In my own work, I have seen firsthand how using metabolic therapies like the ketogenic diet and other dietary interventions can improve even severe mental illnesses like schizophrenia and bipolar disorder, sometimes putting them into lasting remission. These reports are published in peer reviewed, prestigious medical journals. However, there is a larger issue at play that many have talked about, medical education and public health recommendations are really captured by industry and politics, and at best, they often rely on weak epidemiological data, resulting in conflicting or even harmful advice. We heard a reference to this, but in case you didn't know, a long time ago, we demonized saturated fat. And what was the consequence of demonizing saturated fat? We replaced it with "healthy vegetable shortening." That was the phrase we used, "healthy vegetable shortening." Guess what was in that healthy vegetable shortening? It was filled with trans fats, which are now recognized to be so harmful that they've been banned in the United States. Let's not repeat mistakes like this. Dr. Chris Palmer: So what's the problem? Number one, nutrition and mental health research are severely underfunded, with each of them getting less than 5% of the NIH budget. This is no accident. This is the concerted effort of lobbying by industry, food manufacturers, the healthcare industry, they do not want root causes discovered. We need to get back to funding research on the root causes of mental and metabolic disorders, including the effects of foods, chemicals, medications, environmental toxins, on the human brain and metabolism. Dr. Chris Palmer: The issue of micro plastics and nano plastics in the human body is actually, sadly, in its infancy. We have two publications out in the last couple of months demonstrating that micro plastics are, in fact, found in the human brain. And as Dr. Means said, and you recited, 0.5% of the body weight, or the brain's weight, appears to be composed of micro plastics. We need more research to better understand whether these micro plastics are, in fact, associated with harmful conditions, because microplastics are now ubiquitous. So some will argue, well, they're everywhere, and everybody's got them, and it's just a benign thing. Some will argue that the most compelling evidence against that is a study published in the New England Journal of Medicine a few months ago now, in which they were doing routine carotid endarterectomies, taking plaque out of people's carotid arteries. Just routinely doing that for clinical care, and then they analyzed those plaques for micro plastics. 58% of the people had detectable micro plastics in the plaques. So they compared this 58% group who had micro plastics to the ones who didn't, followed them for three years, just three years, and the ones who had micro plastics had four times the mortality. There is strong reason to believe, based on animal data and based on cell biology data, that microplastics are in fact, toxic to the human body, to mitochondrial function, to hormone dysregulation and all sorts of things. There are lots of reasons to believe that, but the scientists will say, we need more research. We need to better understand whether these micro plastics really are associated with higher rates of disease. I think people are terrified of the answer. People are terrified of the answer. And if you think about everything that you consume, and how much of it is not wrapped in plastic, all of those industries are going to oppose research. They are going to oppose research funding to figure this out ASAP, because that will be a monumental change to not just the food industry but our entire economy. Imagining just cleaning up the oceans and trying to get this plastic and then, more importantly, trying to figure out, how are we going to detox humans? How are we going to de-plasticize human beings? How are we going to get these things out? It is an enormous problem, but the reality is, putting our heads in the sand is not going to help. And I am really hopeful that by raising issues and letting people know about this health crisis, that maybe we will get answers quickly. Dr. Chris Palmer: Your question is, why are our health agencies not exploring these questions? It's because the health agencies are largely influenced by the industries they are supposed to be regulating and looking out for. The medical education community is largely controlled by pharmaceutical companies. One and a half billion dollars every year goes to support physician education. That's from pharmaceutical companies. One and a half billion from pharmaceutical companies. So physicians are getting educated with some influence, large influence, I would argue, by them, the health organizations. It's a political issue. The NIH, it's politics. Politicians are selecting people to be on the committees or people to oversee these organizations. Politicians rely on donations from companies and supporters to get re-elected, and the reality is this is not going to be easy to tackle. The challenge is that you'll get ethical politicians who say, I'm not going to take any of that money, and I'm going to try to do the right thing and right now, the way the system is set up, there's a good chance those politicians won't get re-elected, and instead, their opponents, who were more than happy to take millions of dollars in campaign contributions, will get re-elected, and then they will return the favor to their noble campaign donors. We are at a crossroads. We have to decide who are the constituents of the American government. Is it industry, or is it the American people? 2:09:35 Sen. Ron Johnson (R-WI): Calley Means the co-founder of Truemed, a company that enables tax free spending on food and exercise. He recently started an advocacy coalition with leading health and wellness companies called End Chronic Disease. Early in his career, he was a consultant for food and pharma companies. He is now exposing practices they used to weaponize our institutions of trust, and he's doing a great job doing interviews with his sister, Casey. Calley Means: If you think about a medical miracle, it's almost certainly a solution that was invented before 1960 for an acute condition: emergency surgical procedures to ensure a complicated childbirth wasn't a death sentence, sanitation procedures, antibiotics that insured infection was an inconvenience, not deadly, eradicating polio, regular waste management procedures that helped control outbreaks like the bubonic plague, sewage systems that replaced the cesspools and opened drains, preventing human waste from contaminating the water. The US health system is a miracle in solving acute conditions that will kill us right away. But economically, acute conditions aren't great in our modern system, because the patient is quickly cured and is no longer a customer. Start in the 1960s the medical system took the trust engendered by these acute innovations like antibiotics, which were credited with winning World War Two, and they used that trust to ask patients not to question its authority on chronic diseases, which can last a lifetime and are more profitable. But the medicalization of chronic disease in the past 50 years has been an abject failure. Today, we're in a siloed system where there's a treatment for everything. And let's just look at the stats. Heart disease has gone up as more statins are prescribed. Type 2 diabetes has gone up as more Metformin is prescribed. ADHD has gone up as more Adderall is prescribed. Depression and suicide has gone up as more SSRIs are prescribed. Pain has gone up as more opioids are prescribed. Cancer has gone up as we've spent more on cancer. And now JP Morgan literally at the conference in San Francisco, recently, they put up a graph, and they showed us more Ozempic is projected to be prescribed over the next 10 years, obesity rates are going to go up as more is prescribed. Explain that to me. There was clapping. All the bankers were clapping like seals at this graphic. Our intervention based system is by design. In the early 1900s, John D. Rockefeller using that he could use byproducts from oil production to create pharmaceuticals, heavily funded medical schools throughout the United States to teach a curriculum based on the intervention-first model of Dr. William Stewart Halsted, the founding physician of Johns Hopkins, who created the residency-based model that viewed invasive surgical procedures and medication as the highest echelon of medicine. An employee of Rockefeller's was tasked to create the Flexner Report, which outlined a vision for medical education that prioritized interventions and stigmatized nutritional and holistic remedies. Congress affirmed the Flexner Report in 1910 to establish that any credentialed medical institution in the United States had to follow the Halsted-Rockefeller intervention based model that silos disease and downplay viewing the body as an interconnected system. It later came out that Dr. Halsted's cocaine and morphine addiction fueled his day long surgical residencies and most of the medical logic underlying the Flexner Report was wrong. But that hasn't prevented the report and the Halsted-Rockefeller engine based brand of medicine from being the foundational document that Congress uses to regulate medical education today. Calley Means: Our processed food industry was created by the cigarette industry. In the 1980s, after decades of inaction, the Surgeon General and the US government finally, finally said that smoking might be harmful, and smoking rates plummeted. We listened to doctors in this country. We listened to medical leadership, and as smoking rates plummeted, cigarette companies, with their big balance sheets, strategically bought up food companies, and by 1990 the two largest food companies in the world were Philip Morris and RJ Reynolds, two cigarette companies. These cigarette companies moved two departments over from the cigarette department to the food department. They moved the scientists. Cigarette companies were the highest payers of scientists, one of the biggest employers of scientists to make the cigarettes addictive. They moved these addiction specialists, world leading addiction specialists, to the food department by the thousands. And those scientists weaponized our ultra processed food. That is the problem with ultra processed food. You have the best scientists in the world creating this food to be palatable and to be addictive. They then moved their lobbyists over. They used the same playbook, and their lobbyists co-opted the USDA and created the food pyramid. The Food Pyramid was a document created by the cigarette industry through complete corporate capture, and was an ultra processed food marketing document saying that we needed a bunch of carbs and sugar. And we listened to medical experts in this country, the American people, American parents. Many parents who had kids in the 90s thought it was a good thing to do to give their kids a bunch of ultra processed foods and carb consumption went up 20% in the American diet in the next 10 years. The Devil's bargain comes in in that this ultra processed food consumption has been one of the most profitable dynamics in American history for the health care industry. As we've all just been decimated with chronic conditions, the medical industry hasn't. Not only have they been silent on this issue, they've actually been complicit, working for the food industry. I helped funnel money from Coca Cola to the American Diabetes Association. Yeah. 2:31:40 Sen. Ron Johnson (R-WI): Next presenter will be Brigham Buhler. Brigham is the Founder and CEO of Ways2Well, a healthcare company that provides personalized preventive care through telemedicine, with a strong background in the pharmaceutical industry. Brigham is focused on making healthcare more accessible by harnessing the power of technology, delivering effective and tailored treatments. His vision for improving health outcomes has positioned him as a leader in modern patient centered healthcare solutions. Brigham Buhler: We hear people reference President Eisenhower's speech all the time about the military industrial complex, but rarely do we hear the second half of that speech. He also warned us about the rise of the scientific industrial complex. He warned us, if we allow the elite to control the scientific research, it could have dire consequences. 2:36:30 Sen. Ron Johnson (R-WI): I'm going to call an audible here as moderator, I saw that hopefully the future chairman of the Senate Finance Committee, Senator Mike Crapo from Idaho, came into the room. I asked Mike to share his story. He used to wear larger suits, let's put it that way. But he went down the path of the ketogenic diet, I believe. But Mike, why don't you tell your story? And by the way, he's somebody you want to influence. Chairman of Senate Finance Committee makes an awful lot of decisions on Medicare, Medicaid, a lot of things we talked about with Ozempic, now the lobbying group try and make that available, and how harmful, I think, most people in this room think that might be so. Senator Crapo, if you could just kind of tell us your story in terms of your diet change and what results you had. Sen. Mike Crapo (R-ID): Well, first of all, let me thank you. I didn't come here to say anything. I came here to listen, but I appreciate the opportunity to just have a second to tell you my personal story. I'll say before I do that, thank you for Ron Johnson. Senator Johnson is also a member of the Finance Committee, and it is my hope that we can get that committee, which I think has the most powerful jurisdiction, particularly over these areas, of any in the United States Congress, and so I'm hopeful we can get a focus on addressing the government's part of the role in this to get us back on a better track. 2:54:35 Sen. Ron Johnson (R-WI): Vani Hari, known as the Food Babe -- they wrote that for me, that wasn't me, that's my not my nickname -- is a food activist, author and speaker committed to improving food quality and safety. She has built a powerful platform through her blog advocating for transparency in food labeling and the removal of harmful chemicals from processed food. Her activism has spurred significant change in the food industry, encouraging consumers to make healthier, more informed choices, while prompting companies to adopt cleaner practices. Vani Hari: Our government is letting US food companies get away with serving American citizens harmful ingredients that are banned or heavily regulated in other countries. Even worse, American food companies are selling the same exact products overseas without these chemicals, but choose to continue serving us the most toxic version here. It's un-American. One set of ingredients there, and one set of ingredients here. Let me give you some examples. This is McDonald's french fries. I would like to argue that probably nobody in this room has not had a McDonald's french fry, by the way, nobody raised their hand during the staff meeting earlier today. In the US, there's 11 ingredients. In the UK, there's three, and salt is optional. An ingredient called dimethyl polysiloxane is an ingredient preserved with formaldehyde, a neurotoxin, in the US version. This is used as a foaming agent, so they don't have to replace the oil that often, making McDonald's more money here in the United States, but they don't do that across the pond. Here we go, this is Skittles. Notice the long list of ingredient differences, 10 artificial dyes in the US version and titanium dioxide. This ingredient is banned in Europe because it can cause DNA damage. Artificial dyes are made from petroleum, and products containing these dyes require a warning label in Europe that states it may cause adverse effects on activity and attention in children, and they have been linked to cancer and disruptions in the immune system. This on the screen back here, is Gatorade. In the US, they use red 40 and caramel color. In Germany, they don't, they use carrot and sweet potatoes to color their Gatorade. This is Doritos. The US version has three different three different artificial dyes and MSG, the UK version does not and let's look at cereal. General Mills is definitely playing some tricks on us. They launched a new version of Trix just recently in Australia. It has no dyes, they even advertise that, when the US version still does. This is why I became a food activist. My name is Vani Hari, and I only want one thing. I want Americans to be treated the same way as citizens in other countries by our own American companies. Vani Hari: We use over 10,000 food additives here in the United States and in Europe, there's only 400 approved. In 2013, I discovered that Kraft was producing their famous mac and cheese in other countries without artificial dyes. They used Yellow 5 and Yellow 6 here. I was so outraged by this unethical practice that I decided to do something about it. I launched a petition asking Kraft to remove artificial dyes from their products here in the United States, and after 400,000 signatures and a trip to their headquarters, Kraft finally announced they would make the change. I also discovered Subway was selling sandwiches with a chemical called azodicarbonamide in their bread in other countries. This is the same chemical they use in yoga mats and shoe rubber. You know, when you turn a yoga mat sideways and you see the evenly dispersed air bubbles? Well, they wanted to do the same thing in bread, so it would be the same exact product every time you went to a Subway. When the chemical is heated, studies show that it turns into a carcinogen. Not only is this ingredient banned in Europe and Australia, you get fined $450,000 if you get caught using it in Singapore. What's really interesting is when this chemical is heated, studies show that it turns into a carcinogen. Not only is this ingredient banned, but we were able to get Subway to remove azodicarbonamide from their bread in the United States after another successful petition. And as a bonus, there was a ripple effect in almost every bread manufacturer in America followed suit. For years, Starbucks didn't publish their ingredients for their coffee drinks. It was a mystery until I convinced a barista to show me the ingredients on the back of the bottles they were using to make menu items like their famous pumpkin spice lattes. I found out here in the United States, Starbucks was coloring their PSLs with caramel coloring level four, an ingredient made from ammonia and linked to cancer, but using beta carotene from carrots to color their drinks in the UK. After publishing an investigation and widespread media attention, Starbucks removed caramel coloring from all of their drinks in America and started publishing the ingredients for their entire menu. I want to make an important point here. Ordinary people who rallied for safer food shared this information and signed petitions. Were able to make these changes. We did this on our own. But isn't this something that the people in Washington, our elected politicians, should be doing? Vani Hari: Asking companies to remove artificial food dye would make an immediate impact. They don't need to reinvent the wheel. They already have the formulations. As I've shown you, consumption of artificial food dyes has increased by 500% in the last 50 years, and children are the biggest consumers. Yes, those children. Perfect timing. 43% of products marketed towards children in the grocery store contain artificial dyes. Food companies have found in focus groups, children will eat more of their product with an artificial dye because it's more attractive and appealing. And the worst part, American food companies know the harms of these additives because they were forced to remove them overseas due to stricter regulations and to avoid warning labels that would hurt sales. This is one of the most hypocritical policies of food companies, and somebody needs to hold them accountable. Vani Hari: When Michael Taylor was the Deputy Commissioner of the of the FDA, he said, he admitted on NPR, we don't have the resources, we don't have the capabilities to actually regulate food chemicals, because we don't have the staff. There's no one there. We are under this assumption, and I think a lot of Americans are under this assumption, that every single food additive ingredient that you buy at the grocery store has been approved by some regulatory body. It hasn't. It's been approved by the food companies themselves. There's 1000s of chemicals where the food company creates it, submits the safety data, and then the FDA rubber stamps it, because they don't have any other option. 3:09:15 Sen. Ron Johnson (R-WI): So our next presenter is Jason Karp. Jason is the founder and CEO of HumanCo, a mission driven company that invests in and builds brands focused on healthier living and sustainability. In addition to HumanCo, Jason is the co-founder of Hu Kitchen, known for creating the number one premium organic chocolate in the US. My wife will appreciate that. Prior to HumanCo, Jason spent over 21 years in the hedge fund industry, where he was the founder and CEO of an investment fund that managed over $4 billion. Jason graduated summa cum laude from the Wharton School of the University of Pennsylvania. 3:11:10 Jason Karp: I've been a professional investor for 26 years, dealing with big food companies, seeing what happens in their boardrooms, and why we now have so much ultra processed food. Jason Karp: Having studied the evolution of corporations, I believe the root cause of how we got here is an unintended consequence of the unchecked and misguided industrialization of agriculture and food. I believe there are two key drivers behind how we got here. First, America has much looser regulatory approach to approving new ingredients and chemicals than comparable developed countries. Europe, for example, uses a guilty until proven innocent standard for the approval of new chemicals, which mandates that if an ingredient might pose a potential health risk, it should be restricted or banned for up to 10 years until it is proven safe. In complete contrast, our FDA uses an innocent until proven guilty approach for new chemicals or ingredients that's known as GRAS, or Generally Recognized as Safe. This recklessly allows new chemicals into our food system until they are proven harmful. Shockingly, US food companies can use their own independent experts to bring forth a new chemical without the approval of the FDA. It is a travesty that the majority of Americans don't even know they are constantly exposed to 1000s of untested ingredients that are actually banned or regulated in other countries. To put it bluntly, for the last 50 years, we have been running the largest uncontrolled science experiment ever done on humanity without their consent. Jason Karp: And the proof is in the pudding. Our health differences compared to those countries who use stricter standards are overwhelmingly conclusive. When looking at millions of people over decades, on average, Europeans live around five years longer, have less than half our obesity rates, have significantly lower chronic disease, have markedly better mental health, and they spend as little as 1/3 on health care per person as we do in this country. While lobbyists and big food companies may say we cannot trust the standards of these other countries because it over regulates, it stifles innovation, and it bans new chemicals prematurely, I would like to point out that we trust many of these other countries enough to have nuclear weapons. These other countries have demonstrated it is indeed possible to not only have thriving companies, but also prioritize the health of its citizens with a clear do no harm approach towards anything that humans put in or on our bodies. Jason Karp: The second driver, how we got here, is all about incentives. US industrial food companies have been myopically incentivized to reward profit growth, yet bear none of the social costs of poisoning our people and our land. Since the 1960s, America has seen the greatest technology and innovation boom in history. As big food created some of the largest companies in the world, so too did their desire for scaled efficiency. Companies had noble goals of making the food safer, more shelf stable, cheaper and more accessible. However, they also figured out how to encourage more consumption by making food more artificially appealing with brighter colors and engineered taste and texture. This is the genesis of ultra processed food. Because of these misguided regulatory standards, American companies have been highly skilled at maximizing profits without bearing the societal costs. They have replaced natural ingredients with chemicals. They have commodified animals into industrial widgets, and they treat our God given planet as an inexhaustible, abusable resource. Sick Americans are learning the hard way that food and agriculture should not be scaled in the same ways as iPhones. 3:16:50 Jason Karp: They use more chemicals in the US version, because it is more profitable and because we allow them to do so. Jason Karp: Artificial food dyes are cheaper and they are brighter. And the reason that I chose to use artificial food dyes in my public activist letter is because there's basically no counter argument. Many of the things discussed today, I think there is a nuanced debate, but with artificial food dyes, they have shown all over the world that they can use colorants that come from fruit. This is the Canadian version. This is the brightness of the Canadian version, just for visibility, and this is the brightness of artificial food dyes. So of course, Kellogg and other food companies will argue children prefer this over this, just as they would prefer cocaine over sugar. That doesn't make it okay. Calley Means: Senator, can I just say one thing? As Jason and Vani were talking, it brought me back to working for the food industry. We used to pay conservative lobbyists to go to every office and say that it was the "nanny state" to regulate food. And I think that's, as a conservative myself, something that's resonated. I just cannot stress enough that, as we're hopefully learned today, the food industry has rigged our systems beyond recognition. And addressing a rigged market is not an attack on the free market. Is a necessity for a free market to take this corruption out. So I just want to say that. 3:21:00 Sen. Ron Johnson (R-WI): Our next presenter is Jillian Michaels. Ms. Michaels is a globally recognized fitness expert, entrepreneur, and best selling author. With her no nonsense approach to health, she's inspired millions through her fitness programs, books and digital platforms, best known for her role on The Biggest Loser, Michaels promotes a balanced approach to fitness and nutrition and emphasizing long term health and self improvement. Jillian Michaels: The default human condition in the 21st century is obese by design. Specific, traceable forms of what's referred to as structural violence are created by the catastrophic quartet of big farming, big food, Big Pharma, and big insurance. They systematically corrupt every institution of trust, which has led to the global spread of obesity and disease. Dysfunctional and destructive agricultural legislation like the Farm Bill, which favors high yield, genetically engineered crops like corn and soy, leading to the proliferation of empty calories, saturated with all of these toxins that we've been talking about today for three hours, it seems like we can never say enough about it, and then this glut of cheap calories provides a boon to the food industry giants. They just turn it into a bounty of ultra processed, factory-assembled foods and beverages strategically engineered to undermine your society and foster your dependence, like nicotine and cocaine, so we literally cannot eat just one. And to ensure that you don't, added measures are taken to inundate our physical surroundings. We're literally flooded with food, and we are brainwashed by ubiquitous cues to eat, whether it's the Taco Bell advertisement on the side of a bus as you drive to work with a vending machine at your kids school, there is no place we spend time that's left untouched. They're omnipresent. They commandeer the narrative, with 30 billion worth of advertising dollars, commercials marketed to kids, with mega celebrities eating McDonald's and loving it, sponsored dietitians paid to promote junk food on social media, utilizing anti-diet body positivity messaging like, "derail the shame" in relation to fast food consumption, Time Magazine brazenly issuing a defense of ultra processed foods on their cover with the title, "What if altra processed foods aren't as bad as you think?" And when people like us try to sound the alarm, they ensure that we are swiftly labeled as anti-science, fat shamers, and even racists. They launch aggressive lobbying efforts to influence you. Our politicians to shape policy, secure federal grants, tax credits, subsidy dollars, which proliferates their product and heavily pads their bottom line. They have created a perfect storm in which pharmaceuticals that cost hundreds, if not 1000s per month, like Ozempic, that are linked to stomach paralysis, pancreatitis and thyroid cancer, can actually surge. This reinforces a growing dependence on medical interventions to manage weight in a society where systemic change in food production and consumption is desperately needed and also very possible. These monster corporations have mastered the art of distorting the research, influencing the policy, buying the narrative, engineering the environment, and manipulating consumer behavior. Jillian Michaels: While I have been fortunate enough to pull many back from the edge over the course of my 30 year career, I have lost just as many, if not more, than I have saved. I have watched them slip through my fingers, mothers that orphan their children, husbands that widow their wives. I have even watched parents forced to suffer the unthinkable loss of their adult children. There are not words to express the sadness I have felt and the fury knowing that they were literally sacrificed at the altar of unchecked corporate greed. Most Americans are simply too financially strained, psychologically drained and physically addicted to break free without a systemic intervention. Attempting to combat the status quo and the powers that be is beyond swimming upstream. It is like trying to push a rampaging river that's infested with piranhas. After years of trying to turn the tide, I submit that the powers that be are simply too powerful for us to take on alone. I implore the people here that shape the policy to take a stand. The buck must stop with you, while the American people tend to the business of raising children and participating in the workforce to ensure that the wheels of our country go around. They tapped you to stand watch. They tapped you to stand guard. We must hold these bad actors accountable. And I presume the testimonials you heard today moved you. Digest them, discuss them, and act upon them, because if this current trend is allowed to persist, the stakes will be untenable. We are in the middle of an extinction level event. The American people need help. They need heroes. And people of Washington, your constituents chose you to be their champion. Please be the change. Thank you. Sen. Ron Johnson (R-WI): There was one particular piece of legislation or one thing that we could do here in Washington, what would it be? Jillian Michaels: Get rid of Citizens United and get the money out of politics. Sen. Ron Johnson (R-WI): Okay. 3:37:00 Calley Means: To the healthcare staffers slithering behind your bosses, working to impress your future bosses at the pharmaceutical companies, the hospitals, the insurance companies, many of them are in this building, and we are coming for you. 3:37:25 Sen. Ron Johnson (R-WI): Next up is Ms. Courtney Swan. Ms. Swan is a nutritionist, real food activist, and founder of the popular platform, Realfoodology. She advocates for transparency in the food industry, promoting the importance of whole foods and clean eating. Courtney is passionate about educating the public on the benefits of a nutrient dense diet, and she encourages sustainable, chemical-free farming practices to ensure better health for people and the planet. Courtney Swan: Our current agriculture system's origin story involves large chemical companies -- not farmers, chemists. 85% of the food that you are consuming started from a patented seed sold by a chemical corporation that was responsible for creating agent orange in the Vietnam War. Why are chemical companies feeding America? Corn, soy and wheat are not only the most common allergens, but are among the most heavily pesticide sprayed crops today. In 1974 the US started spraying our crops with an herbicide called glyphosate, and in the early 1990s we began to see the release of genetically modified foods into our food supply. It all seems to begin with a chemical company by the name IG Farben, the later parent company of Bayer Farben, provided the chemicals used in Nazi nerve agents and gas chambers. Years later, a second chemical company, Monsanto, joined the war industry with a production of Agent Orange, a toxin used during the Vietnam War. When the wars ended, these companies needed a market for their chemicals, so they pivoted to killing bugs and pests on American farmlands. Monsanto began marketing glyphosate with a catchy name, Roundup. They claimed that these chemicals were harmless and that they safeguarded our crops from pests. So farmers started spraying these supposedly safe chemicals on our farmland. They solved the bug problem, but they also killed the crops. Monsanto offered a solution with the creation of genetically modified, otherwise known as GMO, crops that resisted the glyphosate in the roundup that they were spraying. These Roundup Ready crops allow farmers to spray entire fields of glyphosate to kill off pests without harming the plants, but our food is left covered in toxic chemical residue that doesn't wash, dry, or cook off. Not only is it sprayed to kill pests, but in the final stages of harvest, it is sprayed on the wheat to dry it out. Grains that go into bread and cereals that are in grocery stores and homes of Americans are heavily sprayed with these toxins. It's also being sprayed on oats, chickpeas, almonds, potatoes and more. You can assume that if it's not organic, it is likely contaminated with glyphosate. In America, organic food, by law, cannot contain GMOs and glyphosate, and they are more expensive compared to conventionally grown options, Americans are being forced to pay more for food that isn't poisoned. The Environmental Working Group reported a test of popular wheat-based products and found glyphosate contamination in 80 to 90% of the products on grocery store shelves. Popular foods like Cheerios, Goldfish, chickpea pasta, like Banza, Nature Valley bars, were found have concerning levels of glyphosate. If that is not alarming enough, glyphosate is produced by and distributed from China. In 2018, Bayer bought Monsanto. They currently have patented soybeans, corn, canola and sugar beets, and they are the largest distributor of GMO corn and soybean seeds. Americans deserve a straight answer. Why does an agrochemical company own where our food comes from? Currently, 85 to 100% of corn and soy crops in the US are genetically modified. 80% of GMOs are engineered to withstand glyphosate, and a staggering 280 million pounds of glyphosate are sprayed on American crops annually. We are eating this roundup ready corn, but unlike GMO crops, humans are not Roundup Ready. We are not resistant to these toxins, and it's causing neurological damage, endocrine disruption, it's harming our reproductive health and it's affecting fetal development. Glyphosate is classified as a carcinogen by the World Health Organization's International Agency for Research on Cancer. It is also suspected to contribute towards the rise in celiac disease and gluten sensitivities. They're finding glyphosate in human breast milk, placentas, our organs, and even sperm. It's also being found in our rain and our drinking water. Until January of 2022, many companies made efforts to obscure the presence of GMOs and pesticides in food products from American consumers. It was only then that legislation came into effect mandating that these companies disclose such ingredients with a straightforward label stating, made with bio engineered ingredients, but it's very small on the package. Meanwhile, glyphosate still isn't labeled on our food. Parents in America are unknowingly feeding their children these toxic foods. Dr. Don Huber, a glyphosate researcher, warns that glyphosate will make the outlawed 1970s insecticide DDT look harmless in comparison to glyphosate. Why is the US government subsidizing the most pesticide sprayed crops using taxpayer dollars? These are the exact foods that are driving the epidemic of chronic disease. These crops, heavily sprayed with glyphosate, are then processed into high fructose corn syrup and refined vegetable oils, which are key ingredients for the ultra processed foods that line our supermarket shelves and fill our children's lunches in schools across the nation. Children across America are consuming foods such as Goldfish and Cheerios that are loaded with glyphosate. These crops also feed our livestock, which then produce the eggs, dairy and meat products that we consume. They are in everything. Pick up almost any ultra processed food package on the shelf, and you will see the words, contains corn, wheat and soy on the ingredients panel. Meanwhile, Bayer is doing everything it can to keep consumers in the dark, while our government protects these corporate giants. They fund educational programs at major agricultural universities, they lobby in Washington, and they collaborate with lawmakers to protect their profits over public health. Two congressmen are working with Bayer right now on the Farm Bill to protect Bayer from any liability, despite already having to pay out billions to sick Americans who got cancer from their product. They know that their product is harming people. Sen. Ron Johnson (R-WI): Couple questions. So you really have two issues raised here. Any concern about just GMO seeds and GMO crops, and then you have the contamination, Glycosate, originally is a pre-emergent, but now it's sprayed on the actual crops and getting in the food. Can you differentiate those two problems? I mean, what concerns are the GMO seeds? Maybe other doctors on t

Ryan Gorman hosts an iHeartRadio nationwide special featuring John Drikell Hopkins, founding member of the Zac Brown Band, who joins the show to discuss his fight to find a cure for ALS through his Hop on a Cure foundation. Also, Dr. Courtney Fitzhugh, Sickle Cell Disease Expert with the National Heart, Lung & Blood Institute, checks in for Sickle Cell Awareness Month to explain the disease, its impact on life, and the latest treatments. Finally, Dr. Christine M. Crawford, Child Psychiatrist & NAMI Associate Medical Director, discusses rising concerns of parents and caregivers who are struggling to navigate children's mental health.

According to the National Heart, Lung, and Blood Institute (NHLBI), 50–70 million Americans have sleep disorders, and one in three adults don't get enough uninterrupted sleep to maintain their health. Listen in to this week's GC episode to learn the physiology of sleep, why we need sleep, and what our role is in educating patients on sleep hygiene sleep disorders, and OTC vs. Non-OTC options. HOSTJen Moulton, BSPharmPresidentCEimpactGUESTEzequiel Medina, PharmDSleep Coach and PharmacistLive Love SleepPharmacists, REDEEM YOUR CPE HERE!CPE is available to Health Mart franchise members onlyTo learn more about Health Mart, click here: https://join.healthmart.com/CPE INFORMATIONLearning ObjectivesUpon successful completion of this knowledge-based activity, participants should be able to:1. Identify common sleep disorders and their impact on patient health and outcomes.2. Explain strategies for managing sleep disorders through pharmacological and non-pharmacological interventions in pharmacy practice.0.05 CEU/0.5 HrUAN: 0107-0000-24-263-H01-PInitial release date: 9/16/2024Expiration date: 9/16/2025Additional CPE details can be found here.

According to the National Heart, Lung, and Blood Institute (NHLBI), 50–70 million Americans have sleep disorders, and one in three adults don't get enough uninterrupted sleep to maintain their health. Listen in to this week's GC episode to learn the physiology of sleep, why we need sleep, and what our role is in educating patients on sleep hygiene sleep disorders, and OTC vs. Non-OTC options. HOSTJen Moulton, BSPharmPresidentCEimpactGUESTEzequiel Medina, PharmDSleep Coach and PharmacistLive Love SleepPharmacist Members, REDEEM YOUR CPE HERE! Not a member? Get a Pharmacist Membership & earn CE for GameChangers Podcast episodes! (30 mins/episode)CPE INFORMATION Learning ObjectivesUpon successful completion of this knowledge-based activity, participants should be able to:1. Identify common sleep disorders and their impact on patient health and outcomes.2. Explain strategies for managing sleep disorders through pharmacological and non-pharmacological interventions in pharmacy practice.0.05 CEU/0.5 HrUAN: 0107-0000-24-263-H01-PInitial release date: 9/16/2024Expiration date: 9/16/2025Additional CPE details can be found here.Follow CEimpact on Social Media:LinkedInInstagram

Protests have been happening across India after a 31-year-old junior doctor was raped and murdered in a hospital in Kolkata earlier this month. Her death prompted marches and strikes nationwide over safety issues for female doctors and this soon developed into a talking point for women's safety in general. BBC Delhi Correspondent Kirti Dubey joins Anita Rani to report on the latest news, along with Dr Aishwarya Singh Raghuvanshi, a female doctor in India.A new Netflix series, Kaos is a modern, darkly comic retelling of Greek mythology that will perhaps have you seeing the gender politics of ancient Greece in a new light. Stage and film actor Janet McTeer stars as the Queen of the gods, Hera. Janet joins Anita to talk about Hera's sexual power as well as her previous roles and what has changed in the industry.In a new analysis, researchers from Imperial College, London estimate that the number of people living with food allergies in England has more than doubled since 2008, with the largest increase seen in young children. Using anonymised data from GP practices covering 13 million patients, researchers estimated trends in the prevalence of food allergy in the UK population. Anita is joined by Dr Paul Turner, Professor of Paediatric Allergy at the National Heart and Lung Institute at Imperial College, who led the research.Author Clare Chambers' novel Small Pleasures was inspired by an interview she heard on Woman's Hour about a 1950's local newspaper competition to find a “virgin mother”. That book, Clare's ninth, became a whirlwind bestseller and now she's back with another, Shy Creatures. Based on a newspaper article Clare discovered in an archive, this story focusses on a man who is found with a beard down to his waist and whose aunts have kept him locked away for several decades. Set in Croydon in 1964, the novel takes in the world of 1960s psychiatry and is told from the perspective of art therapist Helen, a single woman in her thirties and is having an affair with a married man. Clare joins Anita to tell her all about it.Presenter: Anita Rani Producer: Rebecca Myatt

Peter Openshaw CBE is a respiratory physician and mucosal immunologist at Imperial College London, where he is Professor of Experimental Medicine at the National Heart and Lung Institute. His because a familiar voice in the media during the Covid-19 pandemic. We discuss how his clinical and research interests intertwine, and how his Quaker principles underpin his approach to clinical practice and experimental work. https://profiles.imperial.ac.uk/p.openshaw  

91-year-old Cecil ‘John' Farley has made history as the first patient in England to receive an artificial cornea.The new artificial cornea, called EndoArt, was created by EyeYon Medical, and only 200 have been implanted worldwide to date, including John's.We hear from the lead researcher behind an AI tool ‘can rapidly rule out heart attacks in people attending A&E' - and it could eventually have huge benefits for the NHS. Roberto Dario Sesia, a PHD student at the National Heart and Lung Institute at Imperial College London, discusses the groundbreaking technology, known as Rapid-RO.Also in this episode:Fresh water present on Earth ‘500 million years earlier than previously thought'Study finds drinking alcohol then napping on flights could be bad for your heartWhy you might struggle to read your dog's facial expressions.Follow us on X or on Threads. Hosted on Acast. See acast.com/privacy for more information.

In this compelling episode of The Healthy Project Podcast, host Corey Dion Lewis welcomes Dr. Alison Brown, a distinguished public health nutrition and health disparities researcher. Dr. Brown shares her extensive insights into the critical intersection of nutrition, cultural humility, and health disparities. Here's what you can expect from this enlightening discussion:Show Notes:In this compelling episode of The Healthy Project Podcast, host Corey Dion Lewis welcomes Dr. Alison Brown, a distinguished public health nutrition and health disparities researcher. Dr. Brown shares her extensive insights into the critical intersection of nutrition, cultural humility, and health disparities. Here's what you can expect from this enlightening discussion:Introduction to Dr. Alison Brown: Learn about Dr. Brown's role at the NIH's National Heart, Lung, and Blood Institute, her background in nutrition and health disparities, and what drives her dedication to addressing diet-related diseases.Cultural Humility vs. Cultural Competency: Dr. Brown discusses the importance of cultural humility in understanding and respecting diverse nutritional practices and why it's more appropriate than cultural competency in health care and research.The Impact of Culture on Nutrition: Discover how cultural background influences dietary choices, the significance of culturally appropriate food access, and the challenges faced by communities in maintaining their dietary traditions in the face of health issues like hypertension and diabetes.Food Insecurity and Nutrition Security: A deep dive into the definitions, impacts, and the importance of culturally relevant solutions to food insecurity, especially in the wake of the COVID-19 pandemic.Addressing Health Disparities: Dr. Brown elaborates on the social determinants of health, including the historic and ongoing challenges of food apartheid, and the need for a multisectoral approach to improve nutrition and health outcomes.Innovative Programs and Solutions: Insight into the "food is medicine" movement, including produce prescription programs and medically tailored meals, and the potential for these initiatives to address dietary disparities with culturally appropriate interventions.Optimism for the Future: Despite the daunting challenges, Dr. Brown shares her hope for the future, emphasizing grassroots efforts, community partnerships, and the critical role of the younger generation in transforming the landscape of public health nutrition.Resources and Recommendations: Dr. Brown highlights valuable resources such as the DASH eating plan and other NIH initiatives aimed at promoting healthier eating habits.This episode is a must-listen for anyone interested in the intricate layers of nutrition, cultural understanding, and health equity. Join us as Dr. Alison Brown offers invaluable perspectives and actionable advice for embracing cultural diversity in the pursuit of healthier communities.Connect with Dr. Alison Brown:LinkedinClosing Thoughts: Corey Dion Lewis wraps up the episode with reflections on the conversation's highlights and a reminder of the importance of culturally informed approaches to health and nutrition.Don't miss this insightful episode of The Healthy Project Podcast, where we explore the power of nutrition and cultural understanding in building a healthier, more equitable world. ★ Support this podcast ★

Estás escuchando #JUNTOSRadio ¿Qué enfermedades cardiacas son más comunes en la comunidad latina?, ¿Qué medicamentos o sustancias pueden alterar mi ritmo cardiaco?, El Dr. Rigoberto Ramírez, Profesor Asistente de Medicina en el Departamento de Medicina Cardiovascular del Centro Médico de la Universidad de Kansas, nos responde a estas y otras preguntas.       Sobre nuestro invitado:   El Dr. Rigoberto Ramírez obtuvo su título de médico en 2011 en el Centro Médico de la Universidad de Kansas. Su programa de residencia en medicina interna se completó en 2014 en la Universidad de Texas Southwestern Medical Center. A partir de ahí, completó una beca en enfermedades cardiovasculares en junio de 2017, además de una beca en electrofisiología en 2019 en el St. Luke's Hospital de Kansas City. Tras su formación, se incorporó al Centro Médico de la Universidad de Kansas en 2019.      Recursos informativos en español:    U.S. Department of Health and Human Services (HHS)   https://health.gov/espanol/myhealthfinder/problemas-salud/salud-corazon/manten-sano-tu-corazon  National Heart, Lung, and Blood Institute (NIH)   https://www.nhlbi.nih.gov/es/salud/vida-cardiosaludable     Facebook: @juntosKS      Instagram: juntos_ks      YouTube: Juntos KS   Twitter: @juntosKS      Página web: http://juntosks.org      Suscríbete en cualquiera de nuestras plataformas de Podcast: Podbean, Spotify, Amazon Music y Apple Podcast - Juntos Radio      Centro JUNTOS Para Mejorar La Salud Latina      4125 Rainbow Blvd. M.S. 1076,      Kansas City, KS 66160     No tenemos los derechos de autor de la música que aparece en este video. Todos los derechos de la música pertenecen a sus respectivos creadores.   

What does the future of disease research look like? How can artificial intelligence help researchers make new discoveries faster? How can medical professionals synthesize the vast amounts of patient data to offer the best, most personalized care possibleThese are some of the questions we explore with Dr. Julie Panepinto, who leads the National Institutes of Health's Division of Blood Diseases and ResourcesIn this episode, we dive deep in to the Science part of STEM to learn about the latest advances in medical research, how data analytics and AI are accelerating these efforts, and how education can inspire the next generation of medical researchersHear all about:What scientists around the country are researching in the areas of blood diseasesWhy medicine must maximize quantitative and qualitative data together to best serve patientsHow AI will impact clinician's ability to detect and diagnose - especially in medical imagingPredictive risk modeling and the future of precision healthcareThe human aspect of medicine, the importance of face-to-face care, and how data can help doctors develop more customized treatment plans for each individual3 Big Takeaways from this episode:Medical research needs quantitative and qualitative data to produce the best results: The healthcare industry has billions of quantitative datasets from millions of patients. Additionally, patient reported outcomes help turn qualitative information about the patient's personal experience into quantitative data. When healthcare providers have access to both quantitative and qualitative data, they can create personalized treatment plans for each individual, a practice called precision healthcare.Data analytics and artificial intelligence enable predictive risk modeling in medical research: All the data just mentioned can be used in predicting and preventing diseases in individuals based on their unique risk factors. Listen as we discuss the generation of algorithms for predictive healthcare, genomic and curative treatments, and why the quality and structure of the data matters when training AI models.The future of healthcare will be data-driven, but it will never lose the human factor: Expect tele-health visits, chatbots, AI helping clinicians detect and diagnose individuals, and automated health plans based on data-driven models. But also know that the face-to-face connection will always remain a key factor to healthcare; for nothing can replace the doctor-patient relationship.Resources mentioned in this episode:To learn more about Dr. Panepinto, visit her pageLearn more about the research being done by the NIH Division of Blood Diseases and ResourcesConnect with the National Heart, Lung and Blood Institute:Facebook |  YouTube | LinkedIn  |  XGet more resources on the episode page: https://techedpodcast.com/panepinto/Instagram - Facebook - YouTube - TikTok - Twitter - LinkedIn

On today's episode of Danforth Dialogues, Dr. Valerie Montgomery Rice sits down with Dr. Gary H. Gibbons, Director of the National Heart, Lung, and Blood Institute (NHLBI) at the National Institutes of Health (NIH). Dr. Gibbons joined the Morehouse School of Medicine in 1999 and founded the Morehouse Cardiovascular Institute. Prior to founding the Cardiovascular Institute, Dr. Gibbons served on the faculties of Stanford University and Harvard Medical School. In this episode, you'll hear about Dr. Gibbons' experience growing up in the Germantown neighborhood of Philadelphia and the confidence and self-belief he developed in his early years. He shares his passion for entering the field of cardiology, the story around his decision to leave Harvard to  join the Morehouse School of Medicine, and the lessons he learned about engaging communities in a way that meets people where they are. Tune in to this episode of Danforth Dialogues for an enriching exploration of Dr. Gibbons' journey from Germantown to the forefront of cardiology.   RESOURCES RELATED TO THIS EPISODE Visit https://www.nhlbi.nih.gov/ Visit https://msmcvri.org/    CREDITS Theme Music

Hearing loss affects roughly 15.5% of Americans 20 years and older. While the majority of these individuals experience mild hearing loss, the prevalence and severity of hearing loss increases with age. What does this sensory change mean for dementia risk, and can this risk be prevented through interventions like hearing aids? Dr. Frank Lin joins the podcast to discuss the relationship between hearing loss and dementia and share findings from the Aging and Cognitive Health Evaluation in Elders, or ACHIEVE, study. Guest: Frank Lin, MD, PhD, director, Cochlear Center for Hearing and Public Health, Professor of Otolaryngology, Medicine, Mental Health, and Epidemiology, Johns Hopkins University Show Notes Read more about Dr. Lin's study, “Hearing intervention versus health education control to reduce cognitive decline in older adults with hearing loss in the USA (ACHIEVE): a multicentre, randomised controlled trial,”  in The Lancet. Learn more about the Atherosclerosis Risk in Communities (ARIC) study, mentioned at 20:01, through the National Heart, Lung, and Blood Institute and Johns Hopkins Bloomberg School of Public Health's websites. Read more about U.S. regulations surrounding over-the-counter hearing aids, mentioned at 34:00, in “‘A New Frontier' for Hearing Aids,” by The New York Times. Learn more about Dr. Lin at his bio on the Johns Hopkins Bloomberg School of Public Health website. Learn more about the ACHIEVE study on their webpage. Connect with us Find transcripts and more at our website. Email Dementia Matters: dementiamatters@medicine.wisc.edu Follow us on Facebook and Twitter. Subscribe to the Wisconsin Alzheimer's Disease Research Center's e-newsletter. Enjoy Dementia Matters? Consider making a gift to the Dementia Matters fund through the UW Initiative to End Alzheimer's. All donations go toward outreach and production.

A recent study shows that more than a quarter of a million Australians have been affected by heart valve disease, and that most people are unaware of this disease, creating an even greater cause for concern. - இதய வால்வு நோயால் இரண்டரை இலட்சத்திற்கும் அதிகமான ஆஸ்திரேலியர்கள் பாதிக்கப்பட்டுள்ளனர் என்றும் பெரும்பாலான மக்கள் இந்த நோயைப் பற்றி அறிந்திருக்கவில்லை என்றும் சமீபத்திய ஆய்வு காட்டுகிறது.

Thanks to the work of researchers, including guest Sian Harding, and other scientists, we are beginning to understand more about the vital and exquisite organ - the heart. Sian Harding, Professor Emeritus of Cardiac Pharmacology at the National Heart and Lung Institute at Imperial College London, discusses her new book, “The Exquisite Machine: The New Science of the Heart.”Then, in order for humans to survive, it begins with us starting to act with the rest of the biosphere, and each other, in accordance with Darwinian principles that center around figuring out survival. Daniel Brooks, Professor Emeritus at University of Toronto, and Salvatore Agosta, Associate Professor at Virginia Commonwealth University, discuss their new book “Darwinian Survival Guide: Hope for the Twenty-First Century.”

In this podcast, Dr. Ally Larkin, Dr. Carol Mansfield, and Dr. Robyn Cohen discuss their experience implementing Single Maintenance and Reliever Therapy (known as "SMART" or "MART"). SMART is included in the 2020 updates to the National Asthma Education and Prevention Program Asthma Management Guidelines and the 2021 updates to the Global Initiative for Asthma Strategy. In this discussion, they cover how they implemented SMART into their clinical practice, challenges they've faced making the change, how SMART has improved asthma management and control for their patients, and advice for providers seeking to implement SMART into their own practices. References:New NAEPP/NHLBI Guidelines (2020): Expert Panel Working Group of the National Heart, Lung, and Blood Institute (NHLBI) administered and coordinated National Asthma Education and Prevention Program Coordinating Committee (NAEPPCC); Cloutier MM, Baptist AP, Blake KV, Brooks EG, Bryant-Stephens T, DiMango E, Dixon AE, Elward KS, Hartert T, Krishnan JA, Lemanske RF Jr, Ouellette DR, Pace WD, Schatz M, Skolnik NS, Stout JW, Teach SJ, Umscheid CA, Walsh CG. 2020 Focused Updates to the Asthma Management Guidelines: A Report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group. J Allergy Clin Immunol. 2020 Dec;146(6):1217-1270. doi: 10.1016/j.jaci.2020.10.003. Erratum in: J Allergy Clin Immunol. 2021 Apr;147(4):1528-1530. PMID: 33280709; PMCID: PMC7924476.  New GINA Guidelines (2021): Reddel HK, Bacharier LB, Bateman ED, Brightling CE, Brusselle GG, Buhl R, Cruz AA, Duijts L, Drazen JM, FitzGerald JM, Fleming LJ, Inoue H, Ko FW, Krishnan JA, Levy ML, Lin J, Mortimer K, Pitrez PM, Sheikh A, Yorgancioglu AA, Boulet LP. Global Initiative for Asthma Strategy 2021: Executive Summary and Rationale for Key Changes. Am J Respir Crit Care Med. 2022 Jan 1;205(1):17-35. doi: 10.1164/rccm.202109-2205PP. PMID: 34658302; PMCID: PMC8865583.  Articles on Implementation: Reddel HK, Bateman ED, Schatz M, Krishnan JA, Cloutier MM. A Practical Guide to Implementing SMART in Asthma Management. J Allergy Clin Immunol Pract. 2022 Jan;10(1S):S31-S38. doi: 10.1016/j.jaip.2021.10.011. Epub 2021 Oct 16. PMID: 34666208.  Cloutier MM, Teach SJ, Lemanske RF Jr, Blake KV. The 2020 Focused Updates to the NIH Asthma Management Guidelines: Key Points for Pediatricians. Pediatrics. 2021 Jun;147(6):e2021050286. doi: 10.1542/peds.2021-050286. Epub 2021 May 3. PMID: 33941586; PMCID: PMC8168603.  Article on the Implementation Gap: Krings JG, Sekhar TC, Chen V, Blake KV, Sumino K, James AS, Clover AK, Lenze EJ, Brownson RC, Castro M. Beginning to Address an Implementation Gap in Asthma: Clinicians' Views of Prescribing Reliever Budesonide-Formoterol Inhalers and SMART in the United States. J Allergy Clin Immunol Pract. 2023 Sep;11(9):2767-2777. doi: 10.1016/j.jaip.2023.05.023. Epub 2023 May 26. PMID: 37245736.  

NEJM 1991;324:781-788Background A hallmark of post-myocardial infarction (MI) care in the 1980's was the monitoring and suppression of premature ventricular contractions (PVCs) via use of antiarrhythmic drugs. The practice was based on pathophysiologic rationale that PVC burden is a strong risk factor for sudden and non-sudden cardiac death following MI and thus, suppression must reduce death. PVC reduction was a seductive surrogate endpoint that was easy to measure and declare victory on, but it had never been tested in a proper RCT. The Cardiac Arrhythmia Suppression Trial (CAST) was sponsored by the National Heart, Lung and Blood Institute (NHLBI) and sought to test the hypothesis that suppression of asymptomatic or mildly symptomatic PVCs with antiarrhythmic therapy with encainide, flecainide, or moricizine after MI would reduce death due to arrhythmia.Patients Patients were eligible for enrollment 6 days to 2 years post MI with an average of ≥6 PVCs per hour on ambulatory monitoring of at least 18 hours duration, and no runs of VT of ≥15 beats at a rate of ≥120 bpm. An ejection fraction (EF) of ≤55% was required within 90 days of MI or ≤40% if recruited after 90 days. There was a run-in phase. Patients were only enrolled in the main trial if they had at least 80% suppression of PVCs and at least 90% suppression of runs of VT during an initial, open-label titration period. Initial open-label drug assignment was based, in part, on the EF. Flecainide was not given to patients with an EF of ≤30%. Moricizine was only used as a second line drug in patients with an EF of ≥30%.Baseline characteristics Baseline characteristics of the patients enrolled in the trial are not provided in the main manuscript and cannot be inferred from the results, tables or figures presented.Procedures Patients in whom arrhythmias were suppressed were randomly assigned to receive either the effective drug or its matching placebo. A detailed description of study procedures is not presented in the main manuscript. Compliance with the study drug was assessed in follow-up visits and based on pill counts of tablets returned but the schedule of these visits is not provided. Concomitant drug therapy was assessed at the time of the last visit, according to a standardized checklist.During the trial, patients could be instructed to discontinue the study drug based on the occurrence of the following events: ventricular tachycardia, significant increase in arrhythmia burden, disqualifying ECG changes including significant QT prolongation or bradycardia, new or worsened congestive heart failure, the need for treatment with an antiarrhythmic agent outside the entry criteria for the study, or any number of other adverse medical events divided into cardiovascular or non-cardiovascular events.Endpoints The primary endpoint of the study was death or cardiac arrest with resuscitation due to arrhythmia. The site PI was responsible for classifying each death without knowledge of the patient's assigned treatment. Secondary endpoints included cardiovascular and non-cardiovascular causes of death, disqualifying ventricular tachycardia without arrest, syncope, pacemaker implantation, recurrent MI, congestive heart failure, angina pectoris or coronary artery revascularization.Results Observation began on the day of randomization to blinded therapy and was censored on April 18, 1989, the date when the use of encainide and flecainide was discontinued by the Data and Safety Monitoring Board because the data indicated it was unlikely that benefit could be demonstrated, and it was likely that the drugs were harmful. The original CAST trial manuscript reports data on patients assigned to the encainide and flecainide groups. Moricizine use was continued and would be reported separately in the revised CAST II trial.1498 participants were randomized to receive either encainide, flecainide or their matching placebo and followed for an average of 10 months. Compliance with the assigned treatments was estimated to be >90% in 70% of all patients and was similar in the active-drug and placebo groups. Antiarrhythmic therapy significantly increased the relative risk of the primary endpoint of death or cardiac arrest due to arrhythmia (RR 2.64; 5.7% vs 2.2%; p=0.0004) and was associated with a number needed to harm (NNH) of approximately 29. It also increased the risk of all deaths and cardiac arrests (RR 2.38; 8.3% vs 3.5%; p=0.0001; NNH = 20); even those not associated with arrhythmia (2.3% vs 0.7%; p=0.01).Conclusions The CAST trial unexpectedly demonstrated that treatment of asymptomatic or mildly symptomatic PVCs in post-MI patients, with encainide and flecainide, increased death and cardiac arrests. From a chronological standpoint, it is the first major trial in cardiovascular medicine (perhaps all of medicine) that “reversed” a standard medical practice. In this case, one that was instituted and broadly adopted on the basis of pathophysiologic reasoning and one that targeted a surrogate endpoint. Thus, more than anything it highlights the importance of testing interventions in properly conducted RCTs prior to adoption and basing the analysis on hard outcomes that are meaningful to patients and society. How many practices in modern medicine are supported by high quality RCTs? It may be as low as 30-40%. Get full access to Cardiology Trial's Substack at cardiologytrials.substack.com/subscribe

This week, Dr. Victoria Sanchez of the University of South Florida, and Dr. Shannon Basham of Phonak, join host Amyn Amlani to discuss the ACHIEVE study, a multi-year randomized controlled trial examining the effects of best-practice hearing care interventions on cognitive decline in older adults. The study results found that for those at higher risk of cognitive decline, providing hearing aids and counseling slowed cognitive decline by 48% over 3 years compared to a control group. The hearing intervention utilized comprehensive audiological evaluations, evidence-based device fitting, and patient education and support. While additional analyses continue, these significant findings demonstrate the potential impact optimized hearing care can have on supporting long-term cognitive health. The panelists emphasize that complex research like ACHIEVE requires interdisciplinary expertise and collaboration. As the field increasingly focuses on the connections between hearing and cognition, audiologists will need to take a more holistic approach in managing patients while partnering closely with physicians, researchers and others. Resources like Phonak's upcoming ECHHO training program will help clinicians translate recent research on hearing and cognitive health into effective patient care and communication. With cognitive decline emerging as a major health issue, audiology has an opportunity to play a central role in providing interventions that support cognitive health in aging adults. More information about the ECHHO program can be found here: https://www.sonova.com/en/media/phonak-introduces-echho-program-enhance-understanding-link-between-hearing-loss-and-cognitive General acknowledgements and funding for ACHIEVE Parent Study: Members of the ACHIEVE Collaborative Research Group are listed at achievestudy.org. The Aging and Cognitive Health Evaluation in Elders (ACHIEVE) Study is supported by the National Institute on Aging (NIA) R01AG055426 and R01AG060502 with previous pilot study support from the NIA R34AG046548 and the Eleanor Schwartz Charitable Foundation, in collaboration with the Atherosclerosis Risk in Communities (ARIC) Study, supported by National Heart, Lung, and Blood Institute contracts (HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700005I, HHSN268201700004I). Neurocognitive data are collected by 2U01HL096812, 2U01HL096814, 2U01HL096899, 2U01HL096902, 2U01HL096917 from the NIH (NHLBI, NINDS, NIA and NIDCD), and with previous brain MRI examinations funded by R01HL70825 from the NHLBI. The funder of the study had no role in study design, data collection, data analysis, data interpretation, writing of the report, or the decision to submit for publication.  The investigators thank the staff and participants of the ACHIEVE and ARIC studies for their important contributions and dedication to the study, Sonova / Phonak for in-kind donation of hearing technologies and training support of audiologists for the ACHIEVE study, and the members of the ACHIEVE DSMB (Doug Galasko, Julie Buring, Judy Dubno, Tom Greene, and Larry Lustig) for their guidance and insights during the course of the study. ACHIEVE Hearing Intervention Follow-up Study (ACHIEVE – HIFU) The Aging and Cognitive Health Evaluation in Elders (ACHIEVE) Hearing Intervention Follow-Up Study (ACHIEVE – HIFU) is supported by the National Institute on Deafness and Other Communication Disorders (NIDCD) R01DC019408. ACHIEVE Brain Health Follow-up Study (ACHIEVE – BHFU) The Aging and Cognitive Health Evaluation in Elders (ACHIEVE) Brain Health Follow-Up Study (ACHIEVE – BHFU) is supported by the National Institute on Aging (NIA) R01AG076518. The Aging and Cognitive Health Evaluation in Elders (ACHIEVE) Hearing Intervention Follow-Up Study (ACHIEVE – HIFU) is supported by the National Institute on Deafness and Other Communication Disorders (NIDCD) R01DC019408.

This week's episode explores broken heart syndrome, cardiomyocytes, and regenerative medicine. Jonathan is joined by Sian Harding, Emeritus Professor of Cardiac Pharmacology at the National Heart and Lung Institute (NHLI) at Imperial College London, UK, to discuss the relationship between emotions and heart function, as well as her research into regenerative medicine, including pluripotent stem cells, gene editing, and engineered heart tissue patches. Use the following timestamps to navigate the content in this episode: (00.00)-Introduction (02.25)-What led Sian to a career in cardiology? (03.45)-Introduction to cardiomyocytes (05.53)-How has knowledge of cardiomyocytes changed over time? (07.46)-Broken heart syndrome (16.31)-Regenerative medicine in cardiology (20.18)-Engineered heart tissue patches (24.40)-Sian's work in the House of Commons (27.26)-The use of stem cells in cardiology (29.39)-Gene editing (32.08)-Three wishes for the future of healthcare

If you're sedentary and begin to exercise, you get a dose-dependent decrease in mortality, diabetes, depression, high blood pressure, coronary disease, osteoporosis, sarcopenia, falls and more People who are doing the highest volume of vigorous exercise start losing longevity benefits. If you're doing full distance triathlons when you're in your 40s and 50s, your risk of atrial fibrillation increases by 500% to 800% In the case of moderate exercise — loosely defined as exercising to the point where you're slightly winded but can still carry on a conversation — there's clear evidence that more IS better and cannot be overdone Every 1,000 steps you get on average per day reduces your mortality by 10% to 15%. Benefits plateau around 12,000 steps (6 miles) a day Strength training adds another 19% reduction in all-cause mortality on top of the 45% reduction that you get from one hour of moderate exercise per day. However, benefits cease once you go beyond one hour per week. The sweet spot is 20 to 40 minutes of strength training, two to three times a week. Above 60 minutes per week, the benefits of strength training are nullified, and you're worse off than if you did no resistance training at all.Regular moderate exercise is highly beneficial for overall health and longevity, while excessive vigorous exercise may have detrimental effects. Key Points: Sedentary individuals who start exercising experience significant health improvements, including reduced risk of mortality, diabetes, depression, high blood pressure, coronary disease, osteoporosis, sarcopenia, and falls. Engaging in extreme levels of vigorous exercise, such as full-distance triathlons, can increase the risk of atrial fibrillation by 500% to 800%. Moderate exercise, defined as exercising to the point of being slightly winded but able to maintain a conversation, consistently demonstrates dose-dependent benefits. Every 1,000 steps taken daily reduces mortality by 10% to 15%, with benefits plateauing around 12,000 steps (6 miles) per day. Strength training complements moderate exercise, offering an additional 19% reduction in all-cause mortality. The optimal duration is 20 to 40 minutes per session, two to three times a week. Exceeding one hour of strength training per week nullifies the benefits and may even increase health risks. Articles: "Exercise for Older Adults: How Much Is Enough?" by the Centers for Disease Control and Prevention (CDC) "Physical activity for older adults" by the World Health Organization (WHO) "Exercise and Seniors" by the FamilyDoctor.org "How much exercise do older adults need?" by the National Institutes of Health (NIH) "Moderate Exercise May Be the Key to Longevity" by Time Online References: "Physical Activity Guidelines for Older Adults" by the American College of Sports Medicine (ACSM) "Exercise for Older Adults" by the National Institute on Aging (NIA) "Exercise for Seniors" by the Mayo Clinic "Physical Activity for Older Adults" by the U.S. Department of Health and Human Services (HHS) "Older Adults and Physical Activity" by the National Heart, Lung, and Blood Institute (NHLBI) Dr.'s Consensus: "There is a strong consensus among doctors that moderate exercise is beneficial for older adults and can help to reduce the risk of chronic diseases such as heart disease, stroke, type 2 diabetes, and osteoporosis." "Moderate exercise can also help to improve balance, strength, and flexibility, which can help to reduce the risk of falls." "Overcoming the challenges of starting or maintaining an exercise program can be difficult, but there are many resources available to help older adults." 1000 Daily Steps: A Simple Path to Better Health Benefits of 1000 Daily Steps Improved cardiovascular health:  Weight management:  Improved mood:  Reduced risk of falls:  How to Get Started #SilverStreakers,#GeriatricExercise,#ModerateExercise,#HealthyAging,#LongevityBenefits, --- Send in a voice message: https://podcasters.spotify.com/pod/show/bhsales/message

Download our FREE guide — Top 10 Tips to Live Healthier: zoe.com/freeguideHelp us win a Lovie award: vote hereDr. Peter Attia doesn't want a slow death. He doesn't want his final years to be defined by poor mental and physical faculties that only worsen as the years roll by. But, by making changes to his lifestyle today, he's taking control of his health tomorrow.In today's episode of ZOE Science & Nutrition, Jonathan and Peter ask: How can you maintain your health as you age? If you want to uncover the right foods for your body, head to joinzoe.com/podcast, and get 10% off your personalized nutrition program.Timecodes:00:00 - Introduction 1:29 - Quickfire round3:14 - Healthspan vs lifespan09:52 - The difference between slow and quick death 12:23 - What diseases cause slow death13:34 - Acting before there's a problem16:17 - Is it too late to improve my future health19:20 - How to improve modern medicine25:07 - The importance of blood sugar33:03 - The centanarian decathlon34:00 - Cardio training38:00 - Strength training40:43 - Summary and outroFollow ZOE on InstagramMentioned in today's episode: The inequities in the cost of chronic disease from the National Council on Aging Early lesions of atherosclerosis in youth from the Journal of the American Nutrition AssociationCoronary heart disease causes and risk factors from the National Heart, Lung, and Blood InstituteEpisode transcripts are available here.Is there a nutrition topic you'd like us to explore? Email us at podcast@joinzoe.com and we'll do our best to cover it.

Monday at WCLC 2023 features the Presidential Symposium. In this special WCLC 2023 episode of Lung Cancer Considered, hosts Dr. Narjust Florez and Dr. Stephen Liu talk with Dr. Eric Lim about MARS 2: A Multicentre Randomized Trial Comparing (Extended) Pleurectomy Decortication versus No Radical Surgery for Mesothelioma. Dr. Paula Ugalde, discussant for MARS 2, provides her unique overview and perspective on research presented today. The hosts also talk with Dr. P.C. Yang about the new results presented in the TALENT study of lung cancer screening in Taiwan. Patient advocate Emi Bossio adds her unique perspective. Additionally, Dr. Pasi Janne summarizes his presidential abstract: Osimertinib With/Without Platinum-Based Chemotherapy as First-line Treatment in Patients with EGFRm Advanced NSCLC (FLAURA2) and is joined in a discussion with Emi Bossio, a patient with EGFR lung cancer. Professor Eric Lim is a Consultant Thoracic Surgeon at the Royal Brompton Hospital and Professor of Thoracic Surgery at the National Heart and Lung Institute of Imperial College London. Pan-Chyr Yang, MD, PhD--National Taiwan University College of Medicine and National Taiwan University Hospital, Institute of Biomedical Sciences, Genomics Research Center, Academia Sinica, Taiwan. Paula Ugalde – Dr. Paula Ugalde Figueroa, Thoacic Surgeon, Brigham and Women's Hospital Pasi Jänne is the Director of the Lowe Center for Thoracic Oncology at Dana-Farber Cancer Institute and a Professor of Medicine at Harvard Medical School and the David M. Livingston, MD Chair at Dana-Farber Cancer Institute

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-cme-ce/podcast/nhlbi-cystic-fibrosis  Overview: “Cystic Fibrosis: The Primary care Provider's Role in Case Finding and Referral” is a CME podcast episode produced by Pri-Med in partnership with Learn More Breathe Better®, a program of the National Heart, Lung, and Blood Institute of the National Institutes of Health. In this episode, we are joined by Dr. Marrah Lachowicz-Scroggins, Program Director with NHLBI's Division of Lung Diseases, and Dr. Deepika Polineni, director of the Cystic Fibrosis Center, Washington University School of Medicine in St. Louis. We'll be discussing what general practitioners should know about cystic fibrosis, including the factors that contribute to delayed or missed diagnosis, and the similarities and differences with primary ciliary dyskinesia, or PCD. 

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-cme-ce/podcast/nhlbi-sarcoidosis-in-lungs   Overview: “Sarcoidosis in the Lungs: What Primary Care Providers Should Know” is a CME podcast episode produced by Pri-Med in partnership with Learn More Breathe Better®, a program of the National Heart, Lung, and Blood Institute of the National Institutes of Health. In this episode, we are joined by Dr. George Mensah, Director of the NHLBI Center for Translation Research and Implementation Science, and Dr. Mridu Gulati, Associate Professor of Medicine at Yale School of Medicine. We'll be discussing what general practitioners should know about sarcoidosis, including the risk factors, symptoms, challenges in diagnosis, and how sarcoidosis is treated.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-cme-ce/podcast/nhlbi-breathe-better-pulmonary-fibrosis   Overview: “Pulmonary Fibrosis: What Primary Care Providers Need to Know” is a CME podcast episode produced by Pri-Med in partnership with Learn More Breathe Better®, a program of the National Heart, Lung, and Blood Institute of the National Institutes of Health. In this episode, we are joined by Dr. Matt Craig, Chief of the Lung Biology and Disease Branch with NHLBI's Division of Lung Diseases, and Dr. Fernando J. Martinez, Chief of the Pulmonary and Critical Care Medicine Division at Weill Cornell Medicine. Today we'll be discussing pulmonary fibrosis and the role of primary care providers, including signs to look out for, diagnosis, and treatment options.

In this World Shared Practice Forum podcast, Drs. Suchitra Ranjit and Luregn Schlapbach, discuss a framework to provide individualized hemodynamic support for pediatric patients with septic shock, especially those in lower and middle-income countries. The authors discuss considerations described in their expert group's recent article, including how to administer and assess the response of various therapies such as fluids, inotropes, and pressors. LEARNING OBJECTIVES By the end of this podcast, learners will be able to: - Describe the challenges to the early recognition of septic shock in children through a global lens - Introduce the concepts of flow, pressure, and filling in the context of septic shock and their clinical application - Discuss the individualized approach to fluid use in the treatment of septic shock in pediatric patients - Review the literature surrounding the use of fluids in pediatrics and adults AUTHORS Suchitra Ranjit, MD Chief, Pediatric Intensive Care Unit Apollo Children's Hospital, Chennai, India Luregn Schlapbach, Prof, MD, PhD, FCICM Head, Department of Intensive Care and Neonatology University Children`s Hospital Zurich, Switzerland DATES: Initial publication: August 22, 2023 CITATION: Ranjit S, Schlapbach LJ, O'Hara JE, Wolbrink TA. Individualized Hemodynamic Support for Pediatric Patients with Septic Shock. 08/2023. OPENPediatrics. Online Podcast. YT: https://youtu.be/AK6Uz_hZ_SY SC: https://soundcloud.com/openpediatrics/individualized-hemodynamic-support-for-pediatric-patients-with-septic-shock. ARTICLED REFERENCED: - Ranjit S, Kissoon N, Argent A, et al. Haemodynamic support for paediatric septic shock: a global perspective. Lancet Child Adolesc Health. 2023;7(8):588-598. doi:10.1016/S2352-4642(23)00103-7 - Fleischmann-Struzek C, Goldfarb DM, Schlattmann P, Schlapbach LJ, Reinhart K, Kissoon N. The global burden of paediatric and neonatal sepsis: a systematic review. Lancet Respir Med. 2018;6(3):223-230. doi:10.1016/S2213-2600(18)30063-8 (1:15) - Maitland K, Kiguli S, Opoka RO, et al. Mortality after fluid bolus in African children with severe infection. N Engl J Med. 2011;364(26):2483-2495. doi:10.1056/NEJMoa1101549 (4:58) - Gu W, Deng X, Lee M, et al. Rapid pathogen detection by metagenomic next-generation sequencing of infected body fluids. Nat Med. 2021;27(1):115-124. doi:10.1038/s41591-020-1105-z (14:02) - Meyhoff TS, Hjortrup PB, Wetterslev J, et al. Restriction of Intravenous Fluid in ICU Patients with Septic Shock. N Engl J Med. 2022;386(26):2459-2470. doi:10.1056/NEJMoa2202707 (24:50) - National Heart, Lung, and Blood Institute Prevention and Early Treatment of Acute Lung Injury Clinical Trials Network, Shapiro NI, Douglas IS, et al. Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension. N Engl J Med. 2023;388(6):499-510. doi:10.1056/NEJMoa2212663 (24:52) Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access and thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu

In this episode we discuss a case scenario of Asthma exacerbation. This can be one of the most challenging patients to manage on the ventilator. If at all possible we try not to intubate these patients, however there are times when this happens. We will discuss clinical treatment, ventilator management, and what our rolls are as transport clinicians in the transport of these patients. References: 1) National Asthma Education and Prevention Program: Expert Panel Report III: Guidelines for the diagnosis and management of asthma. Bethesda, MD. National Heart, Lung, and Blood Institute, 2007. (NIH publication no. 08-4051) www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm (Accessed on September 19, 2018).2) McFadden ER Jr, Lyons HA. Arterial-blood gas tension in asthma. N Engl J Med. 1968 May 9;278(19):1027-32. doi: 10.1056/NEJM196805092781901. PMID: 5644962.3) Global Initiative for Asthma (GINA). Global Strategy for Asthma Management and Prevention. www.ginasthma.org (Accessed on February 13, 2022)4) National Asthma Education and Prevention Program: Expert Panel Report III: Guidelines for the diagnosis and management of asthma. Bethesda, MD. National Heart, Lung, and Blood Institute, 2007. (NIH publication no. 08-4051) www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm (Accessed on September 19, 2018).5) Rowe BH, Spooner C, Ducharme FM, Bretzlaff JA, Bota GW. Early emergency department treatment of acute asthma with systemic corticosteroids. Cochrane Database Syst Rev. 2001;(1):CD002178. doi: 10.1002/14651858.CD002178. PMID: 11279756.6) Menzies-Gow A, Busse WW, Castro M, Jackson DJ. Prevention and Treatment of Asthma Exacerbations in Adults. J Allergy Clin Immunol Pract. 2021 Jul;9(7):2578-2586. doi: 10.1016/j.jaip.2021.05.016. PMID: 34246434.7) Nanchal R, Kumar G, Majumdar T, et al. Utilization of mechanical ventilation for asthma exacerbations: analysis of a national database. Respir Care 2014; 59:644.

High blood pressure and cholesterol are commonly seen to signal increased risk of heart disease. To lower both, eating less animal fats, like butter, lard, and tallow, is often recommended. Many of us have the standard LDL, aka “bad” cholesterol or low density lipoproteins, level test done. However, this has shown to only be able to accurately predict heart disease risk around 40 percent of the time. So, is having a LDL cholesterol level on its own really so bad? What kind of test can give a more accurate, say 70 percent, prediction rate for heart disease? Dietary Approaches to Stop Hypertension (DASH), a diet promoted by the HHS's National Heart, Lung and Blood Institute, suggests eating vegetable oils over animal fats to lower LDL cholesterol level. But which type of food may be much worse for our blood cholesterol and heart health? Join Brendon Fallon on #VitalSigns to probe a better way gauge heart-disease risk, whether the DASH diet works, and simple and effective ways to lower blood pressure. ⭕️ Watch in-depth videos based on Truth & Tradition at Epoch TV

Heart disease remains the global leading cause of death for both men and women, but women have long been underrepresented in cardiovascular disease research. We talk to Dr. Susanna Mak, who is aiming to help close that research gap with a study at Toronto's Mount Sinai Hospital; and Dr. Véronique Roger, a cardiologist and senior investigator with the National Heart, Lung, and Blood Institute.

https://youtu.be/5mtxGCLTnTA Joy Berger joins Dr. Gloria and Dr. Heidi Horsley on a podcast to share the details about the upcoming Association for Death Education and Counseling 44th Annual Conference on April 25-29, 2023. Joy Berger, DMA, FT, BCC, MT-BC serves the Association for Death Education and Counseling (ADEC) as their new Executive Director. Dr. Berger brings extensive national leadership and clinical care experience. She was awarded the National Heart of Hospice Psychosocial/Spiritual Care, and authored Music of the Soul – Composing Life Out of Loss. Sign up for the conference today: https://www.adec.org

Synopsis: Joel Schneider, Ph.D. and Robert Kotin, Ph.D. are the President & CEO and Founder & Chief Technology Advisor, respectively, of Carbon Biosciences, an emerging leader in the development of novel parvovirus-derived gene therapies. Joel and Robert sit down with host Rahul Chaturvedi to discuss the arc of their careers, how the AAV field has changed over the last decade, and how they approach building out their team at Carbon. They also talk about Carbon's focus on cystic fibrosis and the implications of The Cystic Fibrosis Foundation investing in their Series A. Finally, they both weigh in on what excites them when thinking about the future of gene therapy. Biographies: Dr. Joel Schneider joined Carbon as CEO in 2022, after serving as Chief Operating Officer at Solid Biosciences. As Solid's first employee, he played an instrumental role in building the company's unique disease-focused business model. Dr. Schneider is an accomplished biosciences executive with a track record of achievement in identifying, developing, and financing high potential therapeutic modalities and has diverse leadership experiences across R&D, technical and corporate operations, and corporate development organizations. Dr. Schneider holds a Ph.D. from Rutgers University and an undergraduate degree from Brandeis University and is the author of numerous peer-reviewed articles related to Duchenne and stem cell biology. He completed a postdoctoral fellowship at Harvard University in the Department of Stem Cell and Regenerative Biology, where he characterized and developed the small molecules that enhance skeletal muscle regeneration. Dr. Robert Kotin has been a leader in adeno-associated virus (AAV) research for 35 years, focusing on the molecular biology of the virus's non-structural proteins and then leveraging this understanding to develop novel AAV vectors for somatic cell gene therapy. Beginning as a postdoctoral fellow at Cornell University Medical Center, Dr. Kotin discovered a common integration site for AAV DNA in human chromosome 19, which he designated AAVS1 locus. He spent most of his career in the Intramural Research Program at the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH), first as a tenure-track investigator and then as a tenured senior investigator and Head of the Laboratory of Molecular Biology and Gene Therapy. While at the NIH, Dr. Kotin's laboratory invented and developed a scalable recombinant adeno-associated virus (rAAV) production process in Sf9 cells which was licensed by UniQure, ThermoFisher, Voyager, Biomarin, and others and was used to produce Glybera™, the first rAAV product granted regulatory agency approval for sale. Additional research from the Kotin lab resulted in the discovery of an AAV replicative product that has been described as closed-ended linear duplex DNA (ceDNA) and became the basis of the non-viral gene therapy company Generation Bio (NASDAQ: GBIO). Dr. Kotin served as vice president of virology and gene therapy at Voyager Therapeutics from 2014 to 2016. Since 2016, he has served as an adjunct professor at UMass Medical School, where his research interests include vectorizing and characterizing ancestral parvoviruses based on inferred sequences from endogenous virus elements (EVEs) as novel gene therapy vectors. Dr. Kotin earned his B.A. in biology from the University of California, Santa Cruz, and his doctorate in microbiology from Rutgers University and the University of Medicine and Dentistry of New Jersey (now Robert Wood Johnson Medical School).

On this episode of Inside Health Care, we offer two interviews. NYC Health + Hospitals leaders, Dr. Eric Wei and Dr. Ted Long, discuss hospital worker burnout, including suicide, and the need for awareness, mitigation and prevention. After that, Inland Empire Health Plan Chief Quality Officer, Dr. Edward Juhn, talks about “algorithmic bias,” a software-based anomaly that may adversely affect population health metrics that drive research on equity. Both interviews were recorded live at NCQA's inaugural Health Innovation Summit, held in late 2022 in Washington, DC. Later, in our “Fast Facts” segment, we observe American Heart Month, with hints for keeping your heart healthy from NIH's National Heart, Lung and Blood Institute. We also tell you about an NCQA HEDIS measure, Cardiac Rehabilitation, that assesses the percentage of adults 18 and older who attended cardiac rehab after a cardiac event like a heart attack, heart transplant or heart bypass.

February is heart health month, so Teresa welcomes Chuck Gaidica to explore it from a Catholic angle. Terry Poplava, of church ministry software ACS Technologies, reports on how giving since Covid-19 has affected parishes.

Hear from Victoria Pemberton, RNC, MS, CCRC, project officer for the National Heart, Lung and Blood Institute (NHLBI), as she discusses the importance of heart health literacy and highlights ways nurse practitioners can effectively engage with patients to reduce heart disease risk. February is American Heart Month — the ideal time to remind your patients about the importance of making heart-healthy lifestyle changes. New resources from the NHLBI's The Heart Truth® program can help you empower patients to achieve their cardiovascular health goals.   The American Association of Nurse Practitioners® (AANP) offers continuing education (CE), tools and resources to support nurse practitioners (NPs) working to reduce the risk of heart disease. Members may opt to join the AANP Cardiology Community, complete AANP CE Center activities, attend sessions at the 2023 AANP National Conference in New Orleans June 20-25, download clinical practice briefs or access a variety of cardiology-related resources.   Additional Resources American Heart Month Outreach Toolkit. High Blood Pressure and Women. Pregnancy and Your Heart Health. Heart Disease Prevention.  Heart Smart Basics: What to Know to Keep Yours Healthy. My Heart Health Tracker.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-cme-ce/podcast/copd-patient-cases-reduced-lung-function  Overview: “Lung Health Updates for Primary Care Providers: Conversations with NHLBI” is a series of CME podcast episodes produced by Pri-Med in partnership with Learn More Breathe Better®, a program of the National Heart, Lung, and Blood Institute of the National Institutes of Health. In this episode looking at case studies of patients with reduced lung function, we are joined by Dr. Mihaela Stefan, a Program Officer with NHLBI's Division of Lung Diseases, and Dr. Elizabeth Oelsner, general internist and Irving Assistant Professor of Medicine at Columbia University Department of Medicine Division of General Medicine. We'll be discussing profiles of three patients with reduced lung function, including an asymptomatic smoker, a smoker with respiratory symptoms but without spirometric evidence of COPD, and a COPD patient with history suggestive of AAT deficiency. So let's begin.

What is the DASH diet and why is this dietary pattern promoted by institutions such as the American Heart Association and the National Heart, Lung, and Blood Institute? In this episode, Danielle and Mark discuss why this eating plan was developed and the pros and cons associated with it.If you need help lowering high blood pressure, consider our self study here: https://www.imagonutrition.com/services/p/lowering-high-blood-pressure-self-studyTo submit a question to be answered on a future episode, visit: www.imagonutrition.com/podcast Theme song, Thinkin' Bout Food, courtesy of Happy Pill.

HRRP stands for Hospital Readmissions Reduction Program, by the way. I wanted to encore this episode with Dr. Rishi Wadhera because it's a great representation of a common root cause reason why quality metrics sometimes don't end well in real life. This root cause is otherwise known as Goodhart's Law, and we dig into Goodhart's law later on in this healthcare podcast. But the actual and ultimate impact of HRRP is also a pretty good representation of the consequences, what happens, when you create a blunt-force policy that assumes hospitals with very different circumstances are the same. Before we kick in to the episode, I asked Dr. Wadhera, my guest today as aforementioned, if there'd been any updates regarding HRRP since this show originally aired last year; and he told me that two key pieces have come out this past month in JAMA journals calling out CMS (Centers for Medicare & Medicaid Services) to move on from/retire this policy: A Decade of Observing the Hospital Readmission Reductions Program—Time to Retire an Ineffective Policy Readmission Reduction as a Hospital Quality Measure: Time to Move on to More Pressing Concerns? Thanks so much to Dr. Steve Schutzer and also BoneDoc66 for your really nice reviews this past month. So appreciated … thank you so much! And here is your encore. Today's guest is Rishi Wadhera, MD, MPP. Dr. Wadhera authored a retrospective analysis in the BMJ about the HRRP, which we will talk about in this healthcare podcast. Dr. Wadhera is a cardiologist at Beth Israel Deaconess Medical Center. He also has a master's in public policy at the Harvard Kennedy School of Government and also a master's in public health from the University of Cambridge. But here's the larger epiphany that pertains to all value-based care and all quality metrics which Dr. Wadhera brings up in this healthcare podcast and which my nerd heart could not love more: Goodhart's Law. This law is the root of so very many problems. Goodhart's Law is this (which I learned from Dr. Wadhera): “When a measure becomes a target, it ceases to be a good measure.” In other words, when we set a goal, people will try to take a shortcut to the goal, regardless of the consequences. And sometimes the consequences, paradoxically, are to do worse at the goal. Maybe because bean counters and admins and maybe even goal-oriented clinicians themselves will go right to the end goal, inadvertently skipping a whole bunch of (it turns out) rate-critical steps. For example, teaching to the test may not lead to students who deeply understand a subject. And anyone trying to achieve value-based care success, improve quality, form collaborations, or make sales might want to remember that old proverb, “Sometimes the shortest way home is the long way around.”   You can learn more at Dr. Wadhera's Harvard Catalyst profile and the Beth Israel Deaconess Medical Center Web site.   Rishi K. Wadhera, MD, MPP, MPhil, is an assistant professor of medicine at Harvard Medical School, a cardiologist at Beth Israel Deaconess Medical Center (BIDMC), and the associate program director of the cardiovascular medicine fellowship at BIDMC. He is also health policy and equity researcher at the Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology. Dr. Wadhera received his MD from the Mayo Clinic School of Medicine as well as an MPhil in public health as a Gates Cambridge Scholar from the University of Cambridge. He completed his internal medicine residency and cardiovascular medicine fellowship at Brigham and Women's Hospital in Boston. During this time, he also received a master's in public policy (MPP) at the Harvard Kennedy School of Government, with a focus on health policy. Dr. Wadhera's research spans questions related to healthcare access, quality, and disparities, as well as understanding how local, state, and national policy initiatives impact care delivery, health equity, and outcomes. Dr. Wadhera has published more than 80 articles to date, and he receives research support from the National Heart, Lung, and Blood Institute (NHLBI) and the National Institutes of Health (NIH)   03:30 What was the Hospital Readmissions Reduction Program intended to do? 05:22 Why did the Centers for Medicare & Medicaid (CMS) think some readmissions were preventable? 06:02 “The spirit of the Hospital Readmissions Reduction Program was to incentivize hospitals to improve … discharge planning, transitions of care, and post-discharge follow-up and care.” 06:58 How has research in the last few years changed the thoughts on the effectiveness of the Hospital Readmissions Reduction Program? 08:16 “The 30-day readmission measure—it's an incomplete measure.” 11:48 “I think patients … are smart, and they know what's going on.” 13:34 “What's happening is, we're just increasing the number of times they need to come back to the ER within that 30-day period.” 13:55 “The weird thing about the HRRP is that when it evaluates hospitals' 30-day readmission rates, it's a yes-no phenomenon.” 15:03 “What CMS does is, it risk adjusts … and that is what we should be doing.” 18:30 “This program has been incredibly regressive.” 19:04 “Poverty, neighborhood disadvantage, housing instability—these factors are out of hospitals' control.” 21:50 “Blunt policies like this that are rolled out nationally probably elicit mixed behavioral responses.” 22:06 “It just makes no sense to take resources away from hospitals.” 22:32 EP295 with Rebecca Etz, PhD. 23:47 What's the way to improve quality of care globally? 25:37 “CMS's approach to improving quality of care has really anchored … [that] to payment.” 26:08 “It's time for us to rethink what our approach to quality improvement should be.” 29:22 “Policy makers have an obligation to rigorously test the impact of these types of policies before they roll them out nationally.” 31:41 Can you scale healthcare nationally?   You can learn more at Dr. Wadhera's Harvard Catalyst profile and the Beth Israel Deaconess Medical Center Web site.   @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission What was the Hospital Readmissions Reduction Program intended to do? @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission Why did CMS think some readmissions were preventable? @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission “The spirit of the Hospital Readmissions Reduction Program was to incentivize hospitals to improve … discharge planning, transitions of care, and post-discharge follow-up and care.” @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission How has research in the last few years changed the thoughts on the effectiveness of the Hospital Readmissions Reduction Program? @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission “The 30-day readmission measure—it's an incomplete measure.” @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission “What CMS does is, it risk adjusts … and that is what we should be doing.” @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission “Blunt policies like this that are rolled out nationally probably elicit mixed behavioral responses.” @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission “It just makes no sense to take resources away from hospitals.” @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission What's the way to improve quality of care globally? @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission “It's time for us to rethink what our approach to quality improvement should be.” @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission Can you scale healthcare nationally? @rkwadhera of @BIDMChealth discusses #HRRP on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc #hospitalreadmission   Recent past interviews: Click a guest's name for their latest RHV episode! Ge Bai (Encore! EP356), Dave Dierk and Stacey Richter (INBW37), Merrill Goozner, Betsy Seals (EP387), Stacey Richter (INBW36), Dr Eric Bricker (Encore! EP351), Al Lewis, Dan Mendelson, Wendell Potter, Nick Stefanizzi, Brian Klepper (Encore! EP335), Dr Aaron Mitchell (EP382), Karen Root, Mark Miller, AJ Loiacono, Josh LaRosa, Stacey Richter (INBW35), Rebecca Etz (Encore! EP295), Olivia Webb (Encore! EP337), Mike Baldzicki, Lisa Bari, Betsy Seals (EP375), Dave Chase, Cora Opsahl (EP373), Cora Opsahl (EP372), Dr Mark Fendrick (Encore! EP308), Erik Davis and Autumn Yongchu (EP371), Erik Davis and Autumn Yongchu (EP370)

This entertaining talk is a rewarding look at the heart in a linguistic and cultural context; what does the word and the heart itself actually mean to us? Originally part of the Evidence Based Perioperative Medicine (EBPOM) Dingle conference it is presented here to you for free. If you would like to learn more about EBPOM and the fantastic forthcoming conferences we have to come please go to www.ebpom.org Presented by Desmond Sheridan, Emeritus Professor of Cardiology, National Heart and Lung Institute, Imperial College London.

Welcome to the podcast with Dr. Brendan McCarthy! In this episode we go over the overall struggle and continuous battle with weight loss. Why we aren't losing weight and talking about what doctors aren't doing to help people with that struggle. Dr. Brendan McCarthy founded Protea Medical Center in 2002. While he's been the chief medical officer, Protea has grown and evolved into a dynamic medical center serving the Valley and Central Arizona. A nationally recognized as an expert in hormone replacement therapy, Dr McCarthy s the only instructor in the nation who teaches BioHRT on live patients. Physicians travel to Arizona to take his course and integrate it into their own practices. Besides hormone replacement therapy, Dr. McCarthy has spoken nationally and locally before physicians on topics such as weight loss, infertility, nutritional therapy and more. Thank you for tuning in and don't forget to hit that SUBSCRIBE button! Let us know in the COMMENTS if you have any questions or what you may want Dr. McCarthy to talk about next! Check out Dr. Brendan McCarthy's Book! https://www.amazon.com/Jump-Off-Mood-Swing-Hormones/dp/0999649604 --More Links-- Instagram: www.instagram.com/drbrendanmccarthy TikTok: www.tiktok.com/drbrendanmccarthy Clinic Website: www.protealife.com Cited Links: 1) Foster GD, Wadden TA, Vogt RA, Brewer G. What is a reasonable weight loss? Patients' expectations and evaluations of obesity treatment outcomes. Journal of consulting and clinical psychology. 1997; 65(1):79–85. • Phelan S, Nallari M, Darroch FE, Wing RR. What do physicians recommend to their overweight and obese patients? Journal of the American Board of Family Medicine : JABFM. 2009; 22(2): 115–122. • Rothman AJ. Toward a theory-based analysis of behavioral maintenance. Health psychology : official journal of the Division of Health Psychology, American Psychological Association. 2000; 19(1S):64–69.. 2) Ferri, Fred F., ed. Ferri's Clinical Advisor 2022, E-Book. Elsevier Health Sciences, 2021 3) NIH The Practical Guide. 2000 http://www.nhlbi.nih.gov/guidelines/obesity/ob_gdlns.htm 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults: http://circ.ahajournals.org/content/ear/v/2013/11/11/01.cir.0000437739.71477 ee.citation 4) North American Association for the Study of Obesity, et al. The practical guide: identification, evaluation, and treatment of overweight and obesity in adults. National Institutes of Health, National Heart, Lung, and Blood Institute, NHLBI Obesity Education Initiative, North American Association for the Study of Obesity, 2000. 5) US Food and Drug Administration. "FDA approves new drug treatment for chronic weight management, first since 2014." Washington, DC Center for Drug EvaluationandResearch(2021) 6) Phelan, Sean M., et al. "Impact of weight bias and stigma on quality of care and outcomes for patients with obesity." obesity reviews 16.4 (2015): 319-326.. • Gilbert, P. (1997). The evolution of social attractiveness and its role in shame, humiliation, guilt and therapy. Br. J. Med. Psychol. 70, 113–147. doi: 10.1111/j.2044-8341.1997.tb01893. • Terrizzi Jr, John A., and Natalie J. Shook. "On the origin of shame: Does shame emerge from an evolved disease-avoidance architecture?." Frontiers in Behavioral Neuroscience 14 (2020): 19. • Fessler, D. M. T. (2004). Shame in two cultures: implications for evolutionary approaches. J. Cogn. Cult. 4, 207–262. doi: 10.1163/1568537041725097. • Curtis, V., Aunger, R., and Rabie, T. (2004). Evidence that disgust evolved to protect from risk of disease. Proc. R. Soc. B Biol. Sci. 271, S131–S133. doi: 10.1098/rsbl.2003.0144 • Oaten, M., Stevenson, R., and Case, T. (2009). Disgust as a disease-avoidance mechanism. Psychol. Bull. 135, 303–321. doi: 10.1037/a0014823. • Ananthakumar, Thanusha, et al. "Clinical encounters about obesity: systematic review of patients' perspectives." Clinical obesity 10.1 (2020): e12347..   #weightloss #weightlossjourney #fitness #healthylifestyle #motivation #health #healthylifestyle

“Consider your patient's diagnosis. What kind of cancer do they have? And ask yourself, ‘Could this patient be in disseminated intravascular coagulation (DIC)? Is there something more that we should be doing or looking at?'” Leslie Smith, RN, APRN-CNS, DNP, BMTCN®, AOCNS®, oncology clinical specialist at the National Institutes of Health in Bethesda, MD, told Jaime Weimer, MSN, RN, AGCNS-BC, AOCNS®, oncology clinical specialist at ONS. Smith discussed the nursing considerations for the management of DIC. This episode is part of a series about oncologic emergencies; the others are linked in the episode notes. You can earn free NCPD contact hours after listening to this episode by completing the evaluation linked below. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at myoutcomes.ons.org by October 7, 2024. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Episode Notes Complete this evaluation for free NCPD. Previous Oncology Nursing Podcast episodes on oncologic emergencies ONS book: Understanding and Managing Oncologic Emergencies: A Resource for Nurses (third edition) ONS courses: Oncologic Emergencies Treatment and Symptom Management—Oncology RN Essentials in Oncologic Emergencies for the Advanced Practice Provider ONS Huddle Cards™ DIC Huddle Card ONS Prevention of Bleeding Symptom Intervention and Guideline UpToDate Information from Cleveland Clinic Information from the National Heart, Lung, and Blood Institute To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode “If the D-dimer is high, that is indicative of a clotting issue occurring. So, the next step for the nurse would be to look for the lab or ask for an order—you can order a DIC panel in some institutions—but look at coagulation labs. And really care and support these patients. DIC is not a disease in itself; it is a symptom of a disease, it is a syndrome. And it's indicative of another problem occurring.” Timestamp (TS) 07:09 “In the chronic form, patients who live in a chronic inflammatory state—maybe from arthritis or whatever the process is—their coagulopathy will not be as severe as an acute form. They may have an elevated prothrombin time (PT) or partial thromboplastin time (PTT). Their platelets may be a little bit low and their fibrinogen may be just a little bit low, but it's not life-threatening. And in an acute stage of DIC, it is life-threatening.” TS 08:43 “If we are taking care of patients who have received CAR T cells, for example, nurses know to monitor for cytokine release syndrome, we're watching for fever, we're watching the C-reactive protein levels or the ferritin levels, and we're treating appropriately via tocilizumabs . . . preventing DIC that way. Patients who are at risk for developing sepsis. . . . watching for signs of impeding infection . . . . Those types of things can prevent DIC from occurring.”  TS 12:26 “I think it can be a little bit confusing for the nurse because they're vague symptoms. So, if you have a patient that is maybe thrombocytopenic, you could attribute, ‘Well, they have all this petechiae from their thrombocytopenia.' It's difficult. That's why you need to really draw a lab. . . . It is not just one lab or one sign or symptom that will diagnosis DIC. There's no one thing that tells you that the patient has DIC. You need to look at all the lab work to make that determination.” TS 14:15 “Nurses are going to support the patient with transfusions. . . . And this will help in an attempt to normalize the lab or at least get the factors and the platelets back up. And then treating the disease. . . . And then in addition, if the patient is infected or septic, administering the antibiotics.” TS 16:26 “DIC is often thought—especially by patients or family—that once you start that chemotherapy or the antibiotics, that the DIC will go away. That is not true. It can take days to weeks for the DIC to resolve itself. It's not something that is going to happen overnight. The patient will need to continue to be supported.” TS 18:13 “Consider what is the diagnosis of your patient. If they have cancer, what kind of cancer do they have? And ask the question to yourself, ‘Could this patient be in DIC? Is there something more that we should be doing or looking at?'” TS 19:22

It's weird but true that a lot of people's behavior can actually change just because they wear sunglasses or are in a dimly lit room. This episode begins with an explanation of why this happens and how people act differently. http://www.sciencedaily.com/releases/2010/03/100301122344.htm Being rich is about more than just accumulating money, it is about living the life you want to live. In fact how much money you have is less important than how you spend it. That's according to Ramit Sethi. For years now, Ramit has been helping people define what it means to be rich and helping them devise a plan to get there. And he is here to help you do the same. Ramit is author of the bestselling book I Will Teach You To Be Rich (https://amzn.to/3BB3K2E) as well as his new companion book I Will Teach You to Be Rich, The Journal (https://amzn.to/3flZA7G). He is also host of the podcast I Will Teach You To Be Rich https://www.iwillteachyoutoberich.com/podcast/ and his website is IWillTeachYouToBeRich.com (https://www.iwillteachyoutoberich.com) Did you know it can be a good idea to smell your food just before you eat it to help you eat less? And that it is even better if the food has a vivid smell and taste. Listen as I explain how and why it works. https://www.cbsnews.com/news/smelly-food-leads-to-smaller-bites-study-finds/ Your heart is an amazing machine. For most people, most of the time it works flawlessly without fail until it one day finally stops. But what it does inside your body during your lifetime is truly amazing. Here to explain how awesome your heart is, is Sian Harding a recognized authority in cardiac science, is Emeritus Professor of Cardiac Pharmacology in the National Heart and Lung Institute at Imperial College London, and she is author of the book The Exquisite Machine: The New Science of the Heart (https://amzn.to/3R9bC1d) PLEASE SUPPORT OUR SPONSORS! Confidently take control of your online world with Avast One — it helps you stay safe from viruses, phishing attacks, ransomware, hacking attempts, and other cybercrimes! Learn more at https://Avast.com Visit https://Indeed.com/SOMETHING  to start hiring now! Cancel unnecessary subscriptions with Rocket Money today. Go to https://RocketMoney.com/something - Seriously, it could save you HUNDREDS of dollars per year! Learn more about your ad choices. Visit podcastchoices.com/adchoices