Podcasts about outcomes

What does abundance look like when you work with people in the most fragile moments of their lives?In this deeply moving episode, Amy Sylvis sits down with her former cystic fibrosis physician, Dr. Kamyar Afshar, now Medical Director of the Lung Transplant Program at UC San Diego. Together, they explore what it means to practice medicine with dignity, compassion, and cultural awareness, and how lived experience shapes leadership.Dr. Afshar shares his family's immigration story from Iran, the values of service instilled by his parents, and how those experiences shaped his approach to medicine. He opens up about leading during COVID, navigating misinformation with grace, mentoring the next generation of physicians, and raising children with intentional values. This conversation is about more than medicine. It's about connection. Courage. Asking for help. And creating abundance through service.UC San Diego Health – Lung Transplant Program

When we think about improving client outcomes, it's easy to focus on goals, programs, and data collection. In this episode, we zoom out and talk about what's happening behind the scenes. We dive into Organizational Behavior Management (OBM) and how the systems we work within, including training, communication, leadership, and culture, have a powerful ripple effect on everyone involved.We explore how OBM applies the same ABA principles we use with learners to organizations, teams, and leadership. From analyzing systems using an ABC framework to pinpointing key metrics like staff performance, burnout, and treatment fidelity, we discuss how small, strategic changes can lead to meaningful, sustainable impact. We also talk about leadership, feedback loops, and reinforcement systems, and how clear expectations and compassionate data use can build trust and alignment.Ultimately, we reflect on the ripple effect of strong systems. Better supervision leads to stronger future BCBAs and improved outcomes for clients and families. When we strengthen the system, we strengthen the forest, not just one tree.What's Inside:What Organizational Behavior Management (OBM) really is and why it matters in ABAHow systems and leadership directly impact client outcomesUsing behavioral systems analysis and data to drive meaningful changeThe ripple effect of strong supervision and organizational practicesMentioned in This Episode:Supervision Resource BundleCEU Event: Organizational Behavior Management (OBM) for BCBAs: Driving Change and Improving Workplace Performance with BCBA Mellanie PageHowToABA.com/joinHow to ABA on YouTubeFind us on FacebookFollow us on Instagram

In this episode of Faces of Digital Health, Tjaša Zajc speaks with Dale Atkinson, a stage 4 oesophageal cancer patient who was told he had 11.5 months to live—and who is still alive today. Dale shares how he applied his compliance and investigation skills to healthcare: reading thousands of research papers, building a research-grounded AI workflow to sense-check drug interactions and pathways, and learning how to communicate with clinicians to be taken seriously. We discuss patient agency, the doctor–patient relationship, the promise (and risks) of AI for patients, the digital divide in healthcare, and why quality of life must be central to care decisions. Dale also shares how his journey led to new work in patient advocacy, the Beyond the Standard foundation, and the Clear Path Clinic vision for integrative oncology and wellness. Topics include: patient empowerment, AI in patient journeys, evidence-based complementary approaches, healthcare equity, clinician workload, prognosis anxiety, and new patient-led models of care. TIMESTAMPS (CHAPTER-STYLE) * 00:01 Intro: why patient agency matters more as systems strain * 04:12 Dale's story begins: diagnosis after wife's lung cancer + mother's death * 07:22 Stage 4, inoperable, palliative care: the emotional impact * 08:31 Asking for a timeline: why Dale wanted prognosis data * 09:18 How a financial crime investigator becomes a “patient investigator” * 10:55 The deep dive: thousands of papers, books, and expert conversations * 12:09 Where AI enters: building a research-grounded model for sense-checking * 15:00 Standard of care + complementary approach (not “alternative”) * 16:08 Friction with clinical advice; nutrition and chemo trade-offs * 17:48 Choosing treatments based on quality of life and realistic benefit * 20:06 When Dale felt the trajectory could change: from survival to stability * 21:11 Anxiety, recurrence risk, and “no evidence of disease” vs remission * 24:46 Missed symptoms, dismissal, and why patient agency is learned the hard way * 28:32 “Love-hate” to collaborative: a new model for doctor–patient dynamics * 32:16 How to communicate to be heard: bite-sized, stakeholder-specific info * 35:28 Clinicians under pressure: emotional load and “factory line” care reality * 37:58 AI impact in the patient community—and why it's accelerating * 40:27 Digital divide concerns: will digital skills determine outcomes? * 42:36 AI and emotion: pessimism loops, “horror statistics,” and mental safety * 45:02 A new career: Beyond the Standard, Clear Path Clinic, book, advisory work * 49:25 Closing reflections and thanks Video: https://youtu.be/VeIZkRraxWc www.facesofdigitalhealth.com Newsletter: https://fodh.substack.com/

Retention is becoming an increasingly important factor in how software companies are valued, and many founders are not prepared for the level of scrutiny buyers are applying to these metrics. In this episode, managing director Mike Lyon and senior associate Sarabeth Sandweiss explain why retention has become a key valuation driver, how investors evaluate it, where founders often get the math wrong, and how they can help avoid diligence surprises while positioning your company for a stronger outcome.Securities offered through Vista Point Advisors, member FINRA/SIPC. This has been provided for informational purposes only and should not be considered as investment advice or a recommendation. It is not intended to address all circumstances that might arise. The views expressed herein may change at any time subsequent to the date of issue. Opinions contained herein should not be interpreted as a guarantee of future results. Outcomes will vary depending on individual circumstances. Any examples used in this material are generic, hypothetical and for illustration purposes only. Testimonials from past clients may not be representative of the experience of other clients and there is no guarantee of future performance or success. Clients are not compensated for their comments.

What if the real competitive advantage isn't the technology—but the story you tell about it? In this episode of Shift Happens, Jeff Edwards sits down with Jason Marks, CEO of Techrategy and LEAD Above, to explore why storytelling—not specs—is what actually wins in tech. From simplifying complex platforms to making AI readiness feel practical (not risky), this conversation breaks down how the One Cisco story drives clarity, trust, and better outcomes when it's told well.

Outcomes are increasingly important as a form of media measurement, and how campaigns are planned and budgets are allocated. What role remains for traditional media effectiveness metrics? ITV's Sameer Modha and Kate Brinkley from The Specialist Works join WARC's Alex Brownsell to discuss the evolution of media measurement.

Event Objectives:Understand the scope and prevalence of neurodevelopmental impairments in children with CHD.Identify risks for neurodevelopmental impairments.Review evidence based screening recommendations.Claim CME Credit Here!

Can your business make a million in one year?Most people will say no. Not because it's impossible, but because they're thinking about it the wrong way. Making your first $1 Million is not about hustle. It's not about stacking side projects. It's not about 14 income streams and burnout disguised as ambition.It's about leverage.Leverage over effort.Outcomes over deliverables.Focus over distraction.If your income is tied directly to your time, you're capped. If you're solving small problems, you're paid small money. If you're scattered across too many offers, too many audiences, too many channels, you're diluted.The path to $1 Million requires three uncomfortable shifts:Obsess over leverage, not effort.Solve a $10 Million problem to earn $1 Million.Go narrower to go bigger with one flagship offer, one defined buyer, and one primary distribution engine.This episode also confronts the uncomfortable truth about wealth: if it costs you your family, your health, or your identity, that's not success. That's ego dressed up as ambition. The real question becomes this: " If you had to build a $1 Million business with only one offer, one audience, and one channel… what would you choose?"Your answer will reveal everything...What You'll Learn:Why leverage beats effort if you want real scaleHow to reverse-engineer $1 Million without the hustle trapThe “solve a $10 Million problem” mindset shiftWhy outcomes sell and deliverables get negotiated downHow focus becomes your unfair advantage when discomfort hitsThe one-offer, one-audience, one-channel test that clarifies everythingHow to build recurring revenue while protecting your energyBeyond The Episode Gems:Buy My Book, Strategize Up: The Blueprint To Scale Your Business: StrategizeUpBook.comDiscover All Podcasts On The HubSpot Podcast NetworkGet Free HubSpot Marketing Tools To Help You Grow Your BusinessGrow Your Business Faster Using HubSpot's CRM PlatformListen to My First Million on the HubSpot Podcast NetworkSupport The Podcast & Connect With Troy: Rate & Review iDigress: iDigress.fm/ReviewsFollow Troy's Socials @FindTroy: LinkedIn, Instagram, Threads, TikTokSubscribe to Troy's YouTube Channel For Strategy Videos & See Masterclass EpisodesNeed Growth Strategy, A Keynote Speaker, Or Want To Sponsor The Podcast? Go To FindTroy.com

In this episode of the Neurocritical Care Society Podcast Hot Topics series, host Richard Choi, DO, FNCS, speaks with Wendy Ziai, MD, MPH, professor of neurology and critical care medicine at Johns Hopkins University, about the article The Association Between Hourly Systolic Blood Pressure Variability and Outcomes in Patients With Intracerebral Hemorrhage Is Time-Dependent: A Post Hoc Analysis of the ATACH-2 Trial, recently published in Neurocritical Care. Their discussion explores why blood pressure variability — not just absolute blood pressure targets — may play a critical role in outcomes following acute intracerebral hemorrhage. Dr. Ziai reviews key findings from ATACH-2 and INTERACT trials, the physiologic mechanisms that may link variability to hematoma expansion and neurologic deterioration and why the timing of variability within the first 8 to 12 hours appears especially important. They also examine the unresolved question of causation versus association, implications for antihypertensive management in the ICU and how emerging trials focused on variability may shape future practice. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this week's One Vision Podcast, we welcome back Sandeep Mangaraj, now co-founder of Aileron Group, to discuss lessons from building a company in a crowded AI market and why AI success is more about people and process than technology. The conversation covers executives rushing into GenAI due to FOMO, the importance of starting with desired outcomes rather than applying GenAI everywhere, and why mid-market institutions may benefit from faster time-to-decision, less technical debt, and faster learning cycles. The key question is whether firms can afford the downside of waiting. And the answer is increasingly: No.00:00 Welcome Back: Meet Sandeep Mangaraj 00:55 Building Aileron: Lessons From a Crowded AI Market03:49 The AI ROI Myth: What's Actually Being Measured?05:28 FOMO vs Outcomes: Picking the Right AI Use Cases10:09 Falling Costs & Speed of Learning12:40 Who Owns AI Outcomes and Who's Accountable When It Breaks?14:55 Third-Party Risk: Regulators, Vendors, and Dependencies19:51 “Can You Afford to Wait?”23:02 Closing: Act With Purpose in 2026Hot take:  The barrier to AI success isn't technology, it's people and process. #AI #Fintech #GenerativeAI #DigitalTransformation Hosted on Acast. See acast.com/privacy for more information.

On today's Legally Speaking Podcast, I'm delighted to be joined by Björn Benckert. Björn is the Founder and Managing Partner of Avery Law. He is a corporate lawyer, specialising in M&A transactions. Björn trained at Norton Rose Fulbright and worked at Dewy & LeBoeuf LLP, before founding Avery Law in 2012. Björn built the firm to “provide the kind of clear, strategic and practical legal support fast-growing businesses truly need'. So why should you be listening in? You can hear Rob and Björn discussing:- How Involvement in Every Part of the Business is Crucial- Focus on Two Main Things for Success- Emphasising a More Commercial and Client-Focused Approach- Tasks That Took an Hour and a Half That Can Now Be Done in Five Minutes- Doing this can lead to earning more money and greater career satisfaction.Connect with Björn Benckert here - https://uk.linkedin.com/in/bjornbenckert

Send a textThis episode is a full lesson from one of the premium courses inside The Stoic Vault — my membership community for people who practise Stoicism, not just read about it.The lesson comes from the course Stoic Morning Routine: Start Calm and Strong. It covers the dichotomy of control — the single most useful idea in Stoic philosophy, and the one that changes everything when it actually lands.You'll take one real concern from your day and sort it into two columns: what's mine and what isn't. Outcomes, other people's reactions, delays — not mine. Preparation, breath, tone, when I choose to begin — mine. Then you'll pick one controllable action that matters today and state it clearly.This isn't theory. You'll feel the difference in the body when you stop carrying what was never yours.If this resonates, the full course and 9 others are inside The Stoic Vault, alongside guided meditations, weekly practices, live coaching, and a quiet community of 100+ members doing the work.Join at stoicvault.com

You tell yourself it won't happen. You avoid the word "divorce" like saying it out loud will make it real. You wait. You hope. You pray things shift.Meanwhile, assets move. Attorneys get hired — just not by you. And when it hits, you're blindsided.That was my story. I lost assets, lost leverage, and watched my divorce drag on because I refused to face what was happening. I thought I could handle it. I thought we'd figure it out. I was wrong.If you are in a difficult, abusive, or high-conflict marriage — this episode is for you. Not every divorce requires deep planning. But if your spouse is less than trustworthy, if coercive control or financial manipulation exists, if children and significant assets are involved — you cannot afford to leave your future up to chance.Here's what I walk you through in this episode: the three steps you need to take right now — decide, plan, and act. I share what happened when I didn't plan, what happened when a client did, and why the women who protect themselves aren't bitter — they're grown.Fifty percent of marriages end in divorce. Thinking you're the exception doesn't make you one. Eyes wide open, information in hand, and a solid plan — that's what makes you the exception.No one is coming to save you. But you can save yourself.Ready to create a plan for your next chapter? Schedule a consultation call with Sade at sadecurry.com/schedule-appointment.

Mortality affects hospitals all over the country and having structured systems in place helps improve outcomes. Tiffany Harvey, Quality Assurance Reviewer at INTEGRIS Health, joins host Shannon Hale, Senior PI Program Director at Vizient, to discuss why a meaningful mortality review process is so critical to quality improvement work. They reflect on lessons learned from Vizient's mortality review collaborative and the value of learning alongside peer organizations.   Guest Speaker: Tiffany Harvey, RN Quality Assurance Reviewer INTEGRIS Health   Host: Shannon Hale, MHA, RN, CPHQ  Senior Program Director, Performance Improvement Programs  Vizient     Show Notes:   [00:52] – Participation in Establishing a Structured Mortality Review Team Collaborative   [01:35] – Goals from joining the collaborative   [02:29] – Insights that helped inform change to mortality process   [03:33] – How Integris and Tiffany's team are improving the outcomes   [04:59} – After the collaborative where is team and the improvement work going   [06:04] – Sustainability in mortality review   [07:18] – Looking to the future what is the dream for mortality review     Links | Resources: Contacting Knowledge on the Go: picollaboratives@vizientinc.com    Subscribe Today! Apple Podcasts Spotify YouTube Android RSS Feed

Authors Herng Lee Tan, MSc, and Judith Ju Ming Wong, MBBCh, BAO, and editorialist Vicent Modesto i Alapont, MD, PhD, join CHEST® Critical Care Podcast Moderator Dan Fein, MD, to discuss their research into the impact of mechanical power normalized to predicted body weight on outcomes in pediatric ARDS.  This episode is part of a new series exploring articles published in our open access journal CHEST Critical Care.  DOI: 10.1016/j.chstcc.2025.100162 Disclaimer: The purpose of this activity is to expand the reach of CHEST content through awareness, critique, and discussion. All articles have undergone peer review for methodologic rigor and audience relevance. Any views asserted are those of the speakers and are not endorsed by CHEST. Listeners should be aware that speakers' opinions may vary and are advised to read the full corresponding journal article(s) for complete context. This content should not be used as a basis for medical advice or treatment, nor should it substitute the judgment used by clinicians in the practice of evidence-based medicine.  

Our faith in Christ turns the Father's throne from a seat of judgment into a throne of grace.

Send a textThis week we will be talking the new Competence Outcomes for Architects set by the ARB. This episode content meets PC1 - Professionalism of the Part 3 Criteria.Resources from today's episode:Website:https://arb.org.uk/wp-content/uploads/ARB-Competency-outcomes.pdfThank you for listening! Please follow me on Instagram @part3withme for weekly content and updates or contact me via email me at part3withme@outlook.com or on LinkedIn. Website: www.part3withme.comJoin me next week for more Part3 With Me time.If you liked this episode please give it a rating to help reach more fellow Part3er's!Support the show

On this episode of Day by Day our Journey Through Romans Dr. Clif explains that, according to Romans 2, every person is on one of two roads—obedience to God leading to eternal life, or obedience to self leading to destruction—so it's crucial to examine which path your life is truly on. "Interested in becoming a devoted follower of Christ?" Go to follow.lifeword.org

Welcome to Season 2 of the Orthobullets Podcast. Today's show is Podiums, where we feature expert speakers from live medical events. Today's episode will feature ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Dr. Michael Willey is titled⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ "Acetabular Retroversion and Anteversion: Indications and Outcomes."Follow⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Orthobullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on Social Media:⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Facebook⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Instagram⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Twitter⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠LinkedIn⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠YouTube

What does it really take to redesign education systems for a future that demands equity, human-centered innovation, and world-class learning outcomes?In this riveting Black Excellence Series episode of Voices for Excellence, Dr. Michael Conner sits down with visionary systems leader Dr. Tauheedah Baker-Jones—a powerhouse in transformational education reform whose work bridges research, policy, and practice. As the Southeast Regional Director of the National Center on Education and the Economy and co-founder of the Trinity Strategy Group, Dr. Baker-Jones brings a rare lens: one grounded in faith, justice, and rigorous, evidence-based systems change.From her early days as a classroom teacher in Los Angeles to her groundbreaking role as the first Chief Equity and Social Justice Officer for Atlanta Public Schools, Dr. Baker-Jones has championed coherent, high-impact leadership in some of education's most complex contexts. Her doctoral research at Harvard explored the execution of controversial change efforts in polarized environments—and she didn't stop at the theory. She applied these frameworks in real time, helping to move the needle on outcomes for thousands of students in Atlanta, even amid unprecedented adversity.You'll hear her powerful philosophy: "Design for outcomes, not intentions," and discover her signature Amplify Impact framework—a discipline-driven, change management model shaped by moral clarity, systems architecture, and the deep belief that every child must thrive, not by accident but by design.What you'll learn in this episode:Bold Frameworks for Equity-Centered Change: Why coherence, not isolated initiatives, must guide system redesignSystemic Excellence vs. Good Intentions: How to shift from performative cycles to clear execution aligned to outcomesWhy Equity Is an Engineering Principle: A pragmatic and visionary reframe of equity as intentional design for universal excellenceLeading Through Controversy with Moral Clarity: What it means to be courageous when your leadership becomes a political targetLong-Life Learning & 22nd-Century Readiness: How forward-thinking systems must evolve for a globally connected, AI-enabled futureThe Critical Triad for Transformation: Change management, systems design, and disciplined executionDrawing from both global research at NCEE and real-world systems leadership, Dr. Baker-Jones leaves us with a human truth: the future of learning must be intentionally designed to elevate every learner—and that requires moral leadership, courage, and coherence at every level.Subscribe and share to continue driving the future of education for all.

Artificial lungs kept a man alive until he could get a transplant A simple shift in schedule could make cancer immunotherapy work better Contact the Show: coolstuffdailypodcast@gmail.com Learn more about your ad choices. Visit megaphone.fm/adchoices

Send a textEver catch yourself wondering why the grind never pays off—like you're hustling hard but money, love, or joy keep slipping through your fingers in predictable ways? It's not karma or "your lot in life." It's subtle childhood programming from before age 7, absorbed in those super-suggestible theta brain waves, morphing kid fears into your everyday reality without a second thought.In this real-talk episode of Alison Answers #MissionAwake, Alison Lager LCSW reads right from Chapter 2 of her book The Wake Up Call ("Facing the Truth: The Ultimate Power Move"), walking you through a straightforward "whole life inventory" across 8 everyday areas to uncover the hidden beliefs driving your repeats in money, love, health, joy, and purpose.

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

Kyle McDowell explains the Begin With We principles and how leaders can measure outcomes instead of busy work. In this episode, Tim Staton sits down with Kyle McDowell, author of Begin With We, to explore what modern leadership really looks like and how to measure outcomes that matter. If you've ever asked who is Kyle McDowell or why the Begin With We 10 principles are transforming leaders worldwide, this conversation delivers real insight. Kyle McDowell opens up about hitting rock bottom in his career and feeling unexpected apathy despite professional success. That personal wake-up call sparked his revolutionary Begin With We leadership philosophy and changed how he approaches leadership and accountability. Hear how Kyle McDowell Begin With We transformed his style—from a fear-driven boss to a leader who inspires trust and commitment. This conversation explores why we should do the right thing, how leaders lead by example, why teams must embrace challenge, and why organizations must measure outcomes instead of activity to drive real performance. Whether you're leading a business, managing a team, or preparing for your next leadership role, this episode offers practical insights on how to measure outcomes, build authentic connection, and create a culture where people are committed—not just compliant.   Connect with Kyle McDowell: https://www.instagram.com/kylemcdowellinc/ https://www.tiktok.com/@kylemcdowellinc https://www.youtube.com/@kylemcdowellinc https://www.facebook.com/KyleMcDowellInc https://twitter.com/KyleMcDowellInc www.linkedin.com/in/kylemcdowellinc https://www.kylemcdowellinc.com.   Connect with Tim Website: timstatingtheobvious.com Facebook: https://www.facebook.com/timstatingtheobvious YouTube: https://www.youtube.com/channel/UCHfDcITKUdniO8R3RP0lvdw Instagram: @TimStating TikTok: www.tiktok.com/@theleadershiphatrack LinkedIn: https://www.linkedin.com/in/tim-staton-04b41a271/ SKOOL Community: https://www.skool.com/timstatingtheobvious-9537/about?ref=de9c7e65d8ba4eeabc1a8eea413c125b    

Episode Summary Doc Danny breaks down a major shift in the cash-based business model: moving from visit-based packages to outcome-based offers. After 10 months of testing across dozens of clinics, the data shows higher conversion rates, stronger continuity, and a significant increase in average visit value. In This Episode, You'll Learn Why traditional visit packages create drop-off and unused visits The difference between selling sessions and selling outcomes How outcome-based offers increased average visit value by 26% Why completion drives continuity and lifetime value How to align prognosis, biology, and patient goals into one clear offer What operational friction to expect when making the shift Key Takeaway Patients value outcomes and time saved, not session counts. When you sell duration and results instead of visits, compliance improves, continuity increases, and your business becomes more stable. Technology Spotlight Want to stay fully engaged with patients instead of buried in documentation? Try Claire free for 7 days and see how an AI scribe built for physical therapists removes the documentation burden instantly. Free Resource Ready to go from part-time to full-time in your cash practice? Join the free 5-Day Challenge. Connect Physical Therapy Biz PT Entrepreneur Podcast

On this special segment of The Full Ratchet, the following Investors are featured: Jacob Effron of Redpoint Ethan Austin of Outside VC Arianna Simpson of Andreessen Horowitz We asked guests to share the best question they've ever been asked by an allocator. The host of The Full Ratchet is Nick Moran of New Stack Ventures, a venture capital firm committed to investing in founders outside of the Bay Area. We're proud to partner with Ramp, the modern finance automation platform. Book a demo and get $150—no strings attached.   Want to keep up to date with The Full Ratchet? Follow us on social. You can learn more about New Stack Ventures by visiting our LinkedIn and Twitter.

Send a textThis episode features Chris Stewart, Steve Lester and John VanceWe unpack how clear size-ups, shared language, and realistic tactics turn a scene into a coordinated fireground. Standard conditions guide standard actions, which create standard outcomes—and the trust to avoid freelancing and prevent avoidable failures.• defining standard conditions for typical occupancies in your district• using precise radio language that sets tempo and expectations• matching offensive or defensive strategy to true conditions• aligning tactics with staffing, arrival order, and capabilities• training chiefs in role to build trust and succession• measuring outcomes by all-clear, fire control, loss control• running hot washes that separate activity from results• avoiding benchmark overload that hides core objectives• embracing closed-loop communication and silence while work happensBuy “Timeless Tactical Truths from Alan Brunacini” at bshifter.com in our store for only $10!This episode was recorded at the Alan V. Brunacini Command Training Center in Phoenix on February 10, 2026.For Waldorf University Blue Card credit and discounts: https://www.waldorf.edu/blue-card/For free command and leadership support, check out bshifter.comSign up for the B Shifter Buckslip, our free weekly newsletter here: https://lp.constantcontactpages.com/su/fmgs92N/BuckslipShop B Shifter here: https://bshifter.myshopify.comAll of our links here: https://linktr.ee/BShifterThanks for listening - please subscribe and give us your support! 

Fatigue, joint pain, brain fog, hair loss, anxiety… and your doctor says your labs are fine. What if your breast implants are the missing piece? In this episode, I join Brandi to explore the truth about Breast Implant Illness (BII) and share essential information to help you understand what to do about this growing health concern. What We Cover:What breast implant illness (BII) actually is and why it's not "in your head"The top reported symptoms of BII to look out for How breast implants increase your risk of autoimmune diseasesMechanisms of breast implant illness like the biofilm theoryThe "rain barrel effect": how long-term immune dysregulation leads to gut issues, nutrient deficiencies, and toxic overloadTimeline of symptom onset with BIIHow to safely remove implantsWhy explant is just the beginning and the next steps to true healingSponsors:EQUIP Prime Protein: https://www.equipfoods.com/NHR15 Save 15% off with code: NHR15Connect with Rachel:Free Health Consultation with Rachel: ⁠⁠⁠⁠⁠⁠⁠https://www.naturalhealthrising.net/health-consultation⁠⁠⁠⁠⁠⁠⁠Free Webinar to Heal Your Autoimmune & Mystery Symptoms: ⁠⁠⁠⁠⁠⁠⁠https://www.naturalhealthrising.net/webinar⁠⁠⁠⁠⁠⁠⁠Join the Natural Health Rising community to heal naturally: ⁠https://www.skool.com/natural-health-rising-6209/about?ref=77c29ce69cbf4fb2be0865f18fea6bcc⁠Website: ⁠⁠⁠⁠⁠⁠⁠https://naturalhealthrising.com/⁠⁠⁠⁠⁠⁠⁠Support this podcast: ⁠⁠⁠⁠⁠⁠⁠https://anchor.fm/rachel-smith11/support⁠⁠⁠⁠Breast Explant References:[1] Ferreira, S., Barros, A. S., & Marques, M. (2025). Breast Implant Illness: Symptoms, Outcomes with Explantation and Potential Etiologies—A Systematic Review and Meta-analysis. Aesthetic Plastic Surgery, 49(23), 6600–6620.[2] U.S. Food and Drug Administration. (2025, February 6). Medical Device Reports of Systemic Symptoms in Women with Breast Implants.[3] Suh, L. J., Khan, I., Kelley-Patteson, C., Mohan, G., Hassanein, A. H., & Sinha, M. (2022). Breast Implant-Associated Immunological Disorders. Journal of Immunology Research, 2022, 8536149.[4] Watad, A., Rosenberg, V., Tiosano, S., et al. (2018). Silicone breast implants and the risk of autoimmune/rheumatic disorders: a real-world analysis. International Journal of Epidemiology, 47(6), 1846-1854.[5] Adams, W. P., Jr., & Deva, A. K. (2020). Surgical Best Practices: 14-Point Plan. Sientra.[6] DeCesaris, L. (2022, September 22). A Functional Medicine Approach to Breast Implant Illness: BII. Rupa Health.[7] Dreyfuss, D. (n.d.). 8 Tips for a Quick Breast Implant Removal Recovery. Dreyfuss Plastic Surgery.

In this episode of EMS One-Stop, Dr. Linda Dykes joins Rob Lawrence from the UK for a wide-ranging, transatlantic conversation that starts with workplace culture and ends with a practical look at how health systems can keep patients safely at home. In the first half, Linda breaks down her newly published (open-access) qualitative paper, provocatively titled “It's not bullying if I do it to everyone,” drawn from UK NHS “Med Twitter” responses: a raw, heartbreaking window into the red flags of toxic workplace culture, how bullying is experienced in the eye of the beholder, and why incivility and silence are not just HR problems — they're patient safety threats. In the second half, Linda brings listeners into the UK's evolving admission alternative world: frailty care at home, urgent community response models, and the increasingly important interface between EMS and community-based teams. She explains the UK's SPOA (single point of access) concept, why she dislikes the term “admission avoidance,” and how ED crowding and access change the risk-benefit equation for hospital vs. home. Rob connects the dots back to the U.S. reality — reimbursement, APOT/wall time, treatment-in-place policy — and why this work is becoming a shared challenge on both sides of the Atlantic. Timeline 00:51 – Rob opens, recaps NAEMSP in Tampa and recent content. 02:25 – Rob introduces Linda as the “triple threat” (emergency medicine, primary care/GP, geriatrics) and tees up two-part discussion. 05:39 – Rob introduces Linda's paper: “It's not bullying if I do it to everyone.” 06:13 – Linda explains why toxic culture is increasingly visible and how the tweet prompt became a dataset. 07:33 – “Flash mob research group” forms; Linda explains social-media-to-qualitative methodology and limitations. 10:03 – Rob asks about bias; Linda clarifies purpose: insight, not representativeness. 16:39 – Linda defines gaslighting and why it's so destabilizing. 18:21 – Reactions to publication; resonance, sharing and uncomfortable self-reflection on learned behaviors. 20:18 – The “16:55 Friday email” as a weapon — and as an accidental harm. 23:29 – Leadership as “the sponge” — absorbing pressure rather than passing it down. 25:27 – “One thing right now”: know the impact your words can have, especially on vulnerable staff. 26:41 – Rob on “pressure bubbles,” micro-movements and atmospherics: how leaders shift climate without realizing it. 30:53 – SPOA explained: single point of access and urgent community response behind it. 33:03 – EMS interface: calling before conveyance to find safe pathways to keep patients at home. 35:47 – Linda on mortality risk of access block/long waits and how that reframes risk decisions. 37:19 – Evolving models: primary care-led response vs. hospital at home approaches. 39:34 – Clinical myths challenged: oral antibiotics sometimes non-inferior to IV in conditions we assumed needed admission. 40:34 – Outcomes: hospital at home trial signals safety and fewer patients in institutional care by 6 months. 42:00 – Telemedicine/telehealth: underutilized but useful; when you still need a senior clinician in person. 44:50 – Closing takeaways: read the paper (with trigger warning); admission alternative work is deeply satisfying. Enjoying the show? Email editor@ems1.com to share feedback or suggest guests for a future episode. 

Time for Sports Graffiti! Mason and Ireland discuss the most improbable sports outcomes. Bergman drops into the studio for a ‘Boys in Blue' report! The Dodgers have re-signed Bullpen arm Evan Phillips! Take a listen to Tom Brady and Logan Paul debating athleticism. Can you bet on anything these days? Learn more about your ad choices. Visit podcastchoices.com/adchoices

If the United States brought home a report card on maternal and infant health, it would need a serious parent–teacher conference.  In this episode, Dr. Michael Warren, Chief Medical and Health Officer at March of Dimes breaks down the latest Report Card on birth outcomes and the headline is hard to ignore: the nation earns a D+ for preterm birth, with half of states receiving a D or F.  But this isn't just about grades. It's about what's driving poor outcomes and what public health leaders can actually do about it.  Warren, a former state and federal public health leader, also shares how officials can use the report card as more than a headline, but as a tool to build urgency, strengthen partnerships across maternal health, chronic disease, and Medicaid, and push forward policy and funding priorities.Long COVID Resources for Community Recovery | ASTHOFunding & Collaboration Opportunities | ASTHO

In late 2025, the United Nations concluded its 20-year review of the outcomes emanating from the World Summit on the Information Society (WSIS). Noting that the Caribbean region has been an active participant from WSIS's inception in 2003, we invited Nigel Cassimire, the Deputy Secretary General of the Caribbean Telecommunications Union, to discuss the findings of the review and resulting resolution, including   *  the initial rationale and objectives of WSIS;   *  whether WSIS is still relevant in today's digital environment; how the review addressed matters related to AI; and   *  how regional bodies, such as the CTU, can take the global 2025 outcomes and make them actionable in their member states.    The episode, show notes and links to some of the things mentioned during the episode can be found on the ICT Pulse Podcast Page (www.ict-pulse.com/category/podcast/)       Enjoyed the episode?  Do rate the show and leave us a review!       Also, connect with us on: Facebook – https://www.facebook.com/ICTPulse/   Instagram –  https://www.instagram.com/ictpulse/   Twitter –  https://twitter.com/ICTPulse   LinkedIn –  https://www.linkedin.com/company/3745954/admin/   Join our mailing list: http://eepurl.com/qnUtj    Music credit: The Last Word (Oui Ma Chérie), by Andy Narrell Podcast editing support:  Mayra Bonilla Lopez   ---------------  

"Trauma is not what happens to us, but what we hold inside in the absence of an empathetic witness. The salvation, then, is to be found in the body..."What if trauma isn't something to heal or release but something that formed intelligently in response to life?In this episode, I sit down with Will Rezin of Trauma & Somatics for a deep, grounding conversation on trauma, attachment, procrastination, nervous system regulation, and why so many of us never actually feel completion, only “what's next?”This episode isn't about fixing yourself. It's about understanding how you formed and what becomes possible when survival isn't the only goal anymore.

Dr. Kathryn Paige Harden, PhD, is a psychologist, behavioral geneticist and professor of psychology at the University of Texas at Austin. We discuss how genes interact with your upbringing to shape your level of risk-taking and morality. We also discuss how genes shape propensity for addiction and impulsivity in males versus females. Finally, we discuss how biology impacts societal views of sinning, punishment and forgiveness. Read the episode show notes at hubermanlab.com. Pre-order Protocols: https://go.hubermanlab.com/protocols Thank you to our sponsors AG1: https://drinkag1.com/huberman BetterHelp: https://betterhelp.com/huberman Lingo: https://hellolingo.com/huberman Our Place: https://fromourplace.com/huberman Helix Sleep: https://helixsleep.com/huberman Timestamps (00:00:00) Kathryn Paige Harden (00:03:10) Adolescents, Genes & Life Trajectory; Adolescence Ages (00:06:44) Puberty, Aging & Differences; Epigenome; Cognition (00:14:05) Sponsors: BetterHelp & Lingo (00:16:45) Puberty Onset & Family; Communication & Empathy (00:22:26) 7 Deadly Sins, Substance Use & Conduct Disorders, Genes (00:27:33) Family History; Genes & Brain Development (00:33:05) Personality & Temperament, Motivation, Addiction; Trauma (00:37:59) Knowing Genetic Risk & Outcomes; Understanding Family History (00:46:06) Sponsor: AG1 (00:46:57) Genetic Information & Decision Making; Personal Identity & Uncovering Family (00:52:12) Nature vs Nurture, Bad Genes?; Aggression, Childhood & Males (01:00:17) The Original Sin; Whitman Case & Brain Tumor; Genetic Predisposition (01:10:31) Free Will; Genes & Moral Judgement; Skillful Care for Kids; Social Cooperation (01:21:03) Breaking the Cycle; Genetic Recombination & Differences; Identity (01:25:21) Sponsor: Our Place (01:27:01) Status, Dominance, Science; Positive Attributes of Negative Traits (01:36:15) Relational Aggression & Girls; Male-Female Differences & Conflict (01:40:36) Genes, Boys vs Girls, Impulse Control (01:45:00) Behavior Punishment vs Rewards, Responsibility (01:51:29) Sponsor: Helix Sleep (01:53:03) Accountability; Suffering, Cancel Culture & Punishment (02:00:01) Life Energy & Punishment, Prison (02:08:16) Backward vs Forward-Looking Justice; Forgiveness, Retribution, Power, Choice (02:16:11) Reward, Unfairness & Inequality (02:21:59) Punishment, Reward & Power; Online vs In-Person Communities (02:29:49) Identical Twin Differences; Genetic Influence & Age; Sunlight & Genes (02:39:24) Zero-Cost Support, YouTube, Spotify & Apple Follow, Reviews & Feedback, Sponsors, Protocols Book, Social Media, Neural Network Newsletter Disclaimer & Disclosures Learn more about your ad choices. Visit megaphone.fm/adchoices

Stop using accountability as a weapon and start using it as a tool for growth. In this episode, JP Nerbun, Nate Sanderson, and Betsy Butterick break down why traditional "discipline" often fails and how to build a culture of mutual trust.Subscribe to join us for more discussions like this and go deeper with a FREE membership in the TOC Coach Community: https://www.skool.com/toccoachSubscribe to the Culture Toolbox Newsletter for the notes to this and every episode! https://tocculture.com/culture-toolbox Most coaches want accountability, but few know how to teach the actual communication skills athletes need to hold each other to a standard. We explore the "Trust Gap," the difference between punishment and outcomes, and a powerful story of how one athlete's confession transformed a team's culture.In this episode, we discuss:The Accountability Trap: Why athletes often have a negative association with the word and how to reframe it as "responsibility".   Skill vs. Fear: Why players don't speak up (hint: it's usually because they haven't been taught how).   Consistency is Key: How treating star players differently destroys team trust. Outcomes over Consequences: Shifting the language to emphasize player choice and education over compliance.   Building Mutual Trust: Practical ways to invite your players to hold you accountable as a leader.Chapters:0:00 – What coaches get wrong about accountability2:15 – Why athletes feel frustrated by "The Word"4:45 – The 3 things athletes need: Consistency, Clarity, and Skill7:30 – Accountability vs. Discipline vs. Feedback10:15 – Reframing "Consequences" to "Outcomes"13:40 – Deterrence vs. Grace: The "All-Boys School" example16:20 – A story of radical ownership: The athlete confession19:50 – How to build mutual trust with your players23:10 – Closing thoughts: Modeling the standard

Shift your mindset to abundance. Don't waste your time trying to call in something specific just to realize later that it wasn't actually what you wanted after all. Manifesting specifics is absolutely possible, but will it actually give you what you want? That's what we explore in today's episode.  SHOWNOTES Work with me --> Work with me The Regulation Menu --> Gain Access Here Email List --> Subscribe here Send me an email --> kaila@kailacorsiglia.com Instagram --> @kailacorsiglia Tiktok --> @ina_flowstate Donate --> Thank You

In this segment from What's My Tagline? with host Carol Flagg, Stuart Newsome discusses why AI messaging in healthcare is hitting a wall and how skepticism is forcing a shift toward outcomes-based positioning. The conversation explores what revenue cycle leaders actually care about in 2026 — trust, specificity, governance, and real operational impact.

Scaling user acquisition has become harder to justify and even harder to predict. App teams are under pressure to grow faster while proving, with real data, that every dollar spent delivers meaningful results beyond the install. In this episode, we're sharing an App Talk interview where David Murphy speaks with Lee Aho, Chief Revenue Officer at Perform[cb]. Lee explains how outcome-based user acquisition models help brands move past surface-level metrics like CPI and focus instead on the downstream events that actually define quality — from registrations and deposits to trades, wagers, and long-term value. Today's topics include: How outcome-based user acquisition shifts optimization from installs to the actions that truly define user quality The role of CPI and CPE models — and why they aren't competing approaches when paired with the right down-funnel signals Using cross-program data and pattern recognition to drive more predictable and scalable UA performance Why keyword conquesting remains one of the most effective ways to accelerate organic lift through paid investment How rewarded environments and structured pilot programs can unlock high-intent users and long-term partnerships Links and Resources: Lee Aho on LinkedIn Perform[cb] website Business Of Apps - connecting the app industry Quotes from Lee Aho “We're only getting paid for net new users, so all of our optimization centers around the outcomes that brands tell us are their leading indicators of quality.” “When you're looking at hundreds of programs, you're not just seeing what happened — you're starting to see what's about to happen.” “Brands want user acquisition that scales in a predictable way, and that's where performance-based models can really help.” Host Business Of Apps - connecting the app industry since 2012

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Elizabeth H. Mack, MD, MS, FCCM, speaks with Nadir Yehya, MD, MSCE, an attending physician in the Pediatric Sepsis Program and the Division of Critical Care Medicine at the Children's Hospital of Philadelphia in Philadelphia, Pennsylvania, USA. They discuss Dr. Yehya's study, “Parent and Provider Perspectives on Short-Term Outcomes of Critically Ill Ventilated Children,” published in the September 2025 issue of Pediatric Critical Care Medicine. The study explores whether widely used composite clinical outcomes such as ventilator-free days truly reflect what families value most when their child is in the pediatric intensive care unit (PICU). Dr. Yehya discusses how the project emerged from a long-standing question in pediatric critical care research: Are the outcomes we measure in clinical trials aligned with the priorities and lived experiences of families? Because mortality is low in pediatrics, composite short-term outcomes such as ventilator-free days, ICU-free days, and hospital-free days are commonly used. However, little is known about whether these metrics are truly patient- and family-centered. Using survey data from parents and PICU clinicians, the study found strong agreement between parents and clinicians on the importance of minimizing duration of invasive mechanical ventilation. But parents and clinicians diverged on other short-term outcomes. Families ranked oxygen duration as more important than ICU or hospital length of stay, reflecting concerns about ongoing medical needs, missed work, and the possibility of going home on oxygen. Clinicians prioritized ICU and hospital days over oxygen use. Substantial variation was also found within both groups. Dr. Yehya highlights the value of feedback from patient and family advisory councils in designing this type of research, explaining that such feedback informed the study's instrument design and family approach. He calls for deeper investigation into post-discharge recovery, functional outcomes, and long-term developmental trajectories—areas families consistently identify as their greatest concerns. Resources referenced in this episode: Parent and Provider Perspectives on Short-Term Outcomes of Critically Ill Ventilated Children (Shannon MM, et al. Pediatr Crit Care Med. 2025;26:e1149-e1153)

This week, join authors Shaan Khurshid and Julian S. Haimovich as they discuss their article "Incidence, Risk Factors, and Outcomes in Stressor-Associated Atrial Fibrillation: Insights From the VITAL-AF Trial." For the episode transcript, visit:  https://www.ahajournals.org/do/10.1161/podcast.20260209.180892

Well podcast family, we are back with another installment of our “You ask, We answer” edition. We've got 2 fascinating and real-world clinical conundrums in this episode, both suggested by two separate podcast family members. The first has to do with RH IG maternal administration. Here's the question: If a patient receives routine, prophylactic RH IG at 28 weeks but then has maternal trauma say 1 or 2 weeks after, does she still require an additional dose of RH IG? That's a good question because it's not as intuitive as you would think. We will explain in this episode and there is a bit of a contradiction in the guidance. The second question has to do with finding an asymptomatic uterine rupture at cesarean section. Is there such a thing as a “partial” (silent) uterine rupture? There's recent data from 2025 about this. Listen in for details.1. ACOG PB 181; 2017. 2. Baek S, Froese V, Morgenstern B. Risk Profiles and Outcomes of Uterine Rupture: A Retrospective and Comparative Single-Center Study of Complete and Partial Ruptures. J Clin Med. 2025 Jul 15;14(14):4987. doi: 10.3390/jcm14144987. PMID: 40725680; PMCID: PMC12295210.3. Vandenberghe G, Bloemenkamp K, Berlage S, Colmorn L, Deneux-Tharaux C, Gissler M, Knight M, Langhoff-Roos J, Lindqvist PG, Oberaigner W, Van Roosmalen J, Zwart J, Roelens K; INOSS (the International Network of Obstetric Survey Systems). The International Network of Obstetric Survey Systems study of uterine rupture: a descriptive multi-country population-based study. BJOG. 2019 Feb;126(3):370-381. doi: 10.1111/1471-0528.15271. Epub 2018 Jun 12. PMID: 29727918.

Welcome to episode #1022 of Thinking With Mitch Joel (formerly Six Pixels of Separation). At a moment when organizational change is too often treated as a mandate rather than an experience people choose to embrace, Phil Gilbert has spent his career proving that transformation only sticks when it earns genuine buy-in. Phil is a design executive, transformation leader and former General Manager of Design at IBM, where he architected one of the largest cultural and operational shifts in corporate history, helping nearly 400,000 employees across 180 countries become more entrepreneurial, agile and customer-centered. Trained as both a designer and systems thinker, Phil brought design thinking out of studios and into the core of enterprise decision-making, reshaping how teams collaborated, how products were built, and how leaders understood their customers. His work at IBM addressed hard truths, including the company's struggles with usability and missed opportunities in the early cloud era, by treating change itself as a product worthy of rigor, investment, and care. That experience became the foundation for his book Irresistible Change - A Blueprint For Earning Buy-In And Breakout Success, which blends narrative and field guide to show how large organizations can scale transformation by focusing on people, practices, and environments rather than slogans or top-down directives. Phil's approach reframes culture as an outcome, not an initiative, arguing that lasting change emerges when employees see themselves in the future being designed. Beyond IBM, his work as an executive coach and advisor continues to focus on how leaders navigate complexity, align teams, and thoughtfully integrate technologies like AI into human systems without eroding trust or creativity. Grounded in real-world execution rather than theory, Phil's perspective challenges organizations to stop forcing change and start making it irresistible. Enjoy the conversation… Running time: 1:02:49. Hello from beautiful Montreal. Listen and subscribe over at Apple Podcasts. Listen and subscribe over at Spotify. Please visit and leave comments on the blog - Thinking With Mitch Joel. Feel free to connect to me directly on LinkedIn. Check out ThinkersOne. Here is my conversation with Phil Gilbert. Irresistible Change - A Blueprint For Earning Buy-In And Breakout Success. Follow Phil on LinkedIn. Chapters: (00:00) - Introduction to Phil Gilbert and His Journey. (01:26) - IBM's Transformation and Challenges. (04:17) - The Shift from Technology to Product. (10:55) - Implementing Design Thinking at IBM. (16:30) - Cultural Change and Its Impact on Outcomes. (22:53) - The Role of Teams in Transformation. (26:40) - Branding the Change: Hallmark Program. (32:22) - The Importance of Team Selection in Transformation. (34:59) - Creating Demand for Change. (37:23) - Agency and Team Resilience. (38:06) - IBM's Market Position and Transformation. (41:14) - The Shift in Work Dynamics. (44:46) - Rethinking Office Spaces. (48:58) - Irresistible Change and Transformation Failures. (53:51) - AI Integration and Market Forces. (59:38) - The Impact of Design Thinking on Business.

Episode 211: Understanding HFpEF.  Hyo Mun and Jordan Redden (medical students) explain the pathophysiology of heart failure with preserved ejection fraction (HFpEF) and how it differentiates from HFrEF. Dr. Arreaza asks insightful questions and summarizes some key elements of HFpEF. Written by Hyo Mun, MS4, American University of the Caribbean; and Jordan Redden, MS4, Ross University School of Medicine. Comments and edits by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.What is EF? Just imagine, the heart is a pump, blood gets into the heart through the veins, the ventricles fill up and then squeeze the blood out. So, the percent of blood that is pumped out is the EF. Let's start at the beginning. What is HFpEF?Mike: HFpEF stands for heart failure with preserved ejection fraction. Basically, these patients squeeze normally—their ejection fraction is 50% or higher—but here's the thing: the heart can't relax and fill the way it should. The muscle gets stiff, almost like a thick leather boot that just won't stretch. And because the ventricle can't fill properly, pressure starts backing up into the lungs and the rest of the body. That's when patients start experiencing shortness of breath, leg swelling, fatigue—all those classic symptoms.Dr. Arreaza: And this is where people get fooled by the ejection fraction.Mike: Exactly. The ejectionfraction tells you total left ventricular emptying, not just forward flow.Jordan: The classic example is severe mitral regurgitation. You can eject 60% of your blood volume and still be in cardiogenic shock because most of that blood is leaking backward into the left atrium instead of going into the aorta. So, you get pulmonary edema, hypotension, fatigue, all with a “normal” EF. Which is honestly terrifying if you're over-relying on echo reports without thinking clinically.Dr. Arreaza: And in HFpEF, functional mitral regurgitation often shows up later in the disease. It's not usually the primary cause; it's more of a marker of advanced disease. Moderate to severe MR in HFpEF independently predicts worse outcomes, including a higher risk of mortality or heart failure hospitalization. So, let's contrast this with HFrEF. How are these two different?Mike: HFrEF—heart failure with reduced ejection fraction—is a pumping problem. The heart muscle is weak and can't contracteffectively. Ejection fraction drops below 40%, and this is your classic systolic dysfunction.Jordan: HFpEF, on the other hand, is diastolic dysfunction. The heart muscle is thick, fibrotic, and noncompliant. It squeezes fine, but it just doesn't relax, even though the EF looks reassuring on paper.Mike: I like to explain it this way: HFrEF is a weak heart that can't squeeze. HFpEF is a stiff heart that can't relax. Totally different problems.Dr. Arreaza: And then there's the gray zone: heart failure with mildly reduced EF, or HFmrEF. That's an EF between 41 and 49% with evidence of elevated filling pressures. It really shares the features of both worlds. So, what actually causes HFpEF versus HFrEF?Jordan: HFpEF is basically what happens when all the problems of modern living catch up with you. You've got chronic hypertension, obesity, diabetes, metabolic syndrome, aging, systemic inflammation—all of these things slowly remodel the heart over years. The muscle gets thick and stiff, and eventually the ventricle just loses its ability to relax. So, HFpEF is really a disease of metabolic dysfunction and chronic stress in the heart. Mike: HFrEF is more about direct injury. Think about myocardial infarctions, ischemic cardiomyopathy, viral myocarditis, alcohol toxicity, chemotherapy like doxorubicin, genetic cardiomyopathies, or chronic uncontrolled tachycardia. These insults actually damage or kill heart muscle cells, leading to a dilated, weak ventricle that can't pump effectively.Dr. Arreaza: So the short version: HFpEF is caused by chronic metabolic and hypertensive stress, while HFrEF is caused mainly by myocardial damage. A question we get a lot: does HFpEF eventually turn into HFrEF? What do you guys think?Mike: In most cases, no. HFpEF patients usually stay HFpEF throughout their disease course. They don't just “burn out” and turn into HFrEF.Jordan: They're generally separate disease entities with different pathophysiology. A patient with HFpEF can develop HFrEF if they have a big myocardial infarction or ongoing ischemia that damages the muscle, but that's not the natural progression.Mike: Interestingly though, the opposite can happen. Some HFrEF patients actually improve their ejection fraction with good medical therapy—that's called HF with improved EF—and it's a great sign that treatment is working.Dr. Arreaza: Another question. How do HFpEF and HFrEF compare to restrictive cardiomyopathy and constrictive pericarditis?Jordan: Clinically, they can all look very similar: dyspnea, edema, fatigue, but the underlying mechanisms are completely different.Mike: In HFpEF, the myocardium itself is stiff from hypertrophy and fibrosis. The problem is intrinsic to the heart muscle, and EF stays preserved. Echoshows diastolic dysfunction with elevated filling pressures.Jordan: In HFrEF, the myocardium is weak. The ventricle is often dilated and contracts poorly, with a reduced EF.Mike: Restrictive cardiomyopathy is different. Here, the myocardium gets infiltrated by abnormal stuff—amyloid, iron, sarcoid—and that makes it extremely stiff. It can look like HFpEF on the surface, but it's usually more severe. On Echo You'll see biatrial enlargement, small ventricles, and preserved EF. And importantly, it's a pathologic diagnosis, so you need advanced imaging or biopsy to confirm it.Jordan: Constrictive pericarditis is another mimic, but here the myocardium is usually normal. The problem is that the pericardium is thickened, calcified, and rigid. This will physically prevent the heart from being filled. Imaging shows pericardial thickening, septal bounce, and respiratory variation in flow, and cath shows equalization of diastolic pressures, which is the hallmark of constrictive pericarditis.Dr. Arreaza: So the takeaway is: HFpEF is a clinical syndrome driven by common metabolic and hypertensive causes, while restrictive and constrictive diseases are specific pathologic entities. If “HFpEF” is unusually severe or not responding to treatment, you need to think beyond HFpEF. Which type of heart failure is more common right now?Mike: Good question, the answer is: HFpEF. It now accounts for up to 60% of all heart failure cases, and it's still rising.Dr. Arreaza: Why is that?Jordan: Because people are living longer, gaining weight, and developing more metabolic syndrome. HFpEF thrives in older, or people with obesity, hypertension, or diabetes: basically, the modern American population. At the same time, better treatment of acute MIs means fewer people are developing HFrEF from massive heart attacks.Mike: HFpEF is the heart failure epidemic of the 21st century. It's honestly the cardiology equivalent of type 2 diabetes.Dr. Arreaza: Let's talk aboutCOVID-19. (2025 and still talking about it) Does it actually increase heart failure risk?Mike: Yes, absolutely. COVID increases both acute and long-term heart failure risk.Jordan: During acute infection, COVID can cause myocarditis, trigger massive inflammation, and precipitate acute decompensated heart failure, especially in patients with pre-existing disease. It also causes microthrombi, which can injure the myocardium.Mike: And after infection, even mild cases are linked to a significantly higher risk of developing new heart failure within the following year. Both HFpEF and HFrEF rates go up.Dr. Arreaza: I remember seeing this in 2021, we had a patient with acute COVID and HFrEF, her EF was about 10%, I lost contact with the patient and at the end I don't know what happened to her. What's the pathophysiology of COVID and heart failure?Mike: COVID causes direct viral injury through ACE2 receptors, triggers massive inflammation that damages the endothelium and heart muscle, leads to microvascular clotting and fibrosis—all mechanisms that promote HFpEF.Jordan: Add autonomic dysfunction, persistent low-grade inflammation, and worsening metabolic syndrome, and you've got a perfect storm for heart failure.Dr. Arreaza: Bottom line: COVID is a cardiovascular disease as much as a respiratory one. If someone had COVID and now has unexplained dyspnea or fatigue, think about heart failure. Get an echo, get a BNP, start treatment. Last big question: why did we have so many therapies for HFrEF but essentially none for HFpEF for years?Mike: HFrEF is mechanistically straightforward. You've got a weak heart with excessive neurohormonal activation going on — so you block RAAS, block the sympathetic system, drop the afterload. The drugs make sense.Jordan: HFpEF is messy. It's not one disease. It's stiffness, fibrosis, inflammation, microvascular dysfunction, metabolic disease, atrial fibrillation, all overlapping. One drug can't fix all of that.Mike: And some drugs that worked beautifully in HFrEF actually made HFpEF worse. Take Beta blockers, for example.  They slow heart rate, which is a problem because HFpEF patients rely on heart rate to maintain their cardiac output.Jordan: The breakthrough came with SGLT-2 inhibitors: diabetes drugs that unexpectedly addressed multiple HFpEF mechanisms at once: volume, metabolism, inflammation, and myocardial energetics.Dr. Arreaza: The miracle drug for HFpEF! Alright, let's wrap up.Mike: Bottom line: HFpEF is common, complex, and dangerous: even if the EF looks “normal.”Jordan: And if you're relying on ejection fraction alone, HFpEF will humble you every time.Dr. Arreaza: If you liked this episode, share it with a friend or a colleague and rate us wherever you listen. This is Dr. Arreaza, signing off.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:Barzin A, Barnhouse KK, Kane SF. Heart Failure With Preserved Ejection Fraction. Am Fam Physician. 2025;112(4):435-440.Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure. Circulation. 2022;145(18):e895-e1032.Kittleson MM, Panjrath GS, Amancherla K, et al. 2023 ACC expert consensus decision pathway on management of heart failure with preserved ejection fraction. J Am Coll Cardiol. 2023;81(18):1835-1878.Anker SD, Butler J, Filippatos G, et al. Empagliflozin in heart failure with a preserved ejection fraction. N Engl J Med. 2021;385(16):1451-1461.Solomon SD, McMurray JJV, Claggett B, et al. Dapagliflozin in heart failure with mildly reduced or preserved ejection fraction. N Engl J Med. 2022;387(12):1089-1098.Pitt B, Pfeffer MA, Assmann SF, et al. Spironolactone for heart failure with preserved ejection fraction. N Engl J Med. 2014;370(15):1383-1392.Yusuf S, Pfeffer MA, Swedberg K, et al. Effects of candesartan in patients with chronic heart failure and preserved left-ventricular ejection fraction. Lancet. 2003;362(9386):777-781.Solomon SD, McMurray JJV, Anand IS, et al. Angiotensin-neprilysin inhibition in heart failure with preserved ejection fraction. N Engl J Med. 2019;381(17):1609-1620.Kosiborod MN, Abildstrøm SZ, Borlaug BA, et al. Semaglutide in patients with heart failure with preserved ejection fraction and obesity. N Engl J Med. 2023;389(12):1069-1084.Xie Y, Xu E, Bowe B, Al-Aly Z. Long-term cardiovascular outcomes of COVID-19. Nat Med. 2022;28(3):583-590.Puntmann VO, Carerj ML, Wieters I, et al. Outcomes of cardiovascular magnetic resonance imaging in patients recently recovered from COVID-19. JAMA Cardiol. 2020;5(11):1265-1273.Basso C, Leone O, Rizzo S, et al. Pathological features of COVID-19-associated myocardial injury. Eur Heart J. 2020;41(39):3827-3835.Nalbandian A, Sehgal K, Gupta A, et al. Post-acute COVID-19 syndrome. Nat Med. 2021;27(4):601-615.Badve SV, Roberts MA, Hawley CM, et al. Effects of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in adults with estimated GFR less than 60 mL/min per 1.73 m². Ann Intern Med. 2024;177(8):953-963.Navis G, Faber HJ, de Zeeuw D, de Jong PE. ACE inhibitors and the kidney: a risk-benefit assessment. Drug Saf. 1996;15(3):200-211.Textor SC, Novick AC, Tarazi RC, et al. Critical perfusion pressure for renal function in patients with bilateral atherosclerotic renal vascular disease. Ann Intern Med. 1985;102(3):308-314.Hackam DG, Spence JD, Garg AX, Textor SC. Role of renin-angiotensin system blockade in atherosclerotic renal artery stenosis and renovascular hypertension. Hypertension. 2007;50(6):998-1003.Ronco C, Haapio M, House AA, et al. Cardiorenal syndrome. J Am Coll Cardiol. 2008;52(19):1527-1539.Prins KW, Neill JM, Tyler JO, et al. Effects of beta-blocker withdrawal in acute decompensated heart failure. JACC Heart Fail. 2015;3(8):647-653.Jondeau G, Neuder Y, Eicher JC, et al. B-CONVINCED: Beta-blocker CONtinuation Vs. INterruption in patients with Congestive heart failure hospitalizED for a decompensation episode. Eur Heart J. 2009;30(18):2186-2192.Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/. 

Businesses don't win by selling more features or even better experiences anymore. In this episode, Joe Pine explains why the real value today comes from selling outcomes and guiding customers toward meaningful transformation. We unpack the transformation economy, how it differs from the experience economy, and why charging for outcomes changes pricing, guarantees, and business models. You will learn how both B2B and B2C companies can productize transformation, align messaging with real results, and help customers become who they want to be. Today we discussed: 00:00 Why Transformation Matters Now 11:43 Productizing Transformation 14:00 Pricing and Outcome-Based Models 16:48 Messaging Around Who Customers Become 20:16 How to Start a Transformation Strategy 24:28 Connect With Joe Rate, Review, & Follow If you liked this episode, please rate and review the show. Let us know what you loved most about the episode. Struggling with strategy? Unlock your free AI-powered prompts now and start building a winning strategy today!

In this episode of the Award-winning PRS Journal Club Podcast, 2026 Resident Ambassadors to the PRS Editorial Board – Lucas Harrison, Christopher Kalmar, and Priyanka Naidu- and special guest, Scott P. Bartlett, MD, discuss the following articles from the February 2026 issue: "Anthropometrics versus Experts' Subjective Analysis of Cleft Severity and PSIO Outcomes in Unilateral Clefts: A Proposal for a New Grading" by Tanikawa, Chong, Fisher, et al. Read the article for FREE: https://bit.ly/PSIOoutcomes Special guest Dr. Scott P. Bartlett. Dr. Bartlett is one of the world's leading craniofacial surgeons and serves as Director of the Craniofacial Program and an attending surgeon in the Division of Plastic, Reconstructive, and Oral Surgery at the Children's Hospital of Philadelphia. He is also a Professor of Surgery at the Perelman School of Medicine at the University of Pennsylvania and holds the prestigious Mary Downs Endowed Chair in Pediatric Craniofacial Treatment and Research at CHOP. Dr. Bartlett's clinical expertise encompasses congenital and acquired deformities of the skull, face, jaws, and ears, as well as complex facial aesthetic and reconstructive surgery. He served two terms as Section Editor for the Pediatric Craniofacial Section of Plastic and Reconstructive Surgery. His research portfolio includes landmark contributions to facial growth and development, age-related facial structural changes, non-surgical correction of ear deformities, and the use of advanced imaging and implant materials to improve operative planning and long-term outcomes. READ the articles discussed in this podcast as well as free related content: https://bit.ly/JCFeb26Collection The views expressed by hosts and guests are their own and do not necessarily reflect the official policies or positions of ASPS.

Looking 4 Healing Radio with Dr. Angelina Farella – Donio's concerns weren't unfounded speculation. As someone who worked directly with similar technologies in laboratory settings, he recognized the mRNA vaccines as gene therapy—a technology initially developed for cancer treatment and rare diseases. His research revealed that early clinical trials of modified mRNA therapeutics encountered...

Physical therapists Ziya Altug and Shirish Sachdeva discuss their article "Why your clinic waiting room may affect patient outcomes." Ziya and Shirish explore how the ambiance of a medical office significantly impacts patient anxiety and emotional well-being before treatment even begins. They examine evidence-based strategies to transform functional spaces into healing environments using calming music, nature-inspired art, and ergonomic furniture design. The conversation highlights specific needs for pediatric patients and how transparency through technology can build trust between patients and health care providers. Understanding these environmental factors allows clinics to foster a sense of safety and improve the overall care experience through intentional design interventions. Discover how simple changes to a waiting area can set a positive tone for recovery and comfort. Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

Dr. Read Montague, PhD, is a professor and director of the Center for Human Neuroscience Research at Virginia Tech and an expert in how dopamine and serotonin shape human learning, motivation and decision-making. We discuss how they impact focused effort in the context of short- and long-term goals of all kinds. Also, how SSRIs and low-effort, high-engagement activities reduce the rewarding properties of dopamine, and how AI algorithms are revolutionizing understanding of the brain. Episode show notes are available at hubermanlab.com. Thank you to our sponsors AG1: https://drinkag1.com/huberman David: https://davidprotein.com/huberman Joovv: https://joovv.com/huberman Function: https://functionhealth.com/huberman LMNT: https://drinklmnt.com/huberman Timestamps (00:00:00) Read Montague (00:02:54) Dopamine, Motivation & Learning (00:08:49) Reward Prediction Error, Expectations (00:12:24) Sponsors: David & Joovv (00:14:54) Foraging, Dating, Expectations vs Outcomes; AI (00:23:36) Dopamine, Expectation, Motivation; Forward Drive; Dopamine "Hits" (00:29:58) Baseline Dopamine & Fluctuations; Parkinson's Disease (00:34:36) Movement, Urgency; ADHD, Bee's Dance, Explorer vs Focus Mode (00:42:29) Sponsor: AG1 (00:43:40) Social Media, ADHD; Explorers vs Task-Based, Combat (00:50:54) Effort, Learning; Social Media & Phones, Resisting Behaviors (01:01:36) Serotonin & Dopamine, Opponency, SSRIs (01:11:21) Hunger, Dopamine; Negative Feedback, Learning, Trauma; Torture (01:18:34) Drugs of Abuse & High Dopamine (01:19:48) Sponsor: Function (01:21:35) Trauma & Dopamine Adaptation (01:27:34) SSRIs, Dopamine, Positive Experiences (01:29:50) Deep Brain Stimulation; Measuring Dopamine & Serotonin in Humans (01:36:16) Sleep; Divorce; Science is a Contact Sport (01:45:14) Long-Term Motivation, Learning How to Fail, Tool: Kids & Sports (01:54:14) Sponsor: LMNT (01:55:34) Meditation, Breathing, Learning; Dopamine as a Currency (02:04:38) Function of Sleep, Motivation; Time Perception & Dopamine, Tracking Time (02:13:18) LLMs, AI, Uses & Problem Solving (02:18:33) Future Projects, Commercial Brain-Machine Interfaces; Concentration (02:25:57) Dopamine "Hits"?; Depression & Schizophrenia; Quitting (02:30:17) Dopamine & Serotonin Misunderstandings; Internal Satisfaction; Motivation (02:35:58) Serotonin Syndrome; Acknowledgements (02:38:31) Zero-Cost Support, YouTube, Spotify & Apple Follow, Reviews & Feedback, Sponsors, Protocols Book, Social Media, Neural Network Newsletter Disclaimer & Disclosures Learn more about your ad choices. Visit megaphone.fm/adchoices

Identity congruence means every part of who I am is in alignment, and in this episode, I explain why that matters. When my thoughts, words, actions, and image don't match, it creates friction and confusion for me and everyone around me. Most people think they lack skill or knowledge, but the real problem is internal and external signals being out of sync. When everything lines up, trust, power, and presence show up naturally. Congruence focuses your energy in one direction instead of leaking it everywhere. Show Notes: [03:48]#1 Your thoughts. [06:59]#2 Your image. [12:46]#3 Your words. [15:24]#4 Your actions [17:14]#5 Outcomes.  [20:29] Recap Episodes Mentioned: 2245: What's Up With The Business Suits? 3015: How To Be In Integrity With Yourself Next Steps: --- Power Presence is not taught. It is enforced. If you are operating in environments where hesitation costs money, authority, or leverage, the Power Presence Mastermind exists as a controlled setting for discipline, execution, and consequence-based decision-making. Details live here: http://PowerPresenceProtocol.com/Mastermind  This Masterclass is the public record of standards. Private enforcement happens elsewhere. All episodes and the complete archive: → WorkOnYourGamePodcast.com