Podcasts about PIH

Release Date: 05.14.2025 Hoporenkv Native American Podcast: “An Important Announcement for Indian Country from HUD Secretary Scott Turner” Special Guest: Scott Turner United States Secretary of Housing and Urban Development Episode Description: Today's episode brings you exciting news directly from our very special guest, Scott Turner, the United States Secretary of Housing and Urban Development (HUD)! We're diving into the announcement of a significant $1.1 billion in Indian Housing Block Grant (IHBG) funding, set to empower Native American Tribes, Alaska Native Villages, and Tribally Designated Housing Entities (TDHEs) with vital resources for affordable housing initiatives in Indian Country. We'll highlight the importance of this crucial investment - HUD's largest annually for Indian Country – and how this funding will support crucial housing activities nationwide, as well as HUD's unwavering dedication to serving Tribal Communities and their vision for a brighter, more sustainable future. “From day one, HUD has been engaged on alleviating affordable housing challenges facing urban, rural, and Tribal Communities. Today's announcement reaffirms our commitment to serve Tribal Communities while working towards meeting Indian Country's housing needs,” said Secretary Scott Turner. “HUD has a strong partnership with Tribal Nations, and I look forward to collaborating directly with Tribal Leaders to expand housing opportunities and remove burdensome regulatory barriers that impede progress.” Join us as we look toward the road ahead and Secretary Turner reaffirms HUD's ongoing commitment to addressing housing challenges in Tribal Communities nationwide. Episode Resource Links: • https://www.hud.gov/news/hud-no-25-065 • https://www.hud.gov/sites/default/files/PIH/documents/FY-2025IHBG-Formula-Allocation-Press-Release-Awards-List.pdf • https://www.hud.gov/helping-americans/public-indian-housing-ihbgformula • https://www.hud.gov/news/hud-no-25-054 • https://www.hud.gov/news/hud-no-25-061

In Episode 34, join our founder, Danné Montague-King, alongside DMK's Chief Scientific Officer, Dr. Jayant Lokhande, as they dive deep into "Understanding Pigmentation in Melanated Skin."This episode is packed with essential information on:✅ Demystifying melanin—its science, roles, and unique characteristics in melanated skin.✅ Addressing and correcting common skincare myths surrounding deeper skin tones.✅ Detailed breakdown of pigmentation conditions like melasma and post-inflammatory hyperpigmentation (PIH).✅ DMK's revolutionary bio-inspired approach for safely treating pigmentation concerns.✅ Actionable, culturally-sensitive practices every skincare professional should incorporate.Instagram - Facebook - TikTok - Twitterwww.dannemking.com

A study by Stanford and Encore.org found that the majority of older adults want to give back in some way. Jim Ansara, an AARP 2024 Purpose Prize winner, is making a big difference in his retirement with his organization Build Health International. How might you redirect your skills and experience to make a difference? Jim Ansara joins us from Beverly , Massachusetts. ____________________ Bio Jim Ansara is a retired general contractor who founded Shawmut Design and Construction in Boston in the early 1980's and led it to become one of the top 25 construction companies in the US. While at Shawmut he led several volunteer teams of employees to build low-tech, clean water systems in Nicaragua with the organization, El Porvenir. After retiring as Chairman of the Board, Jim redirected his energy to the developing world. In 2009 a trip to Haiti with Dr. Paul Farmer led to an invitation to build a small community hospital with Partners in Health (PIH) in Haiti's Central Plateau. The process took a major turn when a massive earthquake struck the country on January 10, 2010. For three-and-a-half years after the earthquake, through the outbreak of cholera and political unrest, through hurricanes and unbearable heat, Jim, his partner Dr. David Walton of PIH, and hundreds of Haitian and Dominican workers persevered to build Haiti's new 340-bed National Teaching Hospital in Mirebalais, Haiti. Since its completion, the mission to build and equip global health care infrastructure has continued via a new non-profit, Build Health International, based in Beverly, MA. The BHI team has undertaken projects in low-resource settings across 22 countries with PIH, the Kellogg Foundation, Cure International, Direct Relief International and numerous other NGOS. For Jim's philanthropy he has received Honorary Doctorates in Humane Letters from Amherst College and Salem State University, as well as distinction from Partners in Health, Health Equity International, The American Red Cross Northeast MA Chapter, the Political Asylum and Immigration Representation Project, Summer Search Boston, and more. He serves on the board of Health Equity International, and in years past on the boards of Salem State University, the Boston Children's Museum, Youth Build, and City Year. _____________________ For More on Jim Ansara Build Health International (BHI) Health Equity Humanitarian Delivers Hospitals for the Poor ____________________ Podcast Episodes You May Like Changing the World One Small Act at a Time – Brad Aronson Live Life in Crescendo – Cynthia Covey Haller The Best Day of My Life So Far – Benita Cooper Why People Make a Career Change with Purpose Top of Mind – Chris Farrell ____________________ Wise Quotes On Learning and New Challenges in Retirement "I'm passionate about tackling challenges and solving problems. And one of the things that really excites me in life is learning, not necessarily learning in traditional methods, but learning by sort of immersion, where I'm trying to keep my nose and mouth just above the flood tide. And I need a level of sort of challenge and the accompanying freneticism in my life to really be happy. I'd like it to be different. I'd like to be a more relaxed and easy-going person, but at 67, that's not going to change probably. So it's really a combination of those two things. And I found, and this is an area, Build Health International, where I could really exercise both of those things. It's informative about who I am and who I'm not." On the Transition to Retirement "I'd like to say that I got to where I am by lots of self reflection and and and that kind of thing, but it's not true. I really fell into it. But I kept sort of trying to figure out what was next for me. And I was also clear on what I didn't want to do. I knew some people who had sold companies and made some money, and many of them manage their money and got into business, either as consultants or advisors.

Que signifie la fin de la Prescription Initiale Hospitalière (PIH) des biothérapies et pourquoi ce changement a-t-il été décidé ? Quels sont les avantages et les points de vigilance pour les patients avec cette nouvelle possibilité de prescription en ville ? Quelles seront les implications pour les rhumatologues libéraux dans leur pratique quotidienne ?    Le Dr Véronique Gaud Listrat, rhumatologue libérale attachée à l'hôpital Cochin et Secrétaire Générale du CNP nous éclaire à ce sujet.    Ressources :  Application Hiboot+ - mieux vivre avec votre traitement : https://www.hiboot.fr/ http://www.cri-net.com Joint Bone Spine 85 (2018) 261–262 - questionnaire co morbidités C. Beauvais,j.rhum.2021.10.563 - Biosecure actualisé Rhumatismes.net: polyarthrite en 100 questions, SPA en 100 questions   Notre invitée déclare ne pas avoir de lien d'intérêt en rapport avec le sujet traité.    L'équipe :  Comité scientifique : Pr Jérémie Sellam, Pr Thao Pham, Dr Catherine Beauvais, Dr Véronique Gaud-Listrat, Dr Céline Vidal, Dr Sophie Hecquet.  Animation : Marguerite de Rodellec Production : MedShake Studio Soutien institutionnel : Pfizer

In this episode of The Confidence Doc, Dr. Rukmini Rednam opens up about the unique considerations for women of color when it comes to plastic surgery treatments. Dr. Rednam shares her expert insights on how planning procedures for women of color requires extra care and precision to avoid complications like post-inflammatory hyperpigmentation (PIH). She highlights the importance of tailoring post-op care and adjusting treatments to minimize risks, particularly when using heat-based devices, such as VASER or Renuvion, which can cause inflammation.Dr. Rednam explores alternative approaches to achieve skin tightening through lasers without triggering PIH, discussing how women of color can safely benefit from these procedures. She also dives into the role of heat-based devices in post-op care, emphasizing the need for careful selection of treatments to ensure optimal results and minimize adverse reactions.Key topics include:Special considerations for women of color in plastic surgery.Strategies to prevent post-inflammatory hyperpigmentation (PIH).Safe use of heat-based devices like VASER and Renuvion.Achieving skin tightening through lasers without PIH.The role of heat-based devices in post-op care.Tune in for an enlightening conversation about the specific needs of women of color in the world of plastic surgery, as Dr. Rednam provides valuable guidance on navigating these treatments safely and effectively.Request your consultation here:Contact Rukmini Rednam, MD in Houston TX and The Woodlands (drrukminirednam.com)

In this episode of "The Perfect Dose" podcast, Dr. Kristin Herzog, a board-certified nurse practitioner and injection specialist, breaks down everything you need to know about hyperpigmentation. From sunspots to melasma, she explains the causes of these dark patches on your skin and the most effective treatments. Learn about essential skincare ingredients like hydroquinone, vitamin C, kojic acid, and retinoids. Dr. Herzog also covers in-office treatments such as chemical peels, IPL photofacials, and CO2 lasers, offering insights into how you can maintain clear, radiant skin year-round. Whether you're dealing with post-inflammatory hyperpigmentation (PIH) from acne or long-term sun damage, this episode is packed with practical tips for achieving your best skin yet!Tune in now to discover the best treatment options for different types of hyperpigmentation and how to combine at-home skincare with in-office procedures for optimal results. Don't forget to follow Dr. Herzog on Instagram @theperfectdose for more skincare tips!TIMESTAMPS:Timestamps:[00:00] Intro to Hyperpigmentation[00:21] Common Causes of Hyperpigmentation[01:43] Types of Hyperpigmentation[02:19] Melanin and Overproduction[02:59] Sun Damage and Pigmentation[03:19] Medications and Hormonal Changes[04:00] Sunspots, Melasma, and PIH[05:00] Treating Hyperpigmentation[05:29] Post Inflammatory Hyperpigmentation (PIH)[06:00] Melasma: Causes and Challenges[07:19] Pigment Inhibitors for Hyperpigmentation[09:00] Prescription Treatments: Hydroquinone[10:00] Vitamin C and Other Key Ingredients[13:00] Retinoids and Cell Turnover[16:00] Skincare for Your Body[20:00] In-Office Treatments: Chemical Peels, Lasers[26:00] Cool Peel Laser and Results[28:00] Wrap-Up and Final TipsSEO Tags:hyperpigmentation, skincare, melasma, sunspots, PIH, acne scars, skin brightening, dark spots, laser treatments, chemical peels, hydroquinone, vitamin C, retinoids, kojic acid, pigment inhibitors, skin care routine, anti-aging, clear skin, dermatologist, skin tips, skin texture, sun damage, in-office treatments, aesthetic treatments, skincare podcast, skincare advice, skincare experts, chemical peel, IPL photofacial, CO2 laser, skin pigmentation, healthy skin, beauty routineLINKS:FIND US AThttps://www.theperfectdose.net/FOLLOW US ON SOCIAL MEDIA: https://www.instagram.com/the_perfectdose/SUBSCRIBE TO OUR YOUTUBE CHANNEL:https://www.youtube.com/@theperfectdoseThe Perfect Dose Podcast is produced by Live Your Truth Media: https://www.liveyourtruth.media/

As you age, you might notice dark or brown spots (hyperpigmentation) appearing on your face, arms, or the tops of your hands. These age spots can also develop on your legs, back, and other parts of your body.  Age spots on the face (cheek, chin, nose, forehead, and upper lip) are typically caused by years of exposure to ultraviolet light from the sun (melasma). These age spots are more common in women and those who are pregnant or taking birth control pills. While experts don't know exactly why this is, it's thought that hormones play a role in melasma.  Keep in mind that age spots can also be caused by skin injury, such as a cut, burn, or acne breakout. They can also be caused by inflammation, certain medications, and medical conditions such as hypothyroidism, Addison's disease, and certain vitamin deficiencies (B12 or folate).  While you can't go back in time to apply more sunscreen and prevent age spots, there are peptide therapies that you can use to fade them. As a refresher, peptides are short chains of amino acids. When used topically, they can penetrate the skin and signal cells to perform specific functions, such as collagen production, skin repair, and pigment regulation.  In this podcast, we'll talk about how peptide therapy works to help get rid of the appearance of age spots and what you can expect: How Does Peptide Therapy Work for Age Spots? Inhibition of Melanin Production: Certain peptides can inhibit the activity of tyrosinase, an enzyme crucial for the synthesis of melanin (a dark brown pigment). These peptides help lighten dark spots and even out skin tone by reducing melanin production. Promotion of Skin Renewal: Peptides can stimulate skin cell turnover, promoting the shedding of pigmented cells and the generation of new, healthier skin cells. This helps in fading dark spots over time. Anti-Inflammatory Effects: Peptides can reduce inflammation, which often contributes to hyperpigmentation, especially in conditions like post-inflammatory hyperpigmentation (PIH). Antioxidant Properties: Some peptides have antioxidant properties, protecting the skin from oxidative stress and damage caused by UV radiation, which can exacerbate dark spots. What are Some Common Peptides Used for Treating Dark Spots? Copper Peptides: Known for their wound healing and anti-inflammatory properties, copper peptides can help improve skin texture and reduce pigmentation. Palmitoyl Tetrapeptide-7: This peptide reduces inflammation and promotes the regeneration of new skin cells, helping to diminish dark spots over time. Oligopeptide-68: Specifically designed to reduce hyperpigmentation by inhibiting melanin production and evening out skin tone. Decapeptide-12: Effective in reducing pigmentation and improving overall skin brightness. What are the Benefits of Peptide Therapy for Dark Spots? Targeted Action: Peptides can be formulated to specifically target pigmentation pathways, offering a more precise approach compared to general skin-lightening agents. Minimal Side Effects: Peptides are generally well-tolerated, with a lower risk of irritation and side effects than more aggressive treatments like chemical peels or laser therapy. Multi-functional Benefits: In addition to lightening dark spots, peptides often provide additional skin benefits such as improved texture, firmness, and hydration. Application and Usage of Peptides for Age Spots Topical Serums and Creams: Peptides are commonly found in serums and creams. These should be applied as directed, typically once or twice daily, after cleansing and before moisturizing. Consistency is Key: Peptide therapy results can take several weeks to become noticeable. Consistent use is crucial for achieving the best results. Sun Protection: Peptides used to treat dark spots should be paired with effective sun protection. Sunscreen helps prevent further pigmentation and supports the action of peptides. As a general rule, make sure to choose sunscreen that is broad-spectrum (protects against UVA and UVB rays), SPF 30 (or higher), and water-resistant.  If you are considering peptide therapy for dark spots, it's recommended to consult with a dermatologist to determine the most suitable peptides for your skin type and condition. Often, combining adequate sunscreen, prescription medications, peptide therapy, and certain procedures such as microdermabrasion, lasers, and chemical peels may be needed. Thanks again for listening to The Peptide Podcast. We love having you as part of our community. If you love this podcast, please share it with your friends and family on social media, and have a happy, healthy week! We're huge advocates of elevating your health game with nutrition, supplements, and vitamins. Whether it's a daily boost or targeted support, we trust and use Momentous products to supercharge our wellness journey.  Momentous only uses the highest-quality ingredients, and every single product is rigorously tested by independent third parties to ensure their products deliver on their promise to bring you the best supplements on the market. 

The Federal Reserve has thus far not deviated from its projections of 3 federal funds rate reductions in 2024, but it is in no hurry to start. While current elevated rates are not ideal for multifamily borrowers, multifamily investors with a longer-term view of the apartment market and housing demand have markedly increased their intentions to invest this year. Sources discussed in this episode: The Wall Street Journal: “Stocks Gain after Fed Holds Rates Steady” - https://www.wsj.com/livecoverage/fed-meeting-fomc-interest-rate-decision-march-2024 Trepp: "Trepp Property Price Index (TPPI): Rate Cut Speculations Shape Varied Property Sector Performance in Q4 2023" - https://www.trepp.com/trepptalk/tppi-2023-q4-rate-cut-speculations-shape-varied-property-sector-performances Cushman & Wakefield - “Deciphering Today's Debt Market​” - https://www.cushmanwakefield.com/en/united-states/insights/deciphering-the-debt-market CNBC: “Biden targets ‘rent gouging' landlords as high housing costs factor into 2024 race” - https://www.cnbc.com/2024/03/19/biden-targets-rent-gouging-landlords-as-high-housing-costs-2024-race.html The White House: “FACT SHEET: President Biden Announces Plan to Lower Housing Costs for Working Families” - https://www.whitehouse.gov/briefing-room/statements-releases/2024/03/07/fact-sheet-president-biden-announces-plan-to-lower-housing-costs-for-working-families/ U.S. Department of Housing and Urban Development: "Existing Policy on Non-Rent Fees in Housing Choice Voucher (HCV) and Project-Based Voucher (PBV) Programs" - https://www.hud.gov/sites/dfiles/PIH/images/HCV_PBV%20Non-Rent%20Fees%20Chart_Final_2-21-24.pdf For the latest multifamily news from across the internet, visit the Gray Report website: ⁠https://www.grayreport.com/⁠ Sign up for our free multifamily newsletter here: ⁠https://www.graycapitalllc.com/newsletter⁠ Learn more about Gray Capital's latest multifamily investment offering for accredited investors: https://www.graycapitalllc.com/new-offering/ DISCLAIMERS: This podcast does not constitute professional financial advice and is for educational/entertainment purposes only. This podcast is not an offer to invest. Any offering would be made through a private placement memorandum and would be limited to accredited investors.

According to an October 2023 study, 1 out of 4 adults is dealing with loneliness and/or isolation. Loneliness can have serious health implications, with social isolation being linked to an increased risk of several chronic diseases, such as diabetes and dementia, as well as mental health disorders, including anxiety and depression. It can also affect one financially in terms of lost income. Leaders in non-profits, as well as for-profit organizations, need to understand how to relate to someone who is caught in the spiral of despair, paranoia, and suspicion. Today, I had the chance to interview Matt Peacock, the executive director of Partners in Hope (PIH). PIH is an independent, collaborative ministry focused on eliminating social isolation in Central Texas. They connect neighbors in need with ongoing community support through unique partnerships with local churches, other nonprofits, and servant-hearted volunteers. Through the development of long-term relationships with our isolated neighbors, we connect them with a network of people in the community who can provide the physical, emotional, mental, and spiritual help they need. Learn more about PIH at https://pihtx.org. Get Matt's book, "Unexpected Connections," at UnexpectedConnections.org. If you liked this podcast, please: -subscribe -share it with others -write a review  **Let's stay connected.** Click ⁠⁠Deniseglee.com⁠⁠ to

Dr. Tesha Monteith talks with Dr. Cecilia Hvitfeldt Fuglsang about the effects of migraine and PIH on the risk of stroke and myocardial infarction. Read the related article in Neurology. Disclosures can be found at Neurology.org.

Merriam-Webster's Word of the Day for January 24, 2024 is: capitulate • kuh-PIH-chuh-layt • verb To capitulate is to surrender to an enemy, often after negotiating terms, or to stop trying to fight or resist something. // After months of organized boycotts, company officials finally capitulated to the protesters' demands and announced significant changes to their practices. // The teacher refused to capitulate: no calculators were to be used during the exam. See the entry > Examples: “With [Horst] Hrubesch reluctant to add more attacking thrust to the team until it was too late, it was an odd game to end an odd year for Germany. But you have to give credit to Wales. It would have been easy to capitulate in the final game, given their results, but they continued to show some fighting spirit and finally got a reward for their determined play, pressing the visiting defence and working as a group to claim their first point of the campaign.” — Sophie Lawson, ESPN United Kingdom, 6 Dec. 2023 Did you know? We hope you'll acquiesce to some history about capitulate because we can't resist. When it first entered English in the 16th century, capitulate meant “to discuss terms with an enemy; to negotiate.” Its Latin source is more bookshelf than battlefield: the Medieval Latin word capitulare means “to distinguish [text] by chapters or headings,” as well as “to stipulate in an agreement.” The original “negotiate” sense of capitulate is now rarely heard, and today capitulate typically stresses surrender, whether to agreed-upon terms or in hopelessness before an irresistible opposing force (as in “team owners capitulated to the demands of the players' union”).

In our third episode will be speaking to Christa Michaud from Partners in Health. Christa is a Senior Development Officer on the Major and Principal Gifts team at Partners In Health, a social justice nonprofit that provides high quality health care to those who need it most. In addition to helping generate the funding needed to support PIH's mission, Christa also contributes to several of the organizations Equity, Diversity and Inclusion initiatives. Before transitioning to the nonprofit sector 13 years ago, Christa spent more than a decade working at marketing communications firms across the Midwest, developing and managing multi-million-dollar advertising, public relations, and global brand campaigns.   A native of St. Louis, MO, Christa has been a Miami Beach resident for seven years. She holds a Bachelor of Journalism degree from the Missouri School of Journalism at the University of Missouri-Columbia. Christa is a member of the Gamma Zeta Omega Chapter of Alpha Kappa Alpha Sorority, Incorporated and 100+ Women Who Care Miami Beach. You can find out more about Partners in Health here: https://www.pih.org/

Is chemical exfoliation better than physical exfoliation, how often should you use chemical exfoliation, what works for PIE, PIH and can we really erase our pores? I'm taking these burning questions to Justin Spracklin nursing student and derm laser specialist better known as @maximumskin Watch this episode on YouTube Connect with Justin: Instagram Tik Tok YouTube ⁠ Connect with Kelly: ⁠⁠⁠⁠YouTube⁠⁠⁠⁠ ⁠⁠⁠⁠Instagram⁠⁠⁠⁠ ⁠⁠⁠⁠Tik Tok --- Send in a voice message: https://podcasters.spotify.com/pod/show/unpackingbeauty/message

  Sponsored by PERQUE Integrative Health   It has long been known that dental and orthopedic devices and materials may have a negative impact on certain patients. In this interview, integrative medical expert and immunologist Russell Jaffe, MD, PhD, CCN, explains how to accurately identify immunocompatibility and risk for patients undergoing dental and/or orthopedic procedures. Jaffe explains how reactivity testing can be used to create more effective and less dangerous treatment plans for sensitive patients.   About the Expert Russell Jaffe, MD, PhD, CCN, CEO and Chairman of PERQUE Integrative Health, is one of the pioneers of integrative and regenerative medicine. Since inventing the world's first single-step amplified (ELISA) procedure in 1984, a process for measuring and monitoring all delayed allergies, Jaffe has continually sought new ways to help speed the transition from our current healthcare system's symptom-reactive model to a more functionally integrated, effective and compassionate system. PIH is the outcome of years of Jaffe's scientific research. It brings to market three decades of rethinking safer, more effective, novel and proprietary dietary supplements, supplement delivery systems, diagnostic testing, and validation studies.   About the Sponsor PERQUE Integrative Health (PIH) is dedicated to speeding the transition from sickness care to healthful caring. Delivering novel, personalized health solutions, PIH gives healthcare practitioners and patients the tools to achieve sustained optimal wellness. Combining the best in functional, evidence-based testing with premium professional supplements, and healthful lifestyle guides, PIH solutions deliver successful outcomes in even the toughest cases. Visit ELISAACT.com and PERQUE.com for more.

Community Warehouse and Partners in Hope host special skydiving event - Leap of Faith Saturday, August 19, 2023, Noon to 6:00 pmWisconsin Skydiving CenterN3407 County Road K, Jefferson, WI 53549Show your support and DONATE: The CommunityWarehouse and Partners In Hope- Milwaukee WIWhat's so special? 10 Milwaukee Police Officers and 10 previously incarcerated take a leap of faith together out of a plane. The first-ever event of its kind where two culturally divided groups come together and prove they can form bonds of friendship.Guest: Nancy Aliota a representative from Partners in Hope talks about the organization and the event.Show Highlights:Community Warehouse and Partners in Hope - Who they are?What's the mission and purpose?LocationsServices offeredWho is involved and how to get involved?How did the event Leap of Faith start and what's it all about?Why people are passionate about PIH?Community Warehouse Locations521 S. 9th Street Milwaukee, WI 532044110 W. Green Tree Road Milwaukee, WI 53209.Community Warehouse Social Media Links:WebsiteThe CommunityWarehouse and Partners In Hope- Milwaukee WIFacebookhttps://www.facebook.com/thecommunitywarehouse.orgInstagramTheCommunity Warehouse (@the.community.warehouse) • Instagram photos and videosLinkedIn(8) TheCommunity Warehouse : Overview | LinkedInA Prisoner's PardonFor help with a pardon application email michelle@prisonerspardon.com Advertisement– A Prisoner's Pardon Book by C.C. Skye Book Trailer: https://drive.google.com/file/d/1_dDQrWXk3lc8B-qQDuIgWjTqa2rMxOmv/view?usp=drive_linkAmazon Link: A Prisoner's Pardon: Only Through AFather's Love: Skye, C.C., Foth-Regner,Kitty, Fallahee, Kate:9798988355625: Amazon.com: BooksOn sale now on Amazon is the long-awaited book APrisoner's Pardon, Only through

Is healthcare a human right? That's today's big question, and it clearly shouldn't be a question, but here we are. My guest to help explain the obvious today is Dr. Sheila Davis, the CEO of Partners in Health. Sheila entered the global health arena in 1999, responding to the global HIV and AIDS pandemic. A few years later, she co-founded a small NGO that worked in both South Africa and Boston on a wide array of health projects, including the operation of a rural village nurse clinic. She joined PIH in 2010 as their main operation in Haiti was torn apart by the earthquake there and worked her way up over the years, becoming the Chief of the Ebola response during the 2014-2016 West Africa epidemic. And then as the Chief of Clinical Operations and the Chief Nursing Officer, Sheila oversaw nursing efforts as well as the supply chain, medical informatics, laboratory infrastructure, and quality improvement activities.Dr. Davis is a frequent national speaker on global health and clinical topics, including HIV and AIDS, the Ebola epidemic, leadership in public health, and the role of nursing and human rights. And folks, if it is not clear enough for the past few years, just in the US, much less everywhere around the world, yes, healthcare is a human right, and everyone deserves a fair shake. -----------Have feedback or questions? Tweet us, or send a message to questions@importantnotimportant.comNew here? Get started with our fan favorite episodes at podcast.importantnotimportant.com.-----------INI Book Club:Devotions by Mary Oliver (a starting point, as one of many Mary Oliver poetry selections)Mountains Beyond Mountains by Paul FarmerAbove Ground by Clint SmithFind all of our guest recommendations at the INI Book Club: https://bookshop.org/lists/important-not-important-book-clubLinks:Get involved with Partners In HealthFollow Dr Davis on TwitterFollow us:Subscribe to our newsletter at importantnotimportant.comFollow us on Twitter: twitter.com/ImportantNotImpSubscribe to our YouTube channelFollow Quinn: twitter.com/quinnemmettEdited by Anthony...

Dr. Paul Farmer unexpectedly passed away on February 21, 2022.   He was 62.  Trained as physician and medical anthropologist, Dr. Farmer was known moreover for his healthcare work in Haiti that he more formally forwarded via Partners in Health (PIH), an organization he cofounded in 1987.   Over the subsequent years Dr. Farmer and PIH expanded their work around the world in Africa, Russia, South America and in the US.  Dr. Farmer and his colleagues were also widely known for their international efforts to address multi-drug resistant tuberculosis (MDR TB).  Among other notable achievements, Dr. Farmer served as a University Professor and a department chair at Harvard, served in United Nations' positions, on numerous boards and as editor in chief of Health and Human Rights.  He authored over 100 articles and a dozen books.  His most recent was the 2020 work, “Fevers, Feuds and Diamonds: Ebola and the Ravages of History.”  Among numerous awards Dr. Farmer received a MacArthur fellowship, was elected to the National Academy of Sciences was the recipient of numerous honorary doctorate degrees and prizes.  (Listeners may recall I interviewed Dr. Reinhart on June 24, 2021 regarding mass incarceration, public health and structural racism during the COVID era.)During this 38-minute conversation, Dr. Reinhart begins by noting his relationship with Dr. Farmer.  He goes on to discuss or attempt to interpret Dr. Farmer's work, what informed his work or motivated him, how he pursued his work and what might his legacy be or should be.       Dr. Eric Reinhart is a political anthropologist, psychoanalyst, and physician.  His teaching and research addresses the anthropology of law, inequality, and public health; psychoanalysis, ethnography, and aesthetic politics; and medicine, policing, and logics of apartheid and abolition.  In addition, he conducts conduct policy-oriented public health research to address carceral-community epidemiology,  or how the health and welfare of incarcerated people are always intertwined with that of broader communities. The work examines systemic prejudice in healthcare and legal systems, the uses of confinement and punishment in the US and internationally, and large-scale decarceration policies in relation to public health and safety, pandemic preparedness, and biosecurity.  His research has been published in medical and legal journals including The New England Journal of Medicine, The Lancet, Proceedings of the National Academy of Sciences, Health Affairs, and Journal of Legal Studies – and in popular media venues, such as The New York Times, The Atlantic, TIME, Slate, The Nation, Boston Review, The New Republic, and USA TODAY.  This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

We are sharing all about Glymed Plus peels on today's episode! First, what is a peel? Peels can improve texture and scarring, reduce fine lines and wrinkles, reduce age spots, melasma, and PIH, strengthen the skin, keep it hydrated, helps most types of acne, improves dark spots under the eyes, and more! We have a specific episode about peels that we encourage you to listen to if you want more information! Glymed Plus has amazing products and we specifically love their peels! Here are a few of our favorites that we share all about: Peptide Perfection Peel: Filled with 5% lactic acid, 5% mandelic acid, 5% malic acid so you are getting brightening, lifting, firming, peptides, and it lifts and calms the skin. Perfect for an instant glow up for a same day event or next day event. Oxygen Peel: Made up of 5% lactic acid and oxygen. Helps with dullness, kills bacteria and helps with congestion. This is a good supportive peel that can be used with a variety of masks. We specifically love it with the deep pore cleanser. Lactic Action 30: Filled with 30% lactic acid and calming herbal extracts. Good for brightening, tightening, hydration, reducing fine lines and wrinkles, increasing skin elasticity, and reducing pigmentation. 5-Berry Pigment Control Peel: Made up of 7% TCA and 5 natural berries: cranberry, raspberry, blueberry, blackberry, and bearberry. Perfect for acne, anti-aging, and hyper-pigmentation, with the reparative, protective, and anti-aging benefits of the berries. Peels are a perfect addition to your winter skincare routine! Keep in mind that peels need a good at-home routine to help prepare your skin and always be using SPF on your skin! If you don't have a good at-home skincare routine yet, set up a virtual skincare consult so we can get you going on a good routine prior to starting a peel in the studio! Drink of the episode: Toasted Marshmallow Cold Brew Ingredients: Bizzy coffee toasted marshmallow cold brew, chobani spice pumpkin oat milk creamer, whip cream, and top with pumpkin spice seasoning on top! Connect with us: Please send cocktail recipes or topic ideas to hello@theskyndistillery.com or leave us a voice memo. Click here to set up a Virtual Skincare Consult Click here to shop our Skincare Be sure to follow and tag us on IG! @theskyndistillery @theskyndistillerylounge Subscribe to our Email List by visiting our website HERE --- Send in a voice message: https://anchor.fm/theskyndistillerylounge/message Support this podcast: https://anchor.fm/theskyndistillerylounge/support

Last time we spoke Rear Admiral Seymour took the charge as he waged war first on the city of Canton to hunt down the seemingly tyrannical Ye Mingchen. Seymour took the city quickly and with ease, but knew he had no way to hold onto it so he opted to start capturing all the forts he could along the riverways. Meanwhile back in Britain, the politicians were raging over the entire conflict and what was to be the best course of action. The Torries and Whigs fought another to use the issue for their own interests and it seems the Torries might be successful at thwarting the need for another war with China, but not if the Whigs had anything to say about it. Now a new figure will come to the forefront to be placed in charge of the China issue and it will consume his life. Welcome to the Fall and Rise of China Podcast, I am your dutiful host Craig Watson. But, before we start I want to also remind you this podcast is only made possible through the efforts of Kings and Generals over at Youtube. Perhaps you want to learn more about the history of Asia? Kings and Generals have an assortment of episodes on history of asia and much more  so go give them a look over on Youtube. So please subscribe to Kings and Generals over at Youtube and to continue helping us produce this content please check out www.patreon.com/kingsandgenerals. If you are still hungry for some more history related content, over on my channel, the Pacific War Channel where I cover the history of China and Japan from the 19th century until the end of the Pacific War. #20 This episode is Part 2 of the Second Opium War: Lord Elgin's reluctant War Now outside parliament, the British public was in a jingoistic mood after winning the Crimean War. Palmerston began to appeal to the masses on the basis of patriotism. Meanwhile the Prime Minister decided to appoint a plenipotentiary to carry out negotiations with the Qing court. The Duke of Newcastle was Palmerstons first choice, but he rejected the job as he knew it would be a thankless one and would earn him no favors. On March 13th, in the middle of a general election, Palmerston announced a new appointment for the new envoy to China. It was the popular Scotsman, former governor of Jamaica and British North America, James Bruce the Earl of Elgin, a direct descendant of Robert the Bruce. Lord Elgin was the son of a famous antiquarian who had notoriously preserved or better said vandalized, if you're Greek, parts of Ancient Athens by shipping them back to Britain. Yes the British museum issue. Elgin also sold these pieces of history in question to the British Museum at around 35,000 pounds in 1816 before going bankrupt and leaving England in exile to escape creditors. So yeah daddy was not a good person so to say. Ironically Elgin's fathers actions would haunt him in this story, because he would perform a heinous act on a similar level. During the 3 day voting period that began on March 28th of 1857, the Whigs managed to return to office with a landslide victory. Turns out Palmerston had won the public over, alongside the Queen and now parliament.  The day before Palmerston named Elgin the plenipotentiary to China, Elgin wrote to his wife “My Dearest, I have had a note from [Palmerston] followed by an interview. The proposal is to undertake a special mission of a few months' duration to settle the important and difficult question now embarrassing us in the East and concentrating the attention of all the world. On what grounds can I decline? Not on political grounds for however opposed I might be to the Govt. that would be a reason to prevent them from making the offer, but not me from accepting it. The very mission of a Plenipotentiary is an admission that there are errors of policy to be repaired.” Elgin's wife responded “Dearest, it was unexpected but if your conscience and feelings tell you to say yes I would not for the world dissuade you. God bless you my own darling. I promise you to do my best not to distress you. Forgive me if I can't write more today. Your own ever Mary.” Now Lord Elgin had a very impressive career, as I said he had been the governor of Jamaica and the governor-general of British North America, I live in quebec and he is quite the figure here. There is a statue of him in front of the Quebec parliament building. Lord Elgin attempted to establish responsible government to Canada, wrestled issues of immigration to Canada and took a surprising stance during a French English conflict. You see there were rebellions in what was then Upper and Lower Canada over various colonial issues. Lord Elgin ended up compensating French Canadians who had suffered during the rebellions and this greatly pissed off his British colleagues. On top of that Elgin invited the leader of the lower Canada revolt, Papineau to dine with him at the governor-generals residence in Canada. An English mob began burning parliament buildings in montreal, Elgin was assaulted, but instead of calling in the military, Elgin got his family to safety and allowed civil authorities to restore order. Anyways Elgin did a lot in Canada such as setting up economic treaties with the US and such, he is a large figure in my countries history, though I'd argue not many Canadians are even aware of him haha. Canadian history can be, the best way to put it, a bit boring. Now back to the story at hand, Lord Elgin was a very well regarded figure for his capabilities and royal blood. But he also held a ton of debt from his father, the Greek artifact plunderer. Elgin was notably not xenophobic in a time when many British were. Elgin spoke English and French and was a highly educated man. The day before Elgin set off for China he was given detailed instructions from Lord Clarendon. Clarendon ordered Elgin that under no circumstance was he to try and retake Canton, a tall order since Bowring and Seymour were literally trying to do just that. Clarendon stated he was to acquire the right for Britain to send an ambassador to Beijing to conduct and direct negotiations with the Qing imperial court. He was to demand the opening of new ports of trade and to force the Qing government to adhere to the terms of the treaty of Nanjing. Military force was to be only a last resort if the Emperor refused and Elgin was urged to contain the military action to naval attacks only to save British lives. Elgin had his own demand, he wanted the British military forces in China to be under his sole command. Britain ended up giving Elgin joint command alongside Lt Generals Ashburnham and Seymour who could decide when and where to attack. Elgin made record time journeying to China by riding on the brand new railroad that cut across the Isthmus of Suez. From Suez he took a ship, rounding the coast of India in late May. Elgin came across troops who had been summoned from Bombay and Calcutta. Interesting side note, in May, Sepoy's, those being Indian troops of the East India Company Army, stationed in Meerut performed a mutiny. They had refused to follow orders from the British officers and on May 10th, an entire garrison killed their officers, their families and any Europeans in the vicinity. Word spread of the mutiny resulting in similar outbreaks amongst other sepoy units. Within just a few days there was a widespread rebellion as some Indian prince joined, rallying against the British Raj. Northern India was ablaze with bloodshed and it looked like Britain was at threat of losing its greatest colony. Elgin arrived in Singapore on June 3rd where he was met with two letters from Lord Canning the governor general of india. The letters told Elgin the dire news and begged him to divert troops assigned to the China mission to come help in India. Canning was an old classmate of Elgin and said “If you send me troops they shall not be kept one hour more than is absolutely needed.” Elgin had no time to consult with Plamerston or Clarendon, as it would take 2 months to get word back to London. Without hesitation Elgin diverted 1700 men of the 90th regiment from Mauritius to help quell the rebellion. I obviously cant go into the Indian Rebellion of 1857, but just want to say if you get a chance do learnt about it, an absolutely horrible event. Around 150,000 Indians were killed in the rebellion with 100,000 of them being civilians. The British suffered around 6000 troops and 40,000 civilians killed. The British forces performed massacres and numerous atrocities in places like Delhi, Kanpur, Lucknow and Allahabad. On top of the war deaths, it is estimated up to a possible 800,000 Indians would die from famine and disease as well. A truly horrible event.  Back to Elgin, he faced a period in Singapore where he had to await some troops from India to come over to China and during this period he began to study the China situation. Elgin visited an opium den in Singapore to witness the evil effects of the drug firsthand. He wrote this to his wife about the experience  “They are wretched, dark places with little lamps. The opium looks like treacle, and the smokers are haggard and stupefied, except at the moment of inhaling, when an unnatural brightness sparkles from their eyes,” As a result of dispatching men to India to help Canning, Elgin now had to go to China aboard a single ship, the Shannon without any troops. He arrived in Hong Kong on July 2nd of 1857 and was welcomed warmly by the Chinese. Seymour was not all too pleased to find Elgin arriving without any troops. Seymour soon pressed Elgin to form an attack on Canton, handing to him a petition signed by 85 British opium merchants who all believed if Canton fell to the British, the Emperor would have to capitulate to all of their demands. Elgin did not give in to the pressure, though he also did not have the troops to carry out the task regardless.  Elgin then began to brush shoulders with Harry Parkes and they did not get off on the right foot. Parks said of Elgin  “He may be a man that suits the government well, very cautious, having ever before him [placating] Parliament, the world, the public, etc.” Parkes soon began a campaign against Elgin by sending a ton of letters back home criticizing Elgin for what he called “too generous a treatment of the Chinese”. As warhawkish as Seymour and Parkes could be, it was Bowring who really brought the heat. Bowring felt demoted by Elgin's new position and began to work behind the scenes to bring Elgin down. Bowring also began to lecture Elgin on the imperative for  full scale military action against Canton. “There is quite an explosion of public opinion as to the fatal mistake which would be committed by any movement upon Peking until the Cantonese question is settled. Many think such a movement might imperil the whole trade of China. I am quite of the opinion that any action which refers the Canton question to the Emperor would be a most injurious and embarrassing step.” Elgin for the most part ignored Bowring and opted instead for negotiations as were his instructions. Elgin also shared a concern it seems the other men did not, Elgin worried about tearing China apart. Elgin did not want to topple the Manchu rulers of China and throw the nation into some Balkanization hellscape which would only make things harder for Britain to deal with. The Taiping and their talk of banning private property scared Elgin, who knew Britain's trade would be hurt by such rule. In the end Elgin did not wait for his reinforcements from India, he instead went to India himself. Elgin gathered a small force of 400 marines and sailors aboard the 55 gun ship Shannon and sailed for Calcutta. Elgin made it to Calcutta on June 14th where he found the city abandoned by its European residents. Turned out there was a rumor the Sepoy's were going to march into the city to slaughter the Europeans so they all fled, the rumor proved to be false however. Elgin was mortified by the situation in India. He was lambasted with horror stories of sexual atrocities committed against British subjects and mass hangings in reprisal. One Major Renard, ordered the execution of 12 Indians for allegedly turning their faces the wrong way as Renards troops marched past them. That same Major also allegedly burnt down every Indian village he passed and hung 42 villagers along the way. Elgin sent a letter back to his wife  “I have seldom from man or woman since I came to the East heard a sentence that was reconcilable with the hypothesis that Christianity had come into the world. Detestation, contempt, ferocity, vengeance, whether Chinamen or Indians be the object.” Elgin hopped aboard the steamship Ava on september 20th to return to China. Back in China, Bowring had taken advantage of Elgin's trip by making overtures to Ye Mingchen in violation of Britain's instructions that the Chinese viceroy should only deal with Elgin. When Elgin found out and confronted Bowring, Bowring simply denied it. A month after Elgin had arrived to China, his French counterpart arrived, Baron Gros. The French aristocrat quickly began to share Elgin's hatred for Bowring upon meeting the man. Gros and Elgin both agreed to disagree with Bowring's ideas from the offset. Gros and Elgin agreed the response to the arsenic bakery debacle and the murder of Father Chapedelaine, would be a well coordinated, measured and hopefully light on military deaths. Gros advocated for an attack upon Beijing, while Elgin urged for negotiation. However, foreign minister Clarendon chose another option. Clarendon sent Elgin a letter on October 14th supporting Bowrings ideas. Winter was fast approaching, and the Bei He River, the gateway to Beijing would be frozen before an allied army could reach the city gates. Thus Clarendon advocated for an attack on Canton. Elgin was forced to allow Bowring to take the lead. In november, William Reed, the new American Minister showed up aboard the 55 gun steamship Minnesota. Reed was instructed by his government that America would remain neutral in the inevitable conflict. Russia's emissary, Count Euphemius Putiatin also arrived in november aboard the Amerika. Putiatin brought with him a proposal for China, if the emperor would give Manchuria to the Russians, the Tsar would help the Qing stamp out the Taiping Rebels once and for all. So each of the 4 nations brought their representatives looking to strike a deal with the Qing dynasty. In December of 1857, 3 ships carrying 2000 British soldiers from Calcutta sailed into Canton's harbor followed by a French fleet led by Admiral Rigault de Genouilly. Elgin and Gros sent Ye Mingchen separate ultimatums. France demanded the murderers of Father Chapedelaine to be brought to justice, reparations and permission to operate unrestricted in Canton. Britain demanded compliance with the terms of the treaty of Nanjing; a permanent British ambassador in Beijing; and unspecified reparations for the loss of life and property. Elgin felt his demands were reasonable, but also knew full well they were unacceptable for the Emperor. Ye Mingchen believed the demands to be mere posturing rather than actual threats. He did not have the authority to satisfy the British and French ultimata. So he did nothing…well nothing is a strong word he actually began spending his time by beheading 400 Taiping and placed their heads on spikes atop Cantons walls. It seems perhaps Ye believed such actions would scare off the foreigners, because he had no real army or navy to back him up. Well his brutality against the Taiping sure backfired. The British enlisted 700 really enraged Hakka to man the artillery at the Dutch Folly which was across the Pearl River near the foreign factories. Hakka if you remember made up some of the Taiping ranks as they were a persecuted ethnic minority in Guangxi province. 8 British and 4 French steamships arrived to the scene to add extra military might.  Ye Mingchen replied to the British and French in separate letters. To the British Ye stated, that in 1850 Sir George Bonham had agreed to give up access to Canton to avoid a war with the Qing dynasty. Ye heard that Bonham was given the Order of Bath and perhaps if Elgin did likewise he could also receive such a title. Ye was not aware that the title of Earl was high than that of Sir, but give the guy some credit for doing some homework on the foreign advisory. As for the treaty of Nanjing, Ye simply stated the Emperor declared the terms would be held inviolate for 10 millennium, it would be suicide to go against the Emperor. Ye sent a similar letter to the French and while he made these rather coy and cheeky remarks he did not seem to grasp the very real war threat going on. It may have been because he was too distracted by the Taiping rebellion, which to be brutally honest was a much more pressing concern, regardless Ye lacked any real strategy with how to deal with the foreign threat. When the British and French landed on Henan island, opposite of Canton of December 15th, Ye apparently made no move. The British and French disembarked without any resistance and found the strategic island undefended and without fortification. 200 Chinese war junks and sampans near Henan island fled as soon as the British and French had arrived.  On December 21st, Elgin, Gros and Putiatin had a talk aboard the French flagship Audacieuse. They all agreed to give Ye Mingchen one more chance before the shelling of Canton began. They sent Ye a 2 day deadline to meet their demands. As they waited Elgin wrote in his diary “Canton the great city doomed I fear to destruction by the folly of its own rulers and the vanity and levity of ours.” While they waited for 2 days, Elgin and Gros discussed military organization. Admiral Seymour and Rigault would command sea forces, while land troops would be commanded by General Ashburnham. On paper the invaders seemed to be completely out gunned. Canton's 6 mile wall circumference was 25 feet high and 20 feet wide. The allied force amounted to 800 men of the Indian Royal Sappers and Miners and the British 59th regiment of Foot, 2100 Royal marines, 1829 men of a British naval brigade and 950 men of the French Navy. The Qing forces were 30,000 strong at Canton, they were outnumbered 5 to 1. The Europeans did have one major tactical advantage however. The European ship born artillery had superior range and firepower compared to Cantons gun and their position on Henan island was within shelling distance of Canton.  On December 22nd, Ye's deadline ran out, but Elgin and Gros hesitated. On December 24th, perhaps because it was so close to Christmas they decided to give the Viceroy another 3 days to accept their terms, but Ye did not respond. On the evening of the 27th, the Europeans sent a reconnaissance team ashore a mile from the city's walls. On the morning of the 28th, the Anglo-Franco armada began shelling the city with artillery support from Henan. The bombardment went on for an entire day and on top of the shells, the europeans also fired incendiary rockets. It is alleged the Qing defenders only tossed back 2 shells. It is estimated the Chinese suffered almost 200 casualties to the shelling, while the incendiary rockets lit parts of Canton ablaze.While the day long shelling was raging on, 500 British and French forces landed and made their way through some rice paddies and came across a cemetery. At the cemetery Qing soldiers were taking up positions behind tombstones. Many of the Qing soldiers were armed with an 18th century weapon known as a Jingall. Now if you have a chance to google these, please do because they are comical to say the least. Its a muzzle loaded giant musket, the barrel is around 60 inches. Usually these were mount on walls, but they could be placed on tipods or on the shoulder of a comrade while you shoot it. Picture a comically big musket and thats basically what it looks like. In the west we call them “wall guns”, anyways they are extremely impractical. So for the Qing it took at minimum 2 men to fire one Jingall and usually when they fired them, the kick back knocked the men to the ground which provided quite the slapstick humor for the Europeans witnessing it. Many of the Qing soldiers also fired bow and arrow alongside some firelock muskets. On the other side, the British and French were using 19th century rifles, such as the British Enfield Rifle and French Minie rifle. Basically it was like Mike Tyson fighting an infant. The Europeans began to take up positions behind tombstones similar to the Qing. During the night the european formed an HQ in a temple on the cemetery grounds and apparently did nothing while some of their soldiers began to ransack the cemetery's statuaries thinking they would find gems or gold inside them. Dawn of the next day, the Europeans woke up to a shocking sight. On the hills behind Canton emerged 1500 Qing soldiers. The Qing soldiers had fled the battle to go atop the hill and were simply staring at the Europeans like they were watching a sports game. It seems Ye's brutality had caused a lot of dissatisfaction amongst the local populace and this resulted in quite the lackluster will to fight. At 9am Admiral Rigault personally led French troops towards the walls of canton carrying scaling ladders. The defenders on top of the walls provided little resistance, while some Chinese artillery on some nearby hills tried to shell the invaders. By 10am British and French flags were flying from the 5 story Pagoda near the walls. Alongside the wall climbing, the British stormed the East Gate of the city with ease. Over 4700 British, Indian alongside 950 French troops scaled the walls in total. Seymour and Rigault had stopped the shelling to allow the troops to get atop the walls and began to fire again, but Elgin quickly forced them to stop deeming it overkill. The death toll was incredibly lopsided, the French reported 3 men dead and 30 wounded, the British reported 13 men dead with around 83 wounded. The Qing suffered upto a possible 650 casualties. The allies set to work hunting Ye Mingchen who they believed was still hiding in the city. Ye's second in command Pih-kwei came out suddenly making a proclamation that he would no longer associate himself with Ye Mingchen nor his disastrous policies. On New Years day, Elgin made a tour of Canton and noticed a lack of resistance, confirming to himself he made the right decision to halt the shelling. Then Elgin witnessed large scale looting. Elgin's private secretary Laurence Oliphant noted “While honest Jack was flourishing down the street with a broad grin of triumph on his face, a bowl of goldfish under one arm and a cage of canary-birds under the other, honest Jean, with a demure countenance and no external display, was conveying his well-lined pockets to the waterside.” It seemed the French preferred to grab cash while the British sought out souvenirs. Elgin feared losing control of the men and ordered them to all stop looting, but he had no authority for the French forces. Upon seeing that the French were not halting their looting, the British soldiers soon rejoined the plundering spree. Elgin lamented the situation in his diary “My difficulty has been to prevent the wretched Cantonese from being plundered and bullied. There is a [Hindi] word called ‘loot' which gives unfortunately a venial character to what would, in common English, be styled robbery. Add to this that there is no flogging in the French Army, so that it is impossible to punish men committing this class of offenses.” The son of Howqua and other Cohong merchants began to petition Elgin to do something to restore order and stop the plunder and destruction of Canton. Within mere days of the city's occupation, 90% of its inhabitants fled the city. One thing Elgin did not seem to mind though was “official expropriations” and sent one Colonel Lemon with a few Royal marines to Canton's treasury where they seized 52 boxes of silver, 68 boxes of gold ingots and over a millions dollars worth in silver taels. This “legal plunder” wink wink, was put aboard the HMS Calcutta and sent post haste to India. After all, the war had to be paid for.  On January 5th, over 8000 British and French marched through the gates of Canton unopposed. Harry Parkes grabbed a squad of 100 Royal Marines and rushed over to Ye Mingchens residence armed with a miniature of the man to identify him. This was quite the smart move, because many of Ye Mingchen's subordinates had attempted to pass themselves off as the viceroy to protect him. Well the tactic provided results as they caught Ye as he was trying to climb over the rear wall of his residence. A marine seized Ye by his queue and dragged the man to a sedan chair enclosed with bars to humiliate him. The tiny prison was put aboard the steamship Inflexible to an audience of Europeans and many Hakka, including Taiping rebels who taunted the disgraced viceroy by making the slashing throat gesture. When the marines searching Ye's residence they came across his letters back to the Qing court, giving them a ton of insight into how the Qing worked. That same day, Elgin and Gross named Ye's second in command, Pih-Kwei the new governor of Canton, but he would be advised by the triumvirate of Parkes, Captain Martineau and Colonel Holloway. The 3 real powers behind Pih-Kwei were granted control of judiciary, and to vet edicts before they were promulgated. Each man spoke Chinese and would report to Clarendon. Elgin wrote to Clarendon to explain the situation “If Pih-kwei was removed or harshly dealt with we should be called upon to govern a city containing many hundred thousand inhabitants with hardly any means of communicating with the people.” The Europeans also created a police force for Canton to stop all the looting and restore confidence in the once great commercial city. Howqua, his son and the other Cohong merchants found the new situation with the Europeans a far better deal than what would occur if the Taiping took Canton. Pih-Kwei received secret instructions from Beijing on January 27th, ordering him to organize an army of civilians and kick the invaders out. He also received orders from Seymour to hand over 17 Chinese war junks to help fight off a Taiping fleet obstructing the Pearl River. On the 28th, 2 french warships, the Fusee and Mitraille both shelled Ye's residence to further Ye's punishment. Ye's subordinates made attempts to rescue him from his prison, so Elgin sent Ye into exile to Calcutta on February 20th. In Calcutta Ye lived under house arrest for a year until he starved himself to death. Back over in Canton, the 70th Sepoy regiment arrived in March to reinforce Canton's garrison. The Sepoys were delighted when they found out 200 Chinese servants were assigned to them as they had been dealing with a lot of racism. Notably the British called them the N word and the French killed 3 Sepoys claiming they were looting. No Europeans were ever shot for looting in Canton. Elgin, Seymour and Gross then took a naval squadron up north towards the mouth of the Bei He River by April 24th. The British, French and Russian plenipotentiaries sent a joint communique to the governor of Zhili province, Tan. Elgin, ever the pacifist, tried to negotiate a way out of further bloodshed writing to Tan to see if they could meet a minister duly authorized by Emperor Xianfeng. Tan performed the standard Chinese response, by stalling and claiming he didn't have the power to negotiate with them. Apparently in his letter response, he used larger characters for the Emperor than that of Queen Victoria which infuriated the British as it was yet again in violation of the terms to the treaty of Nanjing, that both nations be considered equal. Ironically if you think about it, the British and Qing were both so uptight about such status symbols and such. Tan sent another letter that indicated the Chinese position was shifting somewhat, iit offer some negotiation, opened some ports, granted religious freedom to Christians and agreed to pay reparations for the foreign factories being destroyed in 1856. Tan also said he passed on the Europeans request for an embassy in Beijing to the Emperor. What he did not tell them, was that the Emperor rejected that request outright. Putiatin in an attempt to avoid further bloodshed pleaded with the parties to accept this offer, but allegedly the French Foriegn office replied to him with a smirk “they are only Chinese lives”. On a bit of a side note, a rather remarkable thing occurred on the Russian side of this story at this time. The Archimandrite, named Palladius, something of a spiritual leader to a tiny population of Russians living in Beijing was granted permission by Emperor Xianfeng to visit the European fleet at the end of may. He was forced to travel in a sealed litter. Prior to leaving, Putiatin got word to the man ordering him to gather as much intelligence as he could traveling towards them. Palladius was able to peer through a small crack in the shutter and did his best to get details on the position of the Qing fleet. When Palladius arrived he brought with him great news, apparently Beijing was starving and the rambunctious life of the Emperor was catching up to him. Please note the Emperor was only 30 years old, guy must have really partied it up. Another thing the Emperor was doing was strongly contemplating leaving the country because he was terrified. Meanwhile Elgin's anxiety was being lifted day by day as more warships arrived. By late May, the combined Anglo-French fleet was now 26 gunboats strong, preparing to take on the famous Taku Forts that guarded the mouth of the Bei He River. D-day was to be may 20th and the invaders were just 100 miles away from Beijing. I would like to take this time to remind you all that this podcast is only made possible through the efforts of Kings and Generals over at Youtube. Please go subscribe to Kings and Generals over at Youtube and to continue helping us produce this content please check out www.patreon.com/kingsandgenerals. If you are still hungry after that, give my personal channel a look over at The Pacific War Channel at Youtube, it would mean a lot to me.  The reluctant Elgin had done it, they seized Canton and finally brought Ye Mingchen to British justice. The British French coalition was working its way slowly but surely to straggle Beijing and force its Emperor to abide by their demands.  

We're back for Season 2 of the Holistic Beauty Podcast! In today's episode we're talking about a highly requested topic – uneven skin tone and hyperpigmentation. Hyperpigmentation occurs when there is excess melanin (a substance that gives our skin color) being produced. It's typically a harmless condition but can cause significant distress and embarrassment in some individuals. The most common hyperpigmentation disorders include melasma, post-inflammatory hyperpigmentation (PIH), and solar lentigines. Join us in today's episode as we dive into hyperpigmentation and discuss helpful skincare active ingredients as well as aesthetic procedures to look into to help address uneven skin tone. Listen to the episode on Apple Podcasts, Spotify, Google Podcasts, Stitcher, TuneIn, or on your favorite podcast platform. Topics Covered: What is hyperpigmentation What causes hyperpigmentation to occur The most common hyperpigmentation disorders Research-backed skincare active ingredients for hyperpigmentation Our favorite products with these skincare active ingredients Research-backed aesthetic procedures for hyperpigmentation Our favorite aesthetic procedures that can help with hyperpigmentation Connect With Us: Connect with Dr. Bryant Esquejo on Instagram, Youtube, and TikTok Interested in becoming a patient in Los Angeles? Schedule an appointment online here! Visit Dr. Bryant's website: http://www.drbryantesquejo.com Connect with Dr. Marilyn Merola on Instagram and TikTok Interested in an aesthetic treatment in San Diego? Schedule a free 15-min phone consultation online here! Struggling with adult acne? Check out Dr. Merola's holistic acne course Glow From Within here. Use code “HOLISTICBEAUTY10” for 10% off! Visit Dr. Merola's website: https://lucerenaturalmedicine.com Follow the Holistic Beauty Podcast on Instagram. Questions or topic requests for the podcast? Send an email to holisticbeautypodcast@gmail.com.

In this interview, leading integrative health expert Russell Jaffe, MD, PhD, CCN, describes the key factors that control bone health and how to address those factors in clinical practice. Inspired by consistent clinical success achieved at the Center for Better Bones, Jaffe explains how diet, lifestyle, and dietary supplements can epigenetically influence bone health. Jaffe is an internist, immunologist, and director of PERQUE Integrative Health. He is also the co-author of the new book Natural Bone Health: A Practitioner's Guide to Healthy Bone, Joints and Muscles. About the Expert Russell M. Jaffe, MD, PhD, is CEO and chairman of PERQUE Integrative Health (PIH). He is considered one of the pioneers of integrative and regenerative medicine. Since inventing the world's first single step amplified (ELISA) procedure in 1984, a process for measuring and monitoring all delayed allergies, Jaffe has continually sought new ways to help speed the transition from our current healthcare system's symptom reactive model to a more functionally integrated, effective, and compassionate system. PIH is the outcome of years of Jaffe's scientific research. It brings to market 3 decades of rethinking safer, more effective, novel, and proprietary dietary supplements, supplement delivery systems, diagnostic testing, and validation studies. About the Sponsor PERQUE Integrative Health (PIH) is dedicated to speeding the transition from sickness care to healthful caring. Delivering novel, personalized health solutions, PIH gives physicians and their patients the tools needed to achieve sustained optimal wellness. Combining the best in functional, evidence-based testing with premium professional supplements and healthful lifestyle guides, PIH solutions deliver successful outcomes in even the toughest cases. If you are interested in delving more deeply into this and other integrative health topics, we invite you to join the PIH Academy.

Quand elle envisage la chirurgie bariatrique, Stéphanie rêve de dompter enfin son corps indocile. A travers son parcours pré-opératoire, sa fille qui grandit, les discussions nombreuses, elle découvre la fabrique de son obésité, et se déconstruit peu à peu en elle lʹimage dʹune monstruosité. Mon corps opératoire : une dérive bariatrique : un documentaire réalisé par Stéphanie Pihéry. Crédit image: S.Pihéry Mixage: Jean-Philippe Zwahlen - Musique Arthur B. Gilette Une production du Labo, Carmen Sage & Gérald Wang Avec Louison Sellier Docteur Raphaelle Audollent Claudie Pfeifer Réjane Nadal Stéfani Gicquiaud Solenne Carof Et l'aide de la bourse Brouillon d'un rêve sonore de la SCAM France

Recorded on 11 August 2022 for ICMDA Webinars. Dr Peter Saunders chairs a webinar and Q&A with Dr Perry Jansen Mission Hospitals operate in some of the most challenging environments in the world. Sustaining health services in a way that maintains quality while honoring God's call to serve the poor can seem unattainable. Prior ICMDA webinars have covered tools and approaches for managing mission hospitals. In this session, we will take the “30,000-foot view” of the complex and dynamic environments we operate in and how we can apply the science of “Systems Thinking” to improve strategies and impact. Dr Perry Jansen Dr. Jansen is a family physician and served with SIM in Malawi from 2000-2016. He founded the Malawi non-profit hospital Partners in Hope (PIH), which has grown to be one of the largest providers of HIV treatment in the region as a key training partner with the Ministry of Health and USAID. After realizing his goal of handing PIH over to Malawi leadership, Dr. Jansen attained his MPH, with an emphasis on global health leadership. Dr. Jansen is now Vice President at African Mission Healthcare leading initiatives to strengthen mission hospitals to expand medical education and strengthen indigenous healthcare leadership. To listen live to future ICMDA webinars, visit https://icmda.net/resources/webinars/

Following Episode 21 on pro bono assistance to disasters, host Alicia Aiken revisits our inaugural episode, which tells the story of how a corporate attorney at Schulte Roth & Zabel stepped up to help Partners In Health get clearance to deliver aid after a devastating earthquake in Haiti. This encore episode features a previously unreleased conversation with PIH co-founder Ophelia Dahl. PLI is proud to offer programs, pro bono memberships, and scholarships to support the essential public service work of the legal profession.  

This week, please join author Sanjiv Shah, Editorialist Evangelos Michelakis, and Associate Editor Justin Ezekowitz as they discuss the article "Latent Pulmonary Vascular Disease May Alter the Response to Therapeutic Atrial Shunt Device in Heart Failure" and Editorial "Atrial Shunt Devices in Patients with Heart Failure and Preserved or Mildly Reduced Ejection Fraction and the Pulmonary Circulation: Promises and Concerns." Dr. Carolyn Lam: Welcome to Circulation On The Run, your weekly podcast summary and backstage pass to the Journal and its editors. We're your co-hosts. I'm Dr. Carolyn Lam, Associate Editor from The National Heart Center and Duke National University of Singapore. Dr. Greg Hundley: And I'm Dr. Greg Hundley, Associate Editor, Director of the Pauley Heart Center at VCU Health, in Richmond, Virginia. Dr. Carolyn Lam: Greg, I love today's featured article. It's all about heart failure with mildly reduced and preserved ejection fraction, talking about device therapy and the response to therapeutic atrial shunt device. Now, this is a very interesting discussion of how specifically selecting patients based on latent pulmonary vascular disease may hold some answers, but we're going to keep everyone hanging here. You've got to, got to listen to the discussion. But first, we'd like to tell you about some of the papers in today's issue. And I think Greg, you've got one to start us with, right? Dr. Greg Hundley: Absolutely. Carolyn, thank you so much. Well, this first paper comes from Dr. Eliot Peyster from the University of Pennsylvania. And Carolyn, the aim of this study was to leverage computational methods for analyzing digital pathology images from routine endomyocardial biopsies, to develop a precision medicine tool for predicting cardiac allograft vasculopathy, years before overt clinical presentation. Dr. Carolyn Lam: Ooh, interesting. Again, precision tools. So what did they find? Dr. Greg Hundley: Right, Carolyn. So there was a clinical predictive model that achieved modest performance on the independent test set, with area under the receiver operating curve of 0.7. But interestingly, a histopath- predictive model for predicting cardiac allograft rejection achieved good performance, with an area under the receiver operating curve of 0.8. Most importantly, however, a model, incorporating both clinical and histopathologic features, achieved excellent predictive performance, with an area under the receiver operating curve of 0.93. Dr. Greg Hundley: So in summary, Carolyn, these authors found that prediction of future cardiac allograft vasculopathy development is greatly improved by incorporation of computationally extracted histologic features. Their results suggest morphologic details, contained within regularly obtained biopsy tissue, have the potential to enhance precision and personalization of treatment plans for post heart transplant patients. Dr. Carolyn Lam: Aw, that's cool. Makes so much sense, but yet so novel. Thanks. Dr. Carolyn Lam: Well, for the paper I want to talk about, we are going to talk about dapagliflozin. Now we know the SGLT-2 inhibitor, dapagliflozin, improved heart failure and kidney outcomes in patients with Type two diabetes with or at high risk for cardiovascular disease, in the DECLARE–TIMI 58 trial. In the current paper, authors, led by Dr. Wiviott from the TIMI study group, aimed to analyze the efficacy and safety of dapagliflozin stratified, according to baseline systolic blood pressure. Dr. Greg Hundley: Ah, so an interesting question, since SGLT-2 inhibitors are known to reduce blood pressure. And given the concerns regarding the safety of SGLT-2 inhibitors, in patients with low to normal systolic blood pressure. So Carolyn, what did they find? Dr. Carolyn Lam: Nicely put Greg. So in patients with type two diabetes with, or at high risk of, atherosclerotic cardiovascular disease, dapagliflozin reduced the risk for heart failure hospitalizations and renal outcomes, regardless of baseline systolic blood pressure, with no difference in benefit for reduction in heart failure or renal outcomes, among patients with blood pressure from the normal range, all the way to severe hypertension. Moreover, there appeared to be no difference in adverse events of volume depletion, acute kidney injury, or amputations, across the levels of baseline blood pressure. So these results indicate that dapagliflozin provides important cardiorenal benefits in patients with Type two diabetes at high risk, the independent of baseline blood pressure. Dr. Greg Hundley: Oh, very nice, Carolyn. Well, my next paper comes to us from the world of preclinical science, and it's from professor Jeffrey Towbin and colleagues, at Le Bonheur Children's Hospital. So Carolyn, as we know, arrhythmogenic cardiomyopathy is an inherited genetic disorder of desmosomal dysfunction, and plakophilin-2 has been reported to be the most common disease causing gene when mutation is positive. Now in the early concealed phase, the arrhythmogenic cardiomyopathy heart is at high risk of sudden cardiac death before cardiac remodeling occurs, due to mis-targeted ion channels and altered calcium handling. However, the results of pathogenic plakophilin-2 variants on myocyte contraction in arrhythmogenic cardiomyopathy pathogenesis, really remains unknown. So Carolyn, these authors studied the outcomes of a human truncating variant of plakophilin-2 on myocyte contraction, using a novel knock-in mouse model, as well as evaluation of human subjects. Dr. Carolyn Lam: Oh, interesting. So what were the results from this plakophilin-2 knock-in mouse model? Dr. Greg Hundley: Right, Carolyn. So serial echocardiography, a plakophilin-2 heterozygous mice revealed progressive failure of the right ventricle, but not the left ventricle, in animals older than three months of age. Now next, adrenergic stimulation enhanced the susceptibility of plakophilin-2 heterozygous hearts to tachyarrhythmia and sudden cardiac death. Contractility assessment of isolated myocytes demonstrated progressively reduced plakophilin-2 heterozygous RV cardiomyocyte function, consistent with right ventricular failure, measured by echocardiography. Dr. Greg Hundley: And the next, Western blotting of plakophilin-2 right ventricular homogenates revealed a 40% decrease in actin. In contrast, plakophilin-2 heterozygous left ventricular myocytes had normal contraction and actin expression. Dr. Greg Hundley: And finally, Carolyn, Western blotting of cardiac biopsies revealed actin expression was 40% decreased in the right ventricles of end stage arrhythmogenic cardiomyopathy patients. So in conclusion, Carolyn, during the early concealed phase of arrhythmogenic cardiomyopathy, reduced actin expression drives loss of RV myocyte contraction, and that contributes to progressive RV dysfunction. Dr. Carolyn Lam: Wow. Thanks, Greg. Well, also in today's issue, there's an exchange of letters among Drs. Whitman, Ibrahim, and Løfgren, regarding physics at the heart of the matter, referring to the article, “Anterior–Lateral Versus Anterior–Posterior Electrode Position for Cardioverting Atrial Fibrillation.” Dr. Greg Hundley: Right Carolyn. And also in the mail bag, there's an On My Mind piece, from Professor Taegtmeyer, entitled, “The 2022 Beijing Winter Olympics, The Spotlight On Cardiac Metabolism.” Dr. Greg Hundley: Well, how about we get onto that feature article, and learn a little bit more about atrial shunts, and how they may be helpful in heart failure with preserved ejection fraction? Dr. Carolyn Lam: Ooh, can't wait. Dr. Greg Hundley: Well, listeners, we have a very interesting feature discussion today related to hemodynamics pertaining to interatrial shunt devices, in those with and without pulmonary hypertension. And we have, gosh, a repertoire of speakers today. We have Dr. Sanjiv Shah, from Northwestern University in Chicago, Dr. Evangelos Michelakis, from Edmonton Alberta, and our own associate editor, Dr. Justin Ezekowitz, also from Edmonton Alberta. Dr. Greg Hundley: Well, Sanjiv, we're going to start with you. Describe for us, some of the background pertaining to your study, and what was the hypothesis that you wanted to address? Dr. Sanjiv Shah: Great. Thanks, Greg. Thanks for having me today. Well, the background of our study is that, it was a subgroup analysis, or a secondary analysis, of the REDUCE LAP-HF II trial. Now this trial has been in the making for over 12 years, almost 13 years. It started out as an idea that was David Celermajer. David is a pediatric cardiologist in Australia, who had this idea that, in mitral stenosis patients, it's well known that, if there's a concomitant secundum ASD, a congenital secundum ASD, in these patients with mitral stenosis do better. They have a way to unload the left atrium, and distribute that blood to the systemic veins and the right atrium, the right side of the heart. And so could this be helpful in quote, diastolic, heart failure or HFpEF? Dr. Sanjiv Shah: And so, I started working with him about 12 years ago. This started out as a concept. It was studied in animal models, and then in humans, in open label studies, and then, in a first randomized controlled trial. Where we showed, that an intraatrial shunt device, an iatrogenic ASD, so to speak, put in humans with heart failure with risk preserved EF, results in a lowering of exercise pulmonary capillary wedge pressure. And so based on that data, we designed a pivotal trial, a Phase III trial, the largest trial of its kind, of heart failure with preserved and mildly reduced ejection fraction, to see if interatrial shunt device would improve outcomes. And we published that trial earlier this year in the Lancet. Unfortunately, it was a totally neutral trial. And when you have a neutral trial in any condition, but as we see often in HFpEF, the question is, was it neutral overall? Or was there a subgroup that benefited? And what we found in that trial was that, there were three predefined subgroups that came out that seemed like there was a difference. Dr. Sanjiv Shah: First, there was a sex difference. Women did better. Men did worse with the device. Then, there was right atrial volume. Those with bigger right atrial volumes did worse. If you had a smaller right atrial volume, you did better. But the most significant interaction and subgroup was exercise pulmonary artery systolic pressure. Dr. Sanjiv Shah: If the pulmonary artery systolic pressure was greater than 70 at 20 Watts of exercise, so just with a little bit of exercise, those patients did worse. And if PA pressure stayed low, the patients did better. And so we sought to further explore this to say, "Okay, what's exactly going on?" In a post hoc analysis, what's going on with the pulmonary vasculature during exercise, and how does that differentiate how patients potentially respond to the device? And that's what we hope to figure out. Dr. Sanjiv Shah: We hypothesize, that if exercise pulmonary vasculature resistance is lower, then the shunt can actually work, and blood can flow from the left to the right, into the lungs, and the right heart doesn't get too overloaded. And we know, that the normal response of the pulmonary vasculature is to vasodilate with exercise. And so, if patients had retained that response, the ability to do that, that they may benefit. And so, we sought to figure that out with this subgroup analysis. Dr. Greg Hundley: Sanjiv, it sounds like a really elegant, well thought out hypothesis. So what was your study design? And describe your study population. Dr. Sanjiv Shah: Yeah. This was a randomized controlled trial. And so this was 626 patients enrolled at 89 centers across the world. And it was really, heart failure with mildly reduced, so an EF of greater than 40, or preserved EF, and 93% of them had HFpEF. And what was unique about this trial is that we, this is the first trial really, that confirmed that these patients actually had heart failure, with mildly reduced or preserved ejection fraction. Most trials say, well, you have to have an elevated BNP, and you have to have some sign of structural heart disease, and maybe, a history of heart failure hospitalization. In this trial, every single patient had to undergo rigorous noninvasive echocardiography. And then, on top of that, they had to undergo exercise invasive hemodynamic testing. And people thought that it wasn't possible for 626 patients, but we did it. And every single patient had had an exercise pulmonary capillary wedge pressure greater than, or equal to, 25. And so this really was HFpEF. So it's a randomized trial. Dr. Sanjiv Shah: And then, beyond that, we did a subgroup analysis. So we looked on various subgroups, focusing on exercise PVR, and we really looked to see the effect on three outcomes. Number one, a hierarchical endpoint, a combination of cardiovascular death, ischemic nonfatal stroke, recurrent heart failure hospitalizations, and the KCCQ. And then the other two outcomes were just the individual recurrent heart failure hospitalizations, and the KCCQ. We looked at all of these, and tried to figure out if there are certain subgroups that benefit. Dr. Greg Hundley: Great detail. So Sanjiv, what did you find? Dr. Sanjiv Shah: Well, we found that, there's this group of patients, that during exercise, the pulmonary vascular resistance at peak exercise stays above 1.74 Wood units. Now that seems like an arbitrary number, but in fact, in older individuals that are healthy, when you exercise them, the PVR upper limit, the exercise PVR upper limit, is about 1.8. So we're right about the upper limit of where the PVR should be. And if it was above that, the patients actually did worse with the shunt device. They had a lot more heart failure hospitalizations. Their KCCQ got worse, didn't benefit. And if they were below that threshold, meaning they were, sort of compliant pulmonary vasculature, and it stayed compliant, or they vasodilated effectively with exercise, then they benefited from the device. And what we call this concept of exercise-induced pulmonary vasoconstriction, or inability to vasodilate, is latent pulmonary vascular disease. Dr. Sanjiv Shah: And so, if you have that latent pulmonary vascular disease, your win ratio is 0.6. That means you do worse. And if you don't have this pulmonary, this latent pulmonary vascular disease, your win ratio is 1.31. And that means, you do better with the device. And we saw very similar findings with the KCCQ. We saw similar findings with the recurrent heart failure hospitalizations. Dr. Sanjiv Shah: And the final thing is, we found that, we looked at various other subgroups, and it turned out that if there was no latent pulmonary vascular disease and no history of pacemaker, which we found was kind of associated with sex and right atrial volume, those patients, for about 50% of the group, actually did the best. And that was what we called, the responder subgroup. Dr. Greg Hundley: Thank you, Sanjiv. Well, listeners, we're going to turn now to our associate editor, Justin Ezekowitz. And Justin, you have many papers come across your desk. What attracted you to this particular manuscript? Dr. Justin Ezekowitz: So Greg, this paper kind of stood out for a number of different reasons, as I sent you. You're to be congratulated for a variety of reasons. But the number one is, pursuing the data from a neutral trial overall, to understand who might benefit and who might be harmed from a pretty novel device and way to treat patients in such a scale, that's not being done like this before. So it stands out by just the magnitude of number of right heart catheterizations, number of patients enrolled, number of procedures done. And all of those things really lead to us to be able to understand the area much better than I think we can in a human population. Dr. Justin Ezekowitz: Where this sits with other devices that are very similar, is hard to really know, if all devices are going to be the same or different, but your population is quite unique is if they're not all end stage, but they're sick enough to get into your trials. So there's this population we treat actively. And I wondered if you could touch on that continuous nature. And so for readers, there's this beautiful figure, which shows a continuous nature of exercise PVR. And I wonder if you could touch on that. Is this mid group, the group that we should target for our future therapies like this, or this needs further study? Dr. Sanjiv Shah: Well, I think it needs further study. I think the listeners should be aware that this is a post hoc analysis. We did pre-specify exercise PA pressure. This is one trial. But it makes a lot of sense, pathophysiologically. What we're doing here is we're shunting this excessive LA, overloaded LA, shunting the blood from the LA to the RA and into the pulmonary vasculature. Well, if that pulmonary vasculature can't accept that increased flow, the patient's not going to do well. And how can we simulate that? Well, we can simulate it with exercise. As the patient's pedaling on the bike, on the cath lab table, there's increasing blood flow to the pulmonary vasculature, and we're seeing what happens with the pulmonary vasculature. Does it vasodilate, does it not? And so, I think that's why we were excited about this finding. Dr. Sanjiv Shah: I do think that, there are at least seven other companies making shunt devices, interatrial shunt devices or therapies. And I do think, they need to pay attention to this and really look at this. Not all trials are doing exercise and basic hemodynamics, that needs to be done, I think. So it'll be really interesting to see. Dr. Sanjiv Shah: Now, one thing I will say is that, and I've written about this, this is a really interesting trial. Because the BNPs were lower, and so you would think, okay, these are patients that are less sick. And yet, their heart failure hospitalization rate was at least one and a half times higher than pharma Phase III trials. KCCQ was way lower, like 30 points lower. So there are these patients out there that are really sick, and they're the ones that I think, are where their life, their sort of quality of life, their outcomes, are being driven by the HFpEF. And that's what we found in this trial. Dr. Greg Hundley: Very nice. Well, listeners, let's turn now to our editorialist, Dr. Evangelos Michelakis. And Evangelos, two questions. How do we put the results of this substudy, really in the context of the main trial? And then secondly, do you have any, with your expertise in endothelial function, and understanding the mechanisms of pulmonary hypertension, can you describe what you think might be operative as a mechanism here, and why Sanjiv observed these positive results in some patients? Dr. Evangelos Michelakis: Thank you. So the first point is that, I have to also repeat, that it was a remarkable achievement to do all this right heart catheterization on a treadmill in the cath lab. It's a very complex procedure. And it is, they have to be congratulated, the authors, for actually doing this. There is no question that, like Sanjiv said, ongoing trials for future trials will need to include the hemodynamics in the trials, before and after the procedure. Dr. Evangelos Michelakis: So another important thing is that, the authors brought up this, they called it latent pulmonary hypertension, we could call it latent pulmonary hypertension, or probably, early pulmonary hypertension, as an entity. Now that entity, it's newer in the heart failure field. It's not that old in the PIH, the pulmonary interior hypertension field, since it used to be in the guidelines for this disease, that exercise pulmonary hypertension was a diagnostic criterion for that. Because the idea is that, exercise pulmonary hypertension reflects early pulmonary hypertension. So you needed to intervene with therapies early. Dr. Evangelos Michelakis: Now, I'm not sure that this is a fact. But it is very likely that these patients, in Sanjiv's trial, that had the early, that had the sort of enhanced response with exercise, did have at least, endothelial dysfunction in the pulmonary arteries. Not only because this population has a number of endothelial risk factors, diabetes, smoking, you name it. But also, there are newer problems like SNPs polymorphism mutations, that will recognize more into the pulmonary arterial hypertension field, to be more unique to the pulmonary circulation. Dr. Evangelos Michelakis: But the reason I say that is that, the reason that you dilate with exercise, is mostly because of your pulmonary arterial endothelial cells, secreting vasodilatory factors. And also, allowing previously closed capillaries to open up with increased flow. However, the problem is that, if you have pulmonary arterial endothelial cells in vitro, and you expose them to high flow, like in this case, you can actually change their identity. Turn them into cells that are not endothelial cells anymore, are proliferative pro-inflammatory, and they can actually cause structural pulmonary circulation damage. Dr. Evangelos Michelakis: Also, there are animal models and people working in PAH and ASD, where they've shown that, if you have, if you're given endothelial toxin in animals, and then, you do an aortocaval shunt, then you get really severe pulmonary hypertension with structural disease, that is not even reversible if you remove the shunt. Dr. Evangelos Michelakis: So from this trial, the conclusion that patients with pulmonary hypertension should not get the device, is very clear. And probably, the ones with exercise pulmonary hypertension. My theoretical concern is, for those that don't have exercise pulmonary hypertension, or those that do have it, could they get worse after a number of years, and have structural pulmonary vascular disease? And unfortunately, we didn't have a follow up right heart catheterization to prove that, whether this is right or wrong. Which is a thing, is the most important thing to do in the future. So mimic the protocol for this trial from now on, but also add a follow up right heart catheterization, perhaps not just in a year, but longer. In other words, enough time to allow the structural pulmonary remodeling get established, but also, affect the right ventricle, these things don't. So maybe in a few years. It's a very demanding thing for these protocols, but I think, that's what needs to be done before we say this device can actually be beneficial for those patients, or for some patients, or not hurt others. Dr. Greg Hundley: Very nice. And so, a great segue, Evangelos, into what we think the next studies may need to be performed in this particular sphere of research. Dr. Greg Hundley: So Sanjiv, in just 30 seconds, could you share your thoughts first, and then we'll circulate back to Justin, and then finish up with Evangelos. Sanjiv? Dr. Sanjiv Shah: Yeah. I think the key thing is, to do a confirmatory trial. And that's what we're aiming for, is to do a confirmatory randomized sham-controlled trial, but focus in on these patients with an exercise peak PVR of less than 1.75, around there. And I think, that'll help answer the question. The Qp/Qs we get with this device is 1.2 to 1.3. So I don't think it's a high flow. And we actually have open label studies, where we've gone out to three years, with repeat invasive hemodynamic testing, echocardiograms, and we've had patients who've been implanted for seven years. We're not seeing, at least at that point, any sort of worsening of pulmonary vascular disease, or RV function, or anything like that. And so, it remains to be seen. Dr. Sanjiv Shah: The last thing I'll say, which I think is provocative, in the field of HFpEF, all pulmonary vasodilator drugs have failed. And though, we only measure pulmonary vascular resistance at rest. And what we saw in this trial, is that some patients have a high PVR and it comes down. Some people have a PVR that stays low, and is low and stays low. Some people have a low PVR and it goes up. You know? So I think what we need to think about in the field of PH‐HFpEF, is more exercise genotyping, to determine what's the dynamic exercise PVR? And maybe, those with exercise elevation of pulmonary vascular resistance are the ones that respond to pulmonary vasodilators. So that's another thing that I think we can think about taking away from this trial. Dr. Greg Hundley: Thank you, Sanjiv. Justin. Dr. Justin Ezekowitz: Yeah. So my thoughts are mimicking Sanjiv's. But one of the things that we desperately need is, ways in which we can noninvasively assess the exercise PVR, so that we can think about the large scale interventions that might come down the road, if interventions such as this work well. Because the noninvasive scans will really help us look at broader populations. Those are, that don't make it into trials, and those that aren't traditionally in our studies of HFpEF. So I think, that's another area where we can really grow the field, and then, grow our knowledge. Dr. Greg Hundley: Very nice. And Evangelos. Dr. Evangelos Michelakis: So, yes. Of course, like everybody said, we need trials that will have a follow up right heart catheterization, at least address, if not both, like the investigators did. But because the big question is, are these patients having an earlier stage pulmonary hypertension or not? These patients that the authors called, latent pulmonary hypertension, we need to phenotype more their endothelial cells, or their disease. And in the absence of biopsies, the only way we could do that, is perhaps, with molecular imaging, or at least, in some small populations. Or with analyzing pulmonary arterial endothelial cells in the blood, and their molecular phenotype, to see if they are a distinct group, which I suspect they may be. So further genotyping of this exercise induced pulmonary hypertension in this population, will be important as well. Dr. Greg Hundley: Thank you. Well, listeners, we've had a great discussion today, from Dr. Sanjiv Shah, from Northwestern University in Chicago, our editorialist, Dr. Evangelos Michelakis, from Edmonton, Alberta, and our own associate editor, Dr. Justin Ezekowitz from Edmonton, who brought us this study, demonstrating that in patients with heart failure and preserved ejection fraction, or heart failure and mildly reduced ejection fraction, the presence of pulmonary vascular disease, uncovered by invasive hemodynamic exercise testing, identifies patients who may worsen with atrial shunt therapy. Whereas, those without pulmonary vascular disease may, at least in the short term, benefit. And of course, as Evangelos has pointed out, the long term findings really warrant further study. Dr. Greg Hundley: Well listeners, on behalf of Carolyn and myself, we want to wish you a great week, and we will catch you next week on the Run. Dr. Greg Hundley: This program is copyright of the American Heart Association, 2022. The opinions expressed by speakers in this podcast are their own, and not necessarily those of the editors, or of the American Heart Association. For more, please visit ahajournals.org.

Welcome to The Nonlinear Library, where we use Text-to-Speech software to convert the best writing from the Rationalist and EA communities into audio. This is: Paul Farmer (1959 – 2022), published by Gavin on March 24, 2022 on The Effective Altruism Forum. One of the most prominent people in global health died last month. Wikipedia makes it hard to see what Paul Farmer actually did, behind the mountain of honors and appointments he received for it (Harvard prof, MacArthur grant, UN envoy, etc). He cofounded Partners In Health, now a $100m+ per year organisation. PIH works in Haiti, Peru, Mexico, Russia, Lesotho, Kazakhstan, Rwanda, Malawi, Sierra Leone, India and Liberia, greatly upgrading the quality of healthcare near their operations, and doing a huge amount of welfare programmes besides. They class themselves as a humanitarian organisation, though most of their work is not the crisis work you'd associate with that (except incidentally, as when an earthquake happened next to the hospital they were building). They do a huge, huge variety of things, under the root-cause theory of public health, where stuff like good shelter and food is treated as part of healthcare. They started out doing HIV treatment - and once you're doing that it only makes sense to do HIV prevention - and after that you're kinda hosed. An incomplete list: "HIV treatment, tuberculosis treatment... food baskets, transportation, lodging... dirty water... from in-home consultations to cancer treatments... job skills training, small business loans... a university in Rwanda... the world's largest TB research study... biocontainment unit in Lima... allowing [children] to attend school and receive food". Farmer's most notable work is being the single most powerful advocate for Haitian public health; PIH staff serve nearly half the entire country, and he was mates with Bills Clinton and Gates. Haiti will need another Farmer: He was an anthropologist by trade. In the past I've gotten annoyed with anthropology for bad epistemics (or for conflating good epistemics and good activism). But it's hard to fault Farmer as exemplar of the general approach "don't just watch, do something". I take his lifework to amount to the importance of operations. He didn't develop any vaccines or pills, he didn't make a pile of cash and give it away, and his research wasn't the main feature. Instead (as per Wikipedia) his org "created specific initiatives", "improved medical infrastructure" and provided "accompaniment rather than charity". (As with all large development organisations, they have their own homebrew intellectual framework, "Supervision-Partners-Incentives-Choice-Education".) Suitably unglamorous terms for good unglamorous things. He was extremely good at getting powerful people to care. There's a whole book about him, and he has been widely elegised. This marks out his strategy as the prestige route, using the system. Near the ceiling of that approach, perhaps. Achievements As usual in global health, most discussion of PIH's impact is actually about their inputs: number of staff, number of programmes, etc. (Not their budget though, which is both good and bad.) GiveWell gave them an ultra-tentative recommendation in 2007, but this was largely on priors about good healthcare in countries with a shortage of it. ("We would guess that it is improving health outcomes") When evaluated properly in 2010, GW found that PIH weren't formally evaluating their own work and mostly wouldn't share their programme budgets, and so they couldn't give them the internalist stamp of approval. ("We would guess that they are outside – though not necessarily far outside – what we consider to be a reasonable range [of cost-effectiveness].") "focused on AIDS prevention during the HIV crisis and successfully decreased HIV transmission rates by 4% from mothers to babies" Built and run several hospitals, including 40% of Haiti's medical system. One nice feature: they're big on videoconferencing for ...

Wywiad z polskim producentem muzycznym Czarny HIFI o jego najnowszej płycie “Jeśli coś się stanie…”. Dużo rapu, ciekawych gości i dobrych bitów, rozmawiamy o wszystkich utworach z krążka. Zapytałem Czarnego również o jego dawną współpracę z Promoe przy jednym z moich ulubionych utworów “Fabric of life”. Lista zagadnień - intro: 00:00 - intro 00:19 - początek wywiadu 00:33 - mała notka biograficzna 01:27 - współpraca z Promoe - “Fabric of life” 04:46 - czego słucha Czarny? Lucky Daye, Khalid, Timbaland Wstęp do rozmowy o płycie: 05:51 - kto współtworzył album? 07:11 - okładka 08:17 - tytuł Analiza płyty - “Jeśli coś się stanie…”: 09:39 - 1. Ostatnie szlugi (feat. Bonson, Skip) 11:13 - 2. Za bramami (feat. Kosi, Szczyl) 13:19 - 3. Małe dziecko (feat. Kasia Sienkiewicz - Kwiat Jabłoni, Gibbs) 14:46 - 4. Pył (feat. Cichoń, Bażant) 16:13 - 5. Raj (feat. Sobel, Young Igi) 18:35 - 6. Wrony (feat. Mikołaj Trzaska) 20:46 - 7. Abramakabra (feat. Pih, Ero, Dj Keys) 21:47 - 8. Loteria (feat. Bonson, Kari) 23:25 - 9. Nie wziąłem się znikąd (feat. Małpa) 25:26 - 10. Wino (feat. Sarius, Zalia) 27:54 - 11. Folia (feat. Tymek) 29:56 - 12. Yeah & Yeah (feat. Skip) 31:35 - 13. Komercja (feat. QRY) 34:09 - 14. Wróć do domu (feat. Filipek) 37:39 - 15. Nie wziąłem się znikąd - Remix feat. Szymon_C 39:44 - BONUS: Armani Jeans + Wybrzeże 40:57 - zakończenie #CzarnyHIFI #wywiad #muzyka #polska

Hi Roomies, In this episode I'm BACK with Jan Marini, founder of Jan Marini Skin Research. If you haven't listened to the first episode with Jan episode 40, make sure you go back and give it a go. Today, we're talking about one of the main skin concerns I hear about: HYPERPIGMENTATION! We talk tyrosinase inhibitors, melisma, PIH, higher Fitzpatrick types/ what's at risk for POC in terms of discoloration, SPF, Albino skin, and MORE. To shop Jan Marini, email me at tessaskinconsulting@gmail.com About Jan Marini JMSR is a recognized leader and innovator in skin care that is committed to continually expanding and improving the professional skin care market. JMSR's two primary focuses are to provide innovative technologies that deliver proven measurable results and an unwavering commitment to the ongoing success of our customers. Follow Jan Marini Skin Research on IG Learn more about Jan Marini MY SOCIAL MEDIA + SHOPS You can shop my Glymed store here or DM me on Instagram to purchase IS Clinical Tess' Instagram @myestytessa Tess' YouTube: Tess Zolly Tess' TikTok: @myestytessa Sweet by LiQWYD | https://www.instagram.com/liqwyd Music promoted by https://www.free-stock-music.com Creative Commons Attribution 3.0 Unported License https://creativecommons.org/licenses/by/3.0/deed.en_US --- Support this podcast: https://anchor.fm/the-treatment-room/support

Welcome to episode 76 [originally broadcast on Wednesday 12 January 2022] of #mhTV​​​​​​​​​​​​​. This week Vanessa Gilmartin-Garrity, Nicky Lambert spoke with guest Dr. Marion Lynch to about the 'I'm Fine' Art Project. Marion currently works in global health systems development and clinical education. She is a general and mental health registered nurse and Visiting Professor at University of West London and University of Global Health Equity, Rwanda. She is also Trustee of the arts and health charity PIH which is where this project on images and art to support nurses' wellbeing comes from. This work includes exploring how the arts help us understand and improve health, our own, and our patients' health and wellbeing. Her Doctorate helps explore this academically and her personal experience working with colleagues and patients during COVID explains this personally. This I'm Fine Art Project comes from listening to nurses say 'I'm fine', but not meaning it, sailing with young people living with cancer and hearing them speak about their experiences during COVID and the impact nurses have had, and seeing the unrepresentative and sometimes unhelpful images of nurses in the media. Some links to follow: You can look at the Healthcare Heroes, #PortraitsForNHSHeroes via https://artsandculture.google.com/project/healthcare-heroes Some Twitter links to follow are: VG - https://twitter.com/VanessaRNMH NL - https://twitter.com/niadla​​​​​​​​​​​​​ ML - https://twitter.com/drmarionlynch Credits: Presenter: Vanessa Gilmartin-Garrity & Nicky Lambert Guest: Prof. Dr. Marion Lynch Theme music: Tony Gillam Production & Editing: David Munday (https://twitter.com/davidamunday)

durée : 00:02:42 - Les Francs Comtois sont formidables France Bleu Belfort Montbéliard

Partners In Health (PIH) recently launched a program to assist states, cities and communities build a more equitable and comprehensive public health response to COVID-19. In this sister episode to Episode 7 “Feed the People,” we talk to Dr. Joia Mukherjee, PIH's Chief Medical Officer about why we need community advocates like Gladys in U.S. public health outreach. Hosted on Acast. See acast.com/privacy for more information.

Vorab der wichtigste Tipp: Vorbeugen, vorbeugen, vorbeugen!

In this episode we have Guest Mandy Bazemore. She is the co owner of Miramae studio in Charlotte North Carolina and an expert on al things skin! Topics of Discussion✨Recognizing acne patterns on the face ✨Hormonal acne treatment✨Best tips for treating acne✨intuitive skincare and how to know what your skin needs✨PIH what is it?✨Lymphatic facial massage ✨Gua sha and ice rolling ✨The 3 simple steps to incorporate today You can connect with many on Instagram @basictobarbieCheck out her blog here Go see her @Miramae_studioSkin care supplements pack!https://ishoppurium.com?prods=4493756923976:1,undefined:1,undefined:1,11924987605:1&giftcard=Erinlynnewellness

Watch on YouTube - https://youtu.be/xfmiDqcB_wwMy Preference of Brightening Skincare Products In This Order:Regimen Lab Level Serum:Niacinamide, Tranexamic Acid, Alpha Arbutin, Undecoylenoyl Phenylalanine / Sepiwhite MSH, Licorice Root, Hexylresorcinol.Great for Dark Spots, Hyperpigmentation, PIE, MelasmaAt Regimen Lab: https://regimenlab.com/products/level-serum(Non-Affiliate Link)Topicals Faded Serum for Dark Spots and Discoloration:Niacinamide, Tranexamic Acid, Alpha Arbutin, Azelaic Acid, Kojic Acid, Chromabright, Phytic Acid, Turmeric, Centella AsiaticaGreat for Hyperpigmentation, Melasma, PIH, Dark SpotsAt Sephora: https://fxo.co/BWbsPaula's Choice Discoloration Repair Serum:Niacinamide, Tranexamic Acid, BakuchiolGreat for hyperpigmentation, Dark SpotsAt Paula's Choice: https://paulachoiceusca.l3km.net/qnEWXgGood Molecules Discoloration Correcting Serum:Niacinamide, Cetyl Tranexamate MesylateGreat for general pigmentation issues, hyperpigmentationAt Ulta: https://fxo.co/CVK8ALLIES OF SKIN Mandelic Pigmentation Corrector Night Serum:Mandelic Acid, Niacinamide, Lactic Acid, Resveratrol, BakuchiolGreat for overall skin brightening, hyperpigmentation, PIHAt BeautyBay: https://tidd.ly/3xe2C0SFor Tough pigmentation issues adding in a L-Ascorbic Acid Serum can be highly beneficial. Using exfoliants can also help with overall skin brightening. Eucerin also has a pigmentation line that can be helpful for some people. For even more stubborn pigmentation prescription products might be worth considering- seeing a Dermatologist can be helpful. For some of the most stubborn hyperpigmentation in-office Laser treatments can help. *******Podcast LinksApple - https://b.link/No_BS_Apple_PodcastGoogle - https://b.link/No_BS_Google_PodcastAmazon - https://b.link/No_BS_Amazon_PodcastSpotify - https://b.link/No_BS_Spotify_PodcastStitcher - https://b.link/No_BS_Stitcher_PodcastRSS - https://feeds.redcircle.com/671dd1b2-a989-41d5-94d5-30c014e06149********Sephora - https://fxo.co/1231867/sephoraUlta - https://fxo.co/1231867/ultaAmazon - https://www.amazon.com/shop/nobsbeautyYes Style - https://ys.style/kk2Vjrv798Style Korean - http://www.stylekorean.com/?af_id2=nobsbeautyThese are affiliate links if you purchase anything from one of these stores using this link No BS Beauty will make a small commission on what you buy.********I am proud to offer my very own beauty products at Amazon. We are starting small but hope to grow these offerings. Take a look and if you can pick one or two up, it helps keep this channel truly independent.My Products:No BS Beauty Travel Set - https://amzn.to/2PgPzFZNo BS Beauty Airless Jars - https://bit.ly/2Ev6X6N or https://amzn.to/2RCEq4sNo BS Beauty Color Switcher - https://amzn.to/2RCEAJ6See my own page on Amazon - https://www.amazon.com/shop/nobsbeautywww.noBSbeauty.net*******My Patreon - https://www.patreon.com/noBSbeauty*******PayPal Tip Jar - https://bit.ly/donate_NBSBIf you want to leave a tip ... Thanks! *****Since so many of you asked for it, here is a link to my favorite PH testing strips https://amzn.to/33ojjIY

On our season finale, Zac and Ashley talk to Dr. Paul Farmer, the co-founder and chief strategist of Partners in Health (PIH). Founded in 1987, PIH has pioneered an approach to medicine that actually resembles Catholic social teaching's preferential option for the poor. They talk about the challenges of bringing the Covid-19 vaccine to the poorest and sickest countries and how to salvage hope in desperate times.  In Signs of the Times, we break down exactly what is happening with the U.S. Bishops and the debates around whether or not President Biden should receive Communion. What's on tap: Duckhorn Chardonnay  Links from the show: Take the Jesuitical Listener Survey! Partners in Health Dr. Farmer's latest book: Fevers, Feuds, and Diamonds: Ebola and the Ravages of History Learn more about your ad choices. Visit megaphone.fm/adchoices

SUMMARY In his memoir ONE BY ONE BY ONE, Dr. Aaron Berkowitz traces his journey as a young doctor grappling to bridge the gap between one of the world's richest countries and one of the world's poorest. On assignment in Haiti with Partners in Health, he meets Janel, a 23-year-old man with the largest brain tumor he or any of his colleagues at Harvard Medical School have ever seen. Trying to make the first big save of his medical career as a neurosurgeon, and determined to “to bring the benefits of modern medical science to those most in need” and work toward “solidarity rather than charity alone,” Dr. Berkowitz aims to save Janel's life by bringing him back to Boston for a 12-hour brain surgery.  With heart-wrenching twists and turns, the story of Janel's uncertain medical future parallels Dr. Berkowitz's own uncertainties as a doctor. Berkowitz brings the reader to the front lines of global humanitarian work as he struggles to overcome the challenges that arise when well-meaning intentions give rise to unintended consequences, when cultures and belief systems clash, and when it's not clear what the right thing to do is, let alone the right way to do it. KEY FACTS About 4 billion people lack access to basic healthcare. Haiti is the poorest country in the Western Hemisphere. More than 10,000 non-governmental organizations (NGOs) work in Haiti (one for every 1,000 people), yet Haiti remains one of the poorest countries, with some of the worst health, education, and sanitation statistics in the world. QUOTES FROM BERKOWITZ "I learned how a few individuals working together might just be able to make a small difference in those big billions, one by one by one.” “From illiteracy to entitlement and corruption, from going to the bathroom with the door open to refusing to sit near the bathroom, Haiti's inequities and their juxtaposition are in plain view before even arriving there.” “PIH [Partners in Health] describes its work as being based on solidarity rather than charity alone. Charity is necessary, of course: those who have more should help those who have less. But charity means us giving to them, to some abstract all. Solidarity redefines this relationship. It invites all of us to share with each other because we are each part of the same all.” “PIH recognized early on that health is not only about medicine but also about combating poverty.” “If we frame problems in terms of their constraints rather than their possibilities, prioritizing risk avoidance above all else, we are less motivated to find solutions.” BUY One by One by One: Making a Small Difference Amid a Billion Problems RECOMMENDATION Learn more about Partners in Health and their mission by visiting their website. Connect with us! Facebook Instagram Twitter YouTube  Website Special thanks… Music Credit Sound Editing Credit

An integrative approach can help enhance the immune response against viruses and provide additional protection. In this interview, Russell Jaffe, MD, PhD, who is a respected researcher, pathologist, immunologist, and biochemist, gives clinicians advice on how to strengthen the body’s viral immune response. He discusses immune system assessment, targeted nutrients, and some lifestyle factors to focus on. About the Expert Russell M. Jaffe, MD, PhD, is CEO and chairman of PERQUE Integrative Health (PIH). He is considered one of the pioneers of integrative and regenerative medicine. Since inventing the world’s first single step amplified (ELISA) procedure in 1984, a process for measuring and monitoring all delayed allergies, Jaffe has continually sought new ways to help speed the transition from our current healthcare system’s symptom reactive model to a more functionally integrated, effective, and compassionate system. PIH is the outcome of years of Jaffe’s scientific research. It brings to market 3 decades of rethinking safer, more effective, novel, and proprietary dietary supplements, supplement delivery systems, diagnostic testing, and validation studies. About the Sponsor PERQUE Integrative Health (PIH) is dedicated to speeding the transition from sickness care to healthful caring. Delivering novel, personalized health solutions, PIH gives physicians and their patients the tools needed to achieve sustained optimal wellness. Combining the best in functional, evidence-based testing with premium professional supplements and healthful lifestyle guides, PIH solutions deliver successful outcomes in even the toughest cases. If you are interested in delving more deeply into this and other integrative health topics, we invite you to join the PIH Academy. Additional resources made available to you by PIH and Jaffe are shown below: Immune Support & Virus Protection Recommendations C Cleanse Coronavirus Resource Center ELISA/ACT Biotechnologies    

Dr. Paul Farmer joins Nate to talk about global health equity, both with reference to past health crises, and today's. In his recent book, Fevers Feuds & Diamonds, Dr. Farmer writes about his first-hand experience responding to the Ebola crisis in West Africa, and what we can learn from it.  Dr. Farmer is professor and chair of the Department of Global Health and Social Medicine at Harvard Medical School, chief of Global Health Equity at Brigham and Women's Hospital in Boston, and co-founder and chief strategist of Partners in Health and a board member of Partners In Health Canada.Partners in Health is dedicated to bringing a high standard of public health care to the most vulnerable communities around the world, and PIH Canada is celebrating its 10th anniversary this year. The story of Dr. Farmer and colleagues Jim Yong Kim and Ophelia Dahl in founding PIH is the subject of the documentary Bending the Arc.

Post-inflammatory hyperpigmentation (PIH), when the skin becomes discolored or darkened, is a common consequence for people of color receiving laser treatments. It's a major challenge for Dermatologists and one with no clear solutions. Dr Vincent Richer of Pacific Derm in Vancouver, joins Kirk to discuss the article he co-authored with Dr. Ian Wong in the Jan/Feb 2021 issue of the Journal of Cutaneous Medicine and Surgery, "Prophylaxis of Post-Inflammatory Hyperpigmentation From Energy-Based Device Treatments: A Review." As Dr Richer explains to Kirk, the article is an attempt to "look into the science behind what supports all the 'witchcraft and wizardry' that we do either before or after our treatments, to try and prevent (PIH) from coming."Dr. Vincent Richer is a medical and cosmetic Dermatologist and holds positions as Clinical Instructor and Director of Continuing Medical Education at the Department of Dermatology and Skin Science at the University of British Columbia. He is motivated by getting optimal outcomes for his medical and cosmetic patients through customized care. This includes using the power of light to treat and enhance skin health, such as ultraviolet phototherapy to treat psoriasis or eczema, lasers and injectables to selectively improve skin appearance as well as photodynamic therapy to treat precancerous lesions.Dr. Vincent's article is available for free for three weeks after this interview is published:https://journals.sagepub.com/doi/full/10.1177/1203475420957633JCMS Author interviews is produced by David McGuffin of Explore Podcast Productions in Ottawa.Our theme music is composed by Lee Rosevere.      #laser, #hyperpigmentation, #post-inflammatory, #skinofcolor, #derm, #dermatology

Post-inflammatory hyperpigmentation (PIH), when the skin becomes discolored or darkened, is a common consequence for people of color receiving laser treatments. It's a major challenge for Dermatologists and one with no clear solutions. Dr Vincent Richer of Pacific Derm in Vancouver, joins Kirk to discuss the article he co-authored with Dr. Ian Wong in the Jan/Feb 2021 issue of the Journal of Cutaneous Medicine and Surgery, "Prophylaxis of Post-Inflammatory  Hyperpigmentation From Energy-Based  Device Treatments: A Review." As Dr Richer explains to Kirk, the article is an attempt to "look into the science behind what supports all the 'witchcraft and wizardry' that we do either before or after our treatments, to try and prevent (PIH) from coming."Dr. Vincent Richer is a medical and cosmetic Dermatologist and holds positions as Clinical Instructor and Director of Continuing Medical Education at the Department of Dermatology and Skin Science at the University of British Columbia. He is motivated by getting optimal outcomes for his medical and cosmetic patients through customized care. This includes using the power of light to treat and enhance skin health, such as ultraviolet phototherapy to treat psoriasis or eczema, lasers and injectables to selectively improve skin appearance as well as photodynamic therapy to treat precancerous lesions. Dr. Vincent's article is available for free for three weeks after this interview is published: https://journals.sagepub.com/doi/full/10.1177/1203475420957633 JCMS Author interviews is produced by David McGuffin of Explore Podcast Productions in Ottawa.Our theme music is composed by Lee Rosevere.             #laser, #hyperpigmentation, #post-inflammatory, #skinofcolor, #derm, #dermatology

While the United States continues to fail to provide Covid Relief to millions of its citizens, Canada tries to change their education curriculum. Google also has changed their help with schools and are now setting limits to data storage that schools can use for free. Join us this week on Cellar Door Skeptics as they break it all down. The show contains the usual segments Answering Conservative Questions and the Quick Save Segments. Subscribe: http://www.spreaker.com/user/cellardoorskeptics YouTube: https://www.youtube.com/c/CellarDoorSkeptics/ Facebook: https://www.facebook.com/CellarDoorSkeptics RSS Feed: https://www.spreaker.com/user/8326690/episodes/feed iTunes: https://itunes.apple.com/us/podcast/cellar-door-skeptics/id10 Website: http://cellardoorskeptics.com Stitcher: http://www.stitcher.com/podcast/cellar-door-skeptics Patreon: https://www.patreon.com/cellardoorskeptics PayPal: https://www.paypal.me/CellarDoorSkeptics Intro Music: https://aloststateofmind.bandcamp.com/ https://www.youtube.com/watch?v=xYKbTG3MdQI Links -------- https://www.eufic.org/en/healthy-living/article/is-a-cucumber-a-fruit-or-a-vegetable-and-why -------- https://education.alberta.ca/media/1626588/ministerial-order-on-student-learning.pdf https://open.alberta.ca/publications/ministerial-order-on-student-learning-2020 -------- https://support.google.com/a/answer/10403871?hl=en&ref_topic=10431464 https://www.theverge.com/2014/9/30/6874911/google-education-unlimited-storage-5tb-file-size https://thejournal.com/articles/2021/02/17/g-suite-for-ed-gets-new-name-and-pile-of-new-features.aspx?m=1 -------- https://www.mlive.com/news/ann-arbor/2021/02/should-police-respond-to-mental-health-emergencies-ann-arbor-exploring-alternatives.html https://github.com/fivethirtyeight/police-settlements -------- https://www.politico.com/news/2021/02/26/house-biden-covid-relief-bill-passage-471733 https://rules.house.gov/bill/117/hr-PIH-american-rescue-plan https://docs.house.gov/billsthisweek/20210222/BILLS-117hrPIH-american-rescue-planRH.pdf https://www.cnet.com/personal-finance/15-federal-minimum-wage-hike-is-now-the-biggest-stimulus-bill-issue-heres-why/ https://www.foxbusiness.com/politics/republican-slashes-trillion-dollar-covid-package-asks-for-10000-stimulus-checks-instead -------- Quick Saves Tanner: New Train in Michigan https://a2tc.org/ Hanna: Neonicotinoids https://www.reddit.com/r/science/comments/ltaj3h/neonicotinoids_threatens_future_for_key/gowna0e?utm_source=share&utm_medium=web2x&context=3 Keith: INDIAN FOLK METAL (Bloodywood - "Jee Veerey" ft. Raoul Kerr) https://youtu.be/6uJoN_I9ebQ

There is a growing awareness of the interconnection between sleep, stress, and mood. Often, all 3 need to be addressed in clinical practice. In this interview, pioneering integrative health researcher, pathologist, immunologist, and biochemist Russell Jaffe, MD, PhD, shares his physiology-first approach to tackling all 3 of these common clinical issues. He and his team have developed and validated personalized, proactive, predictive, primary prevention practices and protocols over the last four decades. Listeners will glean new ideas regarding lifestyle and targeted nutrients that can help with sleep, stress, and mood. About the Expert Russell M. Jaffe, MD, PhD, is CEO and chairman of PERQUE Integrative Health (PIH). He is considered one of the pioneers of integrative and regenerative medicine. Since inventing the world’s first single step amplified (ELISA) procedure in 1984, a process for measuring and monitoring all delayed allergies, Jaffe has continually sought new ways to help speed the transition from our current healthcare system’s symptom reactive model to a more functionally integrated, effective, and compassionate system. PIH is the outcome of years of Jaffe’s scientific research. It brings to market 3 decades of rethinking safer, more effective, novel, and proprietary dietary supplements, supplement delivery systems, diagnostic testing, and validation studies. About the Sponsor PERQUE Integrative Health (PIH) is dedicated to speeding the transition from sickness care to healthful caring. Delivering novel, personalized health solutions, PIH gives physicians and their patients the tools needed to achieve sustained optimal wellness. Combining the best in functional, evidence-based testing with premium professional supplements and healthful lifestyle guides, PIH solutions deliver successful outcomes in even the toughest cases. If you are interested in delving more deeply into this and other integrative health topics, we invite you to join the PIH Academy. Additional resources made available to you by PIH and Jaffe are shown below: Immune Support & Virus Protection Recommendations C Cleanse Coronavirus Resource Center ELISA/ACT Biotechnologies

“Los dos ruiseñores”, “(Versión libre de un cuento de Andersen)”, es uno de los cuentos que se leen en la parte correspondiente al número cuatro de La Edad de Oro. “Los dos ruiseñores” parece la transcripción de un cuento popular, fantástico, retomado de alguna vertiente oral, europea o latinoamericana, pero como lo indica el citado subtítulo de José Martí y la nota de Fernández Retamar: “Se trata de ‘El ruiseñor’, del danés Hans Christian Andersen (1805-1875)”; no obstante, a todas luces retocado por José Martí. La anécdota de “Los dos ruiseñores” se remonta a la legendaria y milenaria China, esa que desde Las mil y una noches habita, de mil y un modos, más de mil y una tradiciones habidas y por haber. Uno de los personajes es el emperador, rodeado, como suele ocurrir, por la maquiavélica cohorte de demiurgos menores, en este caso: los mandarines, que a los chinos del pueblo les dicen: “¡Puh!” o “¡Pih!””, mirándolos de arriba abajo; pero ante el emperador ninguno dice ni hace nada de esto, sino que más rápidos que un rayo láser se postran de hinojos o gritan: “¡Tsing-pé! ¡Tsing-pé!”, y dan vueltas alrededor de él danzando con los brazos abiertos como si el emperador fuera un tótem vivo, con ojos de almendra, corona y espada. --- Send in a voice message: https://anchor.fm/irving-sun/message

This episode’s Community Champion Sponsor is Augmedix. To learn how they are revolutionizing the electronic health record: https://augmedix.com/passionatepioneers/ (CLICK HERE) --- As we now recognize, the Coronavirus pandemic has laid bare the structural problems and inequities in our healthcare system. However, this crisis has also accelerated the adoption of many technologies to care for patients the industry aims to serve.  During this episode, Dr. Kim Gandy, a remote patient monitoring expert, and a national health technology industry leader joins us to discuss Play-it Health's efforts to battle COVID-19 with its personalized remote patient monitoring and virtual care management platform.  While together, Dr. Gandy shares how her company came to be and the quick and decisive business decisions she made during the pandemic's early onset. Additionally, Dr. Gandy outlines how Play-it Health is helping our frontline healthcare heroes and the opportunities for our community to engage with her team. Join us for this timely expert Coronavirus update as we continue to work together to overcome the most significant public health challenge in our lifetimes.  Episode Highlights: History and overview of Dr. Gandy’s vision and need for Play-it Health’s technology How Dr. Gandy and the team quickly adjusted their strategy to address the pandemic Play-it Health’s commitment to using their technology for remote monitoring in nursing facilities The use of educational modules to help battle the pandemic, including vaccine hesitancy About our Guest: Dr. Kim Gandy is a physician, scientist, and entrepreneur with a deep-seated belief in the potential of digital health solutions for optimizing health outcomes. She launched Play-it Health (PIH) in the health adherence engagement space, aiming to utilize digital health technologies to improve adherence, one of the elements known to have the most potential for impact in value-based medicine. Though value-based care never reached significant adoption in the health marketplace, remote patient monitoring or the ability to monitor patient biometrics outside of the clinical setting did. Since RPM was a part of the PIH platform from the beginning, Play-it Health has found itself poised with an RPM  solution embedded in a platform with some of the highest adherence rates in the industry.  Over the last year, PIH has sought to use its platform, Plan-it Med,  to improve community efforts to combat the Coronavirus. Dr. Gandy is not only a former pediatric cardiac and transplant surgeon, she is a scientist, having obtained her Ph.D. from Stanford and having run international committees in translational research. As such, she was imminently qualified to be able to mold the PiH platform to meet community needs in a pandemic. Links Supporting This Episode: Play-it Health website: https://www.playithealth.com/ (CLICK HERE) Dr. Kim Gandy LinkedIn page: https://www.linkedin.com/in/kimberlygandy/ (CLICK HERE) Dr. Kim Gandy Twitter page: https://twitter.com/KimberlyGandy1 (CLICK HERE) Join our online community: https://www.passionatepioneers.com/ (CLICK HERE) Subscribe to newsletter: https://forms.gle/PLdcj7ujAGEtunsj6 (CLICK HERE) Guest nomination form: https://docs.google.com/forms/d/e/1FAIpQLScqk_H_a79gCRsBLynkGp7JbdtFRWynTvPVV9ntOdEpExjQIQ/viewform (CLICK HERE) Support this podcast

Merriam-Webster's Word of the Day for November 28, 2020 is: capitulate • kuh-PIH-chuh-layt • verb 1 a : to surrender often after negotiation of terms b : to cease resisting : acquiesce 2 archaic : parley, negotiate Examples: "Real estate experts say retailers are increasingly looking to pay rent as a percentage of sales, making it a variable expense on their balance sheets rather than a fixed one.… While there could be some hesitation to strike a deal like this, landlords could end up capitulating to keep a space occupied." — Lauren Thomas, CNBC.com, 24 Sept. 2020 "And remember, Rivera didn't draft Haskins last year. His predecessor, Jay Gruden, didn't want to, either, but capitulated to owner Daniel Snyder." — Steve DeShazo, The Free Lance-Star (Fredericksburg, Virginia), 8 Oct. 2020 Did you know? Capitulate and its synonyms yield, submit, and succumb all mean to give way to someone or something, but have a few slight differences in emphasis. Yield may apply to any sort or degree of bowing to force, debate, or pleading ("yields too easily in any argument"). Submit suggests surrender, after resistance, to the will or control of another ("the soldiers submitted to their captors"). Succumb imputes weakness and helplessness to the person giving in, or an overwhelming power to the opposition ("succumbing to temptation"). Capitulate stresses the termination of all resistance and may imply either a coming to terms, as with an adversary, or hopelessness before an irresistible opposing force ("team owners capitulated to the demands of the players' union").

Nowa-stara Polska Izba Hotelarzy pojawiła się tak nagle, że nie każdy zauważył, że to kontynuacja działalności Polskiej Izby Hotelarskiej. A może to zupełnie nowa organizacja, która ma zupełnie inne cele? Kto za nią stoi, jaki mają program i zadania, co chcą nowego wnieść w branżę hotelową? Na te i wiele innych pytań postarają się odpowiedzieć przedstawiciele zarządu: Zbigniew Kowalski, Michał Chabior oraz Marek Łuczyński. Oczywiście liczymy na Wasze pytania i komentarze. Na rozmowę zaprasza Rafał Krzycki

In this interview, Russell Jaffe, MD, shares his immune-boosting protocol that can enhance immunity and help patients achieve better overall wellness. In addition to discussing diet, lifestyle, and dietary supplements, Jaffe shares information about an innovative lymphocyte response assay that is now available. Jaffe is an internal medicine physician, clinical pathologist, immunologist, and biochemist. About the Expert Russell M. Jaffe, MD, PhD, is CEO and chairman of PERQUE Integrative Health (PIH). He is considered one of the pioneers of integrative and regenerative medicine. Since inventing the world’s first single step amplified (ELISA) procedure in 1984, a process for measuring and monitoring all delayed allergies, Jaffe has continually sought new ways to help speed the transition from our current healthcare system’s symptom reactive model to a more functionally integrated, effective, and compassionate system. PIH is the outcome of years of Jaffe’s scientific research. It brings to market 3 decades of rethinking safer, more effective, novel, and proprietary dietary supplements, supplement delivery systems, diagnostic testing, and validation studies. About the Sponsor PERQUE Integrative Health (PIH) is dedicated to speeding the transition from sickness care to healthful caring. Delivering novel, personalized health solutions, PIH gives physicians and their patients the tools needed to achieve sustained optimal wellness. Combining the best in functional, evidence-based testing with premium professional supplements and healthful lifestyle guides, PIH solutions deliver successful outcomes in even the toughest cases. If you are interested in delving more deeply into this and other integrative health topics, we invite you to join the PIH Academy. Additional resources made available to you by PIH and Jaffe are shown below: Immune Support & Virus Protection Recommendations C Cleanse Coronavirus Resource Center ELISA/ACT Biotechnologies

My conversation today is with Hank Green. Many fans recognize Hank as one of the Vlogbrothers and the continuing conversation he has with his brother John Green. You might recognize him as the author of An Absolutely Remarkable Thing and former guest right here on Marginalia. Hank recently published a sequel, A Beautifully Foolish Endeavor . We avoid spoilers, so I can tell you it’s a sequel. We actually talk about the book and so much more. Here’s our conversation: Hank and his brother, John, are raising money to dramatically and systematically improve maternal health care in Sierra Leone, where, if trends continue, one in seventeen women will die in childbirth. You can join them at PIH.org/hankandjohn. - A Beautifully Foolish Endeavor: A Novel by Hank Green is published by Dutton. Marginalia was produced at KMUW Wichita. If you like this podcast, please consider leaving a rating or review on Apple Podcasts . Engineers: Mark Statzer and Torin Andersen Editor: Lu Anne Stephens Producer

My conversation today is with Hank Green. Many fans recognize Hank as one of the Vlogbrothers and the continuing conversation he has with his brother John Green. You might recognize him as the author of An Absolutely Remarkable Thing and former guest right here on Marginalia. Hank recently published a sequel, A Beautifully Foolish Endeavor . We avoid spoilers, so I can tell you it’s a sequel. We actually talk about the book and so much more. Here’s our conversation: Hank and his brother, John, are raising money to dramatically and systematically improve maternal health care in Sierra Leone, where, if trends continue, one in seventeen women will die in childbirth. You can join them at PIH.org/hankandjohn. - A Beautifully Foolish Endeavor: A Novel by Hank Green is published by Dutton. Marginalia was produced at KMUW Wichita. If you like this podcast, please consider leaving a rating or review on Apple Podcasts . Engineers: Mark Statzer and Torin Andersen Editor: Lu Anne Stephens Producer

During the COIVID-19 pandemic, it is telling to see who is faring well, and who is suffering greatly. Like most matters in health, social justice, structural violence and colonial legacies matter enormously in determining health outcomes. For over 30 years, Partners In Health has put social justice at the forefront of health, arguing that good health can be a reality for all regardless of wealth. National Director of PIH in Canada, Mark Brender, offers some thoughts about Social Justice matters in times of a pandemic, and for global health more broadly. Mark Brender is National Director of Partners In Health Canada, a global health NGO striving to make health care a human right for all people. Starting from a one-room clinic in Haiti more than 30 years ago, Partners In Health serves millions of patients annually across 11 countries, working to deliver high quality health care, address the root causes of illness, train service providers, advance research, and advocate for global policy change. Mark opened the PIH Canada office in 2011 and is passionate about raising awareness and funds for this effort. He previously held leadership positions with national and international charitable organizations. Follow Dr. Bob on Twitter: @ProfessorHuish

Chronic health issues can precipitate from a myriad of origins including inflammation. On this episode, integrative medical physician Russell Jaffe, MD, PhD, explains his physiology first approach to restorative healing. In addition to recommended testing, Jaffe will describe a comprehensive strategy that is fundamental to personalized medicine and improved patient outcomes. Jaffe is one of the pioneers of integrative and regenerative medicine with expertise in testing, research, diagnostics, and dietary supplements. About the Expert Russell M. Jaffe, MD, PhD, is CEO and Chairman of PERQUE Integrative Health (PIH). He is considered one of the pioneers of integrative and regenerative medicine. Since inventing the world’s first single step amplified (ELISA) procedure in 1984, a process for measuring and monitoring all delayed allergies, Jaffe has continually sought new ways to help speed the transition from our current healthcare system’s symptom reactive model to a more functionally integrated, effective, and compassionate system. PIH is the outcome of years of Dr Jaffe’s scientific research. It brings to market 3 decades of rethinking safer, more effective, novel, and proprietary dietary supplements, supplement delivery systems, diagnostic testing, and validation studies. About the Sponsor PERQUE Integrative Health (PIH) is dedicated to speeding the transition from sickness care to healthful caring. Delivering novel, personalized health solutions, PIH gives physicians and their patients the tools needed to achieve sustained optimal wellness. Combining the best in functional, evidence-based testing with premium professional supplements and healthful lifestyle guides, PIH solutions deliver successful outcomes in even the toughest cases. If you are interested in delving more deeply into this and other integrative health topics, we invite you to join the PIH Academy

With Covid-19 surging in so many states and a president who tells us the lethal virus is “fading away,” and Trump's former National Security Advisor confirming what we already know, that the POTUS is not “fit for the job,” things are looking pretty bleak in the U.S.. But don't despair. Just when you need it, The Halli Casser-Jayne Show brings you an inspiring story, the tale of a true American hero, Dr. Aaron Berkowitz, his story told in his new book ONE BY ONE BY ONE, MAKING A SMALL DIFFERENCE AMID A BILLION PROBLEMS. Welcome to The Halli Casser-Jayne Show always available at Halli Casser-Jayne dot com, on whichever is your favorite app, and on your Alexa device too.Up first, Halli and her partner in politics, former White House correspondent and Newsweek and Time veteran Matthew Cooper slice and dice all things politics. This week we talk Bat Fever (aka Covid-19), Blabbermouth John Bolton, Election2020, police reform, and the passing of an American icon, the end of an era, Jean Kennedy Smith, the last surviving sibling of President John F. Kennedy, and so much more. Then in our second half-hour: The name Dr. Aaron Berkowitz may not be familiar to you, but he's someone you want to meet. His story is powerful, and in these wretched times, it's an inspiring story. It begins here: Dr. Aaron Berkowitz has just finished his medical training when he was sent to Haiti on his first assignment with Partners In Health, a global health organization that brings health care to the most vulnerable around the world. There, he meets Janel, a 23-year-old man with the largest brain tumor Berkowitz or any of his neurosurgeon colleagues at Harvard Medical School have ever seen. Determined to live up to PIH's mission statement, Berkowitz tries to save Janel's life. And that's just the beginning, the whole story told by Dr. Berkowitz in his inspiring new book ONE BY ONE BY ONE: MAKING A SMALL DIFFERENCE AMID A BILLION PROBLEMS.It's a jam-packed hour. Covid-19, John Bolton, Election2020, the Montana Senate race, John F. Kennedy, Black Lives Matter, Election 2020, Haiti, an inspirational story, Jean Kennedy Smith -- all this week on The Halli Casser-Jayne Show Podcast, always available at Halli Casser-Jayne dot com and on whichever is your favorite app and on your Alexa device too.

Today Jon speaks with Ahmidu Barrie, PIH SL's Director of Operations for an update on Covid-19 in Kono District. Ahmidu is managing the emergency response for PIH in Kono District, while also making sure our ongoing operations are maintained. We hear from Ahmidu on what the increase in cases means for Kono District, and for PIH Sierra Leone. Support this podcast

Welcome to this special conversation with Didi Bertrand Farmer, Founder and President of The Women and Girls Initiative. The Women and Girls Initiative is a very special Life-Changing mission that was founded by Didi in 2008 as a pilot program to support over 400 disadvantaged adolescent girls and young women in two different post-disaster and conflict contexts: Rwanda after the 1994 genocide and Haiti after the 2010 earthquake. Didi is a dynamic and visionary woman that wears a lot of hats, she is a: Human Rights Activist Community Leader Champion of Women and Young Girls She's also a Strategist for Gender and Adolescent Youth Health and Development for Partners In Health also known as PIH. In this conversation we dive deeper into the story of Didi and her advocacy work. We learn more about the Women and Girls Initiative and also get some insights into how the Corona pandemic is affecting the Mental Health of the girls and young women in the program, which is a very appropriate topic as we're currently in the month of May which is Mental Health Awareness Month. Please stay connected to the Women and Girls Initiative: Website: https://womenandgirlsinitiative.org/ Instagram:https://www.instagram.com/womenandgirlsinitiative/ Support by donating to this life-changing mission with a vital gift today to empower some of the most vulnerable adolescent girls and young women…... via https://donate.pih.org/page/contribute/women-and-girls-initiative Art Exhibit - DLO, VAN, DESTRIKSYON https://womenandgirlsinitiative.org/dlo-van-destriksyon Covid response https://womenandgirlsinitiative.org/covid-19-response Galleries - https://womenandgirlsinitiative.org/galleries Contact: https://womenandgirlsinitiative.org/contact-us-1 Host: @ruthiezerai www.ruthiezerai.com

Today, Jon travels just outside Freetown to attend the opening ceremony for the 120 bed community care center that PIH's infrastructure team helped to retrofit over the last 2 weeks. The new repurposed facility will provide additional treatment beds for positive Covid-19 patients who are asymptomatic or mildly symptomatic. Dr. Idris, from the national case management pillar, and the coordinator in charge of the facility provides an update. Support this podcast

Jon visits the final day of the training of trainers for Sierra leone's national contact tracing program. Jon is joined by epidemiologist Gbessay Saffa, the head of contact tracing for the Government of Sierra Leone, to learn a bit more about contact tracing, his experience, and the partnership between PIH and the Ministry of Health's contact tracing response. Support this podcast

Today, Jon and repeat guest on the PIH-SL Audio Update, Dr. Bailor Barrie, talk about the upcoming trainings for Sierra Leone's national contact tracing program. PIH is leading the training with the surveillance pillar and the emergency operations center. #contacttracingtraining. Say that three times fast. Support this podcast

Today, Jon is joined by Dr. Joia Mukherjee, chief medical officer for Partners In Health, to discuss the Massachusetts contact tracing program, and how the Ebola response in Sierra Leone is helping to guide PIH's U.S.-based COVID-19 response. #tonkolilitotewksbury. First hashtag ever, and its a good one. Support this podcast

Today, Jon speaks with Isata Dumbuya, PIH-SL's reproductive, maternal, and child health program manager. She is responsible for leading PIH's maternal health programming at Koidu Government Hospital, Wellbody Clinic, and clinics around Kono District. Isata is also one of the chief planners and designers of the forthcoming Maternal Center of Excellence. We will hear about the impact coronavirus is having on maternal health services in Kono. Support this podcast

Today, Jon joins Ali Pierson, PIH-Sierra Leone's supply chain manager, to understand the impact the coronavirus outbreak is having on the global supply chain of medical equipment and pharmaceuticals, and steps PIH has taken to prepare our supported facilities for a surge of coronavirus cases. Support this podcast

In today's update, Jon joins Ahmidu Barrie, director of operations, and Vicky Reed, director of nursing, to hear more about COVID-19 preparedness at Koidu Government Hospital, Wellbody Clinic, and PIH offices and guesthouses in Kono.  Support this podcast

In this bonus episode, Dr. Philippe Dimitri Henrys shares what it's like working as one of the few emergency doctors in his community, and how his career path with PIH has been “a great adventure.” Share your thoughts on Voices of Haiti by sending us a DM at https://instagram.com/partnersinhealth (instagram.com/partnersinhealth) or https://twitter.com/pih (twitter.com/pih)

Many Haitians returned to their home country to help respond to the devastating earthquake on Jan. 12, 2010. Maxo was among them, and stayed for eight months working in camps for the displaced. He shares his perspective on why the earthquake was so destructive, and how it has affected him personally. Transcript Host, Leslie Friday: Byenvini or welcome. I'm your host, Leslie Friday. Thank you for listening to Voices of Haiti, a Partners In Health podcast that shares the stories of our Haitian colleagues as they reflect on the January 12th 2010 earthquake.  Today, we hear from an infectious disease doctor who began working with Zanmi Lasante, as PIH is known in Haiti, in 2005. He has helped patients battle deadly diseases like tuberculosis and HIV and seen them recover—against all odds.  Some odds, though, are hard to predict. Like when a massive earthquake will bring a nation to its knees. Maxo Luma: It's not magic. You cannot stop a natural disaster. It's very unpredictable, right? But what we can do, we can minimize, we can reduce the magnitude of every single natural disaster, if you have a strong healthcare system ... Host, Leslie Friday: That's Dr. Maxo Luma, who's currently the executive director of Partners In Health in Liberia. But at the time of the 2010 earthquake in Haiti, he was teaching courses within the Faculty of Medicine at the University of British Columbia. You might think Maxo's perspective on the earthquake is unique, or possibly even wrong. But stick with what he has to say. Maxo Luma: The earthquake did not kill people. What I'm trying to say is that all those people who died, it's like a quarter of a million people who died, more than another quarter of million you know, are left injured, you know handicapped after the earthquake, we cannot attribute all this to the earthquake. It was the system, the weakness of the system you know, that kill those people. Host, Leslie Friday: As a direct result of the earthquake, more than 50 hospitals and health centers collapsed. Dozens of nurses and doctors died. This occurred within a public health system that was already struggling.  So…who cares for the gravely injured when there are no first responders?  How do you transport victims, when there are few ambulances?  Where do you take patients when the nearest hospitals stand in ruins? As Maxo says, a weak health system AND overall infrastructural systems were the causes of death for thousands of Haitians. That point became clearer—just one month later--when a larger, 8.8 earthquake struck Chile, spurring a devastating tsunami.  All told, 500 people lost their lives. This comparison is not meant to belittle what happened in Chile--all loss of life is tragic.  But it is necessary when asking the question: why were there such different outcomes between the earthquake in Haiti, and the dual natural disasters in Chile?  As Maxo says, the answer to this question doesn't require magical knowledge.  The answer…is that Chile, among other advantages, had a stronger PUBLIC health system compared to Haiti.  Maxo Luma: After the earthquake, Haiti attracted a lot of attention from the international community, where they made a lot of promises, most of them were not kept, right? And for those who managed to commit or keep their promises, they did it the wrong way. Because whether or not we believe it, it is of the responsibility of the government of the country to ensure safety of citizens, to ensure basic human rights, education, water, sanitation, healthcare. This is the responsibility of the government of the country. Host, Leslie Friday: But here's the catch: the Haitian government received less than 1% of humanitarian aid,  and less than 10% of recovery aid donated in the wake of the earthquake. The vast majority of funding—billions of dollars—flowed to private contractors, foreign-based nonprofit organizations, and the donors' militaries...

What was it like to survive the most devastating earthquake in modern history? In this series, Partners In Health doctors, nurses, and staff—all Haitians—share stories about their most salient memories from the January 2010 earthquake. Some discuss the first moments and days after the disaster, while others reflect on the months and years that followed. This is the first time some of our colleagues have ever shared their stories. As a collection, Voices of Haiti provides listeners with a unique and intimate perspective of what it was like to survive and respond to one of the world's most deadly natural disasters. Learn more about PIH's work in Haiti: pih.org/haiti Support this podcast

Why do we say “head over heels”? What should I wear to a Mountain Goats concert? What is the best thing that happened during the 2010s? Do airplanes have horns? What is my boyfriend’s interesting news?? How much money would I need to donate to PIH to get you to go bungee jumping or skydiving? What should I bring to a zombie turtle party besides a shovel? Justice or mercy? What happened to the short poems? John Green and Hank Green have answers. If you're in need of dubious advice, email us at hankandjohn@gmail.com. Join us for monthly livestreams and an exclusive weekly podcast at patreon.com/dearhankandjohn. Follow us on Twitter! twitter.com/dearhankandjohn Subscribe to the Nerdfighteria newsletter! https://nerdfighteria.com/nerdfighteria-newsletter

Have you ever wanted to be closer to the horror films you absolutely love? How about taking a piece of one of them home? On September 25th and 26th, Profiles In History is holding their Icons and Legends of Hollywood Auction. You could own screen used props from your favorite movies and tv shows: iconic items from the Evil Dead franchise, A Nightmare On Elm Street, Jaws, Alien, The Shining, Child’s Play, Gremlins, Ghostbusters and many more! The Boo Crew haunts their warehouse on location with PIH’s Brian Chanes and Joe Moe to learn how these treasures are acquired, how they authenticate them, the most expensive prop they’ve ever sold, the amazing pieces of cinematic horror that could be yours and the fascinating stories behind them! Collect Episode 68 now! See acast.com/privacy for privacy and opt-out information.

Serum uric acid levels are often ordered for the evaluation of hypertensive disorders of pregnancy. But why is this done? Is this test able to guide clinical management? A staple of PIH evaluation in the 1970s and 1980s, uric acid levels are still around. In this session, we will review why uric acid determinations for hypertensive disorders of pregnancy is not clinically useful – in general. Reference: Sept 2019 ACOG publication, “Questioning Clinical Practice”; Obstet Gynecol.

- Jeszcze przed wydaniem krążka zarzucano mi, że skoro skończyłem z melanżem i ułożyłem sobie życie, to pewnie straciłem pazury i nagram "wygładzony" album -  mówi Pih o swojej ósmej solowej płycie "Non Serviam" -  Tymczasem ja doskonale wiedziałem jaki materiał gromadzę w szufladzie i że te czarne scenariusze raczej się nie zrealizują. Audycja „Numer Raz na fali w każdy wtorek o 22.00.  

We are living in a very fast paced life with more to do, less time to do it and a lot of added pressures. As a result, more adults (especially women), are living with more chronic stress. Combine this with hormonal imbalances, environmental shifts and our busy lifestyles, it's no wonder we are seeing a rise in more breakouts and accelerated signs of skin aging. In this episode we chat with Dr. Angela Murphy about our most recent innovations AGE Bright Clearing Serum and AGE Bright Spot Fader in the new Active Clearing line. Active Clearing formulas harness the best of nature and science to control breakouts and reduce the appearance of related skin aging. This updated skin segment is amazing! AND since adult skin has such a high potential for skin-aging post-inflammatory hyperpigmentation (PIH) spots, having products that address both breakouts and aging simultaneously truly helps streamline treatments and boosts results. Learn more HERE  

This is a lecture on obstetrics and pediatric emergencies. The EMT will learn about childbirth and the associated emergencies as well as PIH and PID. This is a good lecture for those EMT students needing to review OB. Subscribe for exclusive EMT podcast content at https://anchor.fm/thepublicsafetyguru/subscribe --- Send in a voice message: https://anchor.fm/thepublicsafetyguru/message

This podcast interview features integrative health expert Russell Jaffe, MD, PhD, CCN, who shares his philosophy about addressing men's health issues in clinical practice. Jaffe discusses hormonal balance, prostate health, gastrointestinal health, cardiovascular health, and inflammation. About the Expert Russell M. Jaffe, MD, PhD, is CEO and Chairman of PERQUE Integrative Health (PIH). He is considered one of the pioneers of integrative and regenerative medicine. Since inventing the world’s first single step amplified (ELISA) procedure in 1984, a process for measuring and monitoring all delayed allergies, Jaffe has continually sought new ways to help speed the transition from our current healthcare system’s symptom reactive model to a more functionally integrated, effective, and compassionate system. PIH is the outcome of years of Dr Jaffe’s scientific research. It brings to market 3 decades of rethinking safer, more effective, novel, and proprietary dietary supplements, supplement delivery systems, diagnostic testing, and validation studies. About the Sponsor PERQUE Integrative Health (PIH) is dedicated to speeding the transition from sickness care to healthful caring. Delivering novel, personalized health solutions, PIH gives physicians and their patients the tools needed to achieve sustained optimal wellness. Combining the best in functional, evidence-based testing with premium professional supplements and healthful lifestyle guides, PIH solutions deliver successful outcomes in even the toughest cases. If you are interested in delving more deeply into this and other integrative health topics, we invite you to join the PIH Academy. Transcript Karolyn Gazella: Hello, I'm Karolyn Gazella, the publisher of the Natural Medicine Journal. Thank you for joining me today. Our topic is men's health, and my guest is integrative health expert, Dr Russell Jaffe. Before we begin, I'd like to thank the sponsor of this topic, who is Perque Integrative Health. Dr Jaffe, thank you so much for joining me. Russell Jaffe, MD, PhD, CCN: Thanks for the invitation. Gazella: Well, before we dig into the specific health issues that men face, you believe in a philosophy first approach. I'm sorry, physiology first approach. What do you mean by- Jaffe: The philosophy is physiology. Gazella: Exactly. Jaffe: So, that was appropriate. Yeah- Gazella: So, what do you mean by that? Jaffe: Right. It's a high level, brief, 2 words, physiology first. What we mean is, physiology before pharmacology. We mean physiology first because it seeks an upstream assessment of the causes of risk or symptoms, in contrast to most conventional care today, even holistic or not, that remains rooted in downstream symptom management. Physiology first uses global evidence to reduce risks and prevent people from falling into the river of disease. Physiology first uses nature's nutrients in supplements, with enhanced uptake and chaperone delivery, for safer, more effective, essential replenishments, items we must take in since our body doesn't make them. Physiology first urges organic or biodynamic or locally grown sources of nutrient-dense whole foods, as minimally contaminated as possible. Physiology first focuses on underlying causes. For example, too little of essential needs being met, which are eating, drinking, thinking, doing—those are the 4 headline categories—rather than working back from symptom-reactive case management. And finally, physiology first uses predictive biomarkers interpreted to their best outcome goal values. Now, this is a paradigm shift for many colleagues but we now can impersonalize predicted, proactive, primary prevention practices, save individuals probably a million a year just by applying physiology first. Gazella: Yeah. Well, that's exciting so I'm glad that we went over that. Now in general, what should be on the radar of clinicians when it comes to addressing the special health needs of their male patients? Jaffe: Yes, and here again, now that we've kind of gotten the hundred thousand–foot level, we start and recommend colleagues start with self assessment. This includes transit time, urine pH after rest, hydration, and a sea-cleans as overall global self assessments, very inexpensive. The individual does much of it themselves, brings it to the expert who interprets it so that we get a snapshot of the metabolic or metabolon/microbiome, the digestion and metabolism. You interpret that to best outcome goal values. You use that to inform and inspire and motivate people to put it in effort for the 6 to 7 weeks that it takes to change a habit of daily living and you can add years to life, years of quality life and life to years. In people with chronic symptoms, well. Take a careful family history although family history is highly relevant if you have the same behavior and environmental factors. If you change your behavior, your habits, your environment, then your family history to a very large extent disappears into the midst of history. If there have been prior treatments and treatment failures, it's important to assess that. We use the predictive biomarkers to help people celebrate when they are at their best outcome goal value and take action when their risks increase. Now, men and women at all ages need activity, at least 45 minutes a day of walking or equivalent. Sitting is the new smoking. Weight-bearing exercise or cardio exercise 2 or 3 days a week and knowing about it or preaching about it is one thing. It's when you actually do it. I'm glad to tell you that I had just enough glimpse of the consequences of not doing that I do what I'm recommending. Now we want to teach men to prepare for sleep, achieve restorative sleep, using physiology before pharmacology, using salt and soda baths, Epsom salts and baking soda, plus or minus aroma oil, essential oil. The baking soda alkalinizes and relaxes muscles in the pores of the skin, and the Epsom salts, which is magnesium sulfate, allows the magnesium to come in and that's often very helpful. We recommend that teaching people, particularly men who have sleep issues, about abdominal breathing and active meditation and green dichromatic light, along with nature's sources of serotonin and melatonin, which is tryptophan. We ask about changes in urine stream flow and quality after urination. Is there any dribbling? How many times do they get up at night to urinate? And we make lifestyle suggestions tailored to the individual at their phase of life. We want to be proactive with prostate support nutrients, such as micellized soft gel that contains all of active saw palmetto, [inaudible 00:06:03], lycopene. Free lycopene, not just some ketchup. Hygeium, with 14 or 15% beta sitosterols. Urtica dioica, also known as stinging nettles. Zinc, in the picolinate form. And selenomethionine, selenium in the selenomethionine, healthier, safer form. And all of this micellized in pure pumpkin seed oil to enhance uptake in retention, to improve function. And we think people can be pleasantly surprised at how effective and synergistic the above prostate health support is, available in a single, easy-to-swallow soft gel. Ask about adult beverages. If they consume more than 5 a week, provide comprehensive liver support and recommend a glass of water above the four quarts or four liters a day that humans need to avoid marginal dehydration—1 or 2 or 3 percent dehydrated is a big stress on every organ in your body. So this is, again, at a headline level, how our comprehensive approach actually works. Gazella: Perfect. Now I'd like to kind of narrow our conversation and I want to stay on the prostate because you mentioned the prostate. So, what are the roles that testosterone plays when it comes to prostate health and men's health in general? Jaffe: Right. Both men and women need testosterone. They need a balance of free and bound testosterone. They need good and not bad testosterone. Now, what does that mean? Well, you can measure in saliva or in plasma. The free and the bound, free and total testosterone. You can measure the dihydrotestosterone. You don't want much of that, maybe zero. You can measure oxidized testosterone. You want zero of that. And you want to enhance the good T, the good testosterone and reduce the bad T based on testing results because testosterone is needed for brain and muscle and organ and joint and bowel renewal and many other functions beyond just being a male hormone. You want to enhance healthy testosterone production through healthy microbiome and metabolon functions, especially the family of the central antioxidants. Vitamins, minerals, and cofactors that along with good hydration optimize your healthy testosterone, which is one of the vitality factors in the body and minimize the bad testosterone that causes everything from hair loss to loss of erections. Gazella: Okay, perfect. So before we leave the prostate, remind us what the significance is of the PSA test. Jaffe: That's a very important question and I think we're finally, after half a century in laboratory medicine and I've been following the issue all of that time. The PSA test is a measure of prostate repair. So, the PSA goes up if you have prostatitis. For example, if you just sit in your car too long and hold your urine in too long. And the PSA goes up in some but not all prostate cancers, and you can fractionate the PSA, free and bound, and that usually but not always helps distinguish the prostatitis from the cancer risk. If you had concern about the prostate and about PSA levels and have a biopsy, after a single biopsy—often there are multiple biopsies—the future PSA has no interpretable value that I know of except for population, but we're talking about 1 man at a time. And so many review articles that I have seen in the last few years say do other tests of prostate health and don't even do the PSA because if you don't need the test, you wouldn't do the test. If it's a question, it's a gray zone, that's exactly what the test is not very sensitive or specific. Gazella: What about enlarged prostate? Jaffe: The first thing I would do and have recommended for many years for enlarged prostate is to take that combination of prostate vitality factors and we have had men whose prostate was double or triple than usual size come back to that of a 40-year-old by following for about 6 months a program that includes the supplements that I recommended just a few minutes ago, along with eating foods that the man can digest, assimilate, and eliminate without immune burden, and that means the lymphocyte response assay test that measures T and B cell function and that then says eat this and don't eat that, take the supplement and don't take that, follow this mental and physical plan because in the 80,000 cases that we put in our database, we've evolved a very personalized approach to, say, prostate size. Gazella: Okay, perfect. So, let's move on. What does it mean when a man wakes up with an erection or doesn't have an erection? Is that significant? Jaffe: Oh, absolutely. The headline is that every healthy man should wake up in the morning with an erection. In essence, it's the quality control check of the distinctive male. Too often and very commonly, when a man does not wake up with an erection, that's a sign that they have pregnenolone steal, that they have high stress cortisol levels and low DHEA, which is the antistress hormone, usually with low free healthy testosterone, often with a sluggish thyroid and an exhausted adrenal gland, due to lack of adequate intake of the essential antioxidants, minerals, cofactors that are necessary. In addition to prostate health nutrients, I would recommend checking the thyroid, TSH, 3T3, 3T4. That can be done on a blood spot or in many different ways. But you must, by my recommendation, get the 3T3, 3T4, TSH all at the same time, and the healthy range for TSH is .5 to 2.5, not above. The usual range has too many unwell people. (Usual lab range.) You want to check adrenal stress hormones, cortisol and DHEA at four times during one day. And at the same time, in the same saliva or plasma specimen, you can measure male and female hormones and their sources, their precursors to see if the body has learned a distress response that steals the healthy progesterone and pregnenolone and produces too much distress hormone cortisol and too little healthy male and female hormones. They come from the same source. You want to get both and in balance. Now in regard to male sexual performance, there are natural solutions to erectile dysfunction. The following vitamins, minerals, and amino acids work as a team to improve the quality and duration of erections B complex. One phrase is 'B complex is for boners'. Keep the urine sunshine yellow and feel the difference comprehensive B complex means. C, it is ascorbate vitamin C, always fully buffered, fully reduced and we recommend based on the C cleanse, taking that amount is associated with healthier and the more robust erections. Vitamin D is really a neuro hormone and it does a lot of things, including improving cell function and providing cell energy to sustain the generally sixfold increase in blood retention during an erection. Then magnesium choline citrate. Magnesium is essential for a lot of different things, including a healthy sexual function, and choline citrate at the same time, say 220 mg of magnesium solves and a teaspoon of choline citrate. That enhances the uptake dramatically. It enhances the retention because it is an alkalinizing, rather than an acidifying source. Most magnesium solves and magnesium products have very low bioavailability and are in the acid form, which makes the magnesium run out almost as soon as it comes in. And then last is L-citrulline and L-arginine, and these are 2 amino acids. They both enhance nitric oxide production inside cells, and when you take about a gram of L-citrulline and 500 mg of L-arginine 30 minutes before adult activities, most men notice the difference, especially men over 40. Foods that are rich in these amino acids include nuts, seeds, chickpeas, and other legumes, also known as garbanzos, and meats. Making an avocado and chickpea hummus with some mustard seeds or black and white sesame seeds added plus or minus some toasted pine nuts with fresh ground black peppers and your favored high-quality salt, that can blend into a nutritious, delicious, amorous and traditional food. Gazella: That's great and it sounds yummy as well. Jaffe: It is. It should be nutritious and delicious. Gazella: Exactly, exactly. Well, let's now move onto the gastrointestinal tract. What should practitioners focus here when it comes to their male patients? Jaffe: Well, in the 21st century it is a pretty fair assumption that the person sitting across a professional has mild digestion dysbiosis, some degree of atrophy known as enteropathy, a long transit time. Transit time should be 12 to 18 hours. We recommend doing that with charcoal. We have an online instruction if folks are interested because you want to assess what's called the microbiome, which is the digestive tract in its fullness, or the GNS, known as the gut nervous system, which is in constant conversation and communion with the reigning central nervous system. And so we recommend focusing on a full complement of personalized native antioxidant, minerals, and cofactors in their safer higher uptake forms based on the assessments and the predictive biomarker tests that we recommend. We want to pay attention to hydration because even a little bit 1, 2, 3% dehydrated puts a stress on every part of the body. We want to have prebiotics. That is unprocessed fiber from diet or supplements, 40 to 100 grams a day. That's what Dennis Burkitt taught me and the most knowledgeable nutritionists that I know recommend that much fiber a day. Probiotics, 40 to 100 billion healthy by a mixed bacteria, bugs. Then synbiotics, which is really recycled glutamine to energize and repair the lining of the digestive tract. Then you want to eat what you can digest, assimilate, and eliminate without immune burden. So, you've done some functional immunology testing like LRA, lymphocyte response assay. Take in no empty calories. You are sweet enough as you are. If you feed parasites and pathogens, fungi and yeast, they will grow. Improve the digestion, the microbiome and metabolon, the innate biological detoxification competencies and enhance your digestion by eating what you can digest, assimilate, and eliminate without activating your immune responses. We teach people to stop feeding the pathogens and they disappear as digestion improves, repairs improve, resilience is restored, and habits of daily living are improved. Then you want to look at the secretory IgA if you're concerned about the interface between digestion and the body. It's called SIgA, secretory IgA. You can measure that in saliva. There should be protected mucins so that if partially digestive materials get near the wall of the body, they don't become foreign invaders if you have healthy mucins and healthy secretory IgA. And there are other elected protected digestive functions that healthy people have that are lost when people lack the essential nutrients or the essential minerals when their cellular metabolism becomes acidic, when their body is reaching out, calling out, actually crying out for repair enhancement essentials, things you have to take in that you can't make in the body. So, we wanna taper or possibly discontinue medications that impair digestion. We want to use prebiotics, probiotics, and synbiotics, especially in people who have had antibiotics and other digestive-interfering medicines. We want to check transit time, should be 12 to 18 hours. When I have roast beets as a main part of my dinner, I expect to see red in the commode in the morning. But I can tell you after all these years when I see that red, my first thought is never, "Oh, I had beets last night" so that's why we use charcoal. Now, avoid fat-binding medications and supplements that reduce essential fat-soluble vitamin uptake. That's vitamins A, D, E and K. And you need bile from the liver to do that and for that you need phosphatidylcholine-rich foods and/or supplements, and we happen to micellize all of our soft gels with this PC, with this—not politically correct—phosphatidylcholine. Now, many men have atrophy of their intestinal lining because of stress and toxin exposure and it's the 21st century, and maybe less than perfect eating, breathing, and drinking. So, getting the essential needed nutrients restored may mean intensive supplementation for a few months, followed by maintenance supplementation for a long, healthy life, and I personally plan to be dancing at 120 and I would like you to join me. Gazella: That sounds perfect. So, you mentioned tests to assess the microbiome and you also mentioned secretory IgA. Are there other tests that you recommend in terms of assessing the microbiome? Jaffe: Right. So, the transit time we talked about, it's one of the self-assessments, 1 of the 4. Then this SIgA, the secretory IgA, in saliva or serum, with the comprehensive lymphocyte response assay, if there's any indication that the person has shifted from elected protected mode into survival mode, which means all the protective and repair functions are down regulated, that's called chronic illness to happen, or hormone tests that include cortisol and DHEA at 4 different time points, male and female hormones can be measured in their precursors on the same saliva specimen. You can use plasma if you wish. Adrenal and thyroid adaptogenic supplementation is recommended either based on clinical history or these test results. By all means include some way of determining how much ascorbate that person needs because ascorbate is the maternal antioxidant that sacrifices yourself that all others may be presode. And then the magnesium with enhanced uptake choline citrate. The choline helps build acetylcholine, an important neurotransmitter and neurochemical. It also helps build the choline-rich biosalts that are more soluble and help get the thicker bile out of the gallbladder and into the digestive tract, where that helps emulsify fat to be taken up into the body. And then based on the urine pH, we would adjust how many doses of the magnesium choline citrate you take. Do a regular hydration assessment and when in doubt, what I recommend is that you have a carafe of water in front of you and a glass. If the glass is full you drink it and if it's empty you fill it, and you just keep doing that. And personally my goal is to go to the bathroom at least every couple of hours and then I cut down the amount of liquid I take in after 7 or 8 PM so then I'm not overhydrated when I go to bed. But underhydration is a much more common and unappreciated problem. Monitor the breadth of our little chemicals, and this can give very interesting insights that are both diagnosis-specific of mild digestion dysbiosis enteropathies and so forth. But in addition that information often makes it very clear to the individual that this is true for them and not in general. And the last is a zinc taste test. Developed by Harry Henken, you drop a zinc solution on the tongue. The people who need zinc can't taste it. The people who say the zinc tastes strong have enough. And it's a pretty good one-dollar type assessment of a critical mineral and specifically for men, men need lots of minerals but especially zinc. You lose about 25 mg per every ejaculation. Gazella: Yeah, that's good. That makes a lot of sense. So, now it's time to discuss inflammation. Is inflammation really repair deficit and how does that change clinical practice? Remind us why that's such a big deal. Jaffe: Right. Well, we started with the physiology-first concept. Now I'm a doubly board-certified pathologist. I know the 5 aspects of inflammation. I know it's taught as a fire to be fought, something that has to be suppressed with anti-inflammatories. And now I pause and say: Anything that starts with 'anti' is using pharmacology before physiology. Inflammation is repair deficit. What my pathology colleagues see as inflammation is the cumulative lack of repair when your immune defense and repair system is doing too much defensive work because of foreign invaders from the breath or the skin or the gut, and if you enhance the innate immune system's ability to repair, your infrastructure is reborn, your bones get rebuilt, your joints are renewed, your mood is better. Your ability to get restorative sleep and meaningful relationships all are improved when you recognize that repair deficit is an opportunity. You use the hsCRP test as a predictive and validated biomarker. It's also an all-cause mortality, morbidity marker. The healthy goal value—and this is, again, where we have the reframing. I don't even look at the lab range because that includes too many unwell people. You know the goal value for this test, hsCRP, and it's less than 0.5. Ignore statistical lab ranges unless you're treating statistics, and knowing the best outcome goal value we add ascorbate based on the [inaudible 26:350, magnesium choline citrate based on the urine pH, and other similar kinds of monitoring so that the person gets more safely the forms that are more effective because of their enhanced uptake and retention and therefore the deficits get corrected more quickly. I mentioned hydration. I keep mentioning it only because every part of your body is healthier and more resilient and more able to repair when you take in healthy water, 4 liters a day or more of either mineral-rich, I happen to have well water but some mineral-rich water that's not contaminated and/or sparkling water. I happen to like Pellegrino but there's also Gerolsteiner and Apollinaris and actually every culture has a mineral-rich water known as a therapeutic or beneficial or health-promoting mineral water. So, you want to drink hard water, so water softeners are not recommended, at least not total home water softeners. If you want to soften the water in the pipes, I don't care, but your blood vessels are not pipes and now I care about the quality of the water that you take in. Gazella: Perfect. So, I love your perspective about looking at repair deficit as an opportunity. Are there other ways to kind of take advantage of that opportunity to reduce oxidative stress and reign in inflammation? Jaffe: Yes. And again, in a physiology-first point-of-view in regard to, say, blood fats. Cholesterol and triglycerides and blood fats and [inaudible 00:28:14]. If you keep the oxidation of those fats, if you keep oxidized cholesterol to zero, if you keep oxidized LDL to zero, because you're taking enough antioxidants and especially ascorbate. Now, the fat-related cardiovascular risks just went away. What remains is understanding your hemoglobin A1C, your hsCRP, your homocysteine, your LRA (lymphocyte response assay immune responses), your vitamin D, your first morning urine pH, your omega-3 index, and [inaudible 00:28:51]. Those are the eight predictive biomarker tests and we have online for folks to peruse and/or download or watch on YouTube discussions of why these eight predictive biomarkers cover all of that genetics, which is 92% of your lifetime quality of life and health. And yes, you can blame mom and dad for the other 8%, and yes transgenerational influences on RNA are a big scientific field but not yet ready to measure clinically. Live in the moment, do one thing at a time, practice gratitude and random acts of kindness, breathe abdominally for at least 5 minutes a day, and make enhance repair your practice and banish inflammation. Gazella: That's perfect. It's a very integrative approach that includes lifestyle as well. I'd like to end with heart disease because heart disease remains the leading cause of death for men in the United States. So, what do you recommend when it comes to protecting heart health for male patients? Jaffe: Yes, and as I think you know part of my primary research when I was in government service at the National Institutes of Health Clinical Center was collaborating with the Heart Institute on animal models of heart disease. Now, Paul Dudley White in the 1930s was a famous cardiologist. He helped invent the electrocardiogram. He taught when I was a young student that in the 1930s at Mass General Hospital in Boston, Massachusetts if they had 1 heart attack a year, they published the case. And yet 40 years after that, cardiovascular disease was the major killer of Western civilization. That's not a genetic change. It's too quick for genetics. A lot has to do with smoking and sitting, sedentary lifestyle, processing of foods, and all that goes with that. Jaffe: So, cardiovascular disease. If your heart attacks you, if you have a clog in a blood vessel, an artery, if you have a stroke, you didn't pay attention to the upstream warnings that you would know about if you did the self-assessment, if you did the predictive biomarker tests because these change. Your risk goes up dramatically decades before catastrophe. And if you change your consumption and attitude, if you change the environmental toxin exposures and by the way 80% of the toxins that people have in their body are of recent exposure, and you can dramatically reduce that by certain simple lifestyle changes. Include 1 to 300 mg a day of micellized CoQ10 in 100% rice-brand oil, and no glycose. No antifreeze in your CoQ10. Keep the 8 predictive biomarkers at their best outcome goal value and when they are, when those 8 tests are at their best outcome goal value, you have a 99% chance of living 10+ years, even if you're 100 at that point, and my main teacher Buntey was 110 when he passed and as I mentioned before I plan to be dancing at 120 by following this lifestyle, and I urge anyone who is willing and interested to join me. Gazella: That's perfect. Well, Dr Jaffe, we covered a lot today. Before I let you go, I'm just wondering if there's any final thoughts or anything else that you'd like to share with our listeners today. Jaffe: Yes. In essence, the physiology-first, the epigenetics is 92% of your life quality has to do with consumption, which you eat and drink and how you think and what you do. Now whatever season of your life is as a man, that may be different. When you're young and immortal, that's one thing. As soon as you're beyond young and immortal, be prudent. Cardiovascular disease starts in teenage years. Cancer risks goes up dramatically when your innate anti-cancer mechanism is turned down because you're eating foods that are causing too much defense burden in your immune defense and repair system. So, just follow through on this physiology-first approach looking at your individual needs for personalized health promotion and put pay to chronic ill health. Gazella: Perfect. Well, once again I'd like to thank today's sponsor, Perque Integrative Health, and Dr Jaffe I'd like to thank you for taking the time and sharing so much information with us today. Jaffe: Well, thanks for inviting me and for making it such an enjoyable time. I hope the listeners will take away much that will be of value, and it's my pleasure. Gazella: Well, thank you and I hope you have a great day. Jaffe: You the same, Karolyn. Always a pleasure. Gazella: Yes, it is. Bye-bye.

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During this interview Russell Jaffe, MD, PhD, CCN, will share his thoughts on how to safely and effectively enhance and protect bone health. Listeners will learn how acid-alkaline balance impacts bone health, as well as key nutrients that can help support bone density.  About the Expert Russell M. Jaffe, MD, PhD, is CEO and Chairman of PERQUE Integrative Health (PIH). He is considered one of the pioneers of integrative and regenerative medicine. Since inventing the world’s first single step amplified (ELISA) procedure in 1984, a process for measuring and monitoring all delayed allergies, Jaffe has continually sought new ways to help speed the transition from our current healthcare system’s symptom reactive model to a more functionally integrated, effective, and compassionate system. PIH is the outcome of years of Dr. Jaffe’s scientific research. It brings to market 3 decades of rethinking safer, more effective, novel, and proprietary dietary supplements, supplement delivery systems, diagnostic testing, and validation studies. About the Sponsor PERQUE Integrative Health (PIH) is dedicated to speeding the transition from sickness care to healthful caring. Delivering novel, personalized health solutions, PIH gives physicians and their patients the tools needed to achieve sustained optimal wellness. Combining the best in functional, evidence-based testing with premium professional supplements and healthful lifestyle guides, PIH solutions deliver successful outcomes in even the toughest cases. Transcript Karolyn Gazella: Hello, I'm Karolyn Gazella, the publisher of the Natural Medicine Journal. Thank you for joining me. Today, we're talking about bone health with pioneering integrative health expert, Dr. Russell Jaffe. Before we being, I'd like to thank the sponsor of this podcast who is Perk Integrative Health. Dr. Jaffe, thank you so much for joining me today. Russell M. Jaffe, MD, PhD: Thanks for the invitation. Gazella: Well you know when we think of our bones, we often think of osteoporosis. Let's start there. How common is osteoporosis in particular? Jaffe: Oh, far too common. Depending on how you make the measurements, somewhere between 50 and 100 million Americans are at risk. One in 4 women over the age of 40 will have a fracture of their bones due to the osteoporosis or osteopenia. Maybe 1 in 5 or 1 in 4 men, maybe more, the precision of diagnosis probably understates the issue. The point is that bones, whatever your birth date might be, your bones should be young. Bones turn over every 10 years, which means no part of any bone that you or I have is more than 10 years old. Remember when we were 10 years old, we could jump around, we could leap around. I don't recommend behaving like a 10-year-old. What I'm saying is, your bones should be resilient, and flexible, and not brittle, and not being leeched by the stress and dietary choices of modern living. Gazella: Yes. It's hard for me to even imagine a 10-year-old, but it would be fun to have bones like a 10-year-old, for sure. Now is the DEXA scan still the gold standard for measuring bone density? Jaffe: Yes. D-E-X-A, DEXA is the "gold standard" reference standard. There are other measures that are coming along. There's N-telopeptides which are a little hard to interpret. There are other measures, but to the best of my understanding, the expert experts in bone say that you can measure DEXA changes over 2years. My colleague, Susan Brown and I did an anecdotal prospective study with 11 people, 10 of whom had between 2% and 10% or 11% new bone growth, unprecedented new bone growth by following this approach to Alkaline Way bone health. Gazella: Yes. How often do you recommend that patients get a DEXA scan? Jaffe: Well, let me come at it 2 or 3 different ways. In regard to the usual and customary use of the DEXA scan, it's a 2-year waiting period. Now many doctors will do a DEXA after one year and try to compare, and interpolate, God bless. Other people will use other measures, including bone mineral protein and how much of that there is in say the urine. You asked the right question, which is what is does the measure that almost everyone agrees, or that about which there is reasonable agreement and consensus. The answer there, DEXA. Until something better is really validated and yes, new things come along all the time, but I'm seeing a lot of them go 'cause as you know, my PhD was in collagen and elastin cross-linking, and how you regulate that. That was half a century ago and learned a lot since then. But collagen has a lot to do with bone health and bone turnover. Then there's certain other unique characteristics contributed by the liver that allow the minerals, not just calcium, but all of the minerals that are necessary to align properly to form what we call a bone. Gazella: When it comes to bone health, what do you mean when you say physiology before pharmacology? Jaffe: Well I mean the fact that bone is piezoelectric, which means when you walk, when you move, actually stimulating tiny electrical flows that say to the bone rebuilding cells, the osteoblast and osteoclast, "Do your job." Moving is a good thing, at least 45 minutes a day of walking. Yes, sitting is the new smoking, but if you get up at least 5 minutes an hour, you can undo most of the adverse effects of cutting off your circulation when you sit in most chairs. Now if you happen to have one of these recliner chairs or something like that, more power to you, but you still have to get up out of the chair. Walk for at 45 minutes a day. [inaudible 00:05:24], to the extent that he had a doctor was me, and [inaudible 00:05:29] very active now, they both agree. Now walking is a terrific way of human beings stimulating bone growth because of this "piezoelectric" or tiny electrical flow that nurtures and nourishes the bone. That's an example of physiology before pharmacology. Gazella: A great example. When it comes to your integrative approach, I want to dig into certain aspects of how we can enhance or protect bone health. You often talk about the acid alkaline balance. How does acid alkaline balance impact bone health? Jaffe: Well in essence when your diet or your environment contributes acid, your bones melt slowly away and sometimes not so slowly. On the other hand, when you have a mineral rich environment that bathes the cells and renews the cell's mineral buffering abilities, now you build new bone. We want to build new bone. We don't want to melt the existing bone. Gazella: Right. That makes a lot of sense. Let's stay on this topic for a bit because I know that most of our listeners understand how to support the acid alkaline balance, but what are some of your foundational aspects when it comes to supporting proper acid alkaline balance? Jaffe: Well as you know, we start with the self-assessments. The assessment we want to start with measuring the pH, that means how much acid or how much mineral is in your urine after 6 or more hours of rest. It's the one time of day when you get a meaningful measure in a non-evasive way of the cellular mineral status, 'cause after 6 hours, the fluid in the bladder equilibrates with the lining cells, and lining cells, if they need magnesium then they put the extra acid into the urine. If it's below a pH value of 6.5, then you're too acid. You're deficient in minerals, particularly magnesium at the cellular level. You should take 2, 3, 4 more doses a day of magnesium, but enhanced uptake magnesium with choline citrate. It must be choline citrate, it cannot be choline bitartrate. Try to fool mother nature and she'll come back and slap you on the tush. You want to enhance the uptake and chaperone delivery of magnesium based on [inaudible 00:08:14] chemistry, and for your listeners who are technical, these are inverted [inaudible 00:08:20] droplets. I really am a biochemist. What that means is tiny little droplets that are taken up by [inaudible 00:08:28], that easily enhance the uptake. In recent studies near 100% comes in and then goes to the cells that are [inaudible 00:08:37]. Gazella: You know it seems like bone broth has been the rage for a while now. What are your thoughts on bone broth as a way to boost bone nutrition? Jaffe: Well I'm a big advocate for broth, but not bone broth. Why not bone broth? Bone broth turns out to be far too rich in glutamate, and why is it rich in glutamate? You wouldn't think there's much glutamate in bone, it's glycine, and proline, and something else. No. What the industry calls bone broth includes skin, it includes things that have no other commercial value that are left after you "render" the animal, or the chicken, or the whatever, [inaudible 00:09:27] bone. Bone broth, no. But meat broth, vegetable broth, fish broth, broth you make at home, or broth that's organic or biodynamic, yes, yes, yes. Broth is a very good source of minerals, and I mean vegetable broth, fish broth, meat broth if you want, but real meat made into a broth, which means you very slowly simmer it until it falls apart, and then you have more or less a broth, especially if you either whisk it or put it in a blender. Broth, yes. Bone broth, no. Gazella: Okay, good. That's a good distinguishing factor. Now we also hear about MSM and hyaluronic acid for bones and joints. I'm wondering what you think about these 2 ingredients when it comes to bone health. Jaffe: Well MSM is a sulfur source. Sulfur sources are very important in protecting and enhancing bone vitality and renewal. Now we recommend that physiology before pharmacology approach, which we use garlic, ginger, onions, brassica sprouts and eggs. G-G-O-B-E, garlic, ginger, onions, brassica sprouts. All sprouts are good, but broccoli sprouts, brassica sprouts especially, and eggs. Why not MSM? 'Cause it's pharmacology. It is water soluble DMSO. DMSO makes you smell like a fish. Not a very healthy fish or a decomposing fish actually. MSM is a supplement that's been around for 20 plus years. It has a certain [inaudible 00:11:04] that comes and goes, but it's pharmacology. We want to start the physiology, the G-G-O-B-E, garlic, ginger, onions, brassica sprouts and eggs. Then if a particular practitioner feels that additional MSM is helpful, I think they make the final decision along with their client. As you can hear from my comments, we want to use nature's pharmacy, which means you generally have to cook the food the way it's traditionally done. If you just chop up an onion, the cell walls will prevent you from getting the good stuff. But if you sauteed the union until it's clear, now you have a nutritious and delicious detoxifying physiologically helpful bone joint and vitality enhancing material that you can make into any broth you want. However, you want to eat the foods you can digest, assimilate and eliminate without immune burden. If your body reacts to one or more of the G-G-O-B-E foods, then substitute with the other 4. Thomas Jefferson said they should be stables in the diet, not condiments. I'm a Jeffersonian democrat, which means I'm a grieving optimist. I believe that we should make these staples in our diet again. Gazella: Yeah, that makes a lot of sense. What about hyaluronic acid? Jaffe: I'm glad you asked that too. Hyaluronic acid is different. It is physiologic, so when you take ... I'm a pathologist, [inaudible 00:12:40] certified pathologist. When you look under a microscope at a joint, more than at bone, but at the joints you do see what are called water absorbing compression-friendly molecules, hyaluronic acid among them. Hyaluronic acid goes back to the early '80s, when a Canadian company thought that this was going to be the answer to joint erosion, to the kind of bone-on-bone pain that very commonly occurs to people who haven't walked enough, and have sat too much, or have been on planes too much, as I have been from time to time. Hyaluronic acid has a medical application. It's an injection. I think after you use nature's pharmacy, after you engage, when you eat and think, drink and do in a comprehensive and holistic way, that injections in hyaluronic acid in the right hands, in experienced hands, are an option. It does provide relief to some people for a period of time while other renewal should be engaged in. Gazella: Okay, that makes a lot of sense. Now let's dig into some of your other go-to nutrients for healthy brains. I'm sorry, health ... Jaffe: Bones. Gazella: Bones. Yeah. Jaffe: That applies to brains too. Gazella: Yeah, yeah. That's good. When it comes to bones, what are some of the nutrients that you like to recommend? Jaffe: Well in regard to the nutrients, there are over a dozen and a half. You can divide these into vitamins, minerals and co-factors. It's mostly about a family or a symphony of minerals. Remember a symphony has many different instruments, each of whom plays a slightly different tune. We recommend, in addition to vitamin K1 and K2, in addition to vitamin D3, we recommend biotin necessary for healthy bone. We recommend half a dozen forms of calcium, half a dozen forms of magnesium. Specialized bio available forms, low contaminant forms of zinc and magnesium, and chromium and selenium, methionine. Copper is the sebacate, iodine and iodide, you need both. Boron, acid citrate, vanadium, which balances out blood sugar and chromium. Silica, but from horsetail. Stable strontium is the gluconate, and fiber, croscarmellose fiber to enhance the easing digestibility making it food-like. Those are the over 18, 19, 20 essential bone building nutrients. Now vitamin D should be the D3. There should be some vitamin C to keep everything reduced and happy. Gazella: 'Cause this does seem like a big list. These all work synergistically? Jaffe: And they're all essential. If you lack any one, your bones won't renew properly. It's amazing how many co-factors, how many minerals and necessary nutrients that allow for bone health. But Dr. Susan Brown and I published an article a decade ago, we're working on an update now, which basically says the more tonic, or soda, or acid beverage you consume, the more quickly your bones will dissolve, the more quickly your bones will melt away. Then on the other hand, when you have a healthy traditional diet, rich in minerals, the Alkaline Way, the joy of living the Alkaline Way, documented by morning urine pH, keeping it in the 6 ½ to 7 ½ range, that's green rather than sandy color which is acid, or blue which is too alkaline, you want to keep it in the green zone. It's Goldilocks scenario. Not too much, not too little. Just right is just right. Gazella: Now before I move on, I want to talk about this combination of vitamins, minerals and co-factors. Are these in one product? What will be ... Jaffe: Oh, yes. This is what Dr. Brown and I used in our prospective study. When I say gaining 2% to 11% new bone, by DEXA in just 2 years, I'm saying people taking this formula and also following a healthy lifestyle of foods they can digest, assimilate and eliminate. Gazella: Okay, great. What's the name of this product and what's the recommended dosage of this product? Jaffe: Well the recommended dosage is 4 tabsules a day to build, 2 tabsules a day to maintain, 6 tabsules a day if you have osteopenia or osteoporosis. Gazella: Okay, so 4 per day, 2 per day. Then, I'm sorry, that was 6 per day if there is osteoporosis or osteopenia? Dr. Jaffe? Jaffe: Oh, I'm back. Sorry. Gazella: Okay, perfect. The dose for osteoporosis or osteopenia is 6 per day. Jaffe: Yes, that would be 6 per day. What I would say would be 3 in the morning, 3 in the evening, so a twice a day dose of 3 tabsules, these are fully active, fully available, and they contain all of these different nutrients, each one of which is necessary, and together they form a symphony or a bone building team. Gazella: Okay, perfect. Great. Now I want to switch gears a little bit. What's your view of bone morphogenic proteins and the long-term effect on bone status? Jaffe: Well you're absolutely up to the minute. Bone morphogenic protein is being studied as we speak. It's promising, but we really don't, in my opinion yet, have enough information. What we know is it's built upon something called 2-Beta Coxatene, for those of you who are technical. This is bone mineral protein precursor. Dr. Brown and I are, at this moment in time, encouraged by what we have heard about this. She and I are collecting information as we speak, and stay tuned for bone [inaudible 00:19:21], as they say. Gazella: If we were going to look into the future when it comes to integrative health and bone support, bone building, is this where we're headed with the morphogenic proteins? Is this an exciting area? Jaffe: Well yes, definitely an exciting area. The question is, how much do you need for each person because, as you can imagine, given that you started with a really healthy organic or biodynamic bone, and then you somehow got out of it, this magic complex, how much do you need, and how much does it cost, and how long will it take before you really confirm what is asserted by some clinicians based on their observations? The observations are encouraging, but stay tuned for the bulletin. Gazella: Okay. Perfect. Now I want to dig into diet and lifestyle. I want to circle back with your G-G-O-B-E, the garlic, ginger, onions, brassica vegetables and eggs. Explain it again or in more detail as to why these 5 dietary items are foundational for you. Jaffe: Right. They're foundational because in traditional societies they are sulfur rich. You can think of sulfur as a fire that burns away bad stuff and toxins. That's a metaphor, but biochemically it's not far from the case. For those of you who are technical, they form thioethers. This makes compounds that would otherwise be free radical generating harmful compounds more water soluble and less harmful, so once they're complex, what these sulfur rich foods, or the sulfur in the foods, then they can be treated in urine, sweat and stool more safely and effectively, and it's been used for millennia in traditional societies. We just have rediscovered it in recent times. Gazella: Perfect. Well I want to stay a little bit with eggs because I've done a lot of writing about eggs, and I had the belief that eggs have gotten a bad rap. I personally eat eggs almost every morning. Explain to us about why eggs got the bad rap, and why eggs are actually good for us. Just remind us of that. Jaffe: Yes, eggs got a bad rap because Levy and Fredrickson had the idea of the diet-heart hypothesis that the amount of fat or cholesterol you ate was determinative or it actually determined how much blood fat you have. Now it turned out to not be the case, but Levy ran the Heart Institute and Fredrickson ran the NIH. They had the dominant ... in their time. At that time, there was a man named Olson, and he pointed out that eggs are the perfect food when you combined the white and the yolk, when you make a gently coddled or gently cooked egg you have a near perfect food in regard to easy to digest, assimilate and eliminate for people that have healthy digestion. Now implied in what you said, I think, is getting a healthy egg. My preference today are goose and duck eggs, or quail eggs because they haven't been messed with very much. If you put in front of me a biodynamic chicken egg, or a home harvested fresh egg, I'll be delighted. Commercial eggs I'm not so sure of. I'm concerned about what the chicken ate the got into the egg and that's what she wrote, as they say. Gazella: I would have that same feeling as well. Let's talk a little bit about what we should not eat if we're trying to protect and enhance bone health. What do you tell your patients not to do from a dietary standpoint? Jaffe: Well as you know, I don't have a private practice. I get to influence other doctors and their probable cases, but what I do recommend is stay alkaline. Stay alkaline means eat foods that are mineral rich, eat foods that are antioxidant rich, eat foods that are nutrient dense and rich, and you are sweet enough as you are, do not add sugar to your diet, do not use edible oils. I think edible oils is an oxymoron. What I mean by that is you avoid packaged goods, shipped foods, crisp foods, extruded foods, things that have been processed because processed means you lost the good stuff and you gained the bad stuff. Do a makeover in your kitchen, eat the foods that are whole, eat more fruits and vegetables that are vying ripe. If you want to have healthy fat in your diet, have an avocado, a whole one. Once you separate the oil from the seed, you know, like the olive oil, once you separate the oil from the seed the protective material is now gone and what you have are dense calories. Fat are dense calories, but those fats, those edible oils are easily oxidized, damaged and rancid. Then they get masking agents to make sure that your tongue and your brain get addicted to wanting those rancid processed fats. I don't think that's a good idea. I can tell you lots of reasons why [inaudible 00:25:15], who taught me about this in the early '80s, late '70, [inaudible 00:25:19], why Patty Deuster is so correct about these issues, but slowly we turned in regard to nutrition [inaudible 00:25:26]. Gazella: Let's talk a little bit about lifestyle factors. Now you mentioned movement and exercise in a scientific literature is so clear that that's protective of bone health. What about other lifestyle factors, like if we're looking at stress, or sleep, or just other things that we do? What do you tell your doctors to tell their patients? Jaffe: Well what I learned from [inaudible 00:25:52] and the Dalai Lama was that afflictive responses, that is the traumas of early life or the traumas of daily living that contribute stress hormones, afflict us, they erode us, they reduce new bone formation. By the way, no one gains from any of that. In the famous words of Bobby McFerrin, "Don't worry, be happy." I don't mean live by denial. What I mean is practice relaxation response. Know that your breath is a refuge and know that stress hormones only come out when you feel under attack. You may have heard about fight or flight, but there's also fortitude, there's also gaining the resilience to know that when you go to your breath, you can stay at ease even if everyone around you is hysterical. I can tell you from personal experience, in my family, if you didn't shout, no one paid any attention to you because everyone else was shouting. They just didn't know it. Gazella: Yeah, that's true. The relaxation ... Stress is a big deal. What about sleep? I know often times, sleep and stress go hand in hand, and one can lead to the other, and vice versa. What's your philosophy on sleep? Jaffe: Yes, my philosophy on sleep is that it's really important, restorative sleep, and how do I prepare for restorative sleep? Well I take a salt and soda bath. I put half to a cup of baking soda and Epsom salts in a warm tub of water, and get in for 20 minutes. First 5 minutes I breathe like a baby into my abdomen, the next 15 minutes I pray that my heart won't attack me, and whatever active mediation you want to do, then I get out and I dry off before I get into bed, and I stretch when I'm in bed before I fall asleep. Then I might even ask myself a question that I would like my dreams to answer if I'm inclined to do that. [inaudible 00:28:03] dreaming myself. In the morning I wake up and I stretch. I got to bed early enough that I get up early enough that I don't need an alarm clock. There is no screen, there is no clock, there's no unnatural sound. Occasionally I'm woken up by a wind chime or by a bird, but that's a nice thing to get woken up by. Then I stretch before I get out of bed, and then I get in the shower and I stretch when I'm in the shower, 'cause if you're not stretching a lot, you'll contract. Look at most old people, they slow down and contract. I am how you say old, but not that old, and I'm not yet contracted. Gazella: That's a good thing. Jaffe: That's a good thing. I'm working on it. Gazella: It's perfect. What would you like to be the most important bone health message that our listeners of health care professionals receive today? What's the most important thing that you want to get across? Jaffe: Most important is that bone health is a choice. It is about what you eat and drink, think and do. When you put it together in this proactive way, you have healthy bones for life. If you follow the "Conventions of modern living and pharmaceutical pill-based solutions," you end up slowing the loss but creating brittle, more fragile bones. In the famous words of Mel Brooks, the 2,000 Year Old Man, "Don't do that." Gazella: Right. Yeah, the physiology before pharmacology, I think, is such an important message. Well this has been very interesting, Dr. Jaffe. Once again, I would like to thank the sponsor of this topic, who is Perk Integrative Health. Dr. Jaffe, once again I'd like to thank you for joining me today. Jaffe: Pleasure to be with you as always. Gazella: Yes. Have a great day. Jaffe: You have the same.

A new study revealed that smelling scents of indulgent food can help satiate people's food cravings. University of South Florida researchers examined how ambient scents, which are often used as a marketing tool to persuade people to buy products, affect people's food choices. To determine how scents influence people's food purchasing decisions, the research team conducted experiments in places like a middle school cafeteria and a supermarket. In the experiments, the participants were exposed to scents of both indulgent and healthy food. Those in the school cafeteria were exposed to pizza and apple scents, while those in the supermarket smelled cookie and strawberry scents. Results revealed that participants bought fewer unhealthy meals when they were exposed to scents of indulgent food, such as pizza, for more than two minutes. Similarly, in the supermarket experiment, shoppers picked healthier food selections after smelling cookies as opposed to when they smelled strawberries. The researchers therefore concluded that extended exposure to scents of indulgent food lowered the participants' preference for unhealthy food. They hypothesized that smelling these scents for over two minutes activates pleasure in the brain's reward center.  As a result, there is reduced craving for indulgent food. Essentially, without actually eating, smelling indulgent food for a longer time could help people fight their cravings. Aisling Pigott [ASH-ling PIH-gut], a dietitian not involved in the study, commended the research. However, she suggested that it should be conducted in different environments to prove a stronger link between scents and food cravings. While the researchers recognized the limitations of the study, they hope that it can lead to further research on the matter.

00:01:18 Georgina's cheque00:06:14 *Georgina's retiree (audio)00:11:34 *Tim Wilson Loses His Shit (audio)00:14:23 *Tim Wilson and the grubby smear (audio)00:16:37 *Michaelia Cash caught out; demands an apology (audio)00:22:22 Stacking AAT on the way out00:25:59 Cormann's totally above board free holiday00:27:45 Constrasting the rorts with robodebt deaths, and revelations robodebt costing almost as much - or more - than it raises00:35:29 Muffin Break reminds us to #changetherules00:42:20 *Socialism Corner - young people are apparently increasingly keen on "socialism", causing Fox News in the US to excoriate teaching kids about "fairness", and Sky News here to rant vaguely about Venezuela (Audio)00:49:40 AvH: Lib Senator Linda Reynolds' revolting crocodile tears00:54:56 Christian Porter's bullshit "glaring" "loophole" nonsense00:57:24 The Libs' "limited tenders" - Paladin ($423m) and PIH ($21.5m), the shonky arrangements, and the impact on refugees00:58:35 The Libs' shonky scheme to send sick refugees to Xmas Island out of spite01:03:01 Hakeem al-Araibi red notice was bc Border Force forgot to send an email.01:03:53 *One Nation rabble (audio)01:06:34 *Vic LDP accidental upper house member's "Rexit"

EPISODE 26: Partners in Health with Jourdan McGinn (This episode was recorded in a public space, so you may hear footsteps, echoes & general titter tatter - we’re sorry, we’ve tried our best to make it easier to listen to!) This week we’re talking to Director of Policy & Partnership with the formidable Partners in Health (PIH) Sierra Leone, Jourdan McGinn. On Thursday 29th November, 2018, we had our final VERVE Think Tank (VTT) of the year and did so in partnership with PIH. We were lucky enough to have Jourdan fly over to our London office so VERVE ‘Mother’ Anna Quick- Palmer could interview her at the event in front of 40+ attendees. This episode is just a snippet of the fundamental work PIH are doing. Anna, Jourdan & VERVE Chief Managing Feminist Erin Whiteley sit down to talk about what PIH do, and how we can go about to help them, too… Give to PIH Sierra Leone here, where all your donations will be MATCHED: https://www.justgiving.com/crowdfunding/vervethinktankglobal2018?utm_term=yp6p9p6gW Emma Minor’s of PIH blogs for more info on PIH: https://www.verveup.com/shesaid/breaking-the-mold-for-pregnant-women-in-sierra-leone https://www.verveup.com/shesaid/feminist-healthcare-in-the-heart-of-sierra-leone?rq=emma%20minor Anna Quick- Palmer’s blog on Drs believing Black People feel less pain than white people: https://www.verveup.com/shesaid/drs-still-think-that-black-people-feel-less-pain-than-whites-and-that-hurts Claire Ryder's blog on healthcare being a human right: https://www.verveup.com/shesaid/is-healthcare-a-human-right?rq=is%20healthcare%20a%20human%20right%20 New York Times article mentioned by Jourdan about Doula's: https://www.nytimes.com/2018/10/02/style/postpartum-doula.html Official PIH Website: https://www.pih.org More on the imperative She Decides organisation: https://www.shedecides.com DO SOMETHING for She Decides here: https://www.shedecides.com/do-something/ VERVE links: Website: https://www.verveup.com IG: https://www.instagram.com/verve_up/ Twitter: https://twitter.com/verve_up FB: https://www.facebook.com/verveup/ Host: Anna Quick- Palmer - Mother of VERVE (Founder & Chief Feminist Operative) Co- Host: Erin Whiteley - Chief Managing Feminist at VERVE Guest: Jourdan McGinn - Director of Policy & Partnership for Partners in Health Music Intro & Outro: Jamie Masterson - Freelance Music Producer (insta: jaytmasterson) Podcast Editor: Helena Burton- Jones Speaking over Intro & Outro music: Anna Quick- Palmer - VERVE Founder & Chief Feminist Operative Please reach out if we've missed something in our episode notes. contact@verveup.com

In an exclusive interview with TheRightDoctors on Emcure AICOG tv, Dr. Keshav Malhotra, the Lab Director for Rainbow IVF Centers spoke about the benefits of single embryo transfer in India. This is what he said: ' clinics are transferring 3 embryos, 4 embryos and 5 embryos in their patients and the major problem. When you transfer so many embryos is that there is a high risk of having multiple pregnancies It is a very high risk in IVF. Once the patient has actually sold their houses or given them for lease, if you give them twins or triplets later on they do not have the money to deal with those pregnancies. Single embryo transfer is the need of the hour IVF is rapidly advancing, not many centers have a proper NICU and when you have multiple pregnancies these women have a higher chance of having PIH, higher chance of having eclampsia, higher chance of having diabetes, hypertension. Twins have higher risk of growth retardations. Pediatricians compared singletons and multiples and found out that there was huge developmental delay as far as growth is concerned in twins or more than that.' TheRightDoctors, a Google Launchpad Digital Health StartUp, is one of the leaders in production and dissemination of Medical Information. We bring Insights from the World's Best Medical Minds to digital audiences worldwide across leading digital and social media platforms. Subscribe for more videos: https: https://goo.gl/BDq1gL Our Social Media Links : Facebook - https://goo.gl/YO1oel Google + - https://goo.gl/ImMXq5 Twitter - https://goo.gl/J1gtvw LinkedIn - https://goo.gl/FClkyl

Sponsored by Perque Integrative Health By Natural Medicine Journal There is a significant link between lack of sleep and hormonal, inflammatory, and immune system health. In this interview, Russell Jaffe, MD, PhD, describes the connection and then provides information about his comprehensive, integrative approach to sleep issues. About the Expert Russell M. Jaffe, MD, PhD, is CEO and Chairman of PERQUE Integrative Health (PIH). He is considered one of the pioneers of integrative and regenerative medicine. Since inventing the world’s first single step amplified (ELISA) procedure in 1984, a process for measuring and monitoring all delayed allergies, Jaffe has continually sought new ways to help speed the transition from our current healthcare system’s symptom reactive model to a more functionally integrated, effective, and compassionate system. PIH is the outcome of years of Dr. Jaffe’s scientific research. It brings to market 3 decades of rethinking safer, more effective, novel, and proprietary dietary supplements, supplement delivery systems, diagnostic testing, and validation studies. About the Sponsor PERQUE Integrative Health (PIH) is dedicated to speeding the transition from sickness care to healthful caring. Delivering novel, personalized health solutions, PIH gives physicians and their patients the tools needed to achieve sustained optimal wellness. Combining the best in functional, evidence-based testing with premium professional supplements and healthful lifestyle guides, PIH solutions deliver successful outcomes in even the toughest cases. Transcript Karolyn Gazella: Hello, I'm Karolyn Gazella, the publisher of The Natural Medicine Journal. Today, I have one of my favorite guests, Dr. Russell Jaffe, with me. Our topic is sleep. But before we begin, I'd like to thank the sponsor of this interview, who is PERQUE Integrative Health. Dr. Jaffe, thank you so much for joining me. Russell Jaffe, MD, PhD: A pleasure to be with you, Karolyn. Gazella: Yes, it's always a pleasure. This is an important great topic. Now, the CDC has said that lack of sleep is a significant national health problem. It's reached epidemic proportions. Now, why do you think so many people today don't get enough quality sleep? Jaffe: Well, first I commend my colleagues at the Center for Disease Control for waking up. Yes, sleep deprivation in our time, in this 21st century, it is at least epidemic, and it may be endemic. Endemic means beyond epidemic. If it becomes so usual that it's like the normal, we don't notice it. Fortunately, CDC has noticed that sleep deprivation causes all sorts of "tsuris." That's a Yiddish word for problems. It causes all sorts of amplifications of dispositions to ill health. Not necessarily the sole cause or the single bullet in the problem that a person has, but anything you have will be made better by good restorative sleep. Anything, any health challenge you have, any performance issue, any life quality issue, will be made better by good quality of sleep and worse by a lack of restorative sleep. The emphasis here is on restorative, not just on being unconscious. Gazella: Right, I would agree with that. I want to dig into some of the technical aspects of sleep. Can you first explain to us the intricacies of the hormonal regulation of sleep? What's going on? Jaffe: Well, half a step back if you permit me, which is in biology, in life, it's always about proportion, or ratios, or balance or imbalance. We can, and I'm happy to talk about the hormones and the neurochemicals, and the sources of these neurochemicals that are amino acids. The sources of some of these neurohormones that are either a vitamin or a fatty acid, a dietary source again. As Hippocrates said several millennia ago, "Let your food be your medicine. Let your medicine be your food." If you start with a healthy, all foods diet that you can digest, assimilate and eliminate, you will then take in a healthy balance of the precursors to all of these neurochemicals, neurohormones, et cetera, and the body will figure out how to utilize them in an efficient and effective way. Now I know that's a kind of high level view. But when we talk about these rhythms, which sleep is a particular example of biological rhythms in action, we do know certain things. There are four phases to sleep. At the end of the fourth phase is the time when a release of growth hormone, a release of neurochemicals, a release of neurohormones occurs, and abnormal cells are identified and eliminated. It's called apoptosis for those of you who speak Greek. But it means that everybody makes abnormal cells, abnormal cells you could hear as cancer. But everyone makes abnormal cells every day. The reason we don't all have cancer is because at night we have a restorative and reparative system that also identifies abnormal cells and eliminates them. Now I mentioned the importance of rhythm, and you asked me about hormones, which is the right question to ask for sure, one of them. One of the hormones we know in relation to stress resilience, and stress adaptation and stress response is cortisol coming out of the adrenal under the stimulation of the pituitary, which in turn is controlled by the pineal, and we'll get upstream at some point. When cortisol goes up because we're under stress, if DHEA, the companion molecule on the other side, the source of the androgens and estrogens, if DHEA goes up in proportion to the cortisol going up, we're fine. It's when the stress hormone cortisol goes up and the DHEA is exhausted and cannot go up, that's when we have a first level of problem. That's when people feel invincible, but they're not. They're cruising for a bruising, but they're not aware of it because the cortisol overrides the commonsense of the DHEA and those androgen and estrogen compounds. There are other hormone ... Go ahead. Gazella: Yeah, that makes a lot of sense, and I was going to ask you, but are there hormonal connections, so please continue. Jaffe: Oh. If I may, there are other modulators. One important balance point or ratio is the cortisol to DHEA. But then there are others including the adrenaline to serotonin. Now adrenaline derived from the amino acid tyrosine, derived from our dietary protein, adrenaline says, "Go and you can persevere until the success shall be won." In contrast, serotonin says, "Now hold on there. Maybe we don't have the fuel to go all the way to the end. Maybe we should be a little more sensible here and not get exhausted." Now serotonin comes from tryptophan just like adrenaline comes from tyrosine. Both of these come from the proteins we eat. If we're a carnivore, we'll have more of those amino acids. If we're a vegan or a vegetarian, we'll have less. If you think your engine is burning too hot because of too much adrenaline, if you think that it would be better for you to be more on the calm than on the assertive side, my suggestion is try a plant based diet. You might not want to be a vegan or a strict vegetarian cause I think you should have a wide variety of foods that you can digest, assimilate and eliminate without immune burden, and I'm not making any political statements about ... Although my personal preference is a more plant-based diet cause I think that's healthier. I think that's less polluted. I also think that's better for the planet. But I put my little advertisement in, and now I'll get back to the fact that tryptophan becomes not just serotonin, the soothing counterbalance to adrenaline, but serotonin becomes melatonin in the pineal, this deep control center. We've learned about the pituitary as the master gland, but the mistress or the master of the master gland is the pineal, modulated through the thalamus and the hypothalamus. We can get into all those tracks if you want cause I really am a biochemist and a neuroanatomist. But the point is that amino acids derived from our diet become the neurochemicals whose balance we express in our personality, in our resilience, or in the way in which we're distressed. The people who have mood issues, the people who have endurance issues, the people who are concerned that sometimes they, maybe either overreact, or they're just not in tune with what's going on and people misunderstand. In any of those situations, you have an imbalance of cortisol to DHEA and/or an imbalance of adrenaline to serotonin. Gazella: Right, that makes a lot of sense. I love how you brought adrenaline and serotonin to life. That was perfect. I want to stick with the topic of amino acids here. You know, I've heard varying views about tryptophan versus 5-HTP regarding sleep. Can you clear up that confusion for us? Jaffe: I absolutely can. There was a time when tryptophan was the favorite approach, the more natural approach to sleep, to sleep enhancement, sleep quality. Then it fell under a cloud because of something called Eosinophilia–myalgia Syndrome. At that time ... This was the late 80s, early 90s ... there was voluntary recall of tryptophan. At the same time, interestingly, that serotonin reuptake inhibitors were being advocated on the pharma side. Tryptophan fell under a cloud until it became clear that due to a change in production techniques, one company called Takeda had inadvertently, not intentionally, but they had changed the way in which they produced tryptophan. It was cheaper for them to produce large bulk of tryptophan. But they also included what turned out to be something called Peak E, which was a dimer. It was two tryptophan molecules bridged by a small carbon bridge. The consequence was induction of pain, myalgia, muscle pain, and an allergic-like response, eosinophilia. The FDA, out of an excess of caution, asked the industry to voluntarily recall tryptophan and they did, which was the right thing to do, in my opinion. At the same time, my group published a clinical observation, which is we had uncontaminated tryptophan, and we gave it to people with this Eosinophilia–myalgia Syndrome, and it helped them get better, and we published that. If tryptophan was the real culprit, then giving them tryptophan would have made them worse, and it made them better, and we published that. Now the agency, the FDA did not yet know about the contaminate now known as Peak E, this dimer of tryptophan that somehow jangles things up or messes things up. In fact, we do know how it does that. It bridges across two receptors in a way that makes the cell very unhappy. Out of an excess of caution, the FDA asked the industry to withdraw tryptophan. In the absence of tryptophan, 5-HTP became popular because it's a tryptophan derivative. That sounds okay. Until you learn that it most often goes to quinolinic acid, and a series of excito-neurotoxin consequences that are not so good. You don't get as much of the serotonin to melatonin conversion when you go through 5-HTP. It's actually better to go directly from tryptophan to melatonin and bypass the 5-HTP. 5-HTP is a supplement. It is available in health food stores and online today. It is not my preferred form because I always believed in tryptophan. I still believe in tryptophan. My recommendation is enhanced uptake tryptophan. Because it turns out when you have a little B6, a little B3, a little zinc, a little of the right fiber, then you double, triple or quadruple the uptake from the intestines into the body so you get smoother uptake and better total absorbability, or what we call bioavailability. That is basically what we recommend. Gazella: Interesting. With the tryptophan, is there a dosage range for sleep that you typically recommend? Jaffe: Well yes, in regard to the tryptophan ... And I do recommend the enhanced uptake and the chaperone delivery. But for the tryptophan itself, it's anywhere from 500 milligrams of free amino acid to 1,000, maybe even 2,000. It is absolutely safe for people to start at the lower end, which would be one capsule, say 500 milligrams, and go up anywhere from two to four, depending on their body mass, depending on their situation. Then often people ask me the question, "Well, what if I get up in the middle of the night?" "Well, why did you get up in the middle of the night? If you got up to go to the bathroom, go to the bathroom and get back to bed. If you want, you can take a second dose of the tryptophan because the peak occurs at 30 minutes. It has really done its job after four hours. If you are in a deep sleep and you stay restorative in your sleep, you don't need more. But if you get up, for whatever reason, my suggestion is take another dose. Take another one, two, three, four capsules, whatever dose works for you, 500 to 2,000 milligrams per dose. You can take that two or three times in a night." Now occasionally, people do tell us that if they take more than 500 milligrams, they sleep really soundly. But when they get up, they're a little bit groggy before they really get going. That feels, to me, like a little too much. "Metabolism does play into this individuality," as Roger Williams told us. Biochemical and individual natures of our metabolism, how robust is our liver, how effective is our spleen and kidney at any moment in time, these are important variables. Gazella: Yeah, and I'm glad that you mentioned that about the breakthrough insomnia, because I think that a lot of people are affected by that, where they will wake up at 2:00 in the morning and then they're frustrated, so that's good to know about the tryptophan. Now are there any- Jaffe: Well, let me add if I can jump in on that, cause it is very, very common. It is also very common in people who are more creative, more sensitive and more aware. Why? Because they're worrying. I think you know this, but the Dalai Lama is my daughter's godfather. One of the things he said to me is, "Don't worry." Gazella: Good advice. Jaffe: Good advice, hard to do. You have to practice it and that's the point. Sometimes two, three, four o'clock, maybe even five o'clock in the morning, it may feel early, but that's the preferred time for monks to meditate. They go to bed early, but they get up early. If you're one of those people ... And I'm in that phase of my life. I tend to go to bed early now, and I tend to get up early. I find those few hours before dawn a delicious time to either relax, or stretch or meditate, or just have a few quiet moments to myself where the phone doesn't ring. Gazella: Yeah, I would agree. Now are there any other amino acids that can be helpful with regulating sleep and mood? Jaffe: Well, yes, and there's two parts to this discussion. There are the amino acids related to detoxification. Then there are the amino acids related to mood stability. If I can take those in reverse order, in regard to mood, it turns out that glycine, the simplest amino acid, is also a neurotransmitter. It's a soothing neurochemical. If the nerves are excited, glycine calms them down. If the nerves are exhausted, glycine provides an energy source to wake them back up. Glycine's really very important in the brain, also important in the gut nervous system. In addition, if you combine glycine with methionine, a methylating detoxifying amino acid, and combine those two with magnesium aspartate, an amino acid that in its own right has been studied as a mood modulator, as an antidepressant. But when combined with the detoxifying methionine and the neuro-balancing glycine, that's a very interesting combo of simple amino acids that in combination with the tryptophan can give even deeper and more restorative sleep. Gazella: Perfect. Then now you mentioned the detox side of things? Jaffe: Right. Now the other side is there are three phases to detoxification, phase one, phase two, phase three. Within the detoxification system, you want sulfur containing amino acids like cysteine, C-Y-S-T-E-I-N-E, you want methionine, but you might want a little phenylalanine because in order for sleep to occur, you must have enough adrenaline in the deep brain sleep center so that the adrenaline falls at the same time that the serotonin rises. That's called going to sleep at the cellular, molecular, biochemical level. Now what happens if the serotonin rises cause you're tired, and your body wants to go to bed, but there isn't enough phenylalanine-derived adrenaline to fall, you'll be exhausted, but you'll still be awake. What about the other side? What if the adrenaline falls, but you didn't take in enough tryptophan so the serotonin doesn't rise? You'll be groggy, but you won't have restorative sleep. We need to have the fall of adrenaline and the rise of serotonin at the time when we're horizontal, not vertical. Gazella: Right. I want to kind of circle back to what's going on when we're sleeping because you mentioned previously when we're sleeping, the body is really quite active. I've read studies associated with inflammation for example. If you get six hours or less in just one night, you put your body in an inflamed state. We know that there's a strong connection between the immune system and the inflammatory system. What's going on with those two systems in particular, and why is it so damaging if we're not getting enough sleep? Jaffe: A profound, important question, and a question for our time, our 21st century challenging time. There is so much that occupies people today, so many screens, so many calls, so many distractions, so many attractions, that most people do not appreciate that sleep is essential for quality of life. If you want to add life to years and you want add years to life, you must have a quality of sleep. Most of us, at some point, we become tired and/or exhausted. We do get into bed. Most of us even take our clothes off before we do that. But most people ... And I'm the exception here and I would advocate being the exception. Most people do not have a roughly half an hour or so during which they prepare for a restive, restorative, rehabilitative sleep time. They might even dream. They might even be able to solve a problem and bring a solution back into waking time. It turns out you can do things called lucid dreaming if you're inclined towards that. But the bottom line is that sleep, preparation for sleep, and appreciation of the importance of sleep has been massively devalued in our society. Where we're supposed to go as close to 24/7 as we can and sleeping is somehow either depreciated, deprecated, or seen as a sign of sloth. Now when I was a young doctor in the academic medical world, I can tell you that I slept so little that when Rebecca and I got together ... Cause she's a fine artist who values her sleep, and she's a terrific human being if she gets 10 to 12 hours of sleep a day. At the time, I was sleeping about four hours a day and thought that was just fine, which meant we had to choreograph being together, but we figured it out. My point is that very often the very people who would benefit from mindfulness and restorative sleep don't "have the time." They can't fit it in. They're too driven to succeed. Or, as the Dalai Lama says, "They sacrifice their health to gain wealth. Then they give back their wealth to regain their health and they are so busy living in the past or ruminating about the future, that when they pass in the moment, they have barely lived." That's a classic Buddhist perspective. I'm not particularly Buddhist, although I've done of lot of mindfulness myself. I have found that it helps to not just to feel that I've indulged in sleep, but to know that with wisdom and more years, having the ability now to go to bed early and get up early is delicious. I don't miss going out to the Kennedy Center as much. Occasionally, I still want to go out and socialize. I have friends over. I prefer to cook for them than to go to a restaurant cause when I cook, I know what they're going to eat. I know we're going to sleep better because it's going to be food you can digest, assimilate and eliminate without any burden. I'm even going to take into account what their biochemical individuality might be and sometimes I get it right, sometimes I don't, but I always try. Sleep is our friend. Sleep is to be appreciated for the positive side, not for the absence of usual consciousness. Gazella: You know, I want to get back to specific nutrients cause we've already talked a lot about amino acids. But before I talk about other nutrients, I'd like to talk about sleep medications. There are some pretty potent prescription sleep medications. There are over the counter sleep medications. Do you have an overarching view of these sleep medications and if they're helpful or if you think it's better to try to get patients off of these sleep medications? What's your view? Jaffe: Well, actually it's interesting. My view is more or less the same as the FDA. The FDA's official view is if you can do without them, please do. If you can possibly do without them, do. Because the adverse effects are clearly known. The benefits are also statistically defined. If you absolutely need them, they are beneficial at least within the reductionist frame of our scientific method. But while I agree with the FDA, I often find that if people will follow through on what we're talking about. Including, having a diet that's appropriate for them, that they can digest, assimilate, and eliminate without a burden. When they have enough of the essential vitamins, include vitamin D, which is really a neural hormone and other essential nutrients. So that their cells can deal with the challenges and stresses of the day without being so overexcited or overexhausted, those are two extremes which we want to avoid. Being overexcited or overexhausted. We want to be resilient, we want to be in the middle. Sleep is just really important for all of that. Now with regard to prescriptions, the most common question I get is, can we approach this nature, nurture, and wholeness approach to sleep ... these amino acids and these fatty acids that are the precursors for these complicated molecules. Can I increase nature's sleep balancing, stress balancing molecules? The answer is yes, although in many cases—especially, in the cases of Ambien and other serotonin reuptake inhibitors—when you bring in nature's team, the full valet or symphony of life, very often you can taper the pharmaceutical hypnogogic sleep medicines. Taper them, eliminate them slowly. The importance of that is that it's known and it's been proven in many scientific studies. That you do sleep, however you don't dream and you don't have the normal sleep rhythms phase one, two, three, four. You don't have the normal release of growth hormone, which is so important to identify abnormal cells and eliminate them. So sleep prescriptive medicines are benefits with a cost. I usually find that when we bring in the essential nutrients that people can't make. That they must take in from their diet or supplements, that they can then taper safely and effectively, the pharmaceutical sleep medications. Gazella: Yeah, that's good to know. Certainly long-term use is definitely not indicated with those pharmaceuticals. Talk a little bit about those specific nutrients that practitioners who are listening can use to help improve sleep quality. Jaffe: Well, we've talked about amino acids, so I'd like to note turn towards the fats. Those essential fatty acids, the omega-3 and omega-6 fats are the sources for the prostaglandins. They're the sources for the thromboxanes, which are the really active but short lived molecules inside the body. We can measure the balance of omega-3 to 6 in laboratories. Neil Harris has devoted decades to validating the omega-3 index. My colleague, Artemus Simopolous, has looked at the NHANES National Health and Nutrition survey data. She says that Americans now, instead of having a balance of omega-3 to -6, because of edible oils, and fats in our diet, and these foods that are crisped, and chipped, and so forth. It's typical for Americans to have 20, 30, 50, 80 times more omega-6 than omega-3, which is pro-inflammatory. That makes you feel worse faster. That makes you more inflamed, and creaky, and uncomfortable faster. Folks like me no longer use edible oils. We cook with wine, or we cook with broth, or we cook with beer, and whole foods. When you do that, you can restore a typical four to one ratio and not be so pro-inflammatory. Many people that I meet today look, feel, and function as if their body is under assault, inflammatory assault as if it's not repairing itself. Inflammatory is really repair deficit. When your body can repair itself, you don't have inflammation. So we don't want to have zero omega-6 intake, but we don't want to have 50 times omega-6 to omega-3. There is an omega-3 index test. It's one of the eight predictive biomarkers. It can help you take in the sources of fat that are essential and good. By the way, there is good fat. Omega-3 and omega-6 fats are good unless they're damaged by air and oxygen, in which case they're bad. So you want them distilled under nitrogen. You want them in whole food sources. You want them in the healthier forms so that your body can convert the omega-3 fats into the prostaglandins that repair you while you still have a little bit of omega-6 to activate the system. But not so much that it creates repair deficit commonly known as inflammation. Gazella: Perfect. Now in addition to the EFAs, before I move on to my next question, are there any other nutrients that you'd like to highlight? Jaffe: Well, yes and it's in the broad category of, life is connected at every level with every thing. But when we think about, say sleep, and how the systems that convert these amino acids or these fats into the quality of sleep molecules that we're looking for. We must have enough antioxidant ascorbate in the cell to donate electrons and prevent free radical oxidative harm. We must have enough magnesium, choline, and citrate. We advocate advanced uptake in chaperone delivery of magnesium using choline citrate. So that you can correct the acetylcholine/bile salt deficiency at the same time you've energized and alkalinized the cell, while bringing magnesium into the cell. When very often, there's too much calcium and too little magnesium. In fact, calcium channel blockers are a major category of pharmaceuticals because there is a relative excess of calcium. But there's an absolute deficiency of magnesium. Magnesium in the diet, Dr. [Rah Aleem 00:06:51] has shown, has dropped half, by 50 percent in the last 50 years. While the need for magnesium ... because of stress and medicines that waste magnesium. Like, proton pump inhibitors and H2 blockers, and many chemotherapies, and even hypertensive medicines like diuretics are known to waste minerals including magnesium. So, as my grandmother used to say, the rents are going up and the ceilings are coming down. Gazella: It's true. So, you know the conversation between the patient and the doctor is an important one. I'm wondering for the Healthcare Professionals who are listening, what type of tips do you give patients to help them get a good night's sleep? I know you believe that it's not just a matter of handing somebody a pill and calling it a day. It's a very comprehensive approach that you have to health. So, what type of advice do you give to people who are struggling with sleep? Jaffe: Thanks for asking and yes, as important as I believe diet and supplementation are in the 21st century, it's about what you eat, drink, think, and do. So, let's talk about the doing part of preparing for sleep. Here's what I do, I set aside the half an hour before I'm gonna get into bed. During that half hour, I want to get as much value as I can. So I set a salt and soda bath. I put a half to one cup of Epsom salts and a half to one cup of baking soda. My skin isn't dry, but if my skin was dry, I might put in a drop of Rosemary or some other Emollient oil, an aromatic. I soak in there for about 20 minutes. While I'm soaking, I do five minutes of deep abdominal breathing. If you want to know what abdominal breathing is like, get a video of a baby or watch a baby because they all do it correctly. They breathe abdominally. Then, do about 15 minutes of mindfulness practice, or active meditation, or whatever is your preference to let go of the day. Very often, people fall into bed, reasonably tired and exhausted. But thinking about the stresses of the day and they bring that into the bedroom. In my bedroom, we actually have no screens, we have no clocks, we have no alarm clocks, we have no phones. I know this is hard to believe, but I actually when I go to bed, I don't need to hear the emails coming in on my phone. I believe, if you can, at the place where you sleep should be a place of serenity. That you should give yourself a half an hour to let go of the day and really let it go. Then, have an active time of restoring yourself through sleep. If you want the bonus round, it's the green dichromatic light that I learned about from [Banti Darmawarh 00:09:56]. A rather extraordinary monk. Green dichromatic light is known to go directly from the retina to the pineal gland. In the pineal gland, it says everything is okay. Green is the harmonizing color. This has nothing to do with vision. It has everything to do with the retinal / pineal direct connection, which has been reconfirmed by others. As [Banti 00:10:25] said, well wisdom, new things, millennia ago, and science is catching up and that's a good thing. Gazella: I have not heard of the green light. That's fascinating to me. Jaffe: No, it is fascinating. You may have heard about light boxes. There are people with what's called Seasonal Affective Disorder or SAD? Gazella: Sure. Jaffe: Norman Rosenthal and NIHMINH, showed that if you stay in front of these fluorescent light boxes for three hours a day, it boosts your pineal, and you get a little more melatonin, and you're less depressed. Banti said, people don't have time for that 20 minutes twice a day in front of the green. That's what we recommend. Gazella: Wow, that's awesome. What about other hygiene aspects? Like the temperature of the room? Light in the room? Are those valid? Jaffe: Thanks for asking. The answer to the second question in regard to light. It should be as dark as possible. Now if for some reason, it is not pitch black in the room where you sleep, please get a comfortable eye mask. You should not have photons of light hitting the retina while your eyes are closed during sleep. If that requires an eye mask, please. They're not expensive, they can be comfortable. Take a flight on the Air Singapore, they'll give them to you. At least in business class. That's the question of dark. Now, the nature of the room itself, should be comfortable, cool, this is a situation where warm is not your friend. What I have is a latex mattress which is very firm and lets me float. That's a nice thing. I have a duvet, so I have ... Some goose donated some feathers and somebody sewed this together. In Germany, this is routine. You have this light Duvet on top of you. You have a mattress that will support you. It's cool in the room, you don't want it warm. Does that address your question? Gazella: Absolutely, absolutely. Those are some great tips that our Practitioners can keep in mind when talking to their patients. I'm just wondering, we're about ready to wrap up, is there anything else that you'd like to talk about sleep for our listeners today? Jaffe: No. I thank you for the opportunity to come at it in this way. Restorative sleep is one of essentially components of a life well lived. As someone who didn't think that sleep was important for many decades of my life, I can tell you it was a mistake. I'm correcting that now. But I do also believe there are different phases to a life. I think if you're an adolescent, you have a different sleep rhythm. My understanding today is that young people actually do go to bed later and get up later, although they may or may not be able to do that and still graduate from schools. But I do think at different seasons of our life, we have different relationships between wake and sleep. I want both my wake time and my sleep time to be as productive as possible because this is the only life that I know I have at this time. Therefore, every moment to me is precious. Gazella: Yeah, absolutely. Great point, great way to end. So once again, thank you Dr. Jaffe for joining me. I'd also like to thank the sponsor of this interview, Kirk Integrative Health. Thank you and have a great day. Jaffe: Thank you, Karolyn. A pleasure. There is a significant link between lack of sleep and hormonal, inflammatory, and immune system health. In this interview, Russell Jaffe, MD, PhD, describes the connection and then provides information about his comprehensive, integrative approach to sleep issues.

By Natural Medicine Journal   While vitamin C may seem like a straightforward topic, it's actually rather complicated. In this interview, leading integrative medical expert Russell M. Jaffe, MD, PhD, describes some of the clinical complexities associated with this popular nutrient. Jaffe describes the different forms, dosages, and synergy with other nutrients. He ends with a description on how ascorbate helps with toxic mineral removal.  Approximate listening time: 18 minutes About the Expert Russell M. Jaffe, MD, PhD, is CEO and Chairman of PERQUE Integrative Health (PIH). He is considered one of the pioneers of integrative and regenerative medicine. Since inventing the world’s first single step amplified (ELISA) procedure in 1984, a process for measuring and monitoring all delayed allergies, Jaffe has continually sought new ways to help speed the transition from our current healthcare system’s symptom reactive model to a more functionally integrated, effective, and compassionate system. PIH is the outcome of years of Dr. Jaffe’s scientific research. It brings to market 3 decades of rethinking safer, more effective, novel, and proprietary dietary supplements, supplement delivery systems, diagnostic testing, and validation studies. About the Sponsor PERQUE Integrative Health (PIH) is dedicated to speeding the transition from sickness care to healthful caring. Delivering novel, personalized health solutions, PIH gives physicians and their patients the tools needed to achieve sustained optimal wellness. Combining the best in functional, evidence-based testing with premium professional supplements and healthful lifestyle guides, PIH solutions deliver successful outcomes in even the toughest cases.

Leading integrative medicine pioneer, Russell Jaffe, MD, PhD, CCN, describes his philosophy regarding hard-to-treat thyroid conditions. Jaffe starts with proper diagnosis and then takes listeners through to the environmental impact, alkalinizing the body, and using targeted nutrients to provide an individualized approach. Approximate listening time: 21 minutes About the Expert Russell M. Jaffe, MD, PhD, is CEO and Chairman of PERQUE Integrative Health (PIH). He is considered one of the pioneers of integrative and regenerative medicine. Since inventing the world’s first single step amplified (ELISA) procedure in 1984, a process for measuring and monitoring all delayed allergies, Jaffe has continually sought new ways to help speed the transition from our current healthcare system’s symptom reactive model to a more functionally integrated, effective, and compassionate system. PIH is the outcome of years of Dr. Jaffe’s scientific research. It brings to market 3 decades of rethinking safer, more effective, novel, and proprietary dietary supplements, supplement delivery systems, diagnostic testing, and validation studies. About the Sponsor PERQUE Integrative Health (PIH) is dedicated to speeding the transition from sickness care to healthful caring. Delivering novel, personalized health solutions, PIH gives physicians and their patients the tools needed to achieve sustained optimal wellness. Combining the best in functional, evidence-based testing with premium professional supplements and healthful lifestyle guides, PIH solutions deliver successful outcomes in even the toughest cases.  

Lyme disease can be a challenging condition to treat. In this interview, integrative medicine expert, Russell Jaffe, MD, PhD, CCN, describes his treatment approach and also explains the important connection between Lyme disease and small intestinal bacterial overgrowth (SIBO). Approximate listening time: 20 minutes About the Author Russell M. Jaffe, MD, PhD, CCN, is CEO and Chairman of PERQUE Integrative Health (PIH). He is considered one of the pioneers of integrative and regenerative medicine. Since inventing the world’s first single step amplified (ELISA) procedure in 1984, a process for measuring and monitoring all delayed allergies, Jaffe has continually sought new ways to help speed the transition from our current healthcare system’s symptom reactive model to a more functionally integrated, effective, and compassionate system. PIH is the outcome of years of Dr. Jaffe’s scientific research. It brings to market 3 decades of rethinking safer, more effective, novel, and proprietary dietary supplements, supplement delivery systems, diagnostic testing, and validation studies. About the Sponsor PERQUE Integrative Health (PIH) is dedicated to speeding the transition from sickness care to healthful caring. Delivering novel, personalized health solutions, PIH gives physicians and their patients the tools needed to achieve sustained optimal wellness. Combining the best in functional, evidence-based testing with premium professional supplements and healthful lifestyle guides, PIH solutions deliver successful outcomes in even the toughest cases.

Hey there townies! This week Jessie the Architect and Remo the Realtor interview education specialist and founder of Piña Reading Academy, Melinda Piña. Social Media: What's Up WhittierFacebookInstagramTwitterEmail: whatsupwhittierpod@gmail.com Piña Reading Academy6740 Bright AveWhittier, CA 90601(562) 698-7323Website Colvard LearningFacebookWebsite Remo the RealtorFacebookInstagramWebsite   Jessie the ArchitectFacebookInstagramWebsite  Producer ChristineFacebookInstagramWebsite  Whittier API ScoresCeres Elementary rank: 8 in WhittierEast Whittier Middle rank: 8 in Whittier*Evergreen Elementary rank: 7 in WhittierGranada Middle rank: 8 in WhittierHillview Middle rank: 6 in WhittierLa Colima Elementary rank: 7 in WhittierLaurel Elementary rank: 6 in WhittierLeffingwell Elementary rank: 9 in WhittierMulberry Elementary rank: 8 in Whittier*Murphy Ranch Elementary rank: 10 in WhittierOcean View Elementary rank: 8 in Whittier*Orchard Dale Elementary rank: 8 in WhittierScott Avenue Elementary rank: 7 in Whittier Community Corkboard Brain Games ClubWho: Children ages 6-12What: Crafts, games, activities featuring STEAM, Science Technology Engineering Arts MathematicsWhen: Every Thursday at 4p.m.Where:Whittier Public Library, 7344 Washington Ave Whittier Farmer’s MarketWhat: Farmer’s MarketWhen: Every Friday 8 am- 1 pmWhere: Corner of Philadelphia & Bright 2nd Annual Unofficial Whittier MarathonWhat: Don MrLA hosts his 2nd Annual Unofficial Whittier MarathonWhen: Saturday, April 29 at 7:30 AMWhere:-The Marathon will start at Whittier City Hall, 13230 Penn St-The Half-Marathon start will be approximately at 9:45 AM at the Whittier Dog Park (on Philadelphia, right across from Whittier High)-The One Mile (walk/run) will start: at approximately 11:45 AM right under the clock at the Nixon Building (the corner of Greenleaf & Philadelphia)-The Ten Foot (crawl): will start close to 12:00 PM noon, exactly ten feet north of the 6740 on Greenleaf The full route will hit all of our major landmarks: WACC, La Serna HS, Whittwood Towne Center, Parnell Park, Cal High, Greenway Trail, Whittier High, Rose Hills, Palm Park, Pioneer High, PIH, Whittier College, Central Park and  of course, Uptown Whittier. For more information, people can message Don MrLA on Facebook, as the Facebook event is private and you need to be invited by the host. Wednesday Night Stroll & Art SceneWhat: Uptown Whittier art strollWhen: May 10, 2017 from 5:00 p.m.- 9:00 p.m.Where: Uptown Whitter, various shops Piña Reading Academy summer programWhat: Summer tutoring for your kiddos!When:June 19-July 20, Monday-Thursday, 9:00a.m.-12:00p.m.Where: Piña Reading Academy, 6740 Bright Ave, Whittier, CA 90601

Hey Whittier townies! This is a special episode where we take bits and pieces form our older episodes to share with you all! This features guests such as Manny Rubalcava, Rose Drieslein, Gio Alonso, Stephanie Portugal, Ricardo Diaz, Eva Macias, Colleen Koestner and more! Enjoy!   Social Media What's Up WhittierFacebookInstagramTwitterEmail: whatsupwhittierpod@gmail.com The Little ShedFacebookInstagramWebsiteEmail:littleshedest2015@gmail.com  Remo the RealtorFacebookInstagramWebsite   Jessie the ArchitectFacebookInstagramWebsite  Producer ChristineFacebookInstagramWebsite    Community Corkboard Brain Games ClubWho: Children ages 6-12What: Crafts, games, activities featuring STEAM, Science Technology Engineering Arts MathematicsWhen: Every Thursday at 4p.m.Where:Whittier Public Library, 7344 Washington Ave Whittier Farmer’s MarketWhat: Farmer’s MarketWhen: Every Friday 8 am- 1 pmWhere: Corner of Philadelphia & Bright Whittier Uptown Association presents Earth Day 2017What: Earth Day 2017When: Saturday, April 22 at 10:00 AMWhere: Greenleaf Grassy Lot, 6724 Greenleaf Ave Ricks 44th AnniversaryWhat: Buy 1, Get 1 for all hamburgers, chili dogs, and chili friesWhen:Where:    Unheard LA- live in Whittier What:KPCC Hosts “Unheard LA – the stories of where you live”When: Sunday, April 23 at 5:30 PMWhere: Ruth B. Shannon Center, 6760 Painter Ave, Whittier, CALink to purchase your tickets!   2nd Annual Unofficial Whittier MarathonWhat: Don MrLA hosts his 2nd Annual Unofficial Whittier MarathonWhen: Saturday, April 29 at 7:30 AMWhere:-The Marathon will start at Whittier City Hall, 13230 Penn St-The Half-Marathon start will be approximately at 9:45 AM at the Whittier Dog Park (on Philadelphia, right across from Whittier High)-The One Mile (walk/run) will start: at approximately 11:45 AM right under the clock at the Nixon Building (the corner of Greenleaf & Philadelphia)-The Ten Foot (crawl): will start close to 12:00 PM noon, exactly ten feet north of the 6740 on Greenleaf The full route will hit all of our major landmarks: WACC, La Serna HS, Whittwood Towne Center, Parnell Park, Cal High, Greenway Trail, Whittier High, Rose Hills, Palm Park, Pioneer High, PIH, Whittier College, Central Park and  of course, Uptown Whittier. For more information, people can message Don MrLA on Facebook, as the Facebook event is private and you need to be invited by the host.

Dan and Gwen Slade are the international directors of Partners in Harvest. Dan provides an update on the work of PIH in europe and beyond, and reminds us of the importance of prayer.

By Karolyn A. Gazella  In this sponsored podcast integrative health expert Russell Jaffe, MD, PhD, CCN, describes a comprehensive approach to identifying immune dysfunction long before illness sets in. He also provides advice regarding diet, lifestyle, and dietary supplements. Jaffe explains why choice is far more significant than genetics and how to counsel patients about reducing immune burden. Approximate listening time: 30 minutes  About the Expert Russell M. Jaffe, MD, PhD, is CEO and Chairman of PERQUE Integrative Health (PIH). He is considered one of the pioneers of integrative and regenerative medicine. Since inventing the world’s first single step amplified (ELISA) procedure in 1984, a process for measuring and monitoring all delayed allergies, Jaffe has continually sought new ways to help speed the transition from our current healthcare system’s symptom reactive model to a more functionally integrated, effective, and compassionate system. PIH is the outcome of years of Jaffe’s scientific research. It brings to market 3 decades of rethinking safer, more effective, novel, and proprietary dietary supplements, supplement delivery systems, diagnostic testing, and validation studies. About the Sponsor PERQUE Integrative Health (PIH) is dedicated to speeding the transition from sickness care to healthful caring. Delivering novel, personalized health solutions, PIH gives physicians and their patients the tools needed to achieve sustained optimal wellness. Combining the best in functional, evidence-based testing with premium professional supplements and healthful lifestyle guides, PIH solutions deliver successful outcomes in even the toughest cases. About the Host Karolyn A. Gazella is the publisher of the Natural Medicine Journal and has been writing and publishing integrative health information since 1992. She is the author or coauthor of hundreds of articles and several booklets and books including her latest book The Definitive Guide to Thriving After Cancer (Ten Speed Press, 2013) that she wrote with Lise Alschuler, ND, FABNO. Together with Alschuler, Karolyn is the cohost of the "Five to Thrive Live!" radio show on the Cancer Support Network and iHeart Radio. She is the co-creator of the Five to Thrive® Plan and the author of "The Healing Factor," a blog on PsychologyToday.com. Gazella is based in Boulder, Colorado.  

Ralph is a retired Supreme court judge in the state of New York. He and Inger are now east coast coordinators for the Partners in Harvest network of churches; they plan gatherings of pastors and leaders and speak at churches carrying the message of revival and renewal with them. PIH makes every effort to cross denominational, generational and cultural lines in order to increase and promote blessing and unity in the global Body of Christ. The Beisners have a passion for Jesus that comes through as they minister the love of the Father in the power of the Holy Spirit.

Both quotes on today’s show were posted by my mother, June Gibson  Holbrook who has been supporting Daggers Of The Mind in so many ways.  Thanks, Mom!   Thomas A. Edison, Inventor   “The reason a lot of people do not recognize opportunity is because it  usually goes around wearing overalls looking like hard work.”   You deserve a break today. Get the service you deserve. Advertising today  spends a lot of time telling you what you deserve even though you haven’t  done anything to earn it.   I remember some friends who were a few years younger than my wife and  myself who spent all their time saying if someone would give them a  chance like we got life would be great.   First of all, the chances we got happened at the point that we earned  them. When we bought a house, it was because we had waited long enough  and our finances were in order to do it.    When they reached a similar age and financial status, they bought a house  too. Then it all went south. He got fired from a couple of great jobs,  then they divorced and everything went to pot.   What was so different about the two situations? One thing is that we  never felt we were owed anything. It never occurred to us that we would  or should be given a chance. We made our own, and to this day continue to  do what it takes to maintain what we have earned.   This is not to “toot our own horns” so to speak, but it seems that most  of our society believes they are owed more than they ever have the  intention to earn.   Ginger Rogers   “The only way to enjoy anything in this life is to earn it first.”   Have you earned what you have? Or are you just sitting hoping someone  will give you a handout? I remember hearing stories about the Great  Depression in the 1930’s where farmers committed suicide when faced with  taking a handout from the government. The shame was just too great.   That shame seems to be a thing of the past these days. A good work ethic  is also in serious decline. Where are you in all this? Have you believed  the advertising hype that says you are owed a living? Or are you doing  your best, earning your own way and the self respect that goes with it?   A final quote:   “We must protect our limited resources for those who are truly in need  and who are doing all they can to be self-sufficient.”   Paul LePage, Governor of The State of Maine   Thomas Edison On Wikipedia   http://www.thomasedison.com/   ---------------------------------------------------   Audrey Hepburn, Actress and Humanitarian   “I saw but one glaring truth: These are not natural disasters, but man- made tragedies for which there is only one manmade solution-- Peace."    Audrey Hepburn is best known for her acting roles in some of the most  iconic movies of the 50’s and 60’s, but her greatest contribution to  humanity was through her work with UNICEF.    From Wikipedia:  She appeared in fewer films as her life went on,  devoting much of her later life to UNICEF. Although contributing to the  organisation since 1954, she worked in some of the most profoundly  disadvantaged communities of Africa, South America and Asia between 1988  and 1992. She was awarded the Presidential Medal of Freedom in  recognition of her work as a UNICEF Goodwill Ambassador in December 1992.    A month later, Hepburn died of appendiceal cancer at her home in  Switzerland at the age of 63.   What an amazing contribution to make for good in this world. When most  with her fame and success simply live the good life, she devoted herself  to helping those whose circumstances made it impossible for them to help  themselves.   While there are few who are as noble as that, there are many things we  can do to help others around us as we travel through this life. Our best  is to help others learn to be self sufficient so that when no one is  around to help, they can learn to live on their own. Don’t simply give  someone a fish, TEACH them to fish. Then you have fed them for a  lifetime.   One organization that fulfills this mission is the Project Self Sufficiency Foundation. It is found at www.pssfoundation.org.    From their website: Project Self Sufficiency Foundation is a non-profit  organization that supports low income, single parents working toward an  educational goal to become economically independent. Our foundation's  goal is to raise the funds needed to provide the tools and support that  will help parents achieve their independence. This is a powerful  initiative for these parents, as it will change the pathway for their  family, many times, breaking the cycle of abuse and building their self- esteem, which ultimately leads to a better future for generations. Thank  you for your interest and we look forward to your support!   Another such organization is called Partners In Housing at  www.partnersinhousing.org.    From the website: PIH provides a self-sufficiency program, not a housing program. The  emphasis of our program is helping people learn the skills they need to  be economically independent. To participate in the program, all adults  must be willing and able to work and, most importantly, be motivated to  achieve self-sufficiency!    Giving others the tools to lift themselves up makes the change permanent.  Invest in charities of that type and the world will actually become a  better place, one success at a time!   Another Audrey Hepburn quote:   “Remember, if you ever need a helping hand, it's at the end of your arm.  As you get older, remember you have another hand: the first is to help  yourself, the second is to help others.”       UNICEF on Wikipedia   Audrey Hepburn on Wikipedia   Audrey Hepburn on International Movie Database   www.pssfoundation.org   www.partnersinhousing.org ---------------------------------     Smokefan14 gave Daggers Of The Mind a 5 star rating and review on iTunes!  Thanks so much for the help! Here’s the review:   “A unique, thought provoking, interesting podcast that doesn’t need bad  language and filth to make it successful. Jeffrey Holbrook keep it up  buddy. Remember, Think Deeply!”   It really helps when you rate and review the show in iTunes. It makes it  easier to be discovered by others. If you are in iTunes, take a moment to  give us an honest review! Thanks!

Reba Carethers has taken on poverty, diabetes, AIDS and prenatal care during her time at the School of Nursing, but she’s just getting started. In May and June 2012, the Angleton, Texas, native traveled to Ghana to work with pregnancy / maternal and child health programs, where she helped to create training materials to promote healthier pregnancies. A key source of inspiration for Carethers comes from world-renowned physician and anthropologist Paul Farmer, chief strategist and co-founder of Partners In Health (PIH), an organization founded in 1987 to deliver health care to the residents of Haiti. During her junior year, Carethers served as president and Steering Committee member of FACE AIDS, a student organization under the auspices of PIH, organizing World AIDS Day on campus and helping to raise $7,000 to revitalize a health center in Rwanda. As a public health intern last summer, she trained at Johns Hopkins University before heading to Sioux Falls, South Dakota, to work on diabetes research, a project that won second prize at the Sanford Children’s Hospital Science Festival. She says she decided to enroll in nursing school because nurses, who clearly get the most patient interaction, are in the best position to make changes, whether in patient care, public policy or research. “Nurses put the plan into action,” Carethers says. Her next milestones? Becoming a critical care nurse practitioner with a master’s degree in public health, then pursuing a doctorate in nursing and continuing her research into health disparities among different populations.

Aims: The decrease in uterine resistance during normal pregnancy is known to be related to invading trophoblast cells which derive from placental tissue. Uterine and peripheral resistance is elevated in preeclampsia. The aim of the present study was to prospectively examine uterine and peripheral resistance in pregnancies complicated by preeclampsia (PE), fetal intrauterine growth restriction (IUGR) and pregnancy induced hypertension (PIH). Methods: Sixty-seven women with normal pregnancies, 17 with PE, 12 with IUGR underwent Doppler sonographic investigation of the uterine and the cubital arteries. The Pulsatility Index (PI) was calculated for each vessel. Statistical analysis was performed and a P-value < 0.05 was considered significant. Results: Patients with preeclampsia and IUGR showed a significant higher resistance at the placental (mean PI 1.267 and 1.063), nonplacental (mean PI 1.631 and 1.124) and cubital artery (mean PI 3,777 and 3.995) compared to the normal pregnancy group (mean PI 0.678; 0.859 and 2.95 respectively). Mean birth weight in the PE group was 1409 g, in the IUGR group 1649 g and 3419 g in the normal pregnancy group. Conclusions: Pregnancies with IUGR are associated with elevated peripheral resistance in the maternal arterial system as seen in pregnancies with preeclampsia. Our findings encourage to further investigate the maternal vascular system in high risk pregnancies.