Podcasts about pmr

Summary Dr. David Rosenblum delivered a comprehensive lecture on gender differences in opiate effects and prescribing practices. He discussed several key studies examining how opiates affect males and females differently, both in animal models and humans. Dr. Rosenblum shared findings showing that morphine has stronger analgesic effects in males, while females experience longer-lasting effects. He also addressed racial disparities in opiate prescribing, noting that white patients are more likely to receive opiates. From his personal clinical experience in Brooklyn, Dr. Rosenblum observed that certain populations tend to be at higher risk for opiate abuse. The lecture covered gender-specific risk factors for opiate misuse, with women tending toward emotional/psychological factors and men showing more behavioral issues. Pain Management Board Prep   Ultrasound Training REGISTER TODAY! Chapters Introduction and Upcoming Conferences Dr. Rosenblum introduced himself as the host of the Pain Exam Podcast and announced several upcoming conferences including ASPN in July, PainWeek in September, and other events where he will be teaching ultrasound and regenerative medicine. Board Preparation and Opiate Topics Dr. Rosenblum discussed his role in board preparation through painxam.com and nreppain.org. He emphasized that opiates are a frequently tested topic across different board examinations (FIP, ABPM, ABIP, ABA). Gender Differences in Opiate Effects - Animal Studies Dr. Rosenblum presented research showing that in animal studies, morphine exhibited stronger analgesic effects in males, while females showed longer-lasting effects and could tolerate higher doses. He noted that physical dependence was more severe in male rats during spontaneous withdrawal. Racial and Gender Disparities in Opiate Prescribing Dr. Rosenblum discussed a 2025 study revealing racial disparities in opiate prescribing, with white patients more likely to receive opiates. He shared his personal clinical experience in Brooklyn, noting that young white males were often higher-risk for abuse. Gender-Specific Risk Factors for Opiate Misuse Dr. Rosenblum detailed how women tend to show emotional and psychological risk factors for opiate misuse, while men demonstrate more behavioral risk factors. Women were more likely to report distress and past trauma, while men showed higher rates of criminal behavior and substance abuse history.   References Djurendic-Brenesel, Maja, et al. "Gender-related differences in the pharmacokinetics of opiates." Forensic science international 194.1-3 (2010): 28-33.   Kosten, Thomas R., Bruce J. Rounsaville, and Herbert D. Kleber. "Ethnic and gender differences among opiate addicts." International Journal of the Addictions 20.8 (1985): 1143-1162.   Cicero, Theodore J., Shawn C. Aylward, and Edward R. Meyer. "Gender differences in the intravenous self-administration of mu opiate agonists." Pharmacology Biochemistry and Behavior 74.3 (2003): 541-549. Jamison, Robert N., et al. "Gender differences in risk factors for aberrant prescription opioid use." The Journal of Pain 11.4 (2010): 312-320.  

Tired of being told that the only way to fix your cortisol is to buy someone's overpriced “happy juice” or miracle supplement?Same. In this episode, I'm breaking down the real, science-backed strategies to lower cortisol—most of which are free, simple, and actually work.As a former scientist turned burnout coach, I'm not here for the pseudoscience. I'm here for facts, function, and helping high-achievers actually regulate their stress hormones in a sustainable way.What You'll Learn:

Tired of being told that the only way to fix your cortisol is to buy someone's overpriced “happy juice” or miracle supplement?Same. In this episode, I'm breaking down the real, science-backed strategies to lower cortisol—most of which are free, simple, and actually work.As a former scientist turned burnout coach, I'm not here for the pseudoscience. I'm here for facts, function, and helping high-achievers actually regulate their stress hormones in a sustainable way.What You'll Learn:

When clients come to a session they often carry tension related to stress and this can be both physical and mental. Progressive muscle relaxation (PMR) works by guiding them to relax different muscle groups... The post WHY DO HYPNOTHERAPISTS USE PROGRESSIVE MUSCLE RELAXATION? appeared first on Getting Clear.

Oggi i PMR ci guidano fra le tempeste di draghi, raccontandoci la lore di Tarkir Dragonstorm!Trovi il video dell'episodio qui: https://www.youtube.com/channel/UCMkQqseTypha6-n8Lsba6KwLINK per il canale Telegram: https://t.me/+dXU4Ko4N2CszODRkIn Risposta Scombo è sponsorizzato da Fantasia store, il paradiso di tutti noi nerd! Sul loro store troverete tutto ciò che un giocatore di Magic può desiderare!

  Summary At some point this medication may show its face on the Physiatry boards.  Whether or not Suzetrigine will appear on the Physical Medicine and Rehabilitation boards, all of us need to know about this new class of analgesic. Brought to you by NRAP Academy, home of the PMRExam Board Prep Here, Dr. David Rosenblum delivered a comprehensive lecture about a new pain medication called Journavx (Suzetrigine). He discussed its mechanism of action as a NAV 1.8 receptor inhibitor, its clinical applications, contraindications, and dosing guidelines. Dr. Rosenblum emphasized that this non-opioid medication represents a new class of pain management drugs with no addiction potential. He also shared information about upcoming educational events, including ultrasound courses and various pain management conferences. The lecture included detailed information about drug interactions, safety considerations, and clinical trial results comparing Journavx to placebo and hydrocodone-acetaminophen combinations. Key findings from clinical trials showed that Jornavix achieved pain relief in 119 minutes compared to 480 minutes for placebo in abdominoplasty trials, and 240 minutes versus 480 minutes in bunionectomy trials. The recommended dosing is 50mg tablets twice daily, with an initial loading dose of 100mg. While the drug showed promising results for moderate to severe acute pain management, it did not demonstrate superiority over hydrocodone in clinical trials. Important contraindications include CYP3A inhibitors, and special considerations are needed for patients with hepatic impairment or those taking hormonal contraceptives. The medication should be taken on an empty stomach, either one hour before or two hours after food, and patients should avoid grapefruit juice while on this medication. For more infomation.... Chapters Introduction and Upcoming Events Dr. Rosenblum announced several upcoming events, including an ultrasound course in New York City on May 17th, 2025. He mentioned offering ultrasound and IV training for healthcare professionals, particularly nurses, ICUs, PAs, and hospital doctors. He also highlighted upcoming conferences including ASPN, Pain Week, Latin American Pain Society, New York, New Jersey Pain Congress, ASIPP, and EPA. Introduction to Journavx (Suzetrigine) Dr. Rosenblum introduced Suzetrigine (Journavx), a new 50mg tablet medication. He emphasized that this discussion was not sponsored by any pharmaceutical company but rather focused on educating about a new class of pain medication. He noted its potential importance as a future board examination topic. Mechanism of Action Dr. Rosenblum explained that Jornavx works by inhibiting the NAV 1.8 receptor. He detailed how the drug blocks sodium ions from entering pain-sensing neurons, disrupting action potential initiation and propagation. He emphasized that the drug is highly selective, binding over 31,000 times more selectively to NAV 1.8 than other NAV subtypes. Contraindications and Drug Interactions Dr. Rosenblum outlined various contraindications, particularly focusing on CYP3A inhibitors and inducers. He listed specific medications in each category and emphasized the importance of careful monitoring when prescribing Journavx alongside these medications. Clinical Trial Results and Dosing Guidelines Dr. Rosenblum presented clinical trial results showing Journavx's effectiveness in treating moderate to severe acute pain. He detailed the dosing guidelines: 50mg tablets twice daily, with an initial loading dose of 100mg. He emphasized the importance of taking the medication on an empty stomach and avoiding grapefruit juice. Q&A No Q&A session in this lecture

In der heutigen Folge spreche ich mit meiner Kollegin Julia Braunstein über progressive Muskelentspannung und autogenes Training. Ich erfahre außerdem für wen es das richtige Angebot ist und warum Entspannung so wichtig für uns ist.Link zum PDF "Praxis der Entspannung" der ÖGKTermine und andere Tipps von der ÖGKNächste Woche gibt es ein Audio mit einer Entspannungstechnik zum Live mitmachen

Tiefenentspannung ist hervorragend gegen Rückenschmerzen. Du hast inzwischen von Autogenem Training, PMR, Phantasiereise und Bodyscan gehört. All diese Techniken findest du zusammengefasst in der kombinierten Yoga Entspannung. Selbst wenn du mal kein Yoga üben kannst, übe mindestens die Kombinierte Yoga Entspannung. Woraus diese besteht, und warum sie so gut ist, erfährst du in dieser Hörsendung. Mehr zur Yoga Entspannung mit mp3 Übungsanleitung. Eine Video Anleitung zur Yoga Entspannung. Infos zu einer Entspannungskursleiter Ausbildung. Verschiedene Videos zum Thema Rücken Yoga.     Der Beitrag 37 Kombinierte Yoga Entspannung gegen Rückenschmerzen erschien zuerst auf Yoga Vidya Blog - Yoga, Meditation und Ayurveda.

Tiefenentspannung ist hervorragend gegen Rückenschmerzen. Du hast inzwischen von Autogenem Training, PMR, Phantasiereise und Bodyscan gehört. All diese Techniken findest du zusammengefasst in der kombinierten Yoga Entspannung. Selbst wenn du mal kein Yoga üben kannst, übe mindestens die Kombinierte Yoga Entspannung. Woraus diese besteht, und warum sie so gut ist, erfährst du in dieser Hörsendung. Mehr zur Yoga Entspannung mit mp3 Übungsanleitung. Eine Video Anleitung zur Yoga Entspannung. Infos zu einer Entspannungskursleiter Ausbildung. Verschiedene Videos zum Thema Rücken Yoga.     Der Beitrag 37 Kombinierte Yoga Entspannung gegen Rückenschmerzen erschien zuerst auf Yoga Vidya Blog - Yoga, Meditation und Ayurveda.

En inédit, un cas supplémentaire abordé dans la suite de l'émission sur M6 de 12h à 12h30 : En 2020, Julien fait l'acquisition d'une maison sur plan auprès d'un promoteur. Lors de l'acte de vente, il négocie deux places de parking dont une aux normes PMR pour sa belle-mère handicapée. Mais à l'arrivée, le promoteur lui délivre deux places aux dimensions classiques. Sa belle-mère ne peut donc pas profiter de l'emplacement, et depuis, rien n'est fait pour rectifier le problème. Mais aussi, les rebondissements des cas du jour abordés de 10h à 12h ! Tous les jours, retrouvez en podcast les meilleurs moments de l'émission "Ça peut vous arriver", sur RTL.fr et sur toutes vos plateformes préférées. Distribué par Audiomeans. Visitez audiomeans.fr/politique-de-confidentialite pour plus d'informations.

När mobilnätet och Internet försvinner kommer vår önskan att kommunicera med varandra vara större än någonsin. Hur löser vi detta när krisen eller kriget kommer. Vi ger en översikt från P4, amatörradios, licensfria PMR och jaktradios till Starlink som lyfts fram som den viktigaste kommunikationsmetoden under kriget i Ukraina. Shownotes och länkar på https://www.hemberedskap.se/avsnitt400 Stötta oss och lyssna på extra bonusavsnitt på https://www.patreon.com/hemberedskap

Dr. Rosenblum Reviews Questions from my previous lecture, he gave at the trigeminal academy in Indonesia. Dr. Rosenblum explores techniques for rich plasma injection and preparation. He discusses centrifuge settings with plasma volume and concentration as well as the addition of hyaluronic acid to platelet rich plasma. Dr. Rosenb;um also received multiple comments on the recent video that he filmed on performing a cervical selective nerve root block under ultrasound.  For more informatin go to NRAPpain.org     Disclaimer: This Podcast,video, website and any content from NRAP Academy   otherwise known as Qbazaar.com, LLC is  for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. Professionals should conduct their own fact finding, research, and due diligence to come to their own conclusions for treating patients. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such conditions.

Oggi i PMR ci guidano nella intricata/complessa/profonda lore di Aetherdrift! Una gara contro il cringe, chi vincerà?Trovi il video dell'episodio qui: https://www.youtube.com/channel/UCMkQqseTypha6-n8Lsba6KwLINK per il canale Telegram: https://t.me/+dXU4Ko4N2CszODRkIn Risposta Scombo è sponsorizzato da Fantasia store, il paradiso di tutti noi nerd! Sul loro store troverete tutto ciò che un giocatore di Magic può desiderare!

C'est une phase dont on parle peu, et pourtant… Après les Jeux Olympiques et les Jeux Paralympiques, que se passe-t-il vraiment ?Quand les projecteurs s'éteignent, que les compétitions sont terminées et que l'effervescence retombe, les athlètes se retrouvent face à une nouvelle réalité. Un mélange d'émotions contradictoires : la fierté d'avoir vécu un événement exceptionnel, mais aussi le vide laissé par ces années de préparation intense.

Send us a text9:01 PM | The Minus 5 | Words & Birds 9:04 PM | The Replacements | Alex Chilton 9:07 PM | R.E.M. | World Leader Pretend 9:13 PM | Mamalarky | Feels so Wrong9:16 PM | Casino Hearts | Say It For Yourself 9:19 PM | Adrian Quesada & Buffalo Hunt | Centrifugal 9:26 PM | Viagra Boys | Man Made of Meat 9:29 PM | Youth of Today | Take a Stand 9:30 PM | Youth Brigade | What Are You Fighting For 9:35 PM | Fleetwood Mac | Hypnotized 9:40 PM | Bob Dylan | Simple Twist of Fate 9:44 PM | Cigarettes After Sex | Pistol 9:50 PM | Everyone Says Hi | Tried And Failed 9:53 PM | Julien Baker & TORRES | Sylvia9:57 PM | Classics IV | Stormy (WBRS Bonus Track)

This gorgeous bedtime soother includes a progressive muscle relaxation, to help relax your body. Then, when you are super relaxed, I read a message, from you to your subconscious mind asking for it to regulate it's threat alerts to you. Includes a subliminal countdown into sleep too. Please note: Muscle tensing should be minimal.Warning: Before starting Progressive Muscle Relaxation (PMR), it is recommended to consult with your General Practitioner (GP), especially if you have any pre-existing health conditions, such as heart problems, high blood pressure, respiratory issues, or back problems. PMR involves deliberate muscle tension, release, and a short, minor back stretch, which could potentially affect your circulation, heart rate, or spinal health. Your doctor can advise whether this relaxation technique is suitable for you and suggest modifications if needed. Always prioritize safety and seek professional guidance to ensure PMR is performed safely.GO AD-FREE!    JOIN OUR APPLE PREMIUM SUBSCRIPTION! Sleep Like a Log EXTRA and get BONUS ANXIETY-REDUCING SLEEPY EPISODES, all 100% Ad-FREE in 2 Clicks for just £4.99 per month: Click HERE to start your FREE 14 DAY TRIAL (Cancel any time)Please leave a 5-STAR REVIEWFREE EXTRAS on PATREON: (Sleep Sounds etc) for you! Click HERE   OUR WEBSITE: http://sleep-like-a-log.com  We are a Sleep and Nighttime Anxiety HUB, and we provide many types of Bedtime Anxiety Soother Sessions, Visualizations & Meditations, One-to-One Counselling Support, 'Ask the Counsellor' Service, Community and Information.. Come and sign up for your FREEBIES & Giveaways! See you over there! Clare (Chief Sloggie!)xDisclaimer / WarningDO NOT drive, operate heavy machinery, or use this video when it is not safe for you to become drowsy and/or fall asleep. All videos are for entertainment or psycho-educational purposes only. Therefore, no videos on this channel should be used as a substitute for clinical professional advice or support. Please consult your GP before listening to this recording About Us  At Sleep Like a Log, we are all about helping you reduce anxiety, so that you can rest well at bedtime. You might be anxious about your ability to sleep well (Sleep Anxiety), or find it difficult to put other anxieties aside at bedtime, so that you can rest. (Nighttime Anxiety). We offer counselling, support, community and guided sleep hypnotherapy, meditations, visualisations (and more) to help you get your nighttime rest.Produced / Written / Performed by: Clare Llewellyn-Bailey, Counselling Psychotherapist, Author and Hypnotherapist (BA Hons) MBACP MNCPS Acc. DHP Acc.Hyp

Unlock new, well-reimbursed services: Spravato, a needle-mover for pain practices. Discover how Spravato, an FDA-approved esketamine treatment for depression, can drive significant financial reimbursement for your practice while improving patient outcomes. Join me as I meet with Yakov Kagan, CEO and co-founder of Big Leap Health, as he highlights the clinical efficacy of Spravato, its comparison to ketamine, and its financial impact. Learn key considerations for launching—whether independently or via an MSO—and actionable steps to get started, from staff training to billing essentials. Yakov will also share insights into future developments like monotherapy developments, helping your practice stay ahead in this rapidly evolving field. For more information and to integrate Spravato into your Pain Practice go to https://www.bigleaphealth.com Host David Rosenblum, MD Long island based anesthesiologist, David Rosenblum, MD, is one of the first interventional pain physicians in the country to integrate ultrasound guidance into his pain practice. Since 2007, he has been an international leader in the treatment of chronic pain. He has helped countless of patients suffering from back, neck, knee, shoulder, hip joint pain and has been at the forefront of regenerative pain medicine, minimally invasive pain therapies and medical education. Patients can schedule a consultation by going to www.AABPpain.com or calling: Brooklyn Office 718 436 7246 Garden City Office 516 482 7246 NRAP Academy also offers: Board Review Anesthesiology Pain Management Physical Medicine and Rehabilitation Regenerative Medicine Training  Live Workshops Online Training The Virtual Pain Fellowship (online training program with discount to live workshops)         Regional Anesthesia & Pain Ultrasound Course   Private Training Available Email Info@NRAPpain.org **Disclaimer:** The information presented in this podcast is for educational purposes only and should not be considered medical advice. Always consult a healthcare professional for medical concerns.

En cette période de fêtes (que toute l'équipe vous souhaite joyeuses et douces) le temps est à la pause, et aux retours en arrière sur l'année, avec une série de rediffusions... Aujourd'hui : Impossible de ne pas évoquer l'Hôpital Notre-Dame à la rose, le joyau au cœur de la ville, en compagnie de Thérèse Claeys, sa directrice. L'un des plus anciens hôpitaux d'Europe ! Un ensemble architectural majestueux et authentique. Un lieu plein d'émotions à découvrir absolument avec ses mille facettes : chapelle baroque, cloître, jardins, salle des malades, couvent… https://www.notredamealarose.be/ Outre son histoire, nous évoquons aussi son actualité et son futur, avec notamment Nathaniel, étudiant en menuiserie qui avec sa classe de l'Athénée d'Enghien et leur professeur Damien Nicaise, ont imaginé et réalisé les rampes d'accès PMR pour tout le musée, le rendant accessible au plus grand nombre. On touchera un petit mot sur la zythologie locale puisque Damien Nicaise est également brasseur à ses heures, d'une bière nommée « La René » en hommage au peintre originaire du pays ! https://www.facebook.com/people/La-Ren%C3%A9/100075817584883/ Merci pour votre écoute Salut les copions, c'est également en direct tous les jours de la semaine de 16h à 17h sur www.rtbf.be/lapremiere Retrouvez tous les épisodes de Salut les copions sur notre plateforme Auvio.be : https://auvio.rtbf.be/emission/19688 Et si vous avez apprécié ce podcast, n'hésitez pas à nous donner des étoiles ou des commentaires, cela nous aide à le faire connaître plus largement.

Hi Sloggies! This bedtime soother includes a progressive muscle relaxation, to help relax your body, and a gently spoken reveal of the 'secret' to falling asleep, that eludes so many of us... while cunningly taking your mind off falling asleep!Warning: Before starting Progressive Muscle Relaxation (PMR), it is recommended to consult with your General Practitioner (GP), especially if you have any pre-existing health conditions, such as heart problems, high blood pressure, respiratory issues, or back problems. PMR involves deliberate muscle tension, release, and a short, minor back stretch, which could potentially affect your circulation, heart rate, or spinal health. Your doctor can advise whether this relaxation technique is suitable for you and suggest modifications if needed. Always prioritize safety and seek professional guidance to ensure PMR is performed safely. SUBSCRIPTION: Join Sleep Like a Log EXTRA and get 3 BONUS ANXIETY-REDUCING SLEEPY EPISODES per Month, all Ad-FREE  for just £4.99 per month: Click here: https://podcasts.apple.com/us/podcast/sleep-like-a-log/id1677920774EXTRAS on Patreon: FREE downloads (Sleep Sounds etc) for you! patreon.com/SleepLikeaLog  Please Support Us!WEBSITE: http://sleep-like-a-log.com  We are a Sleep and Nighttime Anxiety HUB, and we provide many types of Bedtime Anxiety Soother Sessions, Visualizations & Meditations, One-to-One Counselling Support, 'Ask the Counsellor' Service, Community and Information.. Come and sign up for your FREEBIES & Giveaways! See you over there! Clare (Chief Sloggie!)xDisclaimer / WarningDO NOT drive, operate heavy machinery, or use this video when it is not safe for you to become drowsy and/or fall asleep. All videos are for entertainment or psycho-educational purposes only. Therefore, no videos on this channel should be used as a substitute for clinical professional advice or support. Please consult your GP before listening to this recording HCA: This recording has Hypnotic Choreographed Audio (HCA) meaning that the background sound and voiceover recording have been edited in a 'choreographed' way to create a greater hypnotic listening experience.Written and Spoken by Clare Bailey, Counselling Psychotherapist, Author and Hypnotherapist (BA Hons) MBACP MNCPS Acc. DHP Acc.HypAbout Us  At Sleep Like a Log, we are all about helping you reduce anxiety, so that you can rest well at bedtime. You might be anxious about your ability to sleep well (Sleep Anxiety), or find it difficult to put other anxieties aside at bedtime, so that you can rest. (Nighttime Anxiety). We offer counselling, support, community and guided sleep hypnotherapy, meditations, visualizations (and more) to help you get your nighttime rest.

 Painexam Podcast Episode Show Notes   Episode Title:  Exploring Naturopathy in Pain Medicine with Dr. Sarah Trahan  Host: David Rosenblum, MD   David Rosenblum is a dedicated pain management specialist with extensive experience in treating chronic pain conditions. He is passionate about integrating various approaches to improve patient outcomes and enhance quality of life. His expertise and commitment to patient-centered care make him a trusted voice in the field of pain medicine. His NY Practice is located in Brooklyn and Garden City and through his international educaitonal platform he has attracted physicians and pateints from all over the world to seek out consultation on the latest breakthroughs in interventional pain management.   Guest: Dr. Sarah Trahan   Dr. Sarah Trahan is a licensed naturopathic physician with a focus on holistic approaches to pain management and regenerative therapies. With a background in both conventional and alternative medicine, Dr. Trahan is committed to empowering patients through education and personalized treatment plans that address the root causes of pain.  Episode Summary:  In this episode, David Rosenblum, MD, interviews Dr. Sarah Trahan to explore the role of naturopathy in pain medicine and the potential of regenerative therapies. Dr. Trahan shares her insights on how naturopathic principles can complement traditional pain management approaches, offering a comprehensive view of patient care.  Key Discussion Points:  -  ntroduction to Naturopathy:    Dr. Trahan explains the philosophy of naturopathic medicine and its emphasis on treating the whole person rather than just symptoms. -  The Role of Naturopathy in Pain Management:    The conversation delves into how naturopathy can be integrated into pain management strategies, including dietary changes, lifestyle modifications, and natural supplements. - Regenerative Therapies:    Dr. Trahan discusses the latest advancements in regenerative therapies, focusing on how these approaches can be applied in the context of pain management without delving into stem cell treatments. - Patient-Centered Care:    Emphasizing the importance of a collaborative approach, Dr. Trahan shares strategies for working with patients to develop tailored treatment plans that align with their individual needs and preferences. - Success Stories     Dr. Trahan recounts some of her most impactful approaches and  success stories, illustrating the benefits of combining naturopathic and conventional approaches to pain relief. - NRAP Academy Online Courses and Workshops:      Dr. Trahan highlights the educational opportunities available through the NRAP Academy, which offers online courses and workshops aimed at healthcare professionals interested in enhancing their understanding of naturopathic principles in pain management. Private ultrasound training is also available for those seeking hands-on experience. For more information, visit NRAPpain.org  Resources   Pain Management CME Workshop Calendar   Pain Medicine CME Board Prep and Online Courses     Tune in to this insightful conversation to learn more about how naturopathy and regenerative therapies can play a vital role in managing pain and improving patient outcomes. Stay connected with Painexam for more episodes on pain management and treatment innovations. Don't forget to subscribe and leave a review!   For questions or feedback, reach out to us at info@nrappain.org --- This episode promises to provide valuable insights for healthcare professionals and patients alike, highlighting the importance of a holistic approach to pain management.

Quante volte abbiamo sentito la frase “in montagna bisogna saper rinunciare” da amici, istruttori e guide? E' ovviamente un consiglio validissimo, ma che spesso manca di un esempio che ne rafforzi il concetto. Una lacuna a cui poniamo rimedio con questo episodio con protagonista l'incidente accaduto ad Alessandro, durante un'uscita con l'amico Gabriele. Un'intervista a due voci molto onesta e dritta al punto: l'errore finale è ancora una volta solo l'ultimo anello di una serie di errori che sono costati ad Alessandro ben 23 giorni di ospedale. Abbiamo parlato di “non sentirsela”, di comunicazione lacunosa e anche di radio PMR e del progetto Rete Radio Montana

Below is a brief video snippet from our conversation. Full videos of all Ground Truths podcasts can be seen on YouTube here. The current one is here. If you like the YouTube format, please subscribe! This one has embedded one of my favorite TikTok's from Will. There are several links to others in the transcript. The audios are also available on Apple and Spotify.Transcript with links to both audio and videos, commencement addresses, NEJM article coverageEric Topol (00:06):Hi, it's Eric Topol from Ground Truths, and I've got an amazing couple with me today. It's Will Flanary and Kristin Flanary, the Glaucomfleckens. I've had the chance to get to know them a bit through Knock Knock, Hi! which is their podcast. And of course, everyone knows Dr. Glaucomflecken from his TikTok world and his other about 4 million followers on Instagram and Twitter and all these other social media, and YouTube. So welcome.Will Flanary (00:43):Thanks for having us.Kristin Flanary (00:44):Thank you. Happy to be here.By Way of BackgroundEric Topol (00:45):Yeah. Well, this is going to be fun because I'm going to go a quick background so we can go fast forward because we did an interview back in early 2022.Kristin Flanary (00:56):Yes.Eric Topol (00:57):And what you've been doing since then is rocking it. You're like a meteoric, right. And it was predictable, like rarefied talent and who couldn't love humor, medical humor, but by way of background, just for those who are not up to speed. I guess you got your start, Will, as a class clown when your mother was a teacher in the sixth grade.Will Flanary (01:22):Yep, yep. I misbehaved a little bit. It helped that I still made good grades, but I cut up a bit in class.Eric Topol (01:32):And then you were already in the comedy club circuits doing standup in Houston as an 18-year-old.Will Flanary (01:40):It was all amateur stuff, nothing, just dabble in it and trying to get better. I was always kind of naturally funny just with my friend group and everything. I loved making people laugh, but doing standups is a whole different ball game. And so, I started doing that around Houston as a high school senior and kept that going through college and a little bit into med school.Kristin Flanary (02:02):Houston was a good training ground, right? That where Harris Wittels was also coming up.Will Flanary (02:07):Yeah. A lot of famous comedians have come through Houston. Even going back to Bill Hicks back in the, was that the 80s, I think? Or 90s?Eric Topol (02:17):Well, and then of course, it was I think in 2020 when you launched Dr. Glaucomflecken, I think. Is that right?Will Flanary (02:28):That's when it really started to take off. I was on Twitter telling jokes back in 2016.Kristin Flanary (02:39):GomerBlog before that, that's actually where it was born.Will Flanary (02:41):I was doing satire writing. I basically do what I'm doing now, but in article form, trying to be The Onion of medicine. And then the pandemic hit, started doing video content and that's really with lockdown. That's when, because everybody was on social media, nobody had anything else to do. So it was right place, right time for me and branching out into video content.On to Medical School Commencement AddressesEric Topol (03:11):Alright, so that's the background of some incredible foundation for humor. But since we last got together, I'll link the Medicine and the Machine interview we did back then. What has been happening with you two is nothing short of incredible. I saw your graduation speeches, Will. Yale in 2022, I watched the UCSF in 2023 and then the University of Michigan in 2024. Maybe there's other ones I don't even know.Kristin Flanary (03:45):There's a few others.Will Flanary (03:45):There's a few. But I feel like you've done, I'm sure your fair share of commencement addresses as well. It's kind of hard to come up with different ways to be inspirational to the next generation. So fortunately, we have together, we have some life experiences and learned a thing or two by doing all of this social media stuff and just the things we've been through that I guess I have enough things to say to entertain an interest.Eric Topol (04:18):Well, you're being humble as usual, but having watched those commencement addresses, they were the best medical commencement addresses I've ever seen. And even though you might have told us some of the same jokes, they were so great that it was all right. Yeah, and you know what is great about it is you've got these, not the students, they all love you of course, because they're probably addicted to when's your next video going to get posted.(04:44):But even the old professors, all the family members, it's great. But one of the things I wanted to get at. Well, I'll start with the graduation speeches, because you were such an inspiration, not just with humor, but your message. And this gets back to you as a couple and the tragedies you've been through. So you really, I think, got into this co-survivor story and maybe Kristin, since you are the co-survivor of two bouts of Will's testicular cancer, and then the sudden cardiac death. I mean, people don't talk about this much, so maybe you could help enlighten us.Tragedies and Being a Co-SurvivorKristin Flanary (05:26):Yeah, it's funny because the experience of being a co-survivor is nothing new. It's as long as we've had human beings, we've had co-survivors. But the concept around it and giving it a name and a label, a framework to be able to think about it, that is what I think is new and what people haven't talked about before. So co-survivor is just this idea that when a medical trauma happens to a patient, the patient has their experience and if they survive it, they are a survivor and they have a survivor experience. And also, most people are closely attached to at least one other person, if not many. And those people are co-surviving the medical event along with the survivor. That event is happening in their lives as was happening to them too. If someone comes in with a patient to the hospital, that person, you can just assume by default that their lives are pretty intimately or profoundly intertwined or else why would that person be there? And so, thinking of it as there's the patient and then there's also a co-patient, that family members in the past have only been thought of as caregivers if they've been thought of at all. And that is certainly one aspect of the role, but it's important to remember that whatever it is that's happening to the patient is also affecting the family members' lives in a really deep and profound way.Eric Topol (07:04):That's really helpful. Now, the fact that you recognize that in your graduation speech, Will, I think is somewhat unique. And of course, some of the other things that you touched on like playing to your creativity and the human factors, I mean, these are so important messages.Will Flanary (07:23):Well, in the discussion about co-survivorship and because I talk about that whenever I do my keynotes and when I do the commencement addresses, but all credit goes to Kristin for really being the driving force of this idea for me and for many others because as a physician, we take care of patients. Our focus is always on the patient. And it really wasn't until this happened to me and my family and Kristin in particular that I started to understand exactly what she's talking about and this idea. And so, Kristin gets a lot of credit for just really bringing that term and that idea to the forefront.Eric Topol (08:09):Yeah, well, you saved his life. It's just not many have that bond. And then the other thing I just want to mention now, you've been recognized by the American Heart Association and a whole bunch of other organizations awarded because of your advocacy for CPR. And you even mentioned that I think in one of your commencement addresses.Will Flanary (08:31):Yeah, I tried to get the crowd to do CPR. Like team up, partner up, and it kind of fell flat. It wasn't quite the right time, I think, to try to do a mass class on CPR. So maybe next time.Eric Topol (08:47):Right. Well, so you had this foundation with the Glaucomflecken General Hospital and taking on 37 specialties and all these incredible people that became part of the family, if you will, of spoof on medicine and your alter ego and these videos that you would do. And sometimes you have three or four different alter egos in there playing out, but now you've branched into new things. So one which is an outgrowth of what we were just talking about. You've been on this country tour, Wife & Death.“Wife and Death,” A Nationwide TourKristin Flanary (09:28):Yes.Eric Topol (09:29):Wife and death. I mean, yeah, I guess we can make the connect of how you named it that, but what is it you've been selling out in cities all over the country, and by the way, I'm really upset you haven't come to San Diego, but tell us about wife and death.Will Flanary (09:44):Yeah. Well, we have this amazing story and all these medical challenges we've been through, and then developing the Glaucomflecken brand and universe, and we've done keynotes together for years, and then we thought, let's have more fun with it. Let's do keynotes. They're great. We can get our message out, but sometimes they're just a bit stuffy. It's an academic environment.Kristin Flanary (10:15):They're usually at seven in the morning also, so that's the downside.Will Flanary (10:21):So we thought, let's just put together our own live show. Let's put together something that we could just creatively, we can do whatever we want with it. I could dress up as characters, Kristin, who has these beautiful writing and monologues that she's put together around her experience and just to create something that people can come into a theater and just experience this wide range of emotions from just laughter to tears of all kinds, and just have them feel the story and enjoy this story. Fortunately, it has a happy ending because I'm still alive and it's been so much fun. The audiences have been incredible. Mostly healthcare, but even some non-healthcare people show up, and we've been blown away by the response. Honestly, we should have done bigger theaters. That's our lesson for the first go round.Eric Topol (11:21):I saw you had to do a second show in Pittsburgh.Will Flanary (11:24):We did.Kristin Flanary (11:26):That one sold out too. Something about Pittsburgh, that was a good crowd, and there was a lot of them.Will Flanary (11:33):It was almost like in Pittsburgh, they rarely ever get any internet comedian ophthalmologists that come through. I don't know.Eric Topol (11:41):Well, I see you got some still to come in Denver and Chicago. This is amazing. And I wondered who was coming and I mean, it's not at all surprising that there'd be this phenomenal popularity. So that's one thing you've done that's new, which is amazing. And of course, it's a multidimensional story. The one that shocked me, I have to tell you, shocked me, was the New England Journal partnership. The New England Journal is the most stodgy, arrogant, I mean so difficult. And not only that.Kristin Flanary (12:17):You said that. Not us.Partnering with the New England Journal of Medicine!Eric Topol (12:19):Yeah, yeah. They'll get this too. They know we don't get along that well, but that's okay. You even made fun of journals. And now you're partnering with the New England Journal, God's greatest medical journal, or whatever. Tell us about that.Will Flanary (12:39):Well, so one thing that I really enjoy doing, and I've done it with my US healthcare system content is almost like tricking people into learning things. And so, if you make something funny, then people will actually sit there and listen to what you have to say about deductibles and physician-owned hospitals and all these inner workings. DIR fees and pharmacy, all these things that are really dry topics. But if you can make them funny, all of a sudden people will actually learn and listen to it. And the New England Journal of Medicine, they approached me with an idea. Basically just to take one or two of their trials per month. And I just make a skit out of that trial with the idea being to help disseminate some of the research findings that are out there, because I guess it's getting harder and harder for people to actually read, to sit down and read a journal article.(13:43):And so, I have to credit them for having this idea and thinking outside the box of a different way to get medical information and knowledge out to the masses. And you're absolutely right, that I have been critical of journals, and particularly I've been critical of the predatory nature of some of the larger journals out there, like Elsevier. I've specifically named Elsevier, Springer, these journals that have a 40% profit margin. And I certainly thought about that whenever I was looking into this partnership. And the reason I was okay with doing it with the New England Journal is because they're a nonprofit, first of all, so they're run by the Massachusetts Medical Society. That's the publisher for that journal. And so, I feel okay partnering with them because I feel like they're doing it in a much better way than some of the bigger journal corporations out there.Kristin Flanary (14:54):Well, and also part of the deal that we negotiated was that those articles that you make skits about those will be available open access.Will Flanary (15:03):Oh yeah. That was a prerequisite. Yes. It was like, if I'm going to do this, the articles that I'm talking about need to be free and readily available. That's part of it.Eric Topol (15:14):I think you've done about five already, something like that. And I watched them, and I just was blown away. I mean, the one that got me where I was just rolling on the floor, this one, the Belantamab Mafodotin for Multiple Myeloma. And when you were going on about the Bortezomib, Dexamethasone. We'll link to this. I said, oh my God.Will Flanary (15:40):Yeah. The joke there is, you don't have any idea how long it took me to say those things that quickly. And so, I was writing this skit and I'm like, wouldn't it be funny if somehow that triggered a code stroke in the hospital because this person is saying all these random words that don't have any meaning to anybody. Man, I tell you, I am learning. Why would I ever need to know any of this information as an ophthalmologist? So it's great. I know all this random stuff about multiple myeloma that I probably would never have learned otherwise.Kristin Flanary (16:21):It's the only way, you won't read a journal either.Eric Topol (16:23):Well, and if you read the comments on the post. These doctors saying, this is the only way they want to get journal information from now on.Will Flanary (16:33):Which is double-edged sword, maybe a little bit. Obviously, in a 90 second skit, there's no way I'm going to cover the ins and outs of a major trial. So it's really, in a lot of ways, it's basically like, I call it a comedy abstract. I'm not going much further than an abstract, but hopefully people that are actually interested in the topic can have their interest piqued and want to read more about it. That's kind of the idea.Eric Topol (17:06):Yeah. Well, they're phenomenal. We'll link to them. People will enjoy them. I know, because I sure did. And tenecteplase for stroke and all that you've done. Oh, they're just phenomenal.Will Flanary (17:20):Every two weeks we come out with a new one.Eric Topol (17:24):And that is basically between the fact that you are now on the commencement circuit of the top medical schools and doing New England Journal videos on their articles. You've crossed a line from just making fun of insurance companies and doctors of specialties.Kristin Flanary (17:44):Oh, he has crossed many lines, Dr. Topol.Eric Topol (17:46):Yeah. Oh yeah. Now you've done it, really. Back two years ago when we convened, actually it's almost three, but you said, when's it going to be your Netflix special?Will Flanary (18:02):Oh, gosh.Eric Topol (18:02):Is that in the works now?Will Flanary (18:04):Well, I'll tell you what's in the works now.Kristin Flanary (18:06):Do you know anyone at Netflix?Will Flanary (18:09):A New Animated SeriesNo. We're working on an animated series.Eric Topol (18:12):Oh, wow. Wow.Will Flanary (18:13):Yeah. All these characters. It's basically just this fictional hospital and all these characters are very cartoonish, the emergency physician that wears the bike helmet and everything. So it's like, well, what do we have together? What do we, Kristin and I have time for? And it wasn't like moving to LA and trying to make a live action with actors and do all, which is something we probably could have tried to do. So instead, we were like, let's just do an animated series.Kristin Flanary (18:48):Let's have someone else do the work and draw us.Will Flanary (18:51):So we've worked with a writer for the first time, which was a fun process, and putting together a few scripts and then also an animator. We learned a lot about that process. Kristin and I are doing the voiceovers. And yeah, it's in process.Kristin Flanary (19:10):We're the only actors we could afford.Will Flanary (19:12):Right, exactly.Eric Topol (19:13):I can't wait to see it. Now when will it get out there?Will Flanary (19:17):Well, we're hoping to be able to put it out on our YouTube channel sometime early next year. So January, February, somewhere around there. And then we can't fund the whole thing ourselves. So the idea is that we do this, we do this pilot episode, and then we'll see what kind of interest we can generate.Eric Topol (19:37):Well, there will be interest. I am absolutely assured of that. Wow.Will Flanary (19:42):Let us know if you know anybody at the Cartoon Network.Kristin and Will Flanary (19:45):Yeah, we're open to possibilities. Whatever, Discovery channel. I don't know.Eric Topol (19:51):You've gotten to a point now where you're ready for bigger things even because you're the funniest physician couple in medicine today.Kristin Flanary (20:05):Well, that's a very low bar, but thank you.Will Flanary (20:08):There are some funny ones out there, but yeah, I appreciate that.Eric Topol (20:11):Well, I'm a really big comedy fan. Every night I watch the night before, since I'm old now, but of Colbert and Jimmy Kimmel, just to hear the monologues. Trevor Noah, too. And I can appreciate humor. I'll go to see Sebastian Maniscalco or Jim Gaffigan. That's one of the things I was going to ask you about, because when you do these videos, you don't have an audience.Will Flanary (20:39):Oh yeah.Eric Topol (20:40):You're making it as opposed to when you are doing your live shows, commencement addresses and things like that. What's the difference when you're trying to be humorous, and you have no audience there?Will Flanary (20:55):Well, whenever I'm filming a skit, it's just all production. In fact, I feel like it's funny. I think it's funny, but it's really not until I see the response to it, or I show Kristin, or what I have is where I really know if it's going to work. It's great to put the content out there and see the responses, but there's nothing like live interaction. And that's why I keep coming back to performing. And Kristin's been a performer too in her life. And I think we both really enjoy just the personal interaction, the close interaction, the response from people to our story.Kristin Flanary (21:36):We do most of our work alone in this room. I do a lot of writing. He does a lot of playing.Will Flanary (21:44):Dress up.Kristin Flanary (21:44):All the people in his head, and we do that very isolated. And so, it's very lovely to be able to actually put names to faces or just see human bodies instead of just comments on YouTube.Will Flanary (21:59):Meet people.Kristin Flanary (21:59):It's really nice.Will Flanary (22:01):We've been doing meet and greets at the live shows and seeing people come up wearing their costumes.Eric Topol (22:07):Oh, wow.Will Flanary (22:11):Some of them talk about how they tell us their own stories about their own healthcare and talk about how the videos help them get through certain parts of the pandemic or a difficult time in their life. And so, it reinforces that this means something to a lot of people.Kristin Flanary (22:29):It's been really fun for me, and probably you too, but to get to see the joy that he has brought so many people. That's really fun to see in person especially.Eric Topol (22:42):No question. Now, when you're producing it together, do you ever just start breaking into laughter because it's you know how funny this is? Or is it just you're on kind of a mission to get it done?Will Flanary (22:54):Well, the skits I do by myself. And sometimes when I'm writing out the skit, when I'm writing the skit itself, I will laugh at myself sometimes. Not often, but sometimes they're like, oh, I know that's really funny. I just wrote a skit that I'm actually going to be debuting. I'm speaking at the American Academy of PM&R, so the big PM&R conference. I'm writing a skit, it's How to Ace your PM&R residency interview.Will Flanary (23:28):I was writing up that skit today and kind of chuckling to myself. So sometimes that happens, but whenever we do our podcast together, we definitely have outtakes.Kristin Flanary (23:38):Oh yeah, we've got some.Will Flanary (23:40):We crack each other up.Kristin Flanary (23:41):We do.Will Flanary (23:42):Sometimes we're getting a little punchy toward the end of the day.Eric Topol (23:47):And how is the Knock Knock, Hi! podcast going?Will Flanary (23:51):It's awesome. Yeah.Kristin Flanary (23:52):Yeah. It's a really fun project.Will Flanary (23:54):We still enjoy. You can work with your spouse and in close proximity and still be happily married. So it's doable everyone.Kristin Flanary (24:06):That's right. And we're in that phase of life that's really busy. We've got kids, we've got a gazillion jobs. House, my parents are around, and so it's like the only time all week that we actually get to sit down and talk to each other. So it's actually kind of like a part of our marriage at this point.Will Flanary (24:28):We're happy to involve the public in our conversations, but we couldn't do it because we have all these things going on, all our hands and all these little places. We can't do it without a team.Kristin Flanary (24:41):Yeah, absolutely.Will Flanary (24:41):And that's the thing that I've learned, because I've always been a very loner type content creator. I just wanted to do it all myself. It's in my head and I have trouble telling others, describing what's in my head. And Kristin and our producers have helped me to be able to give a little bit of control to others who are really good at what they do. And that's really the only way that we've been able to venture out into all these different things we've talked about.Eric Topol (25:12):Well, I think it comes down to, besides your ability to get to people in terms of their laughter receptors, you have this incisive observer capability. And that's one of the things I don't, I can't fathom because when you can understand the nuances of each specialty or of each part of healthcare, and you haven't necessarily interacted with these specialists or at least in recent years, but you nail it every time. I don't know how you do it, really that observational, is that a central quality of a comedian, you think?Will Flanary (25:52):There's definitely a big part of that. You got to get the content from somewhere. But for the specialties, it's really first about just getting the personalities down. And that doesn't change over time.Kristin Flanary (26:08):Or around the world.Will Flanary (26:09):Or around the world. We hear from people from all over the world about, oh, it's the same in Guatemala as it is in the US.Kristin Flanary (26:18):Surgeons are the same.Will Flanary (26:19):Yeah.Kristin Flanary (26:20):Emergency is the same.Will Flanary (26:21):Which has been really cool to see. But so, I draw on my experience interacting with all these specialties back in my med school and intern days. You're right, as an ophthalmologist, we don't get out very much.Eric Topol (26:33):No.Will Flanary (26:35):So very few people have ever seen an ophthalmologist. We do exist. But then beyond that, I do have to include some actual medical things. And so, I actually, I do a lot of research. I find myself learning more about other fields sometimes than I do in my own field. So especially the further out I get from med school, I know less and less.Eric Topol (27:00):Yeah, that's what I was thinking. But you're always spot on. It's interesting to get that global perspective from both of you. Now you're still doing surgery and practicing ophthalmology. Have you reduced it because this has just been taking off so much more over the recent years or keeping it the same?Will and Kristin Flanary (27:21):Nope, I'm still. Do you know how many years I had to come along on all of this medical training? He is not allowed to give this up.Will Flanary (27:29):I know there's something called a sunk cost fallacy, but this is no fallacy. There's enough of a sunk cost. I got to stick with it. No, I still enjoy it. That's the thing. It actually, it informs my comedy, it grounds me. All of the social media stuff is built upon this medical foundation that I have. And if I stopped practicing, I guess I could maybe cut back. But I'm not planning on doing that. If I stop practicing medicine, I feel like it would make my content less.Kristin Flanary (28:07):Authentic.Will Flanary (28:08):Less authentic, yeah. That's a good way to put it.Eric Topol (28:09):Yeah, no, that makes a lot of sense. That's great you can get that balance with all the things you're doing.Will Flanary (28:17):And if I stop practicing medicine, they're not going to invite me to any more commencement addresses, Dr. Topol. So I got to draw the line somewhere.Eric Topol (28:28):One of the statements you made at some point earlier was, it was easier to go to become a doctor than to try to be a comedian. And yeah, I mean you proven that.Will Flanary (28:38):A lot of ways. That's true.Eric Topol (28:40):Wow. I am pretty awestruck about the rarefied talent that you bring and what you both have done for medicine today. And the thing is, you're so young, you have so much time ahead to have an impact.Will Flanary (28:57):You hear that Kristin, we're young. Look at that.Kristin Flanary (29:00):That's getting less and less true.Will Flanary (29:01):Kristin, she just turned 40. It's right around the corner for me. So I don't know.Will Flanary (29:11):We got some years left.Eric Topol (29:12):You're like young puppies. Are you kidding? You're just getting started. But no, I think that what you brought to medicine in terms of comedy, there's no other entity, no person or people like you have done. And just the last thing I want to ask you about is, you have a platform for advocacy. You've been doing that. We talked about co-survivor. We talked about nurturing the human qualities in physicians like creativity and also taking on the insurance companies, which are just monstrous. I'll link a couple of those, but the brain MRI one or the Texaco.Will Flanary (29:54):Texaco Mike.Eric Topol (29:55):Yeah, that one is amazing. But there is so many. I mean, you've just taken them apart and they deserve every bit of it. Do you have any other targets for advocacy or does that just kind of come up as things go?Will Flanary (30:08):It kind of comes up as things go. There's things I keep harping on. The prior authorization reform, which I've helped in a couple of different states. There's a lot of good people around the country doing really good work on prior authorization and reforming that whole process. And I've been able to just play a small part in that in a couple of different ways. And it's been really fun to do that. And so, I do plan on continuing that crusade as it were. There's certain things I'd like to see. I've been learning more about what pharmacists are dealing with as well as a physician. Unfortunately, we are very separate in a lot of ways and just how we come up in medicine. And so, I have had my eyes opened a lot to what community pharmacists are dealing with. For all the terrible things that we have to deal with as physicians in the healthcare system. Pharmacists have just as much, if not more of the things that they're doing that are threatening their livelihoods. And so, I had love to see some more reform on the PBM side of things, pharmacy benefit managers, Caremark, Optum, all of them. They're causing lots of problems.Eric Topol (31:24):I couldn't agree with you more. In fact, I'm going to have Mark Cuban on in a few weeks and we're going to get into that. But the pharmacists get abused by these chains.Will Flanary (31:33):Oh, it's bad. It's really bad.Eric Topol (31:35):Horrible, horrible. I feel, and every time I am in a drugstore working with one of them, I just think what a tough life they have to deal with.Will Flanary (31:45):I guess from an advocacy standpoint, the good news is that there's never a shortage of terrible injustices that are being foisted upon the public and physicians and healthcare workers.Kristin Flanary (31:59):Yes. The US healthcare system is ripe for advocacy.Will Flanary (32:01):Yes. And that's a lesson that I tell people too, and especially the med students coming up, is like, there's work to be done and get in touch with your state societies and there's always work to be done.Eric Topol (32:18):Now you've stayed clear of politics. Totally clear, right?Will Flanary (32:24):For the most part, yeah. Yeah. It depends on what you consider politics. It depends on what you consider politics.Eric Topol (32:32):It being election day, you haven't made any endorsements.Will Flanary (32:36):I haven't. And I don't know. I can only handle so much. I've got my things that I really care about. Of course I'm voting, but I want to talk on the things that I feel like I have the expertise to talk about. And I think there's nothing wrong with that. Everybody can't have an opinion on everything, and it means something. So I am happy to discuss the things that I have expertise about, and I'm always on the side of the patient and wanting to make life better for our patients. And that's the side I'm on.Kristin Flanary (33:25):I think also he never comes out and explicitly touches on certain topics, but it's not hard to tell where he falls.Will Flanary (33:34):If you really want read into it all.Kristin Flanary (33:38):It's not like it's a big secret.Eric Topol (33:40):I thought that too. I'm glad you mentioned it, Kristin. But it doesn't come out wide open. But yeah, it's inferred for sure.Eric Topol (33:49):I think the point being there is that because you have a reach, I think there's no reach that it has 4 million plus people by your posts and no less the tours and keynotes and everything else. So you could go anywhere but sticking to where you're well grounded, it makes a lot of sense. And anyway, I am going to be staying tuned. This is our two-year checkup. I'm hoping you're going to come to San Diego on your next tour.Kristin Flanary (34:21):We're working on 2025 plans.Will Flanary (34:23):Oh, we got more shows coming up. And we'll hit up other parts of the country too.Eric Topol (34:28):I feel like I got to meet you in person, give you a hug or something. I just feel like I'm missing out there. But it's just a joy to have had a chance to work with you on your podcast. And thanks for coming back on one of mine. There's lots of podcasts out there, but having you and joining you is such fun. So thank you.Will Flanary (34:54):This has been great. Thank you for having us.Kristin Flanary (34:55):Yeah, thank you.*****************************************Thank you for reading, listening and and subscribing to Ground Truths.If you found this fun and informative please share it! Yes, laughter is the best medicine.All content on Ground Truths—its newsletters, analyses, and podcasts, are free, open-access.Paid subscriptions are voluntary. All proceeds from them go to support Scripps Research. Many thanks to those who have contributed—they have greatly helped fund our summer internship programs for the past two years.Thanks to my producer Jessica Nguyen and to Sinjun Balabanoff for audio and video support at Scripps Research.Note on Exodus from X/twitter:Many of you have abandoned the X platform for reasons that I understand. While I intend to continue to post there because of its reach to the biomedical community, I will post anything material here in the Notes section of Ground Truths on a daily basis and cover important topics in the newsletter/analyses. Get full access to Ground Truths at erictopol.substack.com/subscribe

Dernière étape lessinoise en compagnie de deux joyeux joueurs, emmenés par une non moins guillerette équipe composée (entre autres, car ils sont nombreux dans l'ombre !) de Charlotte Dekoker, Raoul Reyers, Walid et Eric De Staercke. Impossible de ne pas enfin évoquer l'Hôpital Notre-Dame à la rose, le joyau au cœur de la ville, en compagnie de Thérèse Claeys, sa directrice. L'un des plus anciens hôpitaux d'Europe ! Un ensemble architectural majestueux et authentique. Un lieu plein d'émotions à découvrir absolument avec ses mille facettes : chapelle baroque, cloître, jardins, salle des malades, couvent… https://www.notredamealarose.be/ Outre son histoire, nous évoquons aussi son actualité et son futur, avec notamment Nathaniel, étudiant en menuiserie qui avec sa classe de l'Athénée d'Enghien et leur professeur Damien Nicaise, ont imaginé et réalisé les rampes d'accès PMR pour tout le musée, le rendant accessible au plus grand nombre. On touchera un petit mot sur la zytologie locale puisque Damien Nicaise est également brasseur à ses heures, d'une bière nommée « La René » en hommage au peintre originaire du pays ! https://www.facebook.com/people/La-Ren%C3%A9/100075817584883/ Merci pour votre écoute Salut les copions, c'est également en direct tous les jours de la semaine de 16h à 17h sur www.rtbf.be/lapremiere Retrouvez tous les épisodes de Salut les copions sur notre plateforme Auvio.be : https://auvio.rtbf.be/emission/19688 Et si vous avez apprécié ce podcast, n'hésitez pas à nous donner des étoiles ou des commentaires, cela nous aide à le faire connaître plus largement.

In this special Complex Care Journal Club podcast episode, co-hosts Drs. Kilby Mann and Kristie Malik interview presenters of posters and oral abstracts relevant to the care of children with medical complexity at the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) 78th Annual Meeting in Quebec City, Canada that took place October 23rd-26th 2024. Speakers describe the implications of their study findings, messages for patients and families, and priority areas for research that they hope can be investigated further by the complex care community in the coming years. SPEAKERS Tori Bahr, MD MedPeds Complex Care Physician Section Chief of Pediatrics Gillette Children's, St. Paul, Minnesota Laura Brunton, PT, PhD Associate Professor School of Physical Therapy Western University, London, Ontario Caitlin Cassidy, MD Associate Professor Departments of Physical Medicine & Rehabilitation and Pediatrics Western University, London, Ontario Adam Rosenbloom, MD, MPH Complex Care Pediatrician Dell Children's Medical Center University of Texas at Austin, Dell Medical School Cristina Sarmiento, MD Assistant Professor Department of Physical Medicine and Rehabilitation University of Colorado Anschutz Medical Campus, Aurora, Colorado Julie Stutzbach, PT, DPT, PhD Assistant Professor School of Rehabilitative and Health Sciences Regis University, Denver, Colorado HOSTS Kristina Malik, MD Assistant Professor of Pediatrics, University of Colorado School of Medicine Medical Director, KidStreet Pediatrician, Special Care Clinic, Children's Hospital Colorado Kilby Mann, MD Assistant Professor Pediatric Rehabilitation Medicine Children's Hospital Colorado DATE Initial publication date: November 11, 2024. ARTICLES AND ADDITIONAL REFERENCES • American Academy for Cerebral Palsy and Developmental Medicine (AACPDM), https://www.aacpdm.org/ • AACPDM Complex Care Committee (https://www.aacpdm.org/about-us/committees/complex-care) • Houtrow AJ, Hurwitz MB. A dearth of disability-related competencies in Accreditation Council for Graduate Medical Education's Milestones 2.0. PM R. 2024 Aug 23. doi: 10.1002/pmrj.13257. Epub ahead of print. PMID: 39177053. • Fehlings D, Agnew B, Gimeno H, Harvey A, Himmelmann K, Lin JP, Mink JW, Monbaliu E, Rice J, Bohn E, Falck-Ytter Y. Pharmacological and neurosurgical management of cerebral palsy and dystonia: Clinical practice guideline update. Dev Med Child Neurol. 2024 Sep;66(9):1133-1147. doi: 10.1111/dmcn.15921. Epub 2024 Apr 19. PMID: 38640091. • AACPDM Care Pathway Dystonia in Cerebral Palsy, https://www.aacpdm.org/publications/care-pathways/dystonia-in-cerebral-palsy TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/as/p9pj6g7sxn5kjmmgps5wnk4/111124_-_Complex_Care_at_the_American_Academy_for_Cerebral_Palsy_and_Developmental_Medicine_Annual_Meeting Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open access-and thus at no expense to the user.For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu CITATION Malik K, Bahr T, Brunton L, Cassidy C, Rosenbloom A, Sarmiento C, Stuzbach J, Mann K. Complex Care at the American Academy for Cerebral Palsy and Developmental Medicine Annual Meeting. 11/2024. OPENPediatrics. Online Podcast.. https://soundcloud.com/openpediatrics/complex-care-at-the-aacpdm-2024.

Western Digital vient de franchir une étape majeure dans l'innovation des disques durs, marquant un tournant dans le stockage de données. Dans un communiqué de presse et un billet sur son blog officiel, l'entreprise a annoncé la création d'un disque dur intégrant un onzième plateau, une prouesse technique jusqu'alors jugée impossible. Cette avancée est particulièrement importante pour les centres de données, principaux utilisateurs de disques durs, qui doivent s'adapter à des besoins croissants de capacité de stockage sans modifier la taille standard des baies.Takaaki Deguchi, responsable de l'équipe de conception chez Western Digital à Fujisawa, au Japon, explique : « Nous avons dû réduire l'espace entre les plateaux et l'épaisseur de certains composants, tout en préservant la rigidité du châssis ». Cette réduction millimétrée permet ainsi d'ajouter un onzième plateau sans altérer les performances mécaniques. Cette innovation s'accompagne de nouvelles capacités impressionnantes. Western Digital prévoit déjà des modèles dépassant les 40 To, mais la dernière série commercialisée comprend le modèle Ultrastar DC HC590, doté de la technologie ePMR (Energy-assisted PMR). Ce modèle atteint 26 To grâce à une densité de 2,36 To par plateau, tout en conservant une vitesse de rotation de 7 200 tours par minute et des débits atteignant 302 Mo/s.Un autre modèle, l'Ultrastar DC HC690, exploite la technologie SMR (Shingled Magnetic Recording), permettant de superposer partiellement les pistes pour obtenir une densité encore plus élevée, avec des capacités allant jusqu'à 32 To. Cependant, cette technologie entraîne des débits légèrement inférieurs, autour de 260 Mo/s. Ces nouveaux disques durs, conçus principalement pour les centres de données, ne seront pas disponibles immédiatement pour le grand public, mais ils représentent un bond en avant dans la gestion du stockage à grande échelle. Hébergé par Acast. Visitez acast.com/privacy pour plus d'informations.

Dr. Shannon Westin and her guest, Dr. Brian  Slomovitz discuss the article “Pembrolizumab or Placebo Plus Adjuvant Chemotherapy With or Without Radiotherapy For Newly Diagnosed, High-Risk Endometrial Cancer: Results in Mismatch Repair-Deficient Tumors” recently published in the JCO and presented at the 2024 International Gynecologic Cancer Society. TRANSCRIPT The guest's disclosures can be found in the transcript.  Dr. Shannon Westin: Hello, and welcome to another episode of JCO After Hours, the podcast where we get in depth on manuscripts and literature published in the Journal of Clinical Oncology. I'm your host, Shannon Westin, gynecologic oncologist and JCO Social Media Editor by trade. I am thrilled because we are going to be talking about gynecologic cancer today. So, this is my jam. And specifically, we're going to be talking about a manuscript that's a simultaneous publication in the Journal of Clinical Oncology and presented at the Annual Meeting of the International Gynecologic Cancer Society on October 16, 2024. And this is “Pembrolizumab or Placebo, Plus Adjuvant Chemotherapy, With or Without Radiotherapy for Newly Diagnosed High Risk Endometrial Cancer: Results in Mismatch Repair Deficient Tumors.” This is affectionately the KEYNOTE-B21 trial, also known as the GOG-3053 trial and the ENGOT-en11 trial. And we are joined today by the primary author in this manuscript, Dr. Brian Slomovitz, who is the Director of Gynecologic Oncology at Mount Sinai Medical Center in Miami Beach, Florida, and the clinical trial advisor in uterine cancer for the Gynecologic Oncology Group foundation. Welcome, Brian. Dr. Brian Slomovitz: Hey, thanks, Shannon, so much. It's a pleasure to be here. And thanks for giving us the opportunity to discuss this trial. Dr. Shannon Westin: Yes, it's a great trial and I'm so excited to talk about it. And I think we'll start just because this is a broad group that listens to this podcast, they're not all GYN oncologists, experts like yourself, so can you just level set a little bit and speak a bit about the incidence and mortality of endometrial cancer overall and the recent trends in this disease? Dr. Brian Slomovitz: Yeah, sure. So, and it is nice to speak about gynecologic cancers, as we know, endometrial cancer was and still is the most common of all gynecologic cancers. The numbers are going up. Right now, there's about 65,000 to 70,000 cases each year in the US diagnosed with endometrial cancer. The numbers are going up. A lot of its obesity related, some other factors, but as the population gets less healthy, those are some of the risk factors for the disease. The thing that, however, is quite surprising is that we're seeing the deaths due to endometrial cancer going up as well, while for other diseases, we're making slow, steady steps to try to decrease the mortality we're actually seeing an increase in mortality. And the most discouraging point, Shannon, as you know is the number of deaths from endometrial cancer is going to outnumber the number of deaths from ovarian cancer if it hasn't done it already. I mean, now's the time. So, we really need to come up with better treatment strategies to everything to decrease the incidence of disease, to help with prevention, but for those poor women who are diagnosed, to come up with better treatment options so we don't have to keep this increasing trend in mortality. Dr. Shannon Westin: Absolutely. And I think some of that is related and we don't need to get on a soapbox here, but the amount of funding that goes towards research in endometrial cancer, and of course you, you have been leading the way and really trying to get a ton of trials in this space and getting our industry partners and our government partners to really support this. So really just commending you on how much you've worked on, on this area. And to that end, we've had a huge renaissance with immunotherapy and endometrial cancer, a lot of really big trials. Why don't you give the audience a rundown of where, so far, this seems to be best utilized for people with endometrial cancer? Dr. Brian Slomovitz: Thanks for that. And as you sort of alluded to, it's been a revolution, really, with immunotherapy. We started off at immunotherapy looking at microsatellite instability or the dMMR patients. What we found is similar to other disease sites in the second and third line setting that we saw good activity with the single agent checkpoints, pembrolizumab dostarlimab, that's based on the earlier KEYNOTE data and the GARNET trial. Really, a landmark study in the second line was Vicki Makker and her colleagues put pembrolizumab and lenvatinib combination for those patients with the cold tumors. Not the dMMRs or MSI Highs, but the proficient mismatch repair. And that study in a second line setting found that it was better than chemotherapy for an overall survival advantage. So right there, we know that it works in the second line setting in the dMMR population, and we got an indication in the PMR population saying that immunotherapy works in all women with endometrial cancer at some point, then we really had the groundbreaking trials. And Shannon, thank you. You are the leader on one of the four trials that happened, to DUO-E, AtTEnd, GY018 and RUBY trial, all very similar studies showing that the combination of immunotherapy with chemotherapy in the first line, metastatic or recurrent setting had a better outcome for patients than if given chemotherapy alone. That actually led to amazing things. We had three of those drugs have FDA approvals, pembrolizumab for all comers, dMMR and PMMR in the first line metastatic setting with chemotherapy; Dostarlimab, PMR, dMMR in the first line or metastatic with chemotherapy. And Shannon, in your study, I think we still have to learn a lot from your study. DUO-E, chemotherapy plus minus dostarlimab. And you also added a PARP inhib, and those patients with a PARP did better. So I'm really looking forward to your data, to the subgroup analysis to figure out which of those patients, depending on the biomarker, do better with PARP therapy. And right now, you have a dMMR FDA indication. But who knows? The future is really exciting to see- to be splitters, not lumpers. And I really want to see how that data pans out. And so that's how it came into the first and second line setting and that led us really to come up with the idea for this trial to put it into the adjuvant setting. Dr. Shannon Westin: Right. And so, I think this would be really important because we're so ingrained in this. We see this on the day to day. Can you kind of tease out a little bit what's different about those patients that would be treated in that advanced recurrent setting versus the patients that would be potentially treated in this B21 study? Dr. Brian Slomovitz: Yeah, so the first step, we demonstrated the efficacy in patients that really the treatment options were an unmet need. In the second line setting, we didn't have good treatment options. Those are the patients with measurable disease, with symptomatic disease giving immunotherapy. And not only did we see the efficacy, which was better, but we also were able to give it with limiting the side effects as seen with chemotherapy, which is nice. And then we know that the first line therapy, traditionally for endometrial cancer with carboplatin paclitaxel, response rates about 50%, progression free survival about a year, really something that we needed to improve upon. So, adding immunotherapy to the platinum backbone therapy really demonstrated an advantage. But now what we want to do is we want to see if we could prevent, in the high-risk patients, those without disease, what can we do to help prevent the disease from recurring and help patients live longer without really the need for really lifesaving types of treatments? We want to prevent it from recurring. Dr. Shannon Westin: Yeah, I think that's essential. We know that if we can sit on that prevention side and kind of invest all the time and effort that we need to upfront, that really does yield the longer survival. So why don't you just walk through the overall design of this trial, please? Dr. Brian Slomovitz: Yeah. So, this was an all-comers trial, meaning in individuals that had high risk endometrial cancer, high risk for recurrence, that included, in endometrial cancer, we have aggressive histologic subtypes, serous histologies, clear cell histologies, any stage, as long as there was some myometrial invasion. We also, for the first time, included patients looking at the molecular subclassifications. So, if there was a P53 mutation and they were stage 1 with myometrial invasion, they were included. And then in all comers, any patients with stage 3 or up to 4a disease, as long as the surgery was for a curative intent, and they had no residual disease after surgery, then they were allowed to enroll into this trial. One of the things is that this is the first time we've done an adjuvant trial this large. I think one of the reasons that helped us succeed in doing a trial like this is that we left radiation as investigator's choice, because a lot of times going into a trial like this, people feel strongly, we know our radiation oncology colleagues, rightfully so, feel that radiation could help prevent disease from coming back. And we also have the camp that says they don't need radiation. We took that question out of this study. We let investigators decide whether or not they're going to get radiation. It was for patients to get chemotherapy, who are going to normally get chemotherapy for their high-risk disease and randomize them to chemotherapy plus placebo or chemotherapy plus pembrolizumab, a PD-1 inhibitor, in order to see if we could prevent the disease from coming back. Dr. Shannon Westin: And the primary results of this study were just presented at ESMO and published in the Annals of Oncology. Can you give us just a quick overview of what that was, what they found? Dr. Brian Slomovitz: Yep. So, we enrolled 1100 patients. The primary objective of the study was to look at the ITT population, progression free survival and overall survival. And the overall study was negative. Okay, so the hazard ratio in the ITT population was 1.02, not demonstrating a benefit of adding pembrolizumab in this population. I would say disappointing, but at the same point, something that we could really learn a lot from and somewhere that we know that in the whole population, we need to come up with better strategies to help prevent recurrence of disease, better adjuvant treatment strategies. But there's also information that we learned from this trial and that we're reporting on that we're actually super excited about and we feel may be game changing. Dr. Shannon Westin: Yeah. So, let's go to that. This is the good news. Your manuscript in the JCO, thank goodness you published it here, was focused on that subset of mismatch repair deficient. So, tell us what you found. Dr. Brian Slomovitz: So, in this study, we found that the first stratification factor was dMMR versus pMMR. Now, in the pMMR group, those patients had further stratification factors, but dMMR by itself was a stratification factor. Amongst those patients that had dMMR tumors, we found the hazard ratio to be 0.31 benefiting those patients who received pembrolizumab in the adjuvant setting. Really something that when we look at the treatment studies, the GY018s, the RUBYs, the atTEnds, the DUO-Es, in a dMMR setting, we see a similar hazard ratio of 0.3, 0.4. But to get that hazard ratio, which was statistically significant, obviously, is something that we were quite pleased with and something that we felt was worthy of reporting further. I will say it was a pre-specified endpoint. We didn't allocate alpha to it. So, at the beginning, it was a pre-specified endpoint, but at the same time even though we didn't specify alpha towards that outcome, it still, we feel is clinically meaningful and can definitely add to affect the standard of care and the management of these patients. Dr. Shannon Westin: Yeah. I'm very intrigued to see what kind of people do with this. It makes sense, mechanistically, it makes sense if there was a population that was going to benefit, if not everybody does, this is the group that will. I mean, do you feel like there's enough data? What are you going to do? FDA approval aside, obviously, those kinds of things. But how do you feel about this? Is this something you're going to offer to your patients? Dr. Brian Slomovitz: The first answer is yes. I think it's something that I would like to offer my patients. As you know, we need one of two things: we either need an FDA approval or for a lot of our payers required to be in the NCCN listings. I don't serve on the committee. I have no influence on NCCN. I'm excited to see how they'll respond to not only the Annals article, but obviously in today's release of the JCO article, I hope that they'll look upon it favorably. It's a drug that we're used to giving. Pembrolizumab, we have a lot of experience with it. It's interesting. We didn't see any new safety signals, Shannon. Dr. Shannon Westin: Yeah, I was going to ask - that's great. Dr. Brian Slomovitz: There was nothing, nothing additional that we found in this trial. So, I feel that it can definitely improve the outcome of those patients, in my view, with high risk for recurrence, treating pembrolizumab in this setting. Dr. Shannon Westin: Yeah, I think it's important, of course, to look at the safety. What about quality of life? Any new findings there? Dr. Brian Slomovitz: Yeah, we did that quality of life as part of the phase 3 trial. No difference between the two arms. No difference between the two arms. When we looked at a couple of the other analyses, we found that the benefit is the same on stage 3, 4 tumors. We saw that the benefit was there as well. So, there were less patients in the stage 1, 2 group. But I think really, for all comers, for the patient population, I would definitely consider giving pembrolizumab, again, for those patients with a deficient mismatch repair. Dr. Shannon Westin: It's really exciting, and I think you mentioned some of the statistical limitations. Anything else that gives you pause about the study or things you wish you did better? I know we always like to armchair quarterback ourselves after we do these kinds of studies. Dr. Brian Slomovitz: Yeah, it's interesting. When we designed the study years ago, we used the best information we had at that time to come up with the study design, and we're happy with it, and we really don't think that we could have done it much better. I should say, this was a great partnership that we had here between the GOG, ENGOT and with sponsor Merck, Toon Van Gorp was the lead PI of the global trial. When he gave me the good opportunity to present it at the IGCS and to be the lead author on this, it was really a great partnership. And when we came up with a trial years ago, it was the best trial that we thought at that time. And based on the information now, I think it's really something that we're excited about these results, even though the overall trial was negative. Dr. Shannon Westin: Yeah, I agree with you. I think it's interesting, it's informative to think about, “Well, what would we do now or then if we knew what we knew now?” But still, you design the trial the best way you can. I think the results are super intriguing. I'm hopeful at the way they'll be reviewed. I agree I don't have any inside information about the NCCN committee, but I do hope that they'll consider the overarching data to support immunotherapy and mismatch repair deficiency and the findings of this study. And then I guess the last question I would just ask, as you're an expert here, what are you looking forward to seeing coming next in this space? What's the stuff you're intrigued about in endometrial cancer? Dr. Brian Slomovitz: I think, Shannon, you and I have talked about this for a while. I think we're getting really close to eliminating chemotherapy for some of the patients who suffer from this disease. So, I'm not sure if we'll do a follow up to this trial, but I think a logical type of follow up would be to see: what if we just took away chemotherapy altogether and we did pembro in the adjuvant setting, pembrolizumab versus chemotherapy? We don't have that trial in the adjuvant setting, but actually, we completed accrual of that trial in the recurrent setting and we're anxiously awaiting those results. That's KEYNOTE-C93, where in the dMMR population we studied pembrolizumab versus carboplatin paclitaxel. How those results may translate into this setting, I'm not sure. Right now, it's exciting what we have, but yeah. And I think future is bright for this. Just to highlight, in the two arms, there's 140 patients approximately in each arm; there were 25 recurrences in those patients who received placebo. Only eight recurrences in those that received pembrolizumab. Really, when we talk about numbers, it's really remarkable and it shows you the benefit it really had on the patients. Dr. Shannon Westin: Well, this was great. It flew by, as it always does when I'm having conversations with you. I just really want to thank you again for taking the time to share your knowledge with our listeners. Dr. Brian Slomovitz: Thanks, Shannon. Dr. Shannon Westin: And listeners. Thank you all for taking the time to hear about endometrial cancer. Again, this was “Pembrolizumab or Placebo, Plus Adjuvant Chemotherapy, With or Without Radiotherapy for Newly Diagnosed High Risk Endometrial Cancer Results in Mismatch Repair Deficient Tumors.” And this was the JCO After Hours. If you loved what you heard, please check out wherever you get your podcast to see what else we have to offer. Have an awesome day.   The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.        

This special student-hosted episode of the Weinberg in the World Podcast features a conversation with Sonia Punjabi '21 who graduated from Northwestern with a Biological Studies Major and a Art Theory & Practice Minor.  Student host Smera Dwivedi, a rising sophomore majoring in chemistry, interviews Sonia Punjabi, a third-year Doctorate of Physical Therapy student at the University of Miami. Sonia shares her journey from Northwestern University, where she explored various fields before finding her passion in physical therapy. She highlights the impact of being a peer advisor on her personal and professional development, emphasizing the importance of interpersonal skills and diversity training. Sonia also discusses her current clinical rotations and the challenges she faced along the way. https://www.linkedin.com/in/sonia-punjabi/ Transcript: Smera Dwivedi: Welcome to the Weinberg in the World Podcast, featuring stories of interdisciplinary thinking in today's environment. My name is Smera, and I'm your student host of this special episode of this podcast. I'm a rising sophomore and I have an intended major in chemistry on the premedical path, although I'm not that sure about that, but I'm very excited to learn about physical therapy and your career. Today, I'm excited to be speaking with Ms. Sonia Punjabi, who is, I'm not sure I asked you where you're working or the title of company or anything. Sonia Punjabi: Totally fine. We can get to that when we start. Smera Dwivedi: Okay. Well, good to know. If you'd like to introduce yourself, thank you so much for speaking with me. Sonia Punjabi: Yeah, of course. So I'm Sonia, she/her/hers pronouns, and I'm currently in Miami, Florida. I am in the third year, third and final year of the Doctorate of Physical Therapy program at the University of Miami, which I never thought I would be doing for multiple reasons. It's really cool. We'll get into that. But because I'm in the final year of the doctorate, we have clinical rotations, which means I'll be at different places until I am fully licensed and practicing on my own. So for now, just UMPT, but I love it here, and when there's a job opportunity, I'll let you know. Smera Dwivedi: Oh, good to know, good to know. So how was your Northwestern undergrad shaped how where you are now? Sonia Punjabi: Oh, I loved Northwestern. I adored it there. I came in not knowing what was going on, which I think is normal. I came in thinking maybe I would do math because I had done well in my math classes in high school. I had excelled in the APs. They offered me the MENU course. I don't know if it's so called MENU. So I was like, "Oh, this is kind of neat." It wasn't quite what I was looking for because I didn't know what I was looking for, so I thought, "Oh, architecture, I like art and math. Maybe journalism. Maybe I should switch to McCormick or potentially SESP." I kid you not, I looked at so many things when I was in Northwestern, but the things that stood out to me and made me who I am were being a peer advisor for two years. I was a peer advisor for the class of 2023 and the class of 2024, which is happy tears since they've graduated, if they stuck with that graduation year, and the fact that I took advantage of Weinberg because it's arts and sciences, I took a bajillion English courses, some short of a minor. I probably could have done a minor in English literature, and I did a minor in art theory and practice, and those highly influenced how I am as a person today, both personally and professionally, but we'll get into that. I don't want to talk your ear off immediately. Smera Dwivedi: You're so good. You're completely good. So what about being specifically a peer advisor made you realize something about yourself or something about your interests or something along those lines? Sonia Punjabi: I think the peer advisor course, the way that they prepare students to be peer advisors is phenomenal. It's so well done. I'm still hoping to encourage my current institution and future institutions to utilize some of the same training techniques where we learn about diversity in ourselves, we learn about identity in ourselves, we learn about how to dialogue, and those are essential skills for humans that interact with other humans, but also for healthcare providers that support other humans in health. So that was huge. That was my 101 and how to talk to people and also who am I. I loved it. I loved it. I gained so many incredible interpersonal skills from being a peer advisor that I probably still use at this moment to this day. They've just been honed as I've entered the doctorate program. Smera Dwivedi: Okay. Good. So what was the hardest part about where you are now? What was the hardest part, whether it was undergrad or something else? Sonia Punjabi: Good question. I think not to be too pithy here, there are ebbs and flows in every stage of life. In undergrad, maybe early undergrad, it was that I didn't know. I was confused about my path, which is the way it's supposed to be. I didn't know if I was even in the right school, right major. I had no idea. So I was a biological sciences major, inevitably, confusingly, begrudgingly pre-med, not that that's not a wonderful track, but it didn't quite fit and I wasn't sure why. And I kid you not, I was thinking about preparing for the MCAT and preparing for applying to medical school until the last quarter I was at Northwestern, the final one. I changed my mind. I think it must've been February 2021 and I graduated in June 2021. So I decided really late that I wanted to go into PT school. So maybe in the beginning it was that uncertainty and that feeling that I hadn't found quite the right fit. I knew what I liked, I loved the art theory and practice classes, I loved being a peer advisor, I loved writing and talking, but I didn't know how that would translate. Smera Dwivedi: So I kind of relate to ... I'm in the pre-med path, but I'm not sure if that's something I want to do. So what made you realize that physical therapy was what you wanted to do or what made you finally decide to get off the medical school path? Sonia Punjabi: Sure, and again, I do want to emphasize that I have some lovely friends in the pre-med, well, now medical school world. They're deep in medical school now, and it's a great path. It's amazing. I don't want anyone to feel like, "Oh, this is wrong," because it's a great path. It just wasn't my path. For me, it was that I had a history of my own PT journey as a patient with dance. I danced at Northwestern. I was one of the first years who auditioned for Ahana when it was formed in 2017. So I was on Ahana, I had auditioned for the Bhangra team, and I realized I couldn't do everything I wanted to do, and that was tough. I hadn't found the right kind of PT for myself either. I didn't know what I was looking for. Finally, we get to February 2021, and in my brain, I've already kind of thought about and entertained physical medicine and rehabilitation. It's called PM&R for short, you may have heard of it, and it is a specialty in medicine in which physicians intervene pain management with rehabilitation, either mildly invasively, moderately invasively, noninvasively. There are a ton of ways that physicians can intervene in PM&R, but I thought that was really attractive to me. I was like, "Oh, there's a physician at Shirley Ryan that takes care of performing artists," and I met her. This was right before the pandemic. I kid you not, it was maybe the week or the week of, week before or week of. I go downtown. I have a meeting with one of these physicians who was nice enough to greet me, and we chat about the differences between the physician track and the physical therapy track because they work closely together for rehab. And she was very honest about it. She said, "Yeah, well, I think as a physician, you get to make decisions about medications if that's applicable, about surgical interventions if that's applicable, but you spend less time with your patients compared to a clinician in physical therapy who might see someone two to three times a week for an hour each, depending on the setting they're in. So you have different relationships with your patients and you accomplish different things together." And I was like, "That's interesting," Smera Dwivedi: Absolutely. Sonia Punjabi: I started entertaining that track during the pandemic when everyone was making sourdough and banana bread. We made a lot of banana bread. I was also- Smera Dwivedi: I forget the [inaudible 00:07:43] Sonia Punjabi: A lot of banana bread and a lot of podcasts. I was listening to podcasts by dance trainers working in the rehab world. I was listening to podcasts and looking at online resources from PTs who did a different kind of PT than I'd ever seen. They did strength-based PT. So I started educating myself and applying some of these skills and I was like, "Well, this is pretty cool." Finally, when I was juggling PM&R, PT, PM&R, PT, I made the decision to do PT because the lifestyle of the educational trajectory made sense to me. I got to be a clinician earlier and for longer time with patients, and that's what I really liked. Smera Dwivedi: Okay. Very nice. A podcast, so I need to start listening to podcasts. Got it. Got it. Sonia Punjabi: You don't have to. It just happened to be- Smera Dwivedi: It's like another avenue to explore to see what I want to do. It's very nice because- Sonia Punjabi: I was exploring on Instagram. There are clinicians that show you how they treat knee pain with certain exercises. Again, be careful, it's the internet. They might be like, "Hang upside down from a tree," and that's obviously not going to ... Well, it might, but it might not be the right thing, but I was exploring resources to understand the variety of people not only in rehab, meaning doctors and PTs and OTs and other folks that help with the rehab world, but also styles of rehab within physical therapy. So this was all on my own accord. Northwestern has a wonderful PT program, but I don't think the undergrads get a lot of exposure to what that is. Smera Dwivedi: Okay. That makes sense. So you looked at you said Instagram. Did you ever shadow a lot of doctors? Did that help or anything of sort? Sonia Punjabi: Yeah, good question. Again, because times were a little different, when COVID picked up, I had just started entertaining that idea, and that's why I met with some of the folks at Shirley Ryan. So I'd been to Shirley Ryan a couple times before the pandemic, and I had seen their space, which is really interesting. They overlap their engineers and their PTs and their physicians all in the same space in the same floor. So I got to speak to an engineer there, I got to speak to this performing arts physician and PM&R physician there, and I probably would've continued doing that with the children's hospital I applied for a position, et cetera. But when the pandemic happened, the resources available to me were Spotify or Instagram were folks that were posting information, again, beware, but information that you could learn bite-size pieces about how they treat, and a lot of folks are doing that, especially in this day and age. So it's a wonderful way to explore. It's not the only one. It just happened to be one of mine. We have a family friend who I also was able to speak to on the phone who is at Hopkins Rehabilitation now and specializes in triathletes and runners. I got to speak to him about his experience. So that's also definitely an option. If you have connects in certain areas and they're willing to speak, ask some questions. Smera Dwivedi: Makes sense. Do you have any advice for somebody who's going through something similar or doesn't know what to do or something? Sonia Punjabi: Of course. So I think Northwestern kids are often certain personalities. They often are extremely high achieving, very bright. There's a reason that we're all in this cool place or we're in this cool place. We really like what we're doing and we're good at things that we're doing, and we want to continue to learn and excel. I also feel that sometimes the perfectionism can mask our abilities to see, "Hey, I have all these really cool things going on," and I might not be where that person is, but I've learned how to speak Mandarin. I've learned how to oil paint in Kresge. I've learned how to code, and I'm a history major. Sometimes it's okay to do something purely out of interest and fun, even if it doesn't feel like, "Oh, this is going to be something on my resume or it's going to take me to this future degree," whether it's a medical degree or a law degree or whatever that may be. It doesn't necessarily have to make sense. I think explore and be okay with making mistakes and being lighthearted about it. I will be totally honest, I think my art theory and practice minor and all of my English classes greatly influenced how I am as a future clinician. I think it's made me really well-rounded, and it's something I love. Typically with the pre-medical track, they may not be like, "Go take an art class." They might give you time, but don't feel like that's not the right thing if you're interested in it. Certainly, there's volunteering, there's health related courses, you have to take all of the prerequisites. Those are a given, but give yourself some space to make mistakes, to be lighthearted, to not be too hard on yourself and to explore. Smera Dwivedi: Well, that's really good advice because I feel like a lot of times I think of the longterm value in all the classes I take and if they're going to benefit my career or resume, so that's- Sonia Punjabi: It's not a bad thought. It's not a bad thought at all, but the pressure can feel like a lot sometimes with that. Smera Dwivedi: So along the same lines, do you regret doing something like that? Do you regret something like in undergrad that you wish you'd done differently? Sonia Punjabi: I think I can say the only thing I regret is being too hard on myself, genuinely. I think you are meant to explore and change your path. They know you're going to do that. If you don't, something's wrong. You are meant to explore, make mistakes and grow and change course. So if you're doing that, you're doing the right thing. So I wouldn't regret anything. I think I had a wonderful time. I explored and I did a lot of really unique things that made my Northwestern experience. Smera Dwivedi: That's reassuring to hear, for sure. So I'm worried I'm going to regret doing certain things or taking certain classes. Sonia Punjabi: I took, like I said, a bunch of art courses for the art minor, and I took English courses for fun because based on my Weinberg credits, I didn't need them, based on my premedical requisites I didn't need them, but I remember them maybe the most, and that's super cool to me. Smera Dwivedi: So other than your classes, and you talked a little bit about social media and how that influenced your decision, other than that, were there any extracurriculars that pushed you towards your career or any that you were like, "Oh, wow, I like this a lot. This is something I want to do in the future," or something like that? Sonia Punjabi: Let me think. Well, I did touch on the dance scene at Northwestern, which is lovely, amazing, super cool. There's a wonderful performing arts scene, as you know. The fact that I loved it so much but had some hurdles on my own participating in it, that was a big hole. I was like, "Gosh. If only I could wholeheartedly with my whole musculoskeletal system participate in this, that would be amazing." And I still did, but just at my own pace since I hadn't found the clinician that was right for me yet. I think that is often a common story in my fields. A lot of my classmates in my cohort, they have their ACL history or they have their shoulder labrums or their hockey injuries, and that is a common segue into the field, but not the only one. Some people come from advertising degrees, business degrees, they have kids, they come from serving in the military, in the Navy. So a lot of paths can lead to this, and much like any other career, many paths can lead to a law degree. Many paths can lead back to medicine if you pursue medical school. I don't want people to think that there's one path to get here. I think I deviated from your question a little bit, so we might need to come back to that. Smera Dwivedi: Totally okay, just whatever you'd like to say. I did want to ask, Ahana, is that the Bollywood dance group or is that the one with the Danyas or which one? Sonia Punjabi: Good question. So I think I auditioned for pretty much all of them when I was a freshman, a first year. Ahana is the noncompetitive, as far as I'm aware, still noncompetitive Bollywood dance, like a film fusion dancing. I remember exploring the Raas team exploring the Bhangra team, exploring TONIK Tap, which I thought was super cool, legendary, such interesting performing artists, the TONIK Tap. I was familiar with Refresh. I hope that there's still a large participation in the dance scene at Northwestern, and I would hope that in the fields in physical therapy, there is more tension given to performing artists now than before because I think that's been a developing part of the field where performing artists have a very unique sense of sport, of what they have to do, demands in the sport, and they haven't always been treated as such. So I think getting proper treatment and having clinicians that understand that is so [inaudible 00:16:36] because then it takes people years to figure out who they need because it's not common knowledge. So little mini plug for all of our dancers out there. If something's not right, don't be afraid to get second opinions and look for clinician that makes sense to you and that treats you to your sport and to your needs. Smera Dwivedi: So did you continue doing Ahana all four years? Sonia Punjabi: I did Ahana for a year-ish, a year-ish. I remember I had to say goodbye to the team my sophomore year, I believe, my second year because of my PT journey. I hadn't found what I needed yet. It was getting tougher to participate in dance, but I think life has a funny way of showing you what you need when you need it. So I've found some really amazing resources, clinicians, worlds of PT that lend themselves back to what I was doing in Ahana like, "Oh, that thing I wanted to do, that's why it was so hard because I hadn't had this training, this treatment, this person." I mean, life is kind of funny like that. Smera Dwivedi: So was it the balance, was it a lot of time commitment, which is why you had to just let it go or were you just like, "I need to be more career-oriented," and some extracurriculars can't be balanced well? What was the driving- Sonia Punjabi: It was actually the physical pain injury stuff. I was having trouble with that, and yeah, it's a tough journey for any athlete for any performing artist when you have to take a break because of that, but I'm really glad my life went the way that it did because I don't know if I would be here if it hadn't. Smera Dwivedi: Do you have any role models growing up or just whenever? Sonia Punjabi: Yeah. So currently, a few of my role models here in the Miami area are the women who work in the subspecialty of PT called pelvic floor therapy. It's a therapy that you might not recognize applies to more than just pregnant folk because, certainly, that's a population that needs pelvic floor PT at times, but there are subspecialty of PT that works with stability, strength, integrity and function of the pelvis and the things in the pelvis. So this is bladder and bowel function, this is sexual health, and this is pain, injury, et cetera. They're so cool. I have a wonderful mentor in the Delray, Boca Raton area who has her own clinic, and she's always available for me to ask questions, for me to come in and say like, "Hey, can I participate as a shadow? Can I see who you're treating today?" if they're comfortable with it. She's wonderful. And then I have my own clinicians here, actually, that have treated me, that have seen me throughout my own journey who are so smart, so interesting, such fun individuals to provide support. They show me that being a colorful human is not only allowed but also encouraged in a field where you're treating humans. So I think if we handle ourselves with imperfect grace, that's great. That's going to be a wonderful way to connect with people when you show them like you're doing your best and you are acknowledging when things get a little twisted and continuing on. So definitely my role models in pelvic PT, my parents and my brother who are all Northwestern alum. We are a very purple family. They are definitely a big support system to me. There are so many other people on the list, my sister-in-Law, my brother's wife and the cat outside. Essentially, your support system cheers you on, and the mentors and the role models I have are often one and the same, so to keep it light. Smera Dwivedi: Right. Good to know. It's also nice to have a support system, for sure. Sonia Punjabi: Absolutely. Oh, I should probably mention, if you do another degree after Northwestern, all of the faculty, all of the clinicians, all the people who are teaching you become amazing role models and support systems. A little shout out to the faculty and staff at the University of Miami Physical Therapy Program. They're a family. That's why I came. They are like a bonafide family. They will care for you. They will help you to the point of texting you when something's wrong or you texting them when something's wrong and they'll respond to you. They are available by email. They're available to meet with you. They're honestly available to give life advice. I have a faculty member's book sitting in my bookcase right now. So if you're open to being vulnerable, which is a huge part of what peer advisor training teaches you, people will help. Smera Dwivedi: Okay. So you talked a little bit about your post post-grad struggles. Sonia Punjabi: So again, every chapter is going to have its own flavor of ups and downs. When I graduated from Northwestern, so bittersweet, amazing, very exciting. I started a gap year position at a Miami-based gym and physical therapy clinic. I was doing their photography, their media, their patient and client interactions. It was amazing because I got to learn all these wonderful things from people who were already doing it ahead in this part of the career, but it was tough because I didn't have any peers and I felt a little bit like an island. So that can be a little isolating when you have a new chapter and you feel like you're on your own footing and you would benefit maybe from seeing where some of your classmates are or having a peer that's just at the same stage of life. So it was helpful when someone else came in at that position who was applying to med school, and so we had that commonality of life chapter. Smera Dwivedi: That's nice that you were able to navigate through that. So your two years post ... You said you graduated in 2021? Sonia Punjabi: I did, yes, in June 2021. Smera Dwivedi: So you mentioned your doctorate program that you have to get back to. What is that? Sonia Punjabi: Yes. So the PT program, typically in the United States now, are three-year programs and they're doctorates. So when you graduate, you have a doctorate of physical therapy, and then you take the licensing exam to practice. So okay, you have the doctorate, you're knowledgeable, now you're allowed to practice. So that is where I am. I'm in the third year and I'm finishing classwork in October, and then October through May for our program, we have three clinicals in a row where we get to have hands-on experience with a clinical instructor who will oversee you and you'll treat people in the hospital, you'll treat pediatrics if you're into that. For me, I'm going to be treating pelvic in March. So this termination of the program is really hands-on practical work. Smera Dwivedi: Got it. Okay. Is there anything else you'd like to say or, I don't know, speak about, give advice for anything? Sonia Punjabi: Open-ended. I have silly versions of this answer and I have serious versions. Do you want both? Silly versions. Still, they hold weight, go check out Bookends and Beginnings. It's, I think, still in the alley at where the box is. You know where the campus gear store is? Smera Dwivedi: Yeah. Sonia Punjabi: There's an alley, there's a bookstore in there. They also have a book front, which is beautiful, if I'm remembering correctly, on Sherman. I think it's on Sherman. Go check it out. It was my little lifeline during PT or not PT school, during my Northwestern undergrad experience. And if the fourth floor of North still exists- Smera Dwivedi: Yeah. They're doing some construction with North, but it's like they're adding a pub of something. Sonia Punjabi: Interesting. Smera Dwivedi: There's still like a third and fourth floor. Yes. Sonia Punjabi: I think it's the fourth floor and people don't know about it. If you take a staircase, go check that out if nobody knows about that yet. Smera Dwivedi: It's nice and quiet up there, for sure. Sonia Punjabi: Oh, yes. Oh, yes. I think I have a few about the library. Do they still take out the Mario Kart Wii during reading week? Smera Dwivedi: Yes, of course. Sonia Punjabi: Okay. Good. Play a lot of that. Do a lot of that. Participate in every primal screen you can. Smera Dwivedi: Haven't done that yet, actually. Sonia Punjabi: Yeah, you should. I think it's 9:00 PM. Is it the Sunday before finals? Smera Dwivedi: Yeah, I believe so, around that time. Sonia Punjabi: Do that. If you're feeling adventurous, go take a look at Blick, the art store near where the movie theater used to be. Smera Dwivedi: There's still a movie theater there, the AMC. Sonia Punjabi: Oh, surprising. I'm sure more fun, silly ones will come to mind, but my gist here is just explore just a cool place. Evanston's a great place. Northwestern's a great community. Don't be afraid to strike up conversations with people you haven't really crossed paths with. Serious ones would be don't be afraid of change. Change is the only constant. It's that very famous saying or phrase. Don't be afraid of change with anything, with undergrad, with your personal life, with post-grad. Don't be resistant to change. It will often make you better. Smera Dwivedi: No, good to know. I do. Sonia Punjabi: Yeah, of course. Smera Dwivedi: Well, I mean, that was really helpful for me to consider. Thank you so much for your advice and for talking about your career and personal stuff about your life and [inaudible 00:25:50] I appreciate it. Sonia Punjabi: If anyone has questions about the physical therapy world, I'm more than happy to chat, to get on a video call, phone call. It's a really cool place. I think a lot of health leaning undergrads may not know this is an option for them or what it even looks like. There are a million different things you could do in PT. You can help folks post-stroke walk again. You can help folks post-spinal cord injury participate in leisure, in recreation. For me, I can help folks during pregnancy or if you just want to rehab ankles and pediatrics who play soccer, do that. It's a cool field. Consider it, and I'm here for questions. Smera Dwivedi: Okay. Thank you. Sonia Punjabi: Yeah, of course. Smera Dwivedi: We appreciate you tuning into the special edition of the podcast, Weinberg in the World. Go Cats. We hope you have an amazing day.

Dans cet épisode de La Saga, Elisabeth Assayag s'entretient avec Karima Kirkoub, fondatrice de Lilee, une application qui vise à faciliter l'accès au logement pour les personnes en situation de handicap. Après un an depuis son passage sur Europe 1, Karima revient pour nous raconter les évolutions de Lilee. Initialement lancée comme une start-up, l'application a désormais pris la forme d'une association, un changement stratégique pour mieux répondre aux besoins spécifiques de son public cible.Karima explique en détail les motivations derrière cette transition, mettant en lumière l'importance de l'accompagnement individualisé et de la gratuité du service pour les personnes en situation de précarité. Lilee se positionne désormais comme une plateforme accessible à l'échelle nationale, proposant des logements aux normes PMR vérifiés, dans le but de permettre à ces personnes de trouver plus facilement un hébergement, que ce soit pour des vacances ou un logement à l'année.Malgré les défis rencontrés, Karima et son équipe continuent de se battre pour améliorer l'accessibilité et l'inclusion des personnes en situation de handicap. Leur changement de statut vers une association les ouvre à de nouvelles opportunités de financement et de partenariats, dans l'objectif de développer davantage leur impact social. Cet épisode captivant nous plonge au cœur de l'entrepreneuriat social, illustrant comment une initiative innovante peut évoluer pour mieux répondre aux besoins de la communauté.

In a conversation with CancerNetwork®, Jessica Cheng, MD, spoke about her work in the growing field of physical medicine and rehabilitation (PMR) and how it may improve quality of life outcomes among patients with cancer. Above all else, Cheng, an assistant clinical professor in the Department of Supportive Care Medicine at City of Hope, emphasized how supportive care through PMR aims to ensure patient function. By developing a whole-person approach that focuses on the musculoskeletal and nervous systems, those involved in the field may minimize adverse effects and help patients participate in day-to-day activities more easily. Additionally, Cheng highlighted how this modality can involve the efforts of a comprehensive multidisciplinary team including physical therapists, occupational therapists, and speech therapists as well as those involved in disciplines such as integrative medicine, neurology, and orthopedics. As part of ensuring function in patients who undergo therapy for cancer, Cheng discussed the importance of integrating exercise into their care routines. She highlighted how exercise in preparation for surgery, stem cell transplantation, or other treatment modalities may help patients recover from their treatment more quickly and yield improvements in the pathologic complete responses and other outcomes. In terms of the next steps for aiding the growth of PMR across the country, Cheng detailed ongoing plans for a trial assessing the utility of cancer rehabilitation in patients with breast cancer and gynecologic cancer undergoing chemotherapy before surgery. Adopting a catchphrase of “prehab for all,” Cheng said that she wants all patients to be armed with the knowledge of PMR so that they can gain control over their lives and be able to pursue meaningful activities during their treatment courses. “I hope that oncologists and rehabilitation physicians alike will see that there's an opportunity with cancer prehabilitation to enable [patients] to get their cancer treatment, get through it better, and recover better,” Cheng said. “That's my hope: that this [field] will spread even more like wildfire than it already is.”

Guest post by Jennifer Mann, is the co-author of The Secret Language of the Body, out now (£16.99), and co-founder of Somia International. Burnout is a serious issue that many professionals face today. With increasing workloads, constant connectivity, and the pressure to perform, it's easy to become overwhelmed and stressed. Left unchecked, stress can lead to burnout, a state of emotional, physical, and mental exhaustion that can severely impact your health and productivity. The good news is that there are simple exercises you can incorporate into your daily routine to help prevent burnout. These exercises focus on calming the nervous system, managing stress and anxiety, and promoting overall well-being. Here are five simple yet effective exercises to help you prevent burnout from stress at work. Prevent Burnout 1. Vagus Nerve Stimulation The vagus nerve plays a crucial role in regulating the body's stress response. Stimulating the vagus nerve can help calm your nervous system, reduce anxiety, and promote relaxation. One simple way to do this is through the Vagus Nerve Reset exercise. To perform this exercise, find a quiet space where you can sit comfortably. Place your right hand over your heart and your left hand on your belly. Close your eyes and take a deep breath in through your nose, allowing your belly to rise as you inhale. Hold the breath for three seconds, then slowly exhale through your mouth, feeling your belly fall. Repeat this process for 3-5 minutes. As you breathe deeply and slowly, you activate the vagus nerve, which helps shift your body from the fight-or-flight response to a state of calm. Incorporating this exercise into your daily routine can be a powerful way to manage stress and prevent burnout. 2. 4-7-8 Breathing Technique Breathing exercises are a highly effective way to manage anxiety and emotions, especially in a high-stress work environment. The 4-7-8 breathing technique, developed by Dr. Andrew Weil, is one such exercise that can help you regain control over your emotions and reduce stress levels. To practice the 4-7-8 technique, sit in a comfortable position with your back straight. Close your eyes and exhale completely through your mouth, making a whooshing sound. Then, close your mouth and inhale quietly through your nose for a count of four. Hold your breath for a count of seven. Finally, exhale completely through your mouth for a count of eight. Repeat this cycle four times. This technique works by slowing down your breathing, which in turn lowers your heart rate and calms your nervous system. It's particularly useful in moments of acute stress or anxiety, as it helps you refocus and center yourself, preventing the escalation of stressful emotions. 3. Progressive Muscle Relaxation (PMR) Progressive Muscle Relaxation (PMR) is a technique that involves tensing and then relaxing different muscle groups in your body. This exercise helps reduce physical tension, which is often a byproduct of stress and anxiety, and can contribute to burnout if left unaddressed. To perform PMR, start by sitting or lying down in a comfortable position. Begin with your toes - curl them tightly and hold the tension for five seconds, then release and focus on the sensation of relaxation. Gradually move up through your body, tensing and relaxing each muscle group: your calves, thighs, abdomen, chest, arms, hands, neck, and face. As you progress, pay attention to how your body feels after each release of tension. This exercise not only helps relieve physical stress but also encourages mindfulness, as you focus on each part of your body. Regular practice of PMR can help reduce overall stress levels, making it a valuable tool in preventing burnout. 4. Mindful Walking Incorporating physical movement into your daily routine is essential for stress management. Mindful walking is a simple yet effective exercise that combines movement with mindfulness, helping you regulate your nervous system and reduce stress. To practice mi...

Dr. DeVries presented a Real Science Lecture webinar on May 8, 2024, titled “Lessons Learned in Research on Nutritional Management of Robot Milked Cows.” You can find the webinar recording at balchem.com/realscience.  Dr. DeVries begins with an overview of how his robotic milking research has evolved. In Canada, around 20%-plus of farms are using robotic milkers. He describes survey research in the US and Canada as to why producers choose to implement robotic milkers. (9:19)In Trevor's webinar, he discussed the large amount of variation in nutritional management of robot-milked cows across Canada. Some of his research with Dr. Penner has looked at the interaction between feed consumed at the feed bunk and feed consumed at the robot. Ideally, you wish to be able to accurately predict intake because that is a primary driver of milk production. Because cows can be supplemented individually at the robot, there is opportunity to better feed cows to match their individual needs. (13:50)Trevor and Greg describe their respective university's robot milking research facilities. The panel discusses additional technologies that would be useful for all robotic milkers, like load cells to measure feed delivery and disappearance. Cows typically consume around 250-300 grams of concentrate per minute, and that can vary by feed type (pellet vs mash, for example.) The panel also ponders whether the design of the feed bunk in the robots has an impact on intake rate. (17:35)As a consulting nutritionist, Todd prefers to feed as little as possible in the robot and have a more consistent mix in the PMR. The level of milk production of the cows can have a large influence on how much pellet is fed at the robot versus the feed bunk. Todd goes on to describe his strategy for creating proportions of PMR and robot intakes for different scenarios. (26:06)Clay asks the panel what the maximum amount of concentrate should be fed at the robot. They discuss factors that can influence concentration including individual cow variation, length of time in the robot per milking, and the number of visits to the robot per day. Clay goes on to ask how fast fresh cows can be stepped up in their robot feedings. The group has a lively discussion about all the different factors that play a role in that decision. Greg reminds the audience not to get so caught up with programming the robot that we lose sight of the fact we're still feeding cows and good dairy management still applies. (31:29)Todd describes some of the biggest challenges he observes as a consultant in robotic dairies, primarily centered around understanding cow behavior. Trevor underlines the importance of cow comfort and other non-nutritional factors in regard to their influence on the success of the nutrition program.(41:29)Scott asks the panel what they think robotic milkers might look like in 2050 and what problems will have been solved by then. Greg's wish list includes knowing PMR intake to better manage robot feedings and having cow body weights on every dairy. Trevor thinks we will have a much better understanding of how genetics influence cow performance in a robotic system and how we can raise cows to adapt to the technology to be better robot cows. Todd agrees that body weights are critical and also envisions more individualized milkings depending on each cow's preferences. On his wish list is a drone that could be used to fetch cows to the robot who have not gone to be milked. (46:51)​​Trevor and Greg discuss what's next in their upcoming research projects, and Todd gives some wishlist ideas for future research. (54:18)In summary, each guest gives their take home messages. Clay is intrigued by the precision feeding aspects of robotic milking systems. Todd encourages dairy producers not to be scared of robotic milking systems. Greg looks forward to research in the next 5-10 years to support or refute the preconceived notions we have about robotic systems. Trevor reminds listeners that cows must consume a certain amount of nutrients in order to produce milk. In the robotic system, those nutrients are delivered via two different components and research continues to understand the interplay between them. Lastly, animal behavior is a critical component of the success of robotic systems and our management approach should reflect that. (1:02:46)Please subscribe and share with your industry friends to invite more people to join us at the Real Science Exchange virtual pub table.  If you want one of our Real Science Exchange t-shirts, screenshot your rating, review, or subscription, and email a picture to anh.marketing@balchem.com. Include your size and mailing address, and we'll mail you a shirt.

Dr. Amy West is a PM&R sports medicine physician based in New York, specializing in metabolic orthopedics and strength training for women, with a particular focus on CrossFit. As an active competitor in both CrossFit and Olympic weightlifting, Dr. West brings a unique perspective to her practice, combining her medical expertise with firsthand experience in high-intensity fitness. Her passion for metabolic health informs her approach to patient care and athletic performance optimization. Dr. West's professional achievements include serving as a team physician for NCAA events and the CrossFit Games, further solidifying her reputation in the field of sports medicine and functional fitness. Instagram: @amywestmd Twitter:  @amywestmd   Timestamps: 00:00 Trailer. 00:48 Introduction. 05:12 Orthopedic issues often linked to metabolic health. 07:12 Diagnosing diabetes through Achilles stiffness.  10:25 Obesity and inflammation contribute to joint problems. 14:13 Protein intake for women. 15:47 Passion in weightlifting. 18:41 Exploring orthobiologics as treatments for injuries. 23:01 Discovering strength. 24:45 Plyometric training benefits older populations. 27:37 Therapy groups. 31:48 Gout: metabolic issues and inflammation. 33:29 Complex follow-up process. 37:13 Testing strength with simple balance exercises. 40:19 Book about metabolic and orthopedic health. 44:37 Patient upset after doctor declines cortisone injection. 46:42 Keep exercising for health. 49:43 Where to find Amy. See open positions at Revero: https://jobs.lever.co/Revero/ Join Carnivore Diet for a free 30 day trial: https://carnivore.diet/join/ Carnivore Shirts: https://merch.carnivore.diet Subscribe to our Newsletter: https://carnivore.diet/subscribe/ . ‪#revero #shawnbaker #Carnivorediet #MeatHeals #HealthCreation   #humanfood #AnimalBased #ZeroCarb #DietCoach  #FatAdapted #Carnivore #sugarfree  ‪

Dr. Julie Silver is an associate professor and associate chairperson in the department of physical medicine and rehabilitation at Harvard Medical School PART 1 Her presentation is a data-driven lecture for individuals who believe in science.  A big theme in her work is to focus on tipping points that will drive change faster. An important large study reported in the journal Lancet in 2018 attracted widespread attention. Researchers looked at clinical practice guidelines. They found that the representation of female authors was low, but even lower for female physicians. Looking at PM&R since then shows similar findings. Problems were not being solved because while medical societies indicated that they were not at fault, their journals expressed the same opinion. It became obvious that many organizations were working together in ways that were complicit. Not many women were included in the clinical practice guidelines. Compensation is an important issue that also was studied extensively. Dr. Silver provided an example of how men were compensated more than women for performing similar procedures. She discussed medical recognition awards that also reveal a considerable amount of disparity that favors men over women. The same holds true for minoritized groups as explained using the concept of inexorable zero. A promotion problem is involved in this situation, which can be fixed. Additionally, her lecture also focused on challenges pertaining to faculty retention. Women physicians are more likely to leave academia at all career stages.  A key issue is enabling individuals to feel that they belong. PART 2 In Part 2, Dr. Silver began by indicating that thinking about belonging and social integration are super important. There are two bodies of literature--a retention literature and a belonging literature. Very few studies have looked at them together. One investigation that did so found that women who have fewer belonging components are more likely to leave their workplace and more likely to stay if they have more of these components. What can be done right now to improve the situation? Her answer is that individuals should be told that they belong. Inclusion is not a synonym of belonging. She provided examples of constructive steps that have been implemented at other academic institutions. Mentoring is a critically important model. She described how she works with individuals in helping them to feel that they belong and indicated five strategies that leaders can implement. Let's not assume that progress happens. Instead, let's believe the science and follow the data. When looking at the proportion of women on specialty boards, they found in a comparison study that six boards decreased and that two stayed the same. Progress does not just happen on its own. In PM&R, there was an increase, but it still is not really at the equitable level.  We must continue to focus on it. The same holds true when looking at race and ethnicity.

Interviewees: Raffi Najarian and Justin Ramsey Interviewer: Lisa Meeks Description: In this conversation, Lisa Meeks interviews Raffi Najarian and Justin Ramsey, both pediatric rehabilitation physicians with cerebral palsy. They discuss their journey to medical school and the challenges they faced along the way. Raffi shares his experience of applying to medical school and the support he received from his family. Justin talks about the internal barriers he faced and the importance of finding the right mentor. They also discuss the challenges they encountered during medical school, including access barriers. In this conversation, Raffi Najarian and Justin Ramsey discuss their experiences as medical students with disabilities. They share the challenges they faced in anatomy lab and how they overcame them. They also talk about dealing with difficult faculty members and the importance of kindness and feedback in medical training. Raffi and Justin explain why they chose physiatry as their specialty and the impact they have on their patients. They emphasize the importance of visibility and representation for individuals with disabilities in the medical field. Finally, they offer advice for students with disabilities who are considering a career in medicine. Keywords: physiatry, medical education, doctors with disabilities, cerebral palsy, pediatric rehabilitation, med school applications, accessibility, accommodations, disability representation Transcript: https://bit.ly/3yuxJf8 Bios: Justin Ramsey, M.D. is board certified in Physical Medicine and Rehabilitation and is sub-specialty boarded in Pediatric Rehabilitation Medicine. He graduated from the Kansas University School of Medicine. He then completed his Physical Medicine and Rehabilitation training at the Kansas University Medical Center and a fellowship program in Pediatric Rehabilitation Medicine at Children's Mercy Hospital (Kansas City, MO). Dr. Ramsey spent several years as faculty with the Pediatric Rehabilitation Medicine fellowship program at Children's Mercy Hospital and the Kansas University Medical Center's Physical Medicine and Rehabilitation Department. He has served as chair of the Advocacy Committee for the American Academy for Cerebral Palsy and Developmental Medicine and has served on its Communications Committee. Currently, he works at a private pediatric rehabilitation hospital (Bethany Children's Health Center) near Oklahoma City, which specializes in the care of children with disabilities. In collaboration with neurology and OU Health Science Center's neurosurgery department, he has created Oklahoma's joint pediatric movement clinic. He currently serves as the Associate Medical Director for the Movement clinic and Cerebral Palsy. He volunteers as a Clinical Associate Professor of Neurology at The University of Oklahoma Health Sciences Center. Justin has hemiparetic cerebral palsy and is active in local advocacy. He is married to his wife (Kendra) and has 2 beautiful young children (Ryan and Reese), who keep his family busy. Medical and disability education are some of his major subjects of interest. He is grateful for early college experiences in working with individuals with disabilities while volunteering at Hetlinger Developmental Services, Inc in his hometown of Emporia, KS. Dr. Raffi Najarian has been in practice since 2013. He is a pediatric physiatrist and director of the Spasticity Clinic at Akron Children's Hospital. A graduate of the University of Michigan and Wayne State University School of Medicine in Detroit, MI, he completed his residency in physical medicine and rehabilitation at MetroHealth Rehabilitation Institute of Ohio in Cleveland. He then completed a fellowship in Pediatric Rehabilitation Medicine at Gillette Children's Specialty Healthcare in Saint Paul, MN. Dr. Najarian has a special interest in cerebral palsy, spasticity management, brain injury, stroke, spinal cord injury, spina bifida, acute inpatient and outpatient rehabilitation and concussion management. He is certified by the American Board of Physical Medicine and Rehabilitation and subspecialty certified in Pediatric Rehabilitation Medicine. He is a member of the American Academy of Physical Medicine and Rehabilitation and the American Academy for Cerebral Palsy and Developmental Medicine, and served on the latter's Lifespan Committee.  He is an Associate Professor of Pediatrics at Northeast Ohio Medical University (NEOMED).  Raffi has diplegic cerebral palsy and is an advocate for children and adults with disabilities.  He serves as a member of the United Cerebral Palsy Research Committee and on the board of directors for Adaptive Sports Ohio, while participating  as an active member of the Akron Rhinos wheelchair rugby team.   Produced by: Gabe Abrams and Dr. Lisa Meeks.  Audio editor: Jacob Feeman Digital Media: Katie Sullivan Resources: Professional Learning Series - United Cerebral Palsy, UCP Research Initiative & Committee - United Cerebral Palsy, Physicians' Perceptions Of People With Disability And Their Health Care   https://www.yourcpf.org https://cprn.org  

Dr. Julie Silver is an associate professor and associate chairperson in the department of physical medicine and rehabilitation at Harvard Medical School PART 1 Her presentation is a data-driven lecture for individuals who believe in science.  A big theme in her work is to focus on tipping points that will drive change faster. An important large study reported in the journal Lancet in 2018 attracted widespread attention. Researchers looked at clinical practice guidelines. They found that the representation of female authors was low, but even lower for female physicians. Looking at PM&R since then shows similar findings. Problems were not being solved because while medical societies indicated that they were not at fault, their journals expressed the same opinion. It became obvious that many organizations were working together in ways that were complicit. Not many women were included in the clinical practice guidelines. Compensation is an important issue that also was studied extensively. Dr. Silver provided an example of how men were compensated more than women for performing similar procedures. She discussed medical recognition awards that also reveal a considerable amount of disparity that favors men over women. The same holds true for minoritized groups as explained using the concept of inexorable zero. A promotion problem is involved in this situation, which can be fixed. Additionally, her lecture also focused on challenges pertaining to faculty retention. Women physicians are more likely to leave academia at all career stages.  A key issue is enabling individuals to feel that they belong. PART 2 In Part 2, Dr. Silver began by indicating that thinking about belonging and social integration are super important. There are two bodies of literature--a retention literature and a belonging literature. Very few studies have looked at them together. One investigation that did so found that women who have fewer belonging components are more likely to leave their workplace and more likely to stay if they have more of these components. What can be done right now to improve the situation? Her answer is that individuals should be told that they belong. Inclusion is not a synonym of belonging. She provided examples of constructive steps that have been implemented at other academic institutions. Mentoring is a critically important model. She described how she works with individuals in helping them to feel that they belong and indicated five strategies that leaders can implement. Let's not assume that progress happens. Instead, let's believe the science and follow the data. When looking at the proportion of women on specialty boards, they found in a comparison study that six boards decreased and that two stayed the same. Progress does not just happen on its own. In PM&R, there was an increase, but it still is not really at the equitable level.  We must continue to focus on it. The same holds true when looking at race and ethnicity.    

BUFFALO, NY- July 15, 2024 – A new #research paper was #published in Oncotarget's Volume 15 on June 20, 2024, entitled, “Comparison of FDG-PET/CT and CT for evaluation of tumor response to nivolumab plus ipilimumab combination therapy and prognosis prediction in patients with unresectable malignant pleural mesothelioma.” Malignant pleural mesothelioma (MPM) is an aggressive neoplasm and affected patients have low survival rates. In this new retrospective study, researchers Kazuhiro Kitajima, Kozo Kuribayashi, Toshiyuki Minami, Hiroyuki Yokoyama, Akifumi Nakamura, Masaki Hashimoto, Takashi Kijima, Seiki Hasegawa, Hayato Kaida, and Koichiro Yamakado from Hyogo Medical University and Kindai University Faculty of Medicine examined the effectiveness of fluorodeoxyglucose positron emission tomography (FDG-PET) criteria, i.e., immunotherapy-modified PET response criteria in solid tumors (imPERCIST), with morphological computed tomography (CT) criteria, i.e., modified response evaluation criteria in solid tumors (mRECIST), to evaluate patients with unresectable MPM undergoing nivolumab plus ipilimumab combination therapy as first-line treatment regarding response and prognosis prediction. “Results for malignant pleural mesothelioma (MPM) patients following first-line treatment with nivolumab plus ipilimumab obtained with immunotherapy-modified PERCIST (imPERCIST), shown by [18F] (FDG-PET/CT), and modified RECIST (mRECIST), shown by CT, were compared for response evaluation and prognosis prediction.” Twenty-six patients (23 males, 3 females; median 73.5 years) with histologically proven MPM and no curative surgery received nivolumab plus ipilimumab combination therapy. FDG-PET/CT and diagnostic CT scanning at the baseline, and after 2–4 cycles (2 in three, 3 in 17, 4 in six patients) were performed. Therapeutic response findings evaluated using imPERCIST and mRECIST were compared. PFS and OS analyses were done using log-rank and Cox methods. Results: imPERCIST indicated nine progressive metabolic disease (PMD), eight stable metabolic disease (SMD), four partial metabolic response (PMR), and five complete metabolic response (CMR) cases. mRECIST showed nine with progressive disease (PD), nine stable disease (SD), seven partial response (PR), and one complete response (CR). Although high concordance was noted (κ = 0.827), imPERCIST correctly judged a greater percentage with CMR (15.4%). Following a median 10.0 months, 15 patients showed progression and eight died from MPM. With both, progression-free survival (PFS) and overall survival (OS) were significantly longer in patients without progression (CMR/PMR/SMD, CR/PR/SD, respectively) as compared to PMD/PD patients (imPERCIST p < 0.0001 and p = 0.015, respectively; mRECIST p < 0.0001 and p = 0.015, respectively). “For unresectable MPM patient examinations, FDG-PET and CT provide accurate findings for evaluating tumor response and also prognosis prediction following first-line nivolumab plus ipilimumab immunotherapy (approximately three cycles).” DOI - https://doi.org/10.18632/oncotarget.28594 Correspondence to - Kazuhiro Kitajima - kazu10041976@yahoo.co.jp Video short - https://www.youtube.com/watch?v=7ZRTRwig60Y About Oncotarget Oncotarget (a primarily oncology-focused, peer-reviewed, open access journal) aims to maximize research impact through insightful peer-review; eliminate borders between specialties by linking different fields of oncology, cancer research and biomedical sciences; and foster application of basic and clinical science. To learn more about Oncotarget, please visit https://www.oncotarget.com. MEDIA@IMPACTJOURNALS.COM

Interviewer: Dr. Peter Poullos Interviewees: Emmanuel Asenso, DO, Allison Kessler, MD, MSc, Joseph Samona, DDS, Satendra Singh, MD   Description:  This episode of the DWDI podcast brings together four incredible individuals for a live recording session during the 5th annual SMADIE conference on April. The panel featured Emmanuel Ascenso, Dr. Joe Simona, Dr. Satendra Singh, and Dr. Allison Kessler, all of whom had previously been interviewed on the podcast and had garnered significant listenership. Each guest shared their personal and professional journeys, highlighting their experiences as healthcare professionals with disabilities. Throughout the episode, the guests touched on themes of mentorship, intersectionality, and the importance of allies in driving change. They also highlighted the need for tailored feedback, proactive advocacy, and the power of sharing personal stories to educate and empower others. The episode underscored the significance of acceptance, education, and cross-movement solidarity in creating a more inclusive healthcare environment.   Key Words: ADA, Accommodation, Clinical Work, Ableism, Storytelling, Podcast, DocsWithDisabilities, Stuttering, SCI, Deaf, Physical Disability. Transcript: https://bit.ly/DWDI_Ep_96_Transcript  Docs With Disabilities Original Interview Episodes Linked Bio's:  Dr. Emmanuel Asenso Jr is a second-year resident physician in the combined Family Medicine and Preventive Medicine residency program at Johns Hopkins and MedStar Franklin Square in Baltimore, MD. He was born and raised in Northern Virginia to Ghanaian immigrant parents. He completed his undergraduate studies at Virginia Tech, completed his Masters in Public Health from George Washington University in DC, and then completed medical school at Rowan University SOM in New Jersey. He is a person with a childhood-onset fluency disorder, also known as stuttering. Navigating a communication disorder throughout training has been challenging, rewarding, and full of lessons. He is passionate about supporting marginalized people and advocating for health equity through primary care and public health. He is also interested in the intersectionality between racism and people with disabilities.    Allison Kessler, MD, MSc, is the Section Chief of Renée Crown Center for Spinal Cord Innovation. She is board-certified in Physical Medicine & Rehabilitation (PM&R) and Spinal Cord Injury (SCI) Medicine. Dr. Kessler is the Associate Director of Shirley Ryan AbilityLab's SCI Medicine Fellowship. She holds appointments at Northwestern University Feinberg School of Medicine as Assistant Professor in the Department of PM&R.  Bonus: Behind the white coat interview   Dr. Joseph Samona graduated from the University of Michigan School of Dentistry and completed AEGD residency at the University of Texas Health San Antonio. He currently works as an associate in private practice in the Metro Detroit area. He is also profoundly Deaf and is a strong advocate for the Deaf and Hard of Hearing community who are underrepresented in the dental field. He have given lectures at several dental schools and local dental organizations on effective communication with the Deaf and Hard of Hearing community.  He also developed a project where he created a series of educational videos about oral health in American Sign Language on YouTube to increase accessibility to oral health care.  He is currently a member of the American Academy of Cosmetic Dentistry, Academy of General Dentistry, and American Dental Association.   Satendra Singh, MD, serves as the Director Professor and Coordinator of the Enabling Unit at the University College of Medical Sciences, Delhi, India. Additionally, he holds the role of Co-chair of the International Council for Disability Inclusion in Medical Education and is a steering committee member of the Health Humanities Consortium. As a disability justice advocate, he has spearheaded numerous policy reforms, notably the inclusion of disability rights as mandatory competencies in the new medical curriculum in India. He serves as the organizational head of Doctors with Disabilities: Agents of Change in India, a nationwide group of health professionals with disabilities dedicated to social justice. Furthermore, he is a member of the core group on disability at the National Human Rights Commission. Bonus: We Don't Shy Away From Our Disability: Dr Satendra Singh  

Merci à FRESH, rappeur Belge de Liège, d'être venu dans le studio de LEGEND ! FRESH La Peufra, de son vrai nom Julien Aberi Moska, est le gagnant de la saison 1 de la série Netflix Nouvelle école. Il sort son 1er album “À L'ABRI”, en 2022 ainsi que son titre “Chop” qui a cumulé plus de 42 millions de vues sur Youtube.Écoutez sa dernière mixtape PMR ➡️ : https://bfan.link/fresh-pmrRetrouvez FRESH sur ses différents réseaux ⬇️: X : https://x.com/Fresh_lapeufra?prefetchTimestamp=1719686175329Instagram : https://www.instagram.com/fresh_lapeufra/YouTube : https://www.youtube.com/c/IcebergClickTVPour toutes demandes de partenariats : legend@influxcrew.comRetrouvez-nous sur tous les réseaux LEGEND !Facebook : https://www.facebook.com/legendmediafrInstagram : https://www.instagram.com/legendmedia/TikTok : https://www.tiktok.com/@legendTwitter : https://twitter.com/legendmediafrSnapchat : https://t.snapchat.com/CgEvsbWV Hébergé par Acast. Visitez acast.com/privacy pour plus d'informations.

Dr. David Jevotovsky is in the second year of a residency program at the Rusk Rehabilitation Institute at NYU Langone Health. A former graduate of NYU Grossman School of Medicine, he is keen on pursuing a fellowship in interventional pain medicine. Having experienced a traumatic brain injury during his medical training, he possesses a unique understanding of both the patient and provider perspectives of this condition. As patients differ on the basis of age, gender, and racial/ethnic background,  whether they also tend to differ in how they express what it is like to experience a TBI and live with its aftermath; the role played by social media in the residency program; whether beneficial outcomes can result from having patients with a TBI participate in physical exercise activities; why it is hard for many patients, their loved ones, and even PM&R physicians to understand how a brain could be rewired; and different perspectives that patients and physicians may have regarding agitation/delirium, cognition, return to work, and support systems.     

In this episode, special guest host Court Wing interviews Monica Verduzco-Gutierrez, MD: professor and chair of rehabilitation medicine at UT Health San Antonio; Joel Castellanos, MD: co-founder and associate medical director of the Center for Psychedelic Research at UC San Diego; and MaryAnn Welke Lesage: a long COVID survivor who reports experiencing drastic improvement in symptoms after MDMA and psilocybin therapy. As the world slowly recovers from COVID, many people are seeing continued or new symptoms, and while much is still not understood, these symptoms are being categorized as long COVID: essentially a persistent viral inflammation causing brain fog, headaches, depression, and other hard-to-diagnose symptoms. With estimations of as many as 18% of people in the U.S. experiencing this at one point and 6.8% currently dealing with it, could psychedelics – which can decrease inflammation and reset neural networks – help alleviate these symptoms?  They discuss:  How long COVID fits into what we already know about psychedelics, pain, and inflammatory medicine Why MDMA or psilocybin therapy, specifically, can help The importance of physical medicine and rehabilitation (PM&R) and the myriad of tools these physicians have learned to work with Why anecdotal evidence matters towards future research and more!  For more info, read Lesage's article, "How Psychedelics Became Key to My Long COVID Recovery," as well as the official paper: "Long-COVID symptoms improved after MDMA and psilocybin therapy: A case report." For more links, head to the show notes page.

Slowly relax every muscle in your body with this guided progressive muscle relaxation meditation. Do this practice all the way until the end to instill a deep sense of calmness. PMR has been shown to reduce anxiety and stress by the process of progressively tensing and relaxing every muscle in your body. #meditation #guidedmeditation #relaxing #relaxation #musclerelaxation #calm #relax Narrated by: Martin Welcome to Guided Meditations by Look In: Powerful meditations guided by a selection of the best meditation voices. All of our guided meditations are completely original pieces. The writing, the narration, and the music are all designed to help you relax, create calmness and clarity, and guide you through personal growth and development. We utilize many different meditation techniques, including mindfulness, visualization, breath work, zen meditation, loving kindness, mantras, and affirmations. Come join us for a regular meditation practice, and see how our guided meditations will transform your mindset and your life to be more positive, productive, and fulfilling. If you enjoy this guided meditation, please leave a comment or review and be sure to follow the show so you never miss a new episode!

Dr. Jina Libby completed her PM&R residency in Michigan. Her dedication to that profession and sports medicine extends beyond clinical practice as she serves on the executive committee for the International Rehab and Global Health Committee of AAPM&R. Her fervor for education is evident through her commitment to teaching physical medicine and rehabilitation, not only locally, but also by championing its integration on an international scale. Beyond her current role as a fellow physician, Dr. Laurenie Louissaint's compassionate spirit leads her on frequent global impact trips, where she provides critical medical support to underserved communities, such as Haiti and Namibia. She also is an active member of the New York City cycling community while also providing medical care for injured cyclists and developing related research. Part 1 The discussion in Part 1 included the following items: demographic aspects of Namibia, major health problems in that nation, how health care is financed, similarities with western allopathic health practices, use of traditional and alternative health care interventions, status of health professions educational institutions, and nature of the auspices sponsoring the visitation trip by U.S. clinicians to that country. Part 2 The discussion in Part 2 included the following items: types of health professionals in the group visiting Namibia, kinds of Namibian practitioners interacted with during the visit, most evident aspects of health care in that nation where improvements would appear to be beneficial, possibly reversing the flow of clinicians to enable Namibians to spend time in U.S. clinical facilities, and health professional literature produced in that country.

On this week's Keepin' It Real, Cam has seen much more of the healthcare world these days than he would like. His advice: Stay well. ----- I've been given an up a close look at our health care system over the past several months. It's been, well, disappointing. And this comes after hearing a remarkable speaker discuss the importance of customer service on company culture. I made a reference several months ago to the pain I've had. It's finally been diagnosed as polymyalgia rhumatica, or PMR. It showed up around February first and has been a part of every day since. It's a sickness that can't be confirmed through tests. Once they rule out everything else, it's one of the ones that's left. I've dealt with some pain in my life. Cluster headaches. A blood clot in my lung. However, nothing day in and day out has been like this PMR pain. On a scale from one to ten it's regularly an 8 in the morning dipping to a four or five in the afternoon and back to an 8 the next morning. I need help getting my shirt on and off. I can barely brush my teeth. Right now, I'm on a steroid that masks the pain and I pray that the pain ends before the prescription runs out. Now, the heath care system. I've seen five different doctors to try to diagnose this. I'm guessing I've spent less than an hour total with all of them. Averaging, maybe, ten minutes each. They burst through the door, they ask a handful of questions, they order tests. It's quick. I've spent lots of time with nurses and assistants and in waiting rooms. But the doctors are hard to come by. One hospital wouldn't let me speak to a doctor who I heard might can help. “Unless you're a patient,” they said, “you can't speak to him.” “Well, I might become a patient if he thinks he can help. I've seen others of his specialty, but I hear he knows more. “Sorry,” they said. So, I wrote him a letter to get him to call me. I got a voice mail from the office supervisor – “you can't talk to him. Please call me back,” she said. And I tried, got an exhaustive phone tree, zero'd out and asked, “Can I leave a message for the supervisor?” “Sorry,” they said. “Her phone isn't hooked up to the system.” Over and over. Round and round. There were some phone trees that never allowed me to speak with anyone. If I weren't in pain already my experience with today's health care system was getting me there. Another – “before I can treat you further, I have to do some tests,” the doctor said. “Make an appointment on the way out.” “We don't make appointments,” the front desk said. Annoyed. Staring at her phone. “Someone will call you.” A day later, “Our next available appointment is in July.” “So, I have to live in level 8 pain from early April to July?” “Sorry. That's all I got. You want the appointment or not?” The culture of healthcare today is painful. Don't get sick, folks. Don't get sick. If your sickness doesn't kill you, finding the treatment just might. I'm Cam Marston and I'm just trying to keep it real.   

Dr. Jina Libby completed her PM&R residency in Michigan. Her dedication to that profession and sports medicine extends beyond clinical practice as she serves on the executive committee for the International Rehab and Global Health Committee of AAPM&R. Her fervor for education is evident through her commitment to teaching physical medicine and rehabilitation, not only locally, but also by championing its integration on an international scale. Beyond her current role as a fellow physician, Dr. Laurenie Louissaint's compassionate spirit leads her on frequent global impact trips, where she provides critical medical support to underserved communities, such as Haiti and Namibia. She also is an active member of the New York City cycling community while also providing medical care for injured cyclists and developing related research. Part 1 The discussion in Part 1 included the following items: demographic aspects of Namibia, major health problems in that nation, how health care is financed, similarities with western allopathic health practices, use of traditional and alternative health care interventions, status of health professions educational institutions, and nature of the auspices sponsoring the visitation trip by U.S. clinicians to that country. Part 2 The discussion in Part 2 included the following items: types of health professionals in the group visiting Namibia, kinds of Namibian practitioners interacted with during the visit, most evident aspects of health care in that nation where improvements would appear to be beneficial, possibly reversing the flow of clinicians to enable Namibians to spend time in U.S. clinical facilities, and health professional literature produced in that country.

In this episode we took a deeper dive into 2 of ASPN's stars, Dr. Jordan Tate and Dr. Alexa Moreira. We discussed the current state of women in medicine and talked about the female mentorship program. We also discussed the poster to podium program and some tips to become an attractive fellowship candidate. We had our first APSN member, Dr. Tolga Suvar, ask a few questions to the guests.  Host, Patrick Buchanan, MD: Dr. Buchanan is double board certified in Physical Medicine and Rehabilitation and Pain Medicine. His goal is to help his patients get their life back by managing their pain and focus on things they love and enjoy. https://www.californiapaindoctors.com/patrick-buchanan-m-d/ https://www.instagram.com/patdbmd/?hl=en Host, Timothy Deer, MD: Dr. Deer is the president and CEO of the Spine and Nerve Centers of the Virginias. Dr. Deer has led a revolution in interventional spine and nerve care by teaching thousands of physicians an algorithmic approach to care including methods that are less invasive at a lower risk for complications. https://centerforpainrelief.com/about/tim-deer-md/ https://twitter.com/doctdeer?lang=en https://www.instagram.com/timdeer30a/?hl=en   Guest, Dr. Jordan Tate MD: Dr. Tate is a double board-certified pain medicine and physical medicine and rehabilitation specialist at Southern Pain and Spine in Jasper, Georgia. She is the Chair of the Diversity/Inclusion Committee and editor of the ASPN newsletter. https://www.southernpainandspine.com/md/jordan-tate-md-mph https://www.instagram.com/drjordantate/ Guest, Dr. Alexa Moreira MD: Dr. Moreira is PMR resident at University of Miami and part of the poster to podium program at ASPN. She will be a pain medicine fellow at Rush University this year. https://www.linkedin.com/in/alexandra-moreira/ https://www.linkedin.com/in/alexandra-moreira/ Guest member, Dr. Tolga Suvar MD: Dr. Suvar is an assistant professor of Anesthesia and Pain Medicine at Rush University. https://suvarmd.com/ About ASPN: ASPN was created to bring the top minds in the fields of pain and neuroscience together. ASPN has a mission to improve education, highlight scientific curiosity, establish best practice, and elevate each other in a quest to improve the field of pain and neuroscience. All initiatives of ASPN are dedicated to improving patient outcomes, education, research, and innovation. ASPN's website and social links: https://aspnpain.com https://www.youtube.com/channel/UCixMNhEtOiRm1aQmDWtzxmg https://www.instagram.com/aspn_painneuro/ https://www.facebook.com/PainNeuro https://www.linkedin.com/in/aspn/ https://twitter.com/aspn_painneuro Our sponsors: Mainstay Medical: The Only FDA Approved Restorative Therapy for Chronic Mechanical Low Back Pain caused by Multifidus Dysfunction. Restore Control, Restore Function, Restore Stability, ReActiv8 Life. https://mainstaymedical.com/  Saluda Medical: Saluda is the first to directly measure the spinal cord's physiologic response to stimulation. A 10+ year journey since the first ECAP measurement to transform the science and practice of SCS using Evoked Compound Action Potentials (ECAPs) to pioneer smart neuromodulation therapy. The Evoke® System listens and responds to each patient's neural signature.  https://www.saludamedical.com/ Nalu Medical: Nalu Offers a Long-Term Solution For Pain. More than just new technology; it's a whole new world of opportunities. https://nalumed.com/  

This past February, Tesfa Williams released his debut album—over 20 years into his career. Raves Of Future Past distilled decades of experience on London dance floors into a potent and powerful blend of grime, house, rave and techno. Made with an Elektron Digitakt to imitate the rough textures of early '00s UK dance music, the LP is an anachronistic history lesson that throws everything in a blender, imagining what gqom might sound like as an Eski track and giving new life to the short-lived "sublow" sound Williams helped invent with classic tracks like "Invasion," released under his earlier alias DJ Dread D. Since the sublow days, however, Williams has become a torchbearer for UK house music and African diasporic sounds like Afro house and gqom in London. He's put out soulful hits like "Heartbeat"—recently reissued by Local Action—and released a steady stream of dance records for PMR and Strictly Rhythm. He's what you might call a jack of all trades, except for that he's actually a master of them all. His RA Podcast charts his musical journey in reverse chronological order, starting with smooth, African-influenced sounds and winding through grime and dubstep, eventually landing at jungle. He threads a needle through diverse genres (and eras), and posits that the traditional UK hardcore continuum is a bigger spectrum than you might think, with gqom's heave and amapiano's log drum equally important in the musical equation. It's nearly two hours of UK dance music past and present, from a DJ who has lived it all. @twilliamsmusic Read more at https://ra.co/podcast/935

“But I'm buying stuff where, revenue's growing rapidly. I'm buying stuff where value creation is happening rapidly. I'm buying, you know, growth momentum names. I'm buying them before anyone else realizes that they're growth momentum names...they're still valued like uh, value stocks. If you look at this sort of stuff we're doing, we call it--, I call it inflection investing for lack of a better word, but they tend to be industries that have destroyed a lot of capital that have bored people to death, that give people PTSD.” -Kuppy, Praetorian Capital --Kuppy has been a great friend to Chase since he started PMR. This week they discuss position sizing, what inflection investing really means, how to spot the convergence of cyclical and secular tailwinds, and most importantly, how getting away from the markets allows you to express your trades more effectively. Kuppy's approach to investing is bold, well researched, and decisive. We also discussed how he decided to stop missing stuff with the inception of Kuppy's Event Driven Monitor (KEDM). --Timestamps:(00:00) - Intro(01:46) – Kuppy is a value investor that makes money(02:58) – Charity of Choice: Sugar Pine Foundation(04:09) – Roman History isn't a real major (06:03) – Inflection investing is momentum investing with a value overlay (09:28) – Middleman companies provide the best value?(09:46) – Cyclical sectors with secular change(12:02) – Find ways to be out of the office(12:46) – Kuppy makes the chart (12:55) – Fundamental Momentum(13:42) – Exit criteria: When something better comes along(15:40) – Sizing of trades: There's not enough good ideas to trade small positions(19:54) – Get away from granularity unless it's earnings season(24:42) – Massive events still take weeks to figure out (26:25) – Surfing – no phones allowed(28:20) – Good food and good weather for good living(29:13) – Being wrong isn't personal. Get out before you change your mind (31:39) – Between Two Pines (35:21) – Sidestep the politics and sales pitches of corporate management leadership(40:45) – KEDM – Kuppy got tired of missing stuff(46:16) – Tomorrow's Gold by Marc Faber & Reminiscences of a Stock Operator by Edwin Lefèvre and Roger Lowenstein(47:00) – Sleepwalking into YCC(48:04) – Kuppy reaches out the finance circle for “smell tests”(49:23) – Luck in trades because of long timeline horizons(51:46) – Plugs --This Episode's Charity:The Sugar Pine Foundation began in 2004.They are dedicated to restoring sugar pines in the Lake Tahoe National Forest in California. Donate here: https://sugarpinefoundation.org/get-involved/donate --Referenced in the Show:Kuppy's Book Recommendations: Tomorrow's Gold by Marc Faber &Reminiscences of a Stock Operator by Edwin Lefèvre and Roger Lowenstein --Guest Plugs:Kuppy's X : https://twitter.com/hkuppy Praetorian Capital : https://pracap.com/ Kuppy's Event Driven Monitor (KEDM) :

Join us as we sit down and talk with our fearless leader Mandi Feely-Swain about how she does what she does! She is an EXCELLENT leader and someone we can all learn a thing or two from!    If you are interested in joining PMR with us, reach out to Paul and we can get you set up with a call with Mandi and Cory Swain to learn more about what PMR can do for you as a loan officer!

Eldorado Peak, with its knife edge summit, is one of the most iconic peaks in the Pacific Northwest. Our very own PMR member, Marc "Milo" Milobinski is joining Amy Graham and Ania Wiktorowicz to talk about his climb of Eldorado  Peak, the accident, rescue and emergency signaling. Sometimes accidents happen in the least expected places that are still far away from cell service. How do you call for help? What options do you have? Is it worth paying for extra gear?  www.pmru.org

Progressive Muscle Relaxation (PMR) is a therapeutic technique developed by Edmund Jacobson in the early 20th century. This method is designed to reduce muscle tension and promote a deep state of relaxation through systematic tensing and then relaxing different muscle groups. PMR is widely used for stress management, anxiety reduction, and improving overall well-being.