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Today's guest is leading the charge in raising awareness for perinatal mental health (PMH). On the Fertility Forward podcast today is Hamish Magoffin, Founder of the Pranaiya & Arthur Magoffin (PAM) Foundation. Hamish established the PAM Foundation in memory of his late wife, Pranaiya, and their son, Arthur. The foundation is dedicated to raising awareness, improving care, and supporting research on (PMH) conditions. Hamish has taken on remarkable challenges to promote PMH awareness, including running and cycling across the UK. Beyond his philanthropic work, he is also the Co-Founder of Break Off Capital, which has been investing long-term capital in companies commercializing cutting-edge science for over a decade. Tune in to hear the story behind the PAM Foundation, the people and projects driving its mission, and the foundation's goals as it expands into the US. Hamish also discusses the importance of developing better awareness and follow-up care for PMH and how his endurance challenges tie into this critical cause. Don't miss it!
On this deeply thought-provoking episode of Coach Talk Radio, host Sandra Beck teams up with Linda Franklin to welcome renowned researcher and author PMH Atwater for a compelling conversation about the nature of consciousness, near-death experiences, and what it truly means to be “Dying to Know You.” PMH Atwater, L.H.D., is one of the most respected authorities in the field of near-death studies. A pioneering researcher since the late 1970s, she has personally experienced three near-death episodes and has interviewed thousands of adults and children who've crossed to the other side and returned. With over 18 books to her name—including the seminal Dying to Know You: Proof of God in the Near-Death Experience—PMH brings decades of groundbreaking insights into what happens when life and death intersect. Together, Sandra, Linda, and PMH explore the life-altering revelations that come with these experiences, the common themes reported by those who return, and the spiritual, emotional, and even neurological implications of these journeys. Whether you're a skeptic, a seeker, or someone who's had your own brush with the beyond, this episode will challenge you to think differently about death—and more importantly, about how we choose to live. Tune in to discover what science, spirituality, and human experience reveal when we are truly Dying to Know You. Tune in to Coach Talk Radio on Audible, Amazon Music, Amazon Podcasts, Spotify, iHeart Radio, Apple Podcasts, iTunes, Stitcher, Player FM, and Podcast Addict.
Danny Moses is joined by Ivy Zelman, Founder and Executive VP of Zelman Associates, to discuss her career and insights into the housing market. Ivy shares her journey from a financial analyst at Solomon Brothers in the 1990s to becoming a renowned figure in the housing sector. They delve into her famous predictions on the housing market downturn, the impacts of the 2008 financial crisis, and her strategies for maintaining accurate market forecasts. The conversation also explores current market challenges such as affordability, immigration, tariffs, and declining home sales, along with her perspectives on builders, mortgage rates, and industry consolidation. Ivy also shares details about her memoir 'Gimme Shelter' and her ongoing work at Zelman Associates. On The Tape on X: https://x.com/OnTheTapePod Danny Moses on X: https://x.com/dmoses34 Ivy Zelman's Stock Disclosures: AMWD, BLD, BLDR, CSL, FBHS, IBP, MBC, RMAX, SWK, BZH, CCS, HOV, KBH, LEN, MDC, MHO, MTH, PMH, TOL & TMHC Stock Ownership: Analyst: No Analyst's Family: No Analyst's Firm: No Investment Banking Client: No Other Conflicts: Yes – Zelman has received compensation for products or services other than investment banking services. DFH Stock Ownership: Analyst: No Analyst's Family: No Analyst's Firm: No Investment Banking Client: Yes Other Conflicts: Yes – Zelman has received compensation for products or services other than investment banking services -- ABOUT THE SHOW For decades, Danny has seen it all on Wall Street and has built his reputation on integrity, curiosity and skepticism that he will bring with him each week. Having traded through the Great Financial Crisis and being featured in "The Big Short" is only part of the experiences Danny wants to share with the listener. This weekly podcast cuts through market noise, offering entertaining and informative discussions with expert guests giving their views of the financial world and the human side of it. Whether you're a seasoned investor or just getting started, On The Tape provides something for all listeners. Follow Danny on X: @dmoses34 The financial opinions expressed are for information purposes only. The opinions expressed by the hosts and participants are not an attempt to influence specific trading behavior, investments, or strategies. Past performance does not necessarily predict future outcomes. No specific results or profits are assured when relying on this content. Before making any investment or trade, evaluate its suitability for your circumstances and consider consulting your own financial or investment advisor. The financial products discussed in 'On The Tape' carry a high level of risk and may not be appropriate for many investors. If you have uncertainties, it's advisable to seek professional advice. Remember that trading involves a risk to your capital, so only invest money that you can afford to lose. Derivatives are not suitable for all investors and involve the risk of losing more than the amount originally deposited and any profit you might have made. This communication is not a recommendation or offer to buy, sell or retain any specific investment or service.
PMH's Website: http://www.pmhatwater.com/ In this captivating episode of "Magic Is Real," I have the honor of speaking with the legendary PMH Atwater, a pioneer in the exploration of near-death experiences. Her personal tale of transformation began with her own three near-death experiences, leading her on a profound spiritual journey. PMH's work unveils the secrets of consciousness and spiritual awakening, offering groundbreaking insights into the phenomenon of near-death experiences. PMH's life story is an inspiring testament to resilience and discovery. From her challenging childhood marked by synesthesia and dyslexia to becoming an international authority on near-death states, her journey is a beacon of hope and enlightenment. Her healing journey and spiritual awakening have empowered her to share transformative insights that resonate deeply with anyone seeking personal growth. Join me, Shannon Torrence, as we delve into PMH's extraordinary experiences and the universal truths they reveal. Don't forget to support Magic Is Real by following us on Instagram, joining our Patreon, and engaging with our content. Like, share, comment, and subscribe to be part of our growing community devoted to spiritual healing and intuitive development. Thank you for your support and for joining us on this journey to uncover life's most profound mysteries. #heavenawaits #selfimprovement #shadowwork #thedarksideofspiritualawakeningnoonetellsyou #spiritualbypassing CHAPTERS: 00:00 - Intro 01:35 - PMH Atwater's Biography 03:15 - PMH's Early Life 11:15 - PMH's Near Death Experiences 18:00 - Becoming a Writer 28:45 - Life-Changing Trauma 30:27 - Anita's Third NDE 38:40 - Anita's Banking Career 45:00 - First Speaking Engagement 54:00 - Out of Body Experiences 59:44 - Mind Training Techniques 01:03:25 - Evolution of NDE Research 01:11:06 - The Concept of Creation 01:18:33 - Subscribe to PMH's Newsletter ZOOM BACKGROUND DESIGN BY FREEPIK.COM Music Credits: Track: Wandering — JayJen [Audio Library Release] Music provided by Audio Library Plus Watch: • Wandering — JayJen | Free Background ... Free Download / Stream: https://alplus.io/wandering FOLLOW Magic Is Real (Host Shannon Torrence) on Instagram: @realmagicshannon Email me at magicisrealshannon@gmail.com with viewer questions you'd like for me to answer in a YouTube short or to pitch your own story to me for an episode. TO BOOK A MEDIUMSHIP READING WITH ME, just email me! magicisrealshannon@gmail.com Thank you so much for your love and support! Please like, share, comment, subscribe and spread the word! --- Support this podcast: https://podcasters.spotify.com/pod/show/shannon-torrence/support
On this episode of Talking Away The Taboo, Rachel Goldberg LMFT, PMH joins Aimee Baron, MD to talk about... -binge and restrictive eating habits and how that can affect fertility -the reasons why disordered eating or exercise can cause fertility issues -the guilt and shame that go along with this these diagnoses -the small changes suggestions people can make to try to get them out of a destructive feeding pattern -her thoughts on ozempic and other meds that have been linked to increased fertility success and how that plays a role in someone's habits This article on safe exercises that CAN be done during fertility treatments was also mentioned in this episode. More about Rachel: Rachel Goldberg is a licensed marriage and family therapist based in Los Angeles, specializing in eating disorders, perinatal mental health, and infertility, with a special focus on third-party reproduction. As a certified perinatal fitness instructor and personal trainer, Rachel's background enriches her approach to navigating body image, disordered eating, and fitness in relation to fertility, pregnancy, and the postpartum period. She is also a regular contributor to various media outlets. Connect with Rachel: -Follow her on Instagram -Check out her website -See her posts on X -Reach out to her via email Contact us: -Website -Follow us on Instagram and send us a message -TikTok -Facebook -YouTube -Email us at info@iwassupposedtohaveababy.org
When Danielle discovered Dr. Kat, she knew she needed to have her on to ask her about so many recent revelations she's had about her personal experience with perinatal OCD, birth trauma, and postpartum depression. As Danielle learns more and unpacks an experience she had almost 20 years ago, she can't help but wish she could go back and tell her younger self so many things. She can't, but she can ask the questions for the women who may encounter (or have encountered) similar issues during their pregnancies. This conversation is one that should be listened to be everyone, regardless of gender, marital and parenting status, and whether or not people personally deal with issues with perinatal Mental Health….it absolutely should be on EVERYONE'S radar. Danielle and Dr Kat discuss:⁃What exactly does the term “perinatal mental health” encompass?⁃Are there regulations in place to ensure that OBGYNs are educated on modern discourse concerning PMH?⁃What are Dr Kat's thoughts about waiting three months to tell people you're pregnant?⁃What necessary questions would she tell every couple (or single human looking to get pregnant) to ask prospective OBGYN's before choosing a physician?⁃What might be some prior warning signs that someone might encounter issues with perinatal mental health?⁃What exactly is a “birth trauma,” and how does a woman know whether or not she went through one?⁃What does Dr. Kat want every person to know about perinatal mental health and how you can help someone who might be experiencing it in some way? Make sure you follow Dr. Kat on IG at @momandmind and listen to her podcast Mom and Mind wherever you get podcasts. Hosted on Acast. See acast.com/privacy for more information.
Director Guy Ritchie brings his style to the classic myth in King Arthur: Legend of the Sword (2017). With the great cast and fun design, why did it get 30% on Rotten Tomatoes? Jim and A.Ron are here to hash that out. It has bigger elephants than Lord of the Rings, but the story is all over the place. Is this movie made of the stuff of legend? Thank you to PMH for commissioning this podcast! You can get your very own custom commissioned podcast by visiting https://support.baldmove.com/. Join the discussion: Email | Discord | Reddit | Forums Follow us: Twitch | YouTube | Twitter | Instagram | Facebook Leave Us A Review on Apple Podcasts Learn more about your ad choices. Visit megaphone.fm/adchoices
TWiP solves the case of the Woman With White Worms, and presents a new clinical case to decipher. Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Join the MicrobeTV Discord server Please support our work at microbe.tv/contribute Hero: Ann Bishop Become a patron of TWiP New Case study: A physician with no significant PMH who is currently doing their fellowship training develops diarrhea. The diarrhea is significant enough that they are beginning to feel weak, lightheaded, and end up going to the local ER. The physician lives in NYC, works most of the time but did just get back from a week-long vacation in Florida with their long-term partner where they got a chance to swim in the pool and get some sun. They returned feeling well and then noted the onset of the diarrhea. The diarrhea was watery, with some abdominal cramping but no noted blood or actual fever. The stool did not have a strong smell and no floating stools were reported. The physician was given IVF and returned home feeling better but now gets a call that there is a parasite on the stool testing and is recommended to take a medicine they have never heard of 3x per day for 3 days. Send your questions and comments to twip@microbe.tv Music by Ronald Jenkees
Episode 164: More Than Just A HeadacheDr. Song presents a case of a subacute headache that required an extensive workup and multiple visits to the hospital and clinic to get a diagnosis. Dr. Arreaza added comments about common causes of subacute headaches. Written by Zheng (David) Song, MD. Editing and comments by Hector Arreaza, MD. You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Introduction to the episode: We are happy to announce the class of 2027 of the Rio Bravo / Clinica Sierra Vista Family Medicine Residency Program. Our new group will be (in alphabetical order): Ahamed El Azzih Mohamad, Basiru Omisore, Kenechukwu Nweke, Mariano Rubio, Nariman Almnini, Patrick De Luna, Sheila Toro, and Syed Hasan. We welcome all of you. We hope you can enjoy 3 enriching and fulfilling years. During this episode, you will hear a conversation between Dr. Arreaza and Dr. Song. Some elements of the case have been modified or omitted to protect the patient's confidentiality. 1. Introduction to the case: Headache. A 40-year-old male with no significant PMH presents to the ED in a local hospital due to over a month history of headaches. Per the patient, headaches usually start from the bilateral temporal side as a tingling sensation, and it goes to the frontal part of the head and then moves up to the top of the head. 8 out of 10 severities were the worst. Pt reports sometimes hypersensitivity to outdoor sunlight but not indoor light. OTC ibuprofen was helpful for the headache, but the headache always came back after a few hours. The patient states that if he gets up too quickly, he feels slightly dizzy sometimes, but it is only for a short period of time. There was only one episode of double vision lasting a few seconds about 2 weeks ago but otherwise, the patient denies any other neurological symptom. He does not know the cause of the headache and denies any similar history of headaches in the past. The patient denies any vomiting, chest pain, shortness of breath, cough, abdominal pain, or joint pain. The patient further denies any recent traveling or sick contact. He does not take any chronic medication. The patient denies any previous surgical history. He does not smoke, drink, or use illicit drugs. What are your differential diagnoses at this moment? Primary care: Tension headache, migraines, chronic sinusitis, and more.2. Continuation of the case: Fever and immigrant.Upon further inquiries, the patient endorses frequent “low-grade fever” but he did not check his temperature. He denies any significant fatigue, night sweats, or weight loss. He migrated from Bolivia to the U.S. 12 years ago and has been working as a farm worker in California for the past 10 years. He is married. His wife and daughter are at home in Bolivia. He is currently living with friends. He is not sexually active at this moment and denies having any sexual partners. Differential diagnoses at this moment? Tension headache, migraine, infections, autoimmune disease, neurocysticercosis. 3. Continuation of the case: Antibiotics and eosinophilia. As we kept asking for more information, the patient remembered he visited a clinic about four months ago for a dry cough and was told he had bronchitis and was given antibiotics and the cough got better after that. He went to another local hospital ED one month after that because the cough came back, now with occasional phlegm and at that time he also noticed two “bumps” on his face but nothing significant. After a CXR at the ED, the patient was diagnosed with community-acquired pneumonia and sent home with cough medication and another course of antibiotics. His cough improved after the second round of antibiotics. We later found on the medical record that the CXR showed “mild coarse perihilar interstitial infiltrates of unknown acuity”. His blood works at the ED showed WBC 15.2, with lymphocyte 21.2%, monocyte 10.1%, neutrophil 61.7%, eosinophil 5.9% (normally 1-4%), normal kidney, liver functions, and electrolytes, and prescribed with benzonatate 100mg TID and doxycycline 100mg bid for 10 days. He went to the same ED one month before he saw us for headache and fever (we reviewed his EMR, and temp was 99.8F at the ED). After normal CBC, CMP and chest x-ray. The patient was diagnosed with a viral illness and discharged home with ibuprofen 400mg q8h.Due to the ongoing symptoms of headache and fever, the patient went back to the same clinic he went to four months ago for a dry cough and requested a complete physical and blood work. The patient was told he had a viral condition and was sent home with oseltamivir (Tamiflu®) for five days. However, the provider did order some blood work for him. Differential diagnoses at this moment? Patients with subacute meningitis typically have an unrelenting headache, stiff neck, low-grade fever, and lethargy for days to several weeks before they present for evaluation. Cranial nerve abnormalities and night sweats may be present. Common causative organisms include M. tuberculosis, C. neoformans, H. capsulatum, C. immitis, and T. pallidum. At his physical exam visit, the patient actually asked the provider specifically to check him for coccidiomycosis because of his job as a farm worker and he heard from his friends that the infection rate is pretty high in the Central Valley of California. His serum cocci serology panel showed positive IGG and IGM with CF titer of 1:128. His HIV, syphilis, HCV, HBV are all negative. The patient was told by that clinic to come to ED due to his history of headache, fever, and very high serum coccidiomycosis titer. The senior and resident intern were on the night shift that night and we were contacted by the ED provider at around 9:30 pm for this patient. When reviewing his ED record, his vitals were totally normal at the ED, the preliminary ED non-contrast head CT showed no acute intracranial abnormality. A lumbar puncture was performed by the ED provider, which showed WBCs (505 - 71%N, 20%L, 7%M), RBC (1), glucose (19), and protein (200). CSF: High Leukocytes, low glucose, and high protein.On the physical exam, the patient was pleasant and cooperative, he was A&O x 4, he had a normal examination except for two brown healing small nodules on his forehead and left cheek and slight neck stiffness. At that point, we knew the patient most likely had fungal meningitis by cocci except for the predominant WBC in his CSF fluid was neutrophil not the more typical picture of lymphocyte dominant. And because of his very benign presentation and subacute history, we were not 100% sure if we had a strong reason to admit this patient. We thought this patient could be managed as an outpatient with oral fluconazole and referred to infectious disease and neurology. 4. Continuation of case: Admission to the hospital.Looking back, one thing that was overlooked while checking this patient in the ED was the LP opening pressure. Later, the open pressure was reported as 340mm H2O (very high). The good thing was, after speaking to the ED attending and our attending, the patient was admitted to the hospital and started on oral fluconazole. Three hours after the admission, a rapid response was called on him. While the floor nurses were doing their check-in physical examination, the patient had a 5-minute episode of seizure-like activity which included bilateral tonic arm/hand movements, eye deviation to the left, LOC unresponsive to sternal rub, and the patient desaturated to 77%. He eventually regained consciousness after the seizure and pulse oximetry increased to 100% on room air. The patient was started on Keppra and seen by a neurologist the following day. His 12-hour EEG was normal, but his head MRI showed “diffuse thickening and nodularity of the basal meninges are seen demonstrating enhancement, suggesting chronic meningitis, possibly related to cocci. Other etiologies including sarcoidosis and TB meningitis and/or infiltration by metastatic process/lymphoma are not excluded. The ventricles are slightly prominent in size”. MRI of the cervical, thoracic, and lumbar spines also showed extensive diffuse leptomeningeal thickening, extensive meningitis, and nodular dural thickening. Also, his chest x-ray showed “some heterogeneity and remodeling of the distal half of the left clavicle. Metabolic bone disease, infectious etiology and/old trauma considered”. This could also be due to disseminated cocci infection. The infectious disease doctor saw this patient and recommended continuing with fluconazole, serial LPs until opening pressure is less than 250 mmH2O and neurosurgery consultation for possible VP shunt placement. The neurologist recommended the patient continue with Keppra indefinitely in the context of structural brain damage secondary to cocci meningitis.Take home points: Suspect cocci meningitis in patients with subacute headache associated with respiratory symptoms, new skin lesions, photophobia, neck stiffness, nausea, vomiting, eosinophilia, erythema nodosum (painful nodules on the anterior aspect of legs). Other symptoms to look for include arthralgias, particularly of the ankles, knees, and wrists.____________________Brief summary of coccidiomycosis. Etiology Coccidioidomycosis, commonly known as Valley fever, is caused by dimorphic soil-dwelling fungi of the genus Coccidioides (C. immitis and C. posadasii). They are indistinguishable in clinical presentation and routine laboratory test results.1, 2, 3, 5Epidemiology In the United States, endemic areas include the southern portion of the San Joaquin Valley of California and the south-central region of Arizona. However, infection may be acquired in other areas of the southwestern United States, including the southern coastal counties in California, southern Nevada, southwestern Utah, southern New Mexico, and western Texas (including the Rio Grande Valley). There are also cases in eastern Washington state and in northeastern Utah. Outside the United States, coccidioidomycosis is endemic to northern Mexico as well as to localized regions of Central and South America.1, 2Overall, the incidence within the United States increased substantially over the 1998-2019, most of that increase occurred in south-central Arizona and in the southern San Joaquin Valley of California. From 1998 to2019, reported cases in California increased from 719 to 9004.1, 6The risk of infection is increased by direct exposure to soil harboring Coccidioides. Past outbreaks have occurred in military trainees, archaeologists, construction or agricultural workers, people exposed to earthquakes or dust storms. However, in endemic areas, many cases of Coccidioides infection occur without obvious soil or dust exposure and are not associated with outbreaks. Change in population, climate change, urbanization and construction activities, and increased awareness and reporting, are possible contributing factors.1, 2, 5 Pathology In the soil, Coccidioides organisms exist as filamentous molds. Small structures called arthroconidia from the hyphae may become airborne for extended periods. Arthroconidia are usually 3-5 μm—small enough to evade bronchial tree mucosal mechanical defenses and reach deep into the lungs.1, 3Once inhaled by a susceptible host into the lung, the arthroconidia develop into spherules (theparasitic existence in a host), which are unique to Coccidioides. Endospores from ruptured spherules can themselves develop into spherules, thus propagating infection locally.1, 3, 5Although rare cases of solid organ donor-derived or fomite transmitted infections have been reported, coccidioidomycosis does not occur in person-to-person or zoonotic contagion, and transplacental infection in humans has never been documented.2, 5Cellular immunity plays a crucial role in the host's control of coccidioidomycosis. Among individuals with decreased cellular immunity, Coccidioides may spread locally or hematogenously after an initial symptomatic or asymptomatic pulmonary infection to extrathoracic organs.1, 3, 7Clinical manifestationThe majority of infected individuals (about 60%) are completely asymptomatic. Symptomatic persons (40% of cases) have symptoms that are related principally to pulmonary infection, including cough, dyspnea, and pleuritic chest pain. Some patients may also experience fever, headache (common finding in early-stage infection and does not represent meningitis), fatigue, night sweats, rash, myalgia.1, 2, 3, 5In most patients, primary pulmonary coccidioidomycosis usually resolves in weeks without sequelae and lifelong immunity to reinfection. However, some patients may develop chronic pulmonary complications, such as nodules or pulmonary cavities, or chronic fibrocavitary pneumonia. Some individuals with intense environmental exposure or profoundly suppressed cellular immunity (e.g., in patients with AIDS) may develop a primary pneumonia with diffuse reticulonodular pulmonary process in association with dyspnea and fever.1, 3, 5Fewer than 1% of infected individuals develop extrathoracic disseminated coccidioidal infection. Common sites for dissemination include joints and bones, skin and soft tissues, and meninges. One site or multiple anatomic foci may be affected. 1, 2, 3, 7It is estimated that coccidioidal meningitis, the most lethal complication of coccidioidomycosis, affects only 0.1% of all exposed individuals. Patients with coccidioidal meningitis usually present with a persistent headache (rather than a self-limited headache in some patients with primary pulmonary infection), with nausea and vomiting, and sometimes vision change. Some may also develop altered mental status and confusion. Meningismus such as nuchal rigidity, if present, is not severe.Hydrocephalus and cerebral infarction may develop in some cases. Papilledema is more commonly observed in pediatric patients.1, 3, 4, 5, 7When meningitis develops, most patients may not have any respiratory symptoms nor radiographic manifestation of pulmonary infection. However, a large number of these individuals also present with other extrathoracic lesions.7DiagnosisAlthough early diagnosis carries obvious benefits for patients and the health care systems as a whole (e.g., decreases patient anxiety, reduces the cost of expensive and invasive tests, removes the temptation for empirical antibacterial or antiviral treatments, and allows for early detection of complications), considerable diagnostic delays up to several weeks to months are common in both endemic areas and non-endemic areas.3, 7 Most symptomatic persons with coccidioidal infection present with primarily pulmonary symptoms and are often misdiagnosed as community-acquired bacterial pneumonia and treated with antibiotics. In endemic areas like south-central Arizona, previous studies found up to 29% of community-acquired pneumonia is caused by coccidioidomycosis. Healthcare providers thus should maintain a high clinical suspicion for coccidioidomycosis when evaluating persons with pneumonia who live in or have traveled to endemic areas recently. Elevated peripheral-blood eosinophilia of over 5%, hilar or mediastinal adenopathy on chest radiography, marked fatigue, and failure to improve with antibiotic therapy should prompt suspicion and testing for infection with coccidioidomycosis in endemic areas.1, 3, 5Serological testing plays an important role in establishing a diagnosis of coccidioidomycosis. Enzyme immunoassay (EIA) to detect IgM and IgG antibodies is highly sensitive and therefore commonly used as the screening tool. Immunodiffusion is more specific but less sensitive than enzyme immunoassay. It is used to confirm the diagnosis of positive EIA test results. Complement fixing (CF) test, which indirectly detects the presence of coccidioidal antibodies by testing the consumption of serum complement, are expressed as titers. Serial measurements of titers are of not only diagnostic but also prognostic value.1, 2, 3, 5Other methods, including culture, microscopic, or polymerase chain reaction (PCR) exam on tissue or respiratory specimens, are limited by their availability, sample obtaining and handling, or lack of sufficient evaluation.1, 2, 3, 5Cerebrospinal fluid (CSF) examination in coccidioidal meningitis usually demonstrates lymphocyte dominated elevation of leukocytes, although polymorphonuclear leukocyte dominance can also be seen in the early stage of the infection. Profound hypoglycorrhachia and elevated protein levels in CSF examination are also very common in coccidioidal meningitis.1, 7Although isolating Coccidioides from CSF or other CNS specimens are diagnostic for coccidioidal meningitis, in practice, diagnoses are often made based on the combination of clinical presentation, CSF examination that suggesting fungal infection, and positive Coccidioides antibodies found in CSF.7Imaging, especially enhanced magnetic resonance imaging (MRI), can help in diagnosing coccidioidal meningitis. Basilar leptomeningeal enhancement is a more common finding even though hydrocephalus, cerebral infarction, and vertebral artery aneurysm can also be seen.7TreatmentMost patients with focal primary pulmonary coccidioidomycosis do not require antifungal therapy. According to 2016 Infectious Diseases Society of America (IDSA) Clinical Practice Guideline, antifungal therapy should be considered in patients with concurrent immunosuppression that adversely affect cellular immunity (e.g., organ transplant patients, AIDS in HIV-infected patients, and patients receiving anti–tumor necrosis factor therapy) and those with significantly debilitating illness, extensive pulmonary involvement, with concurrent diabetes, pregnant women, or who are otherwise frail because of age or comorbidities. Some experts would also include African or Filipino ancestry as indications for treatment. Conversely, humoral immunity comprise splenectomy, hypocomplementemia, or neutrophil dysfunction syndromes are not major risk factors for this disease.1, 2, 3, 4, 5Triazole antifungals (fluconazole or itraconazole) are currently considered as the first-line medications used to treat most cases of coccidioidomycosis. Amphotericin B is reserved for only the most severe cases of dissemination and patients with coccidioidal meningitis in whom triazole antifungal therapy has failed. It is also the choice of therapy for coccidioidomycosis in pregnant women during the first trimester because of the possible teratogenic effect of high-dose triazole therapy during this period of time.1, 3, 4, 5Treating coccidioidal meningitis (CM) poses a special challenge because untreated meningitis is nearly always fatal. Lifelong therapy is recommended for CM because the majority 80% patients with CM experience relapse when therapy is stopped despite initial response to antifungal treatment. Shunting of CSF is required in cases of meningitis complicated by hydrocephalus.1, 3, 4, 5, 7Prevention Avoidance of direct contact with contaminated soil in endemic areas (e.g., respirator use by construction workers) may reduce disease risk, although clear evidence of its benefit is lacking.1, 5Some special population groups may benefit from prophylactic use of antifungals, such as those about to undergo allogeneic solid-organ transplantation or patients with a history of active coccidioidomycosis or a positive coccidioidal serology in whom therapy with tumor necrosis factor α antagonists is being initiated. The administration of prophylactic antifungals is not recommended for HIV-1-infected patients even if they live in an endemic region.1, 5Conclusion: Now we conclude episode number 164, “More than just a headache.” Dr. Song explained that a headache with an indolent course, accompanied by subacute respiratory symptoms, nausea, vomiting, photophobia, neck stiffness, and skin lesions can be secondary to Valley Fever. The Central Valley of California, as well as other areas with dry climate, are endemic and we need to keep this disease in our differential diagnosis.This week we thank Hector Arreaza and Zheng (David) Song. Audio editing by Adrianne Silva.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:Roos KL, Tyler KL. Acute Meningitis. McGraw Hill Medical. Published 2023. Accessed August 18, 2023. https://accessmedicine.mhmedical.com/content.aspx?bookid=2129§ionid=192020493Information for Healthcare Professionals. Published 2023. Accessed August 18, 2023. https://www.cdc.gov/fungal/diseases/coccidioidomycosis/health-professionals.html#printValley Fever (Coccidioidomycosis) a Training Manual for Primary Care Professionals. Accessed August 18, 2023. https://vfce.arizona.edu/sites/default/files/valleyfever_training_manual_2019_mar_final-references_different_colors.pdfAmpel NM. Coccidioidomycosis. Idsociety.org. Published July 27, 2016. Accessed August 18, 2023. https://www.idsociety.org/practice-guideline/coccidioidomycosis/Herrick KR, Trondle ME, Febles TT. Coccidioidomycosis (Valley Fever) in Primary Care. American Family Physician. 2020;101(4):221-228. Accessed August 18, 2023. https://www.aafp.org/pubs/afp/issues/2020/0215/p221.htmlValley Fever Statistics. Published 2023. Accessed August 18, 2023. https://www.cdc.gov/fungal/diseases/coccidioidomycosis/statistics.htmlUpToDate. Uptodate.com. Published 2023. Accessed August 18, 2023. https://www.uptodate.com/contents/coccidioidal-meningitis?search=7%20Coccidioidal%20meningitis&source=search_result&selectedTitle=1~10&usage_type=default&display_rank=1Royalty-free music used for this episode: Tropicality by Gushito, downloaded on July 20, 2023, from https://www.videvo.net/
It's only been a year and Maddie's addicted to mobile games. Has it been a while? It's been a long time. 53yo M w PMH of HTN, HLD, DM2 p/w NSTEMI w CP. Check out Binging with Bbirchtats on YouTube: https://www.youtube.com/watch?v=i6djKQIviwk Ride on the magic council! I went to the school to get the D. Dimothy? Doug Dimmidome? Drubder? YOU DON'T HAVE PARENTS! This anime is trash and I'm Oscar THE FUCKING GROUCH. This dying thing is sick... Triggering all chemists. Say hello to GUMBO, THE DESTROYER OF WORLDS. Has Jim been uploading to YouTube for us?? We know our FBI guy is at least named ..... Eddd.... Wurddd? He knows at least 3 of the 5 guys! The milkman, the paper boy, THE EVENING TV. Gariel and Angelo, the cats who love you. If you'd like to request us to cover YOUR favorite anime on My Favorite Anime, then donate on Ko-fi or Patreon https://ko-fi.com/myfavoriteanime https://www.patreon.com/mfanime Merch is back up (with some exclusive patreon merch soon): https://animate-station.creator-spring.com/listing/tanks-are-for-girls-my-favor Links to the podcast: https://open.spotify.com/show/0AV1raD6J16xjX5sVTuqNR?si=s1174woBQMSAlEAdZZqKgQ https://pca.st/BA5s https://podcasts.apple.com/us/podcast/my-favorite-anime/id1448147787
We hear updates from leaders in the animal health and supplies business, Merck Animal Health and Ritchey Livestock ID. Plus we have the latest cattle and livestock news, bull sale updates, markets, hay auctions and lots more on this all new episode of The Ranch It Up Radio Show. Be sure to subscribe on your favorite podcasting app or on the Ranch It Up Radio Show YouTube Channel. EPISODE 176 DETAILS Merck Animal Health has been a leader in animal health products. Hear how a proper calfhood vaccination program can set your newborn calves up for success later in life. Livestock identification is a must and producers need to have ear tags that don't fade, don't break and are easy to read. We hear an update from the tag that never fades, Ritchey Livestock ID and Ritchey Tags! Meat product labeling (COOL) is back on discussion. Country of Origin Labeling has been a discussion point for a long time. Hear reaction from consumer groups in our news segment. We have the latest sale reports and cattle sales. Plus hear a weekly market recap with Kirk Donsbach with Stone X Financial! MERCK ANIMAL HEALTH Optimizing Vaccine Efficacy In Animal Health: Best Practices & Considerations Vaccines play a crucial role in safeguarding animal health by bolstering their immune systems against various pathogens. Understanding proper storage, handling, and administration of vaccines is essential to ensure their effectiveness. Key Points: 1. Importance of Vaccines: Vaccines are preventive tools designed to prepare an animal's immune system to combat diseases caused by bacteria, viruses, or protozoa. 2. Proper Handling and Storage: Deviations from label instructions regarding storage, transportation, and handling can compromise vaccine efficacy. Vaccines should be stored in refrigerators maintaining optimal temperatures. 3. Factors Affecting Efficacy: Nutritional deficiencies, environmental stressors, and preexisting health conditions can influence an animal's response to vaccination. 4. Administration Best Practices: Proper reconstitution, mixing, and administration techniques are crucial for vaccine effectiveness. 5. Herd Veterinarian Guidance: Tailoring vaccination programs to specific herd needs and consulting with a veterinarian ensures optimal protection. 6. Vaccine Types and Revaccination: Understanding differences between modified live virus (MLV) and killed virus (KV) vaccines and adhering to recommended revaccination schedules are vital. 7. Calfhood Vaccination Programs: Initiating comprehensive vaccination programs early in a calf's life, especially during pre weaning stages, is essential for disease prevention. 8. Essential Components: Commonly included vaccines protect against respiratory diseases and clostridial infections, but specific vaccine decisions should be made with veterinary consultation. 9. Heifer Vaccination: Vaccination programs for replacement heifers should mirror those for mature cows, with consideration for reproductive diseases. 10. Pre Breeding and Pre Calving Vaccinations: Timing and selection of vaccines are critical to ensure adequate immunity transfer and protection for newborn calves. 11. Bull Vaccination: Bulls should receive similar vaccines as the cow herd, with exceptions such as brucellosis vaccination. Effective vaccine utilization requires adherence to proper storage, handling, and administration practices, along with tailored vaccination programs guided by veterinary expertise. By implementing these strategies, livestock producers can enhance animal health and productivity while mitigating disease risks. ALLFLEX® CleanVax™ Nozzles and Shields for Intranasal Vaccination Merck Animal Health, known as MSD Animal Health outside of the United States and Canada, a division of Merck & Co., Inc., Rahway, N.J., USA (NYSE:MRK), today announced new ALLFLEX® CleanVax™ nozzles and shields for clean, fast and convenient administration of intranasal vaccines to cattle. The CleanVax intranasal vaccination system includes shorter nozzles that are less invasive than conventional cannulas, as well as clear plastic disposable shields that can be replaced between animals or groups of animals for more hygienic administration. “CleanVax nozzles and shields optimize every aspect of the intranasal vaccination process for confidence in a clean, consistent dose every time,” said Jonathon Townsend, D.V.M., Ph.D., dairy technical services for Merck Animal Health. “The system is simple to use and enhances calf comfort, hygiene and consistency, making it easier on both the calf and caregiver.” The following are the advantages of the CleanVax intranasal vaccination system: Calf-friendly, shorter nozzles minimize discomfort; Atomizer tips ensure even distribution across mucosal surfaces and reduce product drip; Easy-to-use nozzles attach to any brand of syringe or Luer lock applicator gun; Hygienic shields add a layer of protection and enhance biosecurity. “CleanVax nozzles and shields are designed to make intranasal vaccine administration more hygienic, calf-friendly and consistent,” Dr. Townsend added. “As a leader in intranasal vaccination technologies, Merck Animal Health continues to advance cattle health and production with innovative and effective solutions for cattle producers.” Intranasal vaccines available from Merck Animal Health include BOVILIS® NASALGEN® 3-PMH, BOVILIS NASALGEN 3, BOVILIS NASALGEN IP, BOVILIS CORONAVIRUS and BOVILIS ONCE PMH® IN. ALLFLEX CleanVax products are now available through your Merck Animal Health representative or ALLFLEX supplier. Learn more at MAHcattle.com. RITCHEY LIVESTOCK ID The tag that never fades Tag longevity sets us apart at Ritchey. Livestock ID information is permanently engraved into the tag and readable for the lifetime of the animal. After all, what's a tag work that fades? Absolutely nothing. American Made, Family Owned Being American made and family owned is what makes us unique at Ritchey Livestock ID. It inherently feels right to be making livestock ID tags in the United States. Make Your Mark Ritchey livestock tags are the only tag that allows you to quickly engrave ID information yourself. You can proudly display your family's brand or engrave a last second tag at the chute. The power is yours! COW COUNTRY NEWS USDA Finalizes Voluntary “Product Of USA” Labeling Rule USDA Secretary Tom Vilsack on Monday announced the finalization of a rule to align the voluntary “Product of the USA” label claim with consumer expectations of what the claim means. The designation allows the voluntary “Product of USA” or “Made in the USA” label claim to be used on meat, poultry and egg products only when they come from animals born, raised, slaughtered and processed in the United States. The final rule aims to prohibit misleading U.S. origin labeling in the marketplace and helps ensure that the information that consumers receive about where their food comes from is based on facts. The labels will continue to maintain their voluntary status for use on products and also will be eligible for generic label approval, which removes the need for pre-approval by USDA, but requires manufacturers to maintain documentation to support the claim. Last summer, the country of origin labeling rules (COOL), as they were proposed, covering meat, poultry and egg products, were criticized by the Canadian government and the National Pork Producers Council because they included specific regulations on where the animals were raised, which were not part of earlier versions of the rule. Companies that use the “Made in the USA” claim will need to comply with the final rule by Jan. 1, 2026, but are being encouraged to do so as soon as possible. The National Cattlemen's Beef Association's Executive Director of Government Affairs Kent Bacus released the following statement on the USDA's finalized rule on the "Product of USA" label by saying, “NCBA has been committed to finding solutions to this problem ever since a producer-led NCBA working group raised the alarm, years ago, that imported beef could be mislabeled as a Product of the USA incorrectly at the end of the supply chain. We appreciate USDA's effort to address this loophole. During the implementation period, NCBA's focus will remain on ensuring that these changes result in the opportunity for producer premiums while remaining trade compliant.” UPCOMING BULL SALES ANGUS CHAROLAIS HEREFORD GELBVIEH BALANCER RED ANGUS SIMMENTAL SIMANGUS Weber Land & Cattle: March 12, 2024, Lake Benton, Minnesota Sundsbak Farms: March 16, 2024, Des Lacs, North Dakota Hidden Angus: March 17, 2024, Sebeka, Minnesota Wheatland Cattle Company: March 21, 2024, Bienfait, Saskatchewan, Canada Miller Angus Farms: March 25, 2024, Watertown, South Dakota L 83 Ranch: March 26, 2024, Mandan, ND Vollmer Angus Ranch: April 2, 2024, Wing, North Dakota A & B Cattle: April 4, 2024, Bassett, Nebraska Montgomery Ranch: April 14, 2024, Carrington, North Dakota Jorgensen Farms: April 15, 2024, Ideal, South Dakota BULL SALE REPORT & RESULTS Churchill Cattle Company Van Newkirk Herefords Gardiner Angus Ranch Cow Camp Ranch Jungels Shorthorn Farms Ellingson Angus Edgar Brothers Angus Schaff Angus Valley Prairie Hills Gelbvieh Clear Springs Cattle Company CK Cattle Mrnak Hereford Ranch Frey Angus Ranch Hoffmann Angus Farms Topp Herefords River Creek Farms Upstream Ranch Gustin's Diamond D Gelbvieh Schiefelbein Farms Wasem Red Angus Raven Angus Krebs Ranch Yon Family Farms Chestnut Angus Eichacker Simmentals & JK Angus Windy Creek Cattle Company Pedersen Broken Heart Ranch Mar Mac Farms Warner Beef Genetics Arda Farms & Freeway Angus Leland Red Angus & Koester Red Angus Fast - Dohrmann - Strommen RBM Livestock Weber Land & Cattle FEATURING Dr. Tim Parks, D.V.M. Merck Animal Health https://www.merck-animal-health-usa.com/ @merckanimalhealth Bryce Kelley Ritchey Livestock ID https://ritcheytags.com/ @RitcheyLivestockID Kirk Donsbach: Stone X Financial https://www.stonex.com/ @StoneXGroupInc Mark Van Zee Livestock Market, Equine Market, Auction Time https://www.auctiontime.com/ https://www.livestockmarket.com/ https://www.equinemarket.com/ @LivestockMkt @EquineMkt @AuctionTime Shaye Koester Casual Cattle Conversation https://www.casualcattleconversations.com/ @cattleconvos Questions & Concerns From The Field? Call or Text your questions, or comments to 707-RANCH20 or 707-726-2420 Or email RanchItUpShow@gmail.com FOLLOW Facebook/Instagram: @RanchItUpShow SUBSCRIBE to the Ranch It Up YouTube Channel: @ranchitup Website: RanchItUpShow.com https://ranchitupshow.com/ The Ranch It Up Podcast available on ALL podcasting apps. Rural America is center-stage on this outfit. AND how is that? Because of Tigger & BEC... Live This Western Lifestyle. Tigger & BEC represent the Working Ranch world by providing the cowboys, cowgirls, beef cattle producers & successful farmers the knowledge and education needed to bring high-quality beef & meat to your table for dinner. Learn more about Jeff 'Tigger' Erhardt & Rebecca Wanner aka BEC here: TiggerandBEC.com https://tiggerandbec.com/ #RanchItUp #StayRanchy #TiggerApproved #tiggerandbec #rodeo #ranching #farming References https://www.stonex.com/ https://www.livestockmarket.com/ https://www.equinemarket.com/ https://www.auctiontime.com/ https://gelbvieh.org/ https://www.imogeneingredients.com/ https://alliedgeneticresources.com/ https://westwayfeed.com/ https://medoraboot.com/ http://www.gostockmens.com/ https://ranchchannel.com/ https://www.merck-animal-health-usa.com/species/cattle https://ritcheytags.com/ https://www.meatingplace.com/Industry/News/Details/113744
Featuring perspectives from Dr Bradley J Monk, including the following topics: Introduction (0:00) Case: A woman (gBRCA1) in her late 40s, 5 months after surgery and adjuvant paclitaxel/carboplatin for Stage II ovarian cancer, now with a single umbilical metastasis — Kellie E Schneider, MD (9:47) Case: A woman (gBRCA2) in her late 60s with Stage IIIC ovarian cancer after surgery and chemotherapy who has received primary olaparib maintenance for 3 years develops acute myeloid leukemia — Swati Vishwanathan, MD (17:21) Case: A woman in her early 60s presents with Stage IV ovarian cancer (BRCA wild-type, homologous recombination deficiency-positive) — Neil Morganstein, MD (22:53) Case: A woman (gBRCA2) in her late 40s with Stage IIIC primary peritoneal cancer receives carboplatin/paclitaxel after R0 debulking surgery; genetic testing results pending — Karim ElSahwi, MD (27:30) Case: A woman in her early 60s with PMH of breast cancer and with limited recurrence of ovarian cancer (BRCA wild-type, homologous recombination deficiency-positive) after chemotherapy and maintenance niraparib refuses to receive chemotherapy — Gigi Chen, MD (33:06) Case: A woman (gBRCA2) in her mid 60s with high-grade serous carcinoma of the fallopian tube undergoes surgery and chemotherapy/bevacizumab but cannot tolerate a PARP inhibitor and refuses to take another agent — Thomas P Morrissey, MD (40:51) Case: A woman (homologous repair deficiency-positive) in her mid 70s with ovarian cancer and disease progression on EPIK-O trial of alpelisib with olaparib tests positive for folate receptor alpha and receives mirvetuximab soravtansine — Lyndsay J Willmott, MD (45:46) Journal Club with Dr Monk (54:13) CME information and select publications
Featuring perspectives from Dr Antonio González-Martín, including the following topics: Introduction: Treatment-Related Second Cancers (0:00) Case: A woman in her mid 40s (gBRCA) who presents with ascites and is diagnosed with high-grade serous ovarian cancer (HGSOC) with extensive peritoneal disease — Lyndsay J Willmott, MD (12:37) Case: A woman in her early 40s (gBRCA1) with HGSOC who experienced cardiac arrest due to anaphylaxis during paclitaxel infusion as part of a neoadjuvant paclitaxel/carboplatin/bevacizumab regimen — Kellie E Schneider, MD (30:33) Case: A woman in her late 50s (gBRCA1) with HGSOC and pelvic node recurrence after perioperative paclitaxel/carboplatin and optimal interval debulking surgery — Karim ElSahwi, MD (39:45) Case: A woman in her late 50s (gBRCA1) with Stage IIIA ovarian cancer and elevated creatinine due to donor nephrectomy — Paul DiSilvestro, MD (43:05) Case: A woman in her early 60s with recurrent ovarian cancer after a chemotherapy and niraparib maintenance regimen and tumor treating fields with paclitaxel on a clinical trial — Gigi Chen, MD (46:28) Case: A woman in her late 50s with gBRCA1 and PMH of breast cancer and prophylactic bilateral salpingo-oophorectomy who develops recurrent peritoneal cancer and responds for 10 months to olaparib followed by chemotherapy followed by rucaparib and nivolumab on the TAPUR trial — John K Chan, MD (51:52) Journal Club (55:30) CME information and select publications
Featuring perspectives from Dr Richard M Stone, including the following topics: • Introduction: ASH 2023 Update — Key Oral Presentations (0:00) • Case: A woman in her early 90s with dementia who presented with anemia and was diagnosed with low-risk myelodysplastic syndromes (MDS) with ring sideroblasts, now receiving luspatercept — Eric H Lee, MD, PhD (9:09) • Case: An African American woman in her early 60s with high-risk del(5q) MDS who receives oral decitabine/cedazuridine — Henna Malik, MD (26:05) • Case: A man in his late 60s with therapy-related acute myeloid leukemia (AML) with a FLT3-ITD mutation — Rebecca L Olin, MD, MSCE (34:49) • Case: A woman in her early 70s with PMH of inflammatory breast cancer diagnosed with FLT3-ITD AML who achieved a complete response (CR) with azacitidine/venetoclax, followed by gilteritinib maintenance for 2 years — Zanetta S Lamar, MD (40:43) • Case: A man in his mid 30s who presents with pathologic spinal fracture, is diagnosed with myeloid sarcoma and receives induction CLAG-M with CR followed by consolidation high-dose cytarabine — Anna Halpern, MD (43:56) • Case: A man in his mid 80s with MDS, complex cytogenetics and a TP53 mutation treated with azacitidine/venetoclax — Neil Morganstein, MD (46:40) • Case: A woman in her early 70s with newly diagnosed, poor-risk AML, ineligible for intensive chemotherapy (ECOG PS 2) who receives a hypomethylating agent/venetoclax — Amany R Keruakous, MD, MS (49:56) • Case: A man in his early 70s with relapsed AML (SRSF2, IDH1, ASXL1 mutations) after azacitidine/venetoclax, now receiving ivosidenib — Dr Halpern (55:23) CME information and select publications
Bob Beaudry, one of three Pure Michigan Hunt winners for 2023, was the first Yooper ever drawn for the PMH in the 13 years the program has been going. Pure Michigan Hunt winners receive tags for everything you can hunt in Michigan - elk, bear, spring and fall turkey, antlerless deer, and the first pick at a managed waterfowl hunt area. Bob filled ALL of his tags last year. You couldn't ask for a better recipient of the PMH. Bob's gratitude for winning, his motivation to fill every single tag, his generosity, and he's a veteran. Hosted on Acast. See acast.com/privacy for more information.
Join Sarah Noll Wilson and guest Jacquette M. Timmons as they discuss our relationship with goals - how we set them, how we assess our successes and failures, and how we must reassess and recalibrate them over time. About Our Guest Jacquette M. Timmons is on a mission to change how people think, behave, and talk about money. It's why she focuses on the human side of money. She works as a financial behaviorist and is committed to getting you to see that you don't manage money - you manage your choices around money. In addition to being an author ("Financial Intimacy: How to Create a Healthy Relationship with Your Money and Your Mate”) and frequent blogger, Jacquette is also the creator of Pricing Made Human®. PMH is designed to help entrepreneurs and small business owners tackle the question, "What should I charge for this?," from all sides: the financial, the emotional, the personal, so they can price more confidently, strategically, and end up with a thriving business and thriving life. She also hosts the podcast, "More Than Money." When she's not providing behavioral-based financial coaching for smart, driven, and curious high-earners, she's traveling the country for speaking engagements on behalf of Fortune 100 companies, AM Law 200 firms, nationally known non-profits and conferences (large & boutique) to talk about the intersection of emotions and money. Her work has been featured on Minnesota Public Radio, SiriusXM, "Good Morning America," Oprah.com, CNN, HLN, FOX, Black Enterprise, NPR, Reuters.com, and the Wall Street Journal. Jacquette holds an MBA in finance from Fordham University's Graduate School of Business and an undergrad in marketing from the Fashion Institute of Technology. A combination she credits, in part, for being able to blend her analytical mind and creative spirit in service to helping her clients shift how they look at money; how they perceive its role in their life; and how they give it direction. She lives in Brooklyn, NY and can be seen running in Prospect Park most days of the week. Website: www.jacquettetimmons.com Instagram: www.instagram.com/jacquettemtimmons LinkedIn: www.linkedin.com/in/jacquettetimmons Resources Mentioned https://www.jacquettetimmons.com/the-crisis-you-face/ https://www.jacquettetimmons.com/sales-slump/ https://www.jacquettetimmons.com/cultivate-more-flow/ https://www.jacquettetimmons.com/done-differently/
In today's episode, I am thrilled to welcome the renowned PMH Atwater once again to the show, where she will discuss her latest book centered around her life story. In her eloquent narrative, PMH artfully weaves together her personal journey, abundant experiences, and their profound impact on her life. She also generously imparts the wisdom she has acquired through over four decades of diligent research, which encompasses an impressive corpus of more than 4,000 client sessions. For full show notes, please visit: https://www.interviewswithinnocence.com/blog/194
TWiP solves two cases this week, the Man with Issues after COVID-19, and the Man with Left Arm Weakness, then describe how the malaria parasite evades mosquito immunity by glutaminyl cyclase–mediated posttranslational protein modification. Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Malaria parasite evades mosquito immunity (Proc Natl Acad Sci USA) Letters read on TWiP 218 Become a patron of TWiP Case Study for TWiP 218 A fun twist for today. Did I mention recently I was spending time with Paul Calle at the Central Park and instead of Jeff Bezos showing up for Dinner Chevy Chase was there. Here we have the case of a 19 month old female who seems to be having some issues. Lots of increased respiratory effort even with minimal exertion. Some issue with loose stools and then followed by the onset of facial swelling. No sig PMH or PSH, fairly confident there is not smoking or drinking of alcohol and certainly not HIV+. On exam the increased respiratory effort that is audible. Directed testing reveals canine coccidia and giardia in the stool. So what is going on? Should I be worried about my daughter who has had lots of exposure? Send your case diagnosis, questions and comments to twip@microbe.tv Music by Ronald Jenkees
06:07 Show Intro (0:30); Times you've tried something new...(8:50); They're apparently the WORST for us...but what are ultraprocessed foods? What does that mean? What's their impact? (14:10); New numbers show agency nursing use is highest in Prairie Mountain....4 nurses just asked for transfers from Glenboro, what's going on in PMH? (21:25); New camping registration launches/ bookings start next week (32:30); Sports Talk with Jim Toth (38:40); Barrett Miller, Fort Whyte Alive (52:00).
P. M. H. Atwater, L. H. D., is one of the original researchers in the field of near-death studies, having begun her work in 1978 and completing 10 books on her findings – some of which have now been verified in clinical settings. Her, The Big Book of Near-Death Experiences, was featured in the online version of “Newsweek Magazine.” Near-Death Experiences: The Rest of The Story is her most complete and controversial work yet. She has won many awards, appeared on numerous TV shows, and spoken around the world – always inviting people to look past appearances for the truth that underlies what we think we know. - www .pmhatwater.comTo listen to all our XZBN shows, with our compliments go to: www.spreaker.com/user/xzoneradiotv.The current edition of The 'X' Chronicles Newspaper is available at www.xchronicles.net.This episode of The ‘X' Zone with Rob McConnell is brought to you by BEAUTIFUL MIND COFFEE - For the coffee that your brain will love, visit Beautiful Mind Coffee, www.beautifulmindcoffee.ca. It's Brainalicious!
Join one of the leading researchers and authorities on Near-Death Experiences (NDE's), PMH Atwater as she shares with us insights she has gained over more than 40 years of research and personal experience into NDE's and transformational states of consciousness. We talk about the difference between adult and childhood NDE's, why the divorce rate is close to 80% after a NDE, what PMH means by the 5th world and how transformational states of consciousness can prepare us for the times we are in. Highlights Gain insights into personal experience and over 40 years of research into transformations of consciousness and Near-Death Experiences (NDE's). Learn how transformations in consciousness are preparing us for the times we are currently in. What is unconditional love? Have any of us actually experienced it? Discover how both NDE's and transformations in consciousness can affect us profoundly both physically and esoterically. Learn the differences between the NDE's of adults and children. Understand what PMH means by, “The baby has rights! Talk to the baby and find out what they want.” Gain insights into what it means to be spiritual and what we should honour. Gain a deeper understanding of how much our children are actually aware of and how this can change the way we interact with them. Discover the 4 main types of NDE's. Discover why children as well as adults may have specific sensitivities after an NDE, including sensitivities to medications. Understand why it is absolutely necessary for your doctor to know that you had a NDE. Understand why the divorce rate of Near-Death Experiencers is close to 80%. Gain insights into why Near-Death Experiencers often have troubles with EMF's and technology. Discover how long it typically takes to integrate a NDE both for adults and children. What are the biggest “Aha” moments in regards to why we have transformations in consciousness and NDE's. Gain insights into what is meant by the “5th world” that we are moving into. Discover some of the main challenges that Near-Death Experiencers can encounter once they come back from their experience. Contact Dr. Atwater pmhatwater.com Free Gift:
This week I had the pleasure to chat with renowned Near-Death Experience Researcher and author PMH Atwater. We talker about her journey to wanting to research the very unique science behind NDE's and how having these experiences can truly affect those who survive NDE's. Connect with PMH: www.PMHATWATER.com Please subscribe to the show, leave a review and follow along with the show on our other social media accounts: Website: https://www.EmbracingDeathPodcast.com/ Instagram: https://www.instagram.com/embracingdeathpodcast/ Host Julia Sheehan on Instagram: https://www.instagram.com/JuliaSheehan/ WE WANT TO HEAR YOUR STORY! If you or someone who know has a unique experience relating to death and dying and would be interested in sharing your story, please send an email to EmbracingDeathPodcast@gmail.com Rights to music purchased from https://www.soundstripe.com
Near-death experience podcast guest 597 is PMH Atwater. During this video we talk about her NDE experience and her research of near death experiences. PHM Atwater is an international authority on near-death states, Dr. PMH Atwater, L.H.D. uses the culmination of her research to establish that the near-death phenomenon is not some kind of anomaly, but is rather part of the larger genre of transformations of consciousness. She combines her 38 years of near-death research with what she was doing in the 60s and 70s, experiencing, experimenting with, and researching altered states of consciousness, mysticism, psychic phenomena, and the transformational process, to reveal what transformations of consciousness really are, why we have them, and where they lead us. This lifetime endeavor covers over 43 years of work, involving nearly 7,000 people. Her meticulous and unique protocol gives validity to what she has discovered, and verified, about the percentage worldwide of people who have undergone near-death experiences. PMH's Website http://pmhatwater.com/ --- Send in a voice message: https://anchor.fm/jeffrey-s-reynolds/message Support this podcast: https://anchor.fm/jeffrey-s-reynolds/support
In this episode of Art of Online Business, we are tapping into a classic episode from last year. It's a conversation that I had with Jacquette Timmons on the topic of pricing, wealth building, and your relationship with money. When it originally aired, it was so well-received that I knew I had to share it again. Jacquette M. Timmons focuses on the human side of money. She works as a financial behaviorist and is committed to getting you to see that you don't manage money - you manage your choices around money.In addition to being an author ("Financial Intimacy: How to Create a Healthy Relationship with Your Money and Your Mate”) and frequent blogger, Jacquette is also the creator of Pricing Made Human®. PMH is designed to help entrepreneurs and small business owners tackle the question, "What should I charge for this?," from all sides: the financial, the emotional, and the personal, so they can price more confidently, and strategically, and end up with a thriving business and thriving life. She also hosts The Comfort Circle™ - a dinner series where she hosts discussions about money, business, and life over food and wine - and the podcast, "More Than Money."Jacquette holds an MBA in finance from Fordham University's Graduate School of Business and an undergrad in marketing from the Fashion Institute of Technology. A combination she credits, in part, for being able to blend her analytical mind and creative spirit in service to help her clients shift how they look at money; how they perceive its role in their life; and how they give it direction. She lives in Brooklyn, NY, and can be seen running in Prospect Park most days of the week.In this episode, you'll learn:Identity-based views of wealthTips for pricing in your businessThings to think about when planning your revenuePlanning for the future How to get started with wealth buildingHow to learn more about stock market investingHow to change your money mindsetExpanding your view of what's possibleGetting outside the box with your revenue streamsLinks & Resources:The Art of Online Business websiteDM me on InstagramVisit my YouTube channelThe Art of Online Business clips on YouTubeFull episodes of The Art of Online Business Podcast on YouTubeThe Art of Online Business Podcast websiteCheck out my Accelerator coaching program*Disclosure: I only recommend products I use and love and all opinions expressed here are my own. This post may contain affiliate links that at no additional cost to you, I may earn a small commission.Jacquette Timmons' Links:Visit Jacquette's websiteFollow Jacquette on InstagramCheck out the We've made some big changes to my Accelerator coaching program recently, including two 30-min 1-on-1 coaching calls with me each month. If you are interested in 1-on-1 and group mentorship to help guide you to the next level of your business through things like clear systems, creating an effective and efficient team, and a growth-focused strategy, head over to www.rickmulready.com/accelerator to fill out the short application.
In this week's episode, we're diving into a conversation around perinatal mental health, and how we screen for and provide better support to parents as they continue to navigate early parenthood. Our expert this week, Dr. Erin Sadler is a psychologist at Children's National in their NICU who has focused her work around supporting infant mental health with starts with pregnancy and parents.She will be sharing a little bit of the process that her hospital has used to implement a universal screening for caregivers around their mental health in both the ER and the NICU environments. This episode is for all of you who are also looking to understand more about how we integrate our mental health care and resources into the standard medical care that we provide to families. Join us for insights on:~Removing barriers to connection~Supporting vulnerable families and decreasing ACEs~Universal mental health screening as standard of care~Safety nets built into screening~Therapeutic interventions for NICU caregivers ~Asking the "scary" questions about mental healthConnect with Dr Sadler and her work here.Here is an addition resource recommended by Dr Sadler:Two of our Children's National physicians discussing an article on the establishment our in-house PMH task force. Support the show
From ASTMH2022 in Seattle, Aisha joins the TWiP team to talk about her training and her career, including delivering a baby on an airplane, and they solve the Case of the Heartsick Guatemalan Septuagenarian. Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula Guest: Aisha Khatib Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Aisha delivers baby on airplane (The Varsity) Helminth infections during pregnancy (J Travel Med) SARS-CoV-2 transmission during air travel (Curr Op Inf Dis) Letters read on TWiP 210 Become a patron of TWiP Case Study for TWiP 210 We are consulted about a rash. A male in his mid 60s originally from Hong Kong with PMH of T2DM, Hypertension, BPH, Hepatitis B infection, COPD (not on home o2), current smoker, ESRD with right chest cath on dialysis (MWF) presented to the ED c/o progressive SOB and DOE for 1 week. 2 weeks prior the patient missed 1 session of hemodialysis. Progressively worsening SOB, DOE, orthopnea began to develop starting one week ago with an associated productive cough with white sputum. Last dialysis was session was 3 days PTA. Pt also began developing nausea and vomiting for 3 days x12 times last week. Pt also started developing diarrhea. Pt has states to have a notable generalized pruritic rash for 3 months that has been worsening. He reports he has been seen by dermatology and was told that the rash is due to certain allergies from food and has been using an unknown cream for 1 month that does not relieve his symptoms. Pt recently admitted for management of bleeding permacath and acute hypoxic respiratory failure likely 2/2 COPD requiring intubation and vent support. Denies recent travel, recent antibiotic use, or sick contacts…but his nephrologist reaches out and is concerned about a certain diagnosis as he says three other patients that come for dialysis have recently been diagnosed with a certain diagnosis. On exam ee has a diffuse symmetrical rash and is scratching the while time. On careful examination there are small linear scabbed areas between his fingers. 9.3 8.97 )———–( 210 28.4 Absolute eosinophil count is >1000 134 | 97 | 51 —————————-
Episode 115: Erectile Dysfunction Diagnosis. Discussion about the diagnosis of erectile dysfunction with Andrew, Adriana, and Dr. Arreaza. Causes, labs, and physical exam is briefly discussed. Written by Andrew Kim, MSIV, Western University of Health Sciences, College of Osteopathic Medicine of the Pacific. Comments by Adriana Rodriguez, MS3, Ross University School of Medicine; and Hector Arreaza, MD.September 22, 2022.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.In episode 39 o erectile dysfunction, Dr. Ihejirika gave us an overview, but today we will be more detailed about the diagnosis of ED. Definition.The American Urological Association (AUA) published an erectile dysfunction guideline in May 2018, which is available online at no cost. Based on that guideline, erectile dysfunction can be defined as “the consistent or recurrent inability to attain and/or maintain penile erection sufficient for sexual satisfaction, including satisfactory sexual performance.” Comment: This guideline provides 25 principles for diagnosing and treating ED. Diagnosis.Getting a good history is important when diagnosing erectile dysfunction. The patient should be asked about the onset of symptoms, severity, how much it hinders his sexual performance, whether the patient can get and maintain an erection, psychological factors, social factors, and presence of morning erections. One can use different questionnaires: the five-question International Index of Erectile Function (IIEF-5) or a single-question self-assessment. Single-question self-assessment:Impotence means not being able to get and keep an erection that is rigid enough for satisfactory sexual activity. How would you describe yourself?Not impotent: always able to get and keep an erection good enough for sexual intercourse.Minimally impotent: usually able to get and keep an erection good enough for sexual intercourse.Moderately impotent: sometimes able to get and keep an erection good enough for sexual intercourse.Completely impotent: never able to get and keep an erection good enough for sexual intercourse.Comment: Basically, the single-question self-assessment is a self-diagnosis of erectile dysfunction; the patient is giving you the severity of his condition. This questionnaire seems to be very subjective. International Index of Erectile Function (IIEF-5):IIEF-5 asks five questions, and the patient answers on a scale of 1 to 5 (1 is the worst, 5 is the best)How do you rate your confidence that you could get and keep an erection?When you had erections with sexual stimulation, how often were your erections hard enough for penetration?During sexual intercourse, how often were you able to maintain your erection after you had penetrated your partner?During sexual intercourse, how difficult was it to maintain your erection to completion of intercourse?When you attempted sexual intercourse, how often was it satisfactory for you?Diagnosis can be made based on the total score. 1 to 7: severe ED, 8 to 11: moderate ED, 12 to 16: mild-moderate ED, 17 to 21: mild ED, and 22 to 25: no ED.This is a self-reported questionnaire, and the score should be interpreted in a clinical context. Answers will likely be biased if, for example, the questionnaire is asked by a female medical assistant. Causes of ED:It is important to assess for medical conditions, psychological conditions, and medications because ED can be caused by vascular, neurological, psychological, and hormonal problems. Cardiovascular: Some common conditions related to ED are cardiovascular disease (PAD, CAD) and HTN.Endocrine: DM, HLD, obesity, testosterone deficiency (hypogonadism), hyperprolactinemia, thyroid disorder, metabolic syndrome.Neurologic: Neurologic conditions (multiple sclerosis, stroke, spine injury), trauma, and venous leakage.Lifestyle causes: sedentary lifestyle, tobacco use.Psychological: Performance anxiety, relationship issues, anxiety, depression, and stress are common psychological causes.Medications and substances: Alcohol, illicit drugs, and nicotine are important causes of ED, but some medications also cause or worsen ED: opiates, diuretics (spironolactone), antifungals (azoles), anticonvulsants, antidepressants (SSRIs), antihistamines, H2 blocker (cimetidine) antihypertensives, nasal decongestants, and antipsychotics. Remember to ask about over-the-counter medications and supplements.Physical exam: Measure blood pressure, BMI, and a complete exam, especially a genital exam. A comprehensive genitourinary exam should include the inspection of the testicles (atrophy, varicocele, signs of hypogonadism). The penis should be inspected and palpated (look for scar tissue and Peyronie's plaques) and assessment of penile stretch/flaccid length (it is done by stretching the penis. An elastic penis is a healthy penis). Dr. Winter's expert opinion: consider a prostate exam in older patients presenting with ED.Labs: Following physical examination, some lab tests can be ordered to further evaluate possible causes of ED. -A1C and glucose levels can be ordered to look for diabetes. -Lipid panel for hyperlipidemia.-TSH should be checked for thyroid function and to rule out hypothyroidism. -Testosterone deficiency can be assessed by measuring morning serum total testosterone level, which is defined as total testosterone < 300 with signs and symptoms. -Prolactin (perform pituitary MRI in any degree of hyperprolactinemia. In patients taking medications that cause hyperprolactinemia, get MRI if prolactin is above 100) Why is it important to diagnose ED?ED can be linked to organic causes.- Glucose: ED is linked to increased fasting serum glucose levels (diabetes). People with PMH of DM are 3 times more likely to develop ED. The longer the patient had diabetes, the stronger association with ED. Fasting glucose levels are associated with the highest risk of ED. The probability of having undiagnosed DM is 1/50 in the age group 40 to 59 without ED but increases to 1/10 for those with ED.- Testosterone and obesity: Low serum testosterone levels can contribute to the link between metabolic syndrome and ED. In men with obesity, the adipose tissue enzyme aromatase is more prevalent and can convert testosterone into estradiol to cause hypogonadism. Furthermore, adipocytes can cause inflammation and recruit inflammatory cytokines, leading to impaired endothelial function and ED. - Cardiovascular disease: ED and CVD have some common risk factors: older age, HTN, dyslipidemia, smoking, obesity, and DM. ED is related to an increased risk of CVD, CAD, and stroke. Usually, it is thought that ED arises two to five years prior to CAD. If a patient develops signs and symptoms of ED before CAD, the patient can be counseled and educated to make lifestyle modifications to prevent CAD.Furthermore, men with ED are more likely to experience angina, MI, stroke, TIA, CHF, and cardiac arrhythmias when compared to their counterparts without ED. A study from 2003 suggested that patients with ED have a 75% increased risk of developing peripheral vascular disease. Studies suggest ED can predict silent CAD, and one study concluded that the incidence of CAD in men below 40 years of age with ED was seven times higher than that of the control population without ED. It is important to diagnose ED because it can be used as a marker for assessing cardiovascular risk.ED can be linked to many causes, and we as clinicians should be able to identify those causes to prescribe a more specific treatment. Not all ED will respond to “the blue pill”. We will talk about treatment in another episode. Conclusion: Now we conclude episode number 115, “Erectile Dysfunction Diagnosis.” Male sexual health sometimes can be taboo, and patients may not fully disclose personal issues like erectile dysfunction. Andrew and Adrianna explained that an open discussion about erectile dysfunction can help you diagnose underlying conditions, including cardiovascular disease. Dr. Arreaza reminded us that the diagnosis of erectile dysfunction should prompt a deeper investigation in most cases before you attribute it to psychological factors. This week we thank Hector Arreaza, Andrew Kim, Adriana Rodriguez, and Fiona Axelsson. Audio edition by Adrianne Silva. Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! ___________________________________________________References:Burnett AL, Nehra A, Breau RH, et al. Erectile Dysfunction: AUA Guideline. Journal of Urology. 2018;200(3):633-641. doi:10.1016/j.juro.2018.05.004. https://www.auajournals.org/doi/epdf/10.1016/j.juro.2018.05.004.Rew KT, Heidelbaugh JJ. Erectile Dysfunction. American Family Physician. 2016;94(10):820-827. Accessed September 19, 2022. https://www.aafp.org/pubs/afp/issues/2016/1115/p820.html.Khera M. Evaluation of male sexual dysfunction. UpToDate. www.uptodate.com. Last updated: April 28, 2020. Accessed September 19, 2022. https://www.uptodate.com/contents/evaluation-of-male-sexual-dysfunction.Abrams H, Winter A, Williams PN, Watto MF. “#317 Erectile Dysfunction”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. January 24, 2022.Royalty-free music used for this episode: Gushito, Burn Flow. by Videvo, downloaded on May 06, 2022, from https://www.videvo.net/royalty-free-music-track/good-vibes-alt-mix/1017292/
The TWiP team solves the case of the Woman From Hawaii With Allodynia and abdominal pain, bilateral hip and leg pain, dizziness, and diffuse hyperesthesia. Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Use coupon code MicrobeTV when purchasing a spike t-shirt from Vaccinated.us Accidental host (TWiP 207) Hero: Dan Colley Letters read on TWiP 209 Become a patron of TWiP Case Study for TWiP 209 Man in his early 70s with PMH sig for HTN, DM-II, HLD, BPH is admitted to the hospital after coming from Guatemala to visit his son. He feels faint with standing and is noted to have a HR in the 40s and does not feel well when he stands. He is also noted to have diarrhea, but this has been going for an unclear period of time. On EKG he is noted to have a RBBB. PMH HTN, DM-II, HLD, BPH PSH neg Allergies NKADR Social -no toxic habits reported, reports living in Guatemala City but grew up in the rural areas. Enjoys fruit juice FH-noncontrib Exam: slow heart rate, orthostatic A number of blood and stool tests are collected and he is referred to a tertiary care center for implantation of a cardiac pacemaker. At the tertiary care center the patient is seen by an Infectious Disease Specialist and a number of tests are ordered by the Infectious Disease Consultant but they are canceled by Cardiologist who writes in their note “no concern for an infectious process”. Now one of the tests collected at the first hospital returns with an interesting result that is later confirmed by a second test. Send your case diagnosis, questions and comments to twip@microbe.tv
Do you want to raise your consciousness and vibrate at the highest level possible? Then do we have A Manual for Developing Humans, show for you! Today I'll be talking with P.M.H Atwater on being more fully aware, fully in touch with yourself, and being more fully human! Dr. PMH Atwater is a world-renowned experts on near death experiences, the brilliant author of more than 15 books including Dying to Know You and Beyond the Indigo Children, and the author of an amazing new handbook on life and consciousness, A Manual for Developing Humans. High Vibration Self-Improvement & Self-Help Topics Include: How is she 80 years young? What happened to her in 1977? What happened to PMH from her 3 near-death experiences Why you're automatically spiritual. What it means to be human, or how to be a human being? How to be more fully what and who you are? What is the brain-mind assembly? What's wrong with schools today? What's the importance of movement, music, and dance? What's the importance of using the body to learn? What's the importance of our emotions? Why part of Michael's mission is to help you find your nature? What's the importance of Nature? What is tree bathing and rock bathing? What's the importance of synchronicity and how to get in a state of flow? How to open yourself up the vibrations around you? What is dowsing? What does it mean to be in search mode? What can we learn from our brain wave states, and how to access higher levels? What it means to be in high alpha and high gamma at the same time What it means to be in a state of presence? What it means to write in presence? How are kids different today – and how are their brains different? What she learned from kids who've had a near death experience What's the importance of visualization? How do we claim our humanity? Why to be human means to be a “god in the making” How to set up our homes for the highest energy-levels possible How to keep yourself safe around your computer? Importance of amber and lepidolite What's the importance of lithium What to do in different rooms in our house? Visit: http://www.pmhatwater.com/ To find out more visit: https://amzn.to/3qULECz - Order Michael Sandler's book, "AWE, the Automatic Writing Experience" www.automaticwriting.com - Automatic Writing Experience Course www.inspirenationuniversity.com - Michael Sandler's School of Mystics https://inspirenationshow.com/ ……. Follow Michael and Jessica's exciting journey and get even more great tools, tips, and behind-the-scenes access. Go to https://www.patreon.com/inspirenation For free meditations, weekly tips, stories, and similar shows visit: https://inspirenationshow.com/ We've got NEW Merch! - https://teespring.com/stores/inspire-nation-store Follow Inspire Nation, and the lives of Michael and Jessica, on Instagram - https://www.instagram.com/InspireNationLive/ Find us on TikTok - https://www.tiktok.com/@inspirenationshow
Welcome to PICU Doc On Call, A Podcast Dedicated to Current and Aspiring Intensivists. I'm Pradip Kamat coming to you from Children's Healthcare of Atlanta/Emory University School of Medicine. Today we are joined by two wonderful clinical pharmacists — Whitney Moore & Stephanie Yasechko. Whitney is a Clinical Pharmacy Specialist at Children's Healthcare of Atlanta. She is on Twitter at @MoorephinRx. Stephanie is a Pediatric Lung Transplant Clinical Pharmacy Specialist at Cincinnati Children's Hospital Medical Center. We are so excited to have you both on today. My name is Rahul Damania and I am a Pediatric Intensivist at Cleveland Clinic Children's Hospital; Welcome to PICU Doc On Call where we focus on all things MED-ED in the PICU. Our podcast focuses on interesting PICU cases & management in the acute care pediatric setting so let's get into our episode: Welcome to our Episode an 18 yo immunocompromised patient with headache & sore throat Here's the case presented by Rahul: An 18-year-old female (40 kg) with PMH significant for fibrolamellar carcinoma of the liver, presents to the ED with headache and sore throat. She is febrile to 38.3, tachycardic, tachypneic, and has a WBC of 27K on her CBC. She is markedly hypotensive with BP on the arrival of 99/65. Cultures were drawn, the patient was given x1 doses of vancomycin and meropenem, and she was transported to the PICU for further workup and management. Due to her progressive hemodynamic instability, increased inflammatory markers, and marked immunocompromised state, the team is considering broadening her anti-microbial coverage. To summarize key elements from this case, this patient has: Fibrolamellar carcinoma of the liver A presentation of headache, sore throat, and hemodynamic instability with concern for sepsis A current regimen of just antibacterials, which brings up the consideration of adding anti-fungal coverage in her clinically ill state. Our episode today will be covering anti-fungal agents in the PICU. We will review general mycology, understand different classes of antifungals, and highlight practical clinical pearls in the acute care setting. As mentioned, this patient has risk factors for an immunocompromised state due to her underlying liver condition. As we dive deeper into antifungals, Whitney, can you please give us an overview of common fungal pathogens in the PICU? Before we discuss the major drugs, it's important that we take some time to briefly review the most common fungi we encounter clinically since it's hard to choose the right agent when you don't know exactly what you are treating. Clinically, Candida is probably the most common fungal pathogen encountered, especially in warm, moist environments. It is important to determine what type of species is growing. The three major species known to cause infection are C. albicans, C. glabrata, and C. krusei, but it is important to differentiate these species when identified since they have different resistance patterns. Cryptococcus is another type of fungus that is known to cause meningitis or fungemia, especially in immunocompromised or cirrhotic patients. Both Candida and Cryptococcus are classified as yeast on Gram stain. Treating cryptococcus will require the use of an agent that has good penetration to the CNS. Endemic fungi known as Coccidia, Histoplasma, and Blastomyces are known to cause disseminated infections in immunocompromised hosts; however, each fungus is associated with a different geographic region in the United States. With any type of infection, it is always very important to consider your patients' exposures and recent travel history. And finally, there are two major molds that have the potential to be pathogenic. The first is Aspergillus which is identified via hyphae (tall filaments) on Gram stain well known to cause invasive pulmonary infections in the immunocompromised, specifically those who are neutropenic and/or received a lung transplant.
Featuring perspectives from Dr Daniel DeAngelo, including the following topics: Introduction: Perspectives on chronic myeloid leukemia (CML) (0:00) Asciminib — ASC4FIRST study (8:33) Case: A woman in her early 60s with a PMH of Stage IA hormone receptor-positive breast cancer on adjuvant tamoxifen with newly diagnosed CML — Michael R Grunwald, MD (22:38) Case: A man in his mid 40s with low-risk CML who achieves MR4 on imatinib but loses molecular response 3 months after discontinuing therapy — Shams Bufalino, MD (27:23) Case: A man in his early 40s with CML on dasatinib who does not achieve treatment milestone (MR3) at 18 months but does at 24 months — Dr Grunwald (33:19) Case: A man in his early 80s with CML who initially receives imatinib followed by nilotinib develops CHF and has a BCR-ABL of 0.8% (IS) — Namrata I Peswani, MD (37:33) Case: A woman in her late 20s with CML that is resistant to multiple TKIs and therapy compliance concerns — Minesh Dinubhai Patel, MD (40:44) Case: A woman in her early 40s who initially receives dasatinib for chronic-phase CML with a good response but then develops lymphoid blast crisis — Dr Grunwald (52:17) Case: A woman in her mid 70s with CML who achieves MMR on nilotinib but then develops peripheral arterial occlusion after 9 years on therapy — Dr Grunwald (58:10) CME information and select publications
A relatively new vaccine for cattle from Merck Animal Health is combining both bacterial and viral protection in one intranasal dose, reducing the number of instances producers have to administer vaccines to each animal. Bovilis Nasalgen 3-PMH, simply called Nasalgen, has been on the market for roughly one year and combines three virals and two... Read More
P. M. H. Atwater, L.H.D. is one of the original researchers in the field of near-death studies, having begun her work in 1978. She has written fifteen books on her findings and is one of the top ranking experts internationally. Her most recent book is Dying to Know You: Proof of God in the Near-Death Experience. It is the people's book – a summation of the words of over 4,000 adult and child experiencers of near-death states – their experience, their truth, their wisdom. It consists of the collective, speaking as a collective, about the collective experience. No other book on the market is like it. None.In 2005, she was awarded the Outstanding Service Award from the International Association For Near-Death Studies (IANDS), and the Lifetime Achievement Award from the National Association of Transpersonal Hypnotherapists (NATH), as well as an honorary Ph.D. from a school in Sri Lanka. In 2010, she was also awarded the Nancy E. Bush Award for Literary Excellence and the Lifetime Achievement and Special Services Award, both from IANDS. She has presented her findings for many organizations and schools, including twice at the United Nations, and as a guest on such TV shows as Geraldo, Regis and Kathie Lee, Larry King Live, Sally Jessy Raphael, and Entertainment Tonight. Her books have been published in over 12 countries. Also a generational researcher, she has completed “Children of the Fifth World: A Guide to the Coming Changes in Human Consciousness (due out in Fall, 2012), “Beyond the Indigo Children," and “The New Children and Near-Death Experiences. Her story as an experiencer of near-death states - I Died Three Times in 1977 - The Complete Story - is available at Amazon.com. A prayer chaplin, visionary counselor, wife, mother, grandmother, her website is filled with many services and features, among them The Marketplace - where near-death experiencers and those like them can promote their products and services without any charge to them. Her monthly newsletters are free to those who sign up on www.pmhatwater.com.For Your Listening Pleasure all the radio shows available on The 'X' Zone Broadcast Network with our compliments, visit - https://www.spreaker.com/user/xzoneradiotv.Our radio shows archives and programming include: A Different Perspective with Kevin Randle; Alien Cosmic Expo Lecture Series; Alien Worlds Radio Show; America's Soul Doctor with Ken Unger; Back in Control Radio Show with Dr. David Hanscom, MD; Connecting with Coincidence with Dr. Bernard Beitman, MD; Dick Tracy; Dimension X; Exploring Tomorrow Radio Show; Flash Gordon; Imagine More Success Radio Show with Syndee Hendricks and Thomas Hydes; Jet Jungle Radio Show; Journey Into Space; Know the Name with Sharon Lynn Wyeth; Lux Radio Theatre - Classic Old Time Radio; Mission Evolution with Gwilda Wiyaka; Paranormal StakeOut with Larry Lawson; Ray Bradbury - Tales Of The Bizarre; Sci Fi Radio Show; Seek Reality with Roberta Grimes; Space Patrol; Stairway to Heaven with Gwilda Wiyaka; The 'X' Zone Radio Show with Rob McConnell; Two Good To Be True with Justina Marsh and Peter Marsh; and many other!That's The ‘X' Zone Broadcast Network Shows and Archives - https://www.spreaker.com/user/xzoneradiotv
P. M. H. Atwater, L.H.D. is one of the original researchers in the field of near-death studies, having begun her work in 1978. She has written fifteen books on her findings and is one of the top ranking experts internationally. Her most recent book is Dying to Know You: Proof of God in the Near-Death Experience. It is the people's book – a summation of the words of over 4,000 adult and child experiencers of near-death states – their experience, their truth, their wisdom. It consists of the collective, speaking as a collective, about the collective experience. No other book on the market is like it. None.In 2005, she was awarded the Outstanding Service Award from the International Association For Near-Death Studies (IANDS), and the Lifetime Achievement Award from the National Association of Transpersonal Hypnotherapists (NATH), as well as an honorary Ph.D. from a school in Sri Lanka. In 2010, she was also awarded the Nancy E. Bush Award for Literary Excellence and the Lifetime Achievement and Special Services Award, both from IANDS. She has presented her findings for many organizations and schools, including twice at the United Nations, and as a guest on such TV shows as Geraldo, Regis and Kathie Lee, Larry King Live, Sally Jessy Raphael, and Entertainment Tonight. Her books have been published in over 12 countries. Also a generational researcher, she has completed “Children of the Fifth World: A Guide to the Coming Changes in Human Consciousness (due out in Fall, 2012), “Beyond the Indigo Children," and “The New Children and Near-Death Experiences. Her story as an experiencer of near-death states - I Died Three Times in 1977 - The Complete Story - is available at Amazon.com. A prayer chaplin, visionary counselor, wife, mother, grandmother, her website is filled with many services and features, among them The Marketplace - where near-death experiencers and those like them can promote their products and services without any charge to them. Her monthly newsletters are free to those who sign up on www.pmhatwater.com.For Your Listening Pleasure all the radio shows available on The 'X' Zone Broadcast Network with our compliments, visit - https://www.spreaker.com/user/xzoneradiotv.Our radio shows archives and programming include: A Different Perspective with Kevin Randle; Alien Cosmic Expo Lecture Series; Alien Worlds Radio Show; America's Soul Doctor with Ken Unger; Back in Control Radio Show with Dr. David Hanscom, MD; Connecting with Coincidence with Dr. Bernard Beitman, MD; Dick Tracy; Dimension X; Exploring Tomorrow Radio Show; Flash Gordon; Imagine More Success Radio Show with Syndee Hendricks and Thomas Hydes; Jet Jungle Radio Show; Journey Into Space; Know the Name with Sharon Lynn Wyeth; Lux Radio Theatre - Classic Old Time Radio; Mission Evolution with Gwilda Wiyaka; Paranormal StakeOut with Larry Lawson; Ray Bradbury - Tales Of The Bizarre; Sci Fi Radio Show; Seek Reality with Roberta Grimes; Space Patrol; Stairway to Heaven with Gwilda Wiyaka; The 'X' Zone Radio Show with Rob McConnell; Two Good To Be True with Justina Marsh and Peter Marsh; and many other!That's The ‘X' Zone Broadcast Network Shows and Archives - https://www.spreaker.com/user/xzoneradiotv
Welcome to PICU Doc On Call, A Podcast Dedicated to Current and Aspiring Intensivists. I'm Pradip Kamat and I'm Rahul Damania. We are coming to you from Children's Healthcare of Atlanta - Emory University School of Medicine. Welcome to our Episode about a 14- year- old female who presented with hypotension after a suicide attempt. Here's the case: A 14 yo F with PMH of depression and oppositional defiant disorder presents with dizziness. Her mother states she was in her normal state of health when on the day of admission she noticed the patient to be dizzy, slurring speech, and pale. The mother became very concerned about the dizziness as the patient was stumbling and a few hours prior to presentation, became increasingly sleepy. The patient does have a history of depression and is controlled on sertraline. Other medications in the home include Metformin, Amlodipine, and Clonidine. The patient denies ingesting any substance. She does have a prior attempt two years prior, after an argument with her mother; however, her mother was able to “stop” her prior to the attempt. She presents to the ER via EMS. Her vital signs are notable for HR 50 bpm with occasional PACs and non-conducted QRS complexes on telemetry; BP of 75/40. A physical exam is notable for AMS and GCS of 10. She is noted to have clear breath sounds, with a cardiac exam notable for slowed and delayed pulses. Initial laboratory work is notable for serum glucose 180 mg/dL and B HCG negative. Initial resuscitation is begun with IV fluids and atropine. Serum acetaminophen and ASA levels are sent and upon stabilization, the patient presents to the PICU for admission. To summarize key elements from this case, this patient has: A history of depression with prior attempt An acute bout of altered mental status Bradycardia, hypotension, and hyperglycemia. All of which brings up a concern for an acute ingestion Let's take a step back and talk about the approach to ingestions in the PICU. What are key aspects to consider in the work-up of these patients? History and physical are key: Stratifying acute or chronic ingestions Baseline prescription medications a patient may be taking or have access to in the household Whether the ingestion involves a single drug or co-ingestants are all first steps in evaluating your patient. In an undifferentiated patient, management is paramount. Initial management is focused on pattern recognition and acute stabilization. A brief initial screening examination should be performed on all patients to identify immediate measures required to stabilize and prevent deterioration of the patient. Assess the airway, vital signs, mental status, pupil size, and skin temperature and moisture. These components of your physical exam should help allude to a toxidrome, and these syndromes are frequently tested on board examinations. Any time a patient has hypotension and bradycardia other drugs that should be considered include beta blockers, digoxin, clonidine, as well as ingestion of barbiturates, opioids, and even benzodiazepines. What are some diagnostic studies you will want to send immediately in a patient with suspected ingestion? Immediate diagnostic studies to be performed include pulse oximetry, continuous cardiac monitoring, an electrocardiogram (ECG), and a capillary glucose measurement (in altered patients). Intravenous (IV) access should be obtained in all cases of serious ingestion. You also want to send beta-hcg and acetaminophen and salicylate levels. an extended toxicology screen may be required on a case-by-case basis. One study found detectable serum acetaminophen concentrations in 9.6 percent of all overdose patients; almost one-third of this subset denied ingestion of acetaminophen. Now that you've focused on ABCs are there more detailed laboratory studies to send in patients with toxidromes? Symptomatic patients and those with an unreliable or unknown history should, at a minimum, undergo...
Perinatal Wellbeing - The Podcast about Prenatal, Pregnancy & Postpartum Health
Content Warning: Intrusive thoughts, birth trauma, postpartum depression, postpartum anxiety, OCD, postpartum OCD, intrusive thoughts/compulsions around sleep and food, challenges with nursing, rage, trauma, fear, NICU experience, some swearing Today is the 2nd part of my conversation with Lisette and Catherine from Together Waterloo. Together came out of a desire to increase the services available to families struggling with perinatal mental health in Waterloo Region. Their goal is to increase support systems, educate health care providers, and build a village so that no parent is left behind. In part 2 of this episode Catherine and Lisette share how they started Together Waterloo, advocating for more PMH supports, building a community of survivors and parents and how they're making shit happen in Waterloo! Lisette Weber is a postpartum doula, the Social Media Manager for The Climb for PSI and co-founder at Together Waterloo along with Catherine Mellinger an expressive arts therapist. They are both trained in Perinatal Mental Health and are making things happen in this space!Highlights:2:50 - Lack of supports, seeking support at our breaking point10:32 - Experiencing postpartum mental illness as a traumatic event 11:00 - Fear of another pregnancy11:58 – Grieving the Postpartum period13:45 - Lisette's experience with being diagnosed with a PMAD and having her second child with supports in place16:13 - NICU experience26:32 - The importance of being trained in Perinatal Mental Health36:51 - How Lisette and Catherine and providing supports and building community in Waterloo and making things happenResources: Togetherhttps://togetherwaterloo.ca/ @togetherwaterlooThe Climbhttps://togetherwaterloo.ca/cotd-waterloo/ @psiclimboutLisette https://postpartumsidekick.ca Instagram @postpartumsidekickCatherine https://catherinemellinger.com Instagram @catherine_mellingerReproductive Life stages Program at Women's College Hospital Torontohttps://www.womenscollegehospital.ca/care-programs/mental-health/rls/ You can find us at www.perinatalwellbeing.ca on Instagram @perinatalwellbeing_ontario or by email info@perinatalwellbeing.ca
This episode was recorded on 4/2/2021. Dear listener, we are almost at the end of season 1, and I cannot believe we are here!!! In today's episode, we are joined by Jacquette M. Timmons, a woman who focuses on the human side of money. Jacquette works as a financial behavioralist and is committed to getting you to see that you don't manage money. You manage your choices around money. In addition to being the author of Financial Intimacy: How to Create a Healthy Relationship with Your Money and Your Mate and frequent blogger, Jacquette is also the creator of Pricing Made Human®. PMH is designed to help entrepreneurs and small business owners tackle the question, what should I charge for this? From all sides, the financial, the emotional, the personal, so you can price more confidently, strategically, and end up with a thriving business and life. Join us as we talk about: Why we should continue to respect numbers but give as much attention to our behavior and our decisions. Why we must stay mindful of the systemic decisions that have been made for us. Pricing is indicative of so many different things: relationship with money, with ourselves, with business, and with people buying from you. How Jacquette found joy after two tough losses in her life, and how she continues to find peace. The existing relationship between money and social instances, and how we should learn to handle it. Some Joyful Tools Song: "His Eye Is on the Sparrow" Books: "Kindred" by Octavia E. Buttler (and any other titles she wrote!) Where can you find Jacquette: Website: jacquettetimmons.com Social Media: Instagram: @jacquettemtimmons Facebook: Financial Intimacy ❤️
Welcome to PICU Doc On Call, a podcast dedicated to current and aspiring intensivists. My name is Pradip Kamat. My name is Rahul Damania, a current 2nd-year pediatric critical care fellow. We come to you from Children's Healthcare of Atlanta-Emory University School of Medicine. Today's episode is dedicated to pediatric post-cardiac arrest care. We are going to split this topic into two episodes, part one of pediatric post-cardiac arrest syndrome will address the epidemiology, causes, and pathophysiology. I will turn it over to Rahul to start with our patient case... 11 yo previously healthy M who is admitted to the PICU after cardiac arrest. The patient was noted to be found unresponsive and submerged in a neighborhood pool. He was pulled out by bystanders and CPR was started for 5 minutes with two rounds of epinephrine prior to achieving ROSC. During transport to the OSH, the patient developed hypotension requiring a continuous epinephrine infusion. His initial blood gas was notable for a mixed respiratory and metabolic acidosis: 7.0/60/-20 His initial serum lactate was 6.8 mmol/L. He presents to the PICU with a temperature of 36.6, HR 130s, MAPs 50s on Epinephrine infusion at 0.03mcg/kg/min He is mechanically ventilated with notable settings PEEP of 10, FiO2 65%. The patient is taken to head CT which shows diffuse cerebral edema and diffusely diminished grey-white differentiation most pronounced in the basal ganglia. Great Rahul, can you please comment on his physical exam & PMH? Important physical exam findings include an unresponsive intubated patient with a cervical collar and bilateral non-reactive pupils at 4mm. The patient received mechanical ventilation with coarse breath sounds. A heart exam revealed tachycardia with no murmur or gallop. The patient does not respond to stimuli, intermittent jerking movements of arms and legs were observed. There was no evidence of rash or trauma. No past medical history of seizures or any heart disease. No home medications or toxic ingestions are suspected. So now he is transferred to the ICU, what did we do? An arterial line, central venous line, urinary catheter, esophageal temperature probe was placed. The patient was ventilated using a TV of 6cc/kg and a PEEP of 10 (FIO2 ~65%) to keep SPO2 >94%. The patient initially had runs of ventricular tachycardia for which lidocaine was used. Although the initial EKG showed mild QTc prolongation, it subsequently normalized and was considered to be due to his cardiac arrest and resuscitation. An echocardiogram revealed normal biventricular systolic function (on epinephrine) and also showed normal origins of the coronary arteries. Comprehensive Arrhythmia Panel did not identify a specific genetic cause for the patient's sudden cardiac arrest. The patient was placed on continuous EEG, which demonstrated severe diffuse encephalopathy with myoclonic status likely from anoxic brain injury Patient was also started on Levetiracetam and valproic acid. Initial portable CT scan done on day # of admission showed diffuse cerebral edema and diffusely diminished gray-white differentiation (most pronounced in the basal ganglia). MRI was deferred due to patient instability. The case we talked about highlights a patient who had a trigger that then resulted in cardiac arrest is common is one of the common reasons for admission to the PICU at Children's hospitals whether from submersion injury, trauma, ingestion, cardiac arrhythmia, sepsis, etc. Can we start by defining post-cardiac arrest syndrome? Successful resuscitation from cardiac arrest results in a post-cardiac arrest syndrome, which can evolve in the days to weeks after the return of spontaneous circulation. The components of post-cardiac arrest syndrome are brain injury, myocardial dysfunction, systemic ischemia/reperfusion response, and persistent precipitating pathophysiology. Prior to 2008, the AHA pediatric advanced life support (PALS) guidelines...
The Transformational Power of NDEs with PMH Atwater “Near Death Experiences (NDEs), like any spiritually significant experience, have tremendous potential to transform our lives.” -- Dr. Amy Robbins Episode Summary: Focused on Near Death Experiences (NDEs) since the 1980's, PMH Atwater asserts that the near death phenomenon is not an anomaly, but rather part of a larger genre of transformations of consciousness. She has combined her experiences in the 1960's and 70's - experimenting with altered states of consciousness, mysticism, psychic phenomena – with her NDE investigation. Her books, A Manual for Developing Humans, and Forever Angels are out now. Topics We Discuss: [3:32] PMH Atwater's three near death experiences within three months at age 39. What she calls “the heavenly sledgehammer effect”. [5:59] The metaphysical abilities PMH experienced in childhood. What it was like living as a differently-able child during WWII years. [9:40] Hearing a voice during her third NDE, telling her to write three books. [12:20] PMH Atwater observes NDE changes how an individual interacts with the world. [17:30] How to help kids live with their experience after an NDE. [24:55] PMH Atwater answers Amy's speed round questions: - Spirituality means…? What is something most people don't know about you? - What is one thing you're looking forward to? - What are you grateful for right now? - What book is on your nightstand? - What is your favorite healing practice? - What is the most transformative experience of your life? FOLLOW PMH Atwater You can find her writings wherever books are sold. You can follow her here: Website SUPPORT DR. AMY ROBBINS: If you're enjoying the podcast and finding value in guest interviews, ghost stories, and the content I share, please consider supporting the show by becoming a Patreon member for as little as $5 a month at Patreon.com/DrAmyRobbins As a member you'll get more say in the content we cover and exclusive access to behind-the-scenes goodness! Stay Connected with Dr. Amy Robbins: Instagram YouTube Fireside Website Facebook
Originally Aired: 07/07/06FOLLOW US ON:Facebook: https://goo.gl/rwvBfwInstagram: https://www.instagram.com/ozarkmtpubTwitter: https://goo.gl/LunK5DWebsite: https://goo.gl/2d5cX4ASSOCIATED LINKS:Ozark Mountain Publishing, Inc.: https://goo.gl/xhgoAPQuantum Healing Hypnosis Academy: https://goo.gl/64G7RD
The Women's Health, Wisdom, and... WINE! podcast is a weekly conversation with practitioners, providers, patients & healers about complex reproductive medicine & women's health challenges, the value of an integrative approach to these challenges, many of the women's health topics you're already thinking about & uncomfortable talking about & my personal favorite... WINE!Perinatal mental health (PMH) conditions are those which occur during pregnancy or in the first year following the birth of a child. Perinatal mental illness affects up to 20% of new and expectant mothers and covers a wide range of conditions.If left untreated, mental health issues can have significant and long-lasting effects on the woman, the child, and the wider family. Specialized PMH services provide care and treatment for women with complex mental health needs and support the developing relationship between parent and baby. They also offer women with mental health needs advice for planning a pregnancy.About Shivonne:Shivonne is passionate about helping improve the mental health of women, helping promote women's empowerment, and mental health awareness. She provides counseling services to women and girls aged 16 years- adult. In addition to cognitive behavioral therapy and person- centered theoretical orientation, Shivonne also uses solution-focused and interpersonal therapy. Her specialization? Maternal mental health counseling for mothers and mothers with perinatal disorders (Postpartum depression, fertility issues, miscarriage, and postpartum anxiety).Resources Mentioned:Therapy for Black GirlsConnect with Shivonne:Akoma Counseling ConceptsFacebook: Akoma Counseling Concepts, LLCTwitter: @DCTherapistInstagram: @akoma_counselingThe hashtag for the podcast is #nourishyourflourish. You can also find our practice on the following social media outlets:Facebook: The Eudaimonia CenterInstagram: theeudaimoniacenterTwitter: eu_daimonismFor more reproductive medicine and women's health information and other valuable resources, make sure to visit our website.Have a question, comment, guest suggestion, or want to share your story? Email us at info@laurenawhite.com.
Labor Pains: Dealing with infertility and loss during pregnancy or infancy.
Dr. Erica Rozmid is a Clinical Psychologist specializing in evidenced based treatment, including CBT and DBT. After her own heartbreaking story of learning that her very wanted baby, Shayla, had brain abnormalities and was not developing properly in utero, Erica made the decision to terminate her pregnancy for medical reasons. She was disappointed by the lack of mental health resources and support she found during her own healing journey. Erica left her research position at UCLA and opened a private practice, with a portion of her practice dedicated to helping families who terminate for medical reasons, TFMR. She is in the process of gaining PMH certification through PSI and creating a therapist directory and TFMR therapy. In the future, she plans to have therapy training for TFMR therapists and an online course for those who are not yet ready for therapy. See more of Erica's story here: https://www.tfmrpsychologist.com/tfmr Connect with Erica: Instagram: TFMRpsychologist Website: TFMRpsychologist.com Connect with me: EMAIL teresa.womenconnect2019@gmail.com or teresa.livingaftergrief.com Facebook https://www.facebook.com/.womenconnectsupport/. and https://www.facebook.com/.livingaftergrief/. Instagram: @womenconnectandsupport or @livingaftergrief Website: www.livingaftergrief.com click and schedule a time to chat
The Psychic and The Doc with Mark Anthony and Dr. Pat Baccili
As a woman in Near Death Studies and in a male dominated field, PMH discusses the hurdles to advance her work. She has conducted nearly 5,000 case studies of children as well as adults having a near death expeirnce. PMH has written 18 books and continues to share in her research.
The Psychic and The Doc - Your Practical Paranormal Power Unleashed
As a woman in Near Death Studies and in a male dominated field, PMH discusses the hurdles to advance her work. She has conducted nearly 5,000 case studies of children as well as adults having a near death expeirnce. PMH has written 18 books and continues to share in her research.
The Psychic and The Doc with Mark Anthony and Dr. Pat Baccili
As a woman in Near Death Studies and in a male dominated field, PMH discusses the hurdles to advance her work. She has conducted nearly 5,000 case studies of children as well as adults having a near death expeirnce. PMH has written 18 books and continues to share in her research.
The Psychic and The Doc - Your Practical Paranormal Power Unleashed
As a woman in Near Death Studies and in a male dominated field, PMH discusses the hurdles to advance her work. She has conducted nearly 5,000 case studies of children as well as adults having a near death expeirnce. PMH has written 18 books and continues to share in her research.
I love my job but rule number 64 is so important as a person, father and husband. I also discuss the importance of listening and paying attention to the PMH and HPI and why a chest x ray is a good idea on that child who had Pneumonia so many times
Hannah and Tia discuss how we use the terms mental health and mental ill-health. Our guest Alana, shares her experience with perinatal health. Suggested links and contacts https://perinatalmhpartnership.com/ https://maternalmentalhealthalliance.org/news/maternal-mental-health-awareness-week-2021/ Up-to-date figures on Maternal Services - https://maternalmentalhealthalliance.org/wp-content/uploads/170820-UK-specialist-PMH-map.pdf The Letters of Light Project - https://lettersoflightproject.com/what-is-a-letter-of-light/ See acast.com/privacy for privacy and opt-out information.
El ayuntamiento de Londres crea una aplicación de diseño de viviendas prefabricadas Contexto Como en otras grandes ciudades europeas, Londres tiene un grave problema de falta de viviendas. Estiman que necesitan construir entre 50.000 y 65.000 viviendas al año.El ayuntamiento quiere apostar por la prefabricación para acelerar la construcción de viviendas. Londres no podrá aumentar significativamente los indices de construcción de viviendas si se basa únicamente en los métodos tradicionales de construcción. El ayuntamiento está comprometido a apoyar y promover la modernización de la industria de la construcción de Londres a través de la entrega de casas prefabricadas de mayor precisión (PMH). https://www.london.gov.uk/decisions/add2206-precision-manufactured-housing-london Según el ayuntamiento, la falta de estandarización y diseños optimizamos para la prefabricación, son el principal obstaculo para la adopción de esta tecnología.Encargaron el desarrollo de una aplicación que incorporara los estándares de diseño de viviendas de Londres y las reglas de fabricación para que las organizaciones pudieran diseñar rápidamente soluciones de viviendas prefabricadas que estuvieran optimizadas. La aplicación Se llama PRISM, es gratuita y de código abierto. https://www.prism-app.io/Está desarrollada por https://www.brydenwood.co.uk/, una empresa de arquitectura e ingeniería famosa por sus desarrollos propios (tienen un software parecido pero para diseño de colegios).Costó 165.000€, de los cuales el ayuntamiento puso 60.000€ y empresas privadas del sector interesadas 105.000€.Tiene una interfaz web (no hay que instalar nada). Y funciona así:Dibujamos el contorno de un edificio en un mapa, introducimos información como el número deseado de viviendas de diferentes tamaños, la altura de piso a techo, etc. Con esos datos, el software crea un edificio en 3D con con una distribución de viviendas y estancias que cumplen la normativa pero también optimizadas para métodos de prefabricación. Por ejemplo, estandarizando los tamaños de las habitaciones y alineando los tabiques panelizados.Finalmente podemos hacer modificaciones de forma manual. https://www.youtube.com/watch?v=nr2pwU7TlXc https://www.youtube.com/watch?v=-ABA4dDts3g El gobierno vasco saca una licitación para un proyecto piloto en BIM VISESA: sociedad pública dependiente de Gobierno Vasco para la promoción de vivienda de protección pública y de rehabilitación/renovación urbana.98 viviendas sociales en Barakaldo, Bizkaia.Redacción del proyecto y dirección facultativa, utilizando metodología BIM.530.000 € +IVA.Web de la licitación Pliego Análisis del EIR 12 páginas.Se podrá usar cualquier tipo de software siempre que sea compatible con IFC 2x3.Las recomendaciones de hardware son una captura de pantalla de los requisitos de Revit.Los modelos se piden en formato nativo y en IFC 2x3. Los planos en DWG.Se dan recomendaciones muy generales de nomenclaturas de archivos y objetos BIM. Se adjunta una matriz de LODs por fases de obra, pero sólo como ejemplo.Si se establecen los elementos que NO son necesarios modelar (soportes de conductos, cables, armaduras, tornillos, etc).Se da un listado de estándares internacionales como referencia pero no obligatorios.Se define bastante bien el proceso de coordinación de interferencias, incluso estableciendo los grupos de elementos que se deben comprobar. Se habla del CDE y del esquema WIP-Compartido-Publicado-Archivado. El CDE lo paga el proyectista. Conclusión En muchas partes más que un EIR parece una guía de cómo hacer un BEP. Hay muchas cosas que no se definen, sino que se dan ejemplos o propuestas, y algunas afectan directamente a los honorarios.Se dice que el responsable de entregar el as-built es la dirección facultativa, pero también que: "el equipo de obra tendrá capacidades BIM, y será el encargado de mantener un modelo así construido en evolución junto con los avances o cambios en el proyecto".En general es una licitación correcta aunque incompleta (por ejemplo en tema de usos, que los menciona por encima), pero se entiende que al ser una experiencia piloto el espíritu es "pedir en general" para ver hasta dónde llega el BIM. El problema es que los licitadores van a ir con el espíritu de "hago lo mínimo de BIM para cumplir". ¿Quieres que responda a tus preguntas en el podcast? Envíamelas en la sección de contactar. ¿Quieres escuchar otro episodio? Los tienes todos en la sección de Podcast de esta web.
In the first episode of Season Four, host Catherine Briley takes a chance on discussing Murphy v. NCAA, the Supreme Court's decision holding a federal ban on legalized sports betting unconstitutional, and its potential effects on Louisiana with Paul West, a professor of Gaming Law at PMH. She also checks in with MJ Hernandez, the new Editor in Chief of the Louisiana Law Review to discuss his goals for Volume 79. Music Credit: the most excellent Professor Wendell Holmes and the Holmes Family Band.
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