Podcasts about PRN

PRN is reporting live from Spire Motorsports, chatting with their drivers and crew chiefs at the halfway point in the season. Andrew Kurland and Brad Gillie talk to NASCAR Cup drivers Carson Hocevar and Michael McDowell, along with the brilliant minds in their crew chief staff. It gets off the rails, and you won't want to miss this one. 

A guide to diagnosing, imaging, and managing acute renal colic and nephrolithiasis in the ED. Hosts: Brian Gilberti, MD Avir Mitra, MD https://media.blubrry.com/coreem/content.blubrry.com/coreem/Nephrolithiasis.mp3 Download Leave a Comment Tags: Kidney Stones, Urology Show Notes 1. CLINICAL CORE & PHYSIOLOGIC FRAMEWORK Epidemiologic Risk Profiles Lifetime incidence parameters hover around 1 in 11, presenting with a prominent male sex skew. Peak demographic manifestation concentrated within the 30–60 age band. High-yield temporal parameter: 50% recurrence vector within a 5-year post-initial-insult window. Mineralogical Composition Vectors Calcium oxalate crystals represent the predominant structural matrix. Struvite configurations (magnesium ammonium phosphate matrix) account for 1–2% of cohorts. Struvite stones function explicitly as infection-driven configurations secondary to upper tract proliferation; higher distribution index noted in female cohorts. Etiological & Modifiable Relational Dynamics Profound systemic dehydration or low baseline fluid throughput states. High-sodium diet structures and heavy animal-protein consumption loads. Positive genetic/familial history variables. Relative risk modulation: Each variable independently operates to expand baseline risk by a factor of 2x to 3x. Pathophysiologic Symptom Complexes Acute, sudden-onset, maximum-intensity (10/10) unilateral flank pain. Classic structural radiation vector tracking downward toward the ipsilateral groin/genitourinary dermatomes. Distinctive behavioral marker: Renal colic pacing/writhing behavior with zero antalgic position availability. Concomitant autonomic triggers: Nausea and emesis manifest in 50% of acute presentations. Physical Exam Discordance Metrics Severe subjective distress contrasted with a characteristically soft, completely non-tender abdominal palpation exam. CVA tenderness is completely variable and lacks reliable negative predictive value. Atypical Presentation Classifications Vague, poorly localized abdominal pain presentations occurring in up to 20% of active cases. Isolated lower urinary tract irritative signs including acute frequency or severe urgency. Incidental & Asymptomatic Dynamics Silent intrarenal or ureteral stones found incidentally. Longitudinal tracking demonstrates up to 33.3% of initially asymptomatic cohorts convert to fully symptomatic renal colic within a multi-year tracking window. 2. EXCLUSION DIAGNOSES & CRITICAL PATHWAY RED FLAGS Vascular Mimics: AAA rupture/expansion. This is a mandatory exclusion pathway in elderly cohorts presenting with acute flank or back pain. Physical tracking requires active exploration for an expansile, pulsatile abdominal mass. Gynecologic Emergencies: Ruptured ectopic pregnancy. Demands universal screening protocols via rapid beta-hCG testing in all female patients of childbearing potential presenting with lower abdominal/pelvic localization. Infectious Upper Tract Decompensation: Acute uncomplicated pyelonephritis. Differentiated via persistent high spikes, high fevers, systemic shaking chills, and profound pyuria. Genitourinary Structural Crises: Acute testicular torsion. Mandates a thorough, explicit scrotal/testicular structural exam if the flank pain radiates into the scrotum. Gastrointestinal and Adnexal Torsional Confounds: Acute appendicitis variants, acute mesenteric/bowel ischemia, and ovarian torsion syndromes. 3. LABORATORY TESTING & PHYSIOLOGIC EVALUATION Urinalysis Interpretation Nuances Microscopic or gross hematuria presents in approximately 66% to 90% of acute cases. Critical Pathological Caveat: Complete absence of hematuria documented in 20% to 33.3% of confirmed, acute obstructing ureteral stones. Diagnostic rule: A pristine urinalysis with zero red blood cells is entirely insufficient to exclude acute ureterolithiasis. Urinary pH as a Composition Clue Consistently low urinary pH parameters (pH < 5.5) point strongly toward a uric acid crystalline composition. Elevated urinary pH parameters (pH > 7.5) indicate the presence of urease-producing microbial pathogens, pointing toward a struvite infection stone. Infectious Screening Metrics Active tracking for marked pyuria, positive leukocyte esterase, and bacterial nitrites to rule out an obstructed, infected upper urinary tract system. BMP Immediate quantification of baseline serum creatinine to establish accurate eGFR values. Targeting detection of post-renal AKI from bilateral obstruction, unilateral obstruction in a single functioning kidney, or severe volume depletion. CBC Evaluation for marked leukocytosis. Physiologic Nuance: Mild-to-moderate white blood cell count elevations frequently represent non-specific stress demargination driven by severe pain and repetitive vomiting. High-grade white blood cell shifts demand immediate exclusion of systemic bacteremia or an infected, obstructed urinary system. Adjunctive Lab Pathways Rapid qualitative urine hCG testing. Reflex urine culture execution whenever urinalysis metrics display significant inflammatory profiles or clinical suspicion of UTI is high. 4. IMAGING MODALITIES & ALGORITHMIC CLINICAL SELECTION Non-Contrast CT Diagnostics Gold standard; diagnostic sensitivity and specificity parameters exceed 95% for stones >2 mm. Provides precise quantification of stone diameter (mm), exact localization (proximal, mid, or distal ureter), and degree of secondary hydronephrosis. Excellent structural visualization for detecting or ruling out alternate retroperitoneal, vascular, or intra-abdominal pathologies. Contrast-Enhanced CT Protocols Indicated when alternative intra-abdominal surgical pathology is highly suspected over isolated renal colic. Retains diagnostic capability to identify urinary tract stones >3 mm even within contrast-enhanced phases. NCCT Structural Architecture Limitations Standard stone protocol CT scans are executed in a prone position without IV contrast enhancement. It does not opacify the ureteral lumen. Presents a cumulative radiation exposure penalty when utilized serially across recurrent ED presentations. POCUS / Radiology Ultrasound Direct stone visualization capabilities are modest, operating at approximately 50% to 60% sensitivity, and is highly dependent on anatomical positioning at the extreme proximal ureter or the UVJ. Secondary obstruction tracking: Demonstration of hydronephrosis operates at a high sensitivity of approximately 80%. POCUS Clinical Utility Metrics Eliminates ionizing radiation exposure and allows immediate, rapid real-time execution directly at the patient’s bedside. Confirmation of significant hydronephrosis within a classic clinical presentation yields high post-test probability for stone presence while lowering suspicion for vascular catastrophes like a AAA. KUB Radiography Extremely poor overall diagnostic sensitivity, hovering around 57%. Fails to image radiolucent configurations (pure uric acid matrices) or small stones measuring

mbincangkan pendekatan unik syarikat tersebut dalam menghadapi tekanan kos hidup dan cabaran industri makanan. Mamee mengambil pendirian berbeza daripada kebiasaan pasaran dengan mengekalkan harga, tidak mengecilkan saiz produk, malah memberikan lebih nilai kepada pengguna melalui penambahan kandungan dalam produk terpilih seperti Mister Potato, Corntoz, Double Decker dan rangkaian mi Mamee.Dalam segmen seterusnya, episod ini meneliti perkembangan politik di Johor susulan pembubaran Dewan Undangan Negeri pada 1 Jun 2026 oleh Menteri Besar, Dato' Onn Hafiz Ghazi, yang membuka laluan kepada Pilihan Raya Negeri Johor Ke-16 dalam tempoh 60 hari. Perbincangan menilai implikasi langkah tersebut terhadap landskap politik negeri serta kesiapsiagaan parti-parti utama dalam menghadapi PRN kali ini.Akhir sekali, episod ini turut mengupas situasi di Negeri Sembilan berikutan pembubaran DUN pada 4 Jun 2026 oleh Menteri Besar, Datuk Seri Aminuddin Harun. Pengumuman yang dibuat pada lewat malam itu turut mencetuskan pelbagai spekulasi kerana ia berlaku hampir dengan perkembangan penting institusi adat negeri. PRN Negeri Sembilan kali ini bukan sahaja tertumpu kepada persaingan politik, tetapi turut berlangsung dalam suasana yang melibatkan sensitiviti perlembagaan dan institusi tradisi negeri.

Denny Hamlin as the top of his game, as he claims career victory number 63 at Michigan. David Styles for PRN's Garage Pass

This week Beyond The Gates has been good but like maddening and I'm both glad and ready for Bill to reap the consequences of letting Hayley destroy what was left of his marriage. For books The Paris Match by Kate Clayborn ended well and I'm glad I got to read it, Mate by Ali Hazelwood was a good return to her PRN world and Ruger by Rose Dior was sadly no good. Some Summer House thoughts too just to round out the week

Denny Hamlin finally captures a victory at Nashville Superspeedway for career win number 62. David Styles reports with a victory lane interview from PRN's Wendy Venturini.

Ryan Blaney picked his first win of the season last year at Nashville Superspeedway. We asked him what he remembers most about the victory. David Styles for PRN's Garage Pass 

PRN's Doug Rice joins Bo and Beth to talk about the tragic and sudden passing of NASCAR star Kyle Busch.See omnystudio.com/listener for privacy information.

Pengumuman BN Johor bertanding solo di PRN, Pengambilalihan Parti BERSAMA oleh Rafizi dan Nik Nazmi, Perbincangan BUDI95 untuk golongan T20.---------------Sembang KS ialah sebuah talk show di mana Zaidel akan berkongsi ringkasan berita semasa sebelum menyelami sesuatu isu dengan lebih mendalam.Topik yang dibincangkan merangkumi pelbagai bidang seperti sosial, politik, teknologi dan hiburan, disampaikan dengan gaya yang tajam, santai serta diperkaya dengan analogi yang pantas dan bersahaja.Misi kami adalah untuk memberi pencerahan dan kefahaman tentang isu-isu penting, sesuai ditonton sepanjang perjalanan dalam kesesakan lalu lintas waktu puncak di Malaysia.

Brad Byrd, the voice of the Topless Outlaw Dirt Late Model Racing Series; Luke Morey, Princeton Speedway and Beckley Motor Speedway DSLM winner; and David Styles, PRN's Garage Pass co-host; and are this week's guests.

Ross Chastain sits down with Andrew Kurland and Brad Gillie to look back at his major win in the Coke 600 at Charlotte last season. NASCAR returns to CMS this Sunday for the Coca-Cola 600. You can listen to it live on PRN!

Denny Hamlin wins three in a row at Dover Motor Speedway and takes home the $1 Million dollars and the Silver Miles the Monster Trophy. PRN's David Styles reports on today's Garage Pass

Cherene Caraco is the Founder, Chief Executive Officer, and Global Strategist of Promise Resource Network, or PRN. PRN is a community organization based in Mecklenburg County NC  that proudly declares they are Survivor Led, Recovery Focused, and Wellness Driven. Members of the PRN community use their lived experience to serve others who have either been kicked out or opted out of traditional mental health and substance use treatments.   Cherene herself has been involved in mental health services for over 33 years, both professionally and personally. She recently spoke at the SMART Recovery conference about her experience as a radical leader and her thoughts about working in the recovery field. In this podcast she expands upon the themes of living and working according to one's values, speaking truth to power, and building resilience in the midst of trauma.

The ASX 200 fell another 40 points to 8630 (0.5%) as the banks came under intense pressure following the budget last night. Adding to the bank woes was the update from CBA, which shocked the market as bad debts rose and growth was sadly lacking. CBA fell an astonishing 10.4%, with the other three banks also falling hard on changes to housing policy in the budget. The CBA fall accounted for around 85 index points. The Big Bank Basket fell hard to $260.67 (-7.1%) as the Big Resource Basket soared 2.2%, overtaking the banks. BHP led resource stocks higher, hitting another record high, up 2.9%, and claiming the mantle back from CBA as the 'big Australian'. RIO also had a good day on the back of near-record highs in copper, with FMG also putting on the ritz. Given the fall in CBA, the index elsewhere had a good day.The gold miners were in demand, although bullion was relatively stable. EVN up 0.6%, and NST up 1.0%. Lithium stocks had a small break today, with PLS easing back 0.9%, as did LTR, but rare earth stocks were back in demand, with LYC up a further 2.0%. Energy stocks were mixed, with WDS up 0.4% and STO having a good day, up 1.6%, but uranium stocks eased back, with PDN falling hard on results. Coal stocks firmed.Industrials generally rose post-budget, with the REITs doing well. GMG up 1.4%, WES finding a base, up 0.4%, and even retail stocks looking a little firmer, JBH up 2.0%. One of the big winners was in the gaming space, with ALL updating the market with some latest numbers and rallying strongly, up 13.3%. Technology stocks were also in demand today. XRO rose after announcing some AI integration progress, although WTC was still on the nose. Healthcare stocks were also slightly better today, with CSL up 0.2% and RMD having a good day for a change, up 2.0%. Financials ex the banking sector were also firm, with AMP up 1.7% and GQG having a very good day, up 4.8%.In corporate news, CSL signed a flu vaccine deal in South America, PRN also doing well up 8.4%, after being awarded a mining contract, and TPW fell again after guidance was cut. In other news, WTC fell slightly after DSV confirmed it will transition away from cargo-wise and on to an in-house solution. ALL was a huge winner on a first half beat.Asian markets better with Japan up 1.2%, China up 0.5% and HK down 0.2%; The Kospi back up 2.4%US futures modestly higher, Dow futures down 2, Nasdaq up 149. European futures opening slightly higher. US PPI tonight.—Marcus Today – Daily Market InsightsMarcus Today provides clear, practical commentary for self-directed investors – covering markets, portfolios, education, and decision-making without the noise.If you'd like to go further:Start a free 14-day trial of Marcus Todayhttp://bit.ly/mt-trial-podcastJoin Marcus TodayUse code MTPODCAST for 10% offhttp://bit.ly/mt-join-podcast-offerMT20 – Managed ETF PortfolioA professionally managed portfolio run by Marcus Padley and the team, using ASX-listed ETFs with active market timing.http://bit.ly/mt20-podcastPrinciples – How We Think About InvestingA short video series on timing, behaviour, and decision-making. No stock tips.http://bit.ly/mt-principles-podcast—DisclaimerThis podcast is general information only and does not consider your personal circumstances. It is not personal financial advice.

Send us Fan MailDr. Brandon Tucker and Dr. Jenelle Ferry share two studies tackling some of the most pressing challenges in the care of extremely low birth weight infants. Dr. Tucker presents a quality improvement initiative examining whether switching from PRN glycerin suppositories to scheduled glycerin enemas every 12 hours reduces feeding intolerance and spontaneous intestinal perforation in babies under 1,000 grams — with early results trending in the right direction. Dr. Ferry then shares findings from a meta-analysis of 14 studies and nearly 4,700 babies showing that an exclusive human milk diet is associated with a roughly 20% reduction in the odds of death — a finding that reached statistical significance when RCTs and observational cohorts were pooled together, and one that carries real weight for units still weighing the evidence on human milk-based nutrition.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

If you've ever said “We'll just set up a walking blood bank when we need it,” this episode will make you rethink everything. Dennis and Andrew Fisher drop straight fire on how to actually build, stock, train, and run a real walking blood bank on a FOB, Firebase, or any austere base — not just theory, but the exact steps special operators and conventional medics are using right now to save lives when the next mass casualty hits.No fluff. No “somebody else will handle it.” Just battle-tested, practical guidance on turning your team (and the units around you) into a living blood bank that can deliver fresh whole blood in under 30 minutes.Key Takeaways You Can Use TomorrowPre-type every donor (especially O's) and keep the roster with key leaders and medics — Medpros + secondary confirmation beats dog tags every time.Distribute kits across the team so one casualty doesn't wipe out all your supplies.Practice full collections with non-medics — they can (and will) be your force multipliers.Have donor questionnaires filled out in advance for anyone outside your unit; do Eldon cards in calm conditions, never under fire.Plan for 20–30 minutes from alert to transfusion — that window dictates how long you have to bridge with other resuscitation tools.Principles over perfection: good stick + patent line + practiced team beats fancy equipment every single time.Chapters00:00 – Welcome & Why Most Walking Blood Banks Stay TheoreticalThe dangerous gap between “we have a plan” and actually practicing it.02:30 – Preferred Blood & ABO Typing Your Entire ForceLow-titer O whole blood, Medpros screening, lab vs. Eldon cards, and why you double-type.08:45 – Eldon Cards: When They Work (and When They Don't)Calm pre-mission testing vs. chaos — real talk on reliability.13:20 – Supplies & Logistics: Bags, Kits, Refrigeration & Cold ChainFenwal vs. Terumo, how many kits to order, and smart storage hacks.19:10 – Point-of-Injury Kits & Load DistributionWhat medics carry, what teammates carry under plates, and spreading risk.24:40 – IV Technique, Saline Locks & Point-of-Care TestingWhy 18-gauge + PRN adapter wins, donor screening, and host-nation considerations.31:15 – Donor Questionnaires & Pre-ScreeningWhen to use them, multilingual options, and why you do this before the fight.35:50 – Selling It to Commanders & Multi-Unit CoordinationRisk-benefit talk that actually works: mutual support, 100+ years of history, and 10,000+ units transfused.41:20 – Real Timelines: 20–30 Minutes from Call to TransfusionTraining goals, the 15-minute bag-fill rule, and why practice beats classroom speed.47:30 – Closing Principles & Final ThoughtsForce multiplication, non-medics stepping up, and adapting under pressure.Whether you're ODA, Ranger, conventional, or just preparing for the next deployment — this is the episode that turns “we should do a walking blood bank” into “here's exactly how we're doing it.”For more content, go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care⁠

Petua dan tips beli rumah, isu tangguh PRN dan artis yang sombong?---------------Sembang KS ialah sebuah talk show di mana Zaidel akan berkongsi ringkasan berita semasa sebelum menyelami sesuatu isu dengan lebih mendalam.Topik yang dibincangkan merangkumi pelbagai bidang seperti sosial, politik, teknologi dan hiburan, disampaikan dengan gaya yang tajam, santai serta diperkaya dengan analogi yang pantas dan bersahaja.Misi kami adalah untuk memberi pencerahan dan kefahaman tentang isu-isu penting, sesuai ditonton sepanjang perjalanan dalam kesesakan lalu lintas waktu puncak di Malaysia.

Episod 195 Keluar Sekejap membincangkan kesan ketegangan perang Iran–AS terhadap ekonomi Malaysia serta global, khususnya implikasinya kepada Malaysia dari sudut harga minyak, perdagangan dan kestabilan pasaran.Seterusnya, tumpuan diberikan kepada langkah UMNO melalui gagasan Rumah Bangsa, termasuk keputusan menerima semula bekas ahli tanpa syarat. Adakah ini strategi penyatuan yang mampu menguatkan parti, atau sekadar langkah survival politik?Turut dibincangkan adalah spekulasi mengenai kemungkinan penangguhan PRN — sejauh mana ia realistik, dan apakah implikasinya terhadap landskap politik serta persepsi rakyat.Akhir sekali, episod ini menyentuh tentang pemerkasaan perusahaan kecil dan sederhana (PKS) dalam suasana ketidaktentuan ekonomi global. 00:00:00 Pengenalan00:02:07 Kesan Perang Iran-AS Kepada Malaysia00:18:52 Pemerkasaan PKS00:28:49 Pergolakan Politik di Perlis & Negeri Sembilan00:30:40 UMNO & Rumah Bangsa00:43:52 Pencaturan Untuk PRN dan PRU00:54:45 Tangguh PRN?CTOS SME Biz Day 2026 merupakan acara perniagaan tahunan utama yang menghimpunkan pembuat keputusan, usahawan dan peneraju industri untuk membincangkan cabaran utama PKS, termasuk akses kepada pembiayaan, pertumbuhan dan kelestarian perniagaan serta transformasi digital.Dapatkan tiket SME Biz Day 2026 sekarang:- Petaling Jaya (9 June 2026): https://www.ticketmelon.com/ctos/smebizday2026pj?aff1=pjbiz26ks- Penang (28 July 2026): https://www.ticketmelon.com/ctos/smebizday2026pg?aff1=pgbiz26ks- Johor Bahru (8 September 2026): https://www.ticketmelon.com/ctos/smebizday2026jhb?aff1=jbbiz26ks

What if the job you loved stopped feeling like you? For so many therapists, the passion that drove them into the field gets buried under productivity requirements and a lack of autonomy. Today's guest knows that feeling well and she did something about it. I'm so excited to share her story!I'm sitting down with Sarah Wilson, a speech-language pathologist and graduate of my Start Your Private Practice Program. Sarah is the owner and founder of Enrichment Therapy Services, based in Scranton, Pennsylvania.Sarah earned her Master's degree from Misericordia University in 2013 and spent the next ten years working primarily in skilled nursing facilities before launching her private practice in 2023. Her clinical passions are diverse: she specializes in speech sound disorders and neurotypical language development in children, while also holding certification in VitalStim for swallowing disorders and treating cognitive-linguistic impairments in adults. Above all, she has a love for "all things speech" and is dedicated to constantly learning and furthering her knowledge across all areas of the field.After a decade working in skilled nursing facilities (SNFs), Sarah knew something had to change. She was burning out and losing the spark that made her love speech therapy. Taking the leap into private practice wasn't just a career change — it was a lifeline.In this episode, Sarah discusses how she went from working multiple PRN jobs just to make ends meet to building a multi-faceted private practice that serves both adults and pediatrics, all while gaining the flexibility to be present for her young son.In Today's Episode, We Discuss:How she pivoted from being a finance major to becoming a speech language pathologistThe moment a Facebook ad for the Start Your Private Practice program showed up at exactly the right timeHow she built a multi-pillar practice with in-person therapy, virtual sessions, and school contractsHow hiring her first clinician opened up a whole new level of growth she never expectedSarah's story is proof that you don't have to stay stuck in a setting that drains you. By taking small, intentional steps and leaning on the right support, she turned her career into something that truly fits her life.Want to build a private practice that gives you your spark back just like Sarah did? Learn more The Start Your Private Practice Program gives you the roadmap, resources, and support to get started. Learn more at www.StartYourPrivatePractice.com.Whether you want to start a private practice or grow an existing one, I can help you get the freedom, flexibility, and fulfillment that you deserve. Visit my website www.independentclinician.com to learn more.Resources Mentioned:Follow Sarah on Facebook: Enrichment Therapy ServicesCheck out her website: www.enrichmenttherapyservices.comWhere We Can Connect:Follow the Podcast: https://podcasts.apple.com/us/podcast/private-practice-success-stories/id1374716199Follow Me on Instagram: https://www.instagram.com/independentclinician/Follow Me on Facebook: https://www.facebook.com/jena.castrocasbon/

Autism and many other health issues are every other child today and it's impossible to have a genetic pandemic, so please learn from our mistake and “Educate BEFORE You Vaccinate!” We are Vaccine Information Coalition, Precision Healing Cell-utions, Wellness on Wheels and Royal Covenant Ministries. Our main website is vacinfo.org and pHcelltox.com points to our Treatment link, so please visit to hear testimonies and learn about our Creator's 21-Day Full Body Cleanse to obtain and maintain health at a cellular level. We also have royalcovenantministries.org pointing to our Support link for over 20 years of clarity and wisdom about our Creator's Word! To access our weekly radio shows visit whatinthecell.podbean.com to listen, share and download from PRN.live (Progressive Radio Network).

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Doug Rice welcomes Kyle Petty and Alexis Erickson to recap the action from Bristol. They discuss Ty Gibbs' first career victory, welcome in David Styles, who made his PRN debut over the weekend, debate whether or not certain drivers will capture a win this year, and much more. 

Jacob Townsend and Bud are joined by Brad Gillie, of PRN, to preview the races this weekend, Tyler Reddick's season so far, 23XI, Michael Jordan, Denny Hamlin, and more. See omnystudio.com/listener for privacy information.

Hour 3 of April 9, 2026 Jacob Townsend and Bud talk with studio sponsor, K.D. Bowen of Fanatics 101. Then, they are joined by Brad Gillie, of PRN, to preview the races this weekend, Tyler Reddick's season so far, 23XI, Michael Jordan, Denny Hamlin, and more. See omnystudio.com/listener for privacy information.

The ASX 200 jumped 190 points to 8672 (2.2%) on US/Iranian news and a spectacularly strong US bounce. End of month and short covering helping lead us in. Confidence built throughout the day. Resources roared back to life as the USD fell slightly, and oil prices steadied. BHP up 4.3% and RIO up 3.5% with FMG joining in up 3.8%. Lithium stocks raced ahead, PLS up 3.5% and MIN rising 5.2% with the gold sector rebounding hard. NEM up 4.5% and EVN jumping 8.2% on gold and copper rises. S32 jumped on aluminium exposure, rare earths also doing well, ARU up 8.9%. Uranium stocks rallied hard, PDN up 6.9% and NXG jumped 6.7%. Oil and gas stocks took a pause, STO up 0.1%. Coal stocks steady.In the banks, a decent rise with the Big Bank Basket at $290.26 (+2.0%).MQG soared 3.3% and other financials also did well, ZIP up 10.7%. REITs mixed, GMG rising 2.3%. Tech stocks gained, XRO up 2.5% and REA up 2.5%. Retail better, JBH up 1.4% and travel stocks jumped, FLT up 4.8% and QAN taking off. The All-Tech Index up 3.3%.In corporate news, APE rose after entering into agreements to acquire two Audi dealers in Melbourne. PRN rose 4.1% on a new CEO. SGR blipped 8.7% higher after Chow Tai Fook Enterprises and Far East Consortium took full control of Brisbane's Queen's Wharf precinct.In economic news, dwelling approvals rose 29.7% in February to 19,022, driven by a surge in private apartments.Asian markets eased, Japan rose 4.5%, HK up 2.0%, and China up 1.4%.10 -year yields fell to 4.91% on peace hopes.US futures: Dow up 76, Nasdaq up 113—Marcus Today – Daily Market InsightsMarcus Today provides clear, practical commentary for self-directed investors – covering markets, portfolios, education, and decision-making without the noise.If you'd like to go further:Start a free 14-day trial of Marcus Today http://bit.ly/mt-trial-podcastJoin Marcus Today Use code MTPODCAST for 10% off http://bit.ly/mt-join-podcast-offerMT20 – Managed ETF Portfolio A professionally managed portfolio run by Marcus Padley and the team, using ASX-listed ETFs with active market timing. http://bit.ly/mt20-podcastPrinciples – How We Think About Investing A short video series on timing, behaviour, and decision-making. No stock tips. http://bit.ly/mt-principles-podcast—Disclaimer This podcast is general information only and does not consider your personal circumstances. It is not personal financial advice.

PRN announcer Doug Turnbull joins the show

We have a double dose of guests for you on episode 214 of the show. First, we discuss the All Star Race format with Dover Motor Speedway president, Mike Tatoian. We then get ready for 2 weeks of NASCAR and IndyCar crossover by talking with IMS Radio and PRN broadcaster, Nick Yeoman. See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

00:00 - 18:58 - Kevin Bowen from The Fan Morning Show hops on! Greg and Kevin discuss Notre Dame basketball traveling to Rome to start next season! What did Kevin think of the Pacers getting the win over the Knicks last night? Who will be the first Hoosier to hear his name called in the NFL Draft other than Fernando Mendoza? 18:59 - 32:42 - Nick Yeoman from PRN joins the show to discuss his new gig calling races from the booth, the upcoming Daytona 500, the difference between calling NASCAR vs IndyCar and more! 32:43 - 47:14 - Zach Osterman from the IndyStar joins the show! Is Zach surprised by any of the Hoosiers returning to the Indiana football program? What are Zach’s thoughts on the basketball program? 47:15 - 56:19 - Josh Mullins, father of UConn star and Greenfield alum Braylon Mullins, joins the show as his son and the Huskies prepare to take on Butler at Hinkle Fieldhouse! 56:20 - 1:04:27 - Carmel grad and current shooting guard for the Miami Redhawks Pete Suder joins the show! Pete gives the rundown on the Redhawks season! Support the show: https://1075thefan.com/the-ride-with-jmv/See omnystudio.com/listener for privacy information.

00:00 – 24:55 - Greg Rakestraw fills in for JMV on a Wednesday edition of the show! Greg first discusses the death of James Van Der Beek. Greg talks Butler basketball as they get set to take on UConn. He recaps the Boilermakers close win over Nebraska. 24:56 – 35:57 – Greg goes over the Pacers injury report ahead of tonight's game against the Nets 35:58 – 45:37 – Greg wraps up the 1st hour of the show! 45:38 – 1:06:53 – Kevin Bowen from The Fan Morning Show hops on! Greg and Kevin discuss Notre Dame basketball traveling to Rome to start next season! What did Kevin think of the Pacers getting the win over the Knicks last night? Who will be the first Hoosier to hear his name called in the NFL Draft other than Fernando Mendoza? 1:06:54 – 1:21:14 – Nick Yeoman from PRN joins the show to discuss his new gig calling races from the booth, the upcoming Daytona 500, the difference between calling NASCAR vs IndyCar and more! 1:21:15 – 1:36:51 – Zach Osterman from the IndyStar joins the show! Is Zach surprised by any of the Hoosiers returning to the Indiana football program? What are Zach’s thoughts on the basketball program? 1:36:52 – 1:56:40 – Josh Mullins, father of UConn star and Greenfield alum Braylon Mullins, joins the show as his son and the Huskies prepare to take on Butler at Hinkle Fieldhouse! 1:56:41 – 2:05:17 – Greg previews the upcoming NFL Combine and the Indiana Hoosiers that’ll be participating! 2:05:18 – 2:17:12 – Carmel grad and current shooting guard for the Miami Redhawks Pete Suder joins the show! Pete gives the rundown on the Redhawks season! Support the show: https://1075thefan.com/the-ride-with-jmv/See omnystudio.com/listener for privacy information.

The Daytona 500 is upon us and PRN is full of predictions.

PRN wins NMPA Awards. David Styles reports.

Join Peter and Ginger Breggin in Nashville, July 2-4, 2026, for an America Out Loud celebration of 250 years of America! Come join us in Nashville, TN, on July 2-4, 2026, for the celebration of two major events in American history: The founding of America Out Loud ten years ago and the founding of the United States of America 250 years ago. We are proud participants in America Out Loud—a free speech news and opinion platform which sponsors our radio show, The Breggin Hour, as well as our columns, which then appear on our Substack, on PRN.live, and on podcast platforms everywhere, including Spotify, Apple, Amazon, Pandora, and more. Register now for this once-in-a-lifetime event and meet some of the most dedicated freedom-loving patriots in the US—all gathered under the America Out Loud umbrella of news and commentary. The event will include talks by patriots like Dr. Alveda King, Peter McCullough, MD, Sherri Tenpenny, MD, Peter Breggin, MD, Dr. Paul Alexander, Dr. Carol Swain, and the founder of America Out Loud, Malcolm Out Loud, and dozens of the bravest nurses, physicians, commentators, attorneys, and others.

While a good chunk of the country is dealing with snow and ice, PRN's David Styles remembers that time it snowed during a Bristol race.

Neonatal nurse practitioner Tomas Cotto joins us to share his unexpected path into healthcare, his 15‑year career in the NICU, and what ultimately led him to transition into locum tenens work. After a decade in project management, Tomas made the leap into nursing, quickly discovering a passion for neonatal care.Tomas reflects on his years in a high‑volume Level III NICU, the mentors and experiences that built his clinical foundation, and the moment he realized he needed a change. He walks through his early travel and PRN experiences, what drew him to Weatherby Healthcare, and how he evaluates assignments based on autonomy, acuity, culture, and fit.Whether you're a nurse practitioner exploring locums for the first time or a seasoned clinician considering a career reset, Tomas's story offers thoughtful guidance and a look at how locums can expand your experience while giving you more control over your schedule and career.Learn more about locum tenens opportunities with Weatherby at weatherbyhealthcare.com.

Dementia is often a highly burdensome disease process for patients, their caregivers and families, and the community at large. Palliating symptoms and providing guidance surrounding advance care planning and prognostication are integral components of the management plan. In this episode, Katie Grouse, MD, FAAN, speaks with Neal Weisbrod, MD, an author of the article "Neuropalliative Care in Dementia" in the Continuum® December 2025 Neuropalliative Care issue. Dr. Grouse is a Continuum® Audio interviewer and a clinical assistant professor at the University of California San Francisco in San Francisco, California. Dr. Weisbrod is a neurologist at Hartford Healthcare with the Ayer Neuroscience Institute in Mystic, Conneticut. Additional Resources Read the article: Neuropalliative Care in Dementia Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Grouse: This is Dr Katie Grouse. Today I'm interviewing Dr Neal Weisbrod about his article on neuropalliative care in dementia, which appears in the December 2025 Continuum issue on neuropalliative care. Welcome to the podcast, and please introduce yourself to our audience.  Dr Weisbrod: Thank you. I'm really excited to be here. I'm Neal Weisbrod. I'm a neurologist and palliative care physician currently working at Hartford Healthcare in Mystic, Connecticut. Dr Grouse: To start, I'd like to ask why you think it's important that neurologists read your article? Dr Weisbrod: The primary reason I think it's really important to read the article is because these are just really common problems that neurologists run into in clinical practice. So, Alzheimer disease and many other dementias are extremely common, and managing the burdensome symptoms and the complex discussions that we have to have with the patients and their families as they go through the course of dementia is something that is very common in clinical practice. And so my hope is that by reading this article, clinicians will pick up a few tools, a few new ideas for how to make these conversations easier and for how to help these patients get through the disease with a little bit less suffering. Dr Grouse: I learned a lot from reading your article, and I really encourage our listeners to check it out. But I was curious what you feel that you discussing your article would come as the biggest surprise to our listeners? Dr Weisbrod: So, I think that the most surprising thing a lot of people will see reading this article is the section on prognosis. A lot of times it seems families are counseled, when they're talking about the prognosis of Alzheimer disease, that it could be ten years or longer. But really, the data show that for many patients, the median prognosis is closer to three to eight years. And that is a little bit longer for Alzheimer disease than many other types of dementia, but also gets significantly shorter as patients get older. So, we're looking at a closer to three-year median prognosis for patients who are over eighty-five, whereas patients in their sixties are probably closer to the eight or nine-year median prognosis. And so I think that piece will hopefully help people give a little bit more accurate counseling about prognosis.  Dr Grouse: I'm glad you brought that up because I was wondering, why is it so important that we are careful to make sure that we're giving prognostic information for our patients and maybe even updating it as their clinical status changes? Dr Weisbrod: I think first of all, it's a really common thing that patients and families are thinking about and worried about. They don't necessarily always seem to ask as much as they want to know. I think there's a lot of fear around that conversation, even though it's really important. And then there's also often tension between the family and caregivers tend to want to know more than patients do. I think that it really helps people plan for the future as well as possible to know what their future might be. And we have a lot of limitations in predicting the future, but using the best information we can, laying out what we think the likely range is, allows people to make a lot more clear plans for their future. Dr Grouse: I'd imagine it's also pretty helpful for hospice referrals, too, having that data.  Dr Weisbrod: Yeah, definitely. And there's a lot of angst about when to refer patients who have dementia to hospice. The most important thing I think about when I'm making a hospice referral is that I don't have to be right. And I think it takes a lot of that concern off to just say, all I'm doing is making a connection, getting someone who's potentially interested in the hospice, who has a really advanced serious illness connected to a hospice agency. And then they can go through the full evaluation with the hospice and the hospice medical director and determine whether they're eligible. So, I think there are really helpful thresholds to think about that would be a good trigger. Like a patient who we think has advanced dementia, who has a hospitalization for pneumonia or a fracture of the hip or some other really serious acute medical condition, I think is a really good trigger to start to think about hospice. But most importantly, it's just the connection, and I tell the patients that upfront. I tell them that you're going to have a conversation and we'll decide whether you're a good fit, and if not, the hospice will usually just check in with you over time and decide when is the right time in the future. Dr Grouse: That's really helpful. And I think just a really great reminder to our listeners about thinking about hospice sooner or at certain critical points in their patient care rather than waiting, maybe, before it's gone on too long and may be of less use later on. I was wondering, in your own clinical practice, what do you think is the most challenging aspect of providing care to patients with dementia?  Dr Weisbrod: I think this one's easy. I would say managing the time has to be the most difficult part. I think that taking care of patients who have dementia is time-consuming. There's a lot of different priorities that we have to manage the time around. How much time are we going to spend doing cognitive testing? How much time are we going to spend doing counseling? How much time are we going to spend making up a treatment plan and discussing medications? How much time are we going to spend on advanced care planning? And the way I try to combat that is really just trying to think about what I'm going to prioritize in a certain visit and not try to accomplish everything. I'll tell patients and their families, the next time you come in, we're going to have a conversation focusing on advanced care planning. Or, the next time you come in, we're going to sit down and try to talk through all the questions you have about what the future might hold. That way I in that visit, I don't feel like, oh, I have to do updated cognitive testing and I have to review all the next steps in medication, and that allows me to take it in more bite-sized chunks. Dr Grouse: You made some of the great points, and specifically you mentioned advanced care planning. Your article makes a really strong case for the importance of advanced care planning, yet you definitely acknowledge the many barriers to initiating discussions that clinicians face. In your patients with dementia, can you walk us through how you integrate discussions about advanced care planning with your patients and their families?  Dr Weisbrod: Yeah, I think this is still something that is evolving in my practice, and I don't think there's any perfect way of doing it. I think there's a lot of right ways of doing it, and as long as we're thinking about it a lot and bringing it up periodically, that's probably the best. What I try to do, though, is after I discuss what I think is the most likely diagnosis with patients and their families, I try to have a fairly close follow-up visit after that. Allow them to digest that information, to often do a little bit of their own research, to talk about it as a family. And then when they come in for that next appointment, I try to at least lay some groundwork about advanced care planning, asking them what they've completed already, and then based on what they've already done to that point, talking to them about what I think the next step would be. If they have done nothing, usually it's just, hey, I really think you should start to think about who would be making decisions for you if you lose the ability to make your own decisions and counsel them about power of attorney paperwork and establishing a healthcare surrogate. When it's patients who have already done some of that initial prep, I think that it's really important to keep in mind it's a longitudinal discussion and you can take it in small pieces over time. Often that helps because you can really establish that rapport and that trust. And then I like to just keep checking in whenever there's major changes in the patient's health or condition, like admission to the hospital or transfer to an assisted living facility or memory care clinic. Those are good times to remember, hey, I really need to revisit this conversation.  Dr Grouse: It's probably good to also mention another really important point from your article, which was that impairment of decision-making in patients with dementia can actually start significantly even in the phase of mild cognitive impairment. Yet these patients will need to make many medical decisions with their neurologist as they go through this journey. How can we make sure our patients have capacity and make decisions appropriately regarding their care? Dr Weisbrod: Yeah, I think that's a definite challenge of taking care of patients with cognitive disorders of any type, including those with stroke and multiple sclerosis, that have some cognitive impairment. In my opinion, the most important way to help manage that is to make sure when we are making important decisions about the future that we're having a deep exploration of the values and the reasoning behind that. And definitely teach back is the most helpful way that I use to explore those values and the logic behind patients' decisions. So, I think we have to have a really low threshold to move on to a formal evaluation of capacity; if there's any inconsistency between what the patient's saying now and what their families say they've said in the past, or if they're having struggled to come up with a really clear logic behind their decision, then I think we have to have a low threshold to move on to a formal evaluation of capacity. So, I think having the family involved, having other people who know the patient really well, usually helps identify some of those periods where it seems like the patient's not making the decision that really reflects their true wishes. Dr Grouse: Now I wanted to switch gears a little bit and get into the management of neuropsychiatric symptoms, which you spend a lot of time on and I think a lot of neurologists find very challenging. What are some nonpharmacologic approaches that can help patients with significant neuropsychiatric symptoms?  Dr Weisbrod: I really like the DICE paradigm for coming up with nonpharmacologic approaches. The DICE paradigm is an acronym. The D is Describe, I is Investigate, C is Create, and E is Evaluate. The idea is that we're exploring what's happening behind the symptoms, we're creating a plan to intervene, and then we're evaluating the outcome of that plan and creating a sort of feedback loop there. But ultimately, I think, when we're creating a solution, thinking about how we can change the environment is the most important thing. We have very limited ability to change the way that someone who has severe cognitive dysfunction reacts to their environment, but we can often change the environment to not produce that reaction in the first place. One example is with wandering behaviors. Trying to change the environment where you put locks that don't have deadbolts that you can use on the inside of the house, you have to have a key on the inside of the house, and then the family can put that key somewhere safe where the patient is not likely to find it and be able to unlock the door and wander out unsafely. I also think it's really important to acknowledge that as doctors, we are maybe not the best people to always have the answer when it comes to changing a patient's environment. And so, I think we really need to rely on the wisdom of support groups and other people who are going through the challenge of dementia. Our interdisciplinary care teams like social workers and nurses who have experience in managing dementia, and really try to plug the caregivers into as many of these avenues as possible so that they can learn from all of that community of wealth and not always rely on the doctor to have the answer. Dr Grouse: Switching gears to pharmacologic management, which is a lot of what we do for patients as neurologists. Thinking about agitation, pharmacologic management of agitation can be very challenging. And reading your article, it reminds me how disheartening it is to reflect and how modest the effect of the available options are, along with the many potential risks of their use, When nonpharmacologic interventions fail, what should neurologists recommend for their patients with agitation? Dr Weisbrod: Yeah, I definitely agree. It's every time I go back and look at this literature and look at what's new, it is a bit disheartening. But even in the face of all that, I really feel like SSRIs are my first-line therapy for most of these patients. I always try to ask myself what might be causing the patient discomfort that they are then manifesting as agitation because they don't have a better way of expressing themselves. Often, I feel like that's anxiety or depression or some other psychological symptom that we might be able to address with an SSRI. So, I tend to use sertraline and escitalopram, start those early and as long as patients are tolerating it, give it a really good trial. Outside of that, escalating to other pharmacologic approaches, even though there's such controversy in the data about antipsychotics and even though there are very real risks, sometimes I think we essentially do need a chemical sedative. And I think that it's important to have a very frank conversation upfront with the caregivers and the medical decision maker for that patient. Make sure we are counseling them on the risk, the increased risk of mortality, and also to make it a time-limited trial. So, I think that saying we're going to try this medication (if the patient's decision maker agrees, obviously) for a month or two months or three months. But I definitely wouldn't want them to just have an open-ended plan where they're going to stay on it indefinitely. It should have some end point where we say, hey, is this working or not? And if it's working, then we'd make a decision, is the improvement in quality of life worth the risks? And if we're not seeing that improvement, then we definitely need to stop it. Dr Grouse: That seems very reasonable. And then thinking more towards some of the other types of symptoms that can be really challenging, I was really surprised to see how often uncontrolled pain is a significant contributor in patients with dementia. And certainly, both uncontrolled pain and poor sleep can worsen cognitive function and neuropsychiatric symptoms in general. But of course, there's ongoing concerns about side effects of these therapies and how they can also potentially worsen things. How should we be approaching management of pain and insomnia or poor sleep in these patients?  Dr Weisbrod: I think the key is just to start with really low burden treatments and escalate carefully and start with low doses of higher risk medications. So, when I think the low burden treatments for pain, scheduling acetaminophen, 1000 milligrams every eight hours, seems like a trivial thing to do, maybe? But it's actually surprising how much scheduled acetaminophen can take the edge off of pain and might be able to avoid some of these flare-ups of neuropsychiatric symptoms, may be able to really improve that pain a little bit. I do think it really has to be scheduled, though. Trying to rely on patients who have significant cognitive dysfunction to use a PRN medication is going to lead to a lot of problems and undertreatment. And then on the sleep disorder side, I think starting with low-dose Trazodone and gradually increasing the dose of Trazodone as a really safe way of initially approaching the insomnia. And then only when it's a more refractory case do I reach for the high-risk medications. Like for pain, we're talking about opiates. I think there's a lot of very reasonable concern about using opioids in patients who have cognitive dysfunction. But if there is a really good reason to think that they have severe pain, like they have a past pain disorder, I think that just like with antipsychotics, there are definitely real risks to these medications. But at the end of the day, if we are improving someone's quality of life dramatically and the patient's medical decision maker is willing to take on those risks, then we're really doing the patients a favor. Dr Grouse: Now, another issue that you mentioned in your article, which I see a lot and often struggle with myself, is how and when to deprescribe certain types of medications such as cholinesterase inhibitors and memantine. Any tips or tricks to how to approach this?  Dr Weisbrod: My approach to this has also evolved a bit over the years. The new data that cholinesterase inhibitors may have a mortality benefit in patients with Alzheimer disease has changed my thinking a little bit. But there are still lots of situations where it's just too burdensome or patients seem to be having side effects. And so, I think about deprescribing. The most important thing in my mind is really thorough counseling before deprescribing with the patient's family and medical decision maker. I think that letting them know that we might actually be holding things more stable with the medication than we realize, there could be a flare-up, that we can resume the medication if that flare-up happens but we don't always guarantee getting back to the same point. I think having that conversation ahead of time will ward off some of the worst issues that you have afterwards. And then I think doing a taper of cholinesterase inhibitors over two weeks to a month is probably the most prudent because of some of the data about withdrawal and exacerbation of neuropsychiatric symptoms or cognitive worsening. Memantine, I think the data is a lot more shaky on withdrawal. And so, I think it's less important to gradually taper memantine. But I think that once again, just having the conversation upfront and letting the family know these are the things we have to look out for and these are the risks is going to be the most important. Dr Grouse: That's really helpful and a great strategy to take advantage of. Another, I think, really difficult topic that I wanted to ask you about was the discussion around nutrition and whether or not to consider putting in some type of a permanent tube for tube feeds. How do you approach that conversation? Certainly a difficult one.  Dr Weisbrod: Yeah, I think it's easily one of the most difficult conversations to have in the care of patients who have dementia. And there's so much emotion in the families when they're having this discussion. And I think really acknowledging there's a huge emotional piece of the conversation is one key piece. For families and caregivers, they're thinking, I don't want my loved one to starve to death. That's usually the most important thing in their mind. We have to address that concern in the conversation, or they're never going to get to a point of satisfaction with the decision that's being made. So, I think while there is still some controversy in the literature about artificial nutrition for patients who have dementia, the bulk of data indicates that it is not helpful for patients. It may exacerbate dementia, it leads to more restraint. And so, I think unless there's some reversible medical condition that we're just trying to do artificial nutrition to get them through, like, they have a stroke and we're expecting that their dysphasia is going to improve because of the stroke is going to heal. Those situations might be a good reason, but if we really think that the driving factor behind their dysphasia is their dementia, I think we should be guiding the families away from that. And I think that explaining that as dementia gets really advanced, the body is slowly shutting down. The body is not needing as much nutrition, and forcing more nutrition in has not been shown to help people who have dementia. Really putting it in that sort of language is going to help the families understand and be comfortable with that decision. I also think that it's really helpful to consider talking to families about what they can do and not have the entire conversation be about what we're not doing or not putting in a feeding tube for artificial nutrition. So, I think really good counseling about, we can do comfort feeding, we can expand what food we're giving the person who has dementia and really focus on foods that they really enjoy and not worry so much about the health and nutrition anymore. I think that focus on what they can take control of can also help make the decision easier for families.  Dr Grouse: I really like that approach. And I agree, it does seem that it being such an emotional decision with just so much a concern about this underlying feeling of not caring for their family member. I think that is a really great way to look at it  and to kind of start off that conversation. Now, I'd love to hear more about what drew you to this field when you first got into your career as a neurologist. Dr Weisbrod: I had an interesting journey to doing neuropalliative care. Definitely didn't know that's what I was going to do when I started neurology residency. At University of Rochester, we had amazing palliative care physicians that were involved in medical school, and so I got a little bit of exposure to it early on. Then when I was in neurology residency, I first of all realized that I really enjoyed making sure that what we were doing respected a patient's wishes. And so, as other people seemed to run away from those conversations, I was really drawn to them. And so that definitely made me realize that that might be more of the right field for me. But also, as I went through neurology residency, I really discovered that I love so many different things in neurology, and that made me not want to subspecialize and focus on a narrower set of conditions in neurology. So, doing palliative care fellowship was a really good way of getting a specialist tool set and expanding my knowledge in one area, but staying a neurologist, generalist. And I think it also really enhances a lot of the other things I do in neurology. It gives me a lot of additional skills on how to counsel patients and how to prepare for the future in general. I think there's a lot about just good bedside manner in palliative care education. I feel like it helped me become a better neurologist, and I decided that I really loved the palliative care piece as well.  Dr Grouse: Well, we're certainly all grateful that you found this aspect of your career and have been able to share the skills you've honed with us as well. And we really appreciate you taking the time to talk with us about your excellent article today, which I encourage everybody to read.  Dr Weisbrod: Yeah, thank you. It's been wonderful to be on, and I hope that people can take away a few small points from the article. Dr Grouse: Again, today I've been interviewing Dr Neal Weisbrod about his article on neuropalliative care in dementia, which appears in the December 2025 Continuum issue on neuropalliative care. Be sure to check out Continuum Audio episodes from this and other issues, and thank you to our listeners for joining today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

NASCAR welcomes a new year of racing as PRN welcomes new Garage Pass hosts, Andrew Kurland and David Styles.

Brett McMillan hosts his final new edition of The Pit Reporters after a 26 year run on PRN. The show will continue with "Best-of" material through January.

On the first of the final four programs on PRN for Mark Garrow...From the big Daytona Mall shows he used to do with Benny Parsons during Speedweeks a funny story from Bill Elliott. Plus don't know which is funnier Kenny Wallace golfing tale or his trademarked laugh?

In this inspiring episode of Nurse Converse, Melanie Van Sistine of Mel's Crafty CoRNer shares her journey from canceled shifts and burnout during the pandemic to becoming a two-time Best of Nursing Award winner and full-time nurse entrepreneur. She opens up about navigating a serious back injury, losing income as a PRN nurse, and facing early business setbacks—all while trying to rediscover who she was beyond the bedside. Mel reveals how creativity became her lifeline and how resilience can look softer, quieter, and more human than we're taught to believe.This episode is a reminder that nurses are allowed to evolve, pivot, and dream beyond the roles they've always known. Whether you're feeling stuck, unseen, or uncertain about your next chapter, this conversation will meet you exactly where you are.>>When a Nurse's Story Changes: How Creativity, Resilience & Community Helped Me Find a New PathJump Ahead to Listen: [00:01:18] Finding purpose through creativity.[00:06:29] Nurse Entrepreneur of the Year.[00:08:39] Evolving as a nurse.[00:12:10] Celebrating nurses beyond the bedside.Connect with Melanie on social media: Instagram: @mels.crafty.cornerTikTok: @mels.crafty.cornerShop Mel's Crafty CoRNer!For more information, full transcript and videos visit Nurse.org/podcastJoin our newsletter at nurse.org/joinInstagram: @nurse_orgTikTok: @nurse.orgFacebook: @nurse.orgYouTube: Nurse.org

The fastest way to improve post-cesarean recovery is to start before the first incision—by setting expectations, testing the block, and validating what patients feel. We sit down with Dr. Ruth Landau, Virginia Apgar Professor and Chief of Obstetric Anesthesia at Columbia University, to map a safer path from the OR to the nursery: neuraxial-first analgesia, scheduled non-opioids, and small, truly PRN opioid prescriptions at discharge. She explains how intrapartum cesareans carry higher risk for discomfort and why simple shifts—active epidural management, timely redosing, and clear, compassionate communication—reduce pain, opioid exposure, and the chance of a traumatic birth experience.We break down practical steps that clinicians can apply today. Learn the difference between systemic and neuraxial opioids for breastfeeding safety, when to use ultrasound-guided TAP or QL blocks after general anesthesia, and how micro-boluses of IV dexmedetomidine can blunt visceral sensations, anxiety, and shivering. Dr. Landau also shares the latest from ASA statements and SOAP guidance, including dose-dependent monitoring strategies that make neuraxial opioids feasible even in resource-constrained settings.The conversation moves beyond pharmacology to focus on outcomes that matter to families: fewer leftovers at home, less persistent opioid use, and birth memories grounded in trust instead of fear. We talk debriefs, trauma-informed care, and patient-reported experience measures, plus new research on sensation profiles and intrathecal adjuvants like dexmedetomidine and clonidine. If you're building an opioid-sparing cesarean pathway—or refining the one you have—this is a clear, evidence-informed playbook.If this resonates with you, follow the show, share it with your OB and nursing teams, and leave a review with one change you plan to make next shift. Your feedback helps more clinicians find these strategies and keeps more parents safe and comfortable.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/284-safer-c-section-pain-control-with-ruth-landau-md/© 2025, The Anesthesia Patient Safety Foundation

Keluar Sekejap Episod 181 membedah keputusan penuh PRN-17 Sabah bersama hos jemputan, Ong Kian Ming yang kembali untuk mengupas angka-angka pilihan raya dan perubahan besar dalam landskap politik negeri Sabah. Episod dibuka analisis angka—siapa yang benar-benar menang, siapa yang tenggelam, dan bagaimana GRS berjaya menguasai medan.Episod ini turut menampilkan tetamu jemputan Philip Golingai, Senior News Editor Star Media Group, yang menawarkan perspektif orang Sabah tentang kejatuhan DAP, kemerosotan UMNO, ketahanan Warisan, gelombang undi Cina serta dinamik KDM. Perbincangan turut merangkumi prospek Kabinet Sabah, kemungkinan peralihan Ketua Menteri dan implikasi nasional terhadap PH, BN dan PRU yang akan datang.Saksikan analisis paling lengkap dan kritikal pasca PRN-17 Sabah hanya di Keluar Sekejap.Ingin jenama anda dikenali oleh ribuan pendengar? Taja episod Keluar Sekejap 2025!Hubungi +6011-1919 1783 atau emel commercial@ksmedia.my00:00 Intro01:18 Topline Numbers - Keputusan Rasmi PRN-17 Sabah10:00 Winners & Losers Narrative14:11 Cabaran Utama Kekalahan DAP19:46 Swing Voters Berpihak Kepada Warisan28:14 Tetamu Jemputan : Philip Golingai, Penganalisis Politik dan Senior Editor Star Media Group45:28 Masa Depan UMNO & BN Di Sabah58:06 Percaturan Barisan Kabinet Negeri Sabah01:01:21 Peralihan Kuasa Ketua Menteri Sabah01:05:18 Rasional KJ Memilih Kawasan Kempen di Sabah01:16:36 Menjelang Rombakan Kabinet PMX01:18:17 Refleksi Ong Kian Ming

Episod 180 ini dibawakan khas oleh MyDigital ID, sebuah platform identiti digital nasional Malaysia yang kini berintegrasi dengan lebih 101 aplikasi kerajaan & swasta bagi memastikan akses perkhidmatan digital kerajaan yang lebih selamat, mudah dan dipercayai. Satu Kunci Untuk Semua , daftar diri anda hari ini!Muat turun MyDigital ID di sini :https://www.digital-id.my/en/downloadEpisod kali ini membuka tirai perbincangan dengan perkembangan terkini MyDigital ID. Status integrasi, FAQ's dan persoalan yang dibangkitkan ramai, peranan identiti digital nasional dalam mengukuhkan ekosistem keselamatan digital negara serta akses rakyat kepada perkhidmatan kerajaan. Episod ini kemudian beralih bersama tetamu jemputan Syed Gaddafi Syed Syed Saifuddin, CEO GNI Pharma Sdn Bhd bagi membincangkan cabaran usahawan digital tempatan. Topik meliputi tekanan persaingan di platform e-dagang, isu standard keselamatan produk, model harga tidak seimbang, dan strategi untuk memastikan SME terus berdaya saing dalam ekonomi digital.KS turut menyentuh perkembangan penting PRN-17 Sabah, di mana medan memilih membawa jumlah calon paling tinggi dalam sejarah, persaingan blok politik utama, manifesto parti-parti, isu serta faktor lapangan yang mencorakkan mood pengundi di Sabah.Akhir episod meneliti keputusan kerajaan untuk melarang pembukaan akaun media sosial bagi kanak-kanak bawah 16 tahun mulai tahun depan. Perbincangan merangkumi mekanisme eKYC, penggunaan MyDigital ID sebagai pengesahan umur, kebimbangan buli siber, risiko eksploitasi, isu privasi, serta persoalan besar — sejauh mana larangan ini praktikal untuk dilaksanakan?Ingin jenama anda dikenali oleh ribuan pendengar?Taja episod Keluar Sekejap 2025!Hubungi +6011-1919 1783 atau emel commercial@ksmedia.my00:00 Intro00:57 My Digital ID21:24 ⁠Cabaran Usahawan Digital bersama Syed Gaddafi Bin Syed Saifuddin59:41 ⁠PRN-17 Sabah01:13:56 Kawalan Akaun Media Sosial

Doug Rice sits down with PRN talents Wendy Venturini and Alan Cavanna to review 2025 and look ahead to 2026.

This week, Michael Sorg and Dave Podnar dive into: • Apple's iPhone “Pocket” sling (Issey Miyake) — a 3D-knit, cross-body way to carry your iPhone that channels the designer behind Steve Jobs' turtlenecks. Is this fashion-meets-tech or iPod Socks 2.0?   • Fortnite's Springfield takeover — an entire Simpsons-styled map, Battle Pass skins, and Sidekicks (pet-like companions). We compare Crew pricing to Game Pass and why this might be the cheapest way to stay current.   • Robotics & AI Discovery Day — we produced a rooftop live demo with SKA Robotics showing AI-assisted corrosion detection on local bridges. Here's what worked, what wind ruined, and why this matters for infrastructure. Watch the talks via PRN.   • iPad Pro at 10 — the unrealized potential vs. real-world utility (monitors, comics, control apps) from a decade-old device that still pulls its weight.   • Pittsburgh International's new terminal — what's changing for travelers, especially those checking oversized gear.   • Chachi's Video Game Minute — Zelda filming news, GTA 6 date chatter, RDR2 sales movement, Switch 2 momentum. (As heard in-show.)  • AI browsers & privacy — early takeaways after dog-fooding an agent-powered browser.  Watch / Subscribe: Tuesdays, 7pm ET. Tag #AC757 with your thoughts.

What if you could stop feeling stretched thin and finally focus on the clients—and the kind of work—you love most? That's exactly what Jackie Larsen-Robinson did when she launched her adult-focused private practice, Livewell Speech Therapy, in Provo, Utah.Jackie is a speech-language pathologist who started her career later in life—returning to school at nearly 40. Like many SLPs, she entered the field with a desire for balance and impact, but soon found herself overwhelmed by the demands of school-based therapy. With an impossible caseload and too many diagnoses to juggle, she knew something had to change.After moving to Utah, Jackie transitioned into the medical side of speech therapy, working PRN at a rehab facility. There, she discovered her love for adult neuro and swallowing disorders—and her confidence grew. One day, a patient with Parkinson's disease specifically requested to work with her. Not wanting to let him down, Jackie dove into specialized training and became certified in SPEAK OUT! therapy for Parkinson's.That decision changed everything. Soon after, referrals started flowing in from support groups and local providers. But it wasn't until her daughter faced health challenges that Jackie realized she needed more control over her time and income. That's when she joined the Start Your Private Practice Program, determined to take small, confident steps toward business ownership.In this episode, Jackie shares how she runs Livewell Speech Therapy, serving adults with Parkinson's disease, swallowing disorders, and voice difficulties. She is certified in SPEAK OUT! and VitalStim and is passionate about helping clients regain their independence and confidence through compassionate, evidence-based care.In Today's Episode, We Discuss:How one determined patient with Parkinson's sparked her path to specializationThe moment she realized she could serve her community and her family better by starting her own private practiceHow she built her confidence step-by-stepThe inspiring quotes that keep her motivated every single dayJackie's practice is more than a business—it's a lifestyle that gives her the flexibility to care for her daughter, set her own hours, and never again have to ask permission for a day off. Her story proves that it's never too late to reinvent your career—or to build a business that truly aligns with your life. By taking one small step at a time, she created a thriving private practice that brings her joy, freedom, and purpose every single day.Ready to start your own private practice and build a career that fits your life—just like Jackie did? The Start Your Private Practice Program gives you the roadmap, resources, and support to begin. Visit StartYourPrivatePractice.com to learn more.Whether you want to Start or Grow a private practice or grow your existing private practice, I can help you get the freedom, flexibility, fulfillment, and financial abundance that you deserve. Visit my website www.independentclinician.com to learn more.Resources Mentioned:Follow Jackie on Instagram:

Una Hopkins, DNP, MSN, FNP-BC, NE-BC, RN, FACCC, president of the Association of Cancer Care Centers (ACCC) designated her theme for the 2025-2026 year as Designing Oncology Care to Meet the Needs of a Growing Patient Population in response to forecasts predicting both patient and survivor populations will grow in coming years. In this episode, CANCER BUZZ speaks with Dr. Hopkins about the importance of peer-to-peer mentorship in workforce development and empowerment, particularly for nurses, and why retired nurses are well-equipped to provide this mentorship. Later in the episode, CANCER BUZZ speaks with Josephine Lisowski, RN, BSN, OCN, PRN nurse at Advocate Health, who came out of retirement to fill a new role reducing burnout and increasing retention of oncology nurses. Throughout her career, Lisowski identified that a strong culture rooted in quality, patient safety, and excellence in nursing must be nurtured to avoid burnout. Upon retirement, she felt a pull to return towards mentoring and supporting younger oncology nurses to improve retention and job satisfaction. Lisowski will discuss how using a retired nurse for this mentorship role at Advocate Health lifted the burden on the main work force and combined generational strengths to enable nurses to provide the best care possible to patients.     “We have to create spaces that are more psychologically safe for both our patients and our providers. I think that once we do that, we will see burnout change” - Dr. Hopkins “When you bring a retired nurse back again, it's meeting them where they are. They still want to share that knowledge that they have.” - Dr. Hopkins There's so much new innovation coming every day. But peer-to-peer, we can knock things between each other... It educates me and it educates them.” - Lisowski “I'm trying to encourage hospital management to keep the older nurses on at some point and not just have a whole new crew... In oncology, experience counts.” - Lisowski   Una Hopkins, DNP, MSN, FNP-BC, NE-BC, RN, FACCC President, Association of Cancer Care Centers Director for Research and Evidence-Based Practice Montefiore Medical Center Bronx, New York Josephine Lisowski, RN, BSN, OCN PRN Nurse Advocate Health Park Ridge, Illinois Resources: Healthcare Burnout: An Epidemic Among Oncology Nurses Burnout Prevention & Education   Mentoring Those New to Oncology   Onboarding Experienced Non-Oncology Nurses to Address Staffing Shortages   A Perfect Fit: Mentoring Experienced RNs to Meet Oncology Clinic Demand   This podcast is part of a special series featuring ACCC members committed to the 2025-2026 ACCC President's Theme: Designing Oncology Care to Meet the Needs of a Growing Patient Population.

Shane Van Gisbergen conducted another road course driving school Sunday, winning big at The Roval in Charlotte. He joins us in studio at PRN. Doug Rice hosts.

It's Roval time, and time to eliminate more drivers in the 2025 Playoffs. Brett McMillan welcomes Doug Turnbull of PRN and The Five to Go podcast, and Zach Sturniolo of NASCAR.com

What if the career you thought you'd never leave ended up being the springboard into something even better? That's exactly what happened to Amanda Smith, who turned years of hospital experience into her own private practice, Lasting Language Therapy Services, in Woodstock, Georgia.Amanda is a speech-language pathologist specializing in adults with neurological conditions. After starting her career in a large neuro clinic outside of Atlanta, she built a reputation for her clinical skills and strong professional network. Amanda loved her work in hospital systems and juggled multiple PRN roles for years. But when her child struggled in public school, she knew she needed more control over her schedule and income to better support her family.At first, the idea of private practice felt intimidating—especially the business side. But after joining the Start Your Private Practice Program, Amanda realized she could use her existing clinical skills and professional connections to take the leap. Within weeks of signing up, she got her first client.Amanda started small, gradually replacing her hospital shifts as referrals grew through her strong reputation and connections. Partnering with neuro rehab and movement centers helped fuel a 650% growth from year one to year two, specializing in adults with neurological conditions, and recently expanded into her own office space designed to feel welcoming and calm.In this episode, we talk about how Amanda treasures the freedom her practice provides. She balances homeschooling support, family life, and business growth—something she never thought possible when tied to hospital shifts. She's even preparing to expand into wellness services with hopes to open a second location closer to home.In this episode, we discuss:How she came to the realization that private practice was the ticket to being able to make more money in less time and provide high quality care for her favorite clientsThe marketing strategies she used to grow her caseload and reputationHow committing to knowing her numbers has made her a much more confident business ownerHow she Built partnerships with other professionals that turned into consistent referralsAmanda's story is proof that you don't have to jump all in at once—starting small and growing step-by-step can still lead to incredible results. With confidence, strategy, and a clear vision, she built a thriving practice that supports both her family and her community.Want to build a private practice that gives you freedom, flexibility, and fulfillment—just like Amanda has? The Start Your Private Practice Program can help you take the leap with confidence. Learn more at www.StartYourPrivatePractice.com.Whether you want to start a private practice or grow your existing private practice, I can help you get the freedom, flexibility, fulfillment, and financial abundance that you deserve. Visit my website www.independentclinician.com to learn more.Resources Mentioned:Follow Amanda on Facebook: https://www.facebook.com/lastinglanguagetherapyCheck out her website:

Elimination round number one is here. Who will be chopped off the list in Bristol? Brett McMillan welcomes Adam Alexander from The CW, and Alan Cavanna from PRN and TNT.