Podcasts about prolonged

Plant suspension at automakers caused by last week's major earthquake in Kumamoto Prefecture is being prolonged, with the impact spreading beyond the Kyushu region, which includes the southwestern Japan prefecture.

Mikael and Jack answer listener questions on indoor versus outdoor FTP differences, whether time in zone is all that matters and how to optimise interval intensity, a first 70.3 debrief covering swim breathing problems and bike cramps, and lots more! Email us your questions, or answer the question prompts in our Instagram stories to get your questions answered on the next Q&A. HIGHLIGHTS AND KEY TOPICS: Why indoor and outdoor FTP differ, whether a 20-watt gap is normal, and why Mikael has never had an athlete test both. Fans and airflow as the most underrated indoor cycling upgrade, including the research showing 40 km time-trial power is maintained up to 27°C when airflow matches outdoor riding speed. How to back-calculate an outdoor FTP from your own sweet spot and threshold interval data rather than doing a second test. Why a 10-minute interval should not be done at your 10-minute power, and how to perform a session so you finish at a session RPE of 7 to 8 with something left in the tank. Is time in zone all that matters? The same power and the same total work can produce very different internal loads. Minimum rep lengths if you want to spread work through a longer ride: 4 to 5 minutes for VO2max reps, 10 to 15 minutes for threshold reps. A first 70.3 debrief: why the swim breathing fell apart and how to break the hypercapnia (CO2 buildup) spiral, and what most likely caused hamstring cramps at 70 km on a hilly bike course. Instagram questions: finding your bike power in the first 20 minutes of a race, whether a VO2max block followed by a threshold block is a silver bullet, training after dental surgery, splitting 120 g of carbs per hour, and preparing for the Ironman Nice climb when you have no long climbs. SHOWNOTES, LINKS, RESOURCES AND RELATED EPISODES: The shownotes for today's episode can be found here. The full podcast episode archives (including category filters) can be found here. Is VO2max more important than lactate threshold? | Research roundup Kolie Moore – Overrated and Underrated Factors for Cycling Performance Why 90 Grams of Carbs Still Beats 120 | Paul Booth Triathlon Base Training Series 1 - How to train smarter in winter to race faster in summer Prolonged self-paced exercise in the heat – environmental factors affecting performance - Junge et al. 2016 Physiological comparison of intensity-controlled, isocaloric intermittent and continuous exercise - Combes et al. 2018 Short intervals induce superior training adaptations compared with long intervals in cyclists - an effort-matched approach - Rønnestad et al. 2015 The higher the fraction of maximal oxygen uptake is during interval training, the greater is the cycling performance gain - Odden et al. 2024 SPONSORS: Precision Fuel & Hydration produce our favourite gels, sports drinks, and electrolyte and carbohydrate products here at That Triathlon Show and Scientific Triathlon. Use the free Fuel & Hydration Planner to get a personalised plan for your carbohydrate, sodium and fluid intake in your next event, and get 15% off your first 2026 order by using the code TTS2026 at checkout. Rouvy is hands down the most complete indoor cycling platform for triathletes. Among their thousands of beautiful bike courses from all around the world, all filmed in stunning quality, they have over 75 IRONMAN and IRONMAN 70.3 race courses plus 20+ Challenge Family courses, so you can pre-ride your race from home. Real gradients, real visuals, and real feel! Head to rouvy.com and use the code TTS to get your first month free on top of a 7-day free trial. Effortless Swimming produce the best swim goggles for triathletes and open water swimmers. Their NanoClear anti-fog lenses give you clear, fog-free vision that lasts and doesn't wear off. Don't let foggy or leaky goggles ruin another swim. Go to shop.effortlessswimming.com and use the code TTS15 to get 15% off your goggles, and get a free two-month Effortless Swimming course membership. ZenAI is the next frontier of podcasting. It lets you turn your ideas into a podcast without any knowledge of audio editing, video, or production. You do the talking, and the AI handles the production, editing, clipping, and the rest, and you can direct your AI producer in plain English. You can even record from your phone, so no expensive studio gear is needed to sound great. ZenAI is a new product from Zencastr, a platform I've been a paying customer of for over nine years here at That Triathlon Show. ZenAI is currently in invite-only beta. Join the waitlist today here.LEARN MORE ABOUT SCIENTIFIC TRIATHLON: The Scientific Triathlon website is the home of That Triathlon Show and everything else that we doContact us through our contact form or email me directly (note - email/contact form messages get responded to much more quickly than Instagram DMs)Subscribe to our NewsletterFollow us on InstagramLearn more about our coaching, training plans, and training camps. We have something to offer for everybody from beginners to professionals.HOW CAN I SUPPORT THAT TRIATHLON SHOW (FOR FREE)? I really appreciate you reading this and considering helping the show! If you love the show and want to support it to help ensure it sticks around, there are a few very simple things you can do, at no cost other than a minute of your time. 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Send us Fan MailThis week on Translational Conversations, we talk with Dr. Zoe Donaldson, a prairie vole researcher, and Dr. Katherine Shear, a human researcher, about how their work has inspired and influenced each other's research on attachment bonding, love and loss, and the development of Prolonged Grief Disorder. In this episode, Dr. Donaldson and Dr. Shear discuss the role of the brain's reward system in grief, how grief differs from depression, the special bonding of prairie voles that makes them an ideal species for studying grief, and how their complementary research has inspired novel treatments for Prolonged Grief Disorder. Their discussion further explores the bidirectional process of translational research, how to consider the language we use when communicating findings from different species, and ways we can build better bonds between researchers to advance scientific progress. We thank Dr. Zoe Donaldson, the Larry Gold Professor in the Department of Molecular, Cellular, and Developmental Biology and the Department of Psychology and Neuroscience at the University of Colorado Boulder and Dr. Katherine Shear, the Marion E. Kenworthy Professor of Psychiatry at Columbia University and the founding Director of the Center for Prolonged Grief at Columbia School of Social Work, for their openness and willingness in discussing their research with us for this podcast.Translational Conversations is made possible through support from Biomedical Research Awareness Day, a program of Americans for Medical Progress and the American College of Neuropsychopharmacology.Resources & Links: Craving Love? Enduring grief activates brain's reward center by Mary-Frances O'ConnorNeurobiology and treatment advances for prolonged grief disorder by Donaldson and ShearPrairie Voles as a model of adaptive reward remodeling following loss of a bonded partner by Sadino and Donaldson Support the showFollow Lab Rat Chat on X! Facebook! Instagram!https://twitter.com/thelabratchat https://www.facebook.com/labratchat https://www.instagram.com/thelabratchat All Lab Rat Chat episodes are edited by Audionauts: https://audionauts.pro/ 

 Learn about the Healing Power of Prolonged Fasting: HEREWhat if the thing you assumed was deprivation is actually one of the oldest healing practices in medicine?Someone you love is exploring a prolonged water fast, and you want to understand what that really means. Host Dr. Katie Deming  walks you through what a supported fast actually is, the way she would explain it to her own family. She describes what happens inside the body when someone stops eating, and why it looks nothing like what most of us learned in school.You'll hear why she compares a supported fast to a retreat rather than a period of going without, and what the structure looks like day to day. She also explains the part of the process almost nobody talks about, the piece she takes more seriously than the fast itself. If you've been worried, confused, or unsure how to bring this up with the person you love, this conversation gives you language and a clearer picture.Dr. Katie also traces fasting back through Hippocrates, Galen, and the physicians who shaped Western medicine, then explains what changed and why we set it aside. And she names what people are truly reaching for when they choose this path, which is rarely what you'd expect.Stay through the end for the most important thing she has learned in two decades of caring for people with cancer, including a deeply personal story about her own mother.Press play and learn how to walk alongside someone you love as they heal.Which Fast Is Right for You? - Take the FREE QUIZ:https://www.whichfastisrightforyou.com/Join Dr. Katie's 3-Day Guided Fast, for expert support, daily live calls, and a community to fast alongside: Sign-Up Follow Dr. Katie Deming on InstagramWatch on YoutubeDISCLAIMER: The Born to Heal Podcast  is intended for informational purposes only and is not a substitute for seeking professional medical advice, diagnosis, or treatment. Individual medical histories are unique; therefore, this episode should not be used to diagnose, treat, cure, or prevent any disease without consulting your healthcare provider.A thought-provoking podcast explores cancer through the lens of holistic medicine and functional medicine, discussing causes of cancer, metabolic health, and unconventional approaches like water fasting, fasting and autophagy, and detox, while weighing fasting benefits against chemo side effects and radiation side effects, sharing stories of a cancer survivor navigating chemotherapy, natural medicine, holistic healing, and even spiritual healing on the path toward cancer remission and holistic health. 

Episode 429: In January 1995, DNA testing excluded Guy Paul Morin, the man convicted of the 1984 murder of Christine Jessop, from the crime. The Ontario Court of Appeal set aside his conviction, and Morin was released. The man whose semen was recovered from Christine Jessop's underwear in 1984 remained unidentified. A public inquiry led by Justice Fred Kaufman spent 10 months examining how an innocent man had been convicted twice. It produced 1,380 pages and 119 recommendations. The real killer remained unnamed for another twenty-five years — until a detective named Steve Smith, a Texas laboratory, and a forensic genealogist pulled a family tree apart and found a killer at the end of it. Sources Report of the Kaufman Commission on Proceedings Involving Guy Paul Morin — Full text (netk.net.au) The Canadian Encyclopedia — Guy Paul Morin Case Innocence Canada — Guy Paul Morin case file Toronto Life — "Inside the Hunt for Christine Jessop's Real Killer" (January 2022) CBC News — "Toronto police identify killer in cold case of 9-year-old Christine Jessop" (October 15, 2020) CBC News — "Calvin Hoover's family 'devastated' to learn police believe he killed Christine Jessop" (October 22, 2020) CBC News — "The answer to the mystery of Christine Jessop's murder leaves killer's ex-wife with painful questions" (February 2021) CBC News — "The science behind why police now believe they have the right suspect in Christine Jessop's murder" (October 2020) Global News — "Who was Calvin Hoover? The man Toronto police say killed 9-year-old Christine Jessop in 1984" (October 2020) Blue Line Magazine — "Out of the Cold: Toronto Police Solve 1984 Jessop Murder With New Science" (January 2021) RCMP — National DNA Data Bank of Canada: 20 Years and Growing Game of Crimes Podcast — "Detective Steve Smith Cracks a 36-Year Old Cold Case" (March 2022) Learn more about your ad choices. Visit megaphone.fm/adchoices

We all understand the emotional impact of grief, but its effects on the body are often overlooked. Forrest is joined by clinical psychologist and researcher Dr. Mary-Frances O'Connor to explore the physiology of grief. Dr. O'Connor explains how our brains and bodies organize themselves around the people we love, creating “maps” of their presence and relying on them for physical and emotional regulation. They discuss the health risks associated with bereavement, how to care for the healing body, ambiguous loss, the difference between grief and prolonged grief, and how we can gradually build a meaningful life around loss. About our Guest: Dr. Mary-Frances O'Connor is a Professor of Clinical Psychology and Psychiatry at the University of Arizona and Director of the Grief, Loss, and Social Stress Laboratory. She is the author of two books on grief: The Grieving Brain and The Grieving Body. Key Topics: 00:00: Intro 4:42: The map that no longer exists 12:00: Co-regulation: the attachment figure as an external pacemaker 16:35: Physiological effects of grief 24:53: Taking care of yourself after a loss 36:46: Protest, despair, and meditative practices 45:45: Prolonged grief and getting stuck in restoration 57:31: Progressive Muscle Relaxation vs mindfulness 1:03:00: Re-engaging with the world 1:15:42: Recap Support the Podcast: We're on Patreon! If you'd like to support the podcast, follow this link. Sponsors Let Rocket Money help you reach your financial goals faster. Join at https://RocketMoney.com/BEINGWELL. Level up your bedding with Quince. Go to Quince.com/BEINGWELL for free shipping on your order and three hundred and sixty-five -day returns. Visit Upwork.com to connect with top talent ready to help your business grow.  Learn more about your ad choices. Visit megaphone.fm/adchoices

Lorenzo Fiori reports Italy is battling severe wildfires in Sicily and Sardinia amid a prolonged heatwave. Fiato reports that Italians face exorbitant fuel costs, reaching $9.50 per gallon on motorways due to heavy taxation. To avoid over-tourism in cities like Florence, he recommends visiting Ascoli Piceno, the "town of the 100 towers," known for its travertine architecture. He concludes with culinary recommendations, including the traditional Spaghetti Ascolana paired with local Pecorino or Rosso Piceno wines. (6)

A prolonged heat wave across parts of the Midwest and northern Plains is worsening pasture conditions and increasing stress on cattle producers already dealing with drought and historically tight cattle supplies. NAFB News ServiceSee omnystudio.com/listener for privacy information.

Ken Carman and Anthony Lima express frustration over the three-week wait for LeBron James' decision, questioning if Cleveland is being used as leverage. They analyze the Guardians' recent offensive surge and debate the polarizing dynamic between Deshaun Watson and Shedeur Sanders. The discussion concludes with a look at modern athlete branding and reports of media changes at ESPN. 02:20 - LeBron Decision Delay Fallout 09:20 - Cleveland Legacy vs. Philly 13:45 - Guardians Home Run Surge 19:45 - Is Cleveland a Fallback? 27:55 - Retirement and Legacy Regrets 34:15 - Deshaun Watson vs. Sanders 38:15 - Modern Fanbase Branding Issues 41:40 - Karl Raveich ESPN Rumors

Episode 428: On October 3, 1984, nine-year-old Christine Jessop stepped off a school bus in Queensville, Ontario, and walked toward home. She was never seen alive again. Her body was found on New Year's Eve, fifty-six kilometres away. She had been sexually assaulted and stabbed. What followed was one of the most consequential criminal proceedings in Canadian history — and the quiet destruction of a man who lived next door. This is Part One of a two-part series. Sources: Kirk Makin, Redrum the Innocent (1992) — Viking Canada. Report of the Kaufman Commission on Proceedings Involving Guy Paul Morin — Full text (netk.net.au) The Canadian Encyclopedia — Guy Paul Morin Case Innocence Canada — Guy Paul Morin case file Canadian Registry of Wrongful Convictions — Guy Paul Morin Library of Parliament — Wrongful Convictions in Canada (2020) Bruce MacFarlane — "Wrongful Convictions: The Effect of Tunnel Vision and Predisposing Circumstances in the Criminal Justice System" (2006) Federal Prosecution Service — Chapter 5: Jailhouse Informers Federal Prosecution Service — Chapter 8: DNA Evidence The Canadian Encyclopedia — Morin Inquiry Report Kaufman Report — Wikipedia summary Globe and Mail — "Morin Informant Named Dangerous Offender" (2007) CBC Digital Archives — Guy Paul Morin acquitted Chippewas of Georgina Island First Nation Williams Treaties — Government of Canada Learn more about your ad choices. Visit megaphone.fm/adchoices

Cyclospora is an uncommon but important cause of prolonged watery diarrhea in children, particularly during the summer months and during foodborne outbreaks. This episode reviews the epidemiology, clinical presentation, diagnostic pitfalls, treatment, and practical emergency department approach to recognizing and managing pediatric cyclosporiasis.   Learning Objectives Recognize the clinical features and epidemiology of Cyclospora cayetanensis infection in children, including when to suspect the diagnosis in patients with prolonged watery diarrhea. Select appropriate diagnostic testing for cyclosporiasis and identify the limitations of routine stool cultures, ova and parasite examinations, and gastrointestinal pathogen panels. Apply evidence-based treatment and supportive care for pediatric cyclospora infection, including appropriate antimicrobial therapy, hydration, and follow-up considerations. References Stobbe M. Outbreak of diarrhea-causing parasite grows to more than 1,000 cases. ABC News. Published July 8, 2026. Accessed July 10, 2026.   Bilung LM, Tahar AS, Yunos NE, et al. Detection of Cryptosporidium and Cyclospora oocysts from environmental water for drinking and recreational activities in Sarawak, Malaysia. Biomed Res Int. 2017;2017:4636420. doi:10.1155/2017/4636420.   Giangaspero A, Gasser RB. Human cyclosporiasis. Lancet Infect Dis. 2019;19(7):e226-e236. doi:10.1016/S1473-3099(18)30789-8.   Pyzocha N, Cuda A. Common intestinal parasites. Am Fam Physician. 2023;108(5):487-493.   Centers for Disease Control and Prevention. Clinical care of cyclosporiasis. Updated March 8, 2024. Accessed July 10, 2026.  Transcript This transcript was generated using Descript and subsequently reviewed and lightly edited for spelling, grammar, and clarity. Minor inaccuracies may remain, and the audio recording should be considered the definitive version of this content.   Welcome to PEM Currents: The Pediatric Emergency Medicine Podcast. As always, I'm your host, Brad Sobolewski. It's July and a seven-year-old comes into your emergency department with 10 days of watery diarrhea. They were seen earlier in the week and told it was probably viral gastroenteritis. Maybe they got a prescription for ondansetron, maybe they didn't. Stool cultures have already come back negative. Mom tells you, “Every time I think he's finally getting better, the explosive diarrhea comes right back.” So what's going on? Today we're talking about Cyclospora. Honestly, it's one of those organisms that most of us forget about until summer rolls around, or since medical school. We don't diagnose it every week, and depending on where you practice, you may go years without seeing a case. But then an outbreak happens, and maybe just a handful of sporadic cases show up, and suddenly you're reminded that not every child with prolonged diarrhea has viral gastroenteritis. Cyclospora cayetanensis is a coccidian protozoan that's transmitted through contaminated food or water. In the United States, it's most commonly associated with imported fresh produce, things like cilantro, basil, lettuce, salad mixes, and berries. Unlike bacterial food poisoning, everyone at the picnic usually isn't sick, so it often presents as an isolated illness because the exposure happened days earlier and may have involved only one particular food item. Families are often trying to remember the one thing that they ate that made everybody sick. Honestly, sometimes it's simply the salad they bought at the grocery store a week ago. One thing that's helped me remember these organisms over the years is that they each sort of develop their own personality. You know, it's often confused with Giardia and Cryptosporidium. So if the diarrhea is greasy, think Giardia. If it's profuse, watery diarrhea after swimming, think Cryptosporidium. If it's prolonged, watery diarrhea during the summer, think Cyclospora. Now, obviously there are exceptions, but I think that's a pretty useful framework, especially when you're seeing patients one after another in a busy ED. One of my favorite pearls about Cyclospora, and I think it's probably the one fact that's most worth remembering because it explains how it sort of works. Unlike Giardia or Cryptosporidium, the oocysts that are passed in stool aren't immediately infectious. They actually have to spend days to weeks out in the environment before they mature enough to infect somebody else. So Cyclospora isn't really spread by the kids sitting next to them at daycare. It's spread by the salad they both ate last week. I think that's a lot easier to remember than trying to memorize the organism's life cycle. The incubation period averages about seven to 10 days, so by the time symptoms begin, families usually don't remember exactly what their kid ate. They're certainly not connecting today's diarrhea with the salad they had a week ago. The diarrhea itself is usually watery, sometimes pretty high volume, sometimes even explosive. One thing that's a little deceptive is that it tends to wax and wane. Parents will tell you, “Yesterday I thought we had finally turned the corner,” and today they're right back where they started. Along with the diarrhea, you'll often see abdominal cramping, bloating, nausea, fatigue, maybe even a low-grade fever, and if this has been going on for a while, some weight loss or poor weight gain. Most of these kids don't walk in looking critically ill. They walk in because they're still having diarrhea when everyone expected them to be over it. That's really the patient where Cyclospora should come to mind. And of course, not every child with prolonged diarrhea has it. Giardia is still incredibly common, especially after untreated water exposure, camping, or daycare. Again, those kids have greasy, foul-smelling stools with bloating and flatulence. Cryptosporidium is the swimming pool organism. Those oocysts are remarkably resistant to chlorine, so swimming pools, splash pads, and water parks should all get your attention. Those patients usually have profuse watery diarrhea, but in otherwise healthy children, it tends to run its course over a couple weeks. Cyclospora is different because it just hangs around. That's really what makes me think about it. It's not necessarily how sick the kid is, it's that they're still sick when they should actually be getting better. So aside from when you're in the middle of an outbreak, when should you actually suspect it? It's really when a few things start lining up. The diarrhea has lasted more than a week. Maybe it got a little better and then came back. The kid has lost some weight or looks a little dehydrated. It's summertime. The bacterial stool studies are negative. Maybe there's a history of travel. Maybe there isn't. Maybe there's a history of eating fresh produce. Maybe there isn't. At some point, you have to stop saying, “Eh, it's probably still viral,” and start asking yourself whether you're dealing with something else. One teaching point that's worth repeating, partly because it shows up on board exams and partly because it explains the epidemiology, is that Cyclospora isn't spread directly from person to person. Fresh stool isn't immediately infectious because those oocysts still have to sporulate in the environment before they can infect the next person. So let's say you're thinking about Cyclospora. What do you actually order? A routine stool culture isn't gonna help you. Even a routine ova and parasite examination may not be enough. That's an easy mistake to make because a lot of us were taught persistent diarrhea, send culture and O&P or a stool molecular pathogen panel. Many labs don't specifically look for Cyclospora unless you ask them to or order it specifically. So there's gastrointestinal PCRs for it, but you have to order them separately. So you can actually get back a negative O&P and feel reassured when in reality no one's really tested for Cyclospora. If your hospital has a multiplex GI PCR panel that includes it, that's probably what you should order first. If you don't, you probably have to order it separately. Another board pearl. So if you're taking a board exam and they describe a child with prolonged watery diarrhea during the summer, maybe after eating fresh produce, and then they casually mention that the routine ova and parasite examination was negative, don't let that throw you off. That's actually the clue. The organism may still be there, the lab just wasn't sent to look for it. If your lab is using microscopy, Cyclospora can be identified with a modified acid-fast stain. The oocysts are a little larger than Cryptosporidium, and one interesting feature is that they stain variably. Some stain bright red, while others hardly stain at all, giving them that classic ghost organism appearance, which I think is just, like, cool. And because oocyst shedding is intermittent, collecting two or three stool specimens over several days can improve the diagnostic yield if you still have a high index of suspicion. The good news is that once you make the diagnosis, treatment is actually pretty straightforward. Trimethoprim-sulfamethoxazole remains the treatment of choice. In adult-sized patients, that means trimethoprim one hundred and sixty milligrams plus sulfamethoxazole eight hundred milligrams, just one double-strength tablet, orally twice a day for seven to ten days. For kids greater than two months of age to eighteen years, it's eight to ten milligrams per kilogram trimethoprim and forty to fifty milligrams per kilogram sulfamethoxazole per day orally in two divided doses for seven to ten days. Most children begin feeling noticeably better within twenty-four to forty-eight hours. Honestly, this can be a pretty satisfying infection to treat because families have often been searching for an answer for a week or two. They've been told it's viral. They've been waiting for it to improve, and then you finally make the diagnosis within a day or two of starting the right antimicrobial, the kid's turning the corner. If the kid has a true sulfonamide allergy, things are a little more complicated, and I mean a true allergy, not just the parent who says, “Well, my mother was allergic to sulfa, so we've always avoided it.” There really isn't a perfect alternative. At this point, I'm probably talking to ID. Nitazoxanide's been used, ciprofloxacin's been used, but we generally try to avoid fluoroquinolones in children. Neither has been shown to work as well as trim-sulfa. And if you've got somebody who's immunocompromised with Cyclospora, which fortunately I've never seen, I'd be calling ID. Of course, don't forget everything else that goes along with taking care of prolonged diarrhea. Oral rehydration is still the goal whenever possible. Some kids are gonna need IV fluids because by the time they get to you, they've been losing fluid for days. Replace electrolytes if they've been really sick. And if the illness has dragged on for a couple of weeks, don't forget the nutritional burden. Sometimes they've lost enough weight that getting them eating and drinking normally again becomes part of an ongoing treatment plan. The good news is that most otherwise healthy children recover completely. Immunocompromised patients are the group that worries us the most. Their symptoms can become prolonged. They can relapse. Sometimes they require longer admissions or even secondary prophylaxis. One question that occasionally comes up is whether you need to repeat stool testing after treatment. In general, you don't. If the kid's symptoms have resolved, then you don't need to prove microbiologic cure. Treat the patient, not the PCR. If the kid feels better, you don't need to prove that the pathogen is gone. So let's get back to that hypothetical scenario we started with, that kid in July that's had watery diarrhea for 10 days. The stool culture was negative. They're starting to lose weight. The parents are frustrated. Everyone keeps telling them it's a virus. Maybe it is another virus. Maybe it's two illnesses in a row. But this is the patient where you have to take a step back and consider just one more test instead of offering more reassurance. That's what Cyclospora is. Of course, you shouldn't suspect it in every single child with prolonged diarrhea, but be aware of whether or not there's an outbreak and test for it. Before wrapping this episode up, here's a few more things I'd like you to remember. One, if watery diarrhea has lasted more than a week, especially during the summer months, make sure Cyclospora is somewhere on your differential. Second, remember my comparison. Greasy diarrhea, think Giardia. Swimming pool exposure and profuse watery diarrhea, think Cryptosporidium. Prolonged watery diarrhea during the summer, think Cyclospora. Third, don't let a negative routine ova and parasite examination or stool molecular pathogen panel falsely reassure you. Make sure your laboratory is actually testing for Cyclospora, and remember that not every GI PCR panel includes it. Finally, once you make the diagnosis, treatment is pretty straightforward. Trimethoprim-sulfamethoxazole for most patients. Kids will start feeling better in 24 to 48 hours. Cyclospora isn't the first diagnosis that comes to mind when a kid has diarrhea, and it shouldn't be. Viral gastro is still far more common. But when the diarrhea has been going on for 10 days, the stool studies are negative, the kid's starting to lose weight, and the family says, “I thought we were finally getting better,” that's when you have to stop and think about Cyclospora. It's the child with the diarrhea that lingered. If you enjoyed this episode, as the kids would say, like, rate, and review. Leaving that review on your favorite podcast platform really does help other people discover the show, and I've been fortunate to be teaching through this podcast since 2013 because of listeners like you. If you got ideas for future episodes or topics you'd like me to cover, I'd love to hear them. For PEM Currents: The Pediatric Emergency Medicine Podcast, this has been Brad Sobolewski. See you next time.  

In this episode of the Prolonged Field Care Podcast, Dennis sits down with Dr. Andre Cap to unpack the evolving role of calcium in trauma resuscitation. What started as the “new hotness” in forward blood transfusion protocols has become far more nuanced. They discuss the dangers of both hypocalcemia and hypercalcemia, how citrate in all blood products binds ionized calcium, cardiac effects, recent observational data showing worse outcomes with hypercalcemia, and practical guidance for when, how, and how much calcium to give in austere and prolonged field care environments.Whether you're running a Role 2, working prolonged field care, or just trying to keep your patient alive until definitive care, this episode challenges long-held assumptions and offers field-practical recommendations.Key Takeaways:All blood products contain citrate, which binds ionized calcium — expect hypocalcemia with significant transfusion.Both hypo- and hypercalcemia are bad; recent data shows hypercalcemia is associated with worse mortality than hypocalcemia.Current TCCC guidance (1g calcium after first unit) was written to fix under-use; it may now be too aggressive in some scenarios.Give calcium after blood products, not before. Consider waiting until after 2+ units in most cases.Slow IV push (over ~5 minutes) through a confirmed good peripheral line; calcium chloride is a vesicant — use caution (gluconate is safer).Avoid calcium chloride via IO if possible. Titrate to clinical response when monitoring isn't available.In refractory shock you can give more, but don't give calcium as a standalone resuscitation drug — it can be harmful without volume replacement.Ideal future state: Bring i-STAT capability forward when feasible and get better RCT data.Perfect for medics, PAs, physicians, and anyone managing hemorrhagic shock in austere environments.Links:⁠www.prolongedfieldcare.org⁠ | @prolonged_field_carePodcast Chapters (with Timestamps):00:00 – Intro & Welcome00:39 – Why Calcium Became “The New Hotness” in Trauma Care01:18 – The Joint Trauma System Audit That Started It All03:46 – Citrate in Every Blood Product – The Science Behind the Bind05:44 – Why We Actually Care: Cardiac Repolarization, Contractility & Vascular Tone08:49 – Hypocalcemia vs Hypercalcemia in Trauma Patients10:21 – Shocking New Data: Hypercalcemia Carries Higher Mortality13:14 – TCCC Guidelines – After First Unit? Is This Too Aggressive?14:03 – When Should You Actually Give Calcium in the Field?19:34 – Clinical Triggers Without Monitoring + Dosing Strategy24:56 – Safety First: IV Patency, Calcium Chloride vs Gluconate, IO Concerns28:44 – When to Stop Giving Calcium & Avoiding Over-Correction32:00 – Historical Lessons: When Calcium Alone Made Things Worse33:39 – Practical PFC Recommendations & Final Thoughts38:04 – Closing & Where to Find MoreFor more content, go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care⁠⁠⁠

North Macedonia has waited 21 years at the EU's door. Zoran Dimitrovski and Linas Kojala ask what delay now costs Europe. Look at a map and the unresolved logic is striking. Albania, Bosnia and Herzegovina, Kosovo, Montenegro, North Macedonia and Serbia are almost entirely surrounded by EU and NATO members. These countries are not on some distant European frontier. They form an enclave within the Union's own geography. In 2003, at the Thessaloniki summit, the EU promised the Western Balkans a European future. More than two decades later, Croatia remains the last country to have joined, back in 2013. Since Russia's invasion of Ukraine, enlargement has shifted from a slow technical process to an urgent geopolitical question: what happens when Europe leaves a space inside its own borders unfilled? My guests brought two unusually powerful perspectives to that question. Zoran Dimitrovski, North Macedonia's Deputy Minister of Foreign Affairs and Foreign Trade, spent 35 years as a journalist before entering government. He edited some of his country's leading newspapers, reported from Washington, wrote more than 1,500 articles and investigations, and continues to teach critical thinking and analytical writing. Alongside him was Linas Kojala, CEO of the Geopolitics and Security Studies Center in Vilnius and a lecturer at Vilnius University. A Fulbright scholar with studies at Oxford, Cambridge and Harvard, Kojala has written about Lithuania's own journey into the European Union and has been ranked among his country's most influential public figures. Twenty-one years at the front door North Macedonia became an EU candidate in 2005, around the same time as Croatia. Yet it still has not opened substantive accession negotiations. The country first faced a long dispute with Greece over its name, eventually resolved through the Prespa Agreement and the adoption of the name North Macedonia. That opened the way into NATO. A second dispute then emerged with neighbouring Bulgaria, involving language, identity, history and the recognition of a Bulgarian community within North Macedonia's constitution. Zoran Dimitrovski did not deny the work still required within his own country. North Macedonia must continue aligning its laws with the EU, strengthening the judiciary and fighting corruption. His argument was that these shortcomings were not the principal reason the country had been stopped. This describes one of the demands that, in Dimitrovski's view, reach beyond the Copenhagen criteria governing democratic institutions, human rights, the rule of law and a functioning market economy. There is, however, responsibility on both sides of the border and both sides of the accession table. The European Parliament's latest assessment expresses regret at North Macedonia's lack of progress, calling for the constitutional amendments, stronger cross-party cooperation and deeper reforms. Yet that same resolution warns that bilateral disputes over language, culture and national identity should not be used to obstruct accession. This is the uncomfortable heart of the story: the EU must remain demanding enough for membership to retain meaning, while remaining fair enough for its promises to retain credibility. The rules were written for a different Europe Kojala argued that the enlargement machinery itself must adapt to a radically altered security landscape. The process still requires unanimity at critical stages, allowing one member state to hold up another country's progress. Under normal circumstances, such caution might be defensible. These, he stressed, are not normal circumstances. The EU's decision-making can be painfully slow because 27 governments must agree on decisions touching sovereignty, money and national interest. Kojala compared it to 27 friends attempting to choose a restaurant, except that several of them may not be friends and the decisions are monumental. The central question is therefore whether procedures devised 20 years ago are still adequate for a Europe facing war, cyber-attacks, sabotage, disinformation and growing competition from authoritarian powers. Railways, bridges and the architecture of security EU enlargement may sound abstract, but it rapidly becomes concrete. It is about railway lines, bridges, roads, energy systems and digital networks. Dimitrovski pointed to Corridors VIII and X, which cross North Macedonia and connect the Adriatic, Black and Aegean Seas with wider Europe. These routes matter for trade and daily life, but also for NATO's ability to move personnel and equipment across the continent. A bridge too weak to carry military vehicles is simultaneously an infrastructure problem, an economic weakness and a security vulnerability. Kojala offered a useful challenge to the language of cost. Security spending is often discussed as money disappearing from productive use. Yet roads, schools, housing, communications and transport capacity remain in the communities where they are built. The same is true of enlargement: investment in the Western Balkans is not charity at Europe's edge. It is investment in the resilience of the continent as a whole. A vacuum rarely stays empty Russia remains an influential force in Serbia and parts of Bosnia and Herzegovina, while Chinese lending and infrastructure investment have expanded across the region. Dimitrovski was careful not to suggest that the Western Balkans would simply abandon Europe for Moscow or Beijing. His warning was more subtle. Prolonged uncertainty can produce weaker institutions, frustrated populations and a region increasingly exposed to financial pressure, political manipulation and disinformation. Europe therefore faces a choice that is larger than whether another flag appears outside the institutions in Brussels. It must decide whether the Western Balkans are genuinely part of its future, and demonstrate that belief through fair conditions, credible timelines and visible results. Kojala described the European Union as something close to a “boring miracle”: cumbersome, imperfect and endlessly predicted to collapse, yet remarkably capable of adapting and surviving. That miracle now requires another act of political imagination. The Western Balkans have spent more than 20 years hearing that their future lies inside the European Union. Europe may now need to ask a harder question of itself: how long can a promise remain credible before waiting becomes its own form of rejection?

Our favourite farmer from Gormanston as the prolonged dry spell really begins to bite agriculture. - DARRAGH MC CULLAGH Hosted on Acast. See acast.com/privacy for more information.

Renewed US-Iran tensions and Russian refinery disruptions are raising concerns over energy supplies, inflation and chemical market demand.• Prolonged disruption could trigger a major supply shock• Russian refinery outages are tightening fuel product supplies• Chemical markets remain cautious despite rising crude prices• Higher energy costs could fuel inflation and demand weakness• Global oil inventories and reserves continue to decline• China's slowdown is weighing on petrochemical demand• Chemical buyers are delaying purchases amid uncertainty• Demand destruction may limit chemical price increases• Companies should strengthen resilience against market shocksIn this Think Tank podcast, Will Beacham interviews ICIS Insight Editor Tom Brown and Paul Hodges, chairman of New Normal Consulting.

Brandon preached about how our posture should be when facing prolonged opposition. Prolonged opposition can lead to discouragement and weariness, causing us to lose focus. Weariness is not a sign that God has abandoned us, it is often where His strength is revealed most powerfully. God is everlasting and He doesn't grow tired or weary. We are created to be totally dependent on Him even when facing opposition.

War Room Tyler Robinson's Furry Boyfriend Lance Twiggs Testifies Against Him In Charlie Kirk Murder Trial… PLUS, Trump Says Iran Called Begging for Deal After US Strikes, As USA Braces for Prolonged Escalation

Brendan Kelly, Professor of Psychiatry at Trinity College Dublin, outlines how prolonged exposure to hotter than usual temperatures can impact mental health and behaviour.

Episode #437 Prolonged Separation and the Convenant. Chris Moles

Impacts of Heat Waves on Human Health Across the United States, climate change is increasing the frequency and intensity of heat waves. A heat wave is defined as a persistent period of high temperature days. Although unusually hot days are a natural part of day-to-day variations in weather, heat waves are becoming more common alongside the rapidly accelerating climate crisis. In major cities across the country, the number of heat waves has increased steadily, from two heat waves per year in the 1960s to six per year into the 2010s and 2020s. In the 1960s, the average heat wave was 2.0 degrees above the local 85th percentile threshold, while the average heat wave during the 2020s has been 2.5 degrees above the local threshold. Approximately 210 million Americans, or two thirds of the population, live in counties vulnerable to health threats from high temperatures. As temperatures increase, the number of heat-related illnesses, emergency room visits, and deaths simultaneously increase. As we head further into the 21st century, adaptive measures to protect human health from the effects of extreme heat waves will be necessary in the face of rising climate risk. Protecting yourself during extreme heat Over the past three decades, heat waves have been the leading cause of weather-related fatalities across the nation. In addition to rising heat-related illnesses and deaths, extreme heat can also worsen health outcomes from chronic conditions such as cardiovascular disease, respiratory disease, and acute kidney injury. Extreme temperatures compromise the body's ability to regulate its internal temperature, resulting in illness, heat cramps, heat exhaustion, heatstroke, and hyperthermia. Individuals living in densely populated cities are extremely vulnerable to the urban heat island effect, which exacerbates high heat temperatures as man made surfaces absorb sunlight during the day and radiate the stored energy at night as heat. Children, the elderly, people experiencing homelessness, low-income communities and individuals with pre-existing health conditions are at the greatest risk to the adverse effects of extreme heat. As temperatures continue to rise, it is necessary that individuals take on adaptive measures to protect themselves from the health risks posed by extreme heat.  Action can be taken on both a policy and an individual level. Local governments can take steps to help residents reduce their vulnerability to heat through heat management plans and vulnerability assessments. For example, officials can create early warning systems and urban cooling centers for individuals to find refuge. On an individual scale, when you need to go outside, taking preventive measures such as sun protection, hats, and umbrellas is vital to stay cool. Trying to stay inside as much as possible and finding refuge from the heat will help one avoid the risks of heatstroke. More educational initiatives will be vital in informing individuals on risk factors, symptoms, and treatment steps to keep people safe and informed. Benefits of protecting oneself during extreme heat  During periods of extreme heat, it is important to take proper care of yourself in order to mitigate the health effects that result from high temperatures such as dehydration, heat stroke, exhaustion, and slowed cognitive function. Taking extreme heat seriously is vital, as the effects of extreme temperatures can be as serious as sudden events like heart attack or stroke. Prolonged periods of heat and humidity make your body work extra hard to maintain a normal temperature, so taking such precautions is necessary to protect yourself and your loved ones. As extreme heat-related weather events become more common, becoming accustomed to the ways you can keep yourself safe is imperative in a warming world. More progress can be made If we fail to take adaptation measures on both an individual and policy level, we will be unprepared to respond to the impacts of extreme heat. As extreme heat rises in prevalence, more awareness on the ways to respond to increasingly high temperatures can help individuals adapt to such events. Currently, heat is already the weather phenomenon that kills the most people in the United States, so taking care of yourself, family, and neighbors during heat waves is essential to saving lives. For residents who do not have the resources or cooling systems in place to seek protection during a heat wave, the use of cooling centers in cities can provide short-term relief. Important to note, however, is that the increased use of cooling systems will heighten electricity costs due to increasing demand, thereby generating more greenhouse gas emissions from rising power generation. If leaks are to occur, concerns can also arise around the potential release of potent refrigerant gasses, which worsen climate change and damage the ozone layer. This creates a self-perpetuating cycle in that air conditioning is used to treat extreme temperatures, but effectively worsens the climate crisis in doing so. More innovative solutions will be necessary to curtail emissions while keeping individuals safe. Beyond individual actions during times of crisis, cities also need to help their residents respond to rising temperatures in the long-term by redesigning public spaces, planting trees to provide cooling, painting rooftops white to repel sunlight, and incorporating new cooling technologies in buildings and homes.  About our guest Dr. David Sklar is an Assistant Dean at the Arizona State University School of Medicine and Advanced Medical Engineering, is a Professor at the ASU College of Health Solutions and works as an emergency physician. Former Editor in Chief of Academic Medicine, Dr. Sklar now works as a senior advisor in health policy and health professions education at ASU Health. Dr. Sklar works to increase awareness on mitigative steps individuals can take to decrease their health risks from extreme heat events. Resources Indiana University: Adaptation strategies for extreme heat and public health NRDC: Climate Change and Health: Extreme Heat EPA: Climate Change Indicators: Heat Waves WHO: Heat and Health NIH: Temperature-related Death and Illness Further Reading Penn State: Climate-driven extreme heat may make parts of Earth too hot for humans Arch Daily:How to Adapt Cities to Extreme Heat White House: Planning Tools for Combatting Extreme Heat For a transcript, please visit https://climatebreak.org/staying-safe-in-extreme-heat-with-dr-david-sklar/

A “prolonged spell of very warm or hot weather” will occur in Ireland this week and into next week. This is according to Met Éireann, with temperatures possibly reaching 30 degrees. We get a weather update with Aoife Kealy, Met Eireann Meteorologist.

Discover how cancer develops and spreads, the biggest factors that increase cancer risk, and natural strategies to help prevent cancer by supporting your immune system and overall health.0:00 Cancer cells2:54 How cancer develops 4:36 Traditional cancer research vs. epigenetics 5:59 More cancer facts6:57 Prolonged fasting and cancer prevention 7:17 Cancer and your immune system 8:24 Cancer and vitamin D 9:08 Inflammation and cancer 9:28 Cancer and your DNA 10:09 Factors that increase cancer risk11:39 Cancer prevention tips

Guest host Charis Hogg talks to Ian Tostenson, President of the B.C. Restaurant and Foodservices Association Learn more about your ad choices. Visit megaphone.fm/adchoices

Greg Brady talked about Prolonged extreme heat wave creates dangerous conditions in Toronto and across Canada Learn more about your ad choices. Visit megaphone.fm/adchoices

Soothe, calm, and heal your nervous system in just 15 minutes with this easy guided meditation. Using scientifically-supported practices like prolonged exhale breathing, this meditation practice will activate the vagus nerve and thereby the parasympathetic (rest and digest) nervous system, instilling calm throughout your whole being, and restoring your natural balance. Be sure that you stay all 15 minutes, as it is the last 5 minutes that are the most effective for calming and rebalancing your nervous system. This guided meditation features: - Prolonged exhale breathing, which is scientifically-shown to stimulate the vagus nerve, instill calm, and relax the mind and body. - Anxiety and stress reduction techniques - Nervous system re-balancing, healing, and regulation - Soothing affirmations to calm and quiet the mind This meditation is designed for daily practice to help foster a regulated nervous system. #meditation #vagusnerve #nervoussystemregulation Check out the Wake Me Up Mindset Coach app: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠http://studio.com/wakemeup⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠. You get: Full Access to the WMU catalog; a personal growth plan based on my guidance and coaching; simple, daily tasks (5-10 minutes a day) to guide you through your own personal transformation; your plan evolves with you as you and your life change. It's the most effective way to digest the content in Wake Me Up for creating personal change! Get ad-free access to the entire WMU catalog + bonus content by joining the WMU Premium Feed. Grab a 7-day free trial of Wake Me Up premium: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://goodpeoplestuff.supercast.com/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ About Wake Me Up Wake Me Up is the # 1 guided morning routine podcast. Our guided morning wake ups offer affirmations, mindfulness, meditation, yoga, and motivation specifically designed to help you get out of bed and start your day with a positive mindset. Stop pressing the snooze button all morning long, and turn on an episode of Wake Me Up instead. You will be happier and more successful at everything in life because of it!   I make this channel to serve you. Part of that is creating tools like journals and courses to dive deeper into certain topics, all of which you can find here: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://stan.store/goodpplstuff⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Follow Wake Me Up on ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Youtube⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ -  ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Spotify⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Apple Podcasts⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Amazon⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Podchaser⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Say hi or request an episode at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.wakemeuppodcast.com/contact⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠. See visual guides for the yoga and stretches in WMU episodes at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.wakemeuppodcast.com/stretches⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠. **Only partake in the physical movements suggested in Wake Me Up episodes if you are physically able and in safe surroundings. All movements are done at the individual's own risk. Be safe, and always consult a doctor if you have any questions or concerns.** Have a wonderful day

Prolonged mechanical ventilation in rural long-term care settings brings a unique set of clinical, ethical, and logistical challenges for care teams, residents, and their families. In this episode, we explore the realities of ventilator use in rural long-term care environments, where limited resources and geographic barriers can complicate care decisions and delivery. We also take a thoughtful look at the emotional and practical impact of ventilator discontinuation, highlighting the experiences of those directly affected. Join us for a nuanced conversation that sheds light on an often-overlooked aspect of long-term care and the difficult decisions that come with it.      Von Vitto, DNP, CNP, AGNP-C, ACHPN® Von Vitto, DNP, CNP, AGNP-C, ACHPN® is a board-certified adult-gerontology nurse practitioner and has advanced certification as a hospice and palliative nurse. He currently serves as a nurse practitioner at HospiceCare in The Berkshires, Inc. in Berkshire County, MA. Von brings years of experience in delivering geriatric and specialty palliative care in skilled nursing facilities and to community-dwelling patients. He is passionate about navigating serious illness conversations and the provision of goal-concordant care. Von has also mentored and precepted nurse educator and nurse practitioner students.    Julie Thurston Julie Thurston is a board-certified Adult-Gerontology Primary Care Nurse Practitioner with advanced certification in Hospice and Palliative Care who currently serves as a key member of the leadership team at HospiceCare in The Berkshires, Berkshire County, Massachusetts. In her role, Julie provides comprehensive patient and family-centered care, supports her organization in ongoing performance improvement projects, and mentors her staff in various professional development opportunities. During her tenure, Julie has embraced diverse roles including RN Case Manager, RN Weekend/Evening Triage, and Staff Educator. Her commitment to the provision of high-quality care across the continuum earned her an Integritus Healthcare Profiles in Care award. Additionally, she shares her expert knowledge and experience providing education throughout the local community for healthcare providers across multiple disciplines. Julie has been an active member of the Hospice and Palliative Nurses Association since 2010.   Brett Snodgrass, DNP, FNP-C, ACHPN®, FAANP Dr. Brett Snodgrass has been a registered nurse for 28 years and a Family Nurse Practitioner for 18 years, practicing in multiple settings, including family practice, urgent care, emergency departments, administration, chronic pain and palliative medicine. She is currently the Operations Director for Palliative Medicine at Baptist Health Systems in Memphis, TN. She is board certified with the American Academy of Nurse Practitioners. She is also a Fellow of the American Association of Nurse Practitioners and an Advanced Certified Hospice and Palliative Nurse. She completed a Doctorate of Nursing Practice at the University of Alabama – Huntsville. She is a nationally recognized nurse practitioner speaker and teacher. Brett is a chronic pain expert, working for more than 20 years with chronic pain and palliative patients in a variety of settings. She is honored to be the HPNA 2025 podcast host. She is married with two daughters, two son in laws, one grandson, and now an empty nest cat. She and her family are actively involved in their church and she is an avid reader.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners.This episode covers the topic of grief with Dr. Cindy Grief, a Geriatric Psychiatrist at Baycrest Health Sciences in Toronto, where she is the Medical Director for Mental Health Services. She is also an Associate Professor at the University of Toronto and has played active roles in postgraduate and continuing education.The learning objectives for this episode are as followsExplain how acute grief becomes integrated over time, and how the dual process model helps us understand this adaptive process.Recognize the clinical features of Prolonged Grief Disorder, understand factors that may increase vulnerability, and distinguish it from trauma-related disorders and depression.Structure a bereavement-focused clinical history, differentiate the management of normative grief from Prolonged Grief Disorder, and approach suicide risk assessment in the context of grief.Guest: Dr. Cindy GriefHosts: Ahmad Khan (incoming PGY1), Dr. Angad Singh (PGY2), and Sara Abrahamson (MS3)Audio editing: Dr. Angad SinghResources:T⁠he Center for Prolonged Grief (https://prolongedgrief.columbia.edu/)Canadian Virtual Hospice  (MyGrief.ca)Association for Death Education and Counseling (https://adec.org)What's Your Grief (https://whatsyourgrief.com/)Podcasts: AllThere Is; Griefcast⁠⁠Books/Memoirs:Joan Didion, The Year of Magical ThinkingHelen Macdonald, H Is for HawkC.S. Lewis, A Grief ObservedChimamand Ngozi Adichie, Notes on GriefArticles:A.C. Shilton, “There Is No Vaccine for Grief,” New York Times, March 2, 2021M. Stroebe, “The Poetry of Grief: Beyond Scientific Portrayal,” OMEGA: Journal of Death and Dying, 2018, 78(1), 67–96References:Shear, K., Frank, E., Houck, P. R., & Reynolds, C. F., III. (2005). Treatment of complicated grief: A randomized controlled trial. Journal of the American Medical Association, 293(21), 2601–2608. https://doi.org/10.1001/jama.293.21.2601Simon, N. M., & Shear, M. K. (2024). Prolonged grief disorder. New England Journal of Medicine, 391(13), 1227–1236. https://doi.org/10.1056/NEJMcp2308707Zisook, S., & Shear, K. (2009). Grief and bereavement: What psychiatrists need to know. World Psychiatry, 8(2), 67–74. https://doi.org/10.1002/j.2051-5545.2009.tb00217.x

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Learn about the Healing Power of Prolonged Fasting: HEREWhat if the secret to deep healing isn't doing more, but going further?Most people assume that repeating short fasts is just as powerful as completing one long fast. Stack enough three-day fasts together and you'll eventually get the same result, right?It's a reasonable assumption, but it may be costing you the deeper healing you're working so hard to reach.Dr. Katie breaks down something many people have never been taught: short fasts and prolonged fasts are not the same healing tool. Short fasts are genuinely valuable. They can support ketosis, lower insulin, improve metabolic flexibility, and put pressure on cancer cells. Dr. Katie does a three-day fast herself every month.But she says they stop short of the second tier.That second tier begins after the early detox window, when the body moves into a much deeper fasting state. Around day eight is the threshold where the fast stops being just a metabolic tool and begins to reveal a much deeper layer of healing. Dr. Katie believes most people never reach because they keep restarting the clock.Chapters:00:04:22 - Why Short Fasts Reset the Clock00:05:21 - Detox Starts After Day Four00:06:21 - Why Long Fasts Need Supervision00:07:23 - The Danger of Refeeding Wrong00:08:21 - The Magic of Day Eight00:09:31 - The Body Targets Damaged Tissue00:10:22 - When Tumor Shrinkage Becomes Possible00:12:17 - The Mind Finally Quiets00:13:20 - Healing Crises Begin00:16:49 - Why You Can't Stack Short Fasts00:17:32 - Cancer Deserves the Full Distance00:18:52 - The Brain Tumor That Disappeared00:19:45 - Why Refeeding Matters Most00:21:00 - Fasting Opens Emotional Healing00:23:19 - What Cancer Experts Would Do00:24:45 - Physical and Emotional Healing Arrive TogetherEvery time you break a fast, your body doesn't just pause. It resets. Dr. Katie uses one simple analogy that makes this clear, and once you hear it, the difference between stacking short fasts and completing a prolonged fast becomes hard to unsee.Press play to learn why Dr. Katie believes anyone fasting for cancer needs to understand the difference between stopping early and going the full distance.Join Dr. Katie's 3-Day Guided Fast, for expert support, daily live calls, and a community to fast alongside: Sign-Up Follow Dr. Katie Deming on InstagramWatch on YoutubeDISCLAIMER: The Born to Heal Podcast  is intended for informational purposes only and is not a substitute for seeking professional medical advice, diagnosis, or treatment. Individual medical histories are unique; therefore, this episode should not be used to diagnose, treat, cure, or prevent any disease without consulting your healthcare provider.A thought-provoking podcast explores cancer through the lens of holistic medicine and functional medicine, discussing causes of cancer, metabolic health, and unconventional approaches like water fasting, fasting and autophagy, and detox, while weighing fasting benefits against chemo side effects and radiation side effects, sharing stories of a cancer survivor navigating chemotherapy, natural medicine, holistic healing, and even spiritual healing on the path toward cancer remission and holistic health. 

What happens to your body during a 5-day fast? Discover the benefits of fasting day by day, how to activate autophagy, support cellular repair and cleanup, plus fasting tips for maximum results. 0:00 Fasting day by day 1:03 mTOR fasting 1:57 Fasting day 1 2:26 Sodium while fasting 3:32 Day 2 fasting 5:10 Autophagy benefits day 3 7:47 Prolonged fasting benefits day 49:24 5 days of fasting results 10:26 Refeeding tips 11:17 Fasting contraindications

A man in China had a happy life and healthy family, he and his wife had three attractive children and they lived in harmony. But then his wife and two of his children developed mental illnesses and his life became miserable. He discovered Falun Dafa in 2005 and began to practice wholeheartedly. His health improved, and he came to understand his hardships were due to past actions. He now sleeps well and lives a life dedicated to helping Master save sentient beings. This and other experience-sharing from the Minghui website.Original Articles:1. Master Saved Me From Prolonged Misery2. Master Repaid My Debts for Me3. Righteous Thoughts Are Powerful To provide feedback on this podcast, please email us at feedback@minghuiradio.org

Prolonged exposure to sin will cause you to have a seared conscious and become insensitive to conviction.

Listen to today's podcast... It is time to take make sure that we take our lunch break.  North American workers who take a lunch break every day scored higher on a wide range of engagement metrics, including job satisfaction, likelihood to continue working at the same company, and likelihood to recommend their employer to others. And though we would like to blame others for not taking our lunch break, that doesn't seem to be the case in reality. It seems that our workload is a much greater influence on whether or not we take a lunch break than our boss or company policy. And if we do eat, we tend to stay at our desks and nibble while we work. Take One Action Today To Build Your #Resiliency!      So Here are today's Tips For Building Resiliency and Celebrating Take Back The Lunch Break Day: Know that it is essential to take that lunch break in order to maintain your energy and productivity. 38% of employees don't feel encouraged to take a lunch break. It is everyone's responsibility to ensure healthy habits within the workplace.  So, invite a friend to go for a lunchtime walk. The light break and exercise will boost your mental health and your immunity. If you are the boss, model healthy habits by not calling lunch time meetings. Encourage your team to leave their desks for lunch. Prolonged sitting is a health risk, so get up, stretch, grab something to eat, and change the scenery. Your mind and body will thank you. Remember, If you like today's wellness tips, let me know. You can leave me a review on amazon or through your #alexa app. Take One Action Today To Build Your Resiliency! #mentalhealth #hr

Welcome to the Courageous Leadership with Virginia Prodan podcast! Episode : Fear Determines Your Actions - Virginia Prodan           Fear can significantly influence your actions in various ways. Fear can be both a hindrance and a motivator. It's essential to recognize its impact on your actions and consider strategies to manage fear effectively, such as mindfulness, therapy, or gradual exposure to feared situations. Prolonged fear can create long-lasting behavior patterns, leading to phobias or anxiety disorders. Overcoming fears can lead to personal growth, resilience, and increased confidence. Join us for weekly episodes that aim to inspire and empower you to: Deepen your Christian faith and live with bold courage; Advocate for freedom and uphold values in an increasingly challenging culture; Gain powerful insights from history; Uncover your God-given purpose and calling; Lead with conviction in your home, church, and society.        I'm Virginia Prodan —international human rights attorney, keynote speaker, author of Saving My Assassin, and a survivor of socialist Romania. I understand the true cost of freedom, the strength of faith, and the courage required to advocate for truth amidst adversity. Whether you're looking for encouragement, solutions to cultural challenges, or actionable steps to boldly live out your faith, this podcast will equip you to stand firm.           Stay Connected with Virginia Prodan

The FBI director publicly criticized how the Nancy Guthrie case was handled. Jennifer Coffindaffer spent 28 years at the Bureau and knows what it takes to push that kind of institutional conflict into the open. Private conversations failed first. Then the director went on record. That sequence tells you something specific about how badly the agency believes the early investigation was compromised.Coffindaffer walks through the operational difference between being notified about a case and having control over it — because the distinction matters when evidence is decaying by the hour. Digital evidence degrades. Biological evidence degrades. Witness memory degrades. An 84-year-old woman who required daily medication was missing, and the clock was running from the moment she disappeared. Speed was the single most important variable. Institutional friction is what kills speed first.She addresses the less visible damage that persists months into an investigation built on inter-agency conflict. Investigators become defensive. Witnesses become hesitant when they sense the people asking questions aren't coordinated. Tips fragment across competing internal systems. Prolonged forensic ambiguity this far into the case may signal that investigators aren't working with clean results — and Coffindaffer explains what that means for the prosecution if a suspect is eventually identified.Meanwhile, a headline sent the community spiraling. Pima County issued a BOLO for Coral Michelle Smith — wanted for kidnapping seven miles from where Nancy was taken. Authorities explicitly stated there's no connection. But four months without a named suspect creates a vacuum that pulls in every nearby crime.Smith's fifteen-year record — four prison stints, two revoked probations, a kidnapping charge pled down — describes opportunistic street-level offenses. Nothing matching the porch figure captured on Nancy's doorbell camera. The FBI describes that figure as male, 5'9" to 5'10". Smith is 5'6". The porch figure has an apparent wrist tattoo. Smith's tattoos are on her ankle, foot, and leg. The profiles don't align. But what Smith's record does reveal is a system that kept releasing a repeat offender — a separate institutional failure in the same county that's already under scrutiny for how it handled Nancy's disappearance.Join Our SubStack For AD-FREE ADVANCE EPISODES & EXTRAS!: https://hiddenkillers.substack.com/Want to comment and watch this podcast as a video? Check out our YouTube Channel. https://www.youtube.com/channel/UC8-vxmbhTxxG10sO1izODJg?sub_confirmation=1Instagram https://www.instagram.com/hiddenkillerspod/Facebook https://www.facebook.com/hiddenkillerspod/Tik-Tok https://www.tiktok.com/@hiddenkillerspodX Twitter https://x.com/TrueCrimePodThis publication contains commentary and opinion based on publicly available information. All individuals are presumed innocent until proven guilty in a court of law. Nothing published here should be taken as a statement of fact, health or legal advice.#NancyGuthrie #SavannahGuthrie #FBI #PimaCountySheriff #JenniferCoffindaffer #CoralMichelleSmith #HiddenKillers #TrueCrime #TucsonArizona #JusticeForNancy

Nancy Guthrie was 84 years old, medically vulnerable, and required daily medication. Speed mattered more in her case than almost any other variable. And speed is exactly what institutional friction destroys first.Jennifer Coffindaffer spent 28 years at the FBI. She explains what happens to an investigation when the lead local agency and the federal agency aren't aligned — not in theory, but operationally. Digital evidence degrades. Biological evidence degrades. Witness memory degrades. Tips fragment across competing systems that aren't sharing information in real time. Investigators become defensive when they sense oversight. Witnesses become hesitant when the people asking questions don't seem coordinated. Prolonged forensic ambiguity months into a case may signal something worse — that investigators aren't working with clean results.The FBI director went public with criticism of how this case was handled. Coffindaffer says that doesn't happen over minor procedural disagreements. It happens when the Bureau believes critical evidence and critical time were lost, and private channels failed to produce change. That public rupture tells you where the institutional relationship was before the director spoke — and where it is now.Four months without a named suspect created a vacuum this week when Pima County issued a BOLO for Coral Michelle Smith — wanted for kidnapping and aggravated assault seven miles from where Nancy disappeared. Authorities stated explicitly there's no connection. Smith's fifteen-year criminal record describes opportunistic street-level offenses — four prison stints, two revoked probations, a kidnapping charge pled down. The FBI describes the porch figure as male, 5'9" to 5'10". Smith is 5'6" with tattoos on her ankle, foot, and leg — not the wrist tattoo visible on the porch figure. Nothing matches. But the headline filled the vacuum because the investigation hasn't filled it with an arrest.The Guthrie family is still waiting. The person who took Nancy is still unidentified. And Coffindaffer forces the question the public hasn't fully confronted: was the biggest obstacle in this case the offender — or the institutions that were supposed to find him?Join Our SubStack For AD-FREE ADVANCE EPISODES & EXTRAS!: https://hiddenkillers.substack.com/Want to comment and watch this podcast as a video? Check out our YouTube Channel. https://www.youtube.com/channel/UC8-vxmbhTxxG10sO1izODJg?sub_confirmation=1Instagram https://www.instagram.com/hiddenkillerspod/Facebook https://www.facebook.com/hiddenkillerspod/Tik-Tok https://www.tiktok.com/@hiddenkillerspodX Twitter https://x.com/TrueCrimePodThis publication contains commentary and opinion based on publicly available information. All individuals are presumed innocent until proven guilty in a court of law. Nothing published here should be taken as a statement of fact, health or legal advice.#NancyGuthrie #SavannahGuthrie #FBI #PimaCountySheriff #JenniferCoffindaffer #CoralMichelleSmith #HiddenKillers #TrueCrime #TucsonArizona #JusticeForNancy

In this episode of the Prolonged Field Care Podcast, Dennis sits down with trauma surgeon Mark Shapiro for a no-BS masterclass on wound ballistics. They break down why understanding the physics of penetrating and blast trauma matters in austere and combat environments — even when experience makes you cynical. From high-velocity rifle rounds and their massive temporary cavities to the infectious nightmare of shotgun wounds and the four phases of blast injury, Mark shares hard-won lessons from civilian Level I trauma centers and years training special operations medics and ground surgical teams.They tackle the myths around entry/exit wounds, when (and when not) to explore right upper quadrant gunshot wounds downrange, why you should almost never pack the abdomen or chest from the outside, how to assess neurovascular status in blast-injured extremities, and why bizarre bullet paths and “stable” patients with signs of life can still surprise you.Key Takeaways:Kinetic energy (½mv²) means velocity is king — high-velocity rifle rounds create devastating temporary cavities and fragmentation that can turn one projectile into many.Jacketed rounds still fragment at rifle speeds; never assume a clean through-and-through. Bone fragments act like secondary missiles and can create wounds up to 3x the size of the fragment.For stable patients with right upper quadrant GSWs in resource-limited settings, expectant management can be reasonable — but you must have a plan, know your limits, and be ready to move if things change.Never pack the abdomen or chest from the outside in most cases. It risks pushing debris deeper and worsening injuries. Cover exposed organs if needed, but don't shove gauze into body cavities.Shotgun wounds (especially buckshot/birdshot) are “mobile IEDs” — massive tissue destruction, heavy debris inoculation, and extremely high risk of infection, fistula, and devascularized tissue requiring serial debridement.In extremity blast trauma, assess vascular status (pulses, Doppler signals, color, warmth, capillary refill) and neurologic function. The ~6-hour window to revascularization is critical, but the decision point comes earlier.Training + common sense + adaptability beat rigid protocols when resources are limited. Sometimes the best move is observation.Chapters04:15 – Why Wound Ballistics Knowledge Still Matters (even when you're cynical)08:30 – High-Energy Rifle Wounds: Muzzle Velocity, Kinetic Energy & Spitzer Bullets13:45 – Fragmentation, Tumbling & Secondary Missiles (bone shards & unpredictable paths)18:20 – Clinical Reality: Multiple Injuries & Why “Small Entrance, Big Exit” Is a Myth22:50 – Entry vs. Exit Wounds: When Trajectory Actually Matters (and when it doesn't)26:40 – Right Upper Quadrant GSWs: Explore, Observe, or Expectant Management Downrange?31:10 – The Dangers of Packing Abdominal & Chest Wounds from the Outside34:55 – Low-Energy Pistol Wounds: How They Differ (or Don't) from Rifles37:20 – Shotgun Wounds: Close-Range Carnage, Debris & Infectious Nightmares42:40 – IEDs & Modern Explosives: Blast Physics, Ukraine Patterns & Hard-Ground Effects48:15 – Primary, Secondary, Tertiary & Quaternary Blast Injuries Explained52:30 – Neurovascular Assessment in Blast-Injured Extremities (Conscious & Unconscious Patients)56:45 – Lessons from the Trauma Bay: Common Sense, Training & Knowing When to Deviate from ProtocolFor more content, go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care⁠

In this high-signal PFC Podcast episode, Dennis sits down with Dr. John Wightman — former 24th Special Operations Wing Surgeon, emergency physician, and one of the world's leading experts on blast injuries. Drawing from decades of clinical, combat, and academic experience (including co-authoring a seminal paper on blast injuries just before 9/11 and multiple combat deployments), Dr. Wightman breaks down the unique pathophysiology, recognition, and prolonged field care management of blast lung injury — the often-hidden threat that can kill even when penetrating trauma doesn't.From the physics of the supersonic pressure wave to practical field decisions on tension pneumothorax, ventilation strategies, fluid management, and avoiding air embolism, this is essential listening for medics, operators, and anyone preparing for large-scale combat operations, urban warfare, or confined-space blasts.Key Takeaways:Primary blast lung injury is caused by the blast wave itself — not fragments or being thrown — and creates unique pulmonary contusions, air leaks, and arterial air emboli risks.Most significant blast lung develops within the first 1–6 hours; subtle dyspnea on exertion can be an early warning.MARCH priorities still rule — aggressively rule out (or treat) tension pneumothorax, even bilaterally, before assuming blast lung.Positive pressure ventilation can worsen outcomes (especially air embolism risk) — use judiciously; CPAP or PEEP may be better bridges when possible.PAO₂/FiO₂ ratio (or SpO₂ on room air) helps stratify severity and predict need for advanced support.Tympanic membrane rupture proves blast exposure but is not required for blast lung.Fluid management must be careful — permissive hypotension may be dangerous in blast lung + shock.Don't forget occult blast bowel injury — delayed perforation is real (up to 8 days).Whether you're running a team in Ukraine-style trench warfare, preparing for mass casualty events, or just want to stay on the bleeding edge of combat medicine, this episode delivers critical, actionable knowledge.Chapters:00:43 - John Wightman Introduction: 32 Years as Air Force EM Physician & Blast Injury Expert02:54 - What Is Blast Lung? Defining Primary vs Secondary, Tertiary, Quaternary & Collateral Injuries05:23 - The Physics of the Blast Wave: Overpressure, Stress Waves & Alveolar Damage09:50 - Pathophysiology: Pulmonary Contusion, Pneumothorax, Air Embolism & Traumatic Pseudocysts12:30 - Timelines: When Does Blast Lung Declare Itself? (Israeli & Combat Data)15:56 - Epidemiology: Confined Spaces, Buses, Buildings vs Open-Air Blasts23:12 - Field Diagnosis & MARCH Priorities — Tension Pneumothorax First28:30 - Advanced Assessment: P/F Ratio, Ultrasound Findings, SpO₂ Guidance35:55 - Ventilation Strategies: When to Intubate, CPAP/PEEP, Lung Protective Settings41:18 - Oxygenation Goals, Fluid Management & Permissive Hypotension Risks52:16 - Air Embolism Management & Patient Positioning56:12 - Other Critical Considerations: Blast Bowel Injury, TM Rupture, Resource Triage01:04:36 - Final Thoughts & Key Advice for Deploying MedicsFor more content, go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care⁠

In today's episode, Tanner and Anne provide ideas on how to get to the root cause of your chronic pain or symptoms.Neuroplastic pain/symptoms occur when there's a sense of danger and dysregulation in the brain and nervous system - not due to physical disease or damage. So it makes sense to ask - what's creating this sense of danger?You'll learn about pain/symptoms can be fueled by:• Prolonged high stress, including perfectionism and people pleasing• Childhood adversity and trauma as sensitizing factros• Pathological views of the body fueled by medical ideas, Googling, ChatGPT, fear, and avoidance • Emotional resistance• Dysregulated responses to feeling pain/symptoms throughout the day.Tanner Murtagh and Anne Hampson are therapists who treat neuroplastic pain and mind-body symptoms. They are also married!In his 20s, Tanner overcame chronic pain and a fibromyalgia diagnosis by learning his symptoms were neuroplastic, not structural. Post-healing, Tanner and Anne have dedicated their lives to developing effective treatment and education for neuroplastic pain and symptoms.Listen and learn how to assess your own chronic pain and symptoms, gain tools to retrain the brain and nervous system, and make changes in your life and health!The Mind-Body Couple podcast is owned by Pain Psychotherapy Canada Inc. This podcast is produced by Alex Klassen, one of the wonderful therapists at our agency in Calgary, Alberta. https://www.painpsychotherapy.ca/Tanner, Anne, and Alex also run the MBody Community, an in-depth online course that provides a step-by-step process for assessing, treating, and resolving mind-body pain and symptoms. https://www.mbodycommunity.comCheck out Tanner's YouTube channel for more free education and practices: https://www.youtube.com/channel/UC-Fl6WaFHnh4ponuexaMbFQAnd follow us for daily education posts on Instagram: @painpsychotherapyDisclaimer: The information provided on this podcast is for general in...

HERE WE ARE!!! Sorry for playing this PROLONGED game of hide and seek, but you see - last week we were riddled with tech issues. The week before that? Just didn't feel like it. Sorry :P Should we fuck around and do a live show? w/e

Joe's Premium Subscription: www.standardgrain.comGrain Markets and Other Stuff Links —Apple PodcastsSpotifyTikTokYouTubeFutures and options trading involves risk of loss and is not suitable for everyone.

Charles Burton and Gordon Chang analyze China's strategic gain from prolonged conflict in the Middle East, with Beijing appearing content to allow the conflict in the Strait of Hormuz to drag out as a way to deplete U.S. military resources. This instability supports China's narrative that the United States is a declining power. (8)1900 SAINT LAWRENCE BASIN

We have fresh drill results to report this morning from Trident Resources, Galleon Gold and Abitibi Metals. Meridian Mining has submitted the Installation Licence application for the Cabaçal gold-copper-silver project. Elemental Royalty has executed an Exploration and Option agreement with a subsidiary of KGHM. Great Pacific Gold has provided an update on field exploration work in the EK Target Area at the Wild Dog Project. This episode of Mining Stock Daily is brought to you by... ⁠⁠⁠⁠⁠Revival Gold ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Vizsla Silver⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Equinox Gold⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Integra Resources ⁠⁠⁠

- U.S. Faces Engine Oil Shortage - Toyota Reorganizes Manufacturing Engineering - EVs and Chinese Soar in Europe - Big Downside to China Speed - Scout Could Move Out of Michigan - Nissan Turns Paint Shop Waste into Insulation - Ram Getting Compact Pickup and 1st SUV - Hyundai Launching Mobile Repair Service

- U.S. Faces Engine Oil Shortage - Toyota Reorganizes Manufacturing Engineering - EVs and Chinese Soar in Europe - Big Downside to China Speed - Scout Could Move Out of Michigan - Nissan Turns Paint Shop Waste into Insulation - Ram Getting Compact Pickup and 1st SUV - Hyundai Launching Mobile Repair Service

In this episode of The Dairy Podcast Show, Dr. Margret Vonholdt-Wenker, postdoctoral researcher at the Friedrich Loeffler Institute, explains prolonged cow calf contact systems and their implications for dairy production. She discusses housing models, calf and cow welfare outcomes, management requirements, milk production impacts, weaning challenges, and practical adoption considerations across Europe. Listen now on all major platforms!“Calves in contact systems can drink according to natural intake patterns and develop within a social herd environment.”Meet the guest: Dr. Margret Vonholdt-Wenker is a postdoctoral researcher at the Institute of Animal Welfare and Animal Husbandry of the Friedrich Loeffler Institute in Germany. Her work focuses on animal behavior and developing housing systems that support natural behavior while maintaining health. With more than ten years of experience in cow-calf contact systems, she also received the 2024 IGN Research Award for her research on dairy welfare. Listen to The Dairy Podcast Show featuring Dr. Margret Vonholdt-Wenker on all major platforms.Liked this one? Don't stop now — Here's what we think you'll love!What you'll learn:(00:00) Highlight(01:32) Introduction(02:58) Prolonged cow calf contact(04:53) Welfare and health(07:53) Housing management(16:00) Foster cow systems(21:42) Weaning challenges(28:20) Final QuestionsThe Dairy Podcast Show is trusted and supported by innovative companies like:* Agri-Comfort* Adisseo* Afimilk* Evonik* Priority IAC* CowManager- dsm-firmenich- AHV- Natural Biologics- DietForge- Agrarian Solutions- Chemlock- Protekta- BoviSync

Why has the war not resumed? Why has a deal not been reached? And what exactly is happening during this strange and uneasy silence between the Islamic Republic and the West? On this edition of Roqe, Jian is joined by Lisa Daftari in Los Angeles and Bozorgmehr Sharafedin in Washington DC for a deeper examination of the prolonged pause following the ceasefire. Is the regime buying time? Is the West hesitating? And for millions of Iranians hoping for regime change, what does this uncertain in-between moment actually tell us about the future? But first, in the aftermath of Arsenal F.C. winning their first Premier League title in 22 years this week, Jian opens the episode with a deeply personal tribute to Aref Jafarzadeh - an Iranian Arsenal supporter from Rasht who was reportedly killed by Islamic Republic forces during the January 2026 protests while still wearing his Arsenal jersey. This episode is supported by: Stellar Law - stellarlaw.ca Famluxy - famluxy.com

You're using collagen wrong. This common collagen mistake could be limiting your results. Discover the benefits of collagen and the best ways to improve collagen absorption for better skin, joints, bones, and more.

Once a month, we're re-releasing a classic StraightioLab episode from the vault. Today we're celebrating Torrey Peters, who was just named a Pulitzer Prize finalist for her book Stag Dance!See omnystudio.com/listener for privacy information.

Australians are living longer and longer, which is on one hand a beautiful thing. But on the other, prolonged old age is wreaking havoc. So how might we respond to this new demographic situation we find ourselves in?Lucinda Holdforth is a writer who specialises in looking at what makes good societies flourish, everything from manners to politics and equality.Most recently, she's set her sights on the unintended negative consequences following the extraordinary increase in life span around the world, particularly in Australia.In the past 50 years, human life expectancy across the globe has jumped from 46 years old to 73, and in Australia that number is even higher -- an Australian born today is likely to live until they are 84 years old.On the surface, living longer is a very good thing. It means more time spent with our loved ones, looking at the stars, feeling the sun, living.But prolonged old age can also be very lonely and painful, and, as Lucinda argues, it is costing society as a whole in many ways.She has seen this firsthand, as a daughter who supported her own parents in their long old age, and has some surprising suggestions about how we could do things differently to ease the impact on our economy, our medical system, our elderly and our youth.GOING ON AND ON: Why our longevity threatens our future is published by Simon & Schuster.This episode was produced by Meggie Morris. Executive Producer is Eliza Kirsch.It explores the sandwich generation, carers, women caring for parents, the elderly, dementia, Alzheimer's, Bryan Johnson, biohackers, Blue Zone, how to live longer, Mediterranean diet, tech bros, longevity, muscle mass, aging, deterioration, aged care, death, grief, how to live well, writing, books, old age, diseases of the elderly, tax, taxation, ageism, voting rights, voting age, lower the voting age.To binge even more great episodes of the Conversations podcast with Richard Fidler and Sarah Kanowski go the ABC listen app (Australia) or wherever you get your podcasts. There you'll find hundreds of the best thought-provoking interviews with authors, writers, artists, politicians, psychologists, musicians, and celebrities.