Podcasts about ucsf

With school sports starting up and people gearing up for fall sporting endeavors, it's important to understand the role of injury prevention, load management, and overuse; not just for professional athletes but for athletes of all ages and skill levels. Listen to our latest podcast as we break this topic down.

As part of the 2025 Developmental Disabilities Conference, Allen Friedland, Terri Hancharick and Jack Jadach talk about a collaborative approach to enhancing health in fitness centers. Series: "Developmental Disabilities Update" [Health and Medicine] [Show ID: 40613]

Dr. Anthony DiGiorgio, a neurosurgeon at UCSF with a strong interest in healthcare policy, joins the show to unpack the complex and often misunderstood world of Medicaid. In a wide-ranging and nuanced discussion, he explores who qualifies for coverage, why most Medicaid spending goes to groups people don't typically expect, and whether the system should be expanded or fundamentally reformed. Dr. DiGiorgio outlines his support for a robust safety net, emphasizing targeted subsidies over a government-run program, and offers his take on the proposed “Big Beautiful Bill” currently in Congress. Along the way, the conversation touches on broader healthcare issues including the 340B drug discount program, the Affordable Care Act, and the role of the free market in ensuring access to care. Check out Chadi's website for all Healthcare Unfiltered episodes and other content. www.chadinabhan.com/ Watch all Healthcare Unfiltered episodes on YouTube. www.youtube.com/channel/UCjiJPTpIJdIiukcq0UaMFsA

Dr. Hope Rugo and Dr. Kamaria Lee discuss the prevalence of financial toxicity in cancer care in the United States and globally, focusing on breast cancer, and highlight key interventions to mitigate financial hardship. TRANSCRIPT  Dr. Hope Rugo: Hello, and welcome to By the Book, a podcast series from ASCO that features engaging conversations between editors and authors of the ASCO Educational Book. I'm your host, Dr. Hope Rugo. I'm the director of the Women's Cancer Program and division chief of breast medical oncology at the City of Hope Cancer Center, and I'm also the editor-in-chief of the Educational Book. Rising healthcare costs are causing financial distress for patients and their families across the globe. Patients with cancer report financial toxicity as a major impediment to their quality of life, and its association with worse outcomes is well documented. Today, we'll be discussing how patients with breast cancer are uniquely at risk for financial toxicity. Joining me for this discussion is Dr. Kamaria Lee, a fourth-year radiation oncology resident and health equity researcher at MD Anderson Cancer Center and a co-author of the recently published article titled, "Financial Toxicity in Breast Cancer: Why Does It Matter, Who Is at Risk, and How Do We Intervene?" Our full disclosures are available in the transcript of this episode.  Dr. Lee, it's great to have you on this podcast. Dr. Kamaria Lee: Hey, Dr. Rugo. Thank you so much for having me. I'm excited to be here today. I also would like to recognize my co-authors, Dr. Alexandru Eniu, Dr. Christopher Booth, Molly MacDonald, and Dr. Fumiko Chino, who worked on this book chapter with me and did a fantastic presentation on the topic at ASCO this past year. Dr. Hope Rugo: Thanks very much. We'll now just jump into the questions. We know that rising medical costs contribute to a growing financial burden on patients, which has [GC1]  [JG2]  been documented to contribute to lower quality-of-life, compromised clinical care, and worse health outcomes. How are patients with breast cancer uniquely at risk for financial toxicity? How does the problem vary within the breast cancer population in terms of age, racial and ethnic groups, and those who have metastatic disease? Dr. Kamaria Lee: Breast cancer patients are uniquely at risk of financial toxicity for several reasons. Three key reasons are that breast cancer often requires multimodal treatment. So this means patients are receiving surgery, many receive systemic therapies, including hormonal therapies, as well as radiation. And so this requires care coordination and multiple visits that can increase costs. Secondly, another key reason that patients with breast cancer are uniquely at risk for financial toxicity is that there's often a long survivorship period that includes long-term care for toxicities and continued follow-ups, and patients might also be involved in activities regarding advocacy, but also physical therapy and mental health appointments during their prolonged survivorship, which can also add costs. And a third key reason that patients with breast cancer are uniquely at risk for financial toxicity is that the patient population is primarily women. And we know that women are more likely to have increased caregiver responsibilities while also potentially working and managing their treatments, and so this is another contributor. Within the breast cancer population, those who are younger and those who are from marginalized racial/ethnic groups and those with metastatic disease have been shown to be at an increased risk. Those who are younger may be more likely to need childcare during treatment if they have kids, or they're more likely to be employed and not yet retired, which can be disrupted while receiving treatment. And those who are racial/ethnic minorities may have increased financial toxicity due to reasons that exist even after controlling for socioeconomic factors. And some of these reasons have been shown to be increased risk of job or income loss or transportation barriers during treatment. And lastly, for those with metastatic breast cancer, there can be ongoing financial distress due to the long-term care that is needed for treatment, and this can include parking, transportation, and medications while managing their metastatic disease. Dr. Hope Rugo: I think it is really important to understand these issues as you just outlined. There has been a lot of focus on financial toxicity research in recent years, and that has led to novel approaches in screening for financial hardship. Can you tell us about the new screening tools and interventions and how you can easily apply that to clinical practice, keeping in mind that people aren't at MD Anderson with a bunch of support and information on this but are in clinical practice and seeing many, many patients a day with lots of different cancers? Dr. Kamaria Lee: You're exactly right that there is incredible nuance needed in understanding how to best screen for financial hardship in different types of practices. There are multiple financial toxicity tools. The most commonly used tool is the Comprehensive Score for Financial Toxicity, also known as the COST tool. In its full form, it's an 11-item survey. There's also a summary question as well. And these questions look at objective and subjective financial burden, and it uses a five-point Likert scale. For example, one question on the full form is, "I know that I have enough money in savings, retirement, or assets to cover the cost of my treatment," and then patients are able to respond "not at all" to "very much" with a threshold score for financial toxicity risk. Of course, as you noted, one critique of having an 11-item survey is that there's limited time in patient encounters with their providers. And so recently, Thom et al validated an abbreviated two-question version of the COST tool. This validation was done in an urban comprehensive cancer center, and it was found to have a high predictive value to the full measure. We note which two questions are specifically pulled from the full measure within the book chapter. And this is one way that it can be easier for clinicians who are in a busier setting to still screen for financial toxicity with fewer questions. I also do recommend that clinicians who know their clinic's workflow the best, work with their team of nurses, financial navigators, and others to best integrate the tool into their workflow. For some, this may mean sending the two-item survey as a portal message so that patients can answer it before consults. Other times, it could mean having it on the tablet that can be done in the clinic waiting room. And so there are different ways that screening can be done, even in a busy setting, and acknowledging that different practices have different amounts of resources and time. Dr. Hope Rugo: And where would people access that easily? I recognize that that information is in your chapter, or your article that's on PubMed that will be linked to this podcast, but it is nice to just know where people could easily access that online. Dr. Kamaria Lee: Yes, and so you should be able to Google ‘the COST measure', and then there is a website that also has the forms as well. So it's also beyond the book chapter, Googling ‘the COST measure', and then online they would be able to find access to the form. Dr. Hope Rugo: And how often would you do that screening? Dr. Kamaria Lee: So, I think it's definitely important that we are as proactive as possible. And so initially, I recommend that the screening happens at the time of diagnosis, and so if it's done through the portal, it can be sent before the initial consult, or again, however, is best in the workflow. So at the time of diagnosis and then at regular intervals, so throughout the treatment process, but then also into the follow-up period as well to best understand if there's still a financial burden even after the treatments have been completed. Dr. Hope Rugo: I wonder if in the metastatic setting, you could do it at the change of treatment, you know, a month after somebody's changed treatment, because people may not be as aware of the financial constraints when they first get prescribed a drug. It's more when you hear back from how much it's going to cost. And leading into that, I think it's, what do you do with this? So, you know, this cost conversation is really important. You're going to be talking to the patient about the cost considerations when you, for example, see that there are financial issues, you're prescribing treatments. How do we implement impactful structured cost conversations with our breast cancer patients, help identify financial issues, and intervene? How do we intervene? I mean, as physicians often we aren't really all that aware, or providers, of how to address the cost. Dr. Kamaria Lee: Yes, I agree fully that another key time when to screen for financial toxicity is at that transition between treatments to best understand where they're at based off of what they've received previously for care, and then to anticipate needs when changing regimens, such as like you said in the metastatic setting. As we're collecting this information, you're right, we screen, we get this information, and what do we do? I do agree that there is a lack of knowledge among us clinicians of how do we manage this information. What is insurance? How do we manage insurance and help patients with insurance concerns? How do we help them navigate out-of-pocket costs or even the indirect costs of transportation? Those are a lot of things that are not covered in-depth in traditional medical training. And so it can be overwhelming for a lot of clinicians, not only due to time limitations in clinic, but also just having those conversations within their visit. And so what I would say, a key thing to note, is that this is another area for multidisciplinary care. So just as we're treating patients in a multidisciplinary way within oncology as we work with our medical oncology, surgical colleagues across the board, it's knowing that this is another area for multidisciplinary care. So the team members include all of the different oncologists, but it also includes team members such as financial counselors and navigators and social workers and even understanding nonprofit partners who we have who have money that can be set aside to help reduce costs for certain different aspects of treatment. Another thing I will note is that most patients with breast cancer often say they do want to have these conversations still with their clinicians. So they do still see a clinician as someone that can weigh in on the costs of their treatment or can weigh in on this other aspect of their care, even if it's not the actual medication or the radiation. And so patients do desire to hear from their clinicians about this topic, and so I think another way to make it feel less overwhelming for clinicians like ourselves is to know that even small conversations are helpful and then being knowledgeable about within your institution or, like I said, outside of it with nonprofits, being aware of who can I refer this patient to for continued follow-up and for more detailed information and resources. Dr. Hope Rugo: Are those the successful interventions? It's really referring to financial navigators? How do people identify? You know, in an academic center, we often will sort of punt this to social workers or our nurse navigators. What about in the community? What's a successful intervention example of mitigating financial toxicity? Dr. Kamaria Lee: I agree completely that the context at which people are practicing is important to note. So as you alluded to, in some bigger systems, we do have financial navigators and this has been seen to be successful in providing applications and assisting with applications for things such as pharmaceutical assistance, insurance applications, discount opportunities.  Another successful intervention are financial toxicity tumor boards, which I acknowledge might not be able to exist everywhere. But where this is possible, multidisciplinary tumor boards that include both doctors and nurses and social workers and any other members of the care team have been able to effectively decrease patients' personal spending on care costs and decrease co-pays through having a dedicated time to discuss concerns as they arise or even proactively. Otherwise, I think in the community, there are other interventions in regards to understanding different aspects of government programs that might be available for patients that are not, you know, limited to an institution, but that are more nationally available, and then again, also having the nonprofit, you know, partnerships to see other resources that patients can have access to.  And then I would also say that the indirect costs are a significant burden for many patients. So by that, I mean even parking costs, transportation, childcare. And so even though those aren't interventions necessarily with someone who is a financial navigator, I would recommend that even if it's a community practice, they discuss ways that they can help offset those indirect costs with patients with parking or if there are ways to help offset transportation costs or at least educate patients on other centers that may be closer to them or they can still receive wonderful care, and then also making sure that patients are able to even have appointments scheduled in ways that are easier for them financially.  So even if someone's receiving care out in the community where there's not a financial navigator, as clinicians or our scheduling teams, sometimes there are options to make sure if a patient wants, visits are more so on one day than throughout the week or many hours apart that can really cause loss of income due to missed work. And so there are also kind of more nuanced interventions that can happen even without a financial navigation system in place. Dr. Hope Rugo: I think that those are really good points and it is interesting when you think about financial toxicity. I mean, we worry a lot when patients can't take the drugs because they can't afford them, but there are obviously many other non-treatment, direct treatment-related issues that come up like the parking, childcare, tolls, you know, having a working car, all those kinds of things, and the unexpected things like school is out or something like that that really play a big role where they don't have alternatives. And I think that if we think about just drug costs, I think those are a big issue in the global setting. And your article did address financial toxicity in the global setting. International financial toxicity rates range from 25% of patients with breast cancer in high-income countries to nearly 80% in low- and middle-income countries or LMICs. You had cited a recent meta-analysis of the global burnout from cancer, and that article found that over half of patients faced catastrophic health expenditures. And of course, I travel internationally and have a lot of colleagues who are working in oncology in many countries, and it is really often kind of shocking from our perspective to see what people can get coverage for and how much they have to pay out-of-pocket and how much that changes, that causes a lot of disparity in access to healthcare options, even those that improve survival. Can you comment on the global impact of this problem? Dr. Kamaria Lee: I am glad that you brought this up for discussion as well. Financial toxicity is something that is a significant global issue. As you mentioned, as high as 80% of patients with breast cancer in low- and middle-income countries have had significant financial toxicity. And it's particularly notable that even when looking at breast cancer compared to other malignancies around the world, the burden appears to be worse. This has been seen even in countries with free universal healthcare. One example is Sri Lanka, where they saw high financial toxicity for their patients with breast cancer, even with this free universal healthcare. But there were also those travel costs and just additional out-of-hospital tests that were not covered. Also, literature in low- and middle-income countries shows that patients might also be borrowing money from their social networks, so from their family and their friends, to help cover their treatment costs, and in some cases, people are making daily food compromises to help offset the cost of their care. So there is a really large burden of financial toxicity generally for cancer globally, but also specifically in breast cancer, it warrants specific discussion. In the meta-analysis that you mentioned, they identified key risk factors of financial toxicity globally that included people who had a larger family size, a lower income, a lack of insurance, longer disease duration, so again, the accumulation of visits and costs and co-pay over time, and those who had multiple treatments. And so in the global setting, there is this significant burden, but then I will also note that there is a lack of literature in low-income countries on financial toxicity. So where we suspect that there is a higher burden and where we need to better understand how it's distributed and what interventions can be applied, especially culturally specific interventions for each country and community, there's less research on this topic. So there is definitely an increased need for research in financial toxicity, particularly in the global setting. Dr. Hope Rugo: Yes, and I think that goes on to how we hope that financial toxicity researchers will have approaches to large-scale multi-institutional interventions to improve financial toxicity. I think this is an enormous challenge, but one of the SWOG organizations has done some great work in this area, and a randomized trial addressing cancer-related financial hardship through the delivery of a proactive financial navigation intervention is one area that SWOG has focused on, which I think is really interesting. Of course, that's going to be US-based, which is how we might find our best paths starting. Do you think that's a good path forward, maybe that being able to provide something like that across institutions that are independent of being a cancer only academic center, or more general academic center, or a community practice? You know, is finding ways to help patients with breast cancer and their families understand and better manage financial aspects of cancer care on a national basis the next approach? Dr. Kamaria Lee: Yes, I agree that that is a good approach, and I think the proactive component is also key. We know that patients that are coming to us with any cancer, but including breast cancer, some of them have already experienced a financial burden or have recently had a job loss before even coming to us and having the added distress of our direct costs and our indirect costs. So I think being proactive when they come to us in regards to the additional burden that their cancer treatments may cause is key to try to get ahead of things as much as we can, knowing that even before they've seen us, there might be many financial concerns that they've been navigating.  I think at the national level, that allows us to try to understand things at what might be a higher level of evidence and make sure that we're able to address this for a diverse cohort of patients. I know that sometimes the enrollment can be challenging at the national level when looking at financial toxicity, as then we're involving many different types of financial navigation partners and programs, and so that can maybe make it more complex to understand the best approaches, but I think that it can be done and can really bring our understanding of important financial toxicity interventions to the next level. And then the benefit to families with the proactive component is just allowing them to feel more informed, which can help decrease anticipation, anxiety related to anticipation, and allow them to help plan things moving forward for themselves and for the whole family. Dr. Hope Rugo: Those are really good points and I wonder, I was just thinking as you were talking, that having some kind of a process where you could attach to the electronic health record, you could click on the financial toxicity survey questions that somebody filled out, and then there would be a drop-down menu for interventions or connecting you to people within your clinic or even more broadly that would be potential approaches to manage that toxicity issue so that it doesn't impact care, you know, that people aren't going to decide not to take their medication or not to come in or not to get their labs because of the cost or the transportation or the home care issues that often are a big problem, even parking, as you pointed out, at the cancer center. And actually, we had a philanthropic donor when I was at UCSF who donated a large sum of money for patient assistance, and it was interesting to then have these sequential meetings with all the stakeholders to try and decide how you would use that money. You need a big program, you need to have a way of assessing the things you can intervene with, which is really tough. In that general vein, you know, what are the governmental, institutional, and provider-level actions that are required to help clinicians do our best to do no financial harm, given the fact that we're prescribing really expensive drugs that require a lot of visits when caring for our patients with breast cancer in the curative and in the metastatic setting? Dr. Kamaria Lee: At the governmental level, there are patient assistant programs that do exist, and I think that those can continue and can become more robust. But I also think one element of those is oftentimes the programs that we have at the government level or even institutional levels might have a lot of paperwork or be harder for people with lower literacy levels to complete. And so I think the government can really try to make sure that the paperwork that is given, within reason, with all the information they need, but that the paperwork can be minimized and that there can be clear instructions, as well as increased health insurance options and, you know, medical debt forgiveness as more broad just overall interventions that are needed. I think additionally, institutions that have clinical trials can help ensure that enrollment can be at geographically diverse locations. Some trials do reimburse for travel costs, of course, but sometimes then patients need the reimbursement sooner than it comes. And so I think there's also those considerations of more so upfront funds for patients involved in clinical trials if they're going to have to travel far to be enrolled in that type of care or trying to, again, make clinical trials more available at diverse locations.  I would also say that it's important that those who design clinical trials use what is known as the “Common Sense Oncology” approach of making sure that they're designed in minimizing the use of outcomes that might have a smaller clinical benefit but may have a high financial toxicity. And that also goes to what providers can do, of understanding what's most important to a particular patient in front of them, what outcomes and what benefit, or you know, how many additional months of progression-free survival or things like that might be important to a particular patient and then also educating them and discussing what the associated financial burden is just so that they have the full picture as they make an informed decision. Dr. Hope Rugo: As much as we know. I mean, I think that that's one of the big challenges is that as we prescribe these expensive drugs and often require multiple visits, even, you know, really outside of the clinical trial setting, trying to balance the benefit versus the financial toxicity can be a huge challenge. And that's a big area, I think, that we still need help with, you know. As we have more drugs approved in the early-stage setting and treatments that could be expensive, oral medications, for example, in our Medicare population where the share of cost may be substantial upfront, you know, with an upfront cost, how do we balance the benefits versus the risk? And I think you make an important point that discussing this individually with patients after we found out what the cost is. I think warning patients about the potential for large out-of-pocket cost and asking them to contact us when they know is one way around this. You know, patients feeling like they're sort of out there with a prescription, a recommendation from their doctor, they're scared of their cancer, and they have this huge share of cost that we didn't know about. That's one challenge, and I don't know if there's any suggestions you have about how one should approach that communication with the patient. Dr. Kamaria Lee: Yes, I think part of it is truly looking at each patient as an individual and asking how much they want to know, right? So we all know that patients, some who want more information, some want less, and so I think one way to approach that is asking them about how much information do they want to know, what is most helpful to them. And then also, knowing that if you're in a well-resourced setting that does have the social workers and financial navigators, also making sure it's integrated in the multidisciplinary setting and so that they know who they can go to for what, but also know that as a clinician, you're always happy for them to bring up their concerns and that if it's something that you're not aware of, that you will connect them to the correct multidisciplinary team members who can accurately provide that additional information. Dr. Hope Rugo: Do you have any other additional comments that you'd like to mention that we haven't covered? I think the idea of a financial toxicity screen with two questions that could be implemented at change of therapy or just periodically throughout the course of treatment would be a really great thing, but I think we do need as much information on potential interventions as possible because that's really what challenges people. It's like finding out information that you can't handle. Your article provides a lot of strategies there, which I think are great and can be discussed on a practice and institutional level and applied. Dr. Kamaria Lee: Yeah, I would just like to thank you for the opportunity to discuss such an important topic within oncology and specifically for our patients with breast cancer. I agree that it can feel overwhelming, both for clinicians and patients, to navigate this topic that many of us are not as familiar with, but I would just say that the area of financial toxicity is continuing to evolve as we gather more information on most successful interventions and that our patients can often inform us on, you know, what interventions are most needed as we see them. And so you can have your thinking about it as you see individual patients of, "This person mentioned this could be more useful to them." And so I think also learning from our patients in this space that can seem overwhelming and that maybe we weren't all trained on in medical school to best understand how to approach it and how to give our patients the best care, not just medically, but also financially. Dr. Hope Rugo: Thank you, Dr. Lee, for sharing your insights with us today. Our listeners will find a link, as I mentioned earlier, to the Ed Book article we discussed today in the transcript of this episode. I think it's very useful, a useful resource, and not just for providers, but for clinic staff overall. I think this can be of great value and help open the discussion as well. Dr. Kamaria Lee: Thank you so much, Dr. Rugo. Dr. Hope Rugo: And thanks to our listeners for joining us today. Please join us again next month on By the Book for more insightful views on topics you'll be hearing at Education Sessions from ASCO meetings and our deep dives into new approaches that are shaping modern oncology. Thank you. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Follow today's speakers:       Dr. Hope Rugo  @hope.rugo  Dr. Kamaria Lee @ lee_kamaria Follow ASCO on social media:       @ASCO on X (formerly Twitter)       ASCO on Bluesky      ASCO on Facebook       ASCO on LinkedIn       Disclosures:      Dr. Hope Rugo:   Honoraria: Mylan/Viatris, Chugai Pharma  Consulting/Advisory Role: Napo Pharmaceuticals, Sanofi, Bristol Myer  Research Funding (Inst.): OBI Pharma, Pfizer, Novartis, Lilly, Merck, Daiichi Sankyo, AstraZeneca, Gilead Sciences, Hoffman La-Roche AG/Genentech, In., Stemline Therapeutics, Ambryx    Dr. Kamaria Lee: No relationships to disclose  

In this episode of Talking Sleep, host Dr. Seema Khosla welcomes Dr. Gulcin Benbir, professor of neurology and sleep researcher from Turkey, and Dr. Lourdes Del Rosso, sleep physician and professor at UCSF who served on the task force for updated AASM RLS guidelines, to discuss groundbreaking research on periodic limb movements in sleep (PLMS) that persist after successful sleep apnea treatment. Following the recent updates to RLS guidelines, this conversation addresses the often-overlooked condition of periodic limb movement disorder (PLMD). The guests reveal surprising findings that challenge traditional teaching: while sleep medicine practitioners have long been taught that PLMD improves with PAP therapy, their research shows that 30% of patients continue to experience significant periodic limb movements even after successful OSA treatment. The discussion explores critical clinical questions: Are PLMs innocent bystanders or pathological processes requiring treatment? When do PLMs become PLMD? How should we evaluate residual hypersomnolence in well-treated OSA patients—should we screen for persistent PLMs before prescribing wake-promoting agents? The experts also delve into the complex relationship between RLS and PLMs, examining whether they represent interconnected sensory and motor phenomena or distinct processes. Practical treatment strategies are covered extensively, including the role of iron supplementation, appropriate diagnostic testing, IV iron protocols, and evidence-based pharmacological interventions. The conversation also addresses how the shift toward home sleep testing may impact our ability to detect and treat this important cause of continued sleep disruption. Whether you're treating OSA patients with persistent daytime sleepiness or managing complex sleep disorders, this episode provides essential insights into recognizing and treating PLMD as a potential contributor to ongoing symptoms. Join us for this clinically relevant discussion that may change how you approach residual hypersomnolence in your practice. 

On this episode, Dr. Sadaf welcomes the amazing Dr. Tami Rowen to talk about everything you need to know when it comes to sex, aging, and hormones! Dr. Rowen is a highly distinguished obstetrician and gynecologist at UCSF, and during this discussion, she shares her expertise on everything from the impact that declining estrogen, progesterone, and testosterone has our bodies and minds, to the latest evidence-based insights on menopausal hormone therapy. So whether you are looking to find out more about the intricate differences between progesterone and progestins or what researchers are aiming towards when it comes to the future of women's sexual medicine, you will learn A LOT on this episode. Enjoy!Disclaimer: Anything discussed on the show should not be taken as official medical advice. If you have any concerns about your health, please speak to your medical provider. If you have any questions about your religion, please ask your friendly neighborhood religious leader. It's the Muslim Sex Podcast because I just happen to be a Muslim woman who talks about sex.To learn more about Dr. Sadaf's practice and to become a patient visit DrSadaf.comLike and subscribe to our YouTube channel where you can watch all episodes of the podcast!Feel free to leave a review on Apple Podcasts and share the show!Follow us on Social Media...Instagram: DrSadafobgynTikTok: DrSadafobgynTopics: hormones, menopause, perimenopause, women's health, sexual medicine, aging, estrogen, progesterone, testosterone, libido, mood changes, hormone therapy, WHI study, sexual health, hot flashes, anxiety, depression, vaginal health

El evento se realiza este jueves en la UCSF. Buscan fortalecer vínculos para diseñar políticas públicas con una mirada colaborativa y territorial.

In 2012, a UCSF researcher teamed up with city and nonprofit officials to launch a novel experiment meant to answer one question: Can singing in a choir provide real health benefits for older adults? Today, a thriving network of neighborhood choirs continues to discover the answer. Reporter Sheryl Kaskowitz has more in this story from 2024.

Healthcare is a team effort, but we don't always see the full team. Behind every physician visit, every hospital discharge, and every community clinic, there's a vast, often invisible network of professionals keeping the system running. In this episode, we sit down with Dr. Sunita Mutha, Director of the Healthforce Center and Professor of Medicine at UCSF, to talk about these hidden threads holding our healthcare system together. She shines a light on the vital roles played by medical assistants, patient navigators, community health workers, and clinic leaders—roles that are essential, yet too often overlooked. Dr. Mutha walks us through the Healthforce Center's mission to strengthen this workforce, from building lasting leadership programs that ripple across organizations, to fostering statewide collaborations, to producing data-driven insights that inform policy at every level. We also dive deep into the realities of burnout—why it's not just about overwork, but about the erosion of meaning in the work itself. Dr. Mutha reframes burnout as a structural failure, not a personal shortcoming, and shares practical ways to design systems that support the people who make care possible. This is an honest, inspiring look at the human infrastructure of healthcare—what it takes to sustain it, and why investing in people is the key to a more equitable and resilient system. Do you have thoughts on this episode or ideas for future guests? We'd love to hear from you.  Email us at hello@rosenmaninstitute.org.

What is shoulder impingement and how do you treat it? Listen to Dr Brian Feeley break it all down.

When you learn to anchor into your own worth, the world no longer gets to decide how you feel about yourself. Beatriz Victoria Albina brings powerful insight and clarity to the conversation on nervous system regulation, emotional outsourcing, and the lifelong practice of coming home to yourself. With equal parts warmth and wisdom, she shares how healing begins when we stop chasing external validation and start reconnecting to the safety, belonging, and worth that already live within us. This conversation is a gentle call to shift from survival mode to self-anchored living—where authenticity and inner peace can finally take root. Key Takeaways: Emotional outsourcing happens when you rely on others to define your safety, worth, or sense of belonging. Nervous system dysregulation can show up as anxiety, over-functioning, or emotional numbness—and it's more common than you think. Healing doesn't mean eliminating big emotions; it means learning how to feel them without abandoning yourself. Anchoring into your truth requires self-awareness, self-regulation, and a commitment to coming back to center—again and again. Regulation is a daily practice, not a quick fix—and community, nature, and breath are powerful allies in that process. About Beatriz Victoria Albina: Beatriz (Béa) Victoria Albina, NP, MPH, SEP (she/her) is a UCSF-trained Family Nurse Practitioner, Somatic Experiencing Practitioner, Master Certified Somatic Life Coach, author of the forthcoming "End Emotional Outsourcing: a Guide to Overcoming Codependent, Perfectionist and People Pleasing Habits" (expected Sept 30, Hachette Balance) and Breathwork Meditation Guide with a passion for helping humans socialized as women to reconnect with their bodies, regulate their nervous systems and rewire their minds, so they can break free from codependency, perfectionism and people pleasing and reclaim their joy. She is the host of the Feminist Wellness Podcast, holds a Masters degree in Public Health from Boston University School of Public Health and a BA in Latin American Studies from Oberlin College. Born in Mar del Plata, Argentina, Béa grew up in the great state of Rhode Island. She has been working in health & wellness for over 20 years and lives with her wife, Billey Albina.   Connect with Dr. Michelle and Bayleigh at: https://smallchangesbigshifts.com hello@smallchangesbigshifts.com https://www.linkedin.com/company/smallchangesbigshifts https://www.facebook.com/SmallChangesBigShifts https://www.instagram.com/smallchangesbigshiftsco   Thanks for listening! Thanks so much for listening to our podcast! If you enjoyed this episode and think that others could benefit from listening, please share it using the social media buttons on this page. Do you have some feedback or questions about this episode? Leave a comment in the section below! Subscribe to the podcast If you would like to get automatic updates of new podcast episodes, you can subscribe to the podcast on Apple Podcasts or Stitcher. You can also subscribe in your favorite podcast app. Leave us an Apple Podcasts review Ratings and reviews from our listeners are extremely valuable to us and greatly appreciated. They help our podcast rank higher on Apple Podcasts, which exposes our show to more awesome listeners like you. If you have a minute, please leave an honest review on Apple Podcasts.  

Welcome back to Snafu w/ Robin Zander.  In this episode, I'm joined by Brian Elliott, former Slack executive and co-founder of Future Forum. We discuss the common mistakes leaders make about AI and why trust and transparency are more crucial than ever. Brian shares lessons from building high-performing teams, what makes good leadership, and how to foster real collaboration. He also reflects on raising values-driven kids, the breakdown of institutional trust, and why purpose matters. We touch on the early research behind Future Forum and what he'd do differently today. Brian will also be joining us live at Responsive Conference 2025, and I'm excited to continue the conversation there. If you haven't gotten your tickets yet, get them here. What Do Most People Get Wrong About AI? (1:53) “Senior leaders sit on polar ends of the spectrum on this stuff. Very, very infrequently, sit in the middle, which is kind of where I find myself too often.”  Robin notes Brian will be co-leading an active session on AI at Responsive Conference with longtime collaborator Helen Kupp. He tees up the conversation by saying Brian holds “a lot of controversial opinions” on AI, not that it's insignificant, but that there's a lot of “idealization.” Brian says most senior leaders fall into one of two camps: Camp A: “Oh my God, this changes everything.” These are the fear-mongers shouting: “If you don't adopt now, your career is over.” Camp B: “This will blow over.” They treat AI as just another productivity fad, like others before it. Brian positions himself somewhere in the middle but is frustrated by both ends of the spectrum. He points out that the loudest voices (Mark Benioff, Andy Jassy, Zuckerberg, Sam Altman) are “arms merchants” – they're pushing AI tools because they've invested billions. These tools are massively expensive to build and run, and unless they displace labor, it's unclear how they generate ROI. believe in AI's potential and  aggressively push adoption inside their companies. So, naturally, these execs have to: But “nothing ever changes that fast,” and both the hype and the dismissal are off-base. Why Playing with AI Matters More Than Training (3:29) AI is materially different from past tech, but what's missing is attention to how adoption happens. “The organizational craft of driving adoption is not about handing out tools. It's all emotional.” Adoption depends on whether people respond with fear or aspiration, not whether they have the software. Frontline managers are key: it's their job to create the time and space for teams to experiment with AI. Brian credits Helen Kupp for being great at facilitating this kind of low-stakes experimentation. Suggests teams should “play with AI tools” in a way totally unrelated to their actual job. Example: take a look at your fridge, list the ingredients you have, and have AI suggest a recipe. “Well, that's a sucky recipe, but it could do that, right?” The point isn't utility,  it's comfort and conversation: What's OK to use AI for? Is it acceptable to draft your self-assessment for performance reviews with AI? Should you tell your boss or hide it? The Purpose of Doing the Thing (5:30) Robin brings up Ezra Klein's podcast in The New York Times, where Ezra asks: “What's the purpose of writing an essay in college?” AI can now do better research than a student, faster and maybe more accurately. But Robin argues that the act of writing is what matters, not just the output. Says: “I'm much better at writing that letter than ChatGPT can ever be, because only Robin Zander can write that letter.” Example: Robin and his partner are in contract on a house and wrote a letter to the seller – the usual “sob story” to win favor. All the writing he's done over the past two years prepared him to write that one letter better. “The utility of doing the thing is not the thing itself – it's what it trains.” Learning How to Learn (6:35) Robin's fascinated by “skills that train skills” – a lifelong theme in both work and athletics. He brings up Josh Waitzkin (from Searching for Bobby Fischer), who went from chess prodigy to big wave surfer to foil board rider. Josh trained his surfing skills by riding a OneWheel through NYC, practicing balance in a different context. Robin is drawn to that kind of transfer learning and “meta-learning” – especially since it's so hard to measure or study. He asks: What might AI be training in us that isn't the thing itself? We don't yet know the cognitive effects of using generative AI daily, but we should be asking. Cognitive Risk vs. Capability Boost (8:00) Brian brings up early research suggesting AI could make us “dumber.” Outsourcing thinking to AI reduces sharpness over time. But also: the “10,000 repetitions” idea still holds weight – doing the thing builds skill. There's a tension between “performance mode” (getting the thing done) and “growth mode” (learning). He relates it to writing: Says he's a decent writer, not a great one, but wants to keep getting better. Has a “quad project” with an editor who helps refine tone and clarity but doesn't do the writing. The setup: he provides 80% drafts, guidelines, tone notes, and past writing samples. The AI/editor cleans things up, but Brian still reviews: “I want that colloquialism back in.” “I want that specific example back in.” “That's clunky, I don't want to keep it.” Writing is iterative, and tools can help, but shouldn't replace his voice. On Em Dashes & Detecting Human Writing (9:30) Robin shares a trick: he used em dashes long before ChatGPT and does them with a space on either side. He says that ChatGPT's em dashes are double-length and don't have spaces. If you want to prove ChatGPT didn't write something, “just add the space.” Brian agrees and jokes that his editors often remove the spaces, but he puts them back in. Reiterates that professional human editors like the ones he works with at Charter and Sloan are still better than AI. Closing the Gap Takes More Than Practice (10:31) Robin references The Gap by Ira Glass, a 2014 video that explores the disconnect between a creator's vision and their current ability to execute on that vision. He highlights Glass's core advice: the only way to close that gap is through consistent repetition – what Glass calls “the reps.” Brian agrees, noting that putting in the reps is exactly what creators must do, even when their output doesn't yet meet their standards. Brian also brings up his recent conversation with Nick Petrie, whose work focuses not only on what causes burnout but also on what actually resolves it. He notes research showing that people stuck in repetitive performance mode – like doctors doing the same task for decades – eventually see a decline in performance. Brian recommends mixing in growth opportunities alongside mastery work. “exploit” mode (doing what you're already good at) and  “explore” mode (trying something new that pushes you) He says doing things that stretch your boundaries builds muscle that strengthens your core skills and breaks stagnation. He emphasizes the value of alternating between  He adds that this applies just as much to personal growth, especially when people begin to question their deeper purpose and ask hard questions like, “Is this all there is to my life or career? Brian observes that stepping back for self-reflection is often necessary, either by choice or because burnout forces a hard stop. He suggests that sustainable performance requires not just consistency but also intentional space for growth, purpose, and honest self-evaluation. Why Taste And Soft Skills Now Matter More Than Ever (12:30) On AI, Brian argues that most people get it wrong. “I do think it's augmentation.” The tools are evolving rapidly, and so are the ways we use them. They view it as a way to speed up work, especially for engineers, but that's missing the bigger picture. Brian stresses that EQ is becoming more important than IQ. Companies still need people with developer mindsets – hypothesis-driven, structured thinkers. But now, communication, empathy, and adaptability are no longer optional; they are critical. “Human communication skills just went from ‘they kind of suck at it but it's okay' to ‘that's not acceptable.'” As AI takes over more specialist tasks, the value of generalists is rising. People who can generate ideas, anticipate consequences, and rally others around a vision will be most valuable. “Tools can handle the specialized knowledge – but only humans can connect it to purpose.” Brian warns that traditional job descriptions and org charts are becoming obsolete. Instead of looking for ways to rush employees into doing more work, “rethink the roles. What can a small group do when aligned around a common purpose?” The future lies in small, aligned teams with shared goals. Vision Is Not a Strategy (15:56) Robin reflects on durable human traits through Steve Jobs' bio by Isaac Walterson. Jobs succeeded not just with tech, but with taste, persuasion, charisma, and vision. “He was less technologist, more storyteller.” They discuss Sam Altman, the subject of Empire of AI. Whether or not the book is fully accurate, Robin argues that Altman's defining trait is deal-making. Robin shares his experience using ChatGPT in real estate. It changed how he researched topics like redwood root systems on foundational structure and mosquito mitigation. Despite the tech, both agree that human connection is more important than ever. “We need humans now more than ever.” Brian references data from Kelly Monahan showing AI power users are highly productive but deeply burned out. 40% more productive than their peers. 88% are completely burnt out. Many don't believe their company's AI strategy, even while using the tools daily. There's a growing disconnect between executive AI hype and on-the-ground experience. But internal tests by top engineers showed only 10% improvement, mostly in simple tasks. “You've got to get into the tools yourself to be fluent on this.” One CTO believed AI would produce 30% efficiency gains. Brian urges leaders to personally engage with the tools before making sweeping decisions. He warns against blindly accepting optimistic vendor promises or trends. Leaders pushing AI without firsthand experience risk overburdening their teams. “You're bringing the Kool-Aid and then you're shoving it down your team's throat.” This results in burnout, not productivity. “You're cranking up the demands. You're cranking up the burnout, too.” “That's not going to lead to what you want either.” If You Want Control, Just Say That (20:47) Robin raises the topic of returning to the office, which has been a long-standing area of interest for him. “I interviewed Joel Gascoyne on stage in 2016… the largest fully distributed company in the world at the time.” He's tracked distributed work since Responsive 2016. Also mentions Shelby Wolpa (ex-Envision), who scaled thousands remotely. Robin notes the shift post-COVID: companies are mandating returns without adjusting for today's realities.” Example: “Intel just did a mandatory 4 days a week return to office… and now people live hours away.” He acknowledges the benefits of in-person collaboration, especially in creative or physical industries. “There is an undeniable utility.”, especially as they met in Robin's Cafe to talk about Responsive, despite a commute, because it was worth it. But he challenges blanket return-to-office mandates, especially when the rationale is unclear. According to Brian, any company uses RTO as a veiled soft layoff tactic. Cites Elon Musk and Vivek Ramaswamy openly stating RTO is meant to encourage attrition. He says policies without clarity are ineffective. “If you quit, I don't have to pay you severance.” Robin notes that the Responsive Manifesto isn't about providing answers but outlining tensions to balance. Before enforcing an RTO policy, leaders should ask: “What problem are we trying to solve – and do we have evidence of it?” Before You Mandate, Check the Data (24:50) Performance data should guide decisions, not executive assumptions. For instance, junior salespeople may benefit from in-person mentorship, but… That may only apply to certain teams, and doesn't justify full mandates. “I've seen situations where productivity has fallen – well-defined productivity.” The decision-making process should be decentralized and nuanced. Different teams have different needs — orgs must avoid one-size-fits-all policies, especially in large, distributed orgs. “Should your CEO be making that decision? Or should your head of sales?” Brian offers a two-part test for leaders to assess their RTO logic: Are you trying to attract and retain the best talent? Are your teams co-located or distributed? If the answer to #1 is yes: People will be less engaged, not more. High performers will quietly leave or disengage while staying. Forcing long commutes will hurt retention and morale. If the answer to #2 is “distributed”: Brian then tells a story about a JPMorgan IT manager who asks Jamie Dimon for flexibility. “It's freaking stupid… it actually made it harder to do their core work.” Instead, teams need to define shared norms and operating agreements. “Teams have to have norms to be effective.” RTO makes even less sense. His team spanned time zones and offices, forcing them into daily hurt collaboration. He argues most RTO mandates are driven by fear and a desire for control. More important than office days are questions like: What hours are we available for meetings? What tools do we use and why? How do we make decisions? Who owns which roles and responsibilities? The Bottom Line: The policy must match the structure. If teams are remote by design, dragging them into an office is counterproductive. How to Be a Leader in Chaotic Times (28:34) “We're living in a more chaotic time than any in my lifetime.” Robin asks how leaders should guide their organizations through uncertainty. He reflects on his early work years during the 2008 crash and the unpredictability he's seen since. Observes current instability like the UCSF and NIH funding and hiring freezes disrupting universities, rising political violence, and murders of public officials from the McKnight Foundation, and more may persist for years without relief. “I was bussing tables for two weeks, quit, became a personal trainer… my old client jumped out a window because he lost his fortune as a banker.” Brian says what's needed now is: Resilience – a mindset of positive realism: acknowledging the issues, while focusing on agency and possibility, and supporting one another. Trust – not just psychological safety, but deep belief in leadership clarity and honesty. His definition of resilience includes: “What options do we have?” “What can we do as a team?” “What's the opportunity in this?” What Builds Trust (and What Breaks It) (31:00) Brian recalls laying off more people than he hired during the dot-com bust – and what helped his team endure: “Here's what we need to do. If you're all in, we'll get through this together.” He believes trust is built when: Leaders communicate clearly and early. They acknowledge difficulty, without sugarcoating. They create clarity about what matters most right now. They involve their team in solutions. He critiques companies that delay communication until they're in PR cleanup mode: Like Target's CEO, who responded to backlash months too late – and with vague platitudes. “Of course, he got backlash,” Brian says. “He wasn't present.” According to him, “Trust isn't just psychological safety. It's also honesty.” Trust Makes Work Faster, Better, and More Fun (34:10) “When trust is there, the work is more fun, and the results are better.” Robin offers a Zander Media story: Longtime collaborator Jonathan Kofahl lives in Austin. Despite being remote, they prep for shoots with 3-minute calls instead of hour-long meetings. The relationship is fast, fluid, and joyful, and the end product reflects that. He explains the ripple effects of trust: Faster workflows Higher-quality output More fun and less burnout Better client experience Fewer miscommunications or dropped balls He also likens it to acrobatics: “If trust isn't there, you land on your head.” Seldom Wrong, Never in Doubt (35:45) “Seldom wrong, never in doubt – that bit me in the butt.” Brian reflects on a toxic early-career mantra: As a young consultant, he was taught to project confidence at all times. It was said that “if you show doubt, you lose credibility,” especially with older clients. Why that backfired: It made him arrogant. It discouraged honest questions or collaborative problem-solving. It modeled bad leadership for others. Brian critiques the startup world's hero culture: Tech glorifies mavericks and contrarians, people who bet against the grain and win. But we rarely see the 95% who bet big and failed, and the survivors become models, often with toxic effects. The real danger: Leaders try to imitate success without understanding the context. Contrarianism becomes a virtue in itself – even when it's wrong. Now, he models something else: “I can point to the mountain, but I don't know the exact path.” Leaders should admit they don't have all the answers. Inviting the team to figure it out together builds alignment and ownership. That's how you lead through uncertainty, by trusting your team to co-create. Slack, Remote Work, and the Birth of Future Forum (37:40) Brian recalls the early days of Future Forum: Slack was deeply office-centric pre-pandemic. He worked 5 days a week in SF, and even interns were expected to show up regularly. Slack's leadership, especially CTO Cal Henderson, was hesitant to go remote, not because they were anti-remote, but because they didn't know how. But when COVID hit, Slack, like everyone else, had to figure out remote work in real time. Brian had long-standing relationships with Slack's internal research team: He pitched Stewart Butterfield (Slack's CEO) on the idea of a think tank, where he was then joined by Helen Kupp and Sheela Subramanian, who became his co-founders in the venture. Thus, Future Forum was born. Christina Janzer, Lucas Puente, and others. Their research was excellent, but mostly internal-facing, used for product and marketing. Brian, self-described as a “data geek,” saw an opportunity: Remote Work Increased Belonging, But Not for Everyone (40:56) In mid-2020, Future Forum launched its first major study. Expected finding: employee belonging would drop due to isolation. Reality: it did, but not equally across all demographics. For Black office workers, a sense of belonging actually increased. Future Forum brought in Dr. Brian Lowery, a Black professor at Stanford, to help interpret the results. Lowery explained: “I'm a Black professor at Stanford. Whatever you think of it as a liberal school, if I have to walk on that campus five days a week and be on and not be Black five days a week, 9 to 5 – it's taxing. It's exhausting. If I can dial in and out of that situation, it's a release.” A Philosophy Disguised as a Playbook (42:00) Brian, Helen, and Sheela co-authored a book that distilled lessons from: Slack's research Hundreds of executive conversations Real-world trials during the remote work shift One editor even commented on how the book is “more like a philosophy book disguised as a playbook.” The key principles are: “Start with what matters to us as an organization. Then ask: What's safe to try?” Policies don't work. Principles do. Norms > mandates. Team-level agreements matter more than companywide rules. Focus on outcomes, not activity.  Train your managers. Clarity, trust, and support start there. Safe-to-try experiments. Iterate fast and test what works for your team. Co-create team norms. Define how decisions get made, what tools get used, and when people are available. What's great with the book is that no matter where you are, this same set of rules still applies.  When Leadership Means Letting Go (43:54) “My job was to model the kind of presence I wanted my team to show.” Robin recalls a defining moment at Robin's Café: Employees were chatting behind the counter while a banana peel sat on the floor, surrounded by dirty dishes. It was a lawsuit waiting to happen. His first impulse was to berate them, a habit from his small business upbringing. But in that moment, he reframed his role. “I'm here to inspire, model, and demonstrate the behavior I want to see.” He realized: Hovering behind the counter = surveillance, not leadership. True leadership = empowering your team to care, even when you're not around. You train your manager to create a culture, not compliance. Brian and Robin agree: Rules only go so far. Teams thrive when they believe in the ‘why' behind the work. Robin draws a link between strong workplace culture and… The global rise of authoritarianism The erosion of trust in institutions If trust makes Zander Media better, and helps VC-backed companies scale — “Why do our political systems seem to be rewarding the exact opposite?” Populism, Charisma & Bullshit (45:20) According to Robin, “We're in a world where trust is in very short supply.” Brian reflects on why authoritarianism is thriving globally: The media is fragmented. Everyone's in different pocket universes. People now get news from YouTube or TikTok, not trusted institutions. Truth is no longer shared, and without shared truth, trust collapses. “Walter Cronkite doesn't exist anymore.” He references Andor, where the character, Mon Mothma, says: People no longer trust journalism, government, universities, science, or even business. Edelman's Trust Barometer dipped for business leaders for the first time in 25 years. CEOs who once declared strong values are now going silent, which damages trust even more. “The death of truth is really the problem that's at work here.” Robin points out: Trump and Elon, both charismatic, populist figures, continue to gain power despite low trust. Why? Because their clarity and simplicity still outperform thoughtful leadership. He also calls Trump a “marketing genius.” Brian's frustration: Case in point: Trump-era officials who spread conspiracy theories now can't walk them back. Populists manufacture distrust, then struggle to govern once in power. He shares a recent example: Result: Their base turned on them. Right-wing pundits (Pam Bondi, Dan Bongino) fanned Jeffrey Epstein conspiracies. But in power, they had to admit: “There's no client list publicly.” Brian then suggests that trust should be rebuilt locally. He points to leaders like Zohran Mamdani (NY): “I may not agree with all his positions, but he can articulate a populist vision that isn't exploitative.” Where Are the Leaders? (51:19) Brian expresses frustration at the silence from people in power: “I'm disappointed, highly disappointed, in the number of leaders in positions of power and authority who could lend their voice to something as basic as: science is real.” He calls for a return to shared facts: “Let's just start with: vaccines do not cause autism. Let's start there.” He draws a line between public health and trust: We've had over a century of scientific evidence backing vaccines But misinformation is eroding communal health Brian clarifies: this isn't about wedge issues like guns or Roe v. Wade The problem is that scientists lack public authority, but CEOs don't CEOs of major institutions could shift the narrative, especially those with massive employee bases. And yet, most say nothing: “They know it's going to bite them… and still, no one's saying it.” He warns: ignoring this will hurt businesses, frontline workers, and society at large. 89 Seconds from Midnight (52:45) Robin brings up the Doomsday Clock: Historically, it was 2–4 minutes to midnight “We are 89 seconds to midnight.” (as of January 2025) This was issued by the Bulletin of Atomic Scientists, a symbol of how close humanity is to destroying itself. Despite that, he remains hopeful: “I might be the most energetic person in any room – and yet, I'm a prepper.” Robin shared that: And in a real emergency? You might not make it. He grew up in the wilderness, where ambulances don't arrive, and CPR is a ritual of death. He frequently visits Vieques, an island off Puerto Rico with no hospital, where a car crash likely means you won't survive. As there is a saying there that goes, ‘No Hay Hospital', meaning ‘there is no hospital'. If something serious happens, you're likely a few hours' drive or even a flight away from medical care. That shapes his worldview: “We've forgotten how precious life is in privileged countries.” Despite his joy and optimism, Robin is also: Deeply aware of fragility – of systems, bodies, institutions. Committed to preparation, not paranoia. Focused on teaching resilience, care, and responsibility. How to Raise Men with Heart and Backbone (55:00) Robin asks: “How do you counsel your boys to show up as protectors and earners, especially in a capitalist world, while also taking care of people, especially when we're facing the potential end of humanity in our lifetimes?” Brian responds: His sons are now 25 and 23, and he's incredibly proud of who they're becoming. Credits both parenting and luck but he also acknowledges many friends who've had harder parenting experiences. His sons are: Sharp and thoughtful In healthy relationships Focused on values over achievements Educational path: “They think deeply about what are now called ‘social justice' issues in a very real way.” Example: In 4th grade, their class did a homelessness simulation – replicating the fragmented, frustrating process of accessing services. Preschool at the Jewish Community Center Elementary at a Quaker school in San Francisco He jokes that they needed a Buddhist high school to complete the loop Not religious, but values-based, non-dogmatic education had a real impact That hands-on empathy helped them see systemic problems early on, especially in San Francisco, where it's worse. What Is Actually Enough? (56:54) “We were terrified our kids would take their comfort for granted.” Brian's kids: Lived modestly, but comfortably in San Francisco. Took vacations, had more than he and his wife did growing up. Worried their sons would chase status over substance. But what he taught them instead: Family matters. Friendships matter. Being dependable matters. Not just being good, but being someone others can count on. He also cautioned against: “We too often push kids toward something unattainable, and we act surprised when they burn out in the pursuit of that.” The “gold ring” mentality is like chasing elite schools, careers, and accolades. In sports and academics, he and his wife aimed for balance, not obsession. Brian on Parenting, Purpose, and Perspective (59:15) Brian sees promise in his kids' generation: But also more: Purpose-driven Skeptical of false promises Less obsessed with traditional success markers Yes, they're more stressed and overamped on social media. Gen Z has been labeled just like every generation before: “I'm Gen X. They literally made a movie about us called Slackers.” He believes the best thing we can do is: Model what matters Spend time reflecting: What really does matter? Help the next generation define enough for themselves, earlier than we did. The Real Measure of Success (1:00:07) Brian references Clay Christensen, famed author of The Innovator's Dilemma and How Will You Measure Your Life? Clay's insight: “Success isn't what you thought it was.” Early reunions are full of bravado – titles, accomplishments, money. Later reunions reveal divorce, estrangement, and regret. The longer you go, the more you see: Brian's takeaway: Even for Elon, it might be about Mars. But for most of us, it's not about how many projects we shipped. It's about: Family Friends Presence Meaning “If you can realize that earlier, you give yourself the chance to adjust – and find your way back.” Where to Find Brian (01:02:05) LinkedIn WorkForward.com Newsletter: The Work Forward on Substack “Some weeks it's lame, some weeks it's great. But there's a lot of community and feedback.” And of course, join us at Responsive Conference this September 17-18, 2025. Books Mentioned How Will You Measure Your Life? by Clayton Christensen The Innovator's Dilemma by Clayton Christensen Responsive Manifesto Empire of AI by Karen Hao Podcasts Mentioned The Gap by Ira Glass The Ezra Klein Show Movies Mentioned Andor Slackers Organizations Mentioned: Bulletin of Atomic Scientists McKnight Foundation National Institutes of Health (NIH) Responsive.org University of California, San Francisco

UCSF researchers June Chan and Stacey Kenfield share evidence-based strategies for improving prostate cancer outcomes through exercise and diet. They highlight studies showing that physical activity—including resistance and high-intensity interval training—is linked to lower risk of prostate cancer progression and death. They discuss plant-based diets, dietary indices, and specific foods like tomatoes, fish, and nuts, along with the benefits of substituting plant oils for butter. Their analysis includes findings on racial disparities and underscores the need for inclusive research. They also describe current clinical trials exploring lifestyle tools and offer guidance on navigating diet and exercise choices during cancer survivorship. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40808]

UCSF researchers June Chan and Stacey Kenfield share evidence-based strategies for improving prostate cancer outcomes through exercise and diet. They highlight studies showing that physical activity—including resistance and high-intensity interval training—is linked to lower risk of prostate cancer progression and death. They discuss plant-based diets, dietary indices, and specific foods like tomatoes, fish, and nuts, along with the benefits of substituting plant oils for butter. Their analysis includes findings on racial disparities and underscores the need for inclusive research. They also describe current clinical trials exploring lifestyle tools and offer guidance on navigating diet and exercise choices during cancer survivorship. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40808]

UCSF researchers June Chan and Stacey Kenfield share evidence-based strategies for improving prostate cancer outcomes through exercise and diet. They highlight studies showing that physical activity—including resistance and high-intensity interval training—is linked to lower risk of prostate cancer progression and death. They discuss plant-based diets, dietary indices, and specific foods like tomatoes, fish, and nuts, along with the benefits of substituting plant oils for butter. Their analysis includes findings on racial disparities and underscores the need for inclusive research. They also describe current clinical trials exploring lifestyle tools and offer guidance on navigating diet and exercise choices during cancer survivorship. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40808]

UCSF researchers June Chan and Stacey Kenfield share evidence-based strategies for improving prostate cancer outcomes through exercise and diet. They highlight studies showing that physical activity—including resistance and high-intensity interval training—is linked to lower risk of prostate cancer progression and death. They discuss plant-based diets, dietary indices, and specific foods like tomatoes, fish, and nuts, along with the benefits of substituting plant oils for butter. Their analysis includes findings on racial disparities and underscores the need for inclusive research. They also describe current clinical trials exploring lifestyle tools and offer guidance on navigating diet and exercise choices during cancer survivorship. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40808]

Osteosarcoma Webinar Series: Amanda Marinoff, MD, a physician-scientist from UCSF will discuss clinical biomarkers for osteosarcoma stratification (cBOSS): Insights from a working group.Despite decades of research, osteosarcoma remains one of the few pediatric cancers without validated molecular biomarkers to guide treatment. The Clinical Biomarkers for Osteosarcoma Stratification (cBOSS) initiative is an international effort to change that. Modeled after a successful framework in Ewing sarcoma, cBOSS convened experts from North America and Europe to systematically evaluate emerging molecular features with the greatest potential for near-term clinical translation. Through a series of structured sessions, the group assessed the biological plausibility, clinical relevance, and implementation feasibility of candidate classifiers across five domains: genomic, transcriptomic, epigenetic, immune, and circulating analytes. This webinar will provide an overview of the cBOSS approach, key findings to date, including the maturity of circulating tumor DNA and MYC amplification as prognostic tools, and the path forward for incorporating molecular stratification into future clinical trials. The goal: to move beyond one-size-fits-all therapy and build a precision medicine framework for osteosarcoma.Dr. Amanda Marinoff is a pediatric oncologist and translational researcher at UCSF, where she focuses on developing molecular biomarkers to improve risk stratification and treatment for children and young adults with osteosarcoma. She co-leads the international cBOSS initiative (Clinical Biomarkers for Osteosarcoma Stratification), which brings together experts across North America and Europe to evaluate and prioritize emerging classifiers for clinical use. Her research aims to bridge the gap between genomic discovery and therapeutic application, advancing precision medicine approaches for patients with high-risk disease. Dr. Marinoff earned her medical degree from Harvard Medical School, completed her pediatrics residency at Boston Children's Hospital, and completed her pediatric hematology/oncology fellowship at UCSF Benioff Children's Hospital. She is an active member of the pediatric solid tumor and early-phase clinical trials groups at UCSF.

The final installment in our leadership series with the Association of Departments of Family Medicine (ADFM) explores how to cultivate new leaders and guide your department forward toward collective growth. In this episode of The STFM Podcast, Dean Seehusen, MD, and Beth Wilson, MD, MPH, MS-HPEd, unpack the distinctions between coaching, mentoring, and sponsoring, as well as how to use each effectively to build a diverse culture of resilience and development within your institution. They also share strategies for identifying emerging talent, fostering inclusive pipelines, and supporting growth across all career stages.Hosted by Omari A. Hodge, MD, FAAFP and Jay-Sheree Allen Akambase, MDCopyright © Society of Teachers of Family Medicine, 2025Resources:Emerging Leaders FellowshipADFM Leader Development Committee -  Resources from the Leader Development Committee for New & Interim ChairsADFM LEADS FellowshipMindset: The New Psychology of Success by Carol S. DweckHarvard School of Public Health Program for Chairs of Clinical Services Guest Bio:Elisabeth "Beth" Wilson, MD, MPH, MS-HPEdElisabeth Wilson, MD, MPH, MS-HPEd is Chair of the Department of Community & Family Medicine at Dartmouth Health and Geisel School of Medicine.  As Chair, Dr. Wilson is responsible for the advancement of Dartmouth's academic and clinical mission.  She leads a system-wide primary care leadership committee, oversees the oldest Practice-Based Research Network in the country, and recently launched a new regional primary care research and policy center.  She also has the honor of working with Dartmouth medical and public health students committed to serving under-resourced communities.  Dr. Wilson is a member of the Primary Care Centers Roundtable and recently served on the board of the Association of Departments of Family Medicine.Prior to joining Dartmouth in 2022, Dr. Wilson held the position of Chair of the Department of Family Medicine at Maine Medical Center for five years.  During that time, she served as the Executive Director of the Preble Street Learning Collaborative, an academic-community partnership to address unmet needs of people experiencing homelessness in the Portland area.  Dr. Wilson spent the first two decades of her career at the University of California San Francisco (UCSF) where she completed her residency and research fellowship, after receiving a dual MD-MPH degree at Tufts University School of Medicine.  While at UCSF, she held the positions of Vice Chair of Education in the Department of Family and Community Medicine, Director of the Northern California Faculty Development Fellowship, Dean's Diversity Leader for the Differences Matter initiative, and founding Director of the Program in Medical Education for the Urban Under

What exactly is a fellow? What is life like as a sports medicine fellow at UCSF? What kind of training do they get? Listen to our latest podcast as we sit down with two of our current fellows, Dr Marcus Trotter and Dr Jamie Confino.

As part of the 2025 Developmental Disabilities Conference, Dr. Mary Dubon of Harvard Medical School talk about adaptive and para sports for youth with physical and developmental disabilities. Series: "Developmental Disabilities Update" [Health and Medicine] [Show ID: 40617]

As part of the 2025 Developmental Disabilities Conference, Dr. Mary Dubon of Harvard Medical School talk about adaptive and para sports for youth with physical and developmental disabilities. Series: "Developmental Disabilities Update" [Health and Medicine] [Show ID: 40617]

As part of the 2025 Developmental Disabilities Conference, Dr. Mary Dubon of Harvard Medical School talk about adaptive and para sports for youth with physical and developmental disabilities. Series: "Developmental Disabilities Update" [Health and Medicine] [Show ID: 40617]

What does it mean to provide care when medicine can no longer cure? In this episode, UCSF palliative care physician Dr. Brieze Bell shares her journey from professional dancer to integrative medicine leader, and how those seemingly unrelated paths came together in a life devoted to service, presence, and healing at the edge of life. Dr. Bell reflects on the principle of non-abandonment, the emotional complexity of medical aid in dying, and her role leading UCSF's End of Life Option Act program. She describes the system's work behind transforming this sensitive process into a compassionate, accessible, and legally sound experience for patients and families. Alongside deeply personal stories—including the death of her mother and a heartfelt posthumous letter from a patient—Dr. Bell reminds us that showing up for someone in their most vulnerable moment can change everything. This conversation is essential listening for clinicians, caregivers, and anyone contemplating the ethics and emotions surrounding end-of-life care. Listen in as Christine Winoto, director of the UCSF Rosenman Institute, explores the dignity, discomfort, and transformative grace that define this powerful chapter of healthcare. Tune in to hear what it truly means to be a companion at the end of life. Do you have thoughts on this episode or ideas for future guests? We'd love to hear from you. Email us at hello@rosenmaninstitute.org.

Comprehensive coverage of the day's news with a focus on war and peace; social, environmental and economic justice. South African police minister fired over organized crime; Senator Padilla introduces legislative update to expand path to citizenship for millions; Governor Newsom meets with Texas lawmakers in response to Trump's Texas redistricting plan; UCSF workers hold 1-day strike to protest layoff of front-line health care workers; July 25 is UN's International Day for Women and Girls of African Descent Deportation flights begin from Florida's Alligator Alcatraz immigrant detention center, destinations unknown The post Senator Padilla legislation would expand path to citizenship; Newsom meets TX lawmakers re Trump's Texas redistricting plan – July 25, 2025 appeared first on KPFA.

Join Kristin Coverly as she speaks with the 2024 Massage is for EveryBody award winners about what inspires them to give back to their communities, as well as their advice for how you can get started, too! Resources: ABMP Education Center: https://www.abmp.com/learn/ ABMP Massage is for EveryBody Week: https://www.abmp.com/massage-week-intro 2024 Massage is for EveryBody Winners:  https://www.abmp.com/massage-week-awards-2024 Healwell's Massage Palliative Advanced Training for Healthcare (MPATH): https://mpath.healwell.org/  Host: Kristin Coverly, LMT is a massage therapist, educator, and the director of professional education at ABMP. She loves creating continuing education courses, events, and resources to support massage therapists and bodyworkers as they enhance their lives and practices. Contact her at ce@abmp.com. Guests: Nicole Kurth Nicole Kurth is a massage therapist who works with pediatric hospice and palliative care patients on the Pediatric Hospice Palliative Care team at By the Bay Health, a UCSF-affiliated nonprofit home health organization. By the Bay Health: https://bythebayhealth.org/pediatrics-care-health-professionals/  Singeli Zaparaniuk Singeli Zaparaniuk is a massage therapist who works with suicide loss survivors. Elevate Healing Arts: https://www.elehealing.com/ Dannie Horton Dannie Horton is the co-founder of the Cleveland Embodiment Collective, a worker-owned collective of massage therapists that offers cost-free and sliding-scale sessions. Cleveland Embodiment Collective: https://www.clevelandembodiment.org/   Julia Semple Julia Semple is a practitioner who, for the 2024 Massage is for EveryBody Week event, held a contest to introduce massage to community members with limited access. Therapeutic Massage of Northern Colorado:  https://www.therapeuticmassageofnoco.com/   Sponsors:   Anatomy Trains: www.anatomytrains.com    PMNT: www.pmnt.org   MassageBook: www.massagebook.com  

Often misunderstood as end-of-life care, palliative care is actually about improving quality of life at any stage of serious illness. In this episode of BackTable Urology, Dr. Ashwin Kotwal, a geriatrician and palliative care physician at UCSF, and Dr. Pauline Filippou, a urologic oncologist at Kaiser Permanente in Northern California join hosts Dr. Gina Badalato and Dr. Lindsay Hampson to discuss the importance of palliative care in the field of urology. --- SYNPOSIS The episode covers how palliative care can improve quality of life for patients with serious illnesses, the challenges and opportunities of integrating palliative care into urology practice, and specific training resources and frameworks for effective communication and symptom management. From addressing common misconceptions to providing practical advice on implementing palliative care, this episode is an essential guide for trainees and urology professionals looking to deepen their understanding of palliative care and enhance their practice. --- TIMESTAMPS 00:00 - Introduction03:04 - Understanding Palliative Care04:43 - Misconceptions and Communication Strategies07:45 - Integrating Palliative Care in Urology10:26 - Collaborative Approaches and Multidisciplinary Teams15:48 - Training and Education for Trainees20:25 - Effective Communication Techniques28:18 - Impact of Palliative Care34:33 - Final Thoughts and Takeaways --- RESOURCES Center to Advance Palliative Care website:https://www.capc.org/ AUA White Paper: https://www.auanet.org/documents/guidelines/white%20papers/postoperative.pdf VitalTalk:https://www.vitaltalk.org/ Eliciting the Patient's Agenda- Secondary Analysis of Recorded Clinical Encounters: https://link.springer.com/article/10.1007/s11606-018-4540-5 Family Meetings on Behalf of Patients with Serious Illness: https://www.nejm.org/doi/full/10.1056/NEJMvcm1913056

UCSF's Dr. Monica Gandhi weighs in on current science policy; Jeff Bellisario of the Bay Area Council and SF Chief Economist Ted Egan on the our aging demographics; No Immigrants No Spice celebrate immigrant contributions.

UCSF's Dr. Monica Gandhi weighs in on current science policy; Jeff Bellisario of the Bay Area Council and SF Chief Economist Ted Egan on the our aging demographics; No Immigrants No Spice celebrate immigrant contributions.

AI is advancing rapidly in the healthcare space, raising important questions about how it will be used responsibly and effectively. Host Courtney Furrow White is joined by Sarah Pollet and Julia Bongiorno from UCSF to explore the evolving role of AI in clinical environments. Together, they break down the development of UCSF's IMPACC framework, a platform designed to evaluate and guide enterprise AI implementation. The conversation dives into what it takes to make AI safe, reliable, and trustworthy, not only for patients, but for the frontline staff who rely on these tools.   Guest speakers: Julia Bongiorno, PMP, MSHC Health AI Program Supervisor (Interim) UCSF Health   Sarah Pollet, MPH Program Director UCSF AI Impact & Monitoring (IMPACC)   Host: Courtney Furrow White MPM, RN Senior Director, Performance Improvement Programs Vizient   Show notes:  [1:47] Overview of UCSF's AI I-M-P-A-C-C framework and how it informs future deployments. [3:02] UCSF's approach to AI governance emphasizes safety, ethics and active research. [4:03] What it takes to ensure AI tools are reliable and clinically trusted. [6:41] Providers seek AI tools that reduce cognitive burden and improve workflows. [10:43] Educating patients on AI while reflecting on tools that failed to deliver. [13:01] How AI is shaping the nurse experience through practical tool integration. [15:44] Advice for other organizations on implementing AI responsibly and effectively.   Links | Resources: Contacting Knowledge on the Go: picollaboratives@vizientinc.com   Subscribe Today! Apple Podcasts Spotify Android RSS Feed

In this episode of A Shot in the Arm Podcast, host Ben Plumley welcomes Dr. mike Reid, Associate Director of Global Health Delivery and Economics at UCSF. The discussion centers on Reid's analysis of the 'seven dead ideas' in global health, criticizing outdated approaches such as the overreliance on donor directives and vertical programs. Reid emphasizes the need for context-sensitive solutions informed by rigorous implementation science and local realities. The conversation also touches on how health, intrinsically political, demands both donor and recipient nations to prioritize equitable solutions. Additional insights include the inefficiencies in current funding models, the dangers of overly technical approaches, and the underutilized role of faith communities and AI in future health strategies. The episode concludes with a call for integrated efforts and sustainable practices as the path forward. 00:00 Introduction and Podcast Overview 00:43 Guest Introduction: Dr. mike Reid 01:23 State of Global Health: Key Issues 02:17 Seven Dead Ideas in Global Health 03:42 Dead Idea #1: We Know What Works 07:19 Dead Idea #2: Health is a Technical Problem 11:27 Dead Idea #3: Donors Know Best 13:07 Dead Idea #4: More Money Means More Impact 15:35 Dead Idea #5: Vertical Programs are Efficient 20:35 Dead Idea #6: Measurement Equals Progress 24:44 Dead Idea #7: We Are on Track to Achieve SDG Goal 3 27:10 The Role of Faith Communities in Global Health 30:18 Artificial Intelligence in Global Health 33:57 Conclusion and Farewell

As part of the 2025 Developmental Disabilities Conference, Dr. Diane Cullinane talks about the spectrum of therapeutic approaches for working with people with autism. Series: "Developmental Disabilities Update" [Health and Medicine] [Show ID: 40615]

As part of the 2025 Developmental Disabilities Conference, Dr. Diane Cullinane talks about the spectrum of therapeutic approaches for working with people with autism. Series: "Developmental Disabilities Update" [Health and Medicine] [Show ID: 40615]

As part of the 2025 Developmental Disabilities Conference, Dr. Diane Cullinane talks about the spectrum of therapeutic approaches for working with people with autism. Series: "Developmental Disabilities Update" [Health and Medicine] [Show ID: 40615]

Esther Wojcicki is a renowned educator and journalist, best known for her transformative parenting philosophy outlined in her books In this episode, she shares the principles that guided her as a mother to Susan Wojcicki, former CEO of YouTube, Anne Wojcicki, founder of 23andMe, and Dr Janet Wojcicki, a professor of paediatrics at UCSF.She reflects on how childhood trauma, loss and adversity can be met with trust, respect, independence, collaboration and kindness—the values at the heart of her TRICK framework. We also explore how her philosophy contrasts with more authoritarian approaches to parenting, such as those advanced by Amy Chua in Battle Hymn of the Tiger Mother. Esther argues that success does not require pressure or fear, but rather autonomy, connection, and trust.Esther also discusses grief - a constant in most of our lives. This conversation goes well beyond parenting. It is about finding strength through meaning, creating space for healing, and choosing stories that uplift rather than confine. Esther's insights offer a profound reminder that while loss is part of life, it does not have to define it.

In this episode of The Psychedelic Podcast, Paul F. Austin is joined by renowned neuroscientist Dr. Robin Carhart-Harris and microdosing policy advocate John Downs for a replay of a live event originally held on June 10th, Microdosing vs. SSRIs: What's Happening in the Brain and Why It Matters. Find full show notes and links here: https://thethirdwave.co/podcast/episode-312b/?ref=278 Together, they explore the scientific distinctions between SSRIs and psychedelics, focusing on neuroimaging, brain entropy, emotional processing, and the REBUS model. Dr. Carhart-Harris shares key insights from landmark studies on psilocybin therapy and discusses the evidence (and limitations) around microdosing. John Downs closes the conversation with an update on the Microdosing Collective's efforts to shift policy and expand access. Robin Carhart-Harris, PhD is a neuropharmacologist, psychologist, and Ralph Metzner Distinguished Professor in Neurology and Psychiatry at the University of California, San Francisco. He leads the Psychedelics Division at UCSF's Neuroscape and formerly founded and led the Centre for Psychedelic Research at Imperial College London. John Downs is Executive Director of the Microdosing Collective, advocating for responsible policy reform and legal access to microdosing. With 25 years' experience in sales, business development, and emerging markets, John helps individuals optimize mindset, performance, and purpose. Episode Highlights: Why SSRIs blunt, while psychedelics reset emotional processing How psilocybin compares to antidepressants in clinical trials Brain entropy, plasticity, and the REBUS model explained The role of the default mode network in mental health Why microdosing research is still so limited Ketamine vs. psilocybin: differences in brain mechanisms Is serotonin syndrome a real microdosing risk? Can psychedelics reverse long-term SSRI effects? The Microdosing Collective's mission for policy reform What Robin Carhart-Harris' upcoming book will explore Episode Links: Robin's lab & upcoming book Microdosing Collective Join Dr. Robin Carhart-Harris at our Practitioner Intensive (November 5–10, Costa Rica) Episode Sponsors: Golden Rule Mushrooms - Get a lifetime discount of 10% with code THIRDWAVE at checkout Psychedelic Coacing Isntitute's  Intensive for Psychedelic Professionals in Costa Rica - a transformative retreat for personal and professional growth.

UCSF's Dr. Cornelia Ding demystifies the prostate cancer pathology report and explains how to read and understand it. The report contains five key sections: patient information, diagnosis and comments, gross description, and any addendums or amendments. It serves multiple purposes—as a medical, legal, and clinical communication tool—and often contains technical language not written for patients. Dr. Ding walks through important terminology such as Gleason score, Grade Groups, and specific diagnostic patterns like intraductal carcinoma, emphasizing how each affects risk assessment and treatment planning. Patients are encouraged to focus on the diagnosis and comment sections and to discuss any unclear details with their doctors. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40797]

UCSF's Dr. Cornelia Ding demystifies the prostate cancer pathology report and explains how to read and understand it. The report contains five key sections: patient information, diagnosis and comments, gross description, and any addendums or amendments. It serves multiple purposes—as a medical, legal, and clinical communication tool—and often contains technical language not written for patients. Dr. Ding walks through important terminology such as Gleason score, Grade Groups, and specific diagnostic patterns like intraductal carcinoma, emphasizing how each affects risk assessment and treatment planning. Patients are encouraged to focus on the diagnosis and comment sections and to discuss any unclear details with their doctors. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40797]

UCSF's Dr. Cornelia Ding demystifies the prostate cancer pathology report and explains how to read and understand it. The report contains five key sections: patient information, diagnosis and comments, gross description, and any addendums or amendments. It serves multiple purposes—as a medical, legal, and clinical communication tool—and often contains technical language not written for patients. Dr. Ding walks through important terminology such as Gleason score, Grade Groups, and specific diagnostic patterns like intraductal carcinoma, emphasizing how each affects risk assessment and treatment planning. Patients are encouraged to focus on the diagnosis and comment sections and to discuss any unclear details with their doctors. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40797]

UCSF's Dr. Cornelia Ding demystifies the prostate cancer pathology report and explains how to read and understand it. The report contains five key sections: patient information, diagnosis and comments, gross description, and any addendums or amendments. It serves multiple purposes—as a medical, legal, and clinical communication tool—and often contains technical language not written for patients. Dr. Ding walks through important terminology such as Gleason score, Grade Groups, and specific diagnostic patterns like intraductal carcinoma, emphasizing how each affects risk assessment and treatment planning. Patients are encouraged to focus on the diagnosis and comment sections and to discuss any unclear details with their doctors. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40797]

Research funded by the federal government has been crucial in many of the defining technologies of our time: the internet, A.I., crispr, Ozempic, and the mRNA vaccines first used widely in the COVID pandemic. Between 2010 and 2019, more than 350 drugs were approved in the United States, and virtually all of them could trace their roots to the National Institutes of Health (NIH). Now this administration is endangering our health by cutting funds to academic medical centers. Moreover, there are threats to Medicaid, as well as ongoing cuts to the Centers for Disease Control (CDC). Many universities have paused hiring due to the uncertainty at the NIH and are curtailing graduate programs. Biotech investors are warning of a contraction in medical innovation. NIH grants have been terminated on ideological grounds, which have resulted in clinical trials shutting down. Global health programs worldwide have been cut. A discussion on these destructive policies on medicine in our country is needed. About the Speaker Monica Gandhi M.D., M.P.H., is a professor of medicine and associate chief in the Division of HIV, Infectious Diseases, and Global Medicine at the University of California, San Francisco (UCSF). She is also the director of the UCSF Center for AIDS Research (CFAR) and the medical director of the HIV Clinic ("Ward 86") at San Francisco General Hospital. She serves as the associate program director of the ID fellowship at UCSF. Her research focuses on HIV treatment and prevention optimization, HIV and women, adherence measurement in HIV and TB, adherence interventions, and on optimizing the use of long-acting antiretroviral therapy (ART). She is a long-standing NIH-funded researcher. Commonwealth Club World Affairs of California is a nonprofit public forum; we welcome donations made during registration to support the production of our programming. A Health & Medicine Member-led Forum program. Forums and Chapters at the Club are organized and run by volunteer programmers who are members of The Commonwealth Club, and they cover a diverse range of topics. Learn more about our Forums. Commonwealth Club World Affairs is a public forum. Any views expressed in our programs are those of the speakers and not of Commonwealth Club World Affairs. OrganizerMichael Baker  Learn more about your ad choices. Visit megaphone.fm/adchoices

What is an AC joint injury? Do you ever need to fix it? Listen to our latest podcast as Dr Brian Feeley and Dr Drew Lansdown break down treatment of this injury.

Meniscus tears can be confusing. They can occur with trauma or not, they come in a variety of shapes and locations which can influence treatment options and outcomes profoundly, and the right treatment remains a matter of great debate. The literature is likewise confusing, and historically has been heterogeneous. Dr. Benjamin MA, MD, PhD from the famed UCSF joins us to discuss an international multi-society expert panel he took part in to generate consensus statements regarding meniscus tear treatment. The consensus statements give all of us in the Sports Medicine world some guidance and reassurance for our approach to this seemingly simple structure, the meniscus, that, when torn, is full of complexities. 

Are you a woman leader or entrepreneur considering a career pivot, especially from academia to the dynamic startup world? Do you wonder how to navigate this transition, build crucial relationships, and drive innovation in a new industry? This episode of How Women Inspire addresses these very challenges, offering invaluable insights into making a successful leap and fostering meaningful connections.This week's episode 177 of How Women Inspire Podcast is about transitioning from academia to startups! In this episode of How Women Inspire Podcast, Grace Wei is sharing the importance of building relationships and maintaining connections with experts and mentors. and actionable steps you can take right now to build a team culture at your startup. Grace Wei has held the position of COO at Encellin since 2016. Prior to that, Grace worked as a biologist at UCSF from 2005 to 2015. Grace Wei has a Bachelor's Degree in Human Genetics from McGill University and a Ph.D. in Molecular and Cellular Biology from the University of Chicago. Grace also completed programs at Stanford University Graduate School of Business and Y Combinator.Some of the talking points Julie and Grace go over in this episode include:Why building and maintaining strong relationships is paramount for founders and leadersThe unique benefits of different accelerators and how they can provide access to experts, community, and professional coaching for your startup journey.How transitioning from a specialized field like academia to a startup environment requires humility and a willingness to seek adviceThe importance of team culture for startup success, and how that differs from academia.What steps will you take today to cultivate your network and embrace new challenges?Thank you for listening! If you enjoyed this episode, take a screenshot of the episode to post in your stories and tag me!  And don't forget to follow, rate, and review the podcast and tell me your key takeaways!Learn more about How Women Inspire at https://www.howwomenlead.com/podcast CONNECT WITH GRACE WEI:LinkedInEncellinCONNECT WITH JULIE CASTRO ABRAMS:LinkedIn - JulieHow Women LeadHow Women InvestHow Women GiveInstagram - HWLLinkedIn - HWLFacebook - HWL

Prostate cancer remains the most commonly diagnosed cancer and second leading cause of cancer death among men in the U.S., with evolving screening and treatment practices reshaping care in 2025. UCSF's Dr. Matthew Cooperberg highlights a shift away from overdiagnosis and overtreatment of low-risk cancers, focusing instead on identifying aggressive disease through tools like MRI and advanced biomarker tests. A new “smarter screening” model now guides primary care, recommending long testing intervals for men with low PSA levels. While active surveillance has increased nationally, significant variation in care remains, and racial disparities—especially for Black men—persist. Patients are encouraged to take time in making treatment decisions, as prostate cancer often progresses slowly and allows for thoughtful, personalized care. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40796]

Prostate cancer remains the most commonly diagnosed cancer and second leading cause of cancer death among men in the U.S., with evolving screening and treatment practices reshaping care in 2025. UCSF's Dr. Matthew Cooperberg highlights a shift away from overdiagnosis and overtreatment of low-risk cancers, focusing instead on identifying aggressive disease through tools like MRI and advanced biomarker tests. A new “smarter screening” model now guides primary care, recommending long testing intervals for men with low PSA levels. While active surveillance has increased nationally, significant variation in care remains, and racial disparities—especially for Black men—persist. Patients are encouraged to take time in making treatment decisions, as prostate cancer often progresses slowly and allows for thoughtful, personalized care. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40796]

Send us a textThe genetics of sleep duration and sleep timing.Episode Summary: Dr. Ying-Hui Fu discusses her research on the genetics of sleep, focusing on natural short sleepers who thrive on 4-6 hours of sleep and the heritability of sleep traits like duration and timing. She explores how sleep efficiency, rather than just duration, may explain why some need less sleep without health deficits, and delves into the molecular and circadian mechanisms regulating sleep. About the guest: Ying-Hui Fu, PhD is a neuroscientist and professor at UCSF, where her lab studies the genetics of human sleep behaviors, particularly sleep duration and schedule.Discussion Points:Sleep Traits Are Genetic: Sleep duration (how long you sleep) and sleep schedule (when you sleep) are partially heritable, with most people needing 7-9 hours, while rare natural short sleepers thrive on 4-6 hours.Natural Short Sleepers: These individuals fall asleep quickly, have high sleep efficiency, and live healthy, active lives without deficits, possibly due to faster toxin clearance and repair during sleep.Sleep Efficiency Matters: Short sleepers may complete restorative sleep processes (e.g., clearing toxins, repairing damage) more efficiently, allowing them to need less sleep.Circadian & Entrainment Pathways: Sleep timing is regulated by a molecular clock and environmental cues like light, with mutations in entrainment pathways causing extreme schedules (e.g., early bedtime or night owl tendencies).Modern Lifestyle Harms Sleep: Stimuli like blue light and tense media disrupt sleep patterns, leading to widespread sleep deprivation and health risks.Shift Work Risks: Shift workers face higher risks of diseases like cancer and neurodegeneration due to disrupted sleep cycles, though genetic background influences susceptibility.Finding Your Sleep Rhythm: A two-week vacation without stimulants or artificial light can help determine your natural sleep schedule and duration.Sleep's Health Impact: Poor sleep is a major factor in aging and diseases like Alzheimer's, making it as critical as diet and exercise for health.Related episode:M&M 237: Circadian Biology: Genetics, Behavior, Metabolism, Light, OxygenSupport the showAll episodes, show notes, transcripts, and more at the M&M Substack Affiliates: KetoCitra—Ketone body BHB + potassium, calcium & magnesium, formulated with kidney health in mind. Use code MIND20 for 20% off any subscription (cancel anytime) Lumen device to optimize your metabolism for weight loss or athletic performance. Code MIND for 10% off Readwise: Organize and share what you read. 60 days FREE through link SiPhox Health—Affordable at-home blood testing. Key health markers, visualized & explained. Code TRIKOMES for a 20% discount. MASA Chips—delicious tortilla chips made from organic corn & grass-fed beef tallow. No seed oils or artificial ingredients. Code MIND for 20% off For all the ways you can support my efforts

I sit down with Dr Aparajita Singh, Gastroenterologist and Director of the Lynch Syndrome Center at UCSF, where it truly is a team effort taking care of Lynch Syndrome patients.  Aside from me mispronouncing Lynch Syndrome, it was a wonderful engaging conversation.  UCSF Lynch Syndrome Center should have the links to everything discussed, which was a lot.  Check it out.        

Dr. Reedy welcomes Dr. Alexa Altman where she discusses how psychedelics bring the unconscious material into consciousness. She talks about the importance of integration. Dr. Altman's Website: https://www.i-psychedelic.com 1. Single-dose psilocybin (25 mg) with psychological support for MDDJAMA – “Single-Dose Psilocybin Treatment for Major Depressive Disorder” psychiatryonline.org+15sunstonetherapies.com+15pmc.ncbi.nlm.nih.gov+15 Summary: Demonstrated strong antidepressant effects and good tolerability over follow-up. Email: info@hopkinspsychedelic.org 2. One-Year Follow-Up of Psilocybin for Depression Study: Long-term effects of psilocybin therapy for depression Johns Hopkins – “Psilocybin treatment for major depression effective for up to a year” Summary: 67% of participants remained in remission one year post-treatment. 3. MDMA-Assisted Therapy for Severe PTSD Randomized, placebo-controlled MDMA-assisted therapy Nature Medicine – “MDMA-assisted therapy for severe PTSD” Summary: Significant reduction in PTSD symptoms, well‑tolerated in a diverse cohort. Contact (MAPS / Lykos Therapeutics): Email: info@maps.org 4. Psilocybin for Cancer-Related Anxiety & Depression Psilocybin in patients with life-threatening cancer PMC – “High-dose psilocybin produced large decreases in depressed mood and anxiety…” Summary: 80% of participants maintained significant symptom relief at 6 months. Website: heffter.org (contact via site) en.wikipedia.org 1. Johns Hopkins University Center for Psychedelic and Consciousness Research Psilocybin for depression, anxiety, addiction, and end-of-life distress Why it's top-tier: The first major U.S. institution to receive regulatory approval for psychedelic research in modern times.

Matt welcomes UCSF sleep expert Dr. Aric Prather to the podcast this week to discuss the science of psychoneuroimmunology: the link between our behavior and immune health. After a primer on the immune system's innate and adaptive arms, Dr. Prather details how insufficient sleep dramatically increases your risk of catching a cold, significantly blunts vaccine effectiveness by reducing antibody response, and promotes a state of chronic, low-grade inflammation - a known pathway to numerous age-related diseases.Ultimately, the conversation illuminates a profound and actionable truth: sleep is arguably our most powerful, yet tragically overlooked, weapon in the daily battle for immunological health.Please note that Matt is not a medical doctor, and none of the content in this podcast should be considered medical advice in any way, shape, or form, nor prescriptive in any way.One of our sponsors this week is the biochemical electrolyte drink company LMNT, and they are very kindly offering eight free sample packs when you purchase any one of their orders at drinklmnt.com/mattwalker. LMNT is an electrolyte sports drink that I can get behind - it's created from the basis of science, and it has no sugar, no coloring, and no artificial ingredients – all qualities that are so important to maintaining your blood biochemical balance. And now their new Lemonade Salt is squeezing onto the scene Tuesday, May 20th! This limited-time flavor is here to keep you at your best all summer long, and, just like summer, it's here for a good time, not a long time, so stock up while supplies last! If you want to give Lemonade Salt or any of the fantastic LMNT flavors a try, just head on over to drinklmnt.com/mattwalker and get your free Sample Pack with your first purchase.Matt will be the first to tell you that launching his sleep-related merchandise sales was incredibly smooth, thanks to our new sponsor Shopify and their integrated sales and inventory system. And now, just for you,  Shopify is generously offering an exclusive trial at shopify.com/mattwalker. Whether it's online or in-person sales, Shopify simplifies it all. So, be sure to stop in at shopify.com/mattwalker to start your exclusive journey now! Matt's good friend Dr. Peter Attia has helped develop David, a revolutionary new protein bar, and a sponsor of today's episode! 28g of protein, 0g sugar, only 150 calories – the best ratio EVER! Amazing taste, six flavors, incredibly satiating, and a great source of the protein that helps build muscle, manage metabolic health, and keep you full. Visit davidprotein.com/mattwalker now for an amazing deal: Buy 4 cartons, and get a 5th FREE! . Hurry! Your new favorite protein bar awaits!As always, if you have thoughts or feedback you'd like to share, please reach out:Matt: Instagram @drmattwalker, X @sleepdiplomat, YouTube https://www.youtube.com/@sleepdiplomatmattwalker9299Dr. Aric Prather: https://www.aricprather.com/

Rates of chronic illness, behavioral disorders, and neurodevelopmental challenges are rising rapidly among children, often tied to underlying gut dysfunction, nutrient deficiencies, and environmental triggers such as toxins and ultra-processed foods. Conventional treatments frequently overlook these root causes, relying instead on symptom management or medication. Functional approaches emphasize foundational lifestyle changes—clean nutrition, microbiome support, movement, sleep, and stress reduction—as powerful tools to restore health. Children are especially responsive to these changes, often experiencing rapid and dramatic improvements in behavior, mood, and physical symptoms. With education, testing, and family-centered strategies, parents can take simple, effective steps to help their children thrive. In this episode, I discuss, along with Dr. Elisa Song, Dr. Suzanne Goh, and Dr. Elizabeth Boham why a root-cause approach is just as important for children, as it is for adults. Dr. Elisa Song, MD is a Stanford-, NYU-, UCSF-trained integrative pediatrician, pediatric functional medicine expert, and mom to 2 thriving children - and she is on a mission to revolutionize the future of children's health. Dr. Song is the bestselling author of the Healthy Kids Happy Kids: An Integrative Pediatrician's Guide to Whole Child Resilience. Dr. Song created Healthy Kids Happy Kids as an online holistic pediatric resource to help practitioners and parents bridge the gap between conventional and integrative pediatrics with an evidence-based, pediatrician-backed, mom-approved approach. In her integrative pediatric practice, she's helped 1000s of kids get to the root causes of their health concerns and empowered parents to help their children thrive by integrating conventional pediatrics with functional medicine, homeopathy, acupuncture, herbal medicine, and essential oils. Dr. Song is chair of A4M's pediatric education and has lectured around the world at leading integrative and functional medicine conferences and premier parenting events. She has also been featured in hundreds of top podcasts, print and online media outlets, including the Wellness Mama podcast, BloomTV, Forbes, Healthline, MindBodyGreen, National Geographic, PopSugar, Parents, Motherly, Parade, Verywell Health, and New York Post. Dr. Suzanne Goh, co-founder and chief medical officer at Cortica, is a Rhodes Scholar and graduate of Harvard University, University of Oxford, and Harvard Medical School who has spent decades working with autistic children. Her work as a board-certified pediatric behavioral neurologist, behavioral analyst, neuroscience researcher, and author led her to create the Cortica Care Model, an innovative, whole-child approach that combines optimal medical treatment with the most effective strategies for advancing cognition, communication, and behavior. Dr. Elizabeth Boham is Board Certified in Family Medicine from Albany Medical School, and she is an Institute for Functional Medicine Certified Practitioner and the Medical Director of The UltraWellness Center. Dr. Boham lectures on a variety of topics, including Women's Health and Breast Cancer Prevention, insulin resistance, heart health, weight control and allergies. She is on the faculty for the Institute for Functional Medicine. This episode is brought to you by BIOptimizers. Head to bioptimizers.com/hyman and use code HYMAN10 to save 10%. Full-length episodes can be found here: How to Raise Healthy Kids: A Functional Medicine Approach The Surprising Causes of Autism & Why It's On The Rise Addressing The Root Causes Of Childhood Obesity