Podcasts about update september

Episode 47: Hearing Carotid Lung.  Dr Civelli explains the updates on screening for lung cancer, hearing loss and carotid artery stenosis; Kafiya explains the use of bupropion and naltrexone in methamphetamine abuse, question of the month pneumonia.Introduction: Methamphetamine useBy Kafiya Arte, MS4, and Ariana Lundquist, MD.Today is April 12, 2021.Bakersfield, California, has a methamphetamine (meth) epidemic currently ravaging this area. We as health care workers believe we can spot somebody addicted to meth from a mile away by their characteristic “older-than-stated-age” appearance and obvious “meth mouth”. However, the actual scope of the epidemic is much larger. It’s not just people who are experiencing homelessness that are addicted to, and dying from, meth.  I saw while volunteering at a needle exchange at Weill Park, people getting out of nice-looking cars wearing clean, pressed clothes with sharps containers full of used needles ready to exchange. One man even had a teacup poodle in tow. It’s clear that meth can affect anybody.  Between May 10 and June 10, 2014, 31.8% of randomly selected patients in the ED of Kern Medical admitted to having used methamphetamine at least once in their life. It’s not just the individual who addicted to meth who is affected. 36.1% of children removed from their home by child protective services in Kern County during the month of May 2014 were cases that involved methamphetamine[1]. Meth accounted for nearly 75% of all drugs seized by the Bakersfield Police Department[2]. Statewide, meth kills more Californians than any single opioid alone[3]. Amphetamine overdose deaths have increased 212% from 777 in 2012 to 2,427 in 2018 in California. In 2020, Kern County had more than double the rate of deaths related to overdose of psychostimulants, of which meth was the dominant drug, compared to the state of California (20.48/100k residents versus 8.21/100k residents, respectively)[3]. This devastating problem, unfortunately, does not have a currently FDA-approved drug to treat it. A promising study called Accelerated Development of Additive Treatment for Methamphetamine Disorder (ADAPT-2), assessed the efficacy of combined bupropion and naltrexone for the treatment of meth use disorder. Bupropion decreases the dysphoria of meth withdrawal that drives continued use; while naltrexone decreases cravings, therefore preventing relapse, as it does with alcohol use disorder.  A total of 403 participants with nearly daily meth use were included in the two-stage randomized, double blind trial conducted at 8 different sites from May 23, 2017 to July 25, 2019. The efficacy of extended-release injectable naltrexone (380 mg every 3 weeks) combined with once-daily oral extended-release bupropion (450 mg) was evaluated, as compared to placebo.  The results of the study showed a 13.6% response rate in the naltrexone-bupropion group and only 2.5% response with placebo. A response was defined as at least three meth negative urine samples out of four samples obtained at the end of each of the two stages.  The trial concluded that although the response rate among participants that received naltrexone and bupropion was low, it was higher than that among participants who received placebo. Although the ADAPT-2 trial did not provide any recommendations that can be adapted to clinical practice, it serves as a starting point for further research of the additive or synergistic effects of bupropion and naltrexone in the treatment of meth use disorder.  Hopefully, it will also serve as a catalyst for more pioneering research regarding the legitimization of meth use disorder as a treatable disease with major medical, psychiatric, socioeconomic and legal consequences. Clinicians should stay up to date with research regarding meth use disorder such as ADAPT-2, as it is our duty to understand the health crises that affect our patients on a daily basis, and the tools we can use to treat them.This is Rio Bravo qWeek, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it’s sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. ________________________________Question of the MonthWritten by Hector Arreaza, MD, read by Jennifer Thoene, MDThis is a 69-yo male patient, who has history of controlled hypertension. He comes to an urgent care clinic for acute onset of fever (102 F), cough, and shortness of breath which has progressively worsened over the last 3 days. He does NOT smoke, but uses recreational marijuana once a month, and drinks 1-2 beers a week. He goes to the doctor once a year for check-ups. He takes benazepril 10 mg daily for his hypertension. He does not believe in vaccines and his last shot was a tetanus shot 5 years ago. No surgical history. He retired as an accountant 5 years ago. Vital signs are normal except for tachycardia of 110 (his baseline is 85) and temperature of 101.5 F (38.6 C). He has bibasilar crackles on auscultation. You perform labs in clinic and he has a white count of 13.5, and a chest x-ray shows a right lower lobe consolidation. He has a negative rapid COVID-19 test. What are your top 3 differential diagnoses and what is the acute management of this patient’s condition?Let’s repeat the question: What are your top 3 differential diagnoses and what is the acute management of a 69-year-old male, non-smoker, who has fever, cough, shortness of breath, tachycardia, bibasilar crackles, elevated WBCs, a right lower lobe consolidation, and a negative rapid COVID-19 test?Send us your answer before May 7, 2021, to rbresidency@clinicasierravista.org and the best answer will win a prize!     Hearing Carotid LungBy Valerie Civelli, MD, and Ariana Lundquist, MDScreening for hearing loss in older adultsHearing loss definition: To answer this, let’s first talk Hertz and Decibels. Many studies and guidelines define mild hearing loss as the inability to hear frequencies associated with speech processing under 25 dB and moderate hearing loss as the inability to hear those frequencies under 40 dB[5].  The most important range for speech processing is typically 500 to 4000 Hz. To check hearing, we often use pure-tone audiometry, which is the most standard quantitative measurement; however, this is not a perfect test. There is often discordance between objectively measured deficits and subjective perceptions of hearing problems. In one study, 1 in 5 persons who reported hearing loss had a normal hearing test result, while 6% of those with severe hearing loss detected on audiometry did not report feeling that they had hearing loss.[6]  I wonder if their significant other would agree with the 6% who self-reported no hearing loss but failed the hearing test?  That would be a great study! Risk factors for hearing loss: The #1 risk factor for hearing loss is increasing age. Hearing loss increases with age after 50 attributable to normal degeneration of hair cells in the ear.  This leads to the most common cause of hearing loss in older adults: Presbycusis.  Presbycusis is your diagnosis for patients with gradual, worsening of perceived high-frequency tones. Insufficient evidence for screening: If the patient reports hearing loss, you should order a hearing test. However, on March 23, 2021, for asymptomatic adults 50 years or older, the US Preventive Services Task Force (USPSTF) published a statement that re-confirmed the 2012 recommendations. That is, current evidence is insufficient to assess the balance of benefits and harms of screening for hearing loss in older adults without symptoms. This statement aligns with the AAFP and is referenced in their practice guidelines. This recommendation applies to asymptomatic older adults (age >50 years) who have not noticed any issues with their hearing. It excludes adults with conductive hearing loss, congenital hearing loss, sudden hearing loss, or hearing loss caused by recent noise exposure, or those reporting signs and symptoms of hearing loss.Screening for Carotid Artery StenosisDo not screen: For the general adult population without symptoms of carotid artery stenosis, do not screen. This is a Grade D recommendation for all adults without a history of stroke or neurologic signs or symptoms of a transient ischemic attack. This is a re-endorsement statement made in Feb of this year, 2021, recommitting to 2014 statements.  The evidence continues to show that the harms of screening for asymptomatic carotid artery stenosis outweigh the benefits. The USPSTF has made other recommendations related to stroke prevention and cardiovascular health. These include: Screening for high blood pressure in adultsScreening for abdominal aortic aneurysmInterventions for tobacco smoking cessation in adults, including pregnant personsInterventions to promote a healthy diet and physical activity for the prevention of cardiovascular disease:In adults with cardiovascular risk factorsIn adults without known cardiovascular risk factorsAspirin use to prevent cardiovascular disease and colorectal cancerStatin use for the primary prevention of cardiovascular disease in adultsLung Cancer Screening Grade B recommendation: On March 9, 2021, there are updated Grade B recommendations by the USPSTF.  For patients 50-80 years old, with a 20 pack-year history of smoking and still smoke or quit within 15 years, annual screening with low dose CT is now recommended.Stop screening when a person has not smoked for 15 year, or has a condition that substantially limits life expectancy or limits their ability to undergo curative lung surgeryThe USPSTF modified guidelines so we are screening earlier and with lower pack years.  It used to be recommended to do low dose Chest CT at age 55-80, but it’s now at 50-80.  Also, pack-years was 30 but it’s now at 20 pack-years that we should screen for lung cancer.  So, screen sooner at 50, and at lower threshold of 20. Screen for lung cancer in male and female patients.Conclusion: Now we conclude our episode number 47 “Hearing Carotid Lung”. Dr Civelli gave us an update on USPSTF screening in asymptomatic adults. For hearing loss, there is insufficient evidence to give a recommendation. For carotid artery stenosis, there is a grade D, meaning do not screen. And for lung cancer screening, it is a grade B recommendations, meaning screen your patients. Don’t forget to order a low dose CT of chest in patients of ANY sex, OLDER than 50 years, WITH a 20 pack/year smoking history, and currently smoking or quit less than 15 years ago. That’s a mouthful, but once you start following the guideline, it gets easier to recall.Remember, even without trying, every night you go to bed being a little wiser. Thanks for listening to Rio Bravo qWeek. If you have any feedback about this podcast, contact us by email RBresidency@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. This podcast was created with educational purposes only. Visit your primary care physician for additional medical advice. This week we thank Hector Arreaza, Jennifer Thoene, Valerie Civelli, Kafiya Arte, Arianna Lundquist, Jacqueline Uy, and voluntarily unidentified medical assistants. Audio edition: Suraj Amrutia. See you next week! _____________________References:The Impact of Methamphetamine in Kern County: 2014, Update September 2014, Kern County Mental Health Department, https://transforminglocalcommunities.com/wp-content/uploads/2018/05/tlc-the-impact-of-meth-in-kern-county-2014-update.pdf Klein, Kerry, To Bakersfield Cops, Concern For Opioids Grows - But Meth Is Still King. Valley Public Radio News, NPR for Central California. May 1, 2019, https://www.kvpr.org/post/bakersfield-cops-concern-opioids-grows-meth-still-king#stream/0 California Opioid Overdose Surveillance Dashboard, California Department of Public Heallh, https://skylab.cdph.ca.gov/ODdash/, accessed on March 27, 2021. Klein, Kerry, Meth Is Making A Comeback In California – And It’s Hitting The San Joaquin Valley Hard. Valley Public Radio News, NPR for Central California. June 28, 2019, https://www.kvpr.org/post/meth-making-comeback-california-and-it-s-hitting-san-joaquin-valley-hard#stream/0 Feltner C, Wallace IF, Kistler CE, et al. Screening for Hearing Loss in Older Adults: An Evidence Review for the U.S. Preventive Services Task Force [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2021 Mar. (Evidence Synthesis, No. 200.) Chapter 1, Introduction. Available from: https://www.ncbi.nlm.nih.gov/books/NBK569275/   US Preventive Services Task Force. Screening for Hearing Loss in Older Adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2021;325(12):1196–1201. doi:10.1001/jama.2021.2566. https://jamanetwork.com/journals/jama/fullarticle/2777723.    Screening for Hearing Loss in Older Adults, March 23, 2021, US Preventive Services Task Force, https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/hearing-loss-in-older-adults-screening#fullrecommendationstart Screening for Asymptomatic Carotid Artery Stenosis, February 02, 2021, US Preventive Services Task Force, https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/carotid-artery-stenosis-screening. Lung Cancer: Screening, March 09, 2021, US Preventive Services Task Force, https://uspreventiveservicestaskforce.org/uspstf/recommendation/lung-cancer-screening.    

Podjetniške Skrivnosti – Filip Pesek – Spletna senzacija & naslov številka 1 za dvig vaše (spletne) prodaje. Več o Filipu si preberite na filippesek.com The post Organski marketing na socialnih omrežjih (UPDATE SEPTEMBER 2018) appeared first on Filip Pesek.

Podjetniške Skrivnosti – Filip Pesek – Spletna senzacija & naslov številka 1 za dvig vaše (spletne) prodaje. Več o Filipu si preberite na filippesek.com The post Organski marketing na socialnih omrežjih (UPDATE SEPTEMBER 2018) appeared first on Filip Pesek.

Johnny FD is the host of Travel Like A Boss Podcast and Author of '12 Weeks in Thailand: The Good Life on the Cheap'. We talk about how he got to making $10k per month, selling his first dropshipping store for $60k, the shopify dropshipping method vs the Amazon FBA importing method, his Travel Like a Boss Podcast, and his tips for getting started as a digital nomad. Johnny's the one who basically got us out to Chiang Mai to join the digital nomad community, therefore changing our lives forever, so this is a special one. Like many of us out here, we first heard about Chiang May by stumbing upon his youtube video 'My $200 Apartment in Chiang Mai', and from there discovered his blog about living cheap in Thailand and making a living online thru dropshipping ecommerce businesses. Soon after following his blog, he and Anton Kraly of DropshipLifestyle.com announced that they were putting on a Digtial Nomad conference in Chiang Mai in October 2014. This was crucial for us cuz it marked a deadline on our calendar to quit our jobs and make that jump out to Thailand, and the dream of extended world travel. We met 100 other digital nomads there, some new, some experienced, and we just payed attention to what people were doing, and the rest is history. I will thank Johnny & Anton forever for putting on the retreat cuz it was the perfect excuse to get out there and make things happen. Now I feel like I'm on vacation everyday: I wake up when I want, eat out 3 meals a day, choose my own working hours, and get to be constantly surrounded by palm trees, exotic cultures, and happy people. Thanks boys -- 8:40 - How Johnny & Anton got us out to Chiang Mai and changed our lives: The Dropship Lifestyle Retreat, October 2014 19:00 - How much did Johnny make last month? ($17k;) 28:42 - Dropshipping vs Amazon FBA / Private Labeling, Startup Costs 43:00 - Listening to Travel Like A Boss podcast 2 years ago while I was knocking doors cold calling on the streets ^^ 44:28 - Our TOP 5 Life Hacks to start as a Digital Nomad 44:80 - Moving to Chiang Mai, how to meet digital nomads -- [*Update:* If you plan to sign up for Anton's Dropship Lifestyle course and you were referred by this channel, you can use my affiliate link if you like, just comment or contact me] -- LINKS: Get His Book on Amazon: 12 Weeks in Thailand: The Good Life on the Cheap: https://www.amazon.com/12-Weeks-Thailand-Travel-Workweek-ebook/dp/B00B1SASZ2 Johnny's Latest Passive Income Report: http://www.johnnyfd.com/2016/05/april-2016-passive-income-report.html Parker and I on Travel Like A Boss Podcast, October 2014: https://youtu.be/gm1GJJIYU68 Subscribe for weekly travel videos and hit me on Snapchat: pliez1000 TRAVEL LIKE A BOSS PODCAST ON iTUNES: https://itunes.apple.com/us/podcast/travel-like-a-boss-podcast/id727446851?mt=2 MY NEW AMAZON COURSE: http://theamazonmethod.com/ Read our full story on my blog: https://livinthatlife.com/ [A Digital Nomad is someone who works from their laptop and chooses to travel for fun, and/or because the cost of living is much cheaper in other countries, in order to bootstrap more money into their online business, while having an exotic lifestyle.] **UPDATE SEPTEMBER 2016** Due to popular demand, I've recorded my own Amazon FBA / Private Labeling Course - to stay up to date on the next Launch Date, join the list on my blog @ https://livinthatlife.com !! SNAPCHAT Say whussup! Snappin daily random expat life @ pliez1000 https://www.snapchat.com/add/pliez1000

My first podcast! How Kai Law became a full-time digital nomad in 6 months by selling his own private label product via Amazon FBA .. [And helped me make over 30k net profit my first year as well!] Originally posted as a video call on my YouTube channel, here: https://youtu.be/epg7CiubWeQ Show notes: For y'all who ain't know, and Kai is the #1 reason we got into selling on Amazon back in January in Chiang Mai, and he's been helping us the whole way ever since... He's currently in Croatia, on month 4 of traveling the world on this "Remote Year" thingy... where he got selected to be one of 75 (out of 25,000) remote employees, online business owners and freelancers who applied to go on this year-long round-the-world trip/experiment to work, live, and travel in 12 different countries in 12 months....pretty tight, right?.... It's crazy cuz I saw him make his first dollar online in November and go on to making a full-time traveling income by January.. i know.. Just check out his blog page of all the places he's been and the shit he's done in the past 6 months... REMOTE YEAR: http://youtu.be/pbkH_y_EvI4 [sry the connection gets bad at the end there…) Major ? Summary: - It starts by reading The 4-Hour Workweek (that's a given) - Kai worked a sales job and saved 20+ grand - Quit job, moved to Chiang Mai to attend E-commerce conference and live cheaply in the "Digital Nomad Capital of the World". - Invested $1,000 in 100 'test units' of a hot-selling Amazon Product (buy wholesale from Alibaba.com and Private-Label your own logo and box) - Went all-in with a 20k investment of 2,000 units (the more you can afford to invest the better) - Gave away 250 units to friends and Facebook review groups to get 100 reviews ASAP. - Used Feedbackgenuis.com email follow-up system to ask customers to leave Seller Feedback ratings, then auto-email those people to also leave a Product Review rating. - Started traveling within 3 months of launch - Hired an employee in the Philippines to handle little customer service messages - Launched second product within 6 months - Applied for the 'Remote Year' among 25,000 applicants - Now working in a new country each month with 75 digital nomads - Making $7,000-$8,000 a month - 'Maintaining' the business 4-hours per week - Spending the rest of his 'computer time' researching other investments, businesses, and income streams. 4HWW Assignment complete. Go do whatever TF u want.? Best Advice: - Hang around people who want to do the same thing, i.e. other 4HWW-business minded people - Take that leap of faith - find an excuse. - Once you get around people who are ahead of you already living it, it starts to become real - Chiang Mai is the cheapest diginomad city to live to quit your job and get started. LINKS! Kai's blog: http://www.accordingtokai.com/where-i... and Instagram: https://instagram.com/lawster101/ RESOURCES TO GET STARTED ON AMAZON: My blog post summary on The Amazon Method: https://livinthatlife.com/2015/10/17/how-we-make-money-while-traveling-the-amazon-method/ How we got here / our story: https://livinthatlife.com/2015/04/23/why-the-fck-are-we-in-asia/ ***UPDATE SEPTEMBER 2016!!*** Our product did over $209k in sales volume our first year (about $50k net profit after $16k initial investment) .. over 5,000 units sold! That was an average of 16 units per day the first year! Safe to say it was a successful product? Also, due to popular demand of Amazon questions.. I'm recording my own AMAZON COURSE! It's a bunch of screen-share videos and PDF's going thru what worked about our product selection process, why our product did so well, and how to set everything up from sourcing from China to importing to Amazon FBA (we screwed it up our first time) to optimizing your sales page. To join the email list about the next course opening, go to my blog at https://livinthatlife.com Also feel free to comment your questions below anytime! Peace from Chiang Mai, Thailand! ?

Update September 2015

QritiQ's second episode in English. Featuring our special guest Professor Evert Gummesson. We converse about the history and future of marketing, with respect to Philip Kotler's recent birthday. Our starting point is Evert's talk and slides when Northwestern University celebrated Kotler turning 75. The role and naming of market actors (e.g.. Consumers, Citizens, Customers) is another important issue. We also touch upon how to market scientific ideas, compare Is science Marketing? (Peter & Olson, 1983). But we start off with a quick note about Amy's assercize in the Daily Source Code #453. We hinted Dawn at Chandra Bindu to plug her institute, and she in turn got her message in at 20 minutes into DSC #454. [Update September 7: those of you interested in consumers vs customers vs citizens might want to listen into Across the sound. It´s host Joseph Jaffe is channeling a growing conversation about the subject in the perspective of content generation. Not in every episode, but for example in #49, #45, and many before those)]. Some time markers from todays episode: 00:00 Welcome 01:30 We introduce ourselfes 03:00 The Chandra Bindu case 05:15 The Conversation 54:40 Outdozed (music from I Awake ) We love comments,feedback and qritiqal reflections. Simply call +468-559 21 689, send an e-mail to qritiq@gmail.com or make a comment here. Thank you for listening. Donwload (direct link to the mp3 file). play any episode now on our Flash-player. record your comment using My Chingo. RSS-link (see FAQ) or use the iTunes 1-click.