Podcasts about vermont medical center

In this episode, Dr. Allen Repp, a hospitalist at the University of Vermont Medical Center and Vice Chair of Quality in the Department of Medicine, shares what inspired his path in internal medicine and what continues to energize his work today. He reflects on the mentors who shaped his approach to patient care and teaching, the rewards and challenges of daily life as a hospitalist, and the principles behind UVMMC's High-Value Care and Quality Program. Dr. Repp also discusses what first sparked his commitment to high-value care and offers his perspective on how the culture of medicine in the U.S. could evolve for the better.   Co-Hosts: Caity Decara: caitlin.decara@med.uvm.edu Haley Bayne: haley.bayne@med.uvm.edu

When should a parotid mass raise red flags? In this episode of the BackTable ENT podcast, Dr. Mirabelle Sajisevi, head and neck surgeon at the University of Vermont Medical Center, joins hosts Dr. Gopi Shah and Dr. Ashley Agan to discuss her approach to diagnosing and managing parotid malignancies. ---SYNPOSISDr. Sajisevi shares insights from her practice, including the importance of thorough physical exams, the utility of ultrasound and biopsy, and the intricacies of surgical planning. They also cover post-operative care, the role of radiation and chemotherapy, surveillance strategies, and the potential of emerging treatments and technologies.---RESOURCESDr. Mirabelle Sajisevi https://www.uvmhealth.org/providers/mirabelle-sajisevi-md

Can you get the latest COVID vaccine? The answer might depend on how old you are, what state you live in or whether you have a prescription. Under Health Secretary Robert F. Kennedy Jr., the Centers for Disease Control and Prevention (CDC) is undergoing a period of upheaval marked by firings and resignations. Kennedy also fired the members of the CDC's immunization panel, and the new panel hasn't met in weeks.Weighing in on Vermont Edition is: Dr. Anne Schuchat, a former deputy director at the CDC; Julie Arel, the interim head of Vermont's Department of Health; and Dr. Timothy Lahey, an infectious disease physician at the University of Vermont Medical Center. Plus, Vermont Public senior political reporter Bob Kinzel talks about the CDC and RFK, Jr. with Sen. Bernie Sanders (I-Vt).Broadcast live on Monday, September 8, 2025, at noon; rebroadcast at 7 p.m.Have questions, comments or tips? Send us a message or check us out on Instagram.

The use of artificial intelligence for therapy is growing, including for minors. AI makes therapy more accessible. But clinicians want to make sure kids get medically sound advice and stay safe.We weigh the pros and cons of this mental health approach with Dr. Steven Schlozman, the chief of child psychiatry at the University of Vermont Medical Center in Burlington, as well as an associate professor of psychiatry and pediatrics at UVM's Larner College of Medicine, and Shannon Newell, who works with the Greater Rutland County Supervisory Union and is president of the Vermont Association of School Psychologists.Plus: Dartmouth researchers recently conducted the first-ever clinical trial of an AI therapy chatbot. Nicholas Jacobson is the study's senior author. He's an associate professor of biomedical data science, psychiatry, and computer science at Dartmouth. He also directs the AIM HIGH Lab at Dartmouth, which stands for AI and Mental Health: Innovation in Technology Guided Healthcare.Broadcast live on Tuesday, August 12, 2025, at noon; rebroadcast at 7 p.m.Have questions, comments or tips? Send us a message or check us out on Instagram.

BUFFALO, NY - June 11, 2025 – A new #research paper was #published in Volume 16 of Oncotarget on May 29, 2025, titled “Durable complete response in leptomeningeal disease of EGFR mutated non-small cell lung cancer to amivantamab, an EGFR-MET receptor bispecific antibody, after progressing on osimertinib.” A team led by first author Jinah Kim, from the University of Vermont Medical Center, and corresponding author Young Kwang Chae, from the Feinberg School of Medicine, reports a clinical case in which a patient with advanced non-small cell lung cancer (NSCLC) carrying rare EGFR mutations responded remarkably to amivantamab after other treatments had failed. The patient experienced a complete resolution of brain and spinal fluid metastases, suggesting that amivantamab may be a viable option for patients with uncommon genetic profiles and limited therapy options. Lung cancer remains one of the leading causes of cancer-related deaths worldwide. Patients with NSCLC who have rare mutations in the EGFR gene often face limited treatment options and poor outcomes, especially when the disease spreads to the brain or spinal fluid. This case involved a 67-year-old man diagnosed with NSCLC who had two rare EGFR mutations—G719A and A289V. After disease progression on osimertinib and other therapies, the patient began amivantamab monotherapy. Within six weeks, his lung tumor shrank by over 30 percent. By six months, imaging confirmed the disappearance of brain metastases and leptomeningeal disease, a serious condition affecting the membranes of the brain and spinal cord. Blood tests showed no detectable cancer-related mutations, and the patient, previously wheelchair-bound, regained the ability to walk and perform daily activities. This response has been sustained for more than 19 months. “Treatment produced a durable response over 19 months, including a 32.2% reduction in tumor size at six weeks, and complete resolution of brain metastases and LMD by six months.” Amivantamab is a bispecific antibody that targets EGFR and MET, two key drivers of tumor growth. While it is approved in combination regimens for common EGFR mutations, its effectiveness as a single agent in rare mutations or in treating brain metastases remains largely unproven. This case challenges the assumption that large antibody drugs cannot cross the blood-brain barrier and suggests that amivantamab may have potential in managing central nervous system involvement. Further research is needed to clarify how the drug achieves these effects and to explore its broader use in patients with rare EGFR mutations and limited treatment options. This case highlights three key findings: amivantamab may be effective against rare EGFR mutations, can be used as monotherapy, and may overcome the challenges of the blood-brain barrier. Although based on a single patient, the results provide encouraging evidence to support further investigation of amivantamab in treating difficult-to-manage forms of NSCLC. DOI - https://doi.org/10.18632/oncotarget.28730 Correspondence to - Young Kwang Chae - young.chae@northwestern.edu Video short - https://www.youtube.com/watch?v=RJX3rmtH7h8 Subscribe for free publication alerts from Oncotarget - https://www.oncotarget.com/subscribe/ Keywords - cancer, amivantamab, monotherapy, rare EGFR mutation, NSCLC, leptomeningeal disease To learn more about Oncotarget, please visit https://www.oncotarget.com and connect with us: Facebook - https://www.facebook.com/Oncotarget/ X - https://twitter.com/oncotarget Instagram - https://www.instagram.com/oncotargetjrnl/ YouTube - https://www.youtube.com/@OncotargetJournal LinkedIn - https://www.linkedin.com/company/oncotarget Pinterest - https://www.pinterest.com/oncotarget/ Reddit - https://www.reddit.com/user/Oncotarget/ Spotify - https://open.spotify.com/show/0gRwT6BqYWJzxzmjPJwtVh MEDIA@IMPACTJOURNALS.COM

Visiting a Shelburne farm where people can snuggle with goats to help release stress. Plus, after exceeding its budget last year the University of Vermont Medical Center proposes a deal to avoid potential penalties, the former president and CEO of Rutland Regional Medical Center has died, there's a plan to extend shelters for unhoused families in Williston and Waterbury that were set to close down next week, and Sen. Peter Welch calls on the secretary of defense to resign after sensitive military information was inadvertently shared with a journalist.

Earlier this month, President Donald Trump issued an executive order calling for a study on the effects of antidepressants and antipsychotics on children. He established the Make America Healthy Again commission to examine childhood chronic diseases, including mental health disorders. This comes as new U.S. Health Secretary Robert F. Kennedy Jr. argues that antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), are overprescribed to children.Dr. Steven Schlozman, chief of child psychiatry at the University of Vermont Medical Center, explains how these medications work, and how they are prescribed, and answered listener questions.Broadcast live on Tuesday, Feb. 25, 2025, at noon; rebroadcast at 7 p.m.Have questions, comments, or tips? Send us a message or check us out on Instagram.

Dr. Steven Ades, - Medical Oncologist at the University of Vermont Medical Center, joins Kurt & Anthony to talk about Prostate Cancer and Screening.

In this season finale, hosts Jodie Sweetin and Amy McCarthy explore how creative expression—through art, music, dance, and storytelling—builds resilience and prevents substance misuse in kids. Joined by special guests John Lawler, award-winning director and arts education leader, and Dr. Steve Schlozman, Chief of Child and Adolescent Psychiatry at the University of Vermont Medical Center, this episode highlights the transformative power of creativity in fostering mental well-being, empathy, and connection. The conversation dives into the critical role arts education plays in schools and families, offering parents and caregivers practical ways to encourage creative outlets at home while building strong, resilient kids. Topics Covered: The role of creative expression in developing resilience and preventing substance misuse How arts education fosters emotional well-being and academic success Practical tips for parents to incorporate creativity into daily life Using pop culture, music, and storytelling to teach life lessons and build connections The importance of community-based arts programs and equitable access to creative opportunities Guest Bios: John Lawler is an award-winning director, writer, and arts educator. He has served as principal of two nationally recognized arts high schools, including the Los Angeles County High School for the Arts (LACHSA), and co-founded multiple nonprofit organizations. With a celebrated career in theater and film, John is a leader in ensuring students have equitable access to high-quality arts education. https://www.psarts.org  Dr. Steve Schlozman is the Chief of Child and Adolescent Psychiatry and Medical Director at the Vermont Center for Children, Youth, and Families at the University of Vermont Medical Center. A renowned child psychiatrist and professor, Dr. Schlozman integrates popular culture into his work, combining his passion for storytelling with his expertise in mental health.  Host Bios: Jodie Sweetin is an actress, author, and advocate best known for her roles on Full House and Fuller House. Her memoir, unSweetined, chronicles her journey through addiction and recovery, fueling her advocacy for substance use awareness. Instagram: https://www.instagram.com/jodiesweetin/ Amy McCarthy, LICSW, is the Director of Clinical Social Work at Boston Children's Hospital's Division of Addiction Medicine, specializing in adolescent substance use. Instagram: https://www.instagram.com/amymccarthylicsw/ Supporting Organizations: The Elks: With nearly one million members across 2,000 lodges, the Elks are dedicated to youth drug prevention through their Drug and Alcohol Prevention (DAP) program. They have donated over $3.6 billion to various causes, including the creation of the first VA hospital for veterans. Elks Drug Awareness Program Website: https://bit.ly/44SunO6 The DEA: Established in 1973, the DEA enforces U.S. controlled substance laws nationally and internationally, with offices around the globe. DEA Website: https://bit.ly/44ed9K9 Resources/Links: SAMHSA Help and Treatment: https://bit.ly/3DJcvJCGet Smart About Drugs: https://bit.ly/45dm8vYDEA on Instagram: https://bit.ly/3KqL7UjElks Kid Zone Website: https://bit.ly/3s79ZdtSAMHSA's “Talk. They Hear You.” Campaign: https://www.samhsa.gov/talk-they-hear-you DSM-5 Substance Use Disorder Definition: https://www.psychiatry.org/file%20library/psychiatrists/practice/dsm/apa_dsm-5-substance-use-disorder.pdf Jodie Sweetin's Links Instagram: https://www.instagram.com/jodiesweetin/ TikTok: https://www.tiktok.com/@jodiesweetin?lang=en Amy McCarthy's Links Instagram: https://www.instagram.com/amymccarthylicsw/ Boston Children's Hospital Addiction Medicine: https://www.childrenshospital.org/departments/addiction-medicine John Lawler PS Arts Website: https://www.psarts.orgDr. Steve Schlozman University of Vermont Medical Center: https://www.uvmhealth.org/medcenter #AwkwardConversations #SubstanceUseDisorder #SAMHSA #Prevention #MentalHealth #DrugMisuseAwareness #EmpathyInParenting #YouthWellBeing    

In this episode of Outperform Cancer, we are privileged to welcome Dr. Magdalena Naylor, MD, PhD. Her remarkable story exemplifies the resilience of the human spirit and the healing power of mindfulness. Join us as we explore the compelling journey of this distinguished psychiatrist and mindfulness expert who faced the ultimate test—her own stage 4 metastatic cancer diagnosis.Dr. Naylor, who spent her career pioneering innovative treatments for chronic pain and exploring the brain's response to mindfulness at the University of Vermont Medical Center, became the patient in 2012 when she was given just six months to live. With cancer widespread through her uterus, lymph nodes, and lungs, she found herself grappling with the same fears and uncertainties she had helped so many patients navigate: pain, guilt, and the looming specter of death.Yet in a pivotal moment—whether triggered by her deep-seated clinical knowledge, a profound inner acceptance, or divine intervention—a remarkable transformation occurred. Dr. Naylor's body began to heal, leading to a radical remission that defied medical expectations. Now, over 12 years later and cancer-free, Dr. Naylor shares her story publicly for the first time.

Join HeHe as she sits down with Dr. Jessica Ryniec from CCRM Fertility of Boston to delve into the crucial topic of sperm quality and male fertility. In this episode, they discuss what sperm quality means, how sperm analysis is conducted, and the impact of lifestyle, supplements, and medications on sperm health. Dr. Ryniec also provides insights into the factors affecting sperm morphology, the importance of a healthy lifestyle, and the potential effects of lifestyle choices like bicycling and using hot tubs. Learn about the role of antioxidants in sperm health, the importance of using fertility-friendly lubricants, and the process and benefits of freezing sperm for future fertility planning. Whether you're trying to conceive or just curious about reproductive health, this episode offers invaluable information and expert advice.   Understanding Sperm Quality Sperm Morphology and Variations Key Terms in Semen Analysis Who Should Get a Semen Analysis? Impact of Lifestyle on Sperm Quality Supplements and Medications for Sperm Quality Lubricants and Sperm Health Steps for Getting a Semen Analysis Freezing Sperm: When and Why     Guest Bio: Dr. Jessica Ryniec is double board certified in Obstetrics and Gynecology, as well as Reproductive Endocrinology and Infertility. She joined CCRM Boston in 2020 after completing her fellowship at the University of Vermont Medical Center in Burlington, VT.   She received her undergraduate degree from Wake Forest University and her MD from Georgetown University School of Medicine in Washington, D.C. During her residency for obstetrics and gynecology at Rutgers Robert Wood Johnson Medical School, Dr. Ryniec received the Excellence in Female Pelvic Medicine Award and recognition for Outstanding Accomplishment in Women's Health.   In addition to presenting her research at prestigious medical conferences, such as the American Society for Reproductive Medicine and the Society for Reproductive Investigation Annual Meeting, Dr. Ryniec has authored several publications for notable peer-reviewed journals, including the American Journey of Obstetrics and Gynecology.   Dr. Ryniec practices medicine embracing the motto of Cura Personalis, or care of the entire person. She believes in education and in the value of shared decision making and patient empowerment, and spends time on social media educating, empowering, and supporting people while trying to conceive, going through fertility treatments or fertility preservation. She believes in family, and understands that family comes in many forms, and is committed to helping her patients achieve the family they desire. Social Media: Connect with HeHe on IG  Connect with Dr. Ryniec on IG  Connect with HeHe on YouTube   BIRTH EDUCATION: Join The Birth Lounge here for judgment-free childbirth education that prepares you for an informed birth and how to confidently navigate hospital policy to have a trauma-free labor experience!   Download The Birth Lounge App for birth & postpartum prep delivered straight to your phone!

Join Katie and Liz this week on True Crime New England as they discuss a case involving a man who was severely mentally ill. Aita Gurung, an immigrant from Nepal, had just come home from a voluntary stay at the University of Vermont Medical Center, when he got upset with his 32-year-old wife, Yogeswari Khadka. Acting out, he took a meat cleaver and killed her, as well as severely injuring his mother-in-law in the process. When facing the court, the question of sanity was brought forth many times, and the result of the trial may surprise you. --- Support this podcast: https://podcasters.spotify.com/pod/show/truecrimene/support

A camp that provides a free getaway for children diagnosed with cancer looks back at its 40-year run, and ahead for what's next. Plus, Sen. Peter Welch and Rep. Becca Balint react to the news that Joe Biden has withdrawn from the 2024 presidential race, there may be an easier path to federal money this year for Vermonters who lost personal possessions in the recent floods, the trial for a Franklin County sheriff facing charges of assaulting a shackled and handcuffed prisoner begins today, migrant workers in West Pawlet say their employer assaulted a farm worker and his teenage nephew, and nurses at University of Vermont Medical Center ratify a new contract with hospital administrators.

A federal program subsidizing high-speed internet for thousands of Vermonters is running out of funding. Plus, the state receives feedback on a management plan for the Worcester Range, A Ukrainian man pleads guilty to a cyberattack against University of Vermont Medical Center, a new study highlights how gardening, foraging, and hunting can help people facing food insecurity, and an early mud season has made it tough on road workers. And now that Mitch Wertlieb is settling in as the new host of The Frequency, we want to hear your feedback on the show. What's working for you? What doesn't? What do you wish was in the podcast that you're not hearing? Your input helps us make the best show we can – one you'll look forward to hearing every day. So please share your thoughts at thefrequency@vermontpublic.org.

In this episode of the Two and a Half Minute Drill, Drex brings us a mix of cyber news from the frontline. We kick off with the uplifting news of a cybercriminal facing justice for attacks on healthcare organizations, including a significant 2020 incident impacting the University of Vermont Medical Center. Dive into the complex world of cybercrime's long-term effects on victims, highlighting the distressing use of a child's stolen data. Explore the evolving roles of CISOs and CIOs as they adapt to the challenges of digital innovation and cybersecurity, moving beyond compliance to become integral parts of business operations. Plus, a cautionary tale about the potential pitfalls of chatbots, serving as a reminder to prioritize accuracy and ethical considerations in digital patient interactions. Join us for these insights and more, and learn how you can contribute to our growing cyber risk community.Contributions & Community:Become part of the conversation and help shape future episodes by contributing stories and insights. Visit thisweekhealth.com/news and click on "Become a Contributor."Stay Connected:Don't miss out on our upcoming episodes focused on hacking healthcare. Follow our podcast, like and share this post to spread the word, and join the new 229 cyber and risk community for more in-depth discussions and resources.Stay Informed, Stay Secure:Visit thisweekhealth.com/security for more information and resources to bolster your cybersecurity knowledge and defenses.Remember, Stay a little paranoid.

How do glasses work? Why do some people need glasses and other people don't? Why do we have different eye colors? We answer your questions about glasses and eyes in the second of two episodes with Dr. Sujata Singh, a pediatric ophthalmologist at the University of Vermont Medical Center. And we hear from Maggie, a kid with low vision, about what it's like to need glasses.  Download our learning guides: PDF | Google Slide | Transcript

What shape are our eyes? What are they made of? How do they work? What's the point of having two eyes if we only see one image? Why do we blink? What's the point of tears and why are they salty? We answer your questions about eyes in the first of two episodes with Dr. Sujata Singh, a pediatric ophthalmologist at the University of Vermont Medical Center.

In an attack that shocked the world, three Palestinian American college students were shot and wounded while walking in Burlington on Nov. 25. The men were in Vermont visiting family for Thanksgiving.Police allege that 48-year old Jason Eaton stepped off his porch and shot the three men. The attack appears to have been unprovoked and the assailant said nothing before opening fire, the victims told police. Eaton has been charged with three counts of attempted second degree murder, and authorities are investigating whether to add a hate crime charge. He has pleaded not guilty and is being held as he awaits a bail hearing. The three victims, all age 20, are Hisham Awartani, a student at Brown University in Rhode Island; Kinnan Abdalhamid, a student at Haverford College in Pennsylvania; and Tahseen Aliahmad, a student at Trinity College in Connecticut. They were classmates at the Ramallah Friends School, a Quaker high school in the West Bank. Two of the students are U.S. citizens and one is a legal resident of the U.S. They have been treated at the University of Vermont Medical Center. Burlington Mayor Miro Weinberger called the attack “one of the most shocking and disturbing events in this city's history.”U.S. Sen. Peter Welch, D-Vt., cited the attack when he reversed himself on Tuesday and called for an indefinite cease-fire in the Israel-Hamas War. “The impact of the conflict in the Middle East has reverberated across the world, and we've seen the effects here at home in the form of Islamophobia and antisemitism,” said Vermont's junior senator. “This cycle of fear, intimidation, and violence must end.”U.S. Attorney General Merrick Garland said the attack in Burlington was part of “a sharp increase in the volume and frequency of threats against Jewish, Muslim and Arab communities across our country since Oct. 7.” That was when Hamas launched a surprise attack that killed 1,200 Israelis, according to Israel's Foreign Ministry. Hamas' attack sparked a bombardment and ground invasion by Israel that has so far killed some 15,000 Palestinians living in the Gaza Strip, according to Gaza's Health Ministry. The United Nations reports that two thirds of the victims are women and children. The Council on Islamic Relations reported an “unprecedented” 216% increase in complaints of Islamophobic or anti-Arab bias from October 7 to November 4 compared to the previous year. The Anti-Defamation League reported that antisemitic incidents surged 316% in that same period. On this Vermont Conversation we speak about the attack on the three Palestinian American young men with Burlington resident Rich Price, the uncle of Hisham Awartani, who was shot in the spine. Doctors have told the family that Hisham may never be able to walk again. We are also joined by Wafic Faour, a Palestinian who is a member of Vermonters for Justice in Palestine, and Fuad Al-Amoody, vice president of the Islamic Society of Vermont. “This hideous crime did not happen in a vacuum,” Hisham Awartani texted from the ICU.“I am but one casualty in this much wider conflict,” he wrote to a professor who read the statement at a vigil at Brown University this week, according to the Boston Globe. “Any attack like this is horrific, be it here or in Palestine. This is why when you send your wishes and light your candles for me today, your mind should not just be focused on me as an individual, but rather as a proud member of a people being oppressed.”Rich Price told The Vermont Conversation that his nephew and his friends who were attacked “represent the best and brightest of Palestine and what it means to be Palestinian.” Price said, "It's important that we stop dehumanizing Palestinians, that we create a place where you can both advocate for the rights of Palestinians, stand in solidarity with Palestinians, and not be viewed as antisemitic or anti-Israeli.” He said that is essential to achieve lasting peace between Israelis and Palestinians.Fuad Al-Amoody added that while he was moved by the outpouring of support for the three Palestinian Americans in Vermont, it underscored a painful reality. “If this tragedy happened in Palestine (to) the same three people, I don't think we'll see the same compassion that we're seeing right now here.”“If you remove that ‘American' and just the ‘Palestinian' remains, I wish, I hope (that) the compassion, the solidarity is shown to the same people in Palestine,” Al-Amoody said. Wafic Faour said that after this tragedy, “I hope people will learn that Palestinians are no different. They are human.”“We should go after hate crimes if it is against Palestinians, or Muslims, or because of Islamophobia, or antisemitism or anti-black and anti-Brown. We have to teach our kids that racism shouldn't be part of our daily life here.”Price observed, "To be Palestinian in this world is difficult. You learn how to deal with trauma, you learn how to deal with tragedy, and I'm seeing in these boys resilience and strength that would really just be awe inspiring to anyone to witness." "They had big dreams to build a bright future. And my hope is that this has pushed pause on that and that they can resume building that bright future sometime soon."

Ever wanted to create your dream life but not sure how? Join me for this fantastic conversation with Dr. Gray as she shares how she has created her dream life while practicing medicine. Meet Dr. Weili Gray, a dreamer and physician who experienced burnout and now happily practices sleep medicine in Vermont's beautiful countryside. Dr. Weili Gray attended the University of Connecticut School of Medicine, followed by an Anesthesiology Residency and Sleep Medicine Fellowship at the University of Vermont Medical Center. With her husband and three kids, she crafts a dream life brimming with family adventures and extraordinary experiences. Beyond practicing medicine at a rural critical access hospital, Dr. Gray founded Dare to Dream Physician, a community to empower fellow doctors to dream big and embrace life through travel. She's all about boosting physician wellness and speaks on multiple platforms, including her inspirational weekly podcast, "Dare to Dream Physician Travel." Join Dr. Gray's mission to reclaim life for physicians, urging them to dream boldly, explore the world, and live life to the fullest. Hop aboard on this adventure of imagination and exploration! Connect with Dr. Gray DreamPhysician on Instagram https://www.instagram.com/dreamphysician/ Weili Gray MD on: LinkedInhttps://www.linkedin.com/in/weili-gray-md/ --- Send in a voice message: https://podcasters.spotify.com/pod/show/urcaringdocs/message

Dr. Tim Lahey, an infectious disease physician and director of clinical ethics at the University of Vermont Medical Center, joins Kurt & Anthony to discuss the current evolution of COVID and vaccines.

Dr Kim Dittus is a medical oncologist at the University of Vermont Medical Center and the executive director of the Annual Women's Health and Cancer Conference at UVM. Dr Dittus joins Kurt & Anthony to discuss this years up coming conference.

Hellllo and welcome to another episode of These Little Moments Podcast. In this episode, I have the pleasure of interviewing Dr. Julian Saad. Julian is a self-change consultant who focuses on behavior change...with intention. In this podcast, he outlines what the stages of change are, how you can assess what stage you are in, and how you can create lasting change in your own life. Dr. Julian Saad is a clinical psychotherapist, a meditation teacher, and Self-Change consultant. He is the creator of the Self-Health Movement, a move to unify Self- and Health-Development within persons and populations using a proven science of intentional-change. He has completed a Ph.D. in Clinical Psychology from the University of Rhode Island, a residency in Medical Psychology at the University of Vermont Medical Center, training in multiple oncology centers including Dana Farber Cancer Institute, a level 1 meditation teacher's certificate with the Sheng Zhen (pronounced “shung jen”) Meditation Society; and is currently serving as a Fellow in Clinical Psychology in the state of Rhode Island. His work has been published in peer reviewed journals, presented in regional and national conferences, cited in news articles during the COVID-19 pandemic, and shared on social media. His psychotherapy, meditation and consulting services are each driven by simple yet proven principles of change that make the practice of intentional-change accessible to persons, organizations, and populations. Dr. Julian Saad's Social Media: TikTok: @the_self_health_movement Instagram: @the_self_health_movement Love you super much, Your Coach, Ry Ry Podcast Links Please leave a 5 star review wherever you listen to this podcast :) If you are interested in 1:1 online coaching, you can apply here: https://bodybyryan.com/coaching/ Use my FREE Calorie Calculator: bodybyryan.com/calculator Follow me on Instagram: https://www.instagram.com/bodybyryanfitness/ Follow me on TikTok: https://www.tiktok.com/@ryankassim?lang=eng BodyByYOU- Fat Loss Made Easy FaceBook Group: https://www.facebook.com/groups/1701659280174513/ Follow me on Twitter: https://twitter.com/Ryan_Kassim Subscribe to my YouTube Channel: https://www.youtube.com/ryankassimlifeisgood 20% off Legion Supplements - Use code: BodyByRyan https://legionathletics.rfrl.co/542mp

How a 93-year-old Burlingtonian fills her days. Hint: It will probably make you cry. Plus, a settlement in the EB-5 case, physician residents at the University of Vermont Medical Center get a contract and farmworkers plan to protest Saturday in Maine.

Those of us that work in the laboratory have experienced a downtime at some point or another. They tend to be about 4 hours long. What if the downtime went on for days? How would you perform tasks such as add-on testing or referencing cultures? What if the whole system was down? Dr. Christina Wojewoda from the University of Vermont Medical Center joins the podcast to tell her "horror" story of when the network at her hospital went down. This is part 1 of 2 episodes.

Anne Dixon, MD, Director of Pulmonary and Critical Care Medicine at University of Vermont Medical Center and the first repeat guest in the history of Lungcast, rejoins American Lung Association Chief Medical Officer Albert Rizzo, MD, on the floor at the American Thoracic Society (ATS) 2023 International Conference in Washington, DC, to discuss headline news from the annual meeting and her ongoing work in clinical airway research. Want more Lungcast? Visit us at HCPLive.com or Lung.org. Episode Highlights 0:15 Intro 1:00 Obesity burdens in asthma 3:22 Weight loss intervention data at ATS 2023 4:53 ALA grants program 7:00 Airways Clinical Research Network 10:52 Seeking research collaborators 12:46 Merging clinicians, patients and industry in innovative research 13:54 Outro

This episode features Dr. Akshat Gargya, Assistant Professor in Anesthesiology and Interventional Pain, The University of Vermont Medical Center. Here he discusses his background, the big headwinds he's planning for this year, how the spine and orthopedics field will evolve in the next 2-3 years, and where he sees the best opportunities for growth.

This episode features Dr. Akshat Gargya, Assistant Professor in Anesthesiology and Interventional Pain, The University of Vermont Medical Center. Here he discusses his background, the big headwinds he's planning for this year, how the spine and orthopedics field will evolve in the next 2-3 years, and where he sees the best opportunities for growth.

Palliative care - the often misunderstood, under utilized, yet empowering option in medicine.  Today my guest is Dr Caitlin Barron an internal medicine physician specializing in palliative care at the University of Vermont Medical Center in Burlington and co-founder and chief medical director of EpioneMD. She also serves on the editorial board for the Journal of Palliative Medicine. Her clinical interests include palliative care in oncology and population community-based palliative care. Above all else, Dr Baran feels privileged to care for patients faced with serious illness, ideally working to help them live as well as possible.  Today we discuss the confusion over palliative care, helpful questions to ask your care partner and their providers, and how palliative care can empower caregivers and their care partners. SHOW NOTES EpioneMD.com

Palliative care - the often misunderstood, under utilized, yet empowering option in medicine.  Today my guest is Dr Caitlin Barron an internal medicine physician specializing in palliative care at the University of Vermont Medical Center in Burlington and co-founder and chief medical director of EpioneMD. She also serves on the editorial board for the Journal of Palliative Medicine. Her clinical interests include palliative care in oncology and population community-based palliative care. Above all else, Dr Baran feels privileged to care for patients faced with serious illness, ideally working to help them live as well as possible.  Today we discuss the confusion over palliative care, helpful questions to ask your care partner and their providers, and how palliative care can empower caregivers and their care partners. SHOW NOTES EpioneMD.com

There is a common misconception that older adults are no longer interested in or capable of having sex. Studies show that more than 50% of men and 30% of women among 1000 adults surveyed aged 65-80 are sexually active. The vast majority of older adults in a relationship report being satisfied with their sexual life. Research also indicates that older adults want to discuss their sexual health and how to optimize their sexual functioning.   My guest today is Dr. Regina Koepp, a board-certified clinical psychologist and founder of the Center for Mental Health & Aging. She is also the creator and host of the Psychology of Aging podcast and a contributing writer at Psychology Today and Psychotherapy Networker. She has been featured in various news outlets, NY Times, Chicago Tribune, Katie Couric Media, News Nation, and many other news outlets. Currently, she holds the role of lead medical psychologist at the University of Vermont Medical Center. She is also the creator of the only dementia and sexual health certification program in the United States.   As we address these common misconceptions and the negative impact the stereotypes could have on the sexual health of older adults, we are providing accurate information about the sexual health of older adults and promoting healthy sexuality to improve the quality of life for all people. In our conversation, we talk about the frequency of sexual activity among older adults, the benefits of sex later in life, coping strategies for new disabilities or chronic illnesses, how we can be empowered in our sexual expression, and the importance of talking about sexually transmitted infections among older adults. We also discuss dementia and sexuality and how we can improve education and awareness around this topic. We look at how healthcare providers and families can better address the sexual health needs of their older adults and loved ones in their life. Thank you, Dr. Koepp, for the important conversation. I'm so thankful for your work and advocacy for sexual health.   Learn more at Center for Mental Health and Aging at www.mentalhealthandaging.com   New course on aging and sexual health is available on Friday 5/5. Sign up now HERE.   Dementia and Sexual Health Basics Course: https://courses.mentalhealthandaging.com/p/dementia-sexual-health-basics-ceu-on-demand   Dementia and Sexual Health Certification Course: https://courses.mentalhealthandaging.com/p/dementia-sexual-health-certification-waitlist     *This episode is brought to you by Gigi Betty co. A boutique gift shop raising awareness and funds for caregivers and care partners. Show now at www.gigibettyco.com. Use the special code WILLGATHER20 for 20% off your order- Just for our podcast listeners!   We are not medical professionals and are not providing any medical advice. If you have any medical questions, we recommend that you talk with a medical professional of your choice. willGather has taken care in selecting its speakers but the opinions of our speakers are theirs alone. Thank you for your continued interest in our podcasts.   Please follow for updates, rate & review!   For more information about our guest, podcast & sponsorship opportunities, visit www.willgatherpodcast.com   Instagram: @willgather Facebook: willGather   Nicole Will is our host and founder of willGather.

Today, we are joined by Dr. Joseph Pierson, MD, dermatologist and program director at the University of Vermont Medical Center Dermatology Program. Dr. Pierson speaks with us about turning topicals into “Over the Counter” medications, updates to the iPLEDGE program, the University of Vermont Dermatology program, as well as advice for medical students pursuing dermatology. Learn More: Instagram: @uvmdermres Website: https://www.uvmhealth.org/gme/residencies/dermatology We Pledge to Change iPLEDGE Topical Prescription Contrition Host: @jonnyhatch Music: District Four by Kevin MacLeod Link: https://incompetech.filmmusic.io/song/3662-district-four License: https://filmmusic.io/standard-license --- Send in a voice message: https://anchor.fm/derminterest/message

Vision 2020 Advances At SVMC: A multi-million dollar expansion project is underway at the southwestern Vermont Medical Center to enlarge its emergency room and cancer center – and more. VSP Recruitment Tries Something New: The Vermont State Police are trying […]

Unions have been a significant force for change in many industries, and in recent years even in healthcare.  They can implement policies - better pay, benefits, and working conditions, and push for more transparency and accountability. With unions, employees can make their voices heard and if successful, it could improve the healthcare system as a whole.   In this episode, we talk to Hannah Porter MD, a 2nd-year Dermatology Resident at the University of Vermont Medical Center. She and her team organized the UVMC residents and fellows as the latest union shop for the Committee of Interns and Residents/SEIU. Her story progresses from leadership's disrespect and lack of transparency on issues as simple as PPE to the face-to-face conversation required to obtain a final tally of 209 for the union and 59 against. It even includes Union Busting Consultants making $2500/day to lobby the Residency Program Directors into threatening withdrawal of funding for attending conferences, and a cameo from none other than Senator Bernie Sanders.   After a year, we'll follow up with Dr. Porter to see if they've successfully negotiated better pay and if work hour restrictions have been enforced.   “I know that there are several ways to approach how we can fix this healthcare system, and this is one of the ways from my perspective.” Hannah Porter MD MBA   Episode Highlights: (01:39) How it all started and recognizing the need for a union (7:27) Spreading the word to colleagues and Senator Bernie Sanders' participation (12:37) The biggest benefit of having a union shop (16:48) Change in the treatment by senior leaders after being unionized (21:37) The first negotiation's top priority change (25:18) Bringing in the anti-union consultants Connect with Dr. Hannah Porter: https://www.linkedin.com/in/hannahjchang/   Resources: Article on the Union Vote https://www.sevendaysvt.com/vermont/resident-physicians-at-the-uvm-medical-center-vote-to-form-union/Content?oid=35346837 Committee of Interns and Residents/SEIU https://www.cirseiu.org/    Learn more about Dr. Dike and The Happy MD: https://linktr.ee/dikedrummond   We would love to hear your feedback. Send us your review on Apple Podcasts/Itunes, or in other directories through this link: https://www.podchaser.com/podcasts/physicians-on-purpose-1546320

CardioNerds (Amit Goyal and Daniel Ambinder) join Dr. Sonu Abraham (Cardiology fellow, Lahey Hospital and Medical Center), Dr. Amitoj Singh (Internal Medicine Resident, Lahey Hospital and Medical Center), Dr. Ahmed Ghoneem (Internal Medicine Resident, Lahey Hospital and Medical Center, CardioNerds Academy Chief) and Dr. Aanika Balaji (Internal Medicine Resident, Johns Hopkins) for a scrumptious meal on the Boston Harbor as they discuss a case of a young woman with metastatic melanoma on immune checkpoint inhibitors presenting with dyspnea. The presentation, risk factors, work up and management of patients with immune checkpoint inhibitor induced myocarditis are described. The E-CPR segment is provided by Dr. Sarju Ganatra, the founding director of the cardio-oncology program at Lahey Clinic.  CardioNerds Clinical Trialist Dr. Carrie Mahurin (University of Vermont Medical Center) is introduced at the beginning of the episode. A 41-year-old woman presented with mild dyspnea on exertion and non-productive cough. She had a history of Hashimoto thyroiditis, nodular thyroid s/p resection on levothyroxine, and metastatic melanoma on immune checkpoint inhibitor therapy with ipilimumab and nivolumab. She also had a history of obesity and underwent gastric bypass surgery several years prior. Though she lost weight after the surgery, she regained a significant amount and was 244 lbs with a BMI of 42. Her exam findings were remarkable for tachycardia, bilateral pulmonary rales, elevated JVP, and symmetric pedal edema. Investigations revealed a mild troponin elevation, non-specific EKG changes, and TTE with severely reduced left ventricular function (EF 15%) and a low GLS. Cardiac MRI showed patchy delayed myocardial enhancement in a non-ischemic distribution with marked global hypokinesis and EF of 11%. Endomyocardial biopsy confirmed the diagnosis of immune checkpoint inhibitor (ICI) associated myocarditis. The ICI therapy was discontinued and she was treated with high dose intravenous corticosteroids followed by a prolonged oral steroid taper with clinical improvement and complete recovery of left ventricular function. Jump to: Case media - Case teaching - References CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Case Media - immune checkpoint inhibitor myocarditis Episode Schematics & Teaching CardioNerds Myocarditis, updated 1.20.21 Pearls - immune checkpoint inhibitor myocarditis ICI-associated myocarditis has a high mortality rate necessitating a high degree of clinical suspicion. When in doubt, check it out! The initial 4 diagnostic pillars include EKG, troponin, BNP and TTE. Cardiac MRI and endomyocardial biopsy help to confirm the diagnosis.Left ventricular function is normal in 50% of these patients with ICI-associated myocarditis, so the ejection fraction is not a sensitive test for ruling this out.Endomyocardial biopsy should be considered in patients with a high clinical suspicion but negative or ambiguous non-invasive imaging.Early initiation of corticosteroids within 24 hours of presentation is associated with better outcomes.ICIs should be discontinued indefinitely in those with Grade 3 or 4 disease. Notes - immune checkpoint inhibitor myocarditis 1. Immune checkpoint inhibitors – What are they and why should we as cardiologists know about them? Immune checkpoint inhibitors (ICI) boost the host immune response against tumor cells by inhibiting the intrinsic brakes of the immune response.There are currently 7 FDA approved drugs in this group: one CTLA-4-blocking antibody called ipilimumab; three PD-1-blocking antibodies [nivolumab, pembrolizumab, and cemiplimab]; and three PD-L1-blocking antibodies [atezolizumab, avelumab, and durvalumab].Like a car,

In this episode, moderated by Dr. Alissa Thomas (University of Vermont), patient caregiver Ms. Sandra Klima, hospice and palliative medicine physicians Dr. Gregg VandeKieft (Providence Institute for Human Caring) and Dr. Frank Ferris (Ohio Health), and medical oncologist Dr. Charles Blanke (Oregon Health and Science University) exchange perspectives on medical aid in dying, including legal, ethical and practical aspects. If you liked this episode, please subscribe. Learn more at https://education.asco.org, or email us at education@asco.org.   TRANSCRIPT Dr. Thomas: Hello, and welcome to the ASCO Education podcast series. My name is Dr. Thomas, and I'm a Neuro-oncologist at the University of Vermont Medical Center, and  Associate Professor in the College of Medicine in the Department of Neurological Sciences in Burlington, Vermont. As today's host, I will be moderating a discussion on medical aid in dying with four guest speakers, Dr. Gregg VandeKieft, who is a Palliative Care Physician, Clinical Ethicist and Executive Medical Director at Providence Institute for Human Caring in Olympia, Washington. Dr. Charles Blanke, a Medical Oncologist and Professor of Medicine at Oregon and Health Sciences University in Portland, Oregon. Sandra Klima, who is the partner and caregiver of a patient who passed away using medical aid in dying in Vermont. And Dr. Frank Ferris, who is a hospice and palliative medicine physician, as well as executive director of Palliative Medicine Research and Education at Ohio Health in Columbus, Ohio.     For consistency during this talk, we'll be using the term medical aid in dying or MAID to refer to death with dignity and physician-assisted dying. So, to begin the discussion, I'd love to hear from Sandra about your perspective as a caregiver. Can you share with us what it was like caring for your partner and what your reaction was when you learned about his wishes?  Sandra Klima: Yes. Thank you. I'm glad to participate. My partner had died of glioblastoma in April of 2018. When we found out, it was pretty shocking. The very first thing he brought up was Act 39. And initially I was very surprised and uncomfortable with it because I didn't want to think about death, I wanted to think about living. And he was very quick, Rob was very quick. We made an appointment at the funeral parlor. He wanted to get everything taken care of quickly. So I was shocked that he wanted to use Act 39. I did not feel that it was, as I said, appropriate to talk about, but he explained he had a friend who had glioblastoma and she did not take that action.  And she kept a diary and he said it was very difficult to read. And he did not want to go through that process that she went through. He didn't want to lose who he was. He wanted to die as himself instead of a short time later as a lesser person. And wanted the choice, and Act 39 gave that to him. And I respected and supported his decision once we talked about it. Cancer is a progressive disease and there comes a time when you will not be in control. Facing that and knowing it only goes downhill is scary. So having the option that looked out before the end phase is a blessing, and it is death with dignity, and that's how it feels to me.  Dr. Thomas: Thank you so much for sharing that experience. This has been a hot topic and I'd love to hear from our panel, what are some of the common misconceptions around medical aid in dying, and how is this different from concepts like euthanasia or assisted suicide?  Dr. VandeKieft: Well, for starters in the United States, all the states that allow aid in dying require the person to self administer the agent. So it's not euthanasia where somebody else administers the lethal agent. Our neighbors to the north in Canada actually do allow voluntary euthanasia and about 90% of their aid in dying individuals do it by voluntary euthanasia as opposed to self-administration. Another misconception is that it is heavily targeting the most vulnerable and disenfranchised, when in fact data from Oregon and Washington really indicate that it's mostly the well-educated, economically privileged who tend to utilize the aid and dying acts. And so there's actually been some questions in recent years about equity in rural areas and for other people who have difficulty accessing aid in dying,  Dr. Blanke: I'd love to reinforce that point. So, the Oregon data suggests that 74% of participants have at least some college, and almost 99% actually have medical insurance, although getting the insurance company to actually pay for the drugs is a different issue. I'd like to also suggest that opponents of death with dignity say that it violates the Hippocratic Oath, which I do not believe it does. Death with dignity deaths make up a tiny minority of overall deaths in any of the states where it is legal, and a good chunk of patients, somewhere between 30% and 60%, get the prescription and never even take it. So, I like to say that the act fights out of its weight class. A lot of people get the power and control of having that medication, but never actually need it.  Dr. Thomas: I understand there are a number of safeguards within the law to try to protect patients and help access and protect physicians. Would you be able to touch on the safeguards?  Dr. Blanke: I'll start there if okay, and most of the other states have modeled their law after Oregon's. So first the patient has to make multiple requests over time. They have to demonstrate a continued interest in death with dignity, and the law has built in cooling off periods. The patients have to clearly understand what will happen if they actually take these drugs, and what happens in 99.5% of cases is they will die as a result. The patients have to put in a witnessed written request for medications, and one of the witnesses cannot be related by blood or marriage, cannot be the patient's doctor, and most importantly can't be in a patient's will. They cannot have a financial interest in the death. So I think those are very reasonable patient safeguards.  Dr. VandeKieft: One exception I would call out is the state of Montana, which did not actually pass the legislation or a voter initiative to legalize aid in dying. But it was a state Supreme Court decision that said it was unconstitutional to prohibit it. So they actually don't have a regulatory framework in place, but they do offer protections to physicians. If they participate, they cannot be prosecuted. But all the other states in the US that have laws have a regulatory framework, much like Dr. Blanke just described.  Dr. Thomas: That's really helpful for the legal ramifications. What are the main ethical considerations around medical aid in dying?  Dr. VandeKieft: If you think of the classic ethical framework, autonomy tends to drive a lot of the conversation, that is the patient's right to self-determination. If they choose to pursue aid in dying, even if we morally disagree with the appropriateness of it, is it our position to prohibit them from following through with it? But then many others will also look at the concepts of beneficence, that is the obligation to do good for our patients, and non-maleficence, that is the obligation to not do harm for our patients. And people on both sides of the arguments will invoke those terms. People who oppose it would say the good is to prolong life. People who support it would say the good is to give people the right to choose the best quality of life and self-determination. People who oppose would say that the death, if it's self administered is actually a harm. The supporters would say the harm is making a person suffer, when in fact they have the potential to cut that suffering short on their own terms.  And so those ethics discussions tend to get into it fairly significantly, particularly around the public policy and social aspects. And then finally, at least within the health system I work, we've really shifted our focus away from a lot of the high-level legal and ethical debates and into what do you do for the patients who request it, and how do we make sure that there's non abandonment, accompaniment through the end of life, and that we seek out the reasons that they asked about aid in dying in the first place, and figure out how we can best serve the concerns that raised the question?  Dr. Blanke: I would love to actually strengthen that last point that Dr. V just brought up. A lot of patients use up three months of their expected six months survival barely finding me. Because what happens is they went to their primary provider, asked for death with dignity. Their physician says, "I don't do it. I don't know anybody who does. Good luck with it." This is a legal option in the state of Oregon, as well as about 11 other states. And the question as to whether or not providers have the obligation to at least refer, is a strong ethical point. A lot of the state's statutes say they can't hinder referral. They have to supply records if the patient asks for it, but I'm not aware that any of them have mandatory referral. And I think the physician is ethically obliged to offer that possibility, even if they don't want to write a prescription, which of course is totally okay.  Dr. Ferris: And if I might comment, I think the other obligation here is to, for the patient, particularly with cancer, but with anybody with any diagnosis who might be choosing this pathway is to ensure that they've had very early referral for palliative care services. That all their symptoms, any issues that are causing suffering are actually being addressed. And that as you have suggested, that they are clearly accompanied by somebody without bias, who understands how to unwrap and provide counseling in all the different realms psychological, social, spiritual counseling, to make sure that they and their families or their partners are in a really good place. Everybody's comfortable with the choice. The family lives on after a situation like this, and they need to have been comfortable with that. That the choice was the appropriate one for the person, and that what we're doing is we're respecting that person's choices and they're comfortable with it.  Dr. Blanke: I totally support that. The flip side of the coin is none of the states really say what to do if you are unable to offer death with dignity. They don't certainly mandate palliative care. I see a number of patients who really don't have terminal illnesses, or they have terminal illnesses that they are not expected to die within the mandatory six months. And I think we should ask ourselves, why are they seeking death with dignity? We have to ask ourselves, "Should we be referring these patients for psychiatric care?"  Dr. Ferris: Well, and if I could come back and emphasize that, I think oncology broadly has frequently had late referral patterns to palliative care services. I've got story after story, I'm a radiation oncologist by background, having done palliative care for the last 35 years. Even in the last couple of weeks, students learning with me have said, "We tried to get referrals and the oncologist wouldn't refer. Is there anything wrong with having a partnership?" So, the oncologist continues to do their wonderful work, at the same time we're managing the patient's experience and that people understand all their options, of which this is one of them, and they have a legal right to that in 11 states, so that we do the best possible care for people.  Dr. VandeKieft: I want to amplify your point. Dr. Ferris, if people choose aid in dying as the culmination of excellent palliative or end-of-life care, that's a very different scenario than if they're choosing it in lieu of palliative care because they don't have access. And so anybody who has access to aid in dying certainly should have access to the highest quality palliative care and hospice care and behavioral health, as Dr. Blanke pointed out, to make sure that they aren't despairing for something that could be treated more readily.  Dr. Ferris: And if I could add one more point, I think there's also a palliative care evangelist who says, "Well, if you just do this a little longer, everything's going to be wonderful." Except that we haven't made a difference. We as a community need to recognize when that's the case as well. So none of us are perfect, but it's the making sure we're a really comprehensive team and able to walk with people and honor and respect their choices.  Dr. Thomas: Thank you. We've spoken a lot about some of the logistics and legal and ethical aspects. I'd love to hear about what the experience is actually like. What are the barriers that patients face when they're trying to seek out medical aid in dying? We have a caregiver here who directly experienced this. How was it trying to access this and are their barriers either individually or systemically?  Sandra Klima: When Rob made his choice, we obviously had to go to the physicians and do the two interviews and get the approvals and wait the days in between and sign all the forms. But eventually we got to go pick up this medicine. But there was one pharmacy that had the medicine. We went, made a drive there. It was far from where we were. So we went over there. We had to plan it to be when there was a physician there who would give us the medicine. So that kind of struck me as strange. So you had to schedule everything and then you get there, and I don't know if it was my paranoia or what, but you feel like everyone's looking at you from behind the counter like, "Oh, you are the people coming to get that medicine?" And it was really just a little uncomfortable.  And you feel like you were almost doing something illegal. So that is the pressure I felt during that process about that. The only other piece is once you start this process in motion, we had the hospice people and the palliative care people contact us. We had several meetings with them. We talked about it with our cancer counselor, so I was very comfortable. And most importantly, Rob was comfortable to get the medicine that he would have to take and have it with him. It gave him peace of mind. It gave him freedom to enjoy his life.  Dr. Blanke: I'll add a few practical matters. The states that have death with dignity mandate that the patient takes it through their GI tract. That usually involves swallowing. We have a number of patients who are unable to swallow, or they have GI obstruction. They're allowed to take the medication through their rectum, although that eliminates a lot of the dignity from death with dignity. But we are not allowed to use intravenous formulations. Even if the patient self-administers. We also have patients and patients with Lou Gehrig's disease or amyotrophic lateral sclerosis make up about 11% of death with dignity users. Many of those patients do not have the use of their limbs. I had one young lady who was nearly completely paralyzed. She could move her head and she could move the pinky of one hand. And I spent somewhere north of four hours simply figuring out how she could fulfill the law by self administering a drug.  Finally we put in an NG and she was able to press a syringe plunger while I held a syringe, legal in Oregon, with that single pinky. I think the law is incredibly discriminatory against people with disabilities in the interest allegedly of protecting them. Next issue is we talked about the written request, which I do think offers safeguards, but sometimes it's hard. If patients want confidentiality, which the law allegedly is interested in, they may not want their neighbor to know that they're going to do this and they may not have somebody who is able to sign the form. Finally, we have talked a little bit about finding a participating provider. That continues to be an absolutely huge barrier, particularly because it's not just one provider, it's a prescribing physician and a consulting physician. They have to find two doctors, and if they're in say a Catholic health system or they're at the VA, sometimes it's nearly impossible for them.  Dr. VandeKieft: Loop back to Miss Klima's comment about the peace of mind that her partner experienced, and note that sometimes even just the conversation provides that. I've had numerous patients who brought the topic up, and they weren't actually asking for requests. They were just seeking information or in one instance, trying to let her family know how badly she was suffering and bringing this up was a way of demonstrating that to them. But I had a patient with ALS who brought the question up. The fact that I accepted it, spoke back to her in a respectful and supportive manner, provided her some relief.  But then when the doctors from End of Life Washington, the advocacy group who can help provide support to people in the home, came out and visited her, she responded that it alleviated her anxiety and her depression, didn't resolve them, but eased them. And that also she learned that she didn't have to act as early as she thought she would have on her own. And so I kind of jokingly said, "So meeting with doctors may have actually prolonged your life." And she laughed and said, "You know, doctor, it did, because I would've done it earlier if I hadn't met with them."  Dr. Ferris: If I can speak to what you just said back in the era of HIV and AIDS, when we had very little, I cared for more than 1,000 people out in the community. And I would say more than 60% of them asked me that question of when they got to a spot of intractable suffering, when I hastened their death. And of course that was illegal in those days. But what I was clearly able to do, is talk about palliative sedation for them, to be clear I would look after them, clear I would look after their families. And just as you have suggested, I think one of the huge issues is, "I have an option. I have an alternative here. Somebody is going to look after me. And if I've decided, if I'm going to go to medical aid in dying, if I'm going to go the palliative route, I don't have to experience the horrible part that I don't want to experience."  We need to talk about both of these openly with people, and be clear that they and their families will be accompanied in whatever the process and as you've suggested, without judgment, maintaining confidentiality. These are super important issues for people. I think about my own personal future, these things loom. I think it is people with lots of thoughts about what might happen, maybe a bit too much knowledge, who worry about the intractable nature of suffering, whatever it is, whether it's psychological, physical, spiritual. It's being able to accompany people appropriately and respect their choices.  Dr. Thomas: Right.  Dr. Blanke: So I'd like to add one more practical detail. We talked a little bit about finding providers and how difficult that is. And if you think about the challenge of finding two providers in Portland, you have to multiply that by about 100 to find any providers in Klamath Falls or Eastern Oregon. The good news is telemedicine has made our lives and the lives of our patients quite a bit easier.  Dr. Thomas: As I listen to the conversation, I'd be curious about your thoughts about health equity issues around this. You've alluded to the fact that somebody who has physical or neurologic disability may have challenges depending on where you live. It may be challenging to access. Are there other populations of patients where you worry about health equity and access to medical aid in dying?  Dr. Blanke: Well, I can comment that most of the patients find me or my colleagues who provide this through web searches. So, they have to have access to computers, which is not necessarily all that easy for all the rural residents of Oregon. Even though I told you that 99% of patients have insurance, we also mentioned that getting the insurance company to pay for the drug is very, very difficult. Hospice almost never wants to pay for it for the usual hospice- related reasons, and the drugs are about $700 in Oregon. That is a hindrance to a lot of my patients.  Dr. VandeKieft: I think being mindful of historic disenfranchised communities, people of color, Native Americans, that the healthcare system has not always treated fairly historically, and they have reasons to be suspect at times. Now this is something that usually they will seek us out as opposed to the healthcare system promoting it, but just being sensitive to the fact that we're doing something that could be perceived as problematic by communities who have historically been mistreated by the health system as well as other systems.  Dr. Thomas: I'd like to just have a better understanding of residency and the law. I think that there is written into most of these laws, you have to be a resident of the state where medical aid in dying is available. But what does that mean to be a resident, and how do states define that?  Dr. Blanke: So for us in Oregon, it's not like the classic situation where you have to demonstrate that you have a driver's license or you have to produce a gas bill in your name. The statute basically allows the prescriber to define residency in their own mind.  Dr. Thomas: What advice would you give to oncologists and other physicians who might have patients approach with questions about this? How do you talk with patients about this matter?  Dr. VandeKieft: The very first thing I respond to is... This is a very important question. I appreciate that you brought it up and that you have the [inaudible 00:20:35] and trust in me to raise the topic. But before I get into the details, I'd like to learn more about what led you to ask me about it. Would that be okay? And even that last phrase, would that be okay as intentional and that by asking permission, I'm making sure that they have agency, and demonstrating respect to them. But that approach has made a huge difference in that I have learned on many occasions, people have no intent of actually proceeding with it. As I mentioned earlier, they may simply be asking for information.  One gentleman, his response was, "Well, my buddies told me about it, and I didn't even know that was a law. And when I started to explain it, he said, oh, that sounds too much like suicide. I would never do that. And then the other woman, I referenced, she went through it and then looked at me and said, “Doctor, I would never do it.”, and looked at her daughter and son-in-law, “I just want my family to know how badly I'm suffering.” And so starting with that open-ended question is really crucial because if we make assumptions and if we start projecting our own biases onto them, we may completely miss what they're looking for and the opportunity to provide them the best services that we could.  Dr. Blanke: If I merely mention that this is an option, the patient is going to think that I'm recommending it, and I certainly don't see it that way. It's just one of many options. If we offer chemotherapy, we are not mandating that particular drug or even suggesting they get chemotherapy at all. Certainly, with the exception of palliative care, I recommend they seek that out, that I really want them to seek it out. But I think it's incumbent on the providers if they see a patient with a terminal illness to list this among the many options that are possible for the patient living in Oregon or those other 10 states. I know that's controversial.  Dr. Ferris: Well, I really want to highlight what you just said, Gregg, about the process of inquiry. To me, everybody practicing oncology, everybody practicing medicine needs to be able to model exactly the way you opened when asking any significant question, including prognosis, "When am I going to die? What about this therapy?" Because what we know, many of the times, patients aren't asking what the words specifically say, they're calling out their suffering and how can we help them? Or they've got a plan, they've got something they want to do. So that was beautiful modeling, Gregg.  Dr. VandeKieft: Dr. Blanke, he used that example of people not hearing. And one of the cases that I still struggle with a little bit, I work in a Catholic health system, so I'm not a participating physician. And we're really counseled that we shouldn't be the one to bring it up. And I had an elderly woman. I was doing a hospice home visit and she asked me how long I thought she had. And unfortunately, Dr. Ferris, I didn't think to ask her what led her to ask me the question on that occasion. And I probably should have, because I told her my prognosis and she looked at me with a profound look of disappointment and said, "I don't think I can suffer that much longer." And a couple of days later, she died very unexpectedly. She took an intentional overdose and the fact that I didn't inform her of the option of aid in dying still haunts me that I may have failed her.  Dr. Thomas: Thank you so much for sharing that. Ms. Klima, we've heard a lot from the experts. Is there advice you'd give patient to patient or caregiver to caregiver about what to ask your physicians?  Sandra Klima: You need to ask as many questions as you want and have the doctor answer you truthfully. I think when a patient is asking a doctor a question, they're asking the doctor, "What are my options?" I'm going to assume you're going to give me all the options. I'm not going to assume you're not going to tell me the options you don't like, because I want to know what are my options. I'm the one who's suffering. I'm the one who will have to make a choice. And I can tell you the choice Rob made, to use Act 39 in Vermont, was a blessing for us. It was a peaceful death that I cannot overemphasize. It was the right decision to make. It was for his decision, but it was the right decision to make.  And I think if a physician would not have told us of that option, I would be in the same situation that you felt, Gregg, where the lady took it upon herself. Because you thought through it, you had a plan, it was planned. It was a nice wind up to an ending. And I think that physicians owe it to their patients to tell them all of the options available and let the patient make a choice. I also think physicians owe it to the patient to be clear what the end phase of their life will be. Because it's not roses. If they don't do this, they have to live through that end phase, which sometimes it's horrific. And I think they need to have a clear understanding of what's to come and a clean list of all the options. And I think that should just be required, and personal choice of a physician is not on the table.  Dr. Ferris: So it's important that we explain all the options, I completely agree, that are available within the context of the law. And certainly in the Americas, in Europe, and I've been in many other countries where palliative sedation is one of those therapeutic options. Where the patients can have amnesia, the family can be well looked after. We need to describe all the available options that are within the law, in the jurisdiction in which we live. I completely agree.  Dr. Blanke: And I'll add that that actually also applies to some of the patients who want death with dignity, are suffering horribly but don't actually qualify because they have a chronic illness expected to live too long. I just saw a patient last week and we actually talked about VCED, the voluntary cessation of eating and drinking, which is something that many, many people fear, including providers, but if done properly is fantastic. She used VCED. She passed away. She died two days later and her family could not have been more thankful.  Sandra Klima: I'll chime in on that because the comparison between my father dying and Rob dying, it really just has an impression on my mind. My father did not have a diagnosis of X amount of months to live, but my father had chronic problems and he was suffering. And the death that I watched him go through and was with him for, was nothing like Rob's death. It wasn't peaceful. It haunts me today. It haunts me. My father should have been a candidate, but he wasn't. What was the point of living four more months in this miserable state?  Dr. Thomas: You know, it dawns on me that this is a very different kind of death. It is not suicide legally or medically. It's a different process than natural death from a terminal illness. And it's not even possible in every state or every country. And I imagine it is very different for the people who are left behind, for family members and caregivers to process this kind of death and bereavement after their loved one passes. Can you comment, Sandra, on how medical aid in dying affects the caregivers and affects the family and how you can prepare for bereavement and support in bereavement?  Sandra Klima: I felt that this death was anticipated, and my bereavement, the part that bothered me about Rob's end of life, was that I was unprepared for how quickly the decision was made. The decision was made quickly because he started getting paralyzed again on the side of his body. And he decided, "Today's the day." And it was three or four hours later, and it took me by surprise at how quickly the decision was going to be made. That's the only part I regret was I didn't have a strong enough plan about what was going to happen when that decision was made. That probably needs to be emphasized because you can plan all you want when it's not going to happen. But at the moment it happens, it's like a fire drill. You got to go through and get all those things lined up. And I can tell you, I felt worse for my father's death than I did for Rob's death. So even though it's a different kind of death, it was a peaceful death with dignity.  Dr. Blanke: In terms of the bereavement, I have seen all sorts of responses from patients' families initially, from those who could not be more supportive. Sometimes they even seem to want it more than the patient does, to those who actively oppose it. But in my experience, which now numbers about 205, the families are almost always on board at the end when they see how much the patient has been suffering and how much peace the actual control over the patient's life and death gives them. I always offer after the patient is gone to the family to contact me whether it's a week later or a month later, or a year later, if they have questions about the process, if they need any help in referrals. It's never happened a single time.  Dr. VandeKieft: I think back to the landmark article that Tim Quill published in the early 1990s about his patient, Diane, and how he highlighted that she ended up committing suicide. And there's kind of a shame, it's done in the shadows, and that when you have aid in dying as an option that can be brought out into a planned open manner in the way that Ms Klima is describing with her partner. And then also with the bereavement and the partners, I think we need to listen once again. I just had a case yesterday that somebody was telling me of a gentleman who got the prescription for aid in dying, but ended up not taking it and died of "natural causes."  His wife told the bereavement counselor afterwards, “That was such a relief because I was struggling terribly with the spiritual aspects of this. And I would've really had a hard time had he gone through with it.” She had not shared that with her husband or anyone else because she wanted to be so supportive of him. And it was only by the bereavement counselor, listening and opening up that she could really understand, "What are the true struggles that this family is going through and how can I meet their needs?"  Dr. Ferris: If I can comment, it doesn't matter whether people have chosen medical aid in dying. When people die, there's a loss for anybody who's a survivor. People can be comfortable with the process that occurred or not. They can perceive suffering or not. The loss leads to changes. And what we know is the transitions through the loss period that we call bereavement for different people are profound in different ways. And what we need to make sure is that people are connected with services. It's why with every patient I care for, whatever therapy provided, I do participate in ventilator withdrawal. I participate in palliative sedation. I've done this all my career. I make sure they're in the hospice system, in the United States, which provides people with 13 months bereavement support or more, because if a death occurs in a hospital without hospice care, then the patient gets a decedent phone call from the chaplain, if they're lucky, or they're lucky enough to have a physician like Dr. Blanke who says call me.  Most people don't make themselves available and you're out at sea. And we know that the suffering of a bereavement can lead to incapacitance, people depressed, not functional, people even get illnesses in the process. So there's a huge cost to society for not addressing this issue carefully. It's about the preparation, and what I try to do is get the bereavement conversation going before the person dies, so that we're talking about it and integrating it.  Sandra Klima: Right, I agree.  Dr. Thomas: Thank you all so much for this conversation. Thank you, Sandra Klima and Dr. VandeKieft and Dr. Blanke and Dr. Ferris. I think this was such an important conversation. Talking about death can be very difficult and I just appreciate the openness and sensitivity and your willingness to share these experiences. Thank you to all of our listeners. We appreciate you tuning into this episode of ASCO Education podcast.    Thank you for listening to the ASCO Education podcast. To stay up to date with the latest episodes, please click subscribe. Let us know what you think by leaving a review. For more information, visit the comprehensive education center at education.asco.org.  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. 

High Reliability welcomes Scott Hemingway to the podcast. Scott has an interesting and unique career journey, he is presently the Director Of Security and Parking at Signature Healthcare, in Brockton, Massachusetts.  Prior to joining Brockton Hospital in 2019, Scott spent 10 years with LifeSpan, a RI-based healthcare system.  Scott has a completely different professional life prior to beginning his healthcare employment. In  2008, he retired as a Lieutenant after 23 years of service to the Rhode Island State Police. Scott also has military experience which includes being a Staff Sergeant with the Rhode Island National Guard, where he was assigned to the 243rd Regional Training Institute as a Certified Instructor. Areas of instruction included Military Police School, Nonlethal Weapons, and Modern Army Combatives.  Scott owns his own consulting firm,  The Hemingway Group, located in Warwick, RI. More information on The Hemingway Group can be found below. In this episode, we discuss:A unique career path, from Military Police duty in the Philipines to delivering a baby with the RI State Police;Healthcare surprise: What Scott did not expect to find, but found, in his transition from law enforcement to healthcare  (18:00);Equipping staff to deal with combative patients and family members in a chaotic age of Covid (23:30);Hospital risk and security (35:00);The importance of Critical Thinking in today's workplace  (38:50);TJC emergency standards at the top of Scott's mind (56:30).High Reliability, The Healthcare FM Podcast is brought to you by Gosselin/Martin Associates. Our show discusses the issues, challenges, and opportunities within the Facilities Management (FM) function. About the Hemingway GroupThe Hemingway Group is a Security Consulting service that specializes in finding solutions to the multidimensional and asymmetrical security issues that continually plague all facets of Government, Businesses, Educational Institutions, and Healthcare Systems. THGLLC conducts Vulnerability/Risk Assessments, Threat Assessments, and Security Evaluations. Please find more information about the Hemingway Group here.New rolesGosselin/Martin Associates is working with Children's Wisconsin to fill their Vice President, CHW Campus & Support Service role, Bassett Healthcare Network to fill their Vice President, Non-Clinical Support Services, as well as Griffin Hospital in Connecticut, Holy Cross Hospital in Florida, and Everett Hospital in Massachusetts to fill their Director of Facilities Management roles. We are also forwarding interested candidates directly to the University of Vermont Medical Center for their open Plant Operator positions. See all jobs here. 

In this special Cybersecurity podcast we have the opportunity to talk to leaders of an AHA member hospital who was a victim of a major ransomware attack in the Fall of 2020. Dr. Stephen Leffler, President and Chief Operating Officer and Dr. Douglas Gentile, Chief Medical Information Officer, join us from the University of Vermont Medical Center in Burlington, Vermont. John previously interviewed them about lessons learned and best practices during the attack which they are willing to share on today's podcast.

What was your personal experience with Match Day? What has your personal experience been like being transgender and how has this impacted your professional track when it comes to clinicians treating patients who are nonbinary or transgender? In this podcast episode, Dr. Mulkey addresses these questions and more about psychiatry residency and Match Day. Dr. Nat Mulkey, MD is a psychiatrist and first-year resident at the University of Vermont Medical Center. They graduated from Boston University School of Medicine, where they worked closely with faculty on LGBTQI+ curricula in undergraduate medical education and related initiatives. Their interests include child and adolescent psychiatry, LGBTQI+ mental health, pharmacology, addiction, and first break psychosis. Their hobbies are creative writing and trail running.  Articles by Nat Mulkey, MD: The Search for a Cause of Transness Is Misguided - Scientific American Misgendering in Medicine: How to Improve Care of Transgender and Gender Non-Binary Patients » in-Training, the online peer-reviewed publication for medical students https://www.psychiatrictimes.com/view/mental-health-crisis-ground-level https://www.aamc.org/news-insights/finding-my-community-gaymedtwitter Resources for LGBTQ+ Clinicians and Caregivers: Gender Spectrum Homepage - Gender Spectrum Transgender Professional Association for Transgender Health | Trans Health by Trans People (tpathealth.org) Education & Training - Fenway Health: Health Care Is A Right, Not A Privilege. Resources for LGBTQ+ Patients:  https://www.lgbtqiahealtheducation.org/resources/ https://www.uvmhealth.org/childrens-hospital/pediatric-specialties/transgender-youth-program/transgender-resources https://www.uvm.edu/health/transhealth

Sarah Schlein is the Physician Medical Director for Northeast Emergency Training Solutions, LLC. She is an Emergency Medicine attending physician at the University of Vermont Medical Center, Associate Professor at the Larner College of Medicine and Wilderness Medicine director in Burlington, VT. She founded and directed the medical school and Emergency Medicine residency Wilderness Medicine program and is […]

Julia O'Shea runs the Pulmonary Rehab Program at the University of Vermont Medical Center. She dives into her work with the breath as a Respiratory Therapist and a Kaiut Yoga teacher.  She gives insight into how both her yoga and her teachings about the breath have changed over the years. Julia provides practical anchors for teaching breath practices to beginners and talks about the role of the nervous system in her offerings. She shares how Covid has influenced her work and what tools can be offered to people experiencing post-Covid symptoms.

Hi Friends! Welcome to another episode of the diversify in path podcast. This podcast explores how  investing in diversity  can lead to  a high return of investment in pathology and laboratory medicine by learning from the knowledge and experiences of  diverse voices within in our field.  My next guess is Dr. William Humphrey Dr. William Humphrey is a writer and 3rd-year resident pathologist at the University of Vermont Medical Center. He is involved in Global Health and Pathology Clinical Informatics at the national level and has accepted a Neuropathology fellowship at the Mayo Clinic. His writings on the medical trainee experience as well as his own personal and professional path can be found in outlets such as Academic Medicine and Path Elective. He recently finished work on a novel, his first work of fiction, and  launched his own blog .Twitter:@TheDoctorIsILLInstagram: TheDoctorisILLWebsite:  TheDoctorIsILL.com

Season 1 | Episode 31 | September 15, 2021In this week's episode, Dr. Trey Dobson hosts outhwestern Vermont Medical Center's Director of Emergency Nursing Jill Maynard, RN. She will share news about SVMC's upcoming Emergency Department renovation and expansion.Jill Maynard, RN, is the director of nursing for the Emergency Department and Intensive Care Unit at Southwestern Vermont Medical Center. She received her bachelor's in nursing from Southern Vermont College in Bennington and will soon graduate with her master's in nursing with a focus on leadership and management. She joined the SVMC nursing staff in 2004.  Prior to this, she served as an Advanced EMT for her local rescue squad and as an ED Technician. In her current role, she manages the ExpressCare, emergency, and ICU nursing. She also leads nursing initiatives, including those to ensure safe emergency access for COVID and non-COVID patients, to decrease workplace violence, and to increase access to high quality efficient emergency care. She has been instrumental in emergency management and preparedness, in the development of the Respiratory Evaluation Center and the Emergency Crisis Area, and in the implementation of support programs for individuals affected by mental health conditions and substance abuse. Underwriter: Mack Molding

This week, Vermont passed milestones of both despair and hope. On a somber note, Vermont saw its 100th death from Covid-19 since the pandemic began in the state nine months ago. On the other side of the split screen was a hopeful milestone: On Tuesday, an emergency department nurse at the University of Vermont Medical Center became the first person in Vermont to receive the new Covid-19 vaccine from Pfizer that just received an emergency use authorization from the FDA. Thousands of Vermonters will be vaccinated by the end of this month. Health Commissioner Dr. Mark Levine observed, “This is a pivotal moment, one that marks the beginning of the end of the pandemic.” But he tempered his message by noting that it will take months for the vaccine to bring Covid-19 under control, and people must continue to be vigilant. Levine warned, “I can't emphasize enough the importance of everyone keeping up their efforts to protect themselves and prevent spread of the virus.” On this week's Vermont Conversation, we talk with Christine Finley, the immunization program manager at the Vermont Department of Health, who is helping to coordinate the statewide program to vaccinate Vermonters against Covid-19.

This episode features Emergency Medicine Attending Physician Doug George. Currently he is a Physician Medical Director at the University of Vermont Medical Center in the Emergency Department. His background includes service as a Firefighter/EMT, medical residency in Boston, MA working with Boston EMS as well as a coveted EMS fellowship in Albuquerque, New Mexico where he provided 911 scene care both on ground units and rotor wing air response. Doctor George has experience working with Critical Care, 911 EMS and Fire Based EMS systems and is always willing to talk EMS. Today we bend his ear about the keys to recognizing and treating Traumatic Brain Injuries (TBIs).

How does a self-described “pro-life, gun-owning combat veteran” end up starring in ads against President Trump? Dan Barkhuff is a former Navy SEAL and now an emergency physician at the University of Vermont Medical Center. He is the founder of …

How does a self-described “pro-life, gun-owning combat veteran” end up starring in ads against President Trump? Dan Barkhuff is a former Navy SEAL and now an emergency physician at the University of Vermont Medical Center. He is the founder of …

Post-Baccalaureate Premedical students at the University of Vermont have access to a Level 1 Trauma Center in the UVM Medical Center. Access to direct patient experience is why many students choose UVM's Post-Bacc Premed program. Graduate of the PBPM Caroline Shrewsbury is working as a LNA while she applies to medical school. Her path to medicine landed her on the McClure 6 floor at the University of Vermont Medical Center, which is the floor accepting COVID-19 or Coronavirus patients. Caroline talks about caring for COVID-19 patients and how this experience has confirmed her passion for medicine. About UVM's Post-Baccalaureate Premedical Program:UVM's Post-Baccalaureate Premedical Program boasts a high acceptance rate into medical school and has helped students pursue medical, dental, veterinary, pharmacy, physician assistant, nurse practitioner, physical therapy, and other health professions. With specialized tracks that help students pursue a background in a specific medical field of interest, students find the most relevant courses to help get them prepared.

Lisa's Adventure Club: Kitchen Adventures (0:00:00)If you're feeling like your life needs a little more adventure, but social distancing is preventing you from experiencing that excitement, look no further! Adventure comes in many forms, and as we talk about our adventure club today, we want to show you that adventure is still possible even when you're following the mandated rules we've all been given to stay inside. One way to bring adventure into your life and try something new is through cooking. This is a great time to use up the food you stocked up in your fridge and to experiment with new recipes. Joining us today to talk about how to make cooking an adventure is personal and television chef Lindsey Hargett.  Composting 101 (0:18:14)Have you noticed your family wasting a lot of food? Are your plants looking limp? We have great news for you! There's a simple way to both reduce food waste and give your plants a shot of nutrition at the same time. What's the secret? Composting! However, composting can seem a little bit intimidating at first, so we've invited C.L. Fornari, an author and radio host known as “the Garden Lady”.  Job Hunting in a Pandemic (0:36:26)If you have ever been in the process of job hunting, you know that it can be an exciting, nerve-wracking and risky time in life. But now that we are facing this economic crisis and the highest rate of unemployment in U.S. history, the thought of job hunting might make you sick to your stomach. There are many people struggling with work, and we just want you to know that we are thinking of you and we are hoping that everyone can come out on the other side of this. With that being said, we wanted to talk to our friend Justin Jones, who is a career development manager and self-named “job coach” about the job hunt and what it might look like for millions of people today.  Finding Screen Balance in Quarantine (0:50:34)One of the biggest transitions we're all having to make is moving everything online. So, whether we're working from home, taking classes from home, or trying to entertain our kids from home, I think we can all relate to feeling plugged in all the time. But are anyone else's eyes starting to hurt from staring at their screen for hours? Well we want to help you get off your screens. So here to share with us her tips on how we can unplug during quarantine or social distancing and the benefits of doing so isCatherine Price, founder of Screen Life Balance.  Mini Book Club: Most Requested Books (1:07:10)Rachel Wadham, of BYU Radio's Worlds Awaiting , talks with Lisa and Richie about the books that are requested most often at the library.  Coping with Missed Milestones (1:28:43)Because social distancing is vital to reducing the spread of COVID-19, many big events have been cancelled across the country including graduations, proms, sports championships, weddings, and many more. Losing these milestone moments can be extremely difficult for the people involved, as many have spent years or even their whole lives anticipating them. While we can't change our circumstances, finding ways to cope with these hardships will encourage us to stay positive. Here to give us some tips on how we can deal with our emotions and find other ways to celebrate is Abby Beerman. Abby is the injury prevention coordinator at the University of Vermont Medical Center.

John Stonestreet and Warren Cole Smith discuss the stunningly clear ruling from the U. S. 8th Circuit Court of Appeals that the state of Minnesota cannot compel videographers Carl and Angel Larsen to engage in speech that violates their religious beliefs. Another win for the Alliance Defending Freedom and for us all. They also discuss HHS citing the University of Vermont Medical Center for forcing a nurse --against her conscience--to participate in an elective abortion. It's pretty clear that HHS under this administration will enforce federal laws when it comes to religious freedom, whereas a certain previous administration was content to look the other way. Finally, Warren and John discuss a new study that is setting the media on fire, a study that concluded there is no single "gay gene." Resources A Win for Free Speech and Conscience Rights… John Stonestreet and David Carlson, BreakPoint, August 27, 2019   From Forcing Nuns to Freeing Nurses John Stonestreet and Shane Morris, BreakPoint, August 30, 2019   "What Would You Say?" The Colson Center's new video series to help you answer the tough questions   Holy Sexuality and the Gospel: Sex, Desire, and Relationships Shaped by God's Grand Story Christopher Yuan, Multnomah, 2018  

According to the records, in Fiscal Year 2018 the U.S. Health and Human Services Civil Rights Office received over a thousand complaints, alleging conscience violations or religious discrimination. That's significantly more than in any year recorded under the previous presidential administration. One complaint came from a Catholic nurse working at the University of Vermont Medical Center. The unnamed nurse claims that her employer forced her to take part in an abortion, though she had informed the hospital of her pro-life beliefs. The nurse was scheduled to help a patient who had suffered a miscarriage, but when she walked into the operating room, she was expected to assist with an elective abortion. The doctor in charge allegedly said to her, “Don't hate me.” This is a university medical center that didn't even practice elective abortions throughout most of its history, but a new rule instated in 2017 changed that and gave management the power to punish staffers who refuse to participate. What this nurse experienced was a violation of federal law. According to what are known as the Church Amendments, healthcare personnel have “an unqualified right... to decline to participate in abortions without fear of adverse employment actions or loss of staff privileges.” Under the Obama Administration, HHS ignored these laws. In fact, according to Roger Severino, who currently directs the Office of Civil Rights at HHS, the previous administration “systematically neglected” to enforce them. Not anymore. On Wednesday, Severino issued a notice of violation against the Medical Center, giving them thirty days to comply with the law and allow medical staff to opt-out of abortions, or lose federal funding. The hospital isn't cooperating. In a statement, they claim HHS lacks the authority to conduct such an investigation, and that the hospital's forced abortion policy strikes “the appropriate and legal balance” between employees' religious rights and patient care. According to Severino, there isn't a balance to strike. As he told The Atlantic, “Religious-freedom laws are the ones mentioned in the very first amendment to the Constitution. They have pride of place. And they have been neglected for too long.” And get what he said next: “America reached a consensus after Roe v. Wade... Nobody should be forced to participate in [an abortion] against their will... How could we countenance a situation where we allow a federally funded entity to force a medical professional to participate in taking a human life? That's what this case is about.” I cannot even imagine anyone working in the previous HHS saying those words. During the Obama Administration, former Health and Human Services secretary Kathleen Sebelius mandated that all employers, with very few exceptions, provide free contraceptives and abortion-inducing drugs as part of their employee health insurance. In fact, they argued all the way to the Supreme Court that the Little Sisters of the Poor, a group of nuns, should be forced to comply with that mandate. From forcing nuns to freeing nurses? Times have changed. This isn't just a win for conscience rights and the First Amendment, it vividly demonstrates that elections matter. People are policy. Which means, worldview matters. The law can be super clear, but if executive branch appointees are unwilling to enforce it, our freedoms are at stake. And this story also demonstrates that cultural engagement is worth it. As Severino said, Americans have reached a consensus in the last forty years: No one should be forced to participate in abortions against their will. With so many things in our culture going from unthinkable to unquestionable, it's nice to see abortion move in the opposite direction. If and when an administration hostile to preborn life moves back in the White House, there's still a forty year movement committed to protecting preborn life already in motion, and it's changing hearts and minds. I thank God the HHS is under new management. Protecting nurses from violating their consciences is an infinite improvement over forcing nuns to violate theirs.