Podcasts about warren alpert medical school

We're honored to have Janet Bickel, MA, join the Faculty Factory Podcast for the third time in our show's history this week. We're discussing the art of adaptability and how to hone it as a skill set to build a successful career in academic medicine. Janet is an acclaimed leadership and career development coach with more than five decades of experience in academic medicine and science. She started her academic career with Brown University's Medical School (now called The Warren Alpert Medical School) in 1972. Resources to Explore Academic Medicine Letter to the Editor: “Helping Medical Education Faculty Navigate a Post-Academic Landing Pad”: https://journals.lww.com/academicmedicine/citation/9900/helping_medical_education_faculty_navigate_a.1175.aspx Janet Bickel's Official Website: https://janetbickel.com/ Equip Your Inner Coach: Personal, Career and Leadership Development in an Uncertain Age: https://www.amazon.com/Equip-Your-Inner-Coach-Development/dp/B0BLFSRKG1 We're Put Here to Love: A Memoir with Poems: https://www.amazon.com/Were-Put-Here-Love-Memoir/dp/B0DDTK7NHM Immunity to Change: How to Overcome It and Unlock the Potential in Yourself and Your Organization (Leadership for the Common Good): https://www.amazon.com/Immunity-Change-Potential-Organization-Leadership/dp/1422117367 More Janet Bickel Interviews As mentioned above, this is Janet's third appearance on our podcast. You can revisit her first time joining us back in June 2019, when she shared with us 7 Crucial Books and Resources for Faculty Affairs Professionals. In March 2022, she joined us once again for a reunion episode, where we caught up with her to discuss what's new in her world of leadership and career development coaching since we last spoke. 

Send us a textThis recording features audio versions of May 2025 Journal of Vascular and Interventional Radiology (JVIR) abstracts:Recurrent Portal Hypertension after Liver Transplant: Impact on Survival and the Role of Transjugular Intrahepatic Portosystemic Shunt Creation in Management ReadNontarget Hemangioma Size Reduction after Bleomycin–Ethiodized Oil Embolization of Primary Hepatic Hemangioma ReadMR–Guided Microwave Ablation for Patients with Cirrhosis Complicated by Small Hepatocellular Carcinoma ReadEmbolotherapy for Pulmonary Arteriovenous Malformations in the Pediatric Population with Hereditary Hemorrhagic Telangiectasias—A Retrospective Case Series ReadEffects of Prophylactic Coil Embolization of Pelvic Arteries on Surgical Outcomes in Hemodynamically Stable Patients with Complex Acetabular Fractures ReadPercutaneous Ablation versus Radiotherapy for Pain Related to Bone and Soft Tissue Malignancies: A Multipayor Database Analysis of Outcomes ReadJVIR and SIR thank all those who helped record this episode. To sign up to help with future episodes, please contact our outreach coordinator at millennie.chen.jvir@gmail.com.  Host:Sonya Choe, University of California Riverside School of MedicineAudio editor:Sonya Choe, University of California Riverside School of MedicineOutreach coordinator:Millennie Chen, University of California Riverside School of MedicineAbstract readers:Ahmed Alzubaidi, Wayne State University School of MedicineIpek Midillioglu, Western University of Health Sciences, College of Osteopathic MedicineNate Wright, Warren Alpert Medical School of Brown University Sanya Dhama, University of California Riverside School of MedicineTiffany Nakla, Touro University Nevada College of Osteopathic MedicineKalei Hering, Harvard Medical School SIR thanks BD for its generous support of the Kinked Wire.Contact us with your ideas and questions, or read more about about interventional radiology in IR Quarterly magazine or SIR's Patient Center.(c) Society of Interventional Radiology.Support the show

This recording features audio versions of April 2025 Journal of Vascular and Interventional Radiology (JVIR) abstracts:Adverse Events After Percutaneous Transhepatic Biliary Drainage: A 10-Year Retrospective Analysis ReadEndovascular Therapy versus Anticoagulation Alone for Subacute Iliofemoral Deep Vein Thrombosis ReadImprovement of Hypoalbuminemia and Hepatic Reserve after Stent Placement for Postsurgical Portal Vein Stenosis ReadSafety and Effectiveness of Yttrium-90 Radioembolization in People Living with Human Immunodeficiency Virus ReadRadiation Segmentectomy and Modified Radiation Lobectomy for Unresectable Early-Stage Intrahepatic Cholangiocarcinoma ReadComparison of Liquid with Particle Embolics in a Translational Rat Model of Hepatocellular Carcinoma: Histologic and Radiographic Responses ReadJVIR and SIR thank all those who helped record this episode. To sign up to help with future episodes, please contact our outreach coordinator at millennie.chen.jvir@gmail.com.  Host:Sonya Choe, University of California Riverside School of MedicineAudio editor:Hannah Curtis, Loma Linda University School of MedicineOutreach coordinator:Millennie Chen, University of California Riverside School of MedicineAbstract readers:Millennie Chen, University of California Riverside School of MedicineTheodore Addo, Warren Alpert Medical School of Brown UniversityIpek Midillioglu, Western University of Health SciencesDaniel Roh, Loma Linda University School of MedicineSunil Balamurugan, Western University of Health SciencesMark Oliinik, Loma Linda University School of MedicineSIR thanks BD for its generous support of the Kinked Wire.Contact us with your ideas and questions, or read more about about interventional radiology in IR Quarterly magazine or SIR's Patient Center.(c) Society of Interventional Radiology.Support the show

Neurologists bring an important perspective to health policy. But few have formal training in how to advocate for patients at a state or national level. Our guest today, Dr. Kara Stavros, is an associate professor of neurology at The Warren Alpert Medical School of Brown University and the President of the Rhode Island Medical Society. She's also a self-described advocate, who's found a number of ways to speak up for her patients and influence health policy. Dr. Stavros spoke about her path to advocacy with Dr. Sarah Nelson, Assistant Professor of Neurology at Tufts Medical Center. Guest: Dr. Kara Stavros, associate professor of neurology at The Warren Alpert Medical School of Brown University and the President of the Rhode Island Medical Society Interviewer: Dr. Sarah Nelson, Assistant Professor of Neurology at Tufts Medical Center Disclosures: None

In this episode, we speak with Dr. Abrar Qureshi, MD, MPH, Chair of the Department of Dermatology at the Warren Alpert Medical School of Brown University and a distinguished leader in dermatology. Along with his academic leadership, Dr. Qureshi has dedicated much of his career to humanitarian work, particularly serving refugee populations through medical missions in Jordan and Turkey. We explore the role of dermatology in global health, the importance of trust in patient care, and what it means to be mission-driven in medicine. Join us to learn about Dr. Qureshi's journey in dermatology, his experiences in refugee health, and his perspective on how dermatologists can contribute meaningfully to global health. We hope you enjoy!Connect with Dr. Qureshi, MD, MPH:Instagram: @dermtracker---DIGA Instagram: @⁠⁠derminterest⁠⁠Host: @ashleyjini---Music: "District Four" Kevin MacLeod (⁠⁠⁠incompetech.com⁠⁠⁠) Licensed under Creative Commons: By Attribution 4.0 License: ⁠⁠⁠http://creativecommons.org/licenses/by/4.0/

The effectiveness of endovascular treatment (EVT) in cases of acute ischaemic stroke caused by distal medium vessel occlusion (DMVO) is still unclear. A study in the JNNP assessed the safety and effectiveness of EVT in comparison to the best medical management for DMVO. Podcast host Dr. Saima Chaudhry¹ spoke to some of the paper's authors, Dr. Adam Dmytriw², Dr. Vivek Yedavalli³ and Dr. Hamza Salim³.   Read the paper: Endovascular therapy versus best medical management in distal medium middle cerebral artery acute ischaemic stroke: a multinational multicentre propensity score-matched study   1. Warren Alpert Medical School, Brown University, Rhode Island, USA 2. Neuroendovascular Program, Massachusetts General Hospital, Boston, Massachusetts, USA 3. Radiology, Johns Hopkins Medicine, Baltimore, Maryland, USA Please subscribe to the show on Apple Podcasts, Spotify or find it on your platform of choice. Your feedback and reviews are very appreciated. Follow JNNP on twitter: @JNNP_BMJ

Curious about how to leave your mark as a mentor and leader in the field of OBGYN? In this episode of the BackTable OBGYN Podcast, Dr. Starr Hampton, a professor of OBGYN and Senior Associate Dean for Medical Education at Warren Alpert Medical School at Brown University, discusses her journey from a newly appointed faculty member to a leader in medical education. --- SYNPOSIS Dr. Hampton emphasizes the importance of kindness, mentorship, and taking opportunities when offered new roles. The conversation covers topics such as transitioning from medical school to residency to practice, fostering a supportive educational environment, and international health work. Dr. Hampton shares valuable insights on creating a culture of psychological safety and the significance of giving corrective yet supportive feedback to trainees. --- TIMESTAMPS 00:00 - Introduction 02:43 - Early Career and First Leadership Roles 12:09 - Navigating National Organizations 24:15 - Mentorship and Sponsorship 28:34 - The Value of Kindness and Psychological Safety 32:14 - Changing Culture 33:48 - Balancing Wellness and Professional Life 39:57 - Advice for Seeking out Mentorship and Positive Experiences 45:21 - Naming Your Work 50:09 - Transitioning to New Jobs/Roles 56:06 - Global Health Initiatives and Personal Growth 01:01:17 Conclusion and Future Topics

In this episode of Resiliency Radio, join Dr. Jill Carnahan as she interviews Dr. Achina Stein and Silvia Covelli from The Depression Project. Together, they explore innovative and holistic approaches to tackling depression at its root. Discover how their programs aim to help individuals break free from the grips of depression and regain energy, joy, and purpose for lasting well-being. Dr. Stein and Covelli dive deep into the science of root-cause resolution, discussing cutting-edge treatments designed to empower patients to overcome depression and reclaim their lives. Whether you're seeking an alternative to conventional therapies or just want to learn about comprehensive, whole-person care, this conversation provides valuable insights for long-lasting relief from depression. Schedule a Call: https://go.healingdepressionproject.com/dc-schedule Key Points ✅ Overview of The Depression Project's mission and approach. ✅ Discussion on the importance of addressing the root causes of depression. ✅ How energy restoration and holistic care impact long-term mental health. ✅ Insights into cutting-edge treatments beyond conventional therapies. ✅ The connection between physical health and emotional well-being. ✅ Practical steps to reclaim joy and resilience in life. Website: https://www.healingdepressionproject.com/ Schedule a Call: https://go.healingdepressionproject.com/dc-schedule

Dr. Armstrong shares a bit about his experience in the field of advocacy and his work with the American Society of Ophthalmic Trauma. We discuss how both of these can positively impact the field of sports ophthalmology as well as ways to get involved at any point in your career! Dr. Grayson Armstrong is the Director of Ophthalmology Emergency Services at Mass Eye & Ear in Boston, MA. He received his MD degree from the Warren Alpert Medical School of Brown University in Providence, RI while concurrently receiving his Master of Public Health from Harvard School of Public Health. He completed his ophthalmology residency, his chief residency where he was director of the Ophthalmic Trauma Service, as well clinical fellowships in both telemedicine and medical retina at Mass Eye & Ear of Harvard Medical School in Boston, MA. Dr. Armstrong is passionate about health policy and public health as well as ophthalmic telemedicine and healthcare technology.

Download my free guided meditation audio bundle here: https://thewellnessengineer.com/audiobundle     Have you heard there's new hope for overcoming depression, even for those with chronic or treatment-resistant symptoms? Join me and my guests, Silvia Covelli & Dr. Achina Stein, DO, DFAPA, FACN, ABIHM, IFMCP, to learn more about a new, innovative, research-backed method that focuses on uncovering the root causes of depression, offering fresh alternatives when traditional treatments fall short, helping you reclaim your life.   In this episode you'll learn: ⏰ 01:00 - Intro ⏰ 06:27 - Silvia's journey through 25 years of chronic depression ⏰ 12:26 - The many puzzle pieces of depression  ⏰ 17:08 - Holistic approaches to healing depression  ⏰ 25:49 - The 45-day in-person Healing Depression Project program ⏰ 36:15 - The ONE thing you can do to activate self-healing  Check out Silvia Covelli's & Dr. Achina Stein's Bio: Dr. Achina Stein DO, DFAPA, FACN, ABIHM, IFMCP Dr. Stein is the Clinical Director at the Healing Depression Project. She is a leading expert in Functional Medicine Psychiatry and a best-selling author with 30 years of experience helping people recover from depression. She is a board-certified psychiatrist, a Distinguished Fellow of the American Psychiatric Association, a certified practitioner of the Institute for Functional Medicine, and a former Clinical Assistant Professor of Psychiatry and Human Behavior at The Warren Alpert Medical School of Brown University. Dr. Stein's Amazon international bestselling book, “What If It's NOT Depression? Your Guide to Finding Answers,” offers groundbreaking functional medicine perspectives, instilling hope and providing healing pathways for those facing chronic depression. In the 45-Day Depression Recovery Program offered by the Healing Depression Project, Dr. Stein works on identifying and addressing all the root causes of your depression-like symptoms. This program brings hope to those who have long struggled with depression and have not found relief with other treatments, including antidepressant medications.   Silvia Covelli Silvia is the founder of the Healing Depression Project. She is an honors graduate from Boston College and a former social science researcher at Harvard University. She pursued graduate studies in finance and business law, and dedicated her career to entrepreneurship, becoming a skilled businesswoman. In parallel with her thriving career, Silvia faced relentless and chronic depression, exploring over 60 different treatments without finding sustained relief. Her personal struggle, combined with her extensive background in human transformation and mind-body connection, led her to develop a program that remarkably eradicated 25 years of depression symptoms, leaving her depression-free ever since. This breakthrough later inspired the creation of the Healing Depression Project, and helping others break free from depression became her life mission.   Silvia Covelli's & Dr. Achina Stein's gift and link: Why Am I Still Depressed? Top 4 Mistakes You're Making - Free E-Guide. A Practical Starter Guide to Overcome Chronic and Treatment-Resistant Depression: https://go.healingdepressionproject.com/guide  Connect with Silvia Covelli & Dr. Achina Stein: Website: https://www.healingdepressionproject.com/  ***** Hi there! I am Jane Hogan, the Wellness Engineer, and the host of Wellness By Design. I spent 30 years designing foundations for buildings until the pain and inflammation of rheumatoid arthritis led me to hang up my hard hat and follow my heart. Now I blend my backgrounds in science and spirituality to teach people how to tap into the power of their mind, body and soul. I help them release pain naturally so they can become the best version of themselves.    Wellness By Design is a show dedicated to helping people achieve wellness not by reacting to the world around them but by intentionally designing a life based on what their own body needs. In this show we explore practices, methods and science that contribute to releasing pain and inflammation naturally.   Learn more at https://thewellnessengineer.com   Would you like to learn how to release pain by creating more peace and calm?  Download my free guided meditation audio bundle here: https://thewellnessengineer.com/audiobundle   Connect with Jane:  Facebook: https://www.facebook.com/JaneHoganHealth/ Instagram: https://www.instagram.com/janehoganhealth    

The nocebo effect demonstrates how the mind can cause illness through negative expectations, as highlighted by a famous incident in a U.S. textile factory in the 1960s. Workers believed a bug was causing dizziness, nausea, and other symptoms, yet no physical cause was found. This mysterious outbreak underscores the potent influence of beliefs on health, a phenomenon that's becoming increasingly relevant in understanding modern psychosomatic conditions like the controversial Havana Syndrome. In this episode, Michael H. Bernstein, an expert on placebo and nocebo effects, explains how psychological factors can result in perceived physical harm. As co-author of The Nocebo Effect: When Words Make You Sick, Bernstein shares insights into the intersection of psychology, medicine, and public health. His research focuses on reducing opioid dependence by leveraging the placebo effect, while also exploring the ethical concerns surrounding nocebo-related side effects. Michael Bernstein, Ph.D., is an experimental psychologist and an Assistant Professor in The Department of Diagnostic Imaging at Brown University's Warren Alpert Medical School. His work is focused on harnessing the placebo effect to reduce opioid use among pain patients. He is Director of the Medical Expectations Lab at Brown. He is the co-author of the new book The Nocebo Effect: When Words Make You Sick, with Charlotte Blease, Cosima Locher, and Walter Brown. Shermer and Bernstein discuss: the placebo and nocebo effects, brain imaging, and the ethics of using these phenomena in medicine. Bernstein discusses the biology and psychology behind these effects, touching on notable cases such as Voodoo deaths and Havana Syndrome. Other subjects include psychogenic illnesses, patient-clinician interactions, alternative medicine, and how expectations can amplify or mitigate pain, anxiety, and depression. The conversation also delves into anticipatory nausea, psychotherapy, and the impact of cognitive behavioral therapy (CBT).

The NACE Journal Club with Dr. Neil Skolnik, provides review and analysis of recently published journal articles important to the practice of primary care medicine. In this episode Dr. Skolnik and guests review the following publications:1. Blood Biomarkers to Detect Alzheimer Disease in Primary Care and Secondary Care. JAMA 2024. Discussion by:Guest:Stephen Salloway, MD Director of Neurology and the Memory and Aging Program at Butler Hospital Professor of Psychiatry and Professor of Neurology at the Warren Alpert Medical School of Brown University. 2. Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity - (The SURMOUNT OSA Trial) – NEJM 2024. Discussion by:Guest:Atul Malhotra, MD Professor of Pulmonary Critical Care & Sleep Medicine Previous at the University of California, San Diego.3. Relative vaccine effectiveness of high-dose vs standard-dose influenza vaccines in preventing hospitalization and mortality: A meta-analysis of the evidence. Journal of Infection July 2024. https://doi.org/10.1016/j.jinf.2024.106187 Discussion by: Guest:Anupriya Grover-Wenk, MDFaculty– Family Medicine Residency Program Jefferson Health – AbingtonMedical Director and Host, Neil Skolnik, MD, is an academic family physician who sees patients and teaches residents and medical students as professor of Family and Community Medicine at the Sidney Kimmel Medical College, Thomas Jefferson University and Associate Director, Family Medicine Residency Program at Abington Jefferson Health in Pennsylvania. Dr. Skolnik graduated from Emory University School of Medicine in Atlanta, Georgia, and did his residency training at Thomas Jefferson University Hospital in Philadelphia, PA. This Podcast Episode does not offer CME/CE Credit. Please visit http://naceonline.com to engage in more live and on demand CME/CE content.

Dr. Stein is the Clinical Director at the Healing Depression Project. She is a leadingexpert in Functional Medicine Psychiatry and a best-selling author with 30 years ofexperience helping people recover from depression.  She is a board-certified psychiatrist, a Distinguished Fellow of the American PsychiatricAssociation, a certified practitioner of the Institute for Functional Medicine, a former Clinical Assistant Professor of Psychiatry and Human Behavior at The Warren Alpert Medical School of Brown University, and was awarded the Exemplary Psychiatris Award by NAMI-RI in 2008. Dr. Stein's Amazon international bestselling book, “What If It's NOT Depression? Your Guide to Finding Answers.”Silvia Covelli is the visionary founder of the Healing Depression Project. She is an honors graduate from Boston College and a former social science researcher at Harvard University. She pursued graduate studies in finance and business law, and dedicated her career to entrepreneurship, becoming a skilled business strategist. In parallel with her thriving career, Silvia faced relentless and chronic depression, exploring over 60 different treatments without finding sustained relief. Her personal struggle, combined with her extensive background in human transformation and mind-body connection, led her to develop a program that remarkably eradicated 25 years of depression symptoms, leaving her depression-free ever since. This breakthrough later inspired the creation of the Healing Depression Project, and helping others break free from depression became her life mission.Website: www.HealingDepressionProject.comFree E-Guide for the audience: www.HealingDepressionProject.com/GiftWhy Am I Still Depressed? Top 4 Mistakes You're Making. A Practical Starter Guide to Overcome Chronic and Treatment-Resistant DepressionPODCAST Thank you for listening please subscribe and share! - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Shop supplements: https://healthybydrjen.shop/ CHECK OUT a list of my Favorite products here: https://www.healthybydrjen.com/drjenfavorites WATCH THIS:https://www.youtube.com/watch?v=2lSyAFy5U4U&list=PLaDiqj0yz1eeCOATXPoUDt8HEJxz1_lfW - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - FOLLOW ME: Instagram :: https://www.instagram.com/integrativedrmom/ Facebook :: https://www.facebook.com/pflegmed Tik Tok :: https://www.tiktok.com/@integrativedrjen YouTube :: https://www.youtube.com/@integrativedrmom - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - FTC: Some links included in this description might be affiliate links. If you purchase a product through one of them, I will receive a commission (at no additional cost to you). I truly appreciate your support of my channel. Thank you for watching! Video is not spons...

Elizabeth Tobin-Tyler is an associate professor at the Brown University School of Public Health and Warren Alpert Medical School. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. E. Tobin-Tyler and S.L. Dickman. Rape, Homicide, and Abortion Bans — The Abandonment of People Subjected to Sexual and Intimate Partner Violence. N Engl J Med 2024;391:289-292.

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) can be difficult to distinguish from autoimmune nodopathy. In this podcast, Dr. Saima Chaudhry (1) is joined from the Netherlands by Dr. Ruth Huizinga (2) and Dr. Maarten Titulaer (3), to discuss their article, "Clinical relevance of distinguishing autoimmune nodopathies from CIDP: longitudinal assessment in a large cohort". They start with explaining what an autoimmune nodopathy really is, patient features to look out for, and the typical testing process for identifying CIDP. (1) Warren Alpert Medical School, Brown University, Rhode Island, USA (2) Department of Immunology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands (3) Department of Neurology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands Please subscribe to the show on Apple Podcasts, Spotify or find it on your platform of choice. Your feedback and reviews are very appreciated. Follow JNNP on twitter: @JNNP_BMJ  

How are we doing?? Click ⁠⁠⁠⁠⁠here⁠⁠⁠⁠⁠ to complete a brief, 2-minute survey. In this episode, we introduce our two new team members, Sydney Dacey and Conor Malone. We share our insights from the recent Eye Trauma 2024 meeting held by the American Society of Ophthalmic Trauma, and dive into a recent article published within the field. We discuss swimming, hurling, and everything in between! Sydney Dacey is a rising 4th year medical student at The Warren Alpert Medical School of Brown University in Providence, RI. Originally from Massachusetts, Sydney received her bachelor of science degree in biology from Boston College. She was a competitive swimmer for 16 years and finished out her career competing for Boston College's varsity team. While at Brown, she has led the Association of Women Surgeons, and been involved with the Rhode Island Free Clinic and numerous research studies. She will be applying into ophthalmology later this year. Conor Malone is a cataract surgery fellow who has trained in Ireland and the UK. He received his medical degree from the Royal College of Surgeons in Ireland, as well as masters degrees in health informatics from University College Dublin and the University of Limerick. Conor's research experience includes medical education and the application of technology in healthcare. He is interested in emergency ophthalmology and the prevention of eye injuries. Moe et al. "International Olympic Committee (IOC) consensus paper on sports-related ophthalmology issues in elite sports" - doi: 10.1136/bmjsem-2023-001644

Dr Ankur Kalra's guest this week is Dr Saraschandra Vallabhajosyula, Interventional and Critical Care Cardiologist, Assistant Professor of Medicine at the Warren Alpert Medical School of Brown University and the Director of the Cardiac Intensive Care Unit at Rhode Island Hospital, the Miriam Hospital and Lifespan Cardiovascular Institute. In this episode of Parallax, they delve into the latest insights from ACC.24 through the lens of five pivotal late-breaking trials. Dr Vallabhajosyula offers a deep dive into the nuances of each study. Together, Dr Kalra and Dr Vallabhajosyula distil the complexities of these trials into key messages for practice, grounded in their own clinical experiences. In the spotlight are five key trials: 1. DanGer Shock: Microaxial Flow Pump or Standard Care in Infarct-Related Cardiogenic Shock 2. RELIEVE-HF: Safety and effectiveness of the V-Wave® Ventura® Interatrial Shunt for the treatment of heart failure (HF) 3. PREVENT: Preventive PCI or medical therapy alone for vulnerable atherosclerotic coronary plaque 4. REDUCE AMI: Decreased usage of beta-blockers after acute myocardial infarction 5. ORBITA-COSMIC: Coronary sinus reducer for the treatment of refractory angina Dr Kalra and Dr Vallabhajosyula dissect the practical implications of these trials, answering pressing questions and addressing emerging dilemmas. What are the key takeaways from ACC.24? How do these findings shape contemporary clinical practice?

The cause of a nutritional neuropathy may not always be obvious when first examining a patient. Restrictive diets with roots in religious practices or personal preferences will be less familiar to neurologists than issues involving bariatric surgery or diseases of malabsorption, and can present as being not overtly malnourished. A recent review in JNNP details links between B-vitamin deficiencies and peripheral neuropathy, and discusses historical trends in the occurrence of nutritional neuropathies. The review's last author, Dr. Alexander Rossor (1), joins host Dr. Saima Chaudhry (2) to talk through how to approach this diagnosis.   Read the paper here: "Nutritional peripheral neuropathies"   (1) UCL Queen Square Institute of Neurology, London, UK (2) Warren Alpert Medical School, Brown University, Rhode Island, USA Please subscribe to the show on Apple Podcasts, Spotify or find it on your platform of choice. Your feedback and reviews are very appreciated. Follow JNNP on twitter: @JNNP_BMJ

The CDC recently released data showing that nationally, there has been a sharp rise in congenital syphilis. Cases have more than tripled in recent years in the US, with 3,700 cases reported in 2022 alone. Here in Rhode Island we've seen several cases of congenital syphilis after over a decade of having none.  What is causing this increase and what can be done to prevent it from happening? On this episode of Public Health Out Loud, Dr. Philip Chan is joined  Dr. Erica Hardy, Director for the Division of Infectious Disease at Women & Infants Hospital and Clinical Assistant Professor of Medicine, Obstetrics, and Gynecology at the Warren Alpert Medical School of Brown University to discuss the answers to these questions and more. 

While collectively uncommon, the clinical presentation of genetically-mediated spinal cord disorders frequently overlaps with other neurologic conditions. Our understanding of these disorders has grown considerably. In this episode, Kait Nevel, MD, speaks with Kara Stavros, MD, FAAN, author of the article “Genetic Myelopathies,” in the Continuum February 2024 Spinal Cord Disorders issue. Dr. Nevel is a Continuum® Audio interviewer and a neurologist and neuro-oncologist at Indiana University School of Medicine in Indianapolis, Indiana. Dr. Stavros is an associate professor of neurology and clinician educator at Warren Alpert Medical School of Brown University in Providence, Rhode Island. Additional Resources Read the article: Genetic Myelopathies Subscribe to Continuum: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @IUneurodocmom Guest: @StavrosKara Transcript  Full transcript available on Libsyn Dr Jones: This is Dr. Lyell Jones, Editor-in-Chief of Continuum, the premier topic-based neurology clinical review and CME journal, from the American Academy of Neurology. Thank you for joining us on Continuum Audio, a companion podcast of the journal. Continuum Audio features conversations with the guest editors and authors of Continuum, who are the leading experts in their fields. Subscribers to the Continuum journal can read the full article or listen to verbatim recordings of the article by clicking on the link in the show notes. Subscribers also have access to exclusive audio content not featured on the podcast. As an ad-free journal entirely supported by subscriptions, if you're not already a subscriber, we encourage you to become one. For more information on subscribing, please visit the link in the episode notes. AAN members, stay tuned after the episode to hear how you can get CME for listening. Dr Nevel: This is Dr Kait Nevel. Today, I'm interviewing Dr Kara Stavros on genetic myelopathies, which is part of the February 2024 Continuum issue on spinal cord disorders. Dr Stavros is an Associate Professor of Neurology and Clinician Educator at Warren Alpert Medical School at Brown University in Providence, Rhode Island. Welcome to the podcast. What is the biggest takeaway from your article that you'd like the neurologists listening to this to know? Dr Stavros: I would have to say that there's maybe two big takeaways that I would want to highlight. One would be that, generally speaking, in a nutshell, the genetic myelopathies can present with chronic and progressive symptoms, oftentimes (but not always) a family history of similar symptoms, and involvement of other structures outside of the spinal cord. Exclusion of the more treatable causes of myelopathy is a really key and important step in the diagnostic process. And because there are many different causes of genetic myelopathies, in some cases, the symptoms can overlap. I think this really underscores the utility of doing genetic testing to really confirm the precise underlying neurologic condition. The second takeaway that I would want to highlight is that, while treatment for most of these conditions is typically supportive, there have been a number of recent therapeutic breakthroughs for treatments in ALS, spinal muscular atrophy, adrenal myeloneuropathy, and Friedreich ataxia. While these aren't cures, it's really exciting and gratifying to see new therapeutics emerge via different mechanisms for patients with conditions that we've had very little treatment options for in the past. Dr Nevel: Yeah, I really enjoyed reading that in your article - about these treatments that have been coming out over the past several years. The one with Friedreich's ataxia, too - that looked like it was really just recently approved this year. Dr Stavros: Yes. Dr Nevel: And so, kind of jumping off of that topic - there have been these exciting treatments that have been coming through. What do you think is going to be the next big thing? Or what do you think is the next thing that might come through? Or what's going on in research in genetic myelopathies that might help our patients? Dr Stavros: That's a really great question. I think that, as far as the future in this area, genetic testing has definitely grown in terms of being able to identify more genes now that are implicated in these disorders than ever before. But this is still an area where our knowledge is continuing to evolve. So, I think the future holds further advancements in our ability to successfully diagnose patients who have these conditions and provide them with the sense of closure that having a definitive diagnosis brings, as well as opening the door to potentially targeted treatment options once a specific diagnosis is made. Another thing I think the future holds is continued development of expanded treatment options for patients with these conditions, both in terms of advancing our supportive care capabilities and then also providing more disease-modifying therapies. Again, as I mentioned, in recent years, new disease-modifying treatments have actually become available for several of these conditions. And I think that's just the beginning. There's going to be more to come, for sure. Dr. Nevel: Yeah, that would be great. Going back to the genetic testing and how things are - we're finding more and more and more genes. When you decide that genetic testing is indicated, how do you counsel your patients about genetic testing and walk them through that process? Dr Stavros: Okay - I would say that it usually starts with having a conversation with the patient about whether they want to pursue genetic testing or not for the particular condition or conditions that are suspected. Genetic testing is really helpful to, again, confirm the diagnosis once the initial diagnostic workup perhaps has given you some clues as to what the underlying condition might be. Again, because sometimes the clinical symptoms can overlap in different genetic myelopathies in particular, the genetic diagnosis can be really important as far as getting a definitive, final diagnosis. Usually testing is pretty carefully considered and the risks versus the benefits are explored with the patient. Oftentimes, this is done in conjunction with a genetic counselor or with genetics clinic. So, there's a lot of teamwork there in working with the genetics department, at least in my experience. There's a lot of options that might include testing a panel of genes for the suspected condition, to up to whole-exome sequencing. Again, this is really like an evolving landscape. So, we have a current understanding of the genes that are implicated in some of the genetic myelopathies, but there's still so much that we don't know. So, a lot of times, testing can result inconclusive or may be falsely negative, and it can be tough because a negative test doesn't necessarily exclude a potential genetic etiology. It becomes a very nuanced, I think, conversation and journey with the patient. Dr Nevel: Yeah, and in your article you mentioned some of the health care disparities that exist around genetic testing and access to genetic testing, specifically. How do we, as clinicians, try to mitigate inequities in regard to access, or in regards to being able to offer our patients genetic testing - is there anything that we can do? Dr Stavros: I do think there are some resources available, where free or sponsored testing can be utilized from nonprofit organizations or pharmaceutical companies. But you're right that this is a real area for potential health care disparities. And making sure that we have equitable access to genetic testing is really important. Some of the issues that come up are: limited access due to location; due to socioeconomic factors; a lack of awareness on the part of the patient or sometimes the provider about testing that's available; cost, of course, being a big issue, oftentimes; and sometimes, distrust of how the medical information, the genetic information, might be used or protected. Dr Nevel: What do you think is one of the most challenging things about managing patients with genetic myelopathies? Dr Stavros: I think one of the more challenging aspects of the care is the diagnostic journey. I think that some of these conditions - most of them are not terribly common – and they may not always be at the top of our differential diagnosis in the course of a workup for myelopathy. The first step, I think, is really continuing to be aware of these conditions and not letting them become a “blind spot” when we're formulating a differential diagnosis for a patient with myelopathic symptoms. I think it can really take some time to reach the ultimate diagnosis for most of these conditions. Another challenging aspect, which I alluded to earlier, is sometimes when genetic testing might come back inconclusive or nonrevealing, and there remains some diagnostic uncertainty despite best efforts and a thorough workup -that can be frustrating as well, sometimes. Again, our knowledge of these genetics and the genetic mutations underlying these disorders is still really evolving. But on the flip side, there's a lot of rewarding aspects as well. I think one of the most rewarding aspects is trying to help patients identify interventions that improve their quality of life, and working with the patients and their families (who oftentimes become very expert in their own rare conditions in their own right), and working amongst the interdisciplinary teams. So many of these conditions are associated with extraneurologic manifestations, and so patients need coordination of care with other specialists. Hereditary spastic paraplegia is a great example, as well as Friedreich ataxia, where you often work closely with the cardiologist and of course, ALS, where there are a lot of multidisciplinary needs. Dr Nevel: Yeah, I'm so glad that you mentioned that because, in neurology in general (and specifically in this area), I can imagine the benefit to patients when there are multiple specialists involved in their care who are experts in the various aspects that are impacted from their underlying condition. Shifting gears a little bit - but going back to something that you've mentioned a few times, about making sure that we don't have a blind spot to genetic myelopathies, and that we consider this in part of our differential diagnosis when we're evaluating patients - in the patient who doesn't have an extensive family history of the exact same neurological symptoms, when should we consider genetic testing for patients that we're seeing in clinic? Like, at what point should we say, “Okay, we've done the other tests and now is the time to consider genetic testing.” Because I think, unless somebody has that really strong family history, it's probably not on the top of your list to do it right away, for a variety of reasons. Dr Stavros: I think you make a great point. Family history is tricky because, typically, we use that as a really strong clue of an inherited disorder of any type. But it can be tricky because, for a variety of reasons, it might be negative. Sometimes there is a de novo mutation, or there's variable phenotypes within the family, variable penetrance within the same family. Autosomal recessive inheritance can actually be, sometimes, hard to pick out. Or sometimes, patients don't have knowledge of their family members' medical histories. For all of these reasons, there may be information lacking in the family history. But I would say one of the most important things to exclude when you're working up patients initially is, of course, acquired causes of myelopathy, because you wouldn't want to miss a more treatable cause. And so, things like structural causes, nutritional, vascular or demyelinating causes (things that are explored more deeply in some of the other articles in this issue) are important. But if you've excluded acquired causes despite lacking a strong family history, I think, at that point, it's worth broadening your differential diagnosis to consider whether you might have reason to suspect a genetic myelopathy, particularly if you have some extraneurologic manifestations, some systemic symptoms that might be a clue towards a more systemic process. In genetic myelopathy, sometimes imaging can actually be quite helpful. It helps you exclude - MRI of the spine can help you exclude acquired causes, but it also helps you sometimes get clues toward a genetic cause. Typically, the finding might be either normal or show some spinal cord atrophy (but typically without signal change, so that can sometimes be a clue). Dr Nevel: What's one mistake that is made in managing patients with genetic myelopathies? Maybe “mistake” is too strong a word; maybe “misconception” about treating patients with genetic myelopathies. Dr Stavros: That's a great question. I think that one of the, maybe, misconceptions might be that these are homogeneous entities, these different diseases. But one of the things that surprised me anew in going back to research this topic and prepare this article was a reminder of just how variable both the genotypes and the phenotypes are within what we consider sometimes just one diagnosis, like hereditary spastic paraplegia, for example, spinocerebellar ataxia. There's so many different presentations and genotypes associated with these. It's really a family of different conditions. You could say the same thing about ALS as well. So, the spectrum of disease, I think, is important to recognize. Dr Nevel: Yeah, and I can imagine because of that spectrum of disease, just having an open mind in considering genetic testing and not excluding a potential genetic cause because it doesn't fit into what we think is the most typical presentation of that genetic condition. Dr Stavros: Yes - I'm in total agreement. Dr Nevel: I've asked you about what some of the misconceptions are and what some of the challenges are, but what's the most rewarding part about taking care of patients with genetic myelopathies for you? Dr Stavros: I think one of the most rewarding parts has to be working with the patients and the families. Like I mentioned earlier, sometimes they become so expert in their own conditions - it's amazing. And, working with them, working with the interdisciplinary teams, is a really rewarding process. I think that the more I've encountered patients with some of these rare conditions, the more I've learned from their stories and experiences, and so, that's, I think, been the most rewarding aspect to me. Dr Nevel: You've mentioned the multidisciplinary team a couple of times that we've talked about this, but who specifically do you usually include or contributes to the care of these patients? Dr Stavros: It may depend on the condition in question. So, for example, for Friedreich ataxia, there's always going to be a cardiologist involved in the patient's care. For ALS, there's going to be a larger team. For those who are familiar with ALS multidisciplinary clinics, this often includes physical therapy, speech therapy, nursing, pulmonary, and many others. And so, it really depends. I think in most cases though, genetics evaluation and genetic counseling is a really important piece. Dr Nevel: How do you work with the genetic counselors in counseling families about testing other family members? Because that's something that's really challenging in genetic conditions, especially for people with children that may be underage, and this is a really complicated topic. But how do you approach that? Dr Stavros: I think that it may depend on your particular institution. Where I'm at, typically, that's something that our genetics department will take the lead on and they will meet with the patient first and then also meet with and bring in any interested family members who are hoping to pursue the possibility of testing themselves. There's a bit of controversy or differing opinions around genetic testing, specifically for presymptomatic individuals for inherited ALS, because - certainly, there's pros and cons for being tested for any condition, but some special considerations come into play when someone is presymptomatic. There's actually been studies done, in particular, on patients who have a family history of ALS who are presymptomatic, and generally, the studies have shown that those patients are usually - the majority - in favor of being tested. But it does certainly bring up some ethical implications. Of course, any discussion is going to be undertaken with the goal of informing the patient and discussing the risks versus the benefits in detail. There's actually recommendations on the principles and the practice of presymptomatic testing for ALS, which is available and referenced in the article. Dr Nevel: Do you think as - hopefully, in the future, as more treatments become available - that presymptomatic genetic testing could play a role in how we manage patients? Dr Stavros: I think that's a great thought. I think it may, especially as more treatments become available, I think there may be a greater interest in demand for finding out early whether you might have a likelihood of developing a certain condition so that you can plan accordingly and perhaps even pursue treatments early on. Dr Nevel: You know, you mentioned this (and this isn't maybe quite exactly the same thing), but in SMA - you mentioned newborn screening for SMA and new treatment for SMA, and that newborn screening is not always a standard, and that there's controversy around that, now that we have treatment for it. Dr Stavros: Yes. That's another area where some controversy comes up as well, as far as cost and treatment, for sure. Dr Nevel: Thank you, Dr Stavros, for joining me on Continuum Audio. Again, today we've been interviewing Dr Kara Stavros, whose article on genetic myelopathies appears in the most recent issue of Continuum on spinal cord disorders. Be sure to check out Continuum Audio podcasts from this and other issues. And thank you to our listeners for joining today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, please consider subscribing to the journal. There's a link in the episode notes. We'd also appreciate you following the podcast and rating or reviewing it. AAN members, go to the link in the episode notes and complete the evaluation to get CME for this episode. Thank you for listening to Continuum Audio.

How often do movement disorder specialists agree when classifying tics? A recent study published in JNNP explores this question with a two-stage approach, seeking a diagnosis from experts first based on video evidence alone and then following the provision of additional clinical data. The study's last author, Dr. Christos Ganos (1), joins host Dr. Saima Chaudhry (2) to discuss the results.   Read the paper here: "Distinguishing functional from primary tics: a study of expert video assessments"    Related links: European Society for the Study of Tourette Syndrome 2022 criteria for clinical diagnosis of functional tic-like behaviours: International consensus from experts in tic disorders https://onlinelibrary.wiley.com/doi/10.1111/ene.15672   Tics and functional tic-like movements: can we tell them apart? https://www.neurology.org/doi/10.1212/WNL.0000000000008372    (1) Department of Neurology (C.G.), Charité University Medicine Berlin, Germany (2) Warren Alpert Medical School, Brown University, Rhode Island, USA Please subscribe to the show on Apple Podcasts, Spotify or find it on your platform of choice. Your feedback and reviews are very appreciated. Follow JNNP on twitter: @JNNP_BMJ

CME credits: 0.75 Valid until: 15-06-2024 Claim your CME credit at https://reachmd.com/programs/cme/the-gut-microbiome-an-evidence-based-approach-to-managing-recurrent-c-difficile-infection/16391/ Explore this series of three modules on C difficile infection and the impact of gut dysbiosis on the development of recurrent disease with Dr. Colleen Kelly, Associate Professor of Medicine in the Division of Gastroenterology at Warren Alpert Medical School of Brown University in Providence, Rhode Island, and Andrea Banty, Nurse Practitioner of Gastroenterology at Cedars-Sinai IBD Center in Los Angeles.=

Dr. Colleen Jackson discusses cognitive testing in a way that makes it easily understandable, alleviating any apprehension associated with the assessment. She starts by distinguishing between neuropsychological testing and cognitive assessments. Colleen shares insights into her approach and describes the valuable information that can be obtained from the testing process. Emphasizing a holistic perspective, she looks at an individual's overall health and well-being when giving her recommendations. Listeners will learn about cognitive assessments and neuropsychological testing to determine whether they might benefit a loved one.   IN THIS EPISODE:   [2:11] Colleen begins by describing the difference between neuropsychological testing and cognitive assessments [4:17] Colleen explains what the tests look like from a client perspective and what is involved [7:36] Colleen talks about how a family member can encourage a loved one to seek a provider and what is learned through the testing [12:06] Colleen discusses older adults, specifically  [16:06] Colleen refers to different treatment protocols based on test results [20:25] Colleen ends by discussing other illnesses that can impact mental health or cognitive impairment   KEY TAKEAWAYS:   [2:01] There is a difference between neuropsychological testing and cognitive assessment [7:27] There are some tips that family members can use to encourage a person to seek a provider [11:44] You can identify different conditions or illnesses through testing.   RESOURCES:   Beyond the Balance Sheet Website Dr. Colleen Jackson - LinkedIn   BIOGRAPHY:  Dr. Colleen Jackson received her doctorate in clinical psychology from the University of Connecticut. She pursued a clinical internship in clinical neuropsychology and dementia clinical research at Rhode Island Hospital through the Warren Alpert Medical School of Brown University, followed by research postdoctoral fellowships in the National Center for PTSD and the Translational Research Center for TBI and Stress Disorders at the VA Boston Healthcare System. After completing postdoctoral training, Colleen assumed a staff neuropsychologist position at the VA Boston Healthcare System, where she was involved in direct clinical care, clinical supervision/mentorship, and research. Colleen served as the Chief of the Neuropsychology Clinic in the Department of Neurology at Boston Medical Center prior to establishing her private practice in 2022. Colleen conducts clinical neuropsychological evaluations with adults presenting with cognitive concerns associated with neurodevelopmental disorders, neurodegenerative conditions, acquired brain injuries, substance use, and psychiatric conditions. Colleen approaches clinical care with a tailored focus on the client's cognitive and psychological needs, individual strengths, and personal values.  

Overdose prevention sites—places where people can use illicit drugs under supervision—are extremely controversial and many cities are opposed to them because of the belief that they'll invite disorder and crime to the communities where they're operating. Dr. Brandon del Pozo, assistant professor of medicine at the Warren Alpert Medical School at Brown, talks with Dr. Josh Sharfstein about a new study that put this question to the test and what they observed in the areas around two OPCs in New York City. Read the JAMA paper here: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2811766 

For the third installment of our mini-series exploring systemic bias and racism in healthcare, our panel of experts discuss various examples which illustrate how systemic racism is embedded in systems of healthcare and social determinants of health. These include measurements such as eGFR, BMI, and metabolic panels, scoring for post-operative risk; lack of diversity in dermatology textbooks; and how subjective information that is potentially deleterious to patients may be captured in EMR systems such as EPIC.  Episode host Christin Zollicoffer (she/her pronouns) serves as Chief Belonging and Equity Officer with Lifespan Health System, an academic medical center affiliated with Brown University and Warren Alpert Medical School. Dr. Carla Harwell is a nationally recognized leader in health care disparities education and medical issues affecting minorities. She is Medical Director, University Hospitals Otis Moss Jr. Health Center, and Associate Professor of Medicine, CWRU School of Medicine, Division of Internal Medicine.  Dr. Daniel Wiznia is Assistant Professor of Orthopaedics and Rehabilitation, Yale University School of Medicine. He is the co-director of Yale's master's program in Personalized Medicine & Applied Engineering.   © Movement is Life 2023

This recording features audio versions of November 2023 Journal of Vascular and Interventional Radiology (JVIR) abstracts:Added Value of Cone-Beam CT to Identify Arterial Supply during Genicular Artery Embolization for Knee Osteoarthritis ReadDirect Thrombectomy versus Bridging Thrombectomy within 6 Hours of Stroke Onset: A Prospective Cohort Study on Cognitive and Physical Function Outcomes ReadOutcomes following Exchange and Upsizing of Malfunctioning Small-Caliber Double-J Ureteral Stents ReadIntraoperative Multivessel Embolization Reduces Blood Loss and Transfusion Requirements Compared to Internal Iliac Artery Balloon Placement during Cesarean Hysterectomy for Placenta Accreta Spectrum ReadProphylactic Uterine Artery Embolization in Placenta Accreta Spectrum—An Active Intervention to Reduce Morbidity and Promote Uterine Preservation ReadMidterm Outcomes of Primary and Secondary Use of an Endoanchor System for Thoracic and Abdominal Aortic Endovascular Aortic Repair ReadOff-Label Use of the 8-F Angio-Seal for Closure of Greater than 8-F Common Femoral Arterial Access: A Systematic Review and Meta-Analysis ReadA Comparison of Histotripsy and Percutaneous Cryoablation in a Chronic Healthy Swine Kidney Model ReadJVIR and SIR thank all those who helped record this episode:Host:Rommell Noche, Frank H. Netter MD School of Medicine at Quinnipiac University, ConnecticutAudio editor: Siddhi Hegde, MBBS, Massachusetts General Hospital Abstract readers:Jeremy Brown, DO, MS, Kaweah Health Medical Center, CaliforniaIsabelle Barbosa, Frank H. Netter MD School of Medicine at Quinnipiac University, ConnecticutNicole Jisoo Kim, The Warren Alpert Medical School of Brown University, Rhode IslandJustin Cook, University of Central Florida College of MedicineSiddharth Venkatraman, Johns Hopkins University School of Medicine, MarylandChirag Divecha, MS, Chicago Medical School at Rosalind Franklin University of Medicine and Science, IllinoisEmily Barr, MBA, Burrell College of Osteopathic Medicine at New Mexico State UniversityColin Standifird, Kirk Kerkorian School of Medicine at University of Nevada, Las Vegas©  Society of Interventional RadiologySupport the show

The brain and its vasculature used to be considered separate domains. But in the last decade, we've learned more about the interplay between brain cells and vascular cells. Pathological studies are revealing a surprising degree of overlap between cerebrovascular disease and neurodegenerative disease. All of this has led to the coining of a new word: the neurovasculome. Our guest today is Dr. Eric Smith, an author of a recent scientific statement about the neurovasculome in the journal Stroke. Dr. Smith is a Professor of Neurology, Radiology, and Community Health Sciences at the University of Calgary, and the holder of the endowed Katthy Taylor Chair in Vascular Dementia. He was interviewed about the neurovasculome by Dr. Christoph Stretz, a Vascular and Critical Care neurologist at the Warren Alpert Medical School of Brown University. Series 5, Episode 1 Featuring: Guest: Eric Edward Smith, MD, MPH, FRCPC, FAHA, University of Calgary Interviewer: Christoph Stretz, MD, Brown University Disclosures: Dr. Smith disclosed that he receives personal consulting fees from Alnylam Pharmaceuticals and Eli Lilly

On this week's 95.9 Company Break, we talked with Dr. Valentin Antoci of University Orthopedics at Newport Hospital. Dr. Antoci is a Fellowship Trained Orthopaedic Surgeon with a focus on Adult Reconstruction, Hip and Knee Joint Replacement Surgery, and a particular interest in unicompartmental partial knee replacement, minimally invasive surgery, complex reconstructions, failed total joints, preservation techniques, and trauma. University Orthopedics includes over 40 board-certified, fellowship-trained musculoskeletal and sports medicine physicians. These specialists are faculty members of the Department of Orthopaedics at the Warren Alpert Medical School of Brown University who teach medical students, orthopedic residents, and fellowship subspecialty surgeons. University Orthopedics leads the way with Basic and Clinical orthopedic research on the latest advances in orthopedic surgery and injury prevention. For more information, visit universityorthopedics.com

Listen-in as 2 doctors talk about myths, magic, the practice of medicine and everything in between. This season all the guests are immigrant doctors who were fully-qualified doctors when they came to the US for postgraduate training and now established in their careers here in the USAThis episode I had a long chat with Dr. Nadia Mujahid, originally from Pakistan, she is an Associate Professor of Medicine, in the Division of Geriatrics at the Warren Alpert Medical School of Brown University. She practices geriatrics in inpatient and nursing home settings and teaches geriatric medicine fellows in training. She and her family love spending time outdoors doing hiking and biking in beautiful Rhode Island. She discovered and fell in love with coaching two years ago and is a certified life coach through the Life Coach School. She can be reached at the following email for a free 30 minute session, nadiamujahidmd@gmail.com. If you are a healthcare professional yourself and find an episode relevant to your own work you will be able to apply for free CME credit (reciprocal CPD for non- US clinicians) here Not a medical professional? Of course, you are also welcome to subscribe and listen but please remember, while we are physicians, we are not YOUR physicians. Please consult with your own medical professional before acting on anything you hear on this, or any other, podcast. Please contact me at: office@aahypnosis.com with any comments or suggestions

With the UK government announcing plans to make recreational use of nitrous oxide illegal, JNNP podcast host Dr. Saima Chaudhry (1) is joined by London-based neurologist Dr. Alastair Noyce (2)(3) to examine the findings of his group's recently published research paper, "Nitrous oxide-induced myeloneuropathy: a case series". Read the paper here: https://jnnp.bmj.com/content/94/9/681 Related links: https://www.gov.uk/government/news/nitrous-oxide-to-be-illegal-by-end-of-the-year (1) Warren Alpert Medical School, Brown University, Rhode Island, USA (2) Barts Health NHS Trust, London, UK (3) Preventive Neurology Unit, Centre for Prevention, Diagnosis and Detection, Faculty of Medicine and Dentistry, Queen Mary University of London, Wolfson Institute of Population Health, London, UK Please subscribe to the show on Apple Podcasts, Spotify or find it on your platform of choice. Your feedback and reviews are very appreciated. Follow JNNP on twitter: @JNNP_BMJ

In this episode we speak to Dr Michael Bernstein who is an Experimental Psychologist and Assistant Professor in the Department of Diagnostic imaging at Warren Alpert Medical School, Brown University, USA. Along with team at the Brown Radiology Human Factors Lab, he conducted a fascinating study that reveals how radiologists have a tendency to follow AI prompts, even when they are incorrect. We discuss the implications of this for patient care as clinical AI adoption increases, and what can be done to mitigate this phenomenon. Check out the full study here: https://link.springer.com/article/10.1007/s00330-023-09747-1

The Assessment of Implementation of Methods in Sepsis and Respiratory Failure (AIMS) Study seeks to determine the safest and most effective approach to sepsis intervention using the evidence-based Surviving Sepsis Campaign guidelines. Marylin N. Bulloch, PharmD, BCPS, FCCM, was joined by Mitchell M. Levy, MD, MCCM, at the 2023 Critical Care Congress to discuss the goal of the AIMS Study and the elements of both the Hour-1 and 3-Hour bundles. Dr. Levy is chief of the Division of Critical Care, Pulmonary, and Sleep Medicine and professor of medicine at the Warren Alpert Medical School of Brown University. He is also the medical director of the medical ICU at Rhode Island Hospital in Providence, Rhode Island, USA.

In 2021, Dr. Sandra Musial gave up a private practice and teaching career to go ALL-IN with what she loves most - helping people transition to a whole food, plant-based lifestyle.She and other plant-based physicians started Plant Docs Providence to provide classes, education, and consultations to the public and medical professionals about how whole food, plant-based nutrition can prevent, improve, and reverse chronic diseases such as type 2 diabetes, obesity, heart disease, and certain cancers.Today, she and Rip discuss:Her Ukrainian roots and why she wanted to pursue medicineWhy she become a pediatrician to work with childrenWhat or who inspired Sandy to pursue plant-based nutritionThe rewards and challenges of working with children and their fammiliesThe dedication and outcomes of starting an obesity clinic and a food garden at Hasbro Children's HospitalWhen she knew it was time to go all-in on plant-based nutrition educationHow Plant Docs found a home at Plant City in Providence, Rhode IslandUpcoming programs at Plant CityThis career transition hasn't come without risk, but when you pursue what you believe, the risk also comes with high-reward when you KNOW you're making a difference in the lives of motivated people. Sandra Musial, MD is a physician specializing in food as medicine who is dedicated to preserving health and reversing lifestyle-related chronic disease through whole, plant-based nutrition. Sandy earned a BS degree in Nutritional Sciences from the University of New Hampshire, and an MD degree from the University of Massachusetts Medical School. She has worked in a private pediatric practice and at Hasbro Children's Hospital teaching the pediatric residents and medical students from the Warren Alpert Medical School of Brown University. She is a Culinary Coach from Harvard's CHEF Coaching program, has a certificate in Plant Based Nutrition from eCornell, and a Health Coaching certificate from the Institute for Integrative Nutrition®. Sandy is board certified in Pediatrics and Obesity Medicine and started an obesity clinic and the first vegetable garden at Hasbro. Though she has witnessed the healing power of conventional medicine, she has also seen its limitations, especially with regard to disease prevention through healthy nutrition. Sandy started the nonprofit Plant Docs as an avenue for people to learn about the power of plant-based nutrition to improve health.https://plantstrongfoods.com/ https://plantstrongfoods.com/pages/2023-sedona-retreat https://plantstrongfoods.com/pages/plant-stock-landing-page-2023 https://www.facebook.com/GoPlantstrong https://www.instagram.com/goplantstrong/https://home.mealplanner.plantstrong.com/ https://app.soundstripe.com/songs/10845 Episode Webpage www.plantstrongpodcast.com/blog/sandra-musial-md Plant City WebsitePlant Docs PVD | Best Nutritionists in Rhode Island - Learn more about their upcoming "Jumpstart Your Health" programs

Social media platforms and clinical patient encounters are abundant in references to brain fog, but how much is it really understood? In this episode, JNNP's podcast host, Dr. Saima Chaudhry (1), speaks with Dr. Laura McWhirter (2) about her recently published article, "What is Brain Fog?"and how further understanding of this can help to better treat patients.  You can read the paper at the following link: https://jnnp.bmj.com/content/94/4/321  (1) Warren Alpert Medical School, Brown University, Rhode Island, USA (2) Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK   Please subscribe to the show on Apple Podcasts, Spotify or find it on your platform of choice. Your feedback and reviews are very appreciated. Follow JNNP on twitter: @JNNP_BMJ

This recording features audio versions of August 2023 Journal of Vascular and Interventional Radiology (JVIR) abstracts:Percutaneous Cryoablation of Plasmacytomas: Oncologic Effectiveness and Adverse Events ReadThe Effect of Endovascular Treatment of Renal Artery Stenoses on Coexistent Aneurysms Associated with Fibromuscular Dysplasia ReadChange in Platelet Count after Transjugular Intrahepatic Portosystemic Shunt Creation: An Advancing Liver Therapeutic Approaches (ALTA) Group Study ReadTransjugular Intrahepatic Portosystemic Shunt and Thrombectomy (TIPS-Thrombectomy) for Symptomatic Acute Noncirrhotic Portal Vein Thrombosis ReadComparison between Suprapapillary and Transpapillary Uncovered Self-Expandable Metallic Stent Placement for Perihilar Cholangiocarcinoma ReadSafety and Effectiveness of Expandable Intravertebral Implant Use for Thoracolumbar Burst Fractures ReadJVIR and SIR thank all those who helped record this episode:Host:Rommell Noche, Frank H. Netter MD School of Medicine at Quinnipiac University, ConnecticutAudio editor:Siddhi Hegde, MBBS, Massachusetts General Hospital Abstract readers:Colin Standifird, Kirk Kerkorian School of Medicine at University of Nevada, Las Vegas Khaleel Quasem, Michigan State University College of Human Medicine Ronnie Festok, Emory University School of Medicine, Georgia Jeremy Brown, DO, MS, Kaweah Health Medical Center, California Nicole Jisoo Kim, The Warren Alpert Medical School of Brown University, Rhode Island Jonathan Dzielski, Kansas City University, Missouri  ©  Society of Interventional RadiologySupport the show

In this episode, host Dr. Christopher Beck interviews Dr. Peter Soukas about his algorithm for below the knee (BTK) critical limb ischemia (CLI) interventions as well as his implementation of new evidence-based guidance. --- CHECK OUT OUR SPONSOR Medtronic HawkOne Directional Atherectomy System https://www.medtronic.com/hawkone --- SHOW NOTES Dr. Soukas serves as the director of vascular medicine, the interventional peripheral vascular lab, and the endovascular medicine fellowship at Brown University in Providence, RI. In addition, he holds the position of associate professor of medicine at The Warren Alpert Medical School at Brown University. Dr. Soukas began his career as an interventional cardiologist. Over the course of his 13-year tenure in Providence, he has dedicated his career to the treatment of CLI and BTK disease. Prior to any interventional work, Dr. Soukas follows a comprehensive work-up including an ankle-brachial index (ABI), arterial duplex, and evaluating kidney function for safe administration of contrast. For a majority of cases, he uses the common femoral artery as the access point, but prefers to prep multiple access sites in the event of needing both anterograde and retrograde, or pedal, access. He discusses the use of the chronic total occlusion crossing approach based on plaque cap morphology (CTOP) classification on angiogram in determining the need for a retrograde approach. The type I morphology is characterized by the convexity of the plaque pointing away and is often treated successfully by an anterograde approach alone, as CTOP types II, III, and IV benefited from the addition of retrograde tibiopedal access. Once access is gained and the plaque morphology is evaluated using angiography, it becomes crucial to address any issues with the inflow to the affected vessel. This step ensures proper blood flow and provides a stable foundation for further interventions. Intravascular ultrasound is then used to assess the size and extent of the plaque, and then depending on the amount of calcification, either intravascular lithotripsy or calcium modifying technology can be used. Scoring balloons with low pressure may also be used for vessels that are moderately calcified and have been shown to have low rates of recoil and dissection. The main initiative of the procedure is to provide blood flow to the target angiosome which is dependent on the location of the wound. During his last remarks, Dr. Soukas comments on the future of BTK interventions, including Paclitaxel vs Sirolimus eluting stents, the use of self-expanding stents, and LimFlow, a minimally invasive technology that creates a channel between an artery and vein allowing the vein to provide blood flow to the foot. With the increasing prevalence of critical limb-threatening ischemia (CLTI) and high 12-month mortality rates in patients with amputations, Dr. Soukas ends the discussion by emphasizing how revascularization should be the preferred initial approach in treating CLTI due to the potential benefits it offers in terms of limb preservation and mortality reduction, urging practitioners to educate patients in being aggressive in their care. --- RESOURCES CTOP article: https://evtoday.com/articles/2018-may/using-plaque-cap-morphology-to-determine-cto-crossing-approach Disrupt PAD III Observational study: https://pubmed.ncbi.nlm.nih.gov/34380334/ PRELUDE BTK Study: https://pubmed.ncbi.nlm.nih.gov/34802313/ Intravascular Ultrasound study: https://www.jacc.org/doi/10.1016/j.jcin.2022.01.001 Intravascular US in Medicare Beneficiaries: https://pubmed.ncbi.nlm.nih.gov/35998803/ PROMISE II study: https://limflow.com/us/clinical-evidence/promise-ii-study-results/

In this episode, KJK Student Defense attorneys Susan Stone and Kristina Supler talk with Dr. Michelle Fourcier, a Professor of Pediatrics, Assistant Dean of Medicine at The Warren Alpert Medical School of Brown University.  Dr. Forcier specializes in gender, sexual and reproductive health.  In this episode, they talk about what all the terms of LGBTQ+ mean, how pediatricians work with both parents and children about gender identity, and resources for parents to learn more about this complicated issue. Links: PubMed Website Show Notes: (04:12) Understanding the Gender Terminology within LGBTQ+ (06:59)  How Does Type of Care Different from Heteronormative (09:27)  Assigned Gender versus Gender Identity: What is the Difference? (12:16)  Is the Child Just Playing With Identities?  Or Do We Need to Act? (15:02)  When Does a Physician Decide if Hormones are Required? (16:44)  Do We Want Puberty in Children to Happen Later? (18:11)  How Pediatricians Work With Children to Keep Them Safe (19:15)  What are the Side Effects of Hormones? (20:52)  Blockers: What Do They Do? (22:43)  Conversations with Parents Who Are Not on Board with Hormones or Blockers (24:45)  When Do Children Go Through Surgery? (25:32)  When Surgery for Minors may be Necessary (27:46)  What are LARCs?  How Do They Prevent STIs? (30:36)  Dual Method for Birth Control and STI prevention (31:46)  Consider This Thought If Your 14 Year Old Child is Sexually Active (34:19)  Resources for Parents to Learn More Transcript: Susan Stone: So everybody out there listening to this podcast know that my, this is Susan and my daughter got married this weekend, and I'm a little tired.  But  Kristina Supler: though you think everyone knows that. Everyone doesn't actually know that.  Susan Stone: I know, but I felt the need. This is Real Talk guys out there on listening land. I am exhausted. But I had to come into work today cuz they knew that we had, the books, the recording of this podcast. And we're gonna talk about pediatric health for the L G P. Lg, I told you I'm tired. BTQ Plus community and I, Kristina, I just wanna have a conversation about the health needs and not a political conversation.  Kristina Supler: Yeah. I'm really looking forward to today's episode because I think there's so muchto talk about and learn to have more real conversations about the issues versus some of the politicized language that has pushed people into corners and people have in many ways shut down and are not open to learning new information. Susan Stone: and I think we're just forgetting that we're still talking about kids. So why don't you kick off the guest so we can just launch in and talk about whatever the health needs are of the kids and guys, let's leave the politics out. Okay? For once.  Kristina Supler: Today we are really happy to be joined by Dr. Michelle Fourier, who is an associate professor of pediatrics and an assistant dean at the medical school at Brown University. And with extensive training and experience in adolescent health and sexual healthcare, she's dedicated her career to addressing the unique needs of the LGBTQ plus youth.  Susan Stone: That is the guest we needed for today's podcast, a Doctor.  Perfect.  Dr. Michelle Forcier: So let's jump in.  Susan Stone: Let's just jump in. Dr. Fourier, can you explain exactly what you do for that population? Dr. Michelle Forcier: I have been a pediatrician for about 25 plus years. And I've been providing gender, sex and reproductive justice care, basically across the lifespanfor this period of time. And it's been a pretty exciting, community, pretty wonderful and satisfying community to work for and to work with. And the way I look at providing care for the L G B T Q community is that it really is primary care. Basically gender and sexuality are part of human identity. And they're there before we leave the womb. There's a neat study about in utero masturbation, which is kind of cool. So we get started early and we are gendered and sexual persons, until we die. So if we look at gender and sexuality as being a ubiquitous part of the human experience, and we look at biology as absolutely diversity is a part of biology. It's one of the basic tenets of biology. Then we understand that both sex and gender are gonna be diverse experiences for a range of different people and folks. And my role has been to provide care for some of our most marginalized community members, which is the L B G T Q I A plus. Sometimes it's easier just to say rainbow population. I like that.  Kristina Supler: Before we dive in further, just to get some terminology nailed down for our listeners who maybe aren't as familiar. you've spoken about gender and sex and we're referencing the plus, but can you just define those terms for our listeners, particularly the plus as well? Dr. Michelle Forcier: Sure. For many gender has been considered in this very binary, traditional way of male, female. Or heterosexual and homosexual. Sexuality is about who we love and who we're attracted to and who we have different sexual behaviors with. Gender is who we are. It's a part of our identity in terms of being masculine, feminine, non-binary and all the other ways that we could express, a gendered self. And the world for many years has been pretty limited in terms of only discussing these binary identities. I think with time, with improved social discourse, with the advent of the internet and increasing knowledge spread in, in diverse ways and diverse communities, we understand that there are many, many ways to be sexual and many ways to be gendered. So the L stands for lesbian, which are persons, we might say women who are attracted to or have sex with women. Gay usually is referenced to either, males or females who are attracted to the same gender partner, bisexual, historically has been the term for people who identify as being attracted to both males and females. But now we have even more inclusive terms, which are things like pansexual, which means gender doesn't factor into who I'm attracted to. Transgender or gender diverse are persons whose gender identity doesn't exactly match the gender they were assigned by their parts, chromosomes or hormones and birth. I is another. Initial for intersex or persons who have differences, in sexual development in the parts and organs they were born with. And A can mean asexual or persons who really don't have a sexual affinity or an interest in, sexual activity.  allied, And the plus means there are probably a million different ways, and we know there are a million different ways people may identify in terms of how they see themselves as a gendered person and their gender expression and gender role and gender self in the world, as well as their sexual, um, attraction, their sexual behaviors and their sexual identity in the world. Susan Stone: That's a lot. That's a lot. But here's messy. Something that comes into my mind, because you are a pediatrician. How do those differences make a difference in terms of just treatment for well visits? What is, what type of care is specific and unique to that population as opposed to what I would call a heteronormative child. Dr. Michelle Forcier: Sure. to be honest, in any visit, and again whether it's children or whether it's adults, we should be talking about these aspects of selfhood and behavior and health needs across the lifespan. Of course, we should do it in a developmentally appropriate way. So if we're gonna talk to a six year old about their gender identity, we might ask them, they're like, what is it like to be a boy or a girl? How does that feel to you? How do you express boyness? How do you express girlness, For a 16 year old, that may have very different words in terms of, how do you view your gender identity? What parts of it are comfortable for you, what parts are not comfortable? Do you have any questions? Again, the same with sexuality. Who might you have a crush on versus, a full sexual history forlater teen or young adult who's sexually active with one or more partners. So it's all about, again, using the language of the patient and understanding where they are developmentally to continue to talk about these aspects of both selfhood and wellness during health visits. Susan Stone: Well, I guess I wanna press you on that because I'm a mother of three. And I would say for the first 14 years of, checkups. It's, you know, height, weight, weight, vaccinations,  Kristina Supler: poking and prodding,  Susan Stone: poking and prodding, talking about school and milestones. We really,  Kristina Supler: or at least that was your experience with your child's children's pediatrician. Susan Stone: Yeah, but I just don't rem I don't think conversations regarding sex came into play until when the making a decision about the H P V vaccine or maybe when does menstruation start for that being the end of growth? I guess that's what I'm confused. Or birth control when that comes in. But other than that, I think of, how big is the baby? Dr. Michelle Forcier: And I'm thrilled that you ask about this. Because what I'm proposing is a slightly more advanced model of care in the sense that, again, if we know that there is gender diversity in the world and some youth present as gender diverse, gender exploratory as early as four, five, and six. Shouldn't we be talking to parents about, say again, educating people? Your child who is assigned male or female at birth. But we don't know what their gender identity may be later down the line. And that's the one or two sentences that a pediatrician can have with a parent to, again, describe and educate the difference between an assigned gender at birth and the fact that potentially two or three of probably more percent of the population of young people are going to be, or exploring gender, or at least talking about it over time. Then when we know that many youth undergo puberty and it's considered normal. As early as seven or eight year old, you can start having breast buds. By age seven or eight, it's considered within the normal range. You can be having a period by the age of 10. So if you're waiting for the magic number of teen years, 13, you've missed a whole bunch of folks that have already started many and of the stages of puberty and actually maybe completely, adult in their hormones and progressing toward adulthood very quickly in terms of their bodies.  So by waiting till kids are teens until quote unquote, they're ready to be sexual or ready to go through the process of puberty, we've missed the boat in preparing both parents and kids for helping their children approach adolescence, approach the changes of puberty. Approach the concepts of being a gendered or a sexual person in a healthy and supportive way.  Think about it. Wouldn't it be easy as a parent or easier as a parent to talk about sexuality when it's theoretical? Versus you're coming in because your daughter's pregnant and you didn't even know she was having sex? I would prefer to talk with kids in a developmentally appropriate way over time. So that kids are prepared to make decisions and that we're not going back and saying, okay, now we need to deal with an issue. Now we need to deal with a problem. Now we need to deal with some sort of health need versus let's talk about anticipatory guidance. Let's have our kids be healthy.  Susan Stone: I know that you are involved in giving T blockers or hormones.  Kristina Supler: Oh, I was gonna ask about that.  Susan Stone: Yeah. I'm really curious, when do you decide that's appropriate? What are the side effects? Are they safe and are they safe? And also, how do you know, and this is a lot, that a child's just not playing with identities and trying on what suit fits because there is discussion versus this is real and we need to act.  Dr. Michelle Forcier: Sure. So we know that gender play trying on identities is common among kids. It's how again, we explore and figure ourselves out. But every kid that plays with their gender identity and gender rules and gender expression doesn't get hormones and doesn't go to a clinician to go get hormones. So if a child is really thinking hard and long about their gender identity, and oftentimes they'll think about it quite a bit before they even talk to their parents, they'll have that conversation with their parents about maybe the gender they were B with were born with doesn't quite fit them. Or maybe it absolutely doesn't fit them. And we have kids really at young ages, just like they know their cisgender identity. We have some kids at very young ages know their transgender identity. Regardless as a parent, in some ways, it really shouldn't matter what their gender identity is. What you want is to create a home situation and ideally again, or early clinical situation where kids and parents have lots of information so they can explore gender in whatever ways make sense for that child in a safe and healthy way. If you look at the studies by Kay Olson, the Trans Youth, project, she shows that kids that grow up in supportive environments, kids who present early as gender diverse and exploring gender identity, she demonstrates that they look just like their cisgender peers in terms of anxiety and depression growing up in supportive households. Now a supportive household doesn't care. The endpoint is a happy and safe child. It doesn't matter which directions the child goes in terms of gender identity, because as an accepting and loving parent, I don't care what their gender identity is. I want my child to be authentic. I want my child to feel safe. I want my child to feel loved. I want my child to feel heard and respected. And it doesn't matter what their gender identity is. They're my child.  Kristina Supler: Is there an average age when the research shows children start to explore gender identity and conversations are starting to be had within households or is it different for everyone? Dr. Michelle Forcier: It's different for everyone. I've had 80 year old patients come to me and say, now is the time that they're ready to start their gender affirmation process.  Susan Stone: But I do wanna press back on the question. Yeah. Because there are parents who do want to help their child. Yep. Good hormones are a health option. And I think Kristina's question was a good one. When does a physician make, how does a physician, and when does a physician make a choice that this is appropriate and are they safe?  Dr. Michelle Forcier: It's not based on age. It's based on need. And so a patient will go through a very thorough evaluation. People don't just walk in clinic and get a shot of puberty blockers, people. Kristina Supler: What do those evaluations entail?  Dr. Michelle Forcier: Oh, long history. About home, about activities, about the family medical history, their medical history, their social history, substances, self harm and mental health issues, exposures at home, in school,  Kristina Supler: it's like I assume questionnaires are given to children and parents as well. Dr. Michelle Forcier: It depends. And I mean, I find that most kids would rather talk to me than fill out a piece of paper.  Susan Stone: Yeah. So we talk. So if you make the decision that it's appropriate, what are the, the benefits and what are the risks?  Dr. Michelle Forcier: So the benefits, again, just remember we're not having the same conversation about, say, kids that are using the same medication for precocious puberty. Again, just to remind yourself in the context of avoiding political chatter, same medicine, kids not talking about it at all. So these are very safe medicines that have been around for many, many years. And we've used them in first, studied them with precocious puberty. Again, completely reversible.  Susan Stone: because Provo, is it true doctor, that precocious puberty, which just for our listeners who mm-hmm. don't know what that is, that's the onset of pub. Pub of puberty, very, very early at life. And we wanna delay that as much as possible because they're now finding that, especially for females, you want a puberty go in later and menopause to be later.  Dr. Michelle Forcier: Well, you want puberty to be later for a couple reasons. Number one, it would be really, really weird to have a fully feminized body at age six. Horrible. Yes. So they're social as well as biological consequences. And these kids use puberty blockers far longer than many of our trans kids. Again without all the bruja about safety and effectiveness. So puberty blockers basically are an hormone analog, and they fool glands in the brain to shut down and stop secreting the hormones that trigger ovaries and testes to secrete testosterone and estrogen, the sort of puberty hormones that start to create adult body and adult sort of physiology. And by putting this temporary pause on those brain gland signals, the ovaries and testes just sort of rust. They stop secreting. And when we take away that hormone, the ovaries and testes start secreting again. So it's sort of like putting a pause button on your Spotify or your, your music player. Pause, lift it back up. The music starts right back where it was. It just has a delay in time.  Susan Stone: Have children ever gone back but forth and said to you, you were, they were on the medication and then said they changed their mind? Or do you see that when kids are evaluated, you make that choice, they're happier, more fulfilled, and they'll stay on it long-term? Or is it across the board?  Dr. Michelle Forcier: It's across the board. as a pediatrician, we wanna keep asking kids, is this the right path for you? Should we be doing this? Does this still help you figure out who you need to be, where you need to go? Or are, have you figured some of these things out and don't need puberty blockers anymore? Or have you figured these things out and now need gender hormones? It all depends on the child. So our job is not to push someone forward through gender hormones or puberty blockers. It's to keep asking kids, what do you need? And that's medicine 1 0 1 patient. Sure. What do you need? Where are we now? Things change in our body. Things change in our heart and mind. We have to keep talking and listening to kids to find out what they need. So if they need to stop, they should. And if they need to, start again because stopping actually demonstrated that they are really uncomfortable with the changes of puberty. Then, yeah, we can honor that request and honor their experience.  Kristina Supler: So what are the, what are some of the risks though, that can be attendant to taking these hormones?  Dr. Michelle Forcier: Well, the way I tell kids and parents having to come to the doctor to get a shot kind of stinks. So that's a risk and that's a bummer. Let's see if kids start these medicines very early in puberty, there's very little change in their internal hormone environment. So they don't have side effects like say, menopause, some hot flashes and some little bit of irritability as hormones are shifting.  Is growth impacted?  Growth usually, is, that's a great question. Impacted in the sense that, trans boys may have the potential to grow a little bit taller because we're gonna block estrogen's effect on growth plates. And for trans girls, again, we can work with them to look at again, their potential height or their, high trajectory to figure out how tall they are gonna be. And will that factor into, again, starting estrogen or gender hormones so we can use it again to inform our patients what their options are. So that they can be in a body that's comfortable and safe for them. Susan Stone: Well, is, are those blockers different than hor gender hormones to help, let's say in a trans. Would it be a child who identifies as trans male wanting to be female? I hope, again, I'm terms right and forgive me if I'm getting 'em wrong. So if you want to help someone develop the other way, or maybe a female by birth sex, who wants to be a male, is that a different type of hormone or medication protocol? Dr. Michelle Forcier: So blockers are used basically just to stop the current gonads, ovaries and testes from secreting, estrogen and testosterone. If a patient is either way past the beginning of puberty or a patient is on gender blockers, you know, puberty blockers, they can start the other hormones in the past referred to as cross-gender hormones to basically start the puberty that makes sense for them. So if I am identifying as female, and I have been on puberty blockers, At age, say 13 or 14 or 15 or 16, whenever again that child, that patient says it's appropriate for them, they have parent support and we all have a plan. They may start estrogen so that they can develop just like their peers. Which we think, again, has a positive health benefit in terms of, again, that congruence.  Socially with my body is developing just like my friends. I feel normal, I feel accepted, I feel like,I'm a part of my community. So for boys puberty usually happens a little bit later, so sometimes they might start their male testosterone hormones a little bit later, say, than females. But again, It's all dependent on when we first see a patient, how far they've gone through puberty, what they understand of their gender identity and where they are in terms of making a plan to affirm their gender identity or not, or just learn more and explore. Kristina Supler: What do you say to parents who are in your office with the child and the parent you can tell, just isn't on board with the child's desire to start hormone therapy or whatever the circumstance may be. What sort of conversations do you have?  Dr. Michelle Forcier: Would that ever happen? Never. So yes, that happens quite frequently. We have parents that want us to say, this is just a phase or a fad. Let me tell you, being transgender or gender diverse is hard in our culture. It's hard. And when we see kids in our clinic, the vast majority of the time, they're there for real issues, real goals, and real pain. And we need again to start with taking our patients at their word and carefully explore what they mean by their experience, their dysphoria or their goals. So I tell parents, listen, you and I are coming from the same place. I want a safe kid, a kid who's around alive participating in the world, the kid who's healthy. Who's mentally and physically healthy. We may come at it from slightly different approaches. You're coming at it as I expected my child to be cisgender and to I wanna walk them down the aisle, at their wedding and they're gonna have a baby and provide me with grandchildren. And my job as that child's pediatrician is to say, your child is telling me that their body, if it's to continue to develop, say, into a female body, is gonna create such harm, such discomfort with their physical self, such anxiety and depression because in their heart and head they identify as male. And so we have to really listen to your, your child and hear what they say in terms of how do we explore the identity you were assigned at birth with the identity that you are telling me you experience now.  Susan Stone: When do you talk about surgery? When does that enter into the conversation? Because it's, I think, One, I think it's a very different conversation. When do you start maybe blockers or hormones versus when do you actually put a child through radical surgery that you can't reverse?  Dr. Michelle Forcier: Most children don't go through quote unquote radical surgeries. In fact, children have far more radical surgeries for lots of other issues or problems, and they ascent to the process of surgery for whatever their healthcare needs, along with the consent of their parents. So I think that's the first thing to take that. would some children  Susan Stone: wa, I would say would wanna com complete the process right?  Dr. Michelle Forcier: But many children don't have necessarily the support or the resources to necessarily go through some of the more major and intensive surgeries. Vaginoplasty and phalloplasty creating a vagina and a penis are very intensive. People don't usually do that until after age 18.  Susan Stone: Okay. So it's not really a pediatric issue then?  Dr. Michelle Forcier: No. Now say there are some youth, and this is the more quote unquote common surgery, although again, with blockers, we don't have to do this quite as often now is say a child's developed breast at age seven or eight and say they identify longstanding as a trans male. Why? When they come see me at age 16, or they come see me at age 14 and by age 16 they're gender dysphoria regarding their adult size breasts, which they've had now for eight years is killing them. They're not showering. They're wearing a binder 24 7. They have suicidality and again, nothing's changed in their gender identity. Why would I say you need to wait two more years until the magic number of 18 to have a male chest construction knowing that nothing has changed from age six to now 16, and you have had eight years of female breast tissue That's harmful. The harm in that is far greater than the harm of saying you're 16, you've been through years of care with us. You're gonna be as assessed by a surgeon. The surgeon may require other information before they do your surgery. And then through this long standing process, not I come in the clinic and tomorrow I have my chest removed, oftentimes months to years I get my chest surgery and I no longer have to wear a binder 24 7 and I can take a shower. And look in the mirror.  Susan Stone: So it can be a pediatric issue. Yeah. Something that a pediatrician. Okay. That's all I wanted to understand. Yeah. Is this something that pediatricians deal with versus not? Dr. Michelle Forcier: Not too often. And most of the time when we get to the point of surgery, again, there may be a number of people involved including gender specialists as well as including mental health people as well as the team that works with the surgeon. So we're talking about a whole lot of people.  Kristina Supler: Dr. Forcier can you tell our listeners a little bit. I, in preparing for today, we came across the term or pneumonic I had never seen before. Lark. Susan Stone: I looked it up too.  Kristina Supler: How do you work with this population in terms of contraception and tell our listeners what a lark is and yeah,  Susan Stone: Because a lark is not a bird, guys. It's an acronym.  Dr. Michelle Forcier: No, and it's wonderful. It's a long acting, completely reversible contraception. They are a little device we can put in the arm or an intrauterine device we put in the uterus. So the I U D, right? Yeah, exactly. They're so effective in terms of preventing pregnancy.  Now we know that young people may not identify, they may identify as straight, but they have either same sex relationships. We also know that young women who have sex with women are actually at increased risk for STIs in pregnancy because they're not prepared.  Susan Stone: Wait, wait. So I was gonna say, if you have a child who tells you that they're interested in only sex with their own matching sex, not gender. Mm-hmm. Because that can be an identity issue. Yeah. You know what? I have to be honest with you, Dr. I would think, why do I need to go down the contraception path?  Dr. Michelle Forcier: Because the data says that young women who have sex with women get STIs and get pregnant because they're exploring well, but wait.  Susan Stone: But long act larks won't prevent an sti I only condom use. Correct. Or dances. They're not  Dr. Michelle Forcier: having sex barriers prevent  Susan Stone: STIs. yes. But given we all know, we can all say that. But we are in the world. World and teens engage in sexual activity. I like the idea of a lark in terms of, you don't have to depend on taking that pill and memory. You got, I gotta be honest with you though, it's not as good though in terms of St I. Infection prevention, is it?  Dr. Michelle Forcier: No, it's purpose is not to prevent STIs. To be like asking your microwave to show you a TV show. Your microwave isn't gonna play Netflix. It's a D, it's a d it's a device for a different purpose. So we need, so I feel like I'm missing about this. Talk about them as separate  Susan Stone: pieces. Help me out. help me out. I'm getting confused.  Dr. Michelle Forcier: I dunno.  Kristina Supler: I'll ask the dumb question. so I mean it's essentially an i u d . Dr. Michelle Forcier: What's essentially an i u D? A lark. Well, no, there's one that goes in the arm or and there's one that goes in the uterus. There, there are different kinds of long, I was confused. Thank you. Yeah. Got it. Cause it's just about the location of the implant. Some young people don't want people putting things in their uteruses. They don't want a pelvic exam. They're freaked out. And so that little rod in the arm that suppresses ovulation, wonderful. Very effective, very easy to put in and take out. Nice.  Kristina Supler: So it's really about patient comfort and what the patient is more,open to.  Dr. Michelle Forcier: Shouldn't that be patient care 1 0 1 anyway?  Susan Stone: Yes. Yeah. But, but, but we still need to insist that students are mindful of using condoms or other ways of preventing disease. So what do you recommend a LARC plus what Dr. Michelle Forcier: I mean the lit well number when the literature shows that, dual methods are wonderful and especially dual methods of STI protection with some sort of barrier method or condom, internal external condom. Or again, a lark in terms of a long-acting reversible contraceptive.  So again,think about the story. You have a parent coming in and she's worried about her teen being sexually active, right? And she says, I don't wanna, I don't wanna allow her to have birth control, even though she tells me this is what she wants, cuz that's gonna give her permission to have sex. Do you really think the parent allowing birth control gives that child permission to have sex? Or do you think that child's gonna make that decision to have sex on their own?  Susan Stone: You're talking to two lawyers whose whole practice is dealing with students and issue sex issue. So and and I have to gather that people who listen to our podcast are well on the way of understand. I guess our questions are focused differently because really our parents all are very supportive of their students and their choices. We're very lucky that by large, by and large, not all of 'em, but. By and large. Yeah.  Dr. Michelle Forcier: but I think the main thing is your kid's telling you they need something and you may not agree with the fact that you want them to be sexually active. Most of us aren't super excited to think about like our 14 year old being sexually active, but I'm not a 14 year old. But if my 14 year old is sexually active, I would really wanna make sure they had good birth control and I would really wanna make sure they understood things like consent. Saying no, saying you need to use a condom. And walking away from that encounter feeling empowered and safe. We don't how Advocacy, yeah. Yeah. If we don't talk about sex and how to manage it, how are young people gonna make thoughtful decisions? And safe decisions.  Kristina Supler: What are some of the most promising or not promising, pressing health issues facing the lgbtq plus community today?  Dr. Michelle Forcier: I thought we weren't gonna talk about politics and legislation. so I'm gonna say health issue. Health issue. Health. Health issue. Yeah. Those are health issues though. Because those are about geographic and political access to care and a state by state basis.  Kristina Supler: So Access's huge. Yeah, funda fundamentally just, it's not even access so much access, the medicine or the science, it's access. Dr. Michelle Forcier: Sure. The science is actually a lot less exciting because the science is pretty consistent. In terms of avail, like different types of availability and access to care for larks is really important. The safety of abortion, the benefits, short term and long term of gender affirmative care.  The science, again, we're not seeing there's like a huge variance in terms of different outcomes in different studies. The outcomes are pretty consistent in terms of access to care improves outcomes. And a whole host of these sexual gender health issues.  Susan Stone: I have to tell you something. I learned something today because, I learned a lot. I did not know what a lot of these acronyms meant, and they're missing, I have to be honest with you. I like taking worries off the table and I did not think you had to worry about pregnancy when you have a child. I thought that, that's, a huge benefit is that's one issue off the table. Or I didn't think about the s t I issue. So I thank you for educating me.  Kristina Supler: Absolutely. I think that this has been a really good discussion with a lot of information for our listeners. And if, parents out there listeners want to learn more about you or any of your research or any good literature, where would you direct them?  Dr. Michelle Forcier: PubMed has lots of good information in terms of all the research. Not just me, but all the research that supports sort of making these types of decisions. Up to date is a nice summary of different information about gender, sexuality, and reproductive healthcare. I'm happy to come on with you guys if you ever wanna have a question and answer session. This is really important stuff and I'm really excited to talk science and to talk evidence and to talk about listening to kids. So I'm, I so appreciate what you're doing and happy to be helpful in any way.  Susan Stone: Thank you, and I'm concerned. I can't imagine, doctor, how many doctors in your area are across the country?  Dr. Michelle Forcier: I wish, that's what, that's why we keep talking about this healthcare being primary care. Primary care, pediatricians, family, medicine doc, nurse practitioners, we all should be comfortable talking about gender and sexuality because they're a part of our lives and they're a part of primary care. Yeah. So we're,  Susan Stone: I can, we're doing more and more training. Yes. Yeah. We do need more discussion about this. Because like I said, when I think of a well visit with the child, I do think of weight, health, and, pumping meningitis, getting,yeah. Yeah. So thank you.  Dr. Michelle Forcier: My 14 year old did not wanna talk about pooping and peeing. There were more pressing and more pertinent issues relevant to her life. Oh, than age 14.  Susan Stone: You need to spend a day at my house because, Pooping is an everyday conversation.  Dr. Michelle Forcier: Okay. And not that, I think it's time to wrap it up.  Kristina Supler: Time to wrap it up. Dr. Forcier thanks so much for joining us and we, hope our listeners enjoyed this episode. Dr. Michelle Forcier: Thank you. Bye-bye. Bye-bye. 

One in every three cancers diagnosed is a skin cancer and one in every five Americans will develop skin cancer in their lifetime. Are you playing it safe this summer?  Dr. Philip Chan explores the best ways to protect yourself with local skin cancer expert Dr. Abrar Qureshi, Chair of the Department of Dermatology at the Warren Alpert Medical School and Professor of Dermatology and Epidemiology at Brown University. What should you look for in an effective sun block? Does a hat with a wide brim really work? Find out in this latest episode of Public Health Out Loud. 

Jeremiah Schuur, MD, MHS, Warren Alpert Medical School, Moderated by: Hamza Ijaz, MD by SAEM

Jeremiah Schuur, MD, MHS, Warren Alpert Medical School, Moderated by: Hamza Ijaz, MD by SAEM

Courtney Voelker, MD, PhD (DPhil Oxon), is a Rhodes Scholar and board certified neurotologist. She is Director of Otology/Neurotology-Lateral Skull Base Surgery; and Director of the Adult & Pediatric Cochlear Implant Program at Pacific Neuroscience Institute. She is an otolaryngology – head & neck surgeon who takes care of adult and pediatric patients seeing a wide range of inner ear and skull base conditions. A Super Doctor Rising Star award recipient, she is committed to offering top quality, compassionate care to all her patients.Prior to joining PNI, Dr. Voelker was at USC Caruso Department of Otolaryngology – Head and Neck Surgery, Keck School of Medicine of USC as Division Chief of Otology, Neurotology and Lateral Skull Base Surgery, and the Director of the Pediatric Cochlear Implant program at Children's Hospital Los Angeles (CHLA). She has conducted leading-edge research on the physiology and diseases of the inner ear at Brown University, the University of Oxford, Washington University in St. Louis, and the National Institutes of Health (NIH).Dr. Voelker has authored numerous research publications and textbook chapters in her field. She is a member of the American Academy of Otolaryngology – Head and Neck Surgery and the American Neurotologic Society.Dr. Voelker graduated with Honors from Brown University and earned her medical degree from The Warren Alpert Medical School of Brown University. As a Rhodes Scholar she earned her PhD from the University of Oxford in developmental neurobiology. She completed her residency in Otolaryngology – Head and Neck Surgery at the Washington University (Barnes-Jewish Hospital) in St. Louis and her fellowship at the world-renowned House Ear Clinic in Los Angeles.Learn more about Dr. Voelker and other PNI Doctorshttps://www.pacificneuroscienceinstitute.org/people/courtney-voelker/

Timothy P. Flanigan, M.D. '16Hon., '18G, the former chief of the Division of Infectious Diseases at Brown University's Warren Alpert Medical School, presented this year's Fiondella Lecture. He shared stories from the front lines of the HIV, Ebola, and COVID health crises, describing how the humanities helped him through these challenging experiences.In 2016, Flanigan received an honorary degree from Providence College for his efforts in public health and service to the Diocese of Providence. In 2018, he completed a graduate degree in theology from PC, which he started while studying to become a deacon.The Fiondella Lecture was made possible by the generosity of Robert W. Fiondella '64, '16Hon. and Carolyn Fiondella.Subscribe to the Providence College Podcast on Apple Podcasts, Spotify, Stitcher, Google Play, and YouTube.  Visit Providence College on Facebook, Twitter, Instagram, YouTube, Snapchat, and LinkedIn. 

Psychedelic Assisted Therapy. Perhaps reading that phrase brings about word associations like “mushrooms” “LSD” “Molly” “Mescaline” “altered state”, “euphoria” and even “the 60's”. Or perhaps just seeing those words makes you curious enough to take a listen to this awesome podcast with Dr. Brian Pilecki, a clinician and researcher in the emerging field of integrating psychedelics into the treatment of behavioral health disorders. Listen in and learn as Dr. Pilecki explains some of the ins and outs of psychedelic assisted therapy to include what it is, who might benefit, types of psychedelics that have been most studied, where the research stands, as well as how to get more information about being trained to provide this type of treatment. You won't be sorry. Dr. Brian Pilecki is a clinical psychologist at the Portland Psychotherapy Clinic specializing in treating anxiety disorders, trauma, and PTSD, and matters related to the use of psychedelics. He completed his doctorate at Fordham University in Bronx, NY, and completed his pre-doctoral internship at the Weill-Cornell Medical center at New York Presbyterian Hospital. He completed a postdoctoral fellowship at The Warren Alpert Medical School of Brown University and practices from an orientation based in Acceptance and Commitment Therapy (ACT). Dr. Pilecki also received a master's degree from the California Institute of Integral Studies in East-West Psychology where he studied psychedelic medicine, non-Western ways of knowing, and contemplative traditions such as Buddhism. He is an active researcher and has published on topics such as anxiety disorders, mindfulness, psychedelics, and the relationship between theory and practice in psychotherapy. At Portland Psychotherapy, Dr. Pilecki is involved in research on the positive benefits of psychedelics and provides clinical services in the preparation for or integration of psychedelic experiences.Resources mentioned in this episode: Multidisciplinary Association for Psychedelic Studies https://maps.org/ Calls-to-action: Subscribe to the Practical for Your Practice PodcastSubscribe to The Center for Deployment Psychology Monthly Email

Prof. Elizabeth Tobin-Tyler is an associate professor at the Brown University School of Public Health and Warren Alpert Medical School. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. E. Tobin-Tyler. Courts' Disregard for Women's Health and Safety — Intimate Partner Violence, Firearms, and “History and Tradition”. N Engl J Med 2023;388:1345-1347.

With national and local headlines about overdoses, fentanyl, and xylazine, it's important to know about the risks of substance use and the local drug supply. In this week's Public Health Out Loud podcast, Dr. Philip Chan is joined by Dr. Alexandra Collins and Dr. Rachel Wightman, who are leading a new research study at the Brown University School of Public Health and Warren Alpert Medical School called testRI. The research team tests drug residue samples from used paraphernalia collected at overdose hotspots and donated from individuals or community organizations across Rhode Island. The results of the toxicology testing are shared via near-real-time updates including harm reduction mobile outreach teams, the State's overdose data and resource website, Prevent Overdose RI, social media, and direct communications to primary care and behavioral health providers to help people understand what's in the supply and how it may be impacting overdose rates in Rhode Island. Listen to the episode to also learn about how to recognize the signs of an overdose and what you can do to respond. To learn more about this innovative research and Rhode Island's drug overdose epidemic, visit PreventOverdoseRI.org.  

As a medical intuitive, healer, and life coach- Dr. Elizabeth Ssemanda is dedicated to helping others find peace in mind, body, and soul. With degrees from Brown University (undergraduate), Johns Hopkins Bloomberg School of Public Health (doctorate), Warren Alpert Medical School at Brown University (medical doctorate), and finally, psychiatry residency at the University of Michigan-Dr. Ssemanda seeks to pursue holistic treatment methods for people suffering from mental illnesses. As a board-certified psychiatrist, she specializes in helping healers heal. Acknowledging that conventional treatments often ignore other aspects of the patient's wellness, as if they only exist in three dimensions- Dr. Ssemanda created her practice called New U Psychiatry, where she offers holistic treatment options alongside psychiatric care within one location, and Soulinyou, where she provides individual and group intuitive readings and healings. Continuing on her mission to change the conversation from coping with mental health issues to mental health wellness-she also hosts an empowering podcast called Stepping into Soul Power which helps encourage listeners to understand their blocks, transform their relationships and career and heal.###Your hosts of Are You Waiting for Permission? are Meridith Grundei and Joseph Bennett. They're friends, co-hosts, actors, improvisers, and coaches. She lives in NYC and coaches actors, business professionals, and presenters to fully engage with their audience, and themselves. She also mentors young actors and directors. He lives in San Miguel de Allende, México, and coaches artists and other creative beings about the beautiful business of art — and life. You can find Meridith: Meridith Grundei the performer artist gal. Or if you are looking to be a more confident and credible speaker, please reach out to Meridith here at Meridith Grundei CoachingYou can find Joseph at Joseph Bennett the artist/coach extraordinaire*Special thanks to Amy Shelley and Gary Grundei of high fiction for letting us use their music for the Are You Waiting for Permission? podcast.And... while the podcast is free, it's not cheap. We'd be thrilled to have your support on PATREONThank you. 

We Need More Illustrations of People of Color in Medical Textbooks— The lack of diversity perpetuates health inequality and stereotypes "The consequences of primarily depicting White, lighter skinned individuals with Eurocentric features in medical images supports the persuasive concept of White supremacy. It perpetuates the belief that the White male body is "the standard" to which all other bodies should be compared. It leads to inequality in medical education and further perpetuates harmful stereotypes of Black individuals. As a result, this issue plays a role in inappropriate diagnosis and health management of Black individuals. Furthermore, medical care becomes subjective, discriminatory, and filled with speculatory assumptions based on stereotypes." Jenna C. Lester is founder of the Skin of Color dermatology program at UCSF, which addresses the  persistent issues that arise from the exclusion and marginalization of non-white patients in medical  research and practice. She is combatting medical disparities due to racial inequality, working to fill education gaps in textbooks and curriculum about non-white skin and training a new generation of  doctors. A graduate of Harvard University and The Warren Alpert Medical School of Brown University, she is an assistant professor of dermatology at UCSF where she practices and teaches general dermatology. Jenna's TedX Talk Susan Y. Chon, a 1991 Brown graduate with an independent concentration in children's literature, is a professor in the Department of Dermatology at the University of Texas M.D. Anderson Cancer Center. Prior to joining the faculty, she earned her M.D. from Stanford University School of Medicine. She then completed her internship in internal medicine and her dermatology residency at Stanford University Hospital. Chon specializes in treating patients with skin cancers, melanomas and skin disorders from cancer treatments. She is a medical educator and an active mentor for medical students and dermatology residents. She is also director of the Skin Cancer Screening and Prevention Program and founded the volunteer physician program for the Brookwood Community, a residential and vocational program for adults with disabilities. Chon is the president of the Brown Club of Houston, helping to maintain the connection between Brown and its graduates throughout the world, and serves as a member of the Women's Leadership Council, Women's Launch Pad and Philanthropy Advisory Group.

You can heal your anxiety and depression by using functional medicine. Making changes to your stressors, hormones, infections, food, and toxins can all significantly impact your lifestyle. I'm joined by Dr. Achina Stein, a functional medicine doctor and psychiatrist, to talk about all the other possible contributing factors to your anxiety and depression.   Address the Shift Model to Heal Anxiety and Depression Stress Hormones Infections Foods Toxins   About Dr. Achina Stein Dr. Achina Stein is the author of What If It's NOT Depression? Your Guide to Finding Answers and Solutions.  She is a board-certified psychiatrist and has been in practice for 25-plus years. Propelled by her son's health crisis in 2010, she found functional medicine which resolved all his mental health problems as well as her own. She has a busy private practice called Functional Mind LLC in Riverside, RI where she sees patients for functional medicine primarily but also sees patients for psychotherapy.  She is a certified practitioner of the Institute for Functional Medicine, a Distinguished Fellow of the American Psychiatric Association, and was awarded the Exemplary Psychiatrist Award by NAMI-RI in 2008.  She is a former Clinical Assistant Professor of Psychiatry and Human Behavior at The Warren Alpert Medical School of Brown University.  Dr. Stein has a companion program to her book called What If It's Not Depression?, a bootcamp to provide an alternative to medication for people with chronic mild depression-like symptoms that do not respond to antidepressant medications and will be offering an SSRI tapering course soon. She enjoys playing ultimate frisbee, singing, and gardening.   In This Episode What the shift model is [8:15] Why you need to find the root causes in all parts of the Shift Model [9:00] How to know if stress is impacting you [10:00] What you need to know about the Hormone Pillar [13:00] How to help your hormone stressors [17:00] Why we need to consciously decide to go against what society does [18:45] How infections can play a role in depression [19:00] How foods can help or harm your health [23:00] How our food has changed over the last 50 years [24:00] What toxins are part of the shift model [27:00] Why you need to support your body with supplements [32:00] What information functional medicine testing provides [33:00] The benefits of a healthy brain [38:00]   Links & Resources Get $300 Off an Air Doctor with Code GRAY15 Use Code MAGNESIUM For 10% Off Magnesium eBook: How to Create Resilient Health by Dr. Stephanie Gray How Mood is Affected by Aging and Hormones with Dr. Stephanie Gray and Dr. Achina Stein What If It's Not Depression Bootcamp Find Dr. Achina Stein Online Follow Dr. Achina Stein on Instagram | YouTube Follow Your Longevity Blueprint on Instagram | Facebook | Twitter | YouTube | LinkedIn Get your copy of the Your Longevity Blueprint book and claim your bonuses here Find Dr. Stephanie Gray and Your Longevity Blueprint online    Follow Dr. Stephanie Gray on Facebook | Instagram | Youtube | Twitter | LinkedIn Integrative Health and Hormone Clinic Podcast Production by the team at Counterweight Creative    Related Episodes  Episode 99: Deep Hidden Stressors With Misty Williams Episode 92: Detox Journeys With Aimee Carlson & Naomi Damask Episode 72: Heart Health 101 With Dr. Joel Kahn

Mindless eating, smoking, and worrying plague the world today. It was bad pre-pandemic, and it's gotten worse since. Adam Schroeder and Naresh Vissa talk to Dr. Jud Brewer about how we can put ourselves in position to defeat these things. Dr. Brewer founded MindSciences, Inc. (now known as DrJud), an app-based digital therapeutic treatment program for anxiety, overeating, and smoking. He is director of research and innovation at Brown University's Mindfulness Center and associate professor in behavioral and social sciences in the Brown School of Public Health, and in psychiatry at Brown's Warren Alpert Medical School. He is also an executive medical director of behavioral health at the digital health company Sharecare and #1 New York Times' bestselilng author of The Craving Mind: From Cigarettes to Smartphones to Love—Why We Get Hooked and How We Can Break Bad Habits and the new book Unwinding Anxiety: New Science Shows How to Break the Cycles of Worry and Fear to Heal Your Mind. Websites: www.Patreon.com/WorkFromHomeShow www.DrJud.com www.MapMyHabit.com www.UnwindingAnxiety.com www.GoEatRightNow.com www.ShareCare.com Featured Photo by Milad Fakurian on Unsplash www.WorkFromHomeShow.com