#3 I Have Got Some People Waiting For Me. Aziz’s life has been a story of chance – and choice. As Michael pieces together Aziz’s journey from Sudan to Manus, he realises Aziz has been searching for a safe place for about eight years. So what gives him the ability, and the energy, to speak out? How has Aziz fought for so long, and what makes him want to be ‘the messenger’? ‘I’m pretending like I’m really happy, and laugh, and you know, smiling on the phones and doing stuff like that – so they feel like, “Oh, my son is really living in a good environment”. So they think like that, but the opposite is the truth.’ Aziz Aziz tells Michael, ‘I have got some people ...waiting for me. They love me, they want me to be with them.’ Haltingly, and sometimes with great difficulty, Aziz starts to share stories about his home, the family that he longs to see, and why he fled. Looking to find out more, Michael speaks to Sudan expert Anne Bartlett about the current situation there. As Aziz shares snapshots from his past, Anne talks Michael through the conflict in Sudan, which, despite leaving the headlines long ago, continues to unfold. Michael worries that he’s adding to Aziz’s trauma by digging up painful memories – ever aware of how hard it is to have these kinds of conversations in short, overlapping messages, without the benefit of reading someone’s signals face to face. Meanwhile, Aziz weighs up how much to tell his family about Manus, and explains to Michael why he’s sometimes tortured by regret. Warning: This episode of The Messenger includes graphic content and mentions self-harm. If you or someone you know needs help, you can contact one of Australia’s national 24/7 crisis services such as Lifeline on 13 11 14 or at lifeline.org.au, or the Suicide Call Back Service on 1300 659 467. Transcript Download a PDF transcript of this episode here. In this episode Abdul Aziz Muhamat Michael Green Associate Professor Anne Bartlett, University of New South Wales, President of the Sudan Studies Association Our theme music was composed by Raya Slavin. Music used in this episode includes: 'Blue Milk' by Stereolab, 'Up the Box' by Andy Stott, 'Feld' by To Rococo Rot, 'Firefly' and 'Four-Day Interval' by Tortoise, 'Cutting Branches for a Temporary Shelter' by Penguin Cafe Orchestra, 'Ending' by Kazumasa Hashimoto, 'Remedios the Beauty' by Oren Ambarchi, 'Lazyboat' and 'Vostok' by Triosk, 'Passages' by Bowery Electric, 'Self Seal Mishap' by Tennis and 'Ba Ba' by Sigur Rós. More information The Messenger is a co-production of Behind the Wire and the Wheeler Centre. It’s produced by Michael Green, André Dao, Hannah Reich and Bec Fary, with Jon Tjhia and Sophie Black at the Wheeler Centre.Narration by Michael Green. With reporting by Abdul Aziz Muhamat. Additional fact checking by the Guardian's Ben Doherty; transcription by Claire McGregor, Victoria Grey, Camilla Chapman, Lena Lettau and many more. This episode was edited and mixed by Bec Fary and Jon Tjhia. Thank you Dana Affleck, Angelica Neville and Sienna Merope. Also to Cameron Ford and Heidi Pett, and to Behind the Wire’s many participants and volunteers. Behind the Wire is supported by the Bertha Foundation.
#107: The Scariest Navy SEAL I've Ever Met...And What He Taught Me. Jocko Willink (@jockowillink) is one of the scariest human beings imaginable. He is a lean 230 pounds. He is a Brazilian jiu-jitsu expert who used to tap out 20 Navy SEALs per workout. He is a legend in the Special Operations world. His eyes look through you more than at you. He rarely does interviews, if ever. But a few weeks ago, Jocko ended up staying at my house and we had a caffeinated mind meld. Here's some background... Jocko enlisted in the Navy after high school and spent 20 years in the SEAL Teams, first as an enlisted SEAL operator and then as a SEAL officer. During his second tour in Iraq, he led SEAL Task Unit Bruiser in the Battle of Ramadi--some of the toughest and sustained combat in the SEAL Teams since Vietnam. Under his leadership, Task Unit Bruiser became the most highly decorated Special Operations Unit of the entire war in Iraq and helped bring stability to Ramadi. Jocko was awarded the Bronze Star and a Silver Star. Upon returning to the United States, Jocko served as the Officer-in-Charge of training for all West Coast SEAL Teams, designing and implementing some of the most challenging and realistic combat training in the world. So why is Jocko opening up? Well, in part, we have mutual friends. Second, he is the co-author of an incredible new book — Extreme Ownership: How U.S. Navy SEALs Lead and Win -- which I've been loving. Trust me. Buy it. This is his first mainstream interview and one you won't want to miss. Show notes and links for this episode can be found at www.fourhourworkweek.com/podcast. This podcast is brought to you by Wealthfront. Wealthfront is a massively disruptive (in a good way) set-it-and-forget-it investing service, led by technologists from places like Apple and world-famous investors. It has exploded in popularity in the last 2 years, and now has more than $2.5B under management. In fact, some of my good investor friends in Silicon Valley have millions of their own money in Wealthfront. Why? Because you can get services previously limited to the ultra-wealthy and only pay pennies on the dollar for them, and it’s all through smarter software instead of retail locations and bloated sales teams Check out wealthfront.com/tim, take their risk assessment quiz, which only takes 2-5 minutes, and they’ll show you—for free–exactly the portfolio they’d put you in. If you want to just take their advice and do it yourself, you can. Or, as I would, you can set it and forget it. Well worth a few minutes: wealthfront.com/tim. Mandatory disclaimer: Wealthfront Inc. is an SEC registered Investment Advisor. Investing in securities involves risks, and there is the possibility of losing money. Past performance is no guarantee of future results. Please visit Wealthfront dot com to read their full disclosure. This podcast is also brought to you by 99Designs, the world’s largest marketplace of graphic designers. Did you know I used 99Designs to rapid prototype the cover for The 4-Hour Body? Here are some of the impressive results. Click this link and get a free $99 upgrade. Give it a test run...
Episode 26: Living Long Enough to Live Forever. In Episode 6, Peter and Dan described how mindset plays a key role in living a long, healthy life, this time they share stories about how they each arrived at their ambitious longevity goals. In this episode: Peter talks about Ray Kurzweil’s belief that children born today will have the ability to have an indefinite lifespan. Dan describes his thoughts on attitude and why the future is something you must work toward. Peter puts into perspective the amazing times we are living in, citing how the human lifespan has doubled over the last century. Dan mentions his visit to Human Longevity Inc., for the full story, listen to Episode 21 here.
#17 Nick Littlehales - Improve your sleep. Nick is regarded as the leading elite sports sleep coach in world sport. A leading industry expert with over 30 years experience in the world of sleep, sleeping habits, and product design and over 15 years dedicated to elite athletes and professional sport. For more information about Nick visit sportsleepcoach.co.uk For more information about Mind Set Game connect with us on Facebook @mindsetgamepodcast. For more information about James Roberts (the host of the podcast), visit fitamputee.co.uk
Rank #1: A Gobbet o' Pus 1038: Not Really Tropical. Adventures of a Pus Whisperer.
Rank #2: A Gobbet o' Pus 808: Belize Boil. Adventures of a Pus Whisperer.
Rank #1: Skin and Soft Tissue Infections 2014 - IDSA Guideline Update. The Infectious Diseases Society of America's Guideline Update presents concise summaries of important IDSA guidelines. This podcast discusses the IDSA Clinical Practice Guideline for Diagnosis and Management of Skin and Soft Tissue Infections: 2014 . For details of the guidelines presented, please go to www.idsociety.org . Presented by: Neil S. Skolnik, M.D., Professor of Family and Community Medicine, Temple University School of Medicine, Associate Director, Family Medicine Residency Program, Abington Memorial Hospital. Dr. Dennis L. Stevens, Chief, Infectious Diseases Section, VA Medical Center, Boise, ID.
Rank #2: Hospital-acquired and Ventilator-associated Pneumonia: 2016 - IDSA Guideline Update. The Infectious Diseases Society of America's Guideline Update presents concise summaries of important IDSA guidelines. This podcast discusses the 2016 IDSA Guideline on Managment of Adults with Hospital-acquired and Ventilator-associated Pneumonia For details of the guidelines presented, please go to www.idsociety.org . Presented by: Neil S. Skolnik, M.D., Professor of Family and Community Medicine, Temple University School of Medicine, Associate Director, Family Medicine Residency Program, Abington Jefferson Health Andre C. Kalil, M.D., Professor, Department of Internal Medicine, Division of Infectious Diseases, University of Nebraska Medical Center, Omaha Mark Metersky, M.D., Professor of Medicine, Associate Chief of Service, Department of Medicine, Director, Center for Bronchiectasis Care, UConn Health, Pulmonary/Critical Care, Farmington, CT
Rank #1: The Mother of All Pandemics. Dr. David Morens, of the National Institute of Allergy and Infectious Diseases, discusses the 1918 influenza pandemic.
Rank #2: Meningitis in U.S. Colleges . Dr. Heidi Soeters, an epidemiologist at CDC, discusses newest vaccines for preventing certain types of meningococcal diseases.
Rank #1: Quackcast 207: Board Disciplinary Actions. What Naturopaths Really Do Not Want You To Know. Disciplinary actions against ND’s in Oregon by the Board. How to find them and what they are.
Rank #2: Quackcast 209: Influenza Vaccine and Health Care Workers. More than one way to skin a literature. There are many ways to apply the medical literature. For me it starts with the premise that health care workers may not injure a human being or, through inaction, allow a human being to come to harm.
Rank #1: 3 - Dark Winter. In episode 3 of Bedside Rounds, I talk about the human triumph of small pox vaccination, and discuss the government exercise called Dark Winter which simulated a bioterrorism attack on the United States.
Rank #2: 34 - The Physical. The physical exam has become a ritual of the modern doctor’s appointment, with pokes, prods, and strange tools. How did this become a normal thing to do? In this episode, I’ll discuss how the physical exam went from the medieval examination of a flask of urine to basically what we have today in just a few decades in early 19th century France, and how the exam is still developing in the 21st century. Plus, a brand new #AdamAnswers about why Americans insist on using the Hermes’ Staff as a symbol for medicine. All this and more in episode 34 of Bedside Rounds, a tiny podcast about fascinating stories in clinical medicine! Sources: Antic T, DeMay RM. “The fascinating history of urine examination,” Journal of the American Society of Cytopathology (2014) 3, 103e107 Ghasemzadeh N and Zafari AM, “A Journey into the History of the Arterial Pulse,” Cardiology Research and Practice Volume 2011 (2011). McGee S, Evidence Based Physical Diagnosis 4th edition. Amazon link: https://www.amazon.com/Evidence-Based-Physical-Diagnosis-Steven-McGee/dp/0323392768 Nicolson M, Commentary: Nicholas Jewson and the disappearance of the sick man from medical cosmology, 1770–1870. Int J Epidemiol 2009;38:622–33) Jewson ND. The disappearance of the sick-man from medical cosmology, 1770–1870, Sociology , 1976, vol. 10 (pg. 225-44) Robertson WE. Physical diagnosis from the time of Rontgen. Ann Med Hist. 1934;6:255–63 Rodgers MM, “Piorry on Pleximetry and Auscultation,” Boston Med Surg J 1852; 46:151-152 Tan SY and Hu M, “Josef Leopold Auenbrugger (1722 - 1809): father of percussion. Singapore Med J 2004 Vol 45(3):103 Walker HK, “The Origins of the History and Physical Examination,” Clinical Methods: The History, Physical, and Laboratory Examinations.Boston: Butterworths; 1990. Wallis F, Signs and Senses: Diagnosis and Prognosis in Early Medieval Pulse and Urine Texts. Social History of Medicine Vol. 13 No. 2 pp. 265-278. Wilcox RA et al, “The Symbol of Modern Medicine: Why One Snake Is More Than Two,” Ann Intern Med. 2003;138:673-677. Verghese et al, A History of Physical Examination Texts and the Conception of Bedside Diagnosis. Voswinkel P, From uroscopy to urinalysis. Clinica Chimica Acta 297 (2000) 5–16
Rank #1: Internal Medicine Pearls Part 1.
Rank #2: Internal Medicine Pearls #3. A look at some new data: COPD and Oxygen use - low serum creatinine levels - BMI considerations - the RDW - the age of blood.
Rank #1: 5 Pearls Ep2: Iron Deficiency Anemia. Solidify your knowledge on iron deficiency anemia! Quiz yourself on the 5 Pearls we will be covering: Should patients be screened for iron deficiency? If so, who and how often? (1:40) What are the indications for diagnostic endoscopy in iron deficient patients? (3:23) How should you advice patients to take oral iron? (5:53) What is optimal dosing for oral iron? In which patients would you consider IV iron? What are the risks? (11:41) Throwback Question: What is a medication-overuse HA? (14:44)For full shownotes: https://www.coreimpodcast.com/2017/11/15/5-pearls-on-iron-deficiency-anemia/
Rank #2: #22 Proton-Pump Inhibitors: 5 Pearls segment. Solidify your knowledge on Proton-Pump Inhibitors (PPIs) and more! Quiz yourself on the 5 pearls we will be covering: What are associated adverse effects for patients are on long-term PPIs? (2:02) What are strategies to get your patient off PPIs? (10:57) How do histamine-2 (H2) receptor antagonists blockers work and how can it explain why H2 blockers might not be as effective as PPIs? (13:30) How should you educate patients to take PPIs to get the maximize benefit? (16:48) How do you manage ongoing symptoms in patients on PPIs? (21:41) For full transcript of the podcast and references: https://www.coreimpodcast.com/2018/08/29/5-pearls-on-ppis/
Rank #1: Episode 418: Opioid use disorder in primary care – PART II. In episode 418, Tina, Mike and James continue to talk about managing opioid use disorder in primary care. We talk about tools used for case finding and decide the POMI tool is the most useful. We also discuss whether or not tapering is useful and look at the naltrexone data.Show notes
Rank #2: Episode 419: Opioid use disorder in primary care – PART III. In episode 419, Tina, Mike and James finish talking about managing opioid use disorder in primary care. We find that positive reinforcement and brief counseling can be of some value but not the opposite – we realize we should treat this in a similar way to a chronic condition.
Rank #1: Acute CVA with Dr. Jignesh Shah. Dr. Shah presents Acute CVA by first explaining how to evaluate a stroke patient, define a stroke and TIA as well as stroke epidemiology. He then discusses the concept of penumbra along with vascular anatomy and pathogenesis. After talking through the risk factors and classifying Ischemic stroke, Dr. Shah finishes with the signs and symptoms of a stroke. Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page.Disclaimers©2016 LouisvilleLectures.org
Rank #2: Nephrology IM Board Review with Dr. Lederer. Dr. Eleanor Lederer presents a Nephrology Board Review for residents at the University of Louisville. Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page. Disclaimers©2016 LouisvilleLectures.org
Rank #1: Diabetes. Intensive glycemic control for type 2 diabetes; interview with Victor Montori, MD, of the Mayo Clinic, Rochester; plus a summary of all the articles in the issue.
Rank #2: Heart failure. Cardiac resynchronization therapy; interview with Mariell Jessup, MD, of the University of Pennsylvania; plus a summary of all the issue's articles.
Rank #1: 392: How to remember antibiotic spectrum of activity. Show notes at http://pharmacyjoe.com/episode392 In this episode, I’ll discuss how to remember antibiotic spectrum of activity. The post 392: How to remember antibiotic spectrum of activity appeared first on Pharmacy Joe.
Rank #2: 138: The role of sodium bicarbonate in critically ill patients. Show notes at pharmacyjoe.com/episode138. In this episode, I ll discuss the role of sodium bicarbonate in critically ill patients. The post 138: The role of sodium bicarbonate in critically ill patients appeared first on Pharmacy Joe.
Rank #1: Screening for diabetes mellitus. This episode features Dr. David Nathan discussing screening adults for type 2 diabetes and increased risk for diabetes, and new recommendations for such screening as part of cardiovascular risk assessment. Dr. Nancy Sokol hosts.
Rank #2: Choice of basal insulin for management of diabetes; Evaluation of children with febrile seizures. In this episode, Dr. David Nathan discusses choice of basal insulin for management of type 1 and type 2 diabetes, and Dr. Douglas Nordli, Jr., discusses evaluation of children with febrile seizures. Dr. Nancy Sokol hosts.
Rank #1: Oxygenation & PEEP. A discussion of ventilation, oxygenation, and the role of PEEP.
Rank #2: Metabolic Acidosis in the ICU. A common problem in the ill or injured patient is a metabolic acidosis. In this episode we will review the common etiology of a metabolic acidosis as well as some lesser known causes.
Rank #1: How to master CPR. Little things can make a big difference when it comes to running a code. EMS director and CPR aficionado Bill Reed gives a primer on High Performance CPR. High Performance CPR core principles Rate = 110 (100-120). Metronome set at 110. Depth = 2.0-2.5 inches. Full recoil (no leaning). Focus on rate & depth. Listen for 15 second countdown warning of upcoming compressor switch. Change compressors at 2-minute intervals/cycles. Whenever possible, compressions performed from patient’s right side and new compressor comes in from the previous compressors right side. Opposite is true for left sided compressions. New compressor to “hover” over chest during rhythm check and/or defibrillation. No more than 5 second pauses for compressor change or rhythm checks. Immediately resume CPR after defibrillation (no pulse checks) or when rhythm check is complete. Airway/Respiratory NRB or nasal cannula at max flow initially. BVM when available. Rate = 1 breath every 10 compressions (unsynchronized). Volume = no more than ½ ambu bag. ETI when feasible or if no ROSC by 6-8 minutes as resources allow. ETCO2 monitor connected as soon as feasible. ETI should be accomplished by a provider other than code lead. Hands off patient and/or airway device at 2-minute check. Monitor/Defibrillator Attach as soon as possible. Standard pad placement. If witnessed VF while pads were in place for another reason, immediate charge and defibrillate. Otherwise, ensure CPR for at least 30 seconds before delivering any defibrillations. Pre-charge defibrillator 15 seconds prior to 2-minute checks. If non-shockable rhythm at 2-minute check, “dump” charge by pressing the decrease energy selection button. If shockable rhythm at 2-minute check, immediately defibrillate & resume CPR (no pulse checks). If VF on rhythm check at 6 minutes (third cycle), immediately defibrillate, then roll patient 30 degrees towards new compressor, attach new posterior pad slightly below and medial to the patients left scapula, roll patient back and resume CPR. Attach new anterior pad over left superior chest. Connect new AP pads to new monitor/defibrillator. At 8 and 10-minute checks (fourth & fifth cycles), pre-charge and defibrillate with new AP pads & monitor/defibrillator set at max joules. At 12-minute check (sixth cycle), pre-charge both defibrillators to max joules and defibrillate both “simultaneously” if patient is still in VF. One operator, two fingers. Caveats Changing to AP pads and/or double sequential defibrillation (DSD) is only for refractory VF. If VF converts with standard pad placement, AP pad placement, or DSD, use that pad placement and energy setting for recurrent VF defibrillations Venous Access IO is faster than IV. IV can follow IO. Central venous access should be accomplished by a provider other than the code lead. Drugs Know your rhythm before giving drugs! That tachycardia might be SVT or something that might not take kindly to a bolus of epinephrine Epinephrine Goal is for 3 doses in first 10 minutes. Can give at 2,4, & 6-minute checks or whatever time interval is most easily accomplished. After 10 minutes, goal is for Epi every 5 minutes. Amiodarone (for VF) Goal is for 2 doses in first 10 minutes. 300mg first dose and 150mg second dose. Can give at 2 & 6-minute checks or whatever time interval is most easily accomplished. Code Lead & Code Scribe/Time Keeper Confirm/ensure metronome use & appropriate CPR depth & rate. Confirm/ensure appropriate BVM or BV ET Tube rate and volume. Confirm/ensure ETCO2 connected and documented. Notify team of impending compressor change and rhythm check 15 seconds prior to the end of the 2-minute cycle. Confirm/ensure defibrillator is pre-charged. Interpret rhythm. Instruct defibrillator operator to deliver shock (or deliver shock if code lead is the operator) after confirming no team member is touching the patient. Confirm/ensure resumption of CPR and BVM after rhythm check and/or defibrillation. Request and confirm drug delivery at appropriately intervals. Confirm/ensure documentation of rhythm(s) and drug doses. Ensure all pauses are less than or equal to 5 seconds (use 5 sec verbal count down).
Rank #2: ZDoggMD. Zubin Damania (ZDoggMD) is an internist and founder of Turntable Health, an innovative healthcare startup that was part of an urban revitalization movement in Las Vegas. During a decade-long hospitalist career at Stanford, he experienced our dysfunctional health care system firsthand leading to burnout and depression. He created videos under the pseudonym ZDoggMD as an outlet to find his voice. This launched a grassroots movement — half a billion youtube views and a passionate tribe dedicated to improving health care for everyone. ERcast 2.0 Launches May 1 Click hereto learn more Or hereto sign up and skip the details In this interview we cover a wide range of topics including Underwear How ZDogg went from hospitalist to rapper to Medicine 3.0evanaglist Meditation The Mind Illuminated The roots of anxiety Mental preparation before giving a talk ZDogg's response to criticism, antipathy, and negative feedback from the anti-vaccine movement Nurse practitioners A Smattering of Performance Improvement, Stress Management, and Wellness Episodes Finding the Joyin Your Job Performance Coach Jason Brooks Making Order Out of Chaos How to Not Freak Out When Consultants Give Bad Advice Beating Stress and the Hot Offload Mastering the Storm Full Video Interview Below https://www.youtube.com/watch?v=bujZmXEtuHA My Favorite Zdogg Song https://www.youtube.com/watch?v=NAlnRHicgWs
Rank #1: Podcast 214: Drug-drug interactions and bleeding risks with NOACs. The non-vitamin-K oral anticoagulants (known familiarly as NOACs or DOACs) share metabolic pathways with other drugs, which can potentiate NOACs’ anticoagulant actions dangerously. Dr. Shang-Hung Chang and his group studied Taiwan’s national health insurance database, which records data on virtually all that nation’s citizens, to measure the actual risks of some of these drug – drug interactions. Their findings were published earlier this month in JAMA. Links: JAMA article (abstract) Physician’s First Watch coverage
Rank #2: Podcast 225: Managing diabetes in primary care — are there quality differences among NPs, PAs, and MDs?. Does the diabetes care afforded by NPs and PAs match that of MDs? According to a careful analysis among Veterans Affairs patients there are no clinical differences in intermediate outcomes — hemoglobin A1c, systolic pressure, or LDL cholesterol. The principal and senior authors of that analysis are our guests this time. Links: Annals of Internal Medicine study (free abstract) Annals editorial (Annals subscription required)