35 Burst results for "AFP"

Dan Bongino Comments on Latest Attack by AFP Face Check

The Dan Bongino Show

01:14 min | 4 months ago

Dan Bongino Comments on Latest Attack by AFP Face Check

"So this is what we were dealing with on the left yesterday The entire weekend The nonstop onslaught by the censorship obsessed laugh They hit our page with another fact check So I wrote this Sometimes on Facebook I'll go out and I'll just type something you know because I can't fit it in a mini blog like parlor So I wanted people to understand what I went through with COVID right After I got COVID and I put that I was saved by these miraculous antibodies when I contracted a severe case of COVID I said it's horrifying how quickly we've descended into total madness and third world republic status I talked about voting these people out and the post was about Biden's war on Florida and monoclonal antibodies I get fact checked by AFP You may say on what Dan that you had COVID Yeah Here's a quote from AFP fact check The Dan bongino said in December 2021 that he contracted COVID a month to a month and a half earlier A time when a crime was not the dominant variant in the United States What the hell does that have to do with anything I never mentioned I don't know what variant I had It's not even in the post I don't even now they're fact checking facts that don't even

Dan Bongino Facebook Biden AFP Florida DAN United States
"afp" Discussed on AFP: American Family Physician Podcast

AFP: American Family Physician Podcast

03:12 min | 9 months ago

"afp" Discussed on AFP: American Family Physician Podcast

"Neighbors right down the street. Doctors bryce and boonchai from abrazos. Family medicine right here. In phoenix arizona are at so this looks at fecal cal protection for use in the evaluation of inflammatory bowel disease for review. Cal protected is a protein expressed by neutrophils and can be an indicator of gastrointestinal inflammation. Fecal cal protected. Testing is fda approved to aid in the diagnosis of inflammatory bowel disease. And specifically the thought is that it can be helpful in differentiating ibd from irritable bowel syndrome in people who have gi symptoms. Dave let's talk accuracy. I are right so using a threshold of greater than fifty micrograms per gram fecal cal protecting and appears pretty accurate. Based on a systematic review of nineteen studies about five thousand persons older than sixteen years old the pooled sensitivity was eighty percent and the pooled. Specificity was eighty percent similar. Accuracy was seen in prospective cohort studies of children this highest sensitivity means that. Ib is unlikely in adults and children with the fecal cal protect and less than that fifty micrograms per gram cutoff in children. Using the combination of fecal cow protect in with a cutoff of two hundred fifty micrograms per gram along with c reactive protein of greater than one milligram per deciliter and hemoglobin of less than two standard deviations below. The mean for age and sex has a sensitivity of one hundred percent and specificity of ninety seven percent for diagnosis of inflammatory bowel disease. Heather talked to us about potential benefits and harms of this test. Yeah so like. Dave said normal level could help rule out. Ibd meaning a major benefit of helping someone to avoid endoscopy on the harm side though. False negatives may delay diagnosis so anyone with high clinical suspicion for inflammatory bowel disease based on history and physical should skip this test. There's also concern for false positives based on the lower specificity of the test which would lead to unnecessary endoscopy. And lastly let's hit on cost. It's relatively cheap according to the cms fee schedule. It's about twenty bucks. Of course that is much less than the cost associated with endoscopy. So bottom line fico cow. Protecting is an accurate cost effective tests that can aid in ruling out inflammatory bowel disease. Nice please email us at af. Podcast at afp. Dot org or tweet at af p podcasts. Please rate and comment wherever you got your podcasts. Our podcast team is jake anderson. David by stra steve brown. Sarah coles maggie gergen zuliana ibrahim heather merchant andrew. Ocho and jamie sherman are sound in technical guru. Is tyler coles..

Facebook Disables Topic Recommendation Software After It Tags Black People As "Primates"

BBC Newsday

00:16 sec | 9 months ago

Facebook Disables Topic Recommendation Software After It Tags Black People As "Primates"

"News agency. AFP says Facebook has told it that it's disabled its topic recommendation feature after it mistook Blackman for primates in video clips. Facial recognition software has been criticized by civil rights activists who say it can be inaccurate.

AFP Blackman Facebook
"afp" Discussed on AFP: American Family Physician Podcast

AFP: American Family Physician Podcast

02:24 min | 9 months ago

"afp" Discussed on AFP: American Family Physician Podcast

"Colorado so drew. I've been thinking during my zuma classes. Socially distance of course can physical activity prevent the development of depression. Yeah heather sure can. Recent meta analysis looked at forty nine different studies included over two hundred sixty thousand individuals to see a physical activity decrease the risk of developing depression. None of the participants had depression at the start of their trials and physical activity was self reported and defined as any bodily movement that required energy expenditure so basically anything like zoom that exactly it was found that patients who had low levels of physical activity were more likely to develop depression than those who had engaged in high levels of physical activity. All the trials lasted at least one year were conducted in multiple different locations and different age groups but regardless of age or the study took place. Physical activity was found to be protective against developing depression. That is great. I got another one for you. A twenty eighteen perspective courts that he with over thirty three thousand adults who were followed for eleven years. That's a long time. I know and it showed a statistically significant increase in the incidence of depression for those who were not physically active compared to those who had just one or two hours of physical activity a week. That's only like to zoom that class. Yeah it sure is. I got another one for you here. It's a twenty eighteen study that looked at sixty one university students to see the effect of exercise intensity and the development of depression subjects were split up into groups of no exercise. Moderate training or six weeks of high intensity interval training both the moderate and high intensity training groups had a significant decrease in depressive symptoms when compared to the control group in fact students in the control group actually had a statistically significant increase in their depressive symptoms which was probably from their university studies. They were probably all pre-med. Yeah probably so in summary yes. Physical activity appears to be associated with a lower risk of developing depression and depressive symptoms with a strength recommendation. Be finally we have a poem. Poems are patient oriented evidence that matters and this is from dr shaughnessy so their question was do. S she l. t. two inhibitors or gop..

depression depressive symptoms heather drew Colorado dr shaughnessy gop
"afp" Discussed on AFP: American Family Physician Podcast

AFP: American Family Physician Podcast

02:28 min | 9 months ago

"afp" Discussed on AFP: American Family Physician Podcast

"The only contra indications known allergy to the vaccine and current pregnancy although vaccination is not routinely recommended in people twenty-seven or older since most have been exposed to hp you can use shared decision making to guide vaccinating folks age twenty seven to forty five. The vaccine used in the us is the gardasil nine which effectively protects against nine hp strains shown to be responsible for more than ninety percent of hp related carcinomas super exciting. So in summary vaccinate everybody and then we can forget about all the scary stuff some day. Yeah let's talk about a gram center policy one pager. An editorial in this issue points out that american family physician has been publishing policy. Briefs from the robert graham center for over two decades the graham center based in washington dc creates and curates evidence to inform policies that support primary care and family medicine so a primary care policy think tank. Yes the graham center and the journal one pagers are gold mine for reviewing things that matter most primary care on a policy level our one pager in this issue is entitled state level variation in primary care physician density from doctors merit jobber. Poor peterson and westfall. Sadly the number of primary care. Physicians has been declining for decades. Even though we have evidence that better health outcomes are achieved with higher proportion of primary care there are substantial geographic disparities as shown in this article using data from the american medical association master file and the us census borough these authors calculated the ratio of primary care physicians per one hundred thousand residents in each state. There is substantial variation between states from the lowest forty nine primary care physicians per one hundred thousand population in mississippi to one hundred and thirty one per one hundred thousand in washington. Dc our own home arizona's in the bottom ten with sixty per one hundred thousand. Oh no we need you along with more family. Medicine residents drew and heather. We're working on it. We need policy advances to recruit more medical students to primary care more expansion of residency training programs to engage a rural workforce and we need to retain current primary care..

graham center robert graham center hp Poor peterson allergy westfall washington dc us american medical association mississippi arizona heather drew
"afp" Discussed on AFP: American Family Physician Podcast

AFP: American Family Physician Podcast

05:26 min | 9 months ago

"afp" Discussed on AFP: American Family Physician Podcast

"Scan to determine the underlying ideology. Yes this is. A green the benefit outweighs the harm. However the generalize ability to family physicians and others performing point of care. Ultrasound is still unclear from this review. Who's ready for a poem me. Let's do it. yes let's talk about. Covert nineteen symptoms after discharge for hospitalize adults. This poem patient oriented evidence that matters is based on a recent perspective court study published in jama and his brought to us by dr henry berry of michigan state university in east lansing michigan. Go green odd to say that. Yeah kind of the take home message from this study. is that more than one. Half of adult survivors of cove in nineteen reported a significant amount of persistent symptoms. Four months after discharge. This was a level of evidence. One be while four months so who is included in the study. This looked at adult patients admitted to a hospital in france between march and may of twenty twenty who had a diagnosis of sars kobe to infection by either pcr or by clinical features associated with typical lung findings on c. t. those who are reporting continued symptoms in all those admitted to the icu. Were also invited for an in-person evaluation which included a cat scan neuro psychometric testing and for any who had been in the icu. A transfer ethic echocardiogram more than half of the patients reported ongoing symptoms at four months. But what symptoms were most common fatigue and around thirty percent and memory difficulties dystopia and persistent para sesia all closer to fifteen percent or the most reported symptoms. Psychometric testing also confirmed cognitive impairment and almost forty percent of patients abnormalities on c. T. an echocardiogram were also commonly noted among these patients as well especially those who had been in the icu well yet another reason to keep encouraging our patients to get vaccinated absolutely. Yes we're going to close out this episode with a message from to special guests american family physician student and resident editorial board members. Hi everyone this is. Go senator from pittsburgh and and risen to representative to a this is priscilla august from arkansas. And i'm a student representative. Afp we are here today to promote the before the contest and share or student and risen repetition in a p. We are super excited to join the podcast. Today let's start with the afc photo contest. This contest is a brand new project and is intended to encourage students and residents to share your stories. About how you use the afc journal all you need to do is take a photo and write a short description then. Email it to us at f. Edits at afp. Dot org and or tweet with the hash tag. Afc journal photo and tag at afdc journal. Precise i saw yours. You're falling asleep while reading a journal. But you're dreaming of reading a few. I suddenly did that before. I also like your photo can't tell because it highlights how great. Afp is as a teaching tool and you know what. I can't wait to see what everyone else comes up with. You can i. Let's talk about our position. E. s. p. definitely the application is now open for joining the afp journal editorial board as the resident and student representative. Prasada can you share what you have done for the past eight months. Sure it's been quite an amazing ride. I submitted a practice. Guideline and a diary of a family physician entry to the afp contributed to social media. Posts helped develop the photo contest and worked on the afc diversity equity and inclusion task force. It's been a great experience and a highly recommended to any student that is interested. Great thing is you don't have to be an expert and the members of the editorial board love to teach that sounds fascinating and he's very true us resident read peer reviewing a p. Papers is editor in chief. Dr sexton was so rich and precious. I highly recommend you to apply for this politician. If you're interesting writing or editing. When is the deadline. The deadline is september eighth. Please for a twitter or facebook account to find information about how apply this is canto this is priscilla. Please email us at afc. Podcast at afp dot org or tweet at afc. Podcast please rate and comment wherever you get your podcast. Our podcast team is jake anderson. David bliss blister steve brown. Sarah coles maggie.

dr henry berry icu afc east lansing jama michigan state university Afc journal afdc journal michigan afp priscilla afp journal france Prasada pittsburgh arkansas Dr sexton
"afp" Discussed on AFP: American Family Physician Podcast

AFP: American Family Physician Podcast

02:33 min | 9 months ago

"afp" Discussed on AFP: American Family Physician Podcast

"Next pertussis tests common questions and answers from doctors. Klein smith and zavala from west virginia. Despite universal immunization the incidents of protests in the united states has increased steadily from a thousand and ten reported cases in nineteen seventy six to a peak of forty eight thousand two hundred and seventy seven cases in two thousand twelve. Therefore pertussis remains a public health concern. Yeah that is a disappointing revelation maggie. Why does protesters remain common disease. Despite the high vaccination rates unfortunately certain protests strains have shifted away from displaying the a cellular vaccine antigens we use in our vaccines we're also seeing a waning of immunity. So i guess it's time to review good old pertussis dave jerry call the typical presentation of protests. Yeah the presentation of protest is classically divided into three stages. The first stage is catarrhal which presents similar to a typical viral respiratory infection lasting one. To two weeks the second ages paroxysm uil which presents as a paroxysm uil coughing with apnea whooping on inspiration. After coughing and post husted emphasis that phase last one to six weeks. The last stage is convalescent. Which is characterized by improving but persistent cough and last two to four weeks. Keep in mind though. Patients don't read the tax but not all patients with these three classic stages of presentation and their symptoms and signs or more dependent on their age and immunization status. All right so how can we diagnose a patient with pertussis. The diagnosis of pertussis is made by both clinical features and confirmatory lab results. Although the cdc and who have developed case definitions to assist with diagnosing protests no validated accepted. Clinical decision rule exists a systematic review found individual signs and symptoms were not particularly helpful in diagnosing protests but the clinicians overall impression may be helpful with the positive likelihood of three point. Three which still isn't really all that helpful. No you might need testing. Pcr remains the most accurate test to confirm protests with a positive likelihood ratio. Much better of thirteen and a negative likelihood ratio of zero point zero three..

Klein smith dave jerry zavala west virginia maggie pertussis united states apnea cough cdc
"afp" Discussed on AFP: American Family Physician Podcast

AFP: American Family Physician Podcast

01:58 min | 10 months ago

"afp" Discussed on AFP: American Family Physician Podcast

"There are a few considerations when it comes to how often to test and which test to use for newborns based on their history and risk newborns should be tested for hiv with nucleic acid amplification testing and pc are testing for hiv dna and arnie as opposed to antibody or combined antigen antibody tests. Be sure to check out table. One in the article for review of the specifics if hiv in the newborn cannot be presumptively excluded. Start backstrom at four to six weeks of age for pj p. prophylaxis and monitor the patients cbc while on art as well as closely monitor for signs of acute hiv infection fever rash and opportunistic infections. Important note thankfully none of this has to delay routine vaccination for the infant the also recommends asking families about pre massification of food and discouraging this practice due to this also leading to transmission. So key points here. Are we have room to improve our ways to prevent and manage. Hiv perinatal transmission efforts should focus on antenatal testing an anti retroviral therapy recommending formula feeding planning for c. actions for patients with high viral loads and frequency of testing and specific art depending on the newborns. And oh don't forget to ask the parents about pre medication please. Email us at. Afp podcast at afp. Dot org or tweet at af podcasts. Please rate and comment wherever you got your podcasts. Our podcast team is jake. Anderson david Steve brown sarah coles maggie gergen zuliana ibrahim heather merchant andrew. Ocho and jamie sherman are sound and technical guru is tyler coles. Our.

hiv infection fever rash backstrom Hiv perinatal cbc Anderson david Steve brown afp sarah coles maggie gergen zuliana ibrahim heather jake jamie sherman Ocho andrew tyler coles
"afp" Discussed on AFP: American Family Physician Podcast

AFP: American Family Physician Podcast

03:32 min | 11 months ago

"afp" Discussed on AFP: American Family Physician Podcast

"The <Speech_Female> <Silence> <SpeakerChange> <Speech_Male> <Speech_Female> compared <Speech_Female> five different <Speech_Female> analgesic treatments <Speech_Female> the <Speech_Female> contenders were <Speech_Female> a thousand <Speech_Female> milligrams of acetaminophen <Speech_Female> with either <Speech_Female> four hundred milligrams <Speech_Female> or eight hundred <Speech_Female> milligrams of ibuprofen <Speech_Female> <Speech_Female> three hundred <Speech_Female> milligrams of acetaminophen <Speech_Female> with thirty <Silence> milligrams of codeine <Speech_Female> <Speech_Female> three hundred milligrams <Speech_Female> of acetaminophen <Speech_Female> with five milligrams <Speech_Female> of hydrocortisone <Speech_Female> <Speech_Female> or three hundred <Speech_Female> twenty five milligrams <Speech_Female> of acetaminophen with <Speech_Female> five <SpeakerChange> milligrams <Speech_Female> of oxycodone. <Speech_Female> They suss <Speech_Female> pain on a scale from <Speech_Female> zero to ten. <Speech_Female> Were ten is <Speech_Female> the worst <Speech_Female> most started between <Silence> eight and ten <Speech_Female> paint <Speech_Female> scores in all <Speech_Female> groups decreased an <Speech_Female> average of three points <Speech_Female> one hour <Speech_Female> after administration <Speech_Female> and <Speech_Female> by four point three <Speech_Female> to four point <Speech_Female> seven points after <Speech_Female> two hours <Speech_Female> without significant <SpeakerChange> differences <Speech_Female> among the groups. <Speech_Male> A decreased <Speech_Male> by over <Speech_Male> four points is pretty <Speech_Male> good. <Speech_Male> Were there any side effects. <Speech_Female> Though <Speech_Female> nausea and vomiting <Speech_Female> were significantly <Speech_Female> higher in the groups <Speech_Female> who perceived <SpeakerChange> opioids <Speech_Female> <Speech_Female> tylenol. Ibuprofen <Speech_Female> for the win. <Speech_Female> And <Speech_Female> another major <Speech_Female> key point they found <Speech_Female> there was <Speech_Female> no added benefit <Speech_Female> of taking eight <Speech_Female> hundred milligrams of ibuprofen <Speech_Female> compared <Speech_Female> to taking four hundred <Speech_Female> milligrams. Save <Speech_Female> those <SpeakerChange> kidneys. <Speech_Female> <Speech_Female> This has given a <Speech_Female> level of evidence <Speech_Female> rating one b <Speech_Female> and. These results <Speech_Female> are similar to previous <Silence> studies. <SpeakerChange> <Speech_Male> Let's <Speech_Male> wrap things up <Speech_Male> with cochran for clinicians <Speech_Male> rapid <Speech_Male> point akara <Speech_Male> antigen and molecular <Speech_Male> tests for <Speech_Male> diagnosis of stars <Silence> kobe to infection <Speech_Male> and <Speech_Male> this comes to us from doctors <Speech_Male> simmons <SpeakerChange> <Speech_Female> and skill <Speech_Female> the clinical question. <Speech_Female> Here is <Speech_Female> what are the sensitivity <Speech_Female> and specificity <Speech_Female> of point <Speech_Female> of care antigen <Speech_Female> and molecular <Speech_Female> based tests for <Speech_Female> detecting <SpeakerChange> sars cova. <Speech_Male> Too <Speech_Male> quick note sars <Speech_Male> kobe to infection <Speech_Male> status to determine <Speech_Male> the accuracy <Speech_Male> here was based <Speech_Male> on positive. Pcr <Speech_Male> testing done <Speech_Male> at the time <Speech_Male> of the point of care test. <Speech_Male> So let's <Speech_Female> start <SpeakerChange> with the antigen <Speech_Female> tests. <Speech_Female> Sars kobe <Speech_Female> to antigen tests <Speech_Female> haven't average <Speech_Female> sensitivity of <Speech_Female> sixty eight point nine <Speech_Female> percent and <Speech_Female> an average specificity <Speech_Female> of ninety <Speech_Female> nine point six <Speech_Female> percent. <Speech_Female> This means that antigen <Speech_Female> testing is <Speech_Female> much better at <Speech_Female> ruling in sarah's <Speech_Female> koby to <Speech_Female> as <SpeakerChange> opposed to <Speech_Male> ruling it out <Speech_Male> much better <Speech_Male> at ruling in <Speech_Male> this was based on <Speech_Male> review of studies that <Speech_Male> included sixteen <Speech_Male> different commercially <Speech_Male> available antigen <Speech_Male> tests with over <Speech_Male> twenty one thousand <Speech_Male> samples in <Speech_Male> over sixty one hundred <Speech_Male> confirmed cases <Speech_Male> sensitivity <Speech_Male> was higher <Speech_Male> in those with symptoms <Speech_Male> and specifically <Speech_Male> those within <Speech_Male> their first week <Speech_Male> of symptoms compared <Silence> to week <SpeakerChange> number two <Speech_Female> the <Speech_Female> standard queue <Speech_Female> covid nineteen <Speech_Female> antigen tests <Speech_Female> stood out in this review <Speech_Female> as having <SpeakerChange> the best <Speech_Male> performance <Speech_Male> and what about <Speech_Male> those rapid <Speech_Female> molecular <SpeakerChange> <Speech_Female> tests sars <Speech_Female> koby to <Speech_Female> rapid molecular tests <Speech_Female> have an average <Speech_Female> sensitivity <Speech_Female> of ninety five <Speech_Female> <Advertisement> point one percent <Speech_Female> <Advertisement> and a specificity <Speech_Female> of ninety <Silence> eight point <SpeakerChange> eight percent <Speech_Female> <Speech_Female> the two most studied <Speech_Female> tests worthy. <Speech_Female> Id now <Speech_Female> nineteen tests <Speech_Female> by abbott <Speech_Female> and <Speech_Female> <Advertisement> the expert express <Speech_Female> sars covy <Silence> to test. <SpeakerChange> <Music> <Music> <Music> <Music> <Speech_Music_Male> <Music> <SpeakerChange> <Speech_Music_Female> <Speech_Female> Please <Speech_Female> email us at af <Speech_Female> podcast <Speech_Female> at. Afp <Speech_Female> dot org <SpeakerChange> or tweet <Speech_Female> <Advertisement> at afp. Podcasts <Speech_Female> <Advertisement> please <Speech_Female> rate and comment wherever <Speech_Female> you <SpeakerChange> got your podcasts. <Speech_Female> Our podcast <Speech_Female> team is <Speech_Female> jake anderson. <Speech_Music_Female> David blake <Speech_Music_Female> steve brown. <Speech_Female> Sarah coles <Speech_Female> maggie <Speech_Female> gergen zuliana <Speech_Female> ibrahim <Speech_Female> had merchant <Speech_Female> andrew. Osceola <Speech_Female> and jamie sherman <Speech_Female> are <Speech_Female> sound and technical. Grew <Speech_Female> is tyler coles. <Speech_Female> Our

"afp" Discussed on AFP: American Family Physician Podcast

AFP: American Family Physician Podcast

04:09 min | 11 months ago

"afp" Discussed on AFP: American Family Physician Podcast

"Back pain more effective with a combination of ibuprofen in a muscle relaxant compared to ibuprofen alone. This is definitely a practice changer. For me metoo. Because they found that in patients with acute low back pain adding muscle relaxant to treatment with ibuprofen does not improve things like functional or pain boom so many good poems as past here. But i think there's one clear poem to in the segment with you guys ready for it all right. Family docs is continuity of care. Associated with decreased mortality greater primary care continuity was associated with lower all cause mortality. We know this but it's nice to have a systematic review that proves it. Let's move along to a practice. Guideline pharmacologic management of copd exacerbate tensions a clinical practice guideline from the afp. And this comes to us. Like i said from our group over at the a. f. p. let's play a game j the j just to be clear which which i am. I the first day or the second jay. Since you asked you could be the first day all right. Well you are older age before beauty all right. So let's see list therapy that can treat. Copd exacerbations i'm going with corticosteroids. Yes corticosteroids has a number needed to treat of three to prevent clinical failure for duration of therapy. Three to five days is our sweet spot. treating for longer does not show a benefit in fact a longer. Steroid course is a sociopath with a higher risk for hospitalization for pneumonia and mortality jamie. What's another therapy antibiotics. Bingo antibiotics increased clinical cure with an n. N. t. of seven evidence is insufficient to suggest a superior antibiotics so amoxicillin augmentin. Doxycycline can be used usually a seven day. Course okay. it's one one. The next round is called your or nay all suggest that therapy and you'll say yay or nay short acting broncho dilates like albuterol. Oh jamie goes with okay ash. Though they're routinely used there is a lack of evidence and studies showing benefit still because of them being recommended so widely and you so commonly in this area the aarp considers this a research gap and considers the use of short acting broncho. Dilate as good practice point all right. The offline magnesium sulfate and mukul lyrics may all right chest physiotherapy. yes man chest. Physiotherapy does not improve outcomes in copd. Exacerbations jamie ran poop. Your prize is to summarize our treatment course for copd exacerbation prize. It is all right so three to five days of steroids and seven days of antibiotics for copd exacerbations and you can skip on the offline magnesium sulfate and mukul ethics with. Let's move onto diagnostic tests. Physicians need to know and this one looks at jean site. Psychotropic genetic testing for psychiatric medication selection and comes to us from doctrine. Natasha pizzonia from seattle washington. I'm all for personalizing medicine and learning about your body and it's needs but i also support the use of evidence based medicine in order to best treat my patients with that in mind. Let's look at the new panel. Gene site psychotropic pharmacogenomic tests. That is supposed to help taylor psychiatric medications for patients based on their jeans. Yep this test. Analyzes the response to fifty seven different medications and separates them into categories that indicate level of gene drug interaction rate of metabolism of the drug and the potential for adverse effects..

copd jamie afp Exacerbations jamie jay pneumonia aarp Natasha pizzonia seattle washington taylor
"afp" Discussed on AFP: American Family Physician Podcast

AFP: American Family Physician Podcast

02:36 min | 11 months ago

"afp" Discussed on AFP: American Family Physician Podcast

"One of the july twenty twenty one issue. I'm jake jamie and zili in. We are residents and faculty mostly residents of the university of arizona. College of medicine phoenix. Family medicine residency. This time on the podcast. We'll talk about unintentional weight. Loss the top twenty research studies at twenty twenty. Copd exacerbations gene site diagnostic tests. Single dose analgesics. And we'll have a cochran for clinicians looking at antigen and molecular test for stars koby to the opinions expressed in the podcast our own and do not represent the opinions of the american academy of family physicians. The editor of american family physician or banner health. Do not use this podcast for medical advice instead. Sear doctor for medical care that's right listeners. It's season seven which means we're back with a whole new team of amazing residents and were excited to bring you more american family physician. Podcast first up. We have a main topic. Unintentional weight loss in older adults in this comes to us from dr day from grant medical center in california and dr holder from kaiser permanent day in vallejo california. What's the first thing that comes into your head when you think about an older adult with unintentional weight loss. Ooh the c word. Yeah cancers one of the first things i think about to but actually malignancies only responsible for up to a third of cases of unintentional weight loss which must mean that non malignant causes are much more common. Yes that would be a logical conclusion. So what are some non malignant causes weight loss that you guys can think of psychological things like depression anxiety or other mood disorders. Social reasons like not being able to go to the grocery store due to weakness disability or dementia. We're not being able to cook meals for yourself or financial like not being able to afford to go to the grocery store or afford reliable transportation. Even if you're physically able to go yeah. So reasons for weight. Loss also includes physical illness like gi disorders. Such as peptic ulcer disease medication side effects and poly pharmacy can change people's sense of taste and smell and caused decreased appetite dry mouth dysphasia and nausea lots of things to consider your thankfully. There's a nifty mnemonic to help us remember all the reasons why older people can lose weight..

"afp" Discussed on AFP: American Family Physician Podcast

AFP: American Family Physician Podcast

02:33 min | 11 months ago

"afp" Discussed on AFP: American Family Physician Podcast

"This could lead us. To increase rates of multi-drug resistant organisms treatment failure prolonged hospitalizations and overall increased healthcare costs. Some it really sounds like determining when a penicillin allergy is true could be of great benefit. Exactly the preferred test is a former drug challenge which checks for i g e mediated hypersensitivity to penicillin which is type one hypersensitivity. Skin test is also validated tool and is commonly used in certain settings where formal drug challenges aren't possible or timely applying clinical prediction rules based off. A patient's history may be worth considering and so we present to you today. The pen fast rule which was recently studied and validated pen. Fast is short for penicillin allergy. Five or f- fewer years ago a nfl. Access andro dima s severe t treatment which is a clinical prediction rule derived from a prospective cohort of six hundred and twenty two allergy tested patients in australia. And then it was externally validated in other areas of australia. And the us it consists of scoring based on three risk factors and the scores range from zero to five. The first risk factor is if the allergy event occurred five years ago or less which gives the patient two points. They had another two points if the reaction was nfl. Axis and gio dima or a severe cutaneous reaction. Lastly they get one point if they required treatment for the episode. The study caught is a score of three or less since it was determined that these patients had nineteen percent. Risk of true positive penicillin. Allergy at this cutoff score. The sensitivity was seventy point seven percent and the specificity was seventy eight point five percent the extrapolated the likelihood of a true allergy for score of three or less with similar to a negative result on skin testing. It's pretty good and it may be a useful tool to help make decisions about immediate antibiotic treatment and a referral for allergy testing. It's important to note that the limitations included an underrepresentation of non white populations. Children were excluded from the study and mostly involved in patient testing also important to note that of those patients who scored a zero or redeemed. Very low risk still had zero.

australia nineteen percent two points five percent zero seven percent five seventy point today one point three gio dima five years ago seventy eight point first risk factor six hundred and twenty two all three risk factors fewer years ago nfl. Axis
"afp" Discussed on AFP: American Family Physician Podcast

AFP: American Family Physician Podcast

03:32 min | 1 year ago

"afp" Discussed on AFP: American Family Physician Podcast

"I don't think anyone would argue with the premise. That blood sugar control is an important component of decreasing post op infection. But this f- pin proves that. I'm not the only one that's pause when reading a note from an orthopedic surgeon with a very specific and often low onc- requirement prior to proceeding with joint replacement. Mri writes the clinical question is in patients with diabetes mellitus who are preparing for total joint replacement. What is the pre-operative a one. C goal to reduce post operative. Perry prosthetic joint infection or any guesses before we dive in lieu. I like it. Great minds think alike clam a bunch of listeners. Just through their a one. C machines at you guys for saying that. But i do love the conservative approach all right so the most direct answer came from two retrospective studies from twenty seventeen. The i included over seven thousand seven hundred patients and affirmed that the risk of infection increases as the peri operative increases. They used seven point five percent as a cutoff and found that of the eight hundred. Seventy seven patients with an a. One c. of seven point five percent or higher twenty one or two point four percent had a post operative perry prosthetic infection compared to sixty nine or one percent of the remaining six thousand eight hundred fifty nine patients with an one c. Less than seven point five for those listeners. That are abm nerds like us. That's an absolute risk reduction of one point. Four percent put another way an a one. C of less than seven point five had an inning t of about seventy two to prevent one infection in the second retrospective study just over sixteen hundred patients with diabetes. Were analyzed only twenty. Two cases of perry prosthetic joint infections occurred but they identified that seven point. Seven percent was a predictive threshold for patients with an agency of less than that seven point. The infection rate was zero. Point eight percent for those with an nc above seven point seven the rate was higher at five point four percent so an unc of less than seven point seven was associated with an absolute risk reduction of four point. Six percent were in an anti of twenty two. Interestingly they weren't able to identify any other complications that were associated with high a onc- levels in that study there has been a meta analysis published in two thousand eighteen. That looked more aggressive. A one c cutoff of seven based on the pool data from six studies there was not a statistically significant association between surgical site infection or prosthetic joint infection. Anyone see over seven. So the authors of this f penn conclude that although there isn't a definitive evidence based a one c goal. The evidence does suggest that had level of less than seven point. Five percent may reduce risk of perry prosthetic joint infections. We were pretty close. Yeah not bad lambert. Yeah you guys. Ready for cochran four clinicians. This one looks at pessaries for managing pelvic organ. Prolapse in comes to us from a team out of penn state university college of medicine in state college pennsylvania. All right you guys. Hold onto your pelvic organs. I guarantee you feel uplifted. After this segment Oh my podcast. They're actually all.

six thousand Seven percent Four percent Six percent eight hundred one percent Five percent five percent four percent Seventy seven patients zero eight hundred fifty nine patie sixty nine two thousand over sixteen hundred patients over seven thousand seven hund one point twenty seventeen two point eight percent
Brittany Higgins Files Police Report on Parliament House Rape Claim

The Signal

05:45 min | 1 year ago

Brittany Higgins Files Police Report on Parliament House Rape Claim

"Almost a not. Australia has been transfixed by the story of brittany hagans. The former political stuff who alleges she was raped in a minister's office inside parliament house more allegations against the same men have followed along with ongoing rounds of recriminations about how badly brittany higgins case was handled all giving rise to the clear impression that something is very wrong in parliament house on stephen smiling. And i'm angie lovelock and today on the signal the case that might just trigger some desperately needed reform women in australian politics. Okay so it's it's been a couple of weeks. Maybe you could take back to the moment when this story broke. Yes so it was the first monday of this sitting fortnight around eight o'clock the morning. This is clear armstrong. She's the national political reporter at the daily telegraph newspaper based in parliament. House in canberra. An article appeared on newstalk today written by a journalist code cement the maiden and she Published the allegations of brittany higgins question of where the parliament housing camera is a safe workplace for women is again in the headlines following allegations that a young government staff member was raped in minister's office in an interview with news dot com dot. Au higgins claimed. She felt forced to choose between reporting the assault to police or keeping her dream job. Britney alleges that she was raped by a maiocco lake in the office of now defense minister linda reynolds and The instant reaction i would say was one of complete and utter shock. This abject failure to provide a safe place of work here in parliament and in politics more. Broadly has got to come to an. I think there is. I called for problem inside this building. I've spoken about it many times. I think for far too long young. Women have copped the brunt of the culture in this place and it's time we cleaned it up often beak political scandal type stories us saved until the monday of a sitting week. Because of course you have all of the politicians in cambra unable to escape the issue which was pretty much exactly why that story was published when it was but then quite quickly became apparent that this was going to be a really huge issue. More than i think what people may be realized at that moment because of course she was also booked. This brittany was also booked to appear on the project that night and give a full kind of unfettered account of what she was alleging. And that's really how it kicked off really starting the week with the most possible drama. I think i've had since. I've been camera eighteen months. Welcome back to this special edition of the project tonight. Claims of ripe roadblocks to a police investigation and a young woman forced to choose between her career and the pursuit of justice. And it all happened right in the heart of our democracy as you said clear. It broke on the monday of the start of this session. But the details of britain higgins allegations relate to twenty nineteen. What does she say happened in. What happened back then when she first talked about it. Yeah absolutely so her. Her allegation dates back to sort of the friday. Saturday of of twenty dead of much in two thousand nineteen And brittany alleges that when she was out at a with colleagues drinking at one point The the man she alleges raped her. She says through the night he'd hurler drink. She realized she was quite drunk. Wanted to home. I notice that he was buying meal out of drinks. And i was just sort of job. Well done kind of broadly being rewarded in a weird way. So would you say you were drunk when you decided to go home obsolete. She says it was suggested that because they lived in the same direction. They should share cab when she was in that cab he said i've got to pick something up from parliament on the way i and she goes along with it ends up being signed dean to parliament. Neither of them have their passes. It's quite light after hours. They have to sign themselves. Will he. signs. Both of the men go into the office. She says she would feel well. She laid down and she alleges that she wake up with with demand on top of that i woke up mid ripe essentially. I don't know why i knew. He was almost finished. But i felt like it had been going on for a while or that. He was done. He was sweaty. I couldn't get him off of me at this point. I started crying fast. Forward to the the the start of the workweek she. She comes to work and immediately. The issue is initially traded as security breach because obviously Linda reynolds was defense industry minister at the time a lot of classified important information potentially in that office so she learns pretty quickly that the male stafa involved in these instant has already been had their employment terminated over these potential security breach and she's brought into a series of formal employment meetings to discuss. What is that time. Believed to be a security breach felt like a disciplinary meeting. It was we've been made aware of the events in that. You guys were here after hours. And you know that's not acceptable She of course then disclosed to her boss when reynolds what she alleged happened to her and that also then led her going to the afp.

Brittany Higgins Parliament House Brittany Hagans Angie Lovelock Parliament Housing Camera Au Higgins Linda Reynolds Cambra Daily Telegraph Brittany Canberra Armstrong Stephen Parliament Britney Australia Higgins Britain Reynolds
No country for face masks: Nordics brush off mouth covers

Heartland Newsfeed Radio Network

08:14 min | 1 year ago

No country for face masks: Nordics brush off mouth covers

"The AFP. Nordics brushoff mouth covers Stockholm as most of the world either orders or recommends the use of facemask swith even US President Donald Trump, seen one nordic nations are remaining hold-outs in supermarkets on buses along with the streets of capitals, such a Stockholm Copenhagen Oslo Helsinki, and Reykjavik. That's the Nordic nations. Face masks are a rare sight worn only by a small minority many of whom are tourists according to a recent survey by YouGov only five to ten percent of respondents in Nordic countries said they used masks in public settings figure that has remained stable since the start of the crisis in March. and. Yeah I. Mean You know I I think that what I would like to see as we walk out of this as masks for. Sort of for people who want to wear them specifically for people who? Aren't feeling really super great that day maybe maybe today's good data wear a mask and not fill the era with whatever you've gotten sometimes, I don't feel good when you get up I. would certainly be railing against the idea if if someone was like, no, we as the government have decided that we need to have heard immunity as quickly as possible. Therefore, we are forbidding masks offer bidding people to wear them or for them to be made or for them to be distributed I, would be railing against that kind of also be a non issue for sick people if it was the social norm that you don't have to go places when you're sick, right I think that that's Know the first thing is that we have to get rid of whatever that idea was. That was going on in the parents of in the ideas of the heads of my parents when I was a kid. Came from a family admittedly, you know the sort of Lutheran Calvin est kind of cut from that cloth where. You could stand you went to work. Suffering is good for your soul that kind of thing, and I got at least half of the Times throughout the thirteen years that I went to school perfect attendance. They'll that is is a declaration that I made people ill. I mean. You there shouldn't be an award for perfect attendance at school. What that says is that you've made poor choices to my mind. So does your parents have made poor choices because they're not talking about college talking about underage people understood but I, and again I'm not an opposing to hang. You know anybody for this. I'm just saying, Hey, we need to stop and think about this. 'cause only recently in the relatively recent past the last couple of decades or something have I heard people talking about you shouldn't go to work or school if you're sick. Actually. I was hearing the opposite when I was young. And so let's go on. That's a move in the right direction. At the same time, the corresponding figures have risen between seventy and eighty percent for most of the other twenty, eight polled including India and the United. States. So that's people wearing masks. Going up to seventy and eighty percent. I have the impression that if the government doesn't say clearly, we advise you to wear a mask nobody will twenty one year old French. Student Camille four to know of Fortuna Rowley told the F. adding that she was shocked to see how rare masks were in Stockholm. Bridget Y DEL sixty three year old pensioner told AFP that she would have preferred if Sweden's authorities recommended masks at least on public transport, but she added that she would keep going without one unless there was a shift in official policy not only she wants you to take care of her health. She doesn't have a car as an adult and she also doesn't intend to where mask until everybody else does. So. I found a couple of graphs which are not exactly easy to talk about verbally but I mean, tell me what you when you look at the graph tell me what you think of. Here's. So this is a daily new confirmed Kovic nineteen deaths and I think the the confirmed part is a very interesting thing because you can think this was covid nineteen you can say it but like to confirm it is a little more solid Canada Okay So you've got the line for America which okay. It shoots up at the beginning and starts to round off a bit and then just sort of goes over to the right and wavers a bit and doesn't really fall that that that low. Now you've got Sweden which it goes up and then it tapers down and down and down, and then it just crashes at the end. So at the very end we're pretty much where we started and they're zero. Like, they're down to zero confirmed covid nineteen deaths now, and this is the country that had the least amount of government regulations and requirements. They're like, Hey, here's what we advise be smart about this be considerate. Fair what is the age. Difference though. The. Democrat shoulder. Oh Yeah. There's a lot of old people in Sweden. So here are the White Gal sixty, nine years old says if they don't if they don't I will not wear it because nobody else does. Martin Spoil Wrong fifty year old businessman said that he would follow government recommendations. If they tell us, we don't need masks we don't wear them. Sweden has received global attention for softer approach to curbing the spread of the virus which coupled with relatively higher death toll has led to the region's largest country being shunned by its neighbors, but when it comes historically about minding their business. But when it comes to masks, the Northeast Nordic nations look staunchly united. So except for Sweden, there are a few cases in those countries KK Chang Epidemiologist University of Birmingham since two for applied health research told AF pay. So I don't blame them for not doing it as long as they have reasonable social distancing and contact tracing has been done properly. Was We to do that? Asked Tuesday what long as you're being spied on I'm okay with it. Yeah. what might change his mind on recommending the use of facemask. Sweden's chief epidemiologist Anders Tangle said that he's still waiting for some of the proof that they're -FFECTIVE So what a novel concept? Portraying some logic questionable I. think it's wrong a responsible and it's stubborn. The epidemiologists said if he's wrong, it cost life. If I'm wrong. What harm does it do? The epidemiologists says there's no harm to wearing masks so we should all wear them I'm not entirely sure that that's true. And I mean. Okay. So there's there's the direct physical health oriented harm that he's talking about. Okay. Well, we've we've discussed some of the issues with that. You've got your mask mouth you've got one of the things that bothers the most bothers me the most is not seeing people's faces actually really bad for your immune system epidemiologist should know bacteria grows in wet damp dark places you would think well, right now they're looking to covert and they're not looking at much else. They're certainly not looking at dental issues and even just looking at cove it. Okay. Let's let's assume. That nothing else exists this is the only thing that means any of our attention. Okay. Viruses need cells to procreate. That's what they are. That's how they work. Now, if you have a multicellular organism, it has defenses it has t cells that will attack the virus and will attack cells that have been infected with the virus. So what what it wants is bacteria to eat that's that's what it means. It means defenseless little single celled organisms so that it can get in procreate and explode. That's what they do. So if you make more bacteria if you well, if you create this environmentally. Rich you will get a lot of viruses I get the idea but wouldn't we be seeing more many more cases and deaths and all these sorts of things going on in countries where mass compliance is significantly higher if that's the case no ours covert isn't. Necessarily, because Kobe isn't all that deadly except to people who are already very fragile.

Sweden Stockholm Nordic Nations Yougov Stockholm Copenhagen Oslo Hels AFP Donald Trump Reykjavik United States Suffering President Trump Kk Chang Epidemiologist Univer America India Kobe Camille Fortuna Rowley Bridget Y
"afp" Discussed on AFP: American Family Physician Podcast

AFP: American Family Physician Podcast

01:43 min | 2 years ago

"afp" Discussed on AFP: American Family Physician Podcast

"Trial <Silence> that would be a no <Speech_Female> three hundred <Speech_Female> twenty patients presenting. Presenting <Speech_Female> to an emergency department <Speech_Female> with low <Speech_Female> back pain for less <Speech_Female> than two weeks <Speech_Female> were randomized to <Speech_Female> receive either ibuprofen <Speech_Female> alone <Speech_Female> with placebo, <Speech_Female> versus in combination <Speech_Female> with one of three <Speech_Female> muscle relaxants. <Speech_Female> One <Speech_Female> week later, the percentage <Speech_Female> of people reporting <Speech_Female> moderate to severe <Speech_Female> pain was similar <Speech_Female> between the groups and <Speech_Female> the disability score <Speech_Female> improved <SpeakerChange> by about the <Speech_Female> same amount in each <Speech_Male> group got <Speech_Male> it and says it <Silence> is then caroline. <Speech_Male> We're going <Speech_Male> to wrap this episode <Speech_Male> up with a covid <Speech_Male> Nineteen daily <Speech_Male> research brief <Speech_Male> as a reminder, <Speech_Male> the AFP <Speech_Male> has <Speech_Male> daily research <Speech_Male> briefs that you can access <Speech_Male> on their website <Speech_Male> at AFP <Speech_Male> <Speech_Male> dot org <Speech_Male> slash a <Speech_Male> F P. This <Speech_Male> daily research <Speech_Male> briefest from <Speech_Male> May Twenty Ninth <Speech_Male> Twenty Twenty and <Speech_Male> comes to us from doctor, <Speech_Male> John Thickener, <Speech_Male> and it asked <Speech_Male> the question. <Speech_Male> How did <Speech_Male> social distancing policies <Speech_Male> affect local <Speech_Male> spread <SpeakerChange> of Covid <Speech_Male> nineteen in Georgia, <Speech_Female> so Clarke <Speech_Female> County Georgia <Speech_Female> implemented mandatory <Speech_Female> social distancing <Speech_Female> policies on <Speech_Female> March Twentieth, twenty <Speech_Female> twenty fourteen <Speech_Female> days prior to statewide <Speech_Female> implementation on <Speech_Female> April third. <Speech_Male> Counties surrounding <Speech_Male> Clark <Speech_Male> followed the <SpeakerChange> statewide guidelines <Speech_Male> right <Speech_Male> so <Speech_Male> the surrounding counties <Speech_Male> worked as a control <Speech_Male> to compare early <Speech_Male> social distancing <Speech_Male> using statewide <Speech_Male> case reports <Speech_Male> by county, <Speech_Male> the investigators <Speech_Male> estimated doubling <Speech_Male> time, which is <Speech_Male> an accepted measure <Speech_Male> of the spread <Speech_Male> of infection <Speech_Male> for Clark, compared <Speech_Male> to the <SpeakerChange> surrounding <Speech_Female> counties. <Speech_Female> April, twenty six, <Speech_Female> the five day, <Speech_Female> rolling average <Speech_Female> doubling time <Speech_Female> was twice as long <Speech_Female> in Clark, <Speech_Female> compared with surrounding <Speech_Female> counties <Speech_Female> roughly forty <Speech_Male> days versus <SpeakerChange> twenty <Speech_Male> days. Yes, <Speech_Male> so <Speech_Male> social distancing <Speech_Male> policy that prohibited <Speech_Male> events <Speech_Male> and gatherings of more than <Speech_Male> ten people, <Speech_Male> and

"afp" Discussed on AFP: American Family Physician Podcast

AFP: American Family Physician Podcast

02:25 min | 2 years ago

"afp" Discussed on AFP: American Family Physician Podcast

"For step, we have a poem. Remember poem stands for patient or evidence that matters boom all right, and this poem is titled. Supplemental emery screening women with very dense breasts reduces interval cancer rate, but may cause over diagnosis, and this comes to us from Dr Market Belt, so this poem looked at the dense study from the Netherlands which randomized women identifying having very dense breast tissue. Normal routine digital mammography to receive either a supplemental MRI or routine care. The primary outcome was the likelihood of interval cancer meaning cancers detected in the twenty four months, following a negative index, digital or MRI Mammogram, and before the next scheduled mammogram dependent on the buyer rats, scoring of women were underwent supplemental emery screening one point six five percent had breast cancer detected. Now there's two ways to look at the state of further the per protocol analysis brought the rate of interval cancers, two zero point eight per one thousand women in those who volunteered for supplemental MRI and five per one thousand women in those who did not however only fifty nine percent of the women randomized to supplemental I actually agreed to the screening. Screening so looking at the intention to treat analysis, the rate of interval cancers was actually two point five per one thousand women in the MRI group versus five per one thousand women in the Usual Care Group. This distinction is important as women who ignored the invitation to screen in other migratory trials had worse health outcomes than those who chose to volunteer so intention to treat is the appropriate comparison here, and when thinking of the harms nine and a half percent of women, undergoing supplemental Mery screening were recalled and six point, three percent of all women had a biopsy. The false positive rate was eight percent among women undergoing supplemental emery screening. Also, the characteristics of the interval cancers didn't differ significantly between groups. Although more early stage cancers were detected in the MRI group, which is not surprising so Herbert. Are you going to be recommending supplemental emery screenings for women with dense breast tissue? Might. Not Likely for now at least likely author state, my biggest concern is over diagnosed cancers..

Usual Care Group Dr Market Belt Herbert the Netherlands
Brazil's Amazon faces surge in deforestation as military prepares to deploy

The Retirement Trailhead

00:25 sec | 2 years ago

Brazil's Amazon faces surge in deforestation as military prepares to deploy

"Deforestation is on the rise in the Amazon jungle AFP reports today that satellite imagery for Brazil's national space research institute reveals that between January and April this year more than four hundred sixty square miles of rainforest jungle growth have been destroyed the area is equivalent to over twenty times the size of Manhattan the report says the figure represents a fifty five percent increase over the same

Brazil Manhattan Amazon
How Will Virus Risks Affect Central Banks?

Bloomberg Daybreak: Europe

01:32 min | 2 years ago

How Will Virus Risks Affect Central Banks?

"Meanwhile let's also talk about central banks and actually what's priced in this year for the fed to be a week and the ECB unit in the context of coronavirus the dust is settling a little bit off to the big moves yesterday so what are we talking about when it comes to central banks well when I say Caroline is a price action in the rates markets in recent weeks have been have been driven by a huge flight to safety and yesterday saw what I would call a material intensification of that move so I guess here's where we stand in terms of central back pricing that is fed easing expectations have risen sharply fed funds futures now price to fully price to twenty five basis point cuts this year and traders actually starting to price a third in some there's just under sixty basis points of cumulative using price by the end of the year with the timing of the first cut now expected in June and then for the C. B. zero S. market now prices in about eight basis points even by year end so it's not quite a full ten basis points rate cut priced but the probability has inched higher and did and did get a little bit of momentum yesterday and then if you look at the the bank of England sterling ask prices in just over twenty five basis points to be easing by year end but another thing that I've known about the hearing aids market that was interesting is that the ten year gilt yields closed yesterday at zero point five four percent now that's back below the level seen before CGG vis resignation as chancellor of the exchequer at that time it was fear of potentially expansive fiscal policy you keep driving AFP gilt yields and we've not really witnessed that so far it's a global considerations to move you keep on market more than domestic drivers and I think that will probably continue to be the case in the coming weeks

Caroline ECB Bank Of England Chancellor AFP
Three men stole 600 toilet paper rolls in Hong Kong amid fears of coronavirus shortages

Bloomberg Daybreak: Europe

00:23 sec | 2 years ago

Three men stole 600 toilet paper rolls in Hong Kong amid fears of coronavirus shortages

"And toilet paper has become as valuable as gold in Hong Kong is a courageous virus Spock's holding shortages and even violent crime a truck driver was held up today outside the supermarket in Mong Kok by three armed robbers he stole hundreds of toilet rolls according to AFP the toilet paper was worth only about one thousand Hong Kong dollar is the may fiction much much more in the

Hong Kong Mong Kok AFP
Six Nations: Andy Farrell 'happy' after Ireland win over Scotland

BBC World Service

11:05 min | 2 years ago

Six Nations: Andy Farrell 'happy' after Ireland win over Scotland

"The US secretary of state Mike Pompeii and has had bike strongly at accusations of the United States no longer believes in the international community addressing the international security conference in Munich he took issue with the German president Frank voter Steinmeier's opening remarks about an American retreat from global cooperation Mister Pompey essay did nothing could be further from the truth paraphrasing Mark Twain he said the death of the trans Atlantic alliance have been grossly exaggerated the foreign ministers of China and the Vatican have met in Germany and was believed to have been the highest level talks between the two sides since the establishment of the people's Republic of China seven decades ago is Roger Wilco when he and arch bishop pull gonna comment on Friday on the sidelines of the security conference in Munich both are said to have expressed a desire to build on the recent agreement it said the Vatican should have the final say on the appointment of Roman Catholic bishops Beijing also now recognizes the pope as the supreme leader of the Roman Catholic Church until twenty eighteen Chinese Catholics was split between a state run church and underground institution there is still no diplomatic relations between room in Beijing the pope Francis is said that he'd like to visit China Australian major report same members of the parliamentary committee have scrapped a planned trip to Britain as part of a worsening diplomatic row between the two countries China wholesale is in Sydney in a rare show of disapproval the UK's High Commissioner has reportedly written to the heads of two Australian parliamentary committees to formally protest the leaked details of sensitive talks with Britain's Foreign Secretary Dominique rob during his visit to camber last week according to local media reports the deputy chair of the intelligence and security committee Anthony burn strongly criticized Mister rob he reportedly said to the to allowing China to build bridges five G. telecoms infrastructure was equivalent to letting Russia constructed the parliamentary committee and the high commission of both declined to confirm the reports you're listening to world news from the BBC who the rebels in Yemen say they've shut down a tornado will play belonging to the Saudi led coalition that intervenes in the country's conflict five years ago a rebel spokesman told a Hootie run television station that ground to air missiles down the aircraft in the northern province of Joel the security forces in Mali say eight to the soldiers have been killed and four others injured in an ambush in the central region of cow early at least twenty people were killed in the multi region imbalance between two ethnic groups Molly has been blighted by instability since an Islamist rebellion began in the north in twenty twelve public press sermones involving thousands of monks have been held in Thailand a week after a soldier show dated twenty nine people the killings began when the soldier killed his commanding officer and stole weapons from a military base he was shot dead by the security forces inside the shopping mail researchers in the United States have warned of the psychological and moral dangers posed by the growing availability of sex robots with artificial intelligence the annual meeting of the American Association for the advancement of science was told that agencies were too embarrassed to investigate and regulates the use of the robots hello good reports the number six robots are advertised online including one large sized mannequin that links and sinks it slips as it talks researchers say that they're concerned that such sex robots pose a psychological risky uses Machon real relationships and they also worry that there's a more risk to society by normalizing operant behavior towards the machine for example some robots can be programmed to protest to create a rape scenario the scientists have verged regulators to investigate the risks of A. I. six robots before they use becomes more widespread and that's the baby see news hello this is Max basin and welcome back to the world this week this week has seen a dramatic shift in the political landscape of the Irish Republic general election produce results which few soul coming including apparently the party which came talk in the poll shin Fane I said that because if shin Fane had fielded more candidates they might have found their way to forming a government a little easier as it is shin Fane widely referred to over the last forty years as the political wing of the IRA secured roughly the same number of seats in the Dublin parliament as the two major parties fina Foyle and fina gale Chris page is our island correspondent it was a huge leap significant results really breaking the mold of Irish politics which is held for several generations shin Fiennes surge in the general election means that it's not up there with the two parties that have really dominated government in the country for decades FIFA fourteen FIFA Gail both centrist parties challenged by should fit in which is very much on the left and shin Fane and its leader Marilyn McDonald ready very successfully positioned itself as an alternative to the tea party some she termed as the establishment art fits of Irish politics focusing relentlessly in issues of housing and health but resonated very strongly with the are selected and Sinn fin really remembers a unique political organization certainly close to unique and that it operates in two different countries as well as not being the second largest party in the Irish parliament in Dublin it's also the second largest party in the regional parliament in Northern Ireland towards parts of the devolved government so in terms of its old Ireland's positioning in politics well it's not an extremely significant position and don't very much mainstream certainly in the in the Irish Republic which is an extraordinary transformation fission fame because this was remember interviewing Gerry Adams for example the formation vainly to in Northern Ireland during the nineteen eighties found that sometimes an intimidating affair with his body guards around him and the association with the IRA and now it's about small country the image yes should finish ready in thirty years gone from being a political pariah to a party of governments in Northern Ireland in the party that's challenging for government in the Irish Republican in many ways stop reflects the journey of the Irish Republican movement from guns to government does he say throughout the course of the conflict in Northern Ireland should fit in links to the Irish Republican Army the main part of the trip fighting for Northern Ireland to leave the you can be absorbed into you the Irish Republican took more life than the other group and not very lengthy conflict since the IRA cold cease fire in nineteen ninety four but shouldn't be in Studley increasing its growth in the power sharing government in Belfast in Northern Ireland and noisy positioning itself is the second biggest party in Dublin and very much in the running to be part of the government there should be taken the chin vent itself is been surprised by its own success given that they they could have run more candidates in in Ireland's proportional representation system possibly could have formed a government yes I think that's certainly true shin Fane Philip forty two candidates that's for a hundred and sixty six in total of thirty seven of them were elected night one of the other parties to be during the course of the election **** a few days ago that if Sinn fin had run say twenty more candidates will that of one probably ten more seats so that's a sign shin Fane strategists themselves didn't quite see a surge on this scale coming so not some really old on to the a parliamentary arithmetic if we got a bit of a three way standoff three to four nine for the gill say they're not going to go into a coalition government with should fan because of policy differences on because of the party's pasta associations with the IRA so you have should fade trying to put together a coalition with other smaller left wing parties but even if all of them came on board we still find that particular coalition coming short of the eighty seats they needs to form a stable administration I think we're going to find this whole process taking certainly weeks if not months and it's also very possible but it will be resolved the toll on will be heading back to the polls for another general election and how much of a problem is that for an island to be in the midst of such uncertainty when you know major things are happening around it well certainly the major international challenge Ireland will have over the coming months is the trade talks between the UK and the European Union since what with which our shuttle trip starts in in the aftermath of the U. K. exiting the E. U. so certainly I think everybody in this whole negotiation process in Dublin would agree it's better for Ireland to have a stable governments to lead the country three about process not the last politics is politics the voters are given their verdict not spend we have this very complicated picture on resolving about is certainly not going to be easy Chris page it's not just an island that old certainties are coming under scrutiny this week saw an unusual cloud of uncertainty descend over German politics the woman angler medical had hand picked as her successor and a great crime Kambala or a K. K. resigned as leader of the governing CDU the Christian Democrats the move was raised all sorts of questions about the future direction of German politics as I've been hearing from Damien McGinnis in Berlin this latest crisis was ready Spock's by a local florist see she shows after votes in the eastern German state of Thuringia in which I'm peas in her policy I voted for candidates as premier of that state's also supported by the far right AFP this display needs that she lost control of her policy because one of the big round was going on within the center right CD you is whether to work with the following safety particularly in eastern German states like syringes or whether to keep this firewall gave the far right that we have right now so I KK stepping down as clearly as you say a very poor reflection on the leadership of the CD you but how much of a blow to the party and indeed to angler miracles supposed plans for a succession if anything the struggles of any potential successors show how indispensable under the necklace so personally speaking it hasn't really hits her very hard but what it does to damages under Michael's vision for her policy and for Germany because what time the mac was done what I leading Germany is ready for a policy to the sensor grounds and what's cook conservative critics want to do is really make a center right possible Conservative Party again on this is a big impacts on the country as a whole because this part is the biggest party in Germany it could well be in government next time and the question is is Germany's biggest policy does journeys next government become more conservative I'm potentially one day even work with the far right safety or does it potentially stay in the US and around the maybe even one day from

Mike Pompeii United States Munich President Trump Frank
Angela Merkel’s preferred successor, Annegret Kramp-Karrenbauer, won’t run for chancellor

AP 24 Hour News

00:44 sec | 2 years ago

Angela Merkel’s preferred successor, Annegret Kramp-Karrenbauer, won’t run for chancellor

"German chancellor Angela Merkel's era parents unexpectedly quit her position on Monday plunging her Conservative Party into an even deeper crisis as it struggles to agree on its future political direction and a great crime car about told leading members of the Christian Democratic Union she won't be seeking the chancellor's ship in next year's general election ending locals plans to handed the reins to more than fifteen years in power the announcement follows days of infighting within the party over its handling last week of the election of a state governor regional party lawmakers voted with the far right's alternative for Germany party or AFP to oust the left wing incumbents defying appeals from crime caramba and further undermining her

Angela Merkel Conservative Party Christian Democratic Union Chancellor Germany
Germany's Annegret Kramp-Karrenbauer Won’t Run for Chancellor

AP 24 Hour News

00:43 sec | 2 years ago

Germany's Annegret Kramp-Karrenbauer Won’t Run for Chancellor

"Angela Merkel's era parents unexpectedly quit her position on Monday plunging her Conservative Party into an even deeper crisis as it struggles to agree on its future political direction and a great crime car about told leading members of the Christian Democratic Union she won't be seeking the chancellor's ship in next year's general election ending locals plans to handed the reins of the more than fifteen years in power the announcement follows days of infighting within the party over its handling last week of the election of a state governor regional party lawmakers voted with the far right alternative for Germany party or AFP to use the left wing incumbents defying appeals from crime caramba and further undermining her

Angela Merkel Conservative Party Christian Democratic Union Chancellor AFP Germany
Annegret Kramp-Karrenbauer Won’t Run for Chancellor

AP 24 Hour News

00:44 sec | 2 years ago

Annegret Kramp-Karrenbauer Won’t Run for Chancellor

"German chancellor Angela Merkel's era parents unexpectedly quit her position on Monday plunging her Conservative Party into an even deeper crisis as it struggles to agree on its future political direction and a great crime car about told leading members of the Christian Democratic Union she won't be seeking the chancellor's ship in next year's general election ending locals plans to handed the reins to more than fifteen years in power the announcement follows days of infighting within the party over its handling last week of the election of a state governor regional party lawmakers voted with the far right alternative for Germany party or AFP to use the left wing incumbents defying appeals from crime caramba and further undermining her

Angela Merkel Conservative Party Christian Democratic Union Chancellor AFP Germany
Germany AfD: How far right caused political earthquake

BBC Newshour

02:58 min | 2 years ago

Germany AfD: How far right caused political earthquake

"A bad day for democracy the words of the German chancellor Angela Merkel who sharply criticised her Christian Democrat colleagues in the state to fear in Jaffa joining forces with the far right in order to get rid of a left wing regional leader she's called it unforgivable let's talk to a Gemini correspondent Jenny Helen that Jenny I know that being some developments in the past hour or so because just to explain the story a little for us what happened yes I'm last year there was an inconclusive regional elections in the states at the ranger largely because a hefty the far right party did pretty well now yesterday everybody expected really on a man who is the current prime minister to be reelected to handle the majority had managed to thrash out on a left wing coalition so if one assumes that this would just be voted through in the state parliament instead very unexpectedly the far right AFP that she had the wrong kind of debate in the fast route for a third round of voting they suddenly ignored him and through that it's behind this on the top of the Thomas camera should know when and how to Thomas camera yesterday morning really but he's right at the center of this political earthquake because he was suddenly unexpectedly voted in to be the state prime minister and with support from the far right AFP and I'm not have caused widespread outrage twenty four hours later he has now stood down and actually further up the the policy change the leader of the free Democrats as the party is from and has also said that tomorrow morning he's going to effectively put himself to a confidence vote amongst the leadership of the policy and by then save there's a lot going on hand and as you rightly point out on the Michael was not amused after school because amongst those voting for this job I'm a one man does regional politicians from her CDU party now they've aligned themselves with a hefty no one knows what the deal was done or was not done and but either way it's broken a huge political to their head in Germany and the coolest the the the Bob run tomorrow or it means fiable this is kind of political consensus that you don't work with the fall rice and on this occasion and the man himself in question the free democratic became the prime minister and what he's seen as a brother beyond the pale because he's actually accepted the job in the first place only the back of support from the far right AFP despite saying he opposes them some of course he said and people very upset and this one hundred and think with him standing down because of course it has no raise the question you know after all a strong wish political force particularly in the east of the country that in a position in the national parliament Hey and I think the mainstream parties are going to have to look harder at what they do about them Jenny thank you very much indeed that was such an hill Lara Berlin correspondent Aaron what happened in the status here in Jeff about more to come it seems on

Angela Merkel Chancellor
Sarah Abitbol: French ice skating head refuses to resign

PRI's The World

03:13 min | 2 years ago

Sarah Abitbol: French ice skating head refuses to resign

"Prosecutors. Prosecutors in France are investigating a prominent figure skating coach after allegations that he raped a French skater when she was a teenager Sarah. Ib Bowl who won a world championship. Bronze Medal says the abuse. I began when she was fifteen French. Authorities say they will try to determine if any other athletes were abused as well. Aw Anita has our report from Paris Sarah. Abbott Ball made the allegations in her new autobiography published last week. She said her figure skating skating. Coach Sheila Bair raped her repeatedly back in the early nineteen nineties. When she was between the ages of fifteen and seventeen speaking to a French news channel? Abby Bowl said that nearly thirty years later she's still on antidepressants pupil dearly. dickers- don't sweat wrong plus Russell. She says she decided to tell her story because she could no longer stand the idea. That bear was still training children. She said she felt guilty about her silence and and couldn't stand it any more Bayer. The skating coach admitted he had with he described as intimate and inappropriate relations with Abby Bl. He he told the French news agency. AFP that he's sincerely sorry. The allegations have shocked the sports world and the public in France. The head head of the French Ice Skating Federation did he guy has also expressed shock but there are allegations that he may have covered up for Bayer and the National Channel Sports Minister Roxana. Massieu says he should take responsibility for the scandal and resigned because he don't let your horses. This ball Douglas Digi Gygi. The president of the French Skating Federation cannot clear himself from his moral and personal responsibilities beyond its president. The nature and number of facts causes me to think that this grave dysfunction is at the least the result of an institutionalized breach silence seems to have been the rule for a number of elected leaders so far guy. A gate has refused to step down as president of the Skating Federation at a press conference today. He said he was disgusted to learn about the allegations. From Abbey Bull up theory this at least two goals dot com. I am dismayed the sad fact that these women's lives have been shattered forever shaken by the weakness of disreputable men who took advantage of their innocence. There are no words to describe my disgust guy. Gay went on to defend his decision not to step down but they are not. I was also skater. A trainer I manage some of these people but you will never find my name in cases of violence or child abuse or the abuse of adolescence. I am an imperfect perfect man but I am clean to other skating coaches. In France face similar accusations of sexual assault one of them has denied the allegations. The other are has refused to comment publicly. Prosecutors say the truth will come out in the coming weeks as they tried to establish if any other athletes were abused for the World Anita Hill Lash

French Ice Skating Federation Skating Massieu France Sarah Anita Hill Lash Sheila Bair Bayer French News Abby Bowl President Trump Douglas Digi Gygi Abbott Ball Abby Bl Paris Assault Russell
Online video shows Hong Kong police shooting protester

Ben Ferguson

03:54 min | 2 years ago

Online video shows Hong Kong police shooting protester

"Hi some breaking news happening now over night Monday in Hong Kong protesters have been shot by police in Hong Kong as officers opened fire with live rounds amid renewed chaos across the city video that was streamed live on Facebook sought officer opened fire during rush hour a man's man in the US are way no district appeared to have been shot in the chest and second mass man went to the ground as the officers let off more live rounds as police detain them the first to go down appeared to be unconscious this is All shown again all on live on Facebook a Hong Kong police officer shot a masked protester again it's Monday morning they're hitting at least that one of the torso during rush hour as a and they get all this was broadcast live on Facebook moments later two more live rounds were fired by the policemen in the second mass man went down although it's not clear from the footage of you two have been wounded police could later be seen attending the two men on the ground the first man had a pool of blood next him his body lamp as officers moved him around and apparently tried to tie his hands the second man was conscious and talking a police source speaking art confirmed to AFP that ought live rounds were fired at more than one protester and then a statement will be issued Hong Kong has been operated by five months of huge increasingly violent rallies but Beijing and refused to give in to most of the movement's demands now tensions have soared in recent days following the death on Friday of a twenty two year old student who succumbed to injuries sustained from a fall in the vicinity of a police clearance operation the weekend before this city has seen it four days of consecutive progestins a student staff as well as tens of thousands attending mass vigils using online messaging forms activists have called for a general strike on Monday morning flash mob protest sprung up in them and multiple districts are in the morning commuter period with small groups of masked protesters starting subway stations of buildings aids on road junctions as well even before the shooting took place tear gas had already been fired at least two other locations this shooting is the third time protesters have been shot with live rounds by police on October the first district was struck in the chest and he was as he and a group of accurate activists attacked an officer was sticks and poles he survives his wounds as being prosecuted days later a fourteen year old boy was shot in the leg when a policeman in plain clothes fired his gun after his car was attacked by a crowd he also survived and was arrested that's right they arrested a fourteen year old now the reason why I bring all this up is because you these I I want you understand just how brave these protesters actually are none of them have weapons because weapons have been outlawed and they've been rounded up and confiscated by the government these people are out there and they are at the mercy of their government that is read I press and to the point where they're willing to die for changes and freedom I just want you to think about that so if you ask me why I get all upset and bent out of shape about second amendment when they try to take away my rights to bear arms a look at Hong Kong right now and that's what life literally looks like that is what life looks like when you don't have the ability to stand up to your government when you don't have the ability to protect yourself this is what happens

Hong Fourteen Year Twenty Two Year Five Months Four Days
Ex-communists win German state vote but far right surges

All Of It

01:45 min | 2 years ago

Ex-communists win German state vote but far right surges

"The German partie de link or the left has surged to victory in an election for the state assembly in the region of touring yeah however the far right alternative alternative for Germany party is also done well the result is being seen as a slap in the face for the centrist parties that have governed Germany for decades a reporter Garth Barlow spoke to earlier as the results were coming in to link all the left they were already positive during his ruling coalition and they are descendants of the former east German communists the topping the exit polls at around thirty percent no it's the policy in second place that is really gonna bring attention that's the alternative for Germany or AFP they are a far right party only found he's back in twenty thirteen four years later they end suit Hahnemann injury to much shock across the country back in the state of three get their share has doubled evolution has doubled in the last five years alone tracking about twenty three percent according to the exit polls as a party to have a big focus on is not an integration I want lance is done he's pushed the center right Christian Democrats the policy of angle in medical the chancellor Jennie into third place back in twenty fourteen they were something the pony offense sells about this leader the leader all of alternative for Germany this is a medical be on her okay and he hates the polity in this state to three injury back in twenty seventeen he calls it a loss of controversy when referring to the Holocaust memorial in Berlin he said in his words the Germans were the only people in the world he planted a memorial of shame in the house with a capital letter the politicians to say he'd use not see language accusing him of incitement the chairman of the council German G. you said he's willing to anti semitic and silly in human

Germany Garth Barlow AFP Lance Jennie Berlin Chairman Reporter Hahnemann Chancellor Twenty Thirteen Four Years Twenty Three Percent Thirty Percent Five Years
Far-right leader expected to gain support in German vote

BBC World Service

01:32 min | 2 years ago

Far-right leader expected to gain support in German vote

"Voters in the eastern German state of touring here go to the polls later today to choose a new regional government a right wing alternative for Germany or A. F. T. is expected to double its share of the vote to around twenty four percent which would match the predicted vote for angle Americal center right CG you party but both parties are likely to trail behind the populist radical left known as D. Linke which could wind up to thirty percent of the vote Danny McGinnis reports from Berlin just weeks before the country prepares to celebrate thirty years since the fall of the Berlin Wall the incumbents left wing success it's the east German Communist Party looks set to win the most votes the right wing populist AFT meanwhile is vying for second place with Angela Merkel's conservatives AFP leaders have played on dissatisfaction in the region by co opting phrases from the pre nineteen eighty nine dissident movements implying that MacColl's government was just as oppressive as east German communism the success of these two populist parties means it could be hard to form a government the conservatives have ruled out working with either the far left or the fall writes the conservatives leader as cold as if the rifle a **** in September the F. T. did well into regional elections elsewhere in eastern Germany but failed to hit its targets of winning the most votes in the states and does some leaders become more radical support for the F. T. nation why it's how stagnated that's around thirteen

Germany D. Linke Danny Mcginnis Berlin Berlin Wall German Communist Party Angela Merkel Maccoll F. T. Nation A. F. T. Americal Center AFP Twenty Four Percent Thirty Percent Thirty Years
"afp" Discussed on AFP: American Family Physician Podcast

AFP: American Family Physician Podcast

11:57 min | 2 years ago

"afp" Discussed on AFP: American Family Physician Podcast

"So this next clip is part of her interview with Emily. which each podcast episode at the Notre S we feature alive story from the event and then we follow it up with a more intimate interview with the storyteller that's kind of teasing out some of the themes that came up up in the story and so you know at the end of that first clip in her story she talks about almost this temptation to walk away because the system is so broken and then in this next clip? I think she really just presents herself. As this incredible example of how really tirelessly working within the system as an advocate hit an activist is really how you can make a difference and sort of turning your back on a system. That's broken isn't going to accomplish anything but if you really put in the hard work and stick around then and you can make are really meaningful difference so I find her incredibly inspiring fifty percent of people within the United States prison system have serious mental illness in New York City County Jail Cook County. La County our largest inpatient psychiatric wards in this country. This is where we take care of our mentally. Ill People We don't have enough resources on the outside so you know it's not a question of whether they should be there or not they. They are there and we need to. We have to treat them there. At our facility we have a very large mental health program and many of the facilities throughout the state date do but the problem is that prison is never no matter how many good psychiatrist or how many programs no matter how many groups and support you give people prison prison will never be an appropriate place to treat people with mental illness. It's it's inherently anxiety provoking. It's inherently the place where you can't build trusting relationships. It's inherently a place without privacy. There is nothing about the millions of prison that's going to allow people to be successfully treated from a mental health perspective so as a society all of those off should probably be in some sort of other setting yeah. I'm super inspired by Dr Thomas also and you mentioned that part of your passion and for advocacy and storytelling as part of how you got involved in the nocturnal so what advice you have for for a family physician or medical Michael Student that would like to be involved in advocating for our communities and our patients and for social justice yeah. I mean again one of the things that really drew you to family. Medicine is that that I feel like that ethos of advocacy is so ingrained almost in the DNA of this specialty and before I started with an alternate at that time I was doing an advocacy and leadership fellowship through an organization called Physicians for reproductive health which is a terrific organization and that was around the time that I I met emily and so I told her at that first meeting you know I'm excited about all the storytelling stuff but really my secret agenda here is to do advocacy work through this and I think that that's been successful. You know we had an event on criminal justice. We've had a couple of events on reproductive health and I think that's all to say that there are just so many different ways to be an advocate again again. Doing this nocturnal storytelling work. I wouldn't have thought as sort of the typical way to do advocacy but what I learned in that leadership fellowship through physicians as for reproductive health is there's just so many different ways to do it so in that fellowship you know we practice letter writing and opinion writing and we met with lawmakers and legislators and we talked about setting up grand rounds in your own institution to educate your colleagues about whatever issue you're passionate about or even just you know what we we all do every day of battling with insurance companies or getting involved in the AFP is that there's so many different avenues and you don't have to do them all and it doesn't have to be a grand gesture and so it's kind of what you were alluding to before about just following your passion and seeing what grabs you and then doing that because I think think of ultimately that's going to be the most professionally satisfying and probably the most effective if you're really doing what you love yeah. That's Great Advice Allie. Do you have a favorite quote or or movie quote. I was thinking about this because I know that you ask if your gas and I was reflecting that in my High School Yearbook Mike Quote was a Mark Twain quote that was every every time I feel the need to exercise I lie down until it passes which doesn't seem like very true quote for family doctor so maybe Daviel revise that and lately the one that I've been thinking about more as I don't know if you're familiar with the Mary Oliver Poem the Summer Day at the end she says tell me what what is it you plan to do with your one wild and precious life and that just really I feel like I'm focusing on that and trying to keep an eye on sort of the big picture for my husband is a palliative care doctor at UCSF and I think that really keeps both of us in a head space of really thinking about sort of the big questions and the big picture sure and what is it we want to do with our lives and our relationship and our careers and our family and I think especially we are balancing so many many different things in life can feel so full and so busy and so just trying to kind of keep an eye on making sure that it's full and rich and that will sort of be happy at the end of the day with what we've done so that's it's kind of quote. That's been thumping around in my head for the last little while lovely. We're going to hear your last story in a second which is about music and healing. If you could only listen to one musical album for the rest of your life what would it be. I talk in the interview. Emily and Catherine forest the storyteller talk in the interview that we're about to listen to a little bit later about how the research shows that music from our teen years. Here's is the music that sort of really resonates the most with us and it's sort of etched into our sub conscious and I think that's definitely true for me. If I had to choose one album it would have to be the indigo girls roles album self titled the one that was the first album that made me fall in love with music when I was like an angsty teen or preteen and I know every word word. It's still the album that at the end of the day if I have a hard day I just WANNA blast and Kinda sing along to that's awesome since December twenty seventeen on the Nocturne Nocturne issue put about twenty doctor stories on the podcast. Our listeners should definitely go back and listen to all of them. what do you guys have coming up next on on the NOCTURNE is we've got a bunch of good stuff coming up so we have I think three live events on the books to our in San Francisco and one is in New York and we are are looking towards expanding even sort of bigger and more nationally in twenty twenty but we do have those live events and so if folks are interested in the bay area we are in the New York region. They can definitely check out information about those on our website and we're also starting to work on season three of the podcast so we have so many agree stories that we've had at our live events and that we have recordings have and we're really excited to feature on the PODCASTS. Were kind of plugging away at that hoping to release that early in Twenty Twenty Allioune is set up the last clip here absolutely this is a really charming story by wonderful family doctor way believe also trained at San Francisco General Catherine Forest and this is about something that was just totally magical that happened to her when she was in training. She had a chance encounter with a famous violinist. Isaac Stern at the bedside of one of her dying patients and one thing that I think is really interesting is that most of our stories actually happened during training so even for our more season docs telling stories who are in their sixties seventies and eighties the stories that really resonate with them that they wanNA share our ones from their training in medical go on residency and I think that just speaks to what an incredibly formative time it is and Catherine is a really such a deep thinker feeler and I love the way that she talks about this moment. I would like to find Ms Beena. He says Mrs. Beena I'm making and I I completely speechless because I recognize Isaac Stern so I walked down the hallway and night time hospital as a sacred place and really quite odd there's that blue light from rooms for people watching TV and there's the sound of you know canned laughter and mechanical sounds. Sir of respirators and the nurses are all different places charting but there are no visitors so together. We walked down the hall and he says I my Stroh taught me everything I know about music everything I know and and she was like a mother to me and I say well. She's he's not awake right now but we know that hearing is the most primitive of the census and if you can communicate with her she will you'll be able connect. You should feel free to do that and we arrive at the door and he says it is okay if I can if I play violin absolutely I say absolutely and then I realize is it okay if I listen and he he says yes I take his hand and we walk into her room together and there's my patient with her head on the pillow her face sagging backing looking Ashen and there's Isaac Stern transparent with emotion. I say Isaac External here to play some music for you. He takes his his violent out of the case and begins to tune up and I step out of the hallway. I sink down onto the floor hands on these to listen. When I was just a kid my brother and I used decline under the piano of my grandfather. My grandfather and my father were playing four hands piano versions of symphonies and we felt like we were inside that piano music was part of us so this is started to play this Tchaykovsky Tchaikowsky violent consider that I know so well but never have I heard played like this in tears streaming down my face and I feel my grandfather actually with me. Byu says beautiful just crying so after about thirty minutes Isaac Stern comes out of the room with wondering eyes any any says. She opened her eyes. She looked at me. I looked at him. He looked at me. We held hands. I looked in his eyes and he he knew that I knew what had happened. Thank you so much much alley for the amazing work that you're doing with the doctrine ensuring these great stories with the world and also for sharing the Nocturne is with us on AF podcast thank you it's been such a pleasure clips from the podcast. NOCTURNE is included here are owned by the nocturne EST and all rights reserved this is Ellie Block from the Contra Costa Family Medicine Residency Program and the nocturnal nocturne s signing off from a rare.

Isaac Stern General Catherine Forest emily La County United States New York City County Jail Cook Mrs. Beena Emily. Twenty Twenty Allioune San Francisco Isaac Contra Costa Family Medicine R AFP New York family physician Mike Quote Dr Thomas Ellie Block Mary Oliver
"afp" Discussed on AFP: American Family Physician Podcast

AFP: American Family Physician Podcast

12:29 min | 2 years ago

"afp" Discussed on AFP: American Family Physician Podcast

"I work get that Contra Costa Family Medicine Residency Program. I'm the ready director there and I'm also the executive producer of the NOCTURNE S and I'm so excited to be on the AF if P fogcast. I've been listening to it for a long time and thank you so much for having me. Thank you so much Dr Block for coming on a podcast we're going to start off right away with clip from the NOCTURNE. Ists so this first cliff that we're going to listen to is from Alana pebbles and she was actually a resident at the UCSF San in just general residency program when she recorded this story and she just finished a fellowship in maternal health and is about to start her first grownup jobs so that's I'm really excited excited for her and this has been one of my favorite stories for a long time. Partly I think your listeners will find that. It's very relatable. She's talking about a woman who who comes into the ER WHO's dying and DNR deny and Milana talks about being really distracted in that moment by the medical record and how that really takes away from the connection that she's trying to have with her patient so I think it's something that resonates with a lot of us and I just love the way that she speaks about that moment. As I'm remembering bring that my job is not to try to save her from what's happening. I decide that we should order the comfort care order set which is like a thing that you can order in the computer and has all of these drugs that you can use to try to treat suffering but I've never done it before so I go to the computer and I'm looking for the order set and I can't find it and so I decided I'm just going to try to order the drugs like one by one just try to come up with it on my own and start earning morphine for pain but I'm ordering ordering it wrong and so I'm getting pizzas from pharmacy star ordering out of an for air hunger and order at like fifteen different times and all of them are wrong and pharmacies paging me and him on the phone and I'm battling with the computer and I look for a second to realize I missing it. The people who aren't missing it are the nurses one by one six nurses walk into the room and they surround her and each put a hand on her and they say it's okay. You don't have to suffer anymore. It took me to let go by and she dies so the second clip that we're going to listen to is part of her interview view with Emily Silverman the host and creator of the NOCTURNE EST and here. She's just talking about again. Sort of the importance of those really monumental moments which I think is why a a lot of US went into family medicine in the first place and the beauty of providing care whether at the beginning of life or the end of life and what's so special and what such an honor about what we get to do every day the greatest privilege of medicine is being able to support people through these incredible the most incredible moments of their lives sometimes the happiest moments when babies are born often some of the saddest and scariest moments when they have a new illness or when they learned that they're going to die and ultimately for everyone when we do die we will we will hopefully be supported by a physician and and when someone is is at the end of their life and is dying to try to fight their death feels like like I am I missing that opportunity to really help them through that by fighting it thank you so much for sharing that first clip. Dr Pepper Benito's story with US Alley. Can you tell us about about the origin of the NOCTURNE Ists. Yeah I'd love to so back in two thousand sixteen a colleague and friend Emily Silverman who was an internal medicine resident at UCSF at the time came up with this idea. I think she had gone to a moth recording or a moth event and she came up with the idea of doing sort of a similar thing for residents. I think she was feeling kind of burnt out at the time and overwhelmed with all of the pain and suffering that she was absorbing from her patients and all of the experiences that she she was going through and so she had this idea of gathering some residents together to share stories and my husband who actually was chief resident at the time went to the event and then came came home and was like Ali mazing. This is totally your thing you really gotta get involved and at that time I was about a year out of residency and just sort live at that point where I was sort of emerging from the post residency Hayes and found myself with all of this time and creative energy that has sort of been laying dormant for all of those years and so emily and I got together at a coffee shop and decided to partner on the project and so then we just kind of took it from and we started producing events we started renting out theaters in San Francisco and the theaters started selling out and we got into bigger and bigger theaters and it just seemed like it was really striking taking a nerve and so what we do is for each event we choose a theme like love or mistakes or death and dying or diversity and then and we put out a call for submissions on the theme. Certainly your listeners are all welcome to submit and then we choose the ones that we think are the most promising and a couple of years ago we brought on ahead of story development a really talented woman named Adelaide Papa Blue Who's actually applying to medical school right now and she's a really talented onto documentarian and she works very closely with the storytellers then to really sort of pull out what's meaningful to them about their stories and find that narrative arc and figure figure out why they're telling the story which isn't usually because it's such an interesting clinical case it's usually because it was something that was really personal and meaningful for the storyteller her and then we put them on stage and we have these beautiful nights where people come together and listen to live music and stories and then what we decided to do was take the most successful stories from the live events and turn them into a podcast for broader consumption. Did you have a background in some kind of creative art well well. I've always loved writing but I had never done any sort of formal storytelling or really creative writing it's always been more from sort of a personal essay in Memoir and opinion writing position and so this just seemed like a really exciting opportunity and I think it tapped into something that I I had been craving of how to share some of these experiences that were having during training and as physicians and also seemed like a really exciting opportunity for advocacy Z. to take our experiences our patient stories and share them in a way that they're not usually shared. Where does the name the NOCTURNES come from. That's such a good question you know. I think that emily come up with it before I came on board and I think she had just batted around a bunch of different ideas and that was kind of the one that stuck I think it has has something a little bit poetic mysterious about it but also people on the inside in medicine definitely know exactly what it means and conservative imagine imagine you know being alone in the hospital late at night and mulling over these stories so I think it kind of the mood that we're looking for. Let's talk a little bit more about your career other than being an executive producer of a hit live show and podcast what drew you to family medicine and what were the major inspirations for your current career path well. I grew up in New York City and so I didn't know that much about family medicine. I know that there is now a thriving family medicine community in New York but I was sort of unaware that I didn't come from a medical family and I think New York oftentimes tends to be a little bit more subspecialize but I think that being family doctor was sort of what I always pictured. Being in a doctor was even if I didn't have a name for it and then I think like a lot of people who ended up going into family medicine. I did my third year rotations and I just liked everything thing I love doing. Ob I loved pediatrics. I love my surgery rotation and I was chugging along in third year getting a little more panicked with every rotation event how I was going to choose shoes and then my very last rotation of the year was my family medicine rotation at San Francisco General and something just totally clicked. I felt like in terms of the clinical fickle side it was exactly what I wanted being able to do women's health and paediatrics and treat chronic conditions and then the ethos of really caring for the whole family and caring community and thinking broadly advocating for our patients with just culturally exactly what I was looking for. You know people always say find your people and it was so clear here to me that those were my people and so then I was lucky to train at UCSF and San Francisco General for Med school and then I went to the Santa Rosa Residency Program for Residency Agency which was such an amazing place. I had fantastic mentors across the board but specifically in women's health and underserved medicine and integrative medicine which are sort of some of the real oh strength of that program and then when I graduated I basically just got really lucky and landed my dream job. At Contra Costa where a woman woman named Sarah Macneil who's now core faculty there was looking for help running the reproductive health curriculum there she since has become a really incredible mentor and advocate for me and so she brought me on and with that job was the option to continue doing et. CETERA and Primary Care Teaching residents and doing this reproductive health work which has always been a big passion of mine and it's just been a great fit. I think I really particularly love working with the residence because they just bring so much passion and so much inspiration. I'm really impressed by them every day so yeah. I feel really lucky. I think I'll probably be there for a good long time so it sounds a not quite totally preplanned. Dan but more sort of like following the the passion or the choice in the moment yeah exactly that's certainly is how my career has been and I think that's what I was always drawn to you. When I met mentors who had really inspiring career pass was they weren't totally linear they just found something and it clicked and they found great mentors and they kind of went with it and so that's what I've been doing and that's how I sort of fell into doing this work but the nocturne s which also has been a really rich part of my life so let's hear your next clip yep so this clip from Michelle Thomas who I believe you actually trained with during your residency in residency at the same time at San Francisco General. That's that's so great so she as you know is an amazing family doctor who's dedicated her career to prison health and specifically end of life care in the prison system and she told a beautiful beautiful story. I really encourage your listeners to go and listen to the whole thing. It's about the compassionate release process and this clip just gives sort of a very small taste of have what that is like practicing within the criminal justice system when I get to the hospice rounding this morning. The nurse gives me an update on our patients and let me know that Mr Turner had died all he wanted to do before he died was to say goodbye to his daughter. She lives in a psychiatric isolation `isolation unit at a women's prison in southern. California and inmates aren't usually allowed to talk to other inmates but our warden is Kinda used to US pushing the boundaries and he got the other one into a great so they took Mr Turner schizophrenic daughter and put her in therapeutic module. That's code for telephone with size cage and allowed them fifteen fifteen minute phone call to say goodbye to their credit. They also pulled together her mental health team to help her processor grief afterwards and one of the officers from the other facility actually sent me an email next day thanking me for allowing him to participate. He said in twenty five years of service. This was one of the most rewarding things exceed done the nurse. I are so happy that Mr Turner got to say goodbye to his daughter and I'm happy that we have one more person in the system who understands that maintaining maintaining safety and security and allowing people their humanity are not mutually exclusive on days like this. I think maybe I'll keep this job.

Emily Silverman San Francisco Contra Costa Family Medicine R US UCSF executive producer Mr Turner UCSF San Alana pebbles Dr Block internal medicine resident director morphine New York New York City Dr Pepper Benito DNR Ali mazing Milana Michelle Thomas
President Macron, France And Macron Renita discussed on Monocle 24: The Globalist

Monocle 24: The Globalist

03:55 min | 3 years ago

President Macron, France And Macron Renita discussed on Monocle 24: The Globalist

"French president Emmanuel Macron gave him much -ticipant address. Yesterday has speech that's been delayed for over a week because of the huge fire Nacho Dom cathedral. His televised remarks came in response to the yellow vest protests, which have caused a cloud over the last six months of his presidency and prompted a great national debate an exercise in which Macron heard complaints from hundreds of thousands of French voters history. Explain it all is Florence Peterman AFP London bureau chief Florence thanks for coming in after three months of negotiations. President Macron has vowed to press ahead with his government's program to transform France. He said that public order must be restored. How does he plan to achieve this? Yeah. That's what is very striking is intervention yesterday. Started after five minutes by saying that he was right in what he was doing his line. The direction is giving to his reformist government is right. And there should be a return to public. Order as you said like there was this month's of tuition by the reverse at time, very violence, and this gave affronts abroad and also in the country that that cannot be tolerated very much longer. So I think like reaffirming that people has to come back was something he had to do anyway because this is a request even from from the French people, but no concrete detail on how actually that will be chief where that will be police measures and during his own intervention, by the way, he gave the lead said the big picture of what he wants to achieve. There was not really much details like for example, mentioned like tax cuts for the middle class. But he didn't give any figures on this. I guess this will be left to to the prime minister to give more details. What he wanted to achieve to to talk to France as who'll after this long national debate and to give some answers to to the request and the. That have been expressed. But what is also remarkable? I think is it's not a direct answer to the elevates. It's rather answers for for for the Huda France and the population, which somehow more reasonable because the elevated said from the start and before his his conclusions of the great national debate that they would never be satisfied with what she was supposed to to to suggest the suggestion that the elite civil service academy is to be shot. This is a very symbolic gesture. I think what is also striking is that Emmanuel himself is a product of of the school. So there was also this kind of university e- could have also chosen to reform it because some some other institutions like sport, for example, in Paris, which is also, and it is school has been a bit transformed. So that there is more opening to to diversity to social diversity too. But so the the fact that you're not say, it would be scrapped is supposed to be an answer to all the critics of these elites ruling the country that seems to be always like working and thinking together and cut from the population. So I would say it's a symbol. But also can achieve some somewhere transformation in in in the way, people are trained before they become those voters in France. Was there any sense of an apology from Macron Renita give one where his head of state? So he cannot come and be that humbled to apologize. But he certainly had some knowledge -ment some remarks here, and there that he appeared he realize the appeal to our gun sometimes call this. It's not meets not my personality. And he certainly used allowed the words human like to put the human at the core of his politics.

President Macron France Macron Renita Emmanuel Nacho Dom Cathedral Florence Peterman Huda France Bureau Chief Prime Minister London Paris Five Minutes Three Months Six Months
"afp" Discussed on AFP: American Family Physician Podcast

AFP: American Family Physician Podcast

02:17 min | 3 years ago

"afp" Discussed on AFP: American Family Physician Podcast

"Of HIV, hepatitis C and high risk. Injecting behaviour without increasing drug use or the number of persons who inject drugs and the AFP supports the use of these exchange. Programmes guys, we almost forgot the clinical recommendation with the highest evidence rating from this article we've talked about it on the pod before buprenorphine or methadone should be offered to people who inject drugs for opioid detoxification and medication assisted treatment yet. This is really important topic gang that sadly is probably not going away anytime soon. So let's all do our part to help absolutely. We're going to close out with our AFP clinical answers lightning round. And you note the lightning round because you hear this sound. But I tips were using AFP at the point of care if you like to use Google to search you can limit the search results to AFP by typing AFP before you search term get to know, ding. Okay. If clinical answers lightning round Joe is there a role for primary closure in animal bites. Yes. Primary closure dog bites does not increase the rate of wound infections. All right, Sean. How should physician screen older patients for risk of future falls to things use a single question? Have you fallen in the past year? Get a time to get up and go test a yes to the first question or more than twelve seconds on the get up and go should lead to multisectoral risk assessment. That might be three things. All right. Jenna does the USPS recommend screening adolescents for scoliosis? It's an eye insufficient evidence. Joe how should Kroupi managed corticosteroids for patients with croup of any severity nebulizer Ephron for patients with moderate to severe croup? All right. Our end said Jenna effective in the treatment of post-partum, para Neil pain. Yes. Could you please be more sustained? No. Les letters? Sean is home therapy for deep vein thrombosis superior to in hospital treatment in reducing recurrent vitae. Also..

AFP Sean croup Joe Jenna buprenorphine HIV deep vein methadone scoliosis Les Google Ephron Neil Kroupi twelve seconds
"afp" Discussed on AFP: American Family Physician Podcast

AFP: American Family Physician Podcast

02:11 min | 3 years ago

"afp" Discussed on AFP: American Family Physician Podcast

"The AFC podcast is supported by the American Academy of family physicians and by the journal FPM, providing practical peer reviewed advice to help primary care providers. Advanced that our practice patient care and career available in prince and online subscription. Formation is available at af dot org slash f PM. Happy new year. And welcome to the American family physician podcast for the January. First twenty nineteen issue. I'm Steve I'm Joe, I'm Jenna, and I'm Sarah. We are residents and faculty from the university of Arizona. College of medicine. Phoenix family medicine residency today on the podcasts. We're going to talk about de prescribing benzodiazepines, migraine prophylaxis advocacy, urine drug tests, HP vaccine N, P H insulin. And we have a new feature. Our lightning round of AFP clinical answers. The opinions expressed in the podcast our own internet represent the opinions of the American Academy of family physicians. The editor of American family physician or banner health do not use this podcast for medical advice. Instead, see our own family, doctor for medical care. We're gonna start things off with our editorial. From this issue de prescribing is an essential part of good prescribing from doctors feral and mansion from on -tario. So paulie pharmacy is something we all encounter frequently and can be challenging to tackle. It's also something that seems to be more common in our aging patient population. Very true nearly one half of our older adults take five or more medications, an older adults prescribed more medications are more likely to be hospitalized due to an adverse drug reaction. So how do we balanced treating our patients medical conditions with managing the benefits and risks of medication therapy?.

American family physician American Academy of family AFP College of medicine university of Arizona HP editor Steve I Jenna Joe
U.S. diplomat found dead in Madagascar, 1 person held

24 Hour News

00:38 sec | 3 years ago

U.S. diplomat found dead in Madagascar, 1 person held

"The US State Department confirms that American diplomat has been found dead overseas. The body was found Friday night inside their home, the diplomat was stationed on Africa's Madagascar ABC's Connor Finnegan is at the United Nations in New York. He says officials have a suspect in custody US and Malagasy authorities are conducting a joint investigation into the diplomats death. The State Department declined to release any details, but local police told AFP a suspect was arrested trying to flee the Americans home. But State Department has it yet identified the Serbs officer it did express its sympathy to the family no cause of death yet. Either

Us State Department Connor Finnegan United States United Nations Madagascar Serbs AFP New York Officer Africa