Better Worse or the Same?

This episode is a preview of a new podcast "Rivalries and Traditions", which looks at coaching and the business of sport. Next week we will get back to our usual topics. Strap in for a captivating conversation with the one and only Dave McCarney, better known as Coach Mac. With a whopping four decades of coaching and teaching under his belt, Coach Mac breaks down his philosophy, drawing on fundamental principles and practical wisdom. From teaching multiple sports to the switch from coaching boys to girls, we're exploring his intriguing career journey. The episode is peppered with insights that will spark a newfound appreciation for the art of coaching. Ever wondered about the secret sauce that sets apart a winning team? Coach Mac shares his perspective on the critical role of confidence, the art of simplifying defenses and offenses, and the importance of having the right practice plans. But it's not just about the game. We delve into the dynamics between parents and their budding athletes, examining the pivotal role they play and the financial and time cost of nurturing a successful athlete. Is sports becoming a game only for those with the deepest pockets? Let's find out!As we navigate the world of sports, from the grassy fields of local games to the spotlight of professional leagues, we touch on the impact of money. Coach Mac shares a thought-provoking viewpoint on how the influx of cash has changed the game's very nature, possibly even leading to more injuries and lesser team loyalty.  Join us for this compelling discussion and see the world of sports through the eyes of Coach Mac.

Explore the medical world with us through the eye of a philosopher. Our guest, Jacob Stegenga, a professor of philosophy and philosophy of science, brings a unique perspective to the table, challenging the conventional methods and concepts in medicine. Join us as we navigate the labyrinth of medical interventions, their effectiveness, financial incentives, and the politics that often overshadow their true value. The journey is insightful, filled with intriguing debates, such as the effectiveness of masks, and fascinating examples from trials like the dexamethasone trial and the Bangladesh mask study.We're stripping down randomized control trials in this episode, scrutinizing their limitations and potential misinterpretations that could impact the efficacy of a drug. While technology like artificial intelligence offers promise in medical care, Jacob emphasizes the indispensability of a humanistic approach towards patients. We also dare to discuss the often overlooked aspects of medicine – the rituals, profit incentives, and commercialization of treatments that are sometimes based on questionable scientific evidence. Stay with us as we dive deeper into the complex world of medicine, revealing the tension between patient perspectives and the interests of various stakeholders. We question the role of pharmaceutical companies in shaping the system and whether a government-run medical system would be more beneficial than a privately-run one. This episode culminates with a potent discussion on medical nihilism and gentle medicine, suggesting a potential shift in the medical landscape. This is an episode that challenges, informs, and offers a fresh, philosophical perspective. Buckle up for a thought-provoking ride.

What if you could peek behind the curtain of modern medicine, exploring its triumphs, trials, and the challenges of adopting life-changing practices? This episode promises a riveting journey, with Dr. Erin Blake as our guide, unraveling the complexities of medical decision making, especially related to cancer treatment. We tackle the inertia that keeps traditional chemotherapy at the forefront and investigate the bureaucratic roadblocks that hinder the adoption of more evidence-based treatments. We also shine a spotlight on the transformative power of PARP inhibitors in oncology care, particularly their impact on ovarian cancer treatment. Dr. Blake enlightens us on the exceptional responses to lankymo therapy and surgery, and the promise of maintenance therapy in extending positive outcomes. Yet, we also confront the contradictory data, the under-utilization of immunotherapy, and the ongoing struggle to revolutionize care. But why is there such a barrier in adopting new ideas in medicine? This episode doesn't shy away from asking hard questions, delving into the history of immunotherapies, the resistance to Coley's toxins, and the decreasing number of physician scientists. We critically examine the challenges of integrating research with clinical practice and grapple with the uncomfortable reality of addressing the unhealthy aspects of modern life without sounding judgmental. Expect a compelling, thought-provoking, and illuminating dialogue that takes a deep dive into the heart of modern medicine. Don't miss this enlightening conversation with Dr. Erin Blake!

Are you ready to have your preconceived notions about the nursing profession challenged? We promise you will leave this episode with a newfound respect for the critical role of nurses in our healthcare system. Our guest, Christina Farrell, an experienced nurse practitioner, provides a unique perspective on the value of nurses, not just for their clinical expertise, but for their essential critical thinking skills as well.Throughout the episode, Christina underscores the importance of appreciating the unique training and experience that nurses bring to the table, and how it differentiates them from physician assistants. But it doesn't stop there. She also builds a strong case for why nurses deserve more recognition in the healthcare hierarchy, and how a lack of respect for their role can lead to a dip in the quality of patient care. Christina believes that the best patient outcomes are achieved when everyone in the healthcare team, including nurses, is treated with respect and appreciation. In our final section, we dive into a thought-provoking discussion about teamwork, hierarchy, and respect. Christina uses her rich experience to illustrate how misperceptions about a nurse's role can lead to a lack of respect, and how that can negatively affect patient care. As Christina aptly puts it, the best outcomes in healthcare happen when everybody operates from a place of respect and appreciation. This episode is a must-listen for anyone involved in healthcare, and for those of us who have ever been, or will be, in the care of a dedicated nurse.

We discuss obesity in our healthcare system and some of the new treatments such as Wegovy

What do medieval armies have to do with today's healthcare system? This episode looks at how innovative tactics can overcome material deficits. We will look at the  Battle of Agincourt and examine how a smaller army was able to prevail and what lessons can be applied to today's medical challenges. 

This episode covers the development of common over the counter medications. Where did these drugs come from and how are they linked to the German dye industry? How do they work and what are their side effects? 

Today's episode will look at fever. Its role, benefits, potential drawbacks and significance. We will also address fever phobia and our often misguided attempts to control it. 

This episode is a follow up from the previous discussion. We discuss how guns despite their toll on public health, are viewed differently than other types of public health challenges. We also look at specific legislation that protects gun manufactures and prevents us from looking at guns from a more objectively. 

In this episode we talk about the lack of attention to gun violence when compared to Covid-19. Highlights include information about the state of guns in our nation and a brief discussion about opportunities for change. 

There is much debate about school masking. What is the science on this? Does it help with covid? Is the US an outlier? We talk with a schoolteacher about her experience with masking and go over some of the latest research. 

Why do we make the decisions we do? What influences our decision making process? In this episode we bring back Dr. Erin Blake and discuss how the decision making process is shaped by our healthcare environment. We also look at an airline accident and analyze some of the factors influencing the decisions of the crew which sadly resulted in a terrible crash. 

Variolation and Coronavirus? In this episode we go over a brief history of vaccination and discuss Dr. Monica Gandhi's recent article that looked at facial masking during Covid-19 and potential benefits outside of preventing infection.

Do you really know the story of the of Thanksgiving?

In this episode we discuss how the pandemic is affecting individuals who are not on the frontline. Guests include oncologist, Dr. Erin Blake, Dr. Elizabeth Holguin medical director of community health at Presbyterian Healthcare Services, middle school teacher Cristina Gonzales, and Scott Lardner owner of Rocky Mountain Stone. 

In this episode of the Journal Committee we discuss the different machines available to assist patients when they struggle with breathing as well as what happens when the air we breathe is polluted with wildfire smoke. Our guests include a respiratory therapist and a wildland firefighter. Citations are posted below:Bruells, C. S., Smuder, A. J., Reiss, L. K., Hudson, M. B., Nelson, W. B., Wiggs, M. P., . . . Powers, S. K. (2013). Negative Pressure Ventilation and Positive Pressure Ventilation Promote Comparable Levels of Ventilator-induced Diaphragmatic Dysfunction in Rats. Anesthesiology, 119(3), 652-662. doi:10.1097/aln.0b013e31829b3692Corrado, A., & Gorini, M. (2002). Negative-pressure ventilation: Is there still a role? European Respiratory Journal, 20(1), 187-197. doi:10.1183/09031936.02.00302602Energy, J. (2020, April 07). Modern iron lung designed to address ventilator shortage. Retrieved October 14, 2020, from https://newatlas.com/medical/british-engineers-modern-iron-lung-covid-19-ventilator-alternative/Grasso, F., Engelberts, D., Helm, E., Frndova, H., Jarvis, S., Talakoub, O., . . . Kavanagh, B. P. (2008). Negative-Pressure Ventilation. American Journal of Respiratory and Critical Care Medicine, 177(4), 412-418. doi:10.1164/rccm.200707-1004ocKurt. O. K., Zhang, J., & Pinkerton, K. E. (2016). Pulmonary health effects of air pollution. Current Opinion in Pulmonary Medicine, 22(2), 138-143. doi:10.1097/mcp.0000000000000248Lee, B., Kim, B., & Lee, K. (2014). Air Pollution Exposure and Cardiovascular Disease. Toxicological Research, 30(2), 71-75. doi:10.5487/tr.2014.30.2.071Liu J. C., Pereira, G., Uhl, S. A., Bravo, M. A., & Bell, M. L. (2015). A systematic review of the physical health impacts from non-occupational exposure to wildfire smoke. Environmental Research, 136, 120-132. doi:10.1016/j.envres.2014.10.015Liu, J. C., Wilson, A., Mickley, L. J., Dominici, F., Ebisu, K., Wang, Y., . . . Bell, M. L. (2017). Wildfire-specific Fine Particulate Matter and Risk of Hospital Admissions in Urban and Rural Counties. Epidemiology, 28(1), 77-85. doi:10.1097/ede.0000000000000556Peters, A., Annette Peters From the Department of Environmental Health (A.P., Dockery, D., Douglas W. Dockery From the Department of Environmental Health (A.P., Muller, J., James E. Muller From the Department of Environmental Health (A.P., . . . Peters, C. (2001, June 12). Increased Particulate Air Pollution and the Triggering of Myocardial Infarction. Retrieved October 14, 2020, from https://www.ahajournals.org/doi/10.1161/01.CIR.103.23.2810Raymondos, K., Ahrens, J., & Molitoris, U. (2015). Combined Negative- and Positive-Pressure Ventilation for the Treatment of ARDS. Case Reports in Critical Care, 2015, 1-5. doi:10.1155/2015/714902Rep. No. EPA-452/R-19-901 (2019).Staff, K., Boxman, K., Rolfe, F., Wu, L., DeMars, G., & Auld, A. (2020). Hays company bringing back 'iron lungs' to help rural hospitals in need of ventilators. Retrieved October 14, 2020, from https://www.kwch.com/content/news/Hays-company-bringing-back-iron-lungs-to-help-rural-hospitals-in-need-of-ventilators-569640331.html