Daily Archives: August 25, 2022

Dr. Mike Ronsisvalle| Special to FLORIDA TODAY

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Sadness, misery, melancholy, sorrow, woe.

We can use multiple words to describe one of the most common human experiences: depression.

Reports of people experiencing depression date back several millennia.

One of the most familiar ancient references might be that of King David from the old testament.

He wrote in the Book of Psalms I am worn out from sobbing. All night I flood my bed with weeping, drenching it with my tears.

Im sure that experience sounds very familiar to anyone who has dealt with a major depressive episode or what those in ancient times called The dark night of the soul.

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While the experience of depression has been a constant across the rise and fall of every human culture, how we address the symptoms of depression has certainly changed over time.

Egyptians used physical restraint and starvation to deal with depression.

The Romans tried a kinder, gentler approach using massage, diet, musicand baths.

It wasnt until the early 1900s that the precursors of modern psychological theories began to dominate our understanding of depression and how to treat it.

Freud wrote about mourning and melancholia, where he theorized depression was rooted in anger about a real or perceived loss.

More recent approaches increasingly stress the biopsychosocial model that looks at the biological, psychologicaland social factors that play a role in depression.

As our understanding of depression has yielded incredible progress in treatment options, it is fair to say that modern psychology has yielded effective interventions like psychotherapy and medication that directly improve levels of depression.

The good news is that we no longer use physical restraints or baths to try to help people walk out of the dark night of the soul.

Therapy works. Medication helps people feel better. These are proven facts in the research.

However, the common wisdom in the field suggests that between 20 and 30 percent of people who struggle with depression never find full recovery.

We call this phenomenon treatment-resistant depression and it leaves some professionals scrambling for other treatment options that might help people feel better.

Throughout my early career, there were many times that I struggled to design treatment plans to help people with treatment-resistant depression.

Its so hard to watch some people with depression get better while others just seem to be stuck in a recurring cycle of pain.

I imagine I felt much like an ancient Egyptian or Roman when the warm bath just didnt seem to relieve my patients heartache.

In the last several years, I have spent a considerable amount of my professional energy looking for creative and effective ways to address treatment-resistant depression.

What do you do as a professional when someone is metaphorically worn out from sobbing and flooding their bed with tears?

Thankfully, Im happy to report that we have been able to implement strategies based on research that provides hope for people with treatment-resistant depression.

If you or someone you love is stuck in this never-ending cycle of depression, I want to encourage you with this simple message:There is hope.

You can break free from the chains of depression and begin to live in peace and joy.

Weve started more intensive programs at our LiveWell clinics that combine psychotherapy with medication and other holistic treatments that work to combat treatment-resistant depression.

Of all the unique and creative treatments we offer, let me take the rest of our time here to focus on TMS (Transcranial Magnetic Stimulation), which is perhaps one of the most exciting new technologies that directly addresses treatment-resistant depression.

TMS is a new technology that has approximately a 70% success rate.

The entire procedure is based on a biological understanding of the cause of depression which suggests that an imbalance of neurotransmitters in the brain is one of the most significant factors that contribute to the experience of depression.

In short, when looking through the lens of neurology it is clear that brain activity is reduced in people with depression.

Ive included an image of two PET (Positron Emission Tomography) scans, which measure vital functions such as blood flow, oxygen use, and blood sugar metabolism that demonstrate just how dramatically brain activity is reduced in depression.

The image on the right is a non-depressed brain.

Notice all bright yellows and greens that reflect the vibrant brain activity of a person who is not currently experiencing depression.

The image on the left of a depressed brain tells a different story.

As you can see, there are hardly any bright colors that indicate healthy blood flow and activation.

Instead, the brain is almost completely dark and lacks any significant activity.

When a client receives a TMS treatment, the brain is mapped to identify areas that are lacking these vital functions and activation.

After a clients unique neurological makeup is identified, the TMS provider uses a highly focused pulsed magnetic field, similar to what is used in a MRI imaging machine, to stimulate cortical neurons involved in mood regulation.

This stimulation physically modulates neurotransmitter release and increases cerebral blood flow and glucose metabolism.

In short, the TMS protocol achieves the same stimulation of neurotransmitters that are encouraged by anti-depressant medications, but it does it in a much more sophisticated and targeted manner.

I sat down with our medical director at LiveWell Behavioral Health, Dr. Parwati Maddali, to ask her a few questions that might help me relay how TMS stimulates the brain and also provide her understanding of the value of TMS from a medical perspective.

As a psychiatrist who has been practicing for decades in the mental health field, Dr. Maddali is in a unique position to talk about the efficacy and benefit of TMS to those struggling with depression.

Here is a snapshot of our conversation that illustrates some of her most important insights.

Q:Dr. Maddali, can you explain the difference between how TMS stimulates a depressed brain as opposed to how an anti-depressant might stimulate a depressed brain?

A: Anti-depressants are designed to increase the stimulation of the brains neurotransmitters similarly to a TMS treatment. While a TMS treatment directly stimulates the brain using electromagnetic stimulation of nerve cells, anti-depressants are systemic, which means they must travel through the entire digestive system and into the bloodstream before they finally end up stimulating the brain.

Although this is a very rudimentary explanation it highlights why anti-depressants come with more side effects than TMS. Many times, my patients who are taking anti-depressants experience side effects like insomnia, headache, blurred vision, dry mouth, fatigue, weight gain, nausea, G.I. distress, and sexual dysfunction.

Because anti-depressants travel through the entire system, the side effects are potentially systemic. TMS on the other hand directly stimulates the brain without involving other bodily systems which will eliminate many of these systemic side effects. The most common side effect of TMS is mild scalp discomfort at the treatment site. So TMS is safe, easy to tolerate, and effective.

Q: Speaking of effectiveness, how effective is TMS in your experience?

A: Medications can typically take 3 to 4 weeks to be effective and can have several of those systemic side effects that Ive mentioned. Especially after psychotherapy and trials on two or three medications have not been effective, I have seen many patients get better with TMS, and it usually doesnt take weeks to see the treatment's impact. Many times we see progress after just several days. Its a great treatment option, especially for people with treatment-resistant depression.

Q: Any TMS success stories youd like to share?

A: Theres one patient I remember, in particular, who made incredible progress with TMS. Before I prescribed a TMS treatment, this young mother encountered many problems getting her depression in check.

It was so gratifying to see this woman, who worked full-time, go from sitting on the couch feeling guilty about how disconnected she was from her kids and career to getting her life back. It was simply gratifying to watch."

After speaking with Dr. Madalli regarding her experience with TMS, it confirmed my own experience professionally, TMS is a great option for many people who are struggling with treatment-resistant depression.

The beauty of TMS is that the research continues to confirm our professional experience. TMS is safe and effective and comes with very few side effects.

Even the major insurance companies agree with the effectiveness of this new technology to treat depression.

Almost every major insurance carrier will cover the treatment, which is, in many ways, the gold standard of the efficacy of a psychological or medical intervention.

Insurance companies dont like to pay for treatments that might or might not work. Instead, they usually wait until the research is unequivocal before they will reimburse for these kinds of services.

Thankfully, we have built enough of a research base that TMS is considered part of the standard of care for treatment-resistant depression.

Yes, depression has been around for millennia and is most certainly part of the human condition.

As our understanding of depression has grown, so has our ability to treat it. Its exciting to know that we have growing options to help people at our LiveWell clinics.

My encouragement to you is simple: if youre struggling to find freedom from depression, dont struggle in isolation.

We have professionals at LiveWell that can meet with you to determine whether or not a creative treatment like TMS is right for you.

Most importantly, have hope that even though depression is an age-old problem, we have more tools at our disposal than ever before to help you move forward out of this dark night of the soul.

Dr. Mike Ronsisvalle is a Licensed Psychologist and the President of LiveWell Behavioral Health, a psychological services agency that provides counseling to clients of all ages and addictions treatment to adolescents and adults. You can find him atwww.LiveWellbehavioralhealth.comor call 321-259-1662.

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Transcranial Magnetic Stimulation is new way to help those with depression - Florida Today

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Thinking about buying stock in Greenbrook TMS, AMC Entertainment, Axsome Therapeutics, Bed Bath & Beyond, - Benzinga

The passing of Jamey Rootes, who served as the president of the Houston Texans for 20 years, hit me pretty hard.

I only met him a couple of times, one of which was in 2020 when he gave me an autographed copy of his book The Winning Game Plan to review. I frequently passed by him on the sidelines while I was photographing Texans games. I doubt he would have remembered my name, but most people in the organization recognize me as the photographer with the cowboy hat.

When Rootes took his life on Sunday, Aug. 21, I was shocked, as were most people. It was akin to Robin Williams committing suicide. Youd never suspect that someone who seemed so happy, content, and confident would be harboring suicidal thoughts. Every time I saw Rootes he was smiling, upbeat, and positive. His book oozed his passion and enthusiasm. He was a man clearly living the dream.

What really brought it home for me was the fact that my brother has been heavy on my heart this week. Tomorrow (Aug. 26) would have been his 56th birthday. He took his life Jan. 1, 2021. Hardly a day goes by that I dont feel the pain of his loss or the fondness of his memory. Yesterday was also the birthday of a former youth pastor at our church. He was energetic, creative, and fun and stunned everyone who knew him when he ended his life three years ago.

I cant say that I fully understand why people suffer in silence and then abruptly end their suffering, but then again, I do understand it. For many years I suffered with moderate to severe depression. I was never to the point of wanting to end my life, but I did have several bouts where I no longer wanted to live. And yes, there is a difference.

I know what its like to feel so lost and hopeless that you just want your misery to end. I know what it feels like to grudgingly trudge through the motions of each day unable to feel any positive emotion at all. I spent more than 12 years not feeling joy, peace, love, happiness, contentment, excitement, euphoria, etc. Oh, there would be brief moments when those feelings would surface, but they were quickly quashed and the darkness would return.

I overcame my depression through Transcranial Magnetic Stimulation (TMS) treatments two years ago. Thats the happy ending to my story. Unfortunately, the treatment is not well known, very expensive, and only has a 75% success rate. My point is, there is hope. The light at the end of the tunnel isnt a train. There are many ways to battle depression. TMS is what worked for me.

The one thing that kept me from tipping over from not wanting to live to wanting to die was love. I couldnt bear the thought of the trauma my death would cause my family. I may not have been able to feel love, but I loved them too much to make them suffer that way. Ive never told anyone that before, so it might come as a surprise when they read this.

Love is powerful and should never be underestimated. As the Bible tells us in 1 Corinthians 13:13, And now these three remain: faith, hope and love.But the greatest of these is love. One of my favorite quotes is from the late Rocky Mountain News columnist John Coit: Life is short and it hurts. Love is the only drug that works.

Today I feel love. Perhaps thats what makes these losses to suicide so painful. Its been said that suicide doesnt end the pain, it just transfers it. As I scroll through my Facebook feed, I see a huge outpouring of love for Jamey Rootes. He made an enormously positive impact not only on the Texans and the city of Houston, but in every aspect of life that he touched. We still need his fire to burn brightly. Now we must carry the torch without him.

I know there are some who are reading this and mentally and emotionally theyre in that dark, foreboding place. Trust me when I say there is hope. There is love. There is a future and world that absolutely needs you. If you find yourself on that threshold, call 988, the suicide prevention hotline. Call a friend. Pray. You are not alone. Your life has meaning and value and its meant to be shared with all those around you.

Joe Southern is the managing editor of the Wharton Journal-Spectator and the East Bernard Express. He can be reached at news@journal-spectator.com.

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Don't go there, your life matters | East Bernard Express | journal-spectator.com - Wharton Journal Spectator

Turvo, provider of the worlds leading collaboration application designed for the supply chain, and project44, the worlds leading advanced visibility platform for shippers and third-party logistics firms, announce a strategic and technical partnership that brings technological innovation to the forefront and raises the bar for collaborative transportation management systems (TMS) in the logistics industry.

By integrating Turvo and project44, shippers, logistics providers, and carriers engaged in full and less-than-truckload (LTL) shipments, will see dramatic improvements in visibility and productivity, helping customers save time and money at a time when its most needed.

Turvo and project44 are bringing together an entire ecosystem of innovative supply chain solutions, saidScott Lang, Chief Executive Officer at Turvo. Logistics is a team sport, but outdated technology makes it hard for shippers, LSPs, and carriers to work together effectively. Were excited to partner with project44 to increase collaboration and visibility throughout the supply chain.

Also Read: Three Key Supply Chain Issues to Watch in 2022

Combined with Turvos advanced collaborative logistics capabilities, brokers, 3PLs, shippers and their customers will gain unprecedented insight into their shipments and supply chain. In turn, project44 customers will benefit from Turvos award-winning collaborative TMS solution, empowering them to become more efficient, grow their businesses, and deliver outstanding customer experiences.

In particular, Turvo customers will be able to capitalize on project44s precise shipment tracking and dynamic estimated times of arrival capabilities.

This partnership advances Turvo and project44s shared goal of a 360-degree digitalization of the supply chain that brings customers so close to the market at any given time that they can detect what change is essential and respond quickly with the most competitive solution.

Changing Markets Demand Smarter Solutions

With the severe staff shortages being felt throughout the global economy, supply chain software has become crucial in enabling lean, agile teams to outperform the complexities of the current operating environment.

Inefficient processes to find carriers, uncertain and highly variable arrival times, and the potential downstream consequences have heralded the need for a better way of working in an extremely complex operating environment.

Also Read: The role of real-time data analytics in improving and guiding business decisions

project44 is on a mission to make the worlds supply chains work, and at a time when they are more volatile than ever before, this partnership enables shippers to gain actionable insights into shipments, orders, and inventory, from the first mile to the last mile, saidThomas Deakins, Senior Vice President Global Partnerships and Alliances, project44. Together we can enable the movement of products globally, while delivering better resiliency, sustainability, and value to our customers.

Turvo and project44 together allow users to stay ahead of disruptions, control costs, and better serve their customers by navigating new remote working policies with greater ease and manage emerging direct-to-consumer business models with a more sustainable and transparent way of working.

Digitalizing the Supply Chain

As part of the partnership, Turvo has become one of the select few project44 certified partners offering easy, rapid integration with its platform, delivering superior real-time tracking and automation capabilities that empower customers to achieve end-to-end visibility across their supply chains.

Our partnership with Turvo is a great example of the importance of collaboration along the supply chain, said Deakins By bringing together a host of our trusted advisors and certified integrations in one place we can deliver superior real-time tracking and automation capabilities that empower users to achieve end-to-end visibility across their operations.

Collaboration is the foundation of Turvos architecture. With project44s industry-leading platform built into its workflow, Turvo is able to help freight brokers, 3PLs, and shippers find a place to easily plan, execute, settle, and automate all of their supply chain operations on one platform, with a cloud-based social network approach.

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Turvo and project44 Collaborate to Transform The Supply Chain - EnterpriseTalk

With the push from the Indian government to augment the state of manufacturing in the country, logistics too has come into the spotlight. In order to keep up with the growing investments in manufacturing that will lead to more freight movement, logistics companies must incorporate any and all tech-led solutions into their offerings to match up. India is geographically vast, and covering that much ground requires a keen understanding of gaps and chokepoints in the freight movement process. There are certain key tech pieces that do and will play a role in bettering logistics offerings.

Of these, here are the 4 most impressive and relevant technologies that are helping logistics companies like FreightFox, Blue Yonder, Ariba, etc constantly evolve and stay on the cutting edge:

Cloud LogisticsThe future of logistics is remote-hosted data and process, with half of the logistics firms now embracing cloud-based services and another fifth soon to. Cloud services, which provide adaptability and immediate access to crucial analytics and operations software, are enabling the expansion of highly responsive on-demand business models, which are quickly taking over the logistics industry. While the setup for cloud systems might be a one-time effort, the payoff in terms of cost and turnaround time is manifold. For manufacturers, this means accessibility to their day-to-day freight movement, along with centralized data storage.

Smart DataIn a world where everything relies on data for consistency, accountability, and decision-making, dynamic data modules are a necessity. In the logistics space, data modules that give customers information in real time across various verticals in logistics. The reach of smart data extends to getting real-time rates for vehicles on the road, understanding any external factors that might affect procurement and freight movement, and so on. Such data can also provide management solutions using advanced analytics to address placement failures, track and trace freight movement, optimize procurement, and much more. Reliable data that is geared to understand and change in cohesion with changing aspects of the logistics industry is a differentiator that provides not just insights, but also solutions for problems that crop up on a day-to-day basis. Heightened manufacturing in the country will also require a close watch on demand and supply trends, which can be predicted and projected by data. Companies that provide this solution can bring in their expertise to factor in external pressures and their impact on demand and supply, and adjust strategies accordingly.

Transportation Management Systems (TMS)TMS are becoming more and more common, particularly among logistics companies. And with good reasonmany tech tools need to be managed and organised properly at a single hub. To manage carriers and enhance route automation, TMS is employed. It helps with real-time delivery driver tracking, freight cost reduction, more transparency, and general customer satisfaction scores. Having one platform that routes, stores, and manages all data related to a logistical operation is essential, especially since freight movement has become a quintessential part of the modern world, across industries.

AutomationIn 2020 and 2021, the pandemic increased the need for automation as companies across industries sought to reduce face-to-face interactions.

Automation in warehouses or distribution centres can range from physical automation to process automation. Typical warehouse automation techniques include digitising manual procedures, employing pick-to-light systems where workers scan barcodes and LED lights indicating the quantity of things to be picked up and their final destination. Depending on the size of their warehouses or distribution centres, as well as the volume and kinds of orders they routinely fill, businesses will continue to automate a number of their procedures to varied degrees. Besides warehouse automation, technology also offers the betterment of procurement automation, which can be extremely useful for manufacturers. Since freight movement relies on procurement to then collate data on the way forward, an automated piece here gives manufacturers the agency to understand and implement procurement strategies that can keep up with the dynamic levels of required freight movement across the country.

Indian logistics is on the cusp of becoming one of the most important segments of the economy. It must keep with the accelerated investments and growth in manufacturing, while also factoring in the vast expanses of the country that need to be covered. More ground to be covered requires better handling of freight, along with smarter, sharper, and faster data and automation. The future of Indian logistics will be ever-evolving, and it will be exciting to see the new cutting edge that technology brings to it.

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Top 4 tech-based solutions that are changing the face of logistics in India - CXOToday.com