Why End-of-Life Care Is So Difficult - And How to Take Back Control | Dr. Karen Lutfey Spencer, Ph.D. - Professor of Health and Behavioral Sciences, University of Colorado Denver

Send us Fan MailWhat if you could take 25 years of experience navigating the halls of Congress - and turn that knowledge into a toolkit that anyone could use?My guest today spent decades on the inside of government, including serving as Chief of Staff to Congressman Luis Gutiérrez.But after Hurricane Maria, she came to a very different realization: maybe ordinary citizens don't need to have access to power - they need to understand how to use the power they already have.So can civic power actually be taught?That's what we're going to explore today with Jennice Fuentes.Jennice Fuentes is the founder and CEO of BoricuActivatEd ( https://boricuactivated.org/ ), a nonprofit focused on teaching people the fundamentals of civic engagement, advocacy, storytelling and community change. She is also the founder and managing partner of Fuentes Strategies ( https://fuentesstrategies.com/ ), a government-relations firm focused on strategic guidance and access involving Congress, federal agencies and Puerto Rico.Before founding these organizations, Jennice spent 25 years working in the U.S. House of Representatives, including more than 20 years as Chief of Staff to Congressman Luis Gutiérrez, where she served as a principal advisor, strategist and manager - helping move legislative initiatives from concept to law. She began her congressional career working in the Office of Puerto Rico's Resident Commissioner.But the experience that ultimately changed the direction of her career came in the aftermath of Hurricane Maria in 2017.As Puerto Rico struggled through the disaster, Jennice saw something beyond the devastating infrastructure crisis: a profound gap in people's ability to navigate government, communicate their needs and advocate effectively for their communities.And that led to a fascinating question:What if ordinary citizens didn't need a congressional insider to make their voices heard?That question became BoricuActivatEd - an organization whose philosophy is essentially: Educate. Activate. Empower. Advocate.Today, Jennice is working to give communities something that can be just as important as money or infrastructure - the knowledge and confidence to understand how government works and participate effectively in it.#JenniceFuentes #BoricuActivatEd #CivicEngagement #CivicPower #Democracy #PublicPolicy #Government #Congress #Advocacy #CommunityEngagement #PuertoRico #HurricaneMaria #CivicEducation #Leadership #PublicService #PoliticalScience #SocialImpact #CitizenEngagement #Storytelling #ProgressPotentialAndPossibilitiesSupport the show

Send us Fan MailWhat if one of the answers to America's drug-shortage problem isn't another pharmaceutical factory - but a genetically engineered yeast cell?For centuries, we've gone to nature to get many of our most valuable medicines - growing poppies, harvesting plants, extracting molecules and building global supply chains around them.But what if we could take the biological instructions that make those molecules and put them into a microorganism?That's the idea behind Antheia - and they've now taken engineered biology all the way to a 116,000-liter production scale.Dr. Christina Smolke, Ph.D. is a pioneer in synthetic biology and metabolic engineering, with more than 20 years of experience engineering biological systems. She is the co-founder and CEO of Antheia ( https://antheia.bio/ ), and is also an Adjunct Professor of Bioengineering at Stanford University. Her laboratory pioneered the engineering of baker's yeast to produce complex plant-derived pharmaceutical compounds - work that helped lay the scientific foundation for what Antheia is doing today.Dr. Kristy Hawkins, Ph.D. is Antheia's co-founder and Chief Scientific Officer. She has more than 20 years of experience in synthetic biology and yeast metabolic engineering, with expertise in pathway engineering, high-throughput screening and engineering microbial hosts to produce complex small molecules. Before Antheia, she worked at synthetic-biology companies Amyris and Lygos.Together, Dr. Smolke and Dr. Hawkins founded Antheia around a remarkably ambitious idea: instead of depending on farms, overseas factories and fragile global supply chains to produce the molecules we need for essential medicines, why not program biology itself to manufacture them?Antheia is now using advanced biosynthesis, genomics, computational biology and fermentation to produce pharmaceutical key starting materials and active pharmaceutical ingredients - including thebaine, an important starting material for several essential medicines.And this isn't simply a laboratory experiment anymore. The company has moved its technology toward commercial-scale manufacturing and has received substantial U.S. government support aimed specifically at strengthening domestic pharmaceutical supply chains.Today we're going to explore why the U.S. drug supply chain is so vulnerable, what it would actually take to bring essential medicine manufacturing back home, and whether engineered biology could become part of the infrastructure of American healthcare.#Antheia #SyntheticBiology #Biomanufacturing #DrugShortages #PharmaceuticalManufacturing #DrugSupplyChain #Biotechnology #Biotech #Pharma #AdvancedBiosynthesis #EngineeringBiology #SyntheticBiology #DrugDiscovery #Thebaine #EssentialMedicines #HealthcareInnovation #Manufacturing #SupplyChain #FutureOfMedicine #Science #Technology #Innovation #ProgressPotentialAndPossibilitiesSupport the show

Send us Fan MailCAR-T therapy can be extraordinarily powerful against cancer - but there's a catch. We currently have to take a patient's T cells out of their body, genetically engineer them in a laboratory, manufacture billions of cells, and then put them back. But what if we could skip the factory entirely - and genetically program the T cells inside the patient's body?Dr. Luke Russell, Ph.D. is President of Vyriad ( https://vyriad.com/ ), a biotechnology company developing viral therapies designed to deliver genetic payloads directly to cells in the body.Dr. Russell has spent much of his career at the intersection of cancer immunotherapy, oncolytic virotherapy, gene delivery, and biotechnology strategy. Before moving into executive leadership, his research focused on using viruses to attack tumors and stimulate antitumor immunity. He earned his PhD in Neuroscience from The Ohio State University, where his work included developing an immunostimulatory oncolytic herpesvirus for brain cancer, and later earned an MBA in Finance and Strategy from Carnegie Mellon University’s Tepper School of Business.Dr. Russell joined Vyriad in 2018 and has held increasingly senior roles spanning research, alliance management, business development, operations and corporate strategy. During that time, he has helped build strategic relationships with major pharmaceutical companies including Novartis, Regeneron and Merck KGaA.And now, as President, Dr. Russell is helping lead Vyriad’s effort to develop a new generation of viral medicines - including VV169, the company’s third clinical program, and its G-Link platform, which is designed to give viral vectors a modular, “plug-and-play” ability to retarget which cells they deliver their genetic payloads to.At the center of today's conversation is a particularly provocative possibility: in-vivo CAR-T - using a targeted viral vector to genetically reprogram a patient’s own T cells inside the body.#CAR T #CAR TCellTherapy #Cancer #CancerResearch #Immunotherapy #ImmunoOncology #GeneTherapy #GeneDelivery #CellTherapy #InVivoCAR T #CAR TResearch #TCells #ViralVectors #OncolyticVirotherapy #Biotechnology #Biotech #PrecisionMedicine #MedicalInnovation #DrugDevelopment #FutureOfMedicine #Vyriad #LukeRussell #ProgressPotentialAndPossibilities #PPPSupport the show

Send us Fan MailWe like to think that modern healthcare gives patients more control than ever before. But what if having more choices doesn't actually mean having more control? And what if, at the end of life, the healthcare system can quietly steer you toward choices you never intended to make?Today we're going to tackle a subject that most of us would rather not think about — until we're suddenly forced to.We all like to believe that when the end of life comes, we will be able to make informed decisions about the care we receive: where we want to be, how aggressively we want to be treated, how much medical intervention we want, and what matters most to us and our families.But what if having a choice isn't the same thing as actually having control?My guest today argues that many of the decisions surrounding the end of life are shaped not just by patients and families, but by the architecture of the healthcare system itself - by fragmented care, medical culture, financial incentives, insurance policies, physician training, family dynamics, and the powerful default toward treatment and intervention.Dr. Karen Lutfey Spencer, Ph.D. ( https://www.karenlutfeyspencer.com/ ) is a medical sociologist and Professor of Health and Behavioral Sciences at the University of Colorado Denver ( https://clas.ucdenver.edu/hbsc/karen-lutfey-spencer ). For more than 25 years, her research has examined doctor-patient relationships, medical decision-making, healthcare inequality, and the ways in which patients and providers navigate complex medical systems. Her NIH-funded research has been published extensively in peer-reviewed journals.For more than a decade, Dr. Lutfey Spencer has focused specifically on end-of-life healthcare, conducting more than 120 in-depth interviews with patients, families, caregivers, physicians, hospice and palliative-care professionals, death doulas, funeral directors, and other experts.That work has now become her first book for a general audience, Your Good Death: Why End-of-Life Healthcare Is So Difficult and How to Make It Work for You ( https://www.amazon.com/Your-Good-Death-End-Life-ebook/dp/B0GZ87LTYS ).And one of the most provocative ideas in the book is that the question may not simply be, "What do you want at the end of your life?" It may be, "What is standing between what you want and the care you're actually likely to receive?"#KarenLutfeySpencer #YourGoodDeath #EndOfLifeCare #PalliativeCare #Hospice #Caregiving #Healthcare #PatientChoice #PatientAdvocacy #MedicalSociology #HealthcareSystem #EndOfLife #Aging #QualityOfLife #SharedDecisionMaking #ProgressPotentialAndPossibilities #PPPSupport the show

Send us Fan MailFor decades, we've thought about space as a place where we put satellites. But what happens when space itself becomes infrastructure - when we can move spacecraft around, refuel them, repair them, and even have robots build enormous structures in orbit? We're entering a very different era of space.Today we’re joined by someone who has spent more than three decades at the intersection of space, national security, aerospace, defense, and geopolitics.John Rood is Chairman and CEO of Momentus ( https://momentus.space/ ), a U.S. commercial space company developing the infrastructure needed to move, deploy, operate and ultimately service spacecraft in orbit.But John's background is almost as fascinating as the technology he's now helping build.Before entering the commercial space industry, he served as Under Secretary of Defense for Policy, where he was the Pentagon's principal advisor on defense policy and helped oversee issues ranging from national defense strategy and missile defense to space, nuclear weapons, cyber policy and America's relationships with allies.Earlier in his government career, he served at the National Security Council and the State Department, including as Acting Under Secretary of State for Arms Control and International Security, and he has also held senior business-development and international leadership positions at Lockheed Martin and Raytheon.Today, at Momentus, he's working on a very different - but increasingly important - frontier: building the infrastructure of the space economy.Momentus operates spacecraft such as its Vigoride Orbital Service Vehicle, which can transport and support satellites and hosted payloads in orbit. The company is also moving toward more ambitious capabilities involving orbital infrastructure, servicing and in-space manufacturing.And perhaps most fascinatingly, Momentus is involved in a DARPA program investigating whether large structures can actually be assembled in space by autonomous robotic systems - potentially laying the groundwork for enormous communications antennas, manufacturing platforms and other infrastructure that would be extremely difficult or expensive to launch from Earth in one piece. DARPA describes the current demonstration as an autonomous robotic assembly of a lightweight truss in low Earth orbit.Today we're going to talk about the rapidly changing economics of space, the rise of commercial space infrastructure, why national security is becoming increasingly dependent on space, what it means to actually build things in orbit - and ultimately, what the infrastructure of a civilization beyond Earth might look like.#Space #SpaceX #SpaceEconomy #SpaceInfrastructure #CommercialSpace #SpaceTechnology #Aerospace #SatelliteTechnology #OrbitalInfrastructure #SpaceExploration #SpaceInnovation #NASA #DARPA #MissileDefense #GoldenDome #NationalSecurity #DefenseTechnology #SpaceRace #Robotics #InSpaceManufacturing #SpaceServicing #SatelliteServicing #Vigoride #Momentus #JohnRood #FutureOfSpace #FutureOfTechnology #STEM #ProgressPotentialAndPossibilitiesSupport the show

Send us Fan MailWhat if the future of regenerative medicine isn't simply making the body grow more tissue - but teaching it exactly WHERE to grow it?That's the idea behind NELL-1, a naturally occurring protein being developed to promote controlled bone formation and potentially transform spinal fusion.Today we're exploring a fascinating area of regenerative medicine: can we make the body build new bone - but do it more precisely, more predictably, and with fewer of the complications associated with today's approaches?My guest is Jeffrey Frelick, President and CEO of Bone Biologics ( https://www.bonebiologics.com/ ), a clinical-stage medtech company developing a new approach to bone regeneration based on a proprietary recombinant protein called NELL-1.NELL-1 is particularly intriguing because it is an osteogenic growth factor that appears to act more selectively on cells involved in bone formation than traditional bone morphogenetic proteins such as BMP-2. Preclinical studies have demonstrated significant increases in bone formation and spinal fusion, including studies in large-animal models.Bone Biologics is now taking that science toward the clinic with its NB1 bone graft device combined with NELL-1, currently being evaluated in a first-in-human pilot clinical study.Jeffrey brings more than 25 years of experience across the medical-device and healthcare industries. Before becoming CEO of Bone Biologics in 2019, he served as the company's COO. Earlier in his career, he was a medical-technology equity research analyst at Canaccord Genuity, ThinkEquity and Lazard, following the industry from the Wall Street perspective. He also worked in strategic consulting at Boston Biomedical Consultants and began his career in diagnostics and medical technology, including roles at Becton Dickinson.Jeffrey holds a B.S. in Biology from the University of Pittsburgh and an MBA from Suffolk University's Sawyer Business School.Today we're going to talk about the science of NELL-1, the future of spinal fusion and bone grafting, why precision may be so important in regenerative medicine, and what it takes to move a promising bone-growth technology from the laboratory into actual patients.#BoneRegeneration #NELL1 #SpinalFusion #RegenerativeMedicine #Orthopedics #BoneHealth #MedicalInnovation #MedTech #Biotechnology #Biotech #StemCells #TissueEngineering #SpineSurgery #Orthobiologics #BoneBiologics #MedicalDevices #PrecisionMedicine #RegenerativeMedicine #HealthcareInnovation #FutureOfMedicine #Science #Technology #Innovation #ProgressPotentialAndPossibilities #PPPSupport the show

Send us Fan MailThe battlefield of the future may look almost nothing like the battlefield of today. AI could make decisions at machine speed. Autonomous drones could operate in enormous numbers. Electronic warfare could turn the electromagnetic spectrum into a battlefield. And quantum sensors could eventually allow military systems to navigate and operate even when GPS is completely denied. So what does warfare look like when all of these technologies converge?Our guest today is Matt Milas, President of Defense & Space at Honeywell Aerospace ( https://www.honeywellaerospace.com/us/en/company/leadership/matt-milas ), where he leads a global business generating more than $7 billion annually across electronic solutions, navigation and sensor systems, engines and power systems, software and connected technologies, microelectronics, electronic warfare capabilities, satellite systems, launch vehicles, and human spaceflight programs serving U.S. and allied customers around the world.Over the course of a remarkable two-decade career, Matt has held leadership roles at Honeywell, L3Harris, Raytheon Technologies, Collins Aerospace, Spirit AeroSystems, and Lockheed Martin, contributing to some of the world's most sophisticated aerospace and defense ecosystems, including the F-35 Joint Strike Fighter and advanced space systems.Known for driving organizational transformation and operational excellence, Matt has built a reputation for turning complex challenges into scalable solutions-  leading global supply chains, integrating breakthrough technologies, and helping position next-generation platforms across autonomous systems, sixth-generation aircraft, electronic warfare, and space infrastructure.At a time when artificial intelligence, autonomy, cyber resilience, advanced sensing, and the growing importance of space are reshaping both national security and modern civilization itself, Matt finds himself at the center of one of the most consequential technological transitions in history.Today, we explore the future of aerospace and defense, the evolution of autonomous systems and space infrastructure, the changing nature of industrial resilience, and what the next several decades may hold for the technologies that protect and connect our world.#AI #ArtificialIntelligence #DefenseTechnology #MilitaryTechnology #Aerospace #Defense #FutureOfWarfare #Drones #AutonomousSystems #ElectronicWarfare #QuantumTechnology #QuantumSensing #QuantumNavigation #Hypersonics #MissileDefense #GoldenDome #SpaceTechnology #NationalSecurity #DefenseInnovation #ArsenalOfDemocracy #HoneywellAerospace #Honeywell #Technology #Innovation #FutureTechnology #ProgressPotentialAndPossibilitiesSupport the show

Send us Fan MailDavid Gottfried ( https://en.wikipedia.org/wiki/David_Gottfried ) helped create the modern green-building movement. LEED became a global phenomenon, green buildings went mainstream, and sustainability became part of corporate vocabulary. But David eventually came to a startling conclusion: maybe making individual buildings greener wasn't enough. Maybe the problem was the operating system underneath civilization itself. So what exactly is wrong with that operating system - and can we actually rewrite it ( https://regen360.net/ )?Today we're going to tackle a question that is both enormous and surprisingly practical: What if humanity's biggest problem isn't a lack of technology, money, or even scientific knowledge - but the operating system we've built underneath civilization itself?My guest today is someone uniquely qualified to ask that question.David Gottfried ( https://davidagottfried.substack.com/ ) is the founder of the U.S. Green Building Council ( https://www.usgbc.org/people/david-gottfried/0000012600 ) and the World Green Building Council ( https://worldgbc.org/article/the-making-of-a-movement/ ) - organizations that helped launch what became a global green-building movement.David founded the U.S. Green Building Council in the early 1990s and wrote the white paper that ultimately became the foundation for the LEED green-building rating system. Today, LEED spans 186 countries, with more than 29 billion square feet of certified green building space and hundreds of thousands of accredited professionals.  He subsequently helped create the World Green Building Council, which now connects green-building organizations across more than 85 countries.David has spent four decades working at the intersection of engineering, real estate, sustainability, entrepreneurship and systems change. He's also taught at Stanford for three decades, advised major corporations and governments, and worked directly on technologies ranging from carbon capture and mineralization to regenerative building systems.But after helping build the modern sustainability movement, David began asking a much harder question:What if sustainability itself isn't enough?What if the problem isn't simply the technologies we use, but the incentives, measurements and assumptions that determine how those technologies are deployed?That's the question at the heart of his new book, Regen360: An Operating System for a Regenerative Earth ( https://www.barnesandnoble.com/w/regen360-david-gottfried/1150108833?ean=9798895741368 ).David proposes something he calls RegenOS - an attempt to rethink the rules by which organizations, markets, technologies and individuals make decisions - and a framework called HOPE: Health on Planet Earth.And because this is Progress, Potential and Possibilities, we're also going to talk about something particularly fascinating: artificial intelligence.David argues that AI isn't inherently good or bad - it's an amplifier of whatever objectives and incentives we give it. So if we're going to build increasingly powerful AI systems, perhaps the question isn't simply what can AI do?Perhaps it's: What should we be asking AI to optimize for?These are all pretty ambitious ideas.But if David is right, maybe changing the world begins by changing the rules by which we define success.#DavidGottfried #Regen360 #RegenerativeEarth #RegenerativeDesign #Sustainability #GreenBuilding #LEED #USGBC #ClimateChange #ClimateAction #Regeneration #HOPE #HealthOnPlanetEarth #RegenOS #ArtificialIntelligence #AI #SustainableTechnology #SystemsThinking #FutureOfEarth #FutureOfCivilization #EnvironmentalInnovation #GreenTechnology #PlanetaryHealth #CircularEconomy #Innovation #ProgressPotentialAndPossibilitiesSupport the show

Send us Fan MailFor decades we've heard that our DNA determines our health, but scientists are increasingly realizing that's only part of the story.Every day, from before we're born until the day we die, we're exposed to thousands of chemicals, pollutants, particles, microbes, foods, medications, consumer products, building materials, and environmental factors that continuously interact with our biology.Scientists now refer to this lifetime collection of exposures as the human exposome, and many believe it may ultimately become as important as the Human Genome Project in understanding why we develop cancer, Alzheimer's disease, autoimmune disorders, infertility, asthma, obesity, cardiovascular disease, and countless other chronic illnesses.But measuring something as vast as every exposure throughout a lifetime sounds almost impossible.Today we're joined by three scientists from UL Research Institutes ( https://ul.org/ ) helping make that possible.Dr. Heather Whitehead, Ph.D. ( https://chemicalinsights.ul.org/our-people/heather-whitehead-phd/ ) is an analytical chemist developing cutting-edge methods to detect both known and previously unknown environmental contaminants, including PFAS and emerging chemicals.Dr. Kristin Isaacs, Ph.D. ( https://chemicalinsights.ul.org/our-people/kristin-isaacs-phd/ ) is one of the world's leading computational exposure scientists, building mathematical models that predict how people encounter complex mixtures of chemicals across their daily lives.Dr. John Wambaugh, Ph.D. ( https://chemicalinsights.ul.org/our-people/john-wambaugh-phd/ ) is a physicist and computational toxicologist whose work helps determine what actually happens once those chemicals enter the human body, transforming massive datasets into meaningful predictions about health.Together, we'll explore one of the biggest frontiers in environmental health - how understanding the exposome could fundamentally change medicine, public health, and even how each of us lives our daily lives.UL Research Institutes is a leading independent safety science organization with global reach, pursuing and applying science-driven knowledge to meet their mission of working for a safer world.#HumanExposome #Exposome #EnvironmentalHealth #ExposureScience #PFAS #Toxicology #Chemistry #PublicHealth #PrecisionMedicine #PreventiveMedicine #HumanHealth #EnvironmentalScience #ComputationalToxicology #Pharmacokinetics #AI #Science #Biotechnology #FutureOfMedicine #Healthcare #DiseasePreventionSupport the show

Send us Fan MailThere aren't enough mental-health professionals to assess everyone who needs help - and the people who need help most may sometimes be the least willing to ask for it. Now an Israeli AI platform called LIV is trying to change both sides of that equation: using an empathetic AI conversation to identify PTSD and other mental-health risks, triage patients, and give clinicians a structured picture before they ever enter the room.Iris Shtein is Co-Founder and CEO of Mentaily ( https://mentaily.com/ ), an Israeli health-tech company developing AI-powered tools for mental-health assessment and clinical decision support.Iris comes to this problem from a remarkably multidisciplinary background. She is a registered nurse who served in the Israel Defense Forces, including as Deputy Head of Medicine for the Southern Command, before moving into healthcare innovation and digital health at Sheba Medical Center. At Sheba's ARC Innovation Center, she led telemedicine and remote-care initiatives and later strategic partnerships.It was there that Iris became involved in the development of LIV, an AI-powered platform designed to conduct conversational psychiatric intake and triage, generate structured clinical summaries, help assess diagnosis and severity, and identify situations that may require more urgent clinical attention. LIV was developed with Sheba and technology partners including Microsoft, and Sheba says the platform has subsequently received approval from Israel's Ministry of Health as an AI-based psychiatric triage system.Today, Mentaily is taking LIV beyond the Israeli healthcare system, including work involving military and security populations and a collaboration with Walter Reed National Military Medical Center and the Henry M. Jackson Foundation focused on PTSD assessment.#AI #ArtificialIntelligence #MentalHealth #PTSD #PostTraumaticStressDisorder #MilitaryMentalHealth #Veterans #VeteranHealth #MentalHealthAwareness #Psychiatry #DigitalHealth #HealthTech #MedTech #HealthcareAI #GenerativeAI #AIHealthcare #MentalHealthTech #Trauma #PTSDTreatment #MilitaryMedicine #VeteransHealth #PsychologicalHealth #HealthcareInnovation #FutureOfHealthcare #IsraeliInnovation #WalterReed #ShebaMedicalCenter #Mentaily #LIVSupport the show