[Dr. Christina Armstrong] Hello, and welcome to "Next Generation Behavioral Health".
[Dr. Julie Kinn] Ten-minute tips for modernizing patient care.
[Armstrong] [music] I'm Dr. Christina Armstrong.
[Kinn] And I'm Dr. Julie Kinn.
[Armstrong] In this show, we review the latest technology to support mental health.
[Kinn] What are we talking about this time, Christy?
[Armstrong] Today, we're going to talk about one of my favorite topics ever, which is sleep.
[Kinn] That's one of my favorite hobbies.
[Armstrong] [laughter] That's right.
How'd you sleep last night?
[Kinn] Great.
Great.
Because I've been working on the "A Better Night's Sleep" podcast, and so I've been
learning lots of really good sleep tips.
You all should check out that show too.
But today, we're talking more about technology to support sleep, right?
[Armstrong] Right.
Sleep impacts so much of our lives.
For the majority of my life, I've been a really terrible sleeper, honestly.
I've had insomnia, and honestly, up until I had kids and then I realized, "Oh."
I was doing all the sleep hygiene things with my own kids.
And I realized, "Oh, I can do these things with myself too."
So now, my sleep is wonderful.
Julie, what are some of the bad things that can happen when we don't sleep well?
[Kinn] The big thing for military populations that we're aware of is that it's a big safety
issue.
First of all, just like when people are drinking alcohol, when people are sleep-deprived, we
don't tend to have really good awareness of it.
We tend to overrate our wellness, for example, when we're drinking alcohol and we tend to
think, "Oh, I could still drive."
And when we're really tired, we tend to think, "No.
My brain's working great."
But the studies show us that's not true.
And as a result, we see lots of car accidents and on-the-job accidents due to sleep deprivation.
And so for military service members, we're especially aware of this and want to help
people understand how to get better sleep to help with the mission.
But of course, there's lots of issues that affect civilians as well.
[Armstrong] When we don't sleep well, like you said, there's a lot of effects all over
in our lives.
So on the job, driving, everything.
But a lot of what people might notice is increased feelings of depression, increased anxiety.
Not sleeping well is associated with higher rates of obesity.
So when we're stressed out, our cortisol levels raise, and we are generally just feeling under
more stress and, as a result, usually, go for the more high-fatty, high-carb things,
and we gain weight which puts us at-risk for all sorts of other health complications as
well.
[Kinn] Yeah.
Absolutely.
If you look at just general health conditions, sleep tends to correlate with a lot of different
areas.
Like you said, mood, cardiac issues, immune system.
We just tend to get sick more when we're sleepy.
If you are someone who lies in bed trying to get to sleep and just being very frustrated,
then you might want to consider some of these technologies.
And if you're someone who the moment your head hits the pillow, you fall asleep, there's
possibility there that you're overly tired, and then that's why you're falling asleep
so quickly.
Did you know, on average, it takes about 10 to 15 minutes to fall asleep?
That's a good sign.
If you're lying in bed, relaxing, it takes about 10 minutes, then you're doing OK.
[Armstrong] And we know that sleep problems affect a lot of people.
So we know about a third of adults report some sort of insomnia symptoms, and five to
10 percent meet criteria for insomnia disorder.
But the great news is, there's really effective treatments for sleep problems.
One of them is cognitive behavioral therapy for insomnia.
There's just a ton of research to back it up.
So we want to talk a little bit about a really great mobile health application that is developed
by the Department of Defense and the Veterans Health Administration called the CBT-i Coach.
[Kinn] The CBT-i Coach is fantastic because it takes the user through all sorts of tools
related to traditional cognitive behavioral therapy for insomnia.
Plus, you've got the benefit of it being on a smartphone or mobile device, so you can
set your own sleep prescription based on when you need to be on-duty, based on when your
kids are going to sleep, those kinds of things.
And it helps you slowly move towards better sleeping habits.
It helps you with sleep hygiene, helps you with relaxation, and helps you identify the
cognitions of thoughts that are keeping you awake.
It is meant to be used with a provider, but as we learned in our recent episode with Dr.
Jason Owen at the VA, they're developing Insomnia Coach, which is a self-help app, that by the
time this episode comes out might be on the market.
That will help users with some of these tools that don't require a clinician too.
So I would check out CBT-i Coach just to even learn about CBT-i and to use some of the tools.
And once it's out, Insomnia Coach, I think, is going to be tremendously helpful.
[Armstrong] Yeah.
The CBT-i Coach is one of my favorites.
The things I like best about it is there's a whole learn section, so if you're experiencing
sleep problems, you can go in there, and even if it's not insomnia specific, if you're just
having sleeping problems, you can go in and look through, "Hey, how is caffeine maybe
impacting my sleep?
How does alcohol affect my sleep?"
How if you're experiencing symptoms, of maybe anxiety or post-traumatic stress, how does
that play into this whole thing?
And so it's really interesting.
And I do love the sleep prescription.
And so you enter a sleep diary every day, and then when you get a few entries in your
sleep diary, it comes up with a sleep prescription for you.
It's a recommendation of what you should be doing based on how you're sleeping.
One of the really cool things that I like to do, because I've dealt with insomnia in
the past and I use this as a tool to help myself as well as patients, I like to wear
-- I have a wearable that tracks my sleep because it's hard for me.
So entering that information in the sleep diary is great, but I find I cannot remember
how many times I necessarily woke up in a night, but then, with my wearable device,
it lets me know, "Oh, you woke up four times."
And then I say, "Oh, that's right."
And so I enter the data from my wearable device into the sleep diary.
Ideally, that would all kind of flow smoothly together, and eventually, it will, but for
now, that's how I like to kind of step up the tech game for tracking sleep.
[Kinn] And you make a good point that one size doesn't fit all.
For some people, the CBT-i Coach is going to be the tool that just unlocks better sleep.
For other people, it could be in-person treatment; it could be podcasts; it could be other apps,
and it could be paying attention to other disorders that are interfering with sleep
like PTSD and post-traumatic stress.
[Armstrong] Oh, speaking of PTSD, Julie, a common problem that comes along with PTSD
is nightmares.
And so let's talk about a tool that was developed to help with those individuals that are diagnosed
with PTSD and are experiencing nightmares.
[Kinn] Best treatment these days for nightmares specifically, is imagery rehearsal therapy
for nightmares.
Prolonged exposure is one of the best treatments for PTSD.
But for patients who really just want to focus on the nightmares specifically, either they're
due to a specific trauma or they're just general nightmares, imagery rehearsal therapy is phenomenal
and it's evidence-based.
So we created the Dream EZ app to help with it, and it's ream and the letters E and Z.
And you'll recognize it in the store because it's got a cute little owl on it.
But basically, what the app does is it teaches you how to do imagery rehearsal therapy.
We created it in conjunction with experts in the field to be used with a provider.
But just like the CBT-i Coach, it's useful just for learning about the treatment on your
own, and there's lots of self-help tools in it.
So I highly recommend this app, especially since it can give you a sense of what it would
be like to go see a provider about the nightmares.
And again, although it's useful for those with PTSD, it's also a good app for folks
who just have nightmares not related to a specific trauma.
And the treatment's good, and the app itself is very easy to use.
[Armstrong] Some things I really love about this is that all those tools, the recording,
all the information on how to do it, step-by-step, is all in the app.
Also, I really love that you can record those nightmare experiences in the app, and then
all your data is safe and secure within the app and is not just going to be uploaded into
the cloud when you connect your device to your computer.
So I love all that, that DoD and VA apps take that extra special precaution to secure the
information that's inside of it.
[Kinn] A thing I like about it is it doesn't have you jump right into nightmares.
You start practicing the tools with really innocuous, easy little exercises, and then
learn the skill, and then you apply that to your nightmares.
I learned a lot just from testing out this app.
[silence] [Kinn] Those are the main points we wanted
to hit in our "Sleep Technology" episode.
But also, our email address is in the show notes.
We want to hear from you and we want to hear your feedback and your questions.
Let us know what's stopping you or your colleagues from using technology to help your clients
and patients.
What questions can we answer for you?
[Armstrong] Thank you for joining us today on "Next Generation Behavioral Health"
and learning about sleep technology tools to support you and your patients.
[Kinn] You can connect with us on Facebook and Twitter @MilitaryHealth.
[Armstrong] "Next Generation Behavioral Health" is produced by the Defense Health
Agency.
[music]
For more infomation >> Ep 15: Tech for Sleep, Insomnia and Nightmares (Next Generation Behavioral Health Podcast) - Duration: 9:44.-------------------------------------------
A combien s'élève la fortune du clan Le Pen ? - Duration: 8:59.
For more infomation >> A combien s'élève la fortune du clan Le Pen ? - Duration: 8:59. -------------------------------------------
Top 10 Avengers 4 Rumours - Duration: 10:25.
Hello internet - and welcome back to the nerdiest channel on YouTube - Top 10 Nerd - the place
where you'll find no finger-snapping of any kind, because we hope that we're better
people than that.
What's going on guys, my name's Jack Finch - and I'll be your host for the day as we
flick through the MCU's playbook and see just what curveballs they've got left for
us - in the Top 10 Avengers 4 Rumours.
Roll the clip.
Before we begin guys, you know the drill by now - make sure to hit that thumbs up button,
and ding that subscribe bell so you can stay up to date with our latest and greatest nerd
uploads.
On with the show.
Kicking off at our Number 10 spot - Avengers: Almost Forever?
Maybe?
Yeah - and there's no better rumour than the hotly debated title of the next Avengers
installment.
Following through from the events of Infinity War - fans have been left with the overwhelming
mystery as to what the fourth film will entail, and whether there's a hint to the plot within
the movies tagline.
Well - the reason that the lid has been kept tight, is that Kevin Feige has alluded to
it being some sort of spoiler - and co-director Anthony Russo revealing to press that Marvel
had chosen the films name fairly early on during production.
Anthony Russo went on to say that the closest anyone has come to guessing the title is with
Avengers: Forever - saying that the actual title is more akin to The Avengers: Almost
Forever.
Well that's led fans to take that almost literally, and assume that almost forever
is an allusion toward Eternity.
Avengers: Eternity, while having quite a ring to it - also has an allusion to the Dr. Strange
plotline involving the cosmic entity, Eternity, and his bid to reset the wrongdoings of Thanos.
Well - we'll have to wait and see.
Let us know your best guess in the comment box down below.
Next up at Number 9 - Time Travel Is A Go
And this is quite a biggy - following a plot leak on 4chan way back when in November 2017
before the release of Infinity War - where an anonymous poster claimed to know the events
of both Avengers: Infinity War and Avengers 4.
Whoever it was, they got a lot of major plot points right for the first film - and the
biggest reveal for Avengers 4?
That it is - indeed - a time-travel film, and we'll see the remaining Avengers and
supporting cast of superheros clamber to undo the events of Thanos' snap.
If this prediction is correct - then it seems that the latest swathe of Quantum Realm fan
theories are right on the money - as we'll see the reassembled Avengers team up with
Ant-Man and utilize the Quantum Realm to hurtle through alternate timelines and realities
to retrieve the infinity stones from several different points in time.
According to the post, this will also include a plot that features the Power Stone - which
subsequently leads to the Guardians of the Galaxy never coming together following the
events of their debut film - but, hopefully, Marvel pulls a fast-one and these timelines
won't be permanent in the grand scheme of things.
Well, we hope.
Coming in at Number 8 - Back to New York
A wide range of set photos have made it pretty clear that the Avengers 4 will feature a revisit
to the Battle of New York - the same that took place in 2012's The Avengers - which
plays into our previous mentions of time travelling shenanigans.
The first indication of this came in late 2017, with set photos showing Robert Downey
Jr. wearing the same Black Sabbath shirt that he sported for the majority of the first Avengers
film.
More set photos went on to show Chris Hemsworth sporting his flowing golden Thor locks once
more - so it's safe to say that the Chitauri showdown will be getting a revisit.
In what capacity?
Well, we'll have to find out.
Swinging in at Number 7 - Tony Stark's Gauntlet
Following up from our number 9 point, with the Avengers using the Quantum Realm to surf
through the cosmic unknown in an effort to find the infinity stones - it actually serves
as a wider plot purpose, which is to power Iron Man's own version of the Infinity Gauntlet.
Many fans have also been quick to point out the fact that Infinity War left all six original
members of the team alive - and you know, there's got to be a reason for that, right?
One theory suggests that Cap, Tony, Thor, Hulk, Black Widow and Hawkeye will all be
tasked with their own separate missions to find the stones and wield its power themselves
- an allusion to the Celestials that originally shared the same cosmic powers of the Infinity
Stones.
This leaves room for a subtle nod to the Infinity Gauntlet comics run - so I guess we'll have
to wait and see.
Next up at Number 6 - Shuri, the Black Panther
One thread left over from the events of Infinity War is the state of Wakanda, with King T'Challa
seemingly snapped away and dissipated into oblivion - who remains to take up the mantle
of Black Panther and rule the vibranium nation?
Well, following the events of Black Panther - and the fact that Killmonger burned the
remaining heart-shaped herbs - things look pretty bleak.
But if we follow the comic run - then T'Challa's sister and fan favourite Shuri is the one
to fill Black Panther's sneaky sneakers, after discovering a way to grow the heart-shaped
herb once more - you know, she's a genius after all.
This could directly correlate to Shuri's visit to the Ancestral Plane - where she may
discover that her brother is absent, and not dead after all - and her return from the Djalia
may play out in the events of Black Panther 2.
Smashing his way in at Number 5 - Professor Hulk
It's safe to say that Bruce Banner didn't really do a lot throughout the events of Infinity
War - much to many fans dismay - but since the fallout of Thor: Ragnarok, Bruce has kind
of had a little bit of an internal struggle with his hulking green alter-ego.
Well - fear not Marvel fans, because Professor Hulk is coming.
Stranded on the world of Sakaar, Hulk won out over this internal conflict and decided
to suppress Bruce Banner - and vice-versa happened throughout Infinity War - but we're
in for an equilibrium with an MCU adaptation of one of the most popular Hulk plots of all
time.
In fact - leaked Avengers 4 artwork that hit the internet back in early June 2018 alluded
to this reveal - with a far different depiction of Hulk's facial structure - more akin to
Mark Ruffalo's face than ever before - and further leaks have even suggested that Hulk
will be sporting some brand new armor for the film.
Well - spandex.
Kinda.
Coming in at Number 4 - Five Years Later …
It's been widely suggested that Avengers 4 will feature a convenient five-year leap
into the future following the events of Infinity War - and while this may seem to be a cheap
way to get us back on track, it actually makes a lot of sense following the emotional aftermath
of the last films conclusion, and a way to slip neatly into the next MCU plot.
After all, a lot of stuff has gone down.
This rumour states that Tony Stark and the surviving superhero team have fumbled along
with their lives since the Thanos snap, and are now working for the government as agents
of S.H.I.E.L.D - with set photos reportedly backing up this rumour.
All of this serves as a means to an end, as the Avengers work with Ant-Man to utilise
the Quantum Realm for time-travel technology and get a second attempt at reverting Thanos'
actions.
It kind of makes sense - you know - as it'd be weird to pick up the main bulk of the movie
literally minutes after the snap-deaths of so many people.
It'll allow us to feel the real gravity of the situation, seeing a world where all
of these characters have been long gone - but never forgotten.
Next up at Number 3 - The Skrulls
If you've seen our breakdown of the Captain Marvel trailer - and why she's got a bad
habit of punching old ladies in the face - then you'll be aware that the Skrulls - a deviant
race of shape-shifting aliens - have made their way to Earth on a slow, secret invasion.
While it's uncertain as to how - or even when - the Skrull/Kree war will rear its ugly
head, it's safe to say that the MCU are finally making the presence of The Skrulls
known.
Rumour has it that Hawkeye's role in Avengers 4 will have him take up the mantle of Ronin
- a claim which is backed up by the Avengers 4 poster leak - and the reason he's there
is to take down some Skrulls posing as Yakuza.
Coming in at our Number 2 point - Asgard On Earth
Asgard is not a place - it's a people - the quote that reverberated its way across the
very fabric of Taika Waititi's 2017 Thor: Ragnarok - and with the fallout of Thanos'
snap, well - I guess there's 50% less of those people, then, really.
Nevertheless though - Infinity War - if it stays true with its rumour of a five year
leap forward - may have found Thor trying to rebuild his Asgardian Kingdom - and what
better place to do so - than on Earth!
Rumour has it that Valkyrie will finally make her triumphant return in Avengers 4 - alongside
fan favourite Korg and whatever remains of the Asgardian population, and with a fourth
installment of the God of Thunder's franchise yet to be confirmed - then this storyline
may possibly be neatly shelved by Thor's decision to park his Asgardian vessel and
deal with the complications that follows as the New King of Asgard.
Well - I guess we'll have to find out.
And finally - at our Number 1 spot - Cap and Iron Man
And - maybe both of them will die.
Well, at least one of them.
Maybe.
Part of this is rumour - and part of this is heavily based in fan theory - but if true,
then Robert Downey Jr and Chris Evans rumoured longing for departure from the Marvel Cinematic
Universe may be neatly wrapped up in Avengers 4.
According to the 4chan leak - only two of the original Avengers will actually survive
this movie - and it's heavily rumoured that Captain America will give his life in an epic-battle
against Thanos - after finally wielding Mjolnir, a point foreshadowed in the 2012 Avengers.
Mjolnir you ask?
Yeah - don't worry about it, it's time-travel stuff.
But what about Tony Stark?
Well - if we take a Gwyneth Paltrow's Instagram photo that she shared of lower half of her
body in a motion capture suit - then perhaps finally, it's because she's suiting up
as the awesome Rescue - in a revenge fit after losing her one true love in the battle against
The Mad Titan.
Well - only time will tell, and we for one can't bloody wait.
Unfortunately folks that's all we've got time for in today's video - leave your thoughts
in the comment box down below.
If you've enjoyed this video - go ahead and give it a thumbs up - and if you'd like
to continue with your MCU binge - then feel free to hit that playlist floating conveniently
above.
Cheers for stopping by guys - I've been your host Jack Finch - you've been watching
Top 10 Nerd - and until next time, you take it easy.
-------------------------------------------
Watch these alienlike robots weave a bus-size fiberglass structure—all by themselves - Duration: 1:38.
No this isn't some alien plant species,
though it may look pretty strange.
This is actually a team of robots working
together to build a structure by winding fibers
into tubes.
Step 1: the winding arm pulls fiber and resin
from a tank on the ground, mixes the materials
in the nozzle and winds the wetted fiber around.
Step 2: the robot turns on an ultraviolet
light to cook and harden the fiber.
Step 3: using a tiny motor and wheels, the
robot inches itself up on top of the hardened
fiber.
Then, the process begins again.
The robot can change directions by angling itself
at the top of the recently printed section.
And it can use different winding patterns
to change the strength of the build.
The swarming bots are also able to communicate with
each other through a computer network.
This allows them to avoid running into each
other or other obstacles that might be in
their path.
Together, the team of robots can find the
most efficient way to build a structure.
Researchers think this technology could be
used to build structures in remote or dangerous
environments.
Like after an extreme weather event.
They might look a little strange, but these
"Fiberbots" are a well-choreographed construction crew.
-------------------------------------------
Volvo S40 1.6 D2 S/S Sport - Duration: 1:07.
For more infomation >> Volvo S40 1.6 D2 S/S Sport - Duration: 1:07. -------------------------------------------
Audi TT Roadster 1.8 5V Turbo 180 PK S-Line Leder Youngtimer Btw Auto - Duration: 1:11.
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Kaaris: Après sa bagarre avec Booba, le rappeur s'apprête à dévoiler un premier extrait de Or Noir 3 - Duration: 4:59.
For more infomation >> Kaaris: Après sa bagarre avec Booba, le rappeur s'apprête à dévoiler un premier extrait de Or Noir 3 - Duration: 4:59. -------------------------------------------
小S稱每天都活在恐懼裏，可中年女性，誰又比誰過得好多少呢？ - Duration: 9:09.
For more infomation >> 小S稱每天都活在恐懼裏，可中年女性，誰又比誰過得好多少呢？ - Duration: 9:09. -------------------------------------------
The Dental Associates of Connecticut Educates us on Pediatric Dentistry - Duration: 2:35.
For more infomation >> The Dental Associates of Connecticut Educates us on Pediatric Dentistry - Duration: 2:35. -------------------------------------------
«Elle est brutale, méprisante» : Jany Le Pen lâche les coups contre sa belle-fille - Duration: 5:18.
For more infomation >> «Elle est brutale, méprisante» : Jany Le Pen lâche les coups contre sa belle-fille - Duration: 5:18. -------------------------------------------
What's a Button Hook? - Duration: 4:18.
I can't button my shirt.
Find out how I do it, next..
On Andrewski Presents!
Part of living independently,
you have to get dressed every day.
For me, I have poor fine motor skills,
so I could never button my shirts.
I would have to wait for someone else to help me.
This all changed when my
occupational therapist introduced me to a button hook.
But how does it work?
You loop the end in the buttonhole,
hook it over the button,
and pull it through.
To make things go faster,
I button my shirts all the way up.
Leaving the top button undone.
That way I can pull it on real fast,
and only use the buttonhook for one button.
You can buy buttonhooks on Amazon,
and some have small hooks to help with zippers.
You can use buttonhooks to do your pants,
but those buttons tend to be a little bigger
and if you pull too hard the buttonhook will break.
I go through a buttonhook once every year,
but it's worth the cost to be that much more independent.
Thanks for watching!
Share this video and subscribe to our channel.
I'm the Andrewski!
I'll see you next time on Andrewski Presents!
-------------------------------------------
(Ep-4) Lets Play #Deadly Premonition The Director's Cut Ft #Trixz2007 - Duration: 3:27:22.
For more infomation >> (Ep-4) Lets Play #Deadly Premonition The Director's Cut Ft #Trixz2007 - Duration: 3:27:22. -------------------------------------------
Drsný životní osud… Nejpotetovanější česká herečka z filmů pro dospělé promluvila! - Duration: 4:55.
For more infomation >> Drsný životní osud… Nejpotetovanější česká herečka z filmů pro dospělé promluvila! - Duration: 4:55. -------------------------------------------
Jany et Jean-Marie Le Pen : cinq choses que vous ne savez (peut-être) pas sur eux - Duration: 7:47.
For more infomation >> Jany et Jean-Marie Le Pen : cinq choses que vous ne savez (peut-être) pas sur eux - Duration: 7:47. -------------------------------------------
Volkswagen Passat Variant BWJ 2015 2.0 TDI 150 PK HIGHLINE R LEER/CLIMA/CRUISE/LMV/PDC/PANORAMADAK/S - Duration: 1:10.
For more infomation >> Volkswagen Passat Variant BWJ 2015 2.0 TDI 150 PK HIGHLINE R LEER/CLIMA/CRUISE/LMV/PDC/PANORAMADAK/S - Duration: 1:10. -------------------------------------------
Soupçons sur la villa des Le Pen père et fille - Duration: 8:44.
For more infomation >> Soupçons sur la villa des Le Pen père et fille - Duration: 8:44. -------------------------------------------
Jean-Marie et Marine Le Pen, une histoire de famille - Duration: 3:04.
For more infomation >> Jean-Marie et Marine Le Pen, une histoire de famille - Duration: 3:04. -------------------------------------------
Kia Picanto 1.2 COMFORT PACK 3-D - GARANTIE 2019 - Duration: 0:53.
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Hey Steve: The Girls Are Ghosting Now - Duration: 3:37.
- Ghosting is not new to men.
You all just pickin' up on how to do it.
(audience laughing)
(audience applauding)
So really ladies, I ain't mad at you
when you choose to do it that way.
'Cause ain't a women in here ain't been ghosted on.
There's not a women in here some guy just,
quit hearin' from him.
That's game, so turnaround is fair.
So if you doin' it, that's fair.
But now, so you wanna.
You've hurt this guy.
You wanna find a way to leave
but without ghostin' him?
- Right, without them like hating me afterwards.
- Okay, this how you do it.
This is him standin' here.
Walk up to him and say,
"Listen, I don't wanna see you anymore.
"One-thousand one, one-thousand two, one-thousand three,
"one-thousand four, one-thousand five,
"one-thousand six, eight, one-thousand nine, and ten."
And then walk away.
(audience cheering)
See...
That way he can't accuse you of ghostin' him
'cause you told it to him.
Then you gave him ten full seconds to drink it all in.
Then you walk off.
He gonna be standin' there goin', "Well, damn!"
But that's not ghostin'.
You stood there.
You gave him a chance to say somethin'.
- Right, okay.
- Now no matter what he say, you count to ten out loud.
(audience laughing)
- Out loud. (laughing)
- So, like he may try to,
he may try to...
Let me show you what I'm talkin' bout.
Alright now, this what I want you to do.
No matter what, I want you to say,
"I'm not interested in you anymore and I'm leavin'."
And then just go, "one-thousand one, one-thousand two."
I don't care what I say - Okay.
you keep that count goin'. - Okay.
Then, at ten, you just walk that-a-way.
Walk all the way to that rail.
- Okay.
- Okay, here we go.
This how this gon' go, go.
- I'm no longer interested,
and I don't wanna see you anymore.
One-thousand one, - Really?
one-thousand two, - Are you kidding me?
one-thousand three, one-thousand four,
one-thousand five, - What do you mean?
six, seven, eight, - What did I do?
one-thousand nine,
one-thousand ten. - Why are you counting?
(audience cheering)
(laughing)
- Now let me tell you somethin'.
Didn't that feel good?
- That felt great!
- It felt wonderful!
- That felt wonderful.
- And the fact that you just kept countin' in his face.
(laughing)
You know, like whatever.
You know what I'm sayin'?
One-thousand one, one-thousand two,
one-thousand three, one-thousand four,
one-thousand five, nine, ten.
(audience applauding)
Now let me show you one more way to walk away.
I don't know how to do this cause I'm a guy,
but kinda walk and leave your hair there.
Do it.
(audience laughing)
You know how to do that? - Yep.
- Yeah. - I got this.
- Okay say ten, then do that.
Ten. - Ten.
(audience cheering)
- Oh, yes, yes!
(audience applauding)
- We'll be right back.
-------------------------------------------
Mercedes-Benz E-Klasse E 200 d Estate Business Solution AMG Automaat - Duration: 1:09.
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DANILO D'AMBROSIO - ULTIMATE CHALLENGE | Inter Player One 😝👔 - Duration: 4:37.
This is tricky!
Voilà.
The first Inter goal I remember
was by a fantastic player.
It was scored by the captain, Javier Zanetti,
in the final when Inter beat Lazio to win the UEFA Cup.
An important goal for us was the one current skipper Mauro Icardi
scored in the derby when he got a hat-trick.
It was a brilliant flying volley
which levelled the scores on the night.
Then he scored another to seal all three points.
We couldn't leave out Danilo D'Ambrosio's goal
that booked our spot in the Champions League
along with goals by Vecino and Mauro Icardi.
To me football is passion, love, dedication
and sacrifice too.
Because to make it this far I've had to make lots of sacrifices in life.
I must say I'm proud of what I've achieved.
It was an exhilarating match.
We went into it convinced we could win it
and achieve our target - which we did.
There were so many emotions running through my head at the end of the game
because as I said I made a lot of sacrifices.
I know that in order to achieve your objectives you have to make sacrifices.
And the rest of the team did likewise.
It's impossible to describe how much joy we all felt,
us, the fans, the club and everyone working behind the scenes.
We'll try to do ourselves justice in this competition.
The goal I scored was something we'd rehearsed in training a few days before.
Generally, I like to dart towards the back post on corners.
I think I'm quite good at getting into decent positions.
Luckily the ball ended up right there at the back stick.
I got a touch on it, the keeper saved
but I managed to react quickly and turn in the loose ball before he could get to it.
It was a great goal and it kept our dream alive.
I've had lots of team-mates over the last five years
and they were all important to me.
They helped me to improve and feel at home at a big club such as Inter.
The funniest was definitely Nagatomo.
He could make you laugh just by saying 'ciao' because of the way he said it
Eder was one of the guys I roomed with
and I got on with him away from the game too.
In the current squad, Gagliardini, Candreva,
Berni, Handanovic… Everyone really.
I get on with and enjoy chatting with everyone
I listen to them and try to give advice to the younger lads
to help them achieve their goals.
-------------------------------------------
Ep 15: Tech for Sleep, Insomnia and Nightmares (Next Generation Behavioral Health Podcast) - Duration: 9:44.
[Dr. Christina Armstrong] Hello, and welcome to "Next Generation Behavioral Health".
[Dr. Julie Kinn] Ten-minute tips for modernizing patient care.
[Armstrong] [music] I'm Dr. Christina Armstrong.
[Kinn] And I'm Dr. Julie Kinn.
[Armstrong] In this show, we review the latest technology to support mental health.
[Kinn] What are we talking about this time, Christy?
[Armstrong] Today, we're going to talk about one of my favorite topics ever, which is sleep.
[Kinn] That's one of my favorite hobbies.
[Armstrong] [laughter] That's right.
How'd you sleep last night?
[Kinn] Great.
Great.
Because I've been working on the "A Better Night's Sleep" podcast, and so I've been
learning lots of really good sleep tips.
You all should check out that show too.
But today, we're talking more about technology to support sleep, right?
[Armstrong] Right.
Sleep impacts so much of our lives.
For the majority of my life, I've been a really terrible sleeper, honestly.
I've had insomnia, and honestly, up until I had kids and then I realized, "Oh."
I was doing all the sleep hygiene things with my own kids.
And I realized, "Oh, I can do these things with myself too."
So now, my sleep is wonderful.
Julie, what are some of the bad things that can happen when we don't sleep well?
[Kinn] The big thing for military populations that we're aware of is that it's a big safety
issue.
First of all, just like when people are drinking alcohol, when people are sleep-deprived, we
don't tend to have really good awareness of it.
We tend to overrate our wellness, for example, when we're drinking alcohol and we tend to
think, "Oh, I could still drive."
And when we're really tired, we tend to think, "No.
My brain's working great."
But the studies show us that's not true.
And as a result, we see lots of car accidents and on-the-job accidents due to sleep deprivation.
And so for military service members, we're especially aware of this and want to help
people understand how to get better sleep to help with the mission.
But of course, there's lots of issues that affect civilians as well.
[Armstrong] When we don't sleep well, like you said, there's a lot of effects all over
in our lives.
So on the job, driving, everything.
But a lot of what people might notice is increased feelings of depression, increased anxiety.
Not sleeping well is associated with higher rates of obesity.
So when we're stressed out, our cortisol levels raise, and we are generally just feeling under
more stress and, as a result, usually, go for the more high-fatty, high-carb things,
and we gain weight which puts us at-risk for all sorts of other health complications as
well.
[Kinn] Yeah.
Absolutely.
If you look at just general health conditions, sleep tends to correlate with a lot of different
areas.
Like you said, mood, cardiac issues, immune system.
We just tend to get sick more when we're sleepy.
If you are someone who lies in bed trying to get to sleep and just being very frustrated,
then you might want to consider some of these technologies.
And if you're someone who the moment your head hits the pillow, you fall asleep, there's
possibility there that you're overly tired, and then that's why you're falling asleep
so quickly.
Did you know, on average, it takes about 10 to 15 minutes to fall asleep?
That's a good sign.
If you're lying in bed, relaxing, it takes about 10 minutes, then you're doing OK.
[Armstrong] And we know that sleep problems affect a lot of people.
So we know about a third of adults report some sort of insomnia symptoms, and five to
10 percent meet criteria for insomnia disorder.
But the great news is, there's really effective treatments for sleep problems.
One of them is cognitive behavioral therapy for insomnia.
There's just a ton of research to back it up.
So we want to talk a little bit about a really great mobile health application that is developed
by the Department of Defense and the Veterans Health Administration called the CBT-i Coach.
[Kinn] The CBT-i Coach is fantastic because it takes the user through all sorts of tools
related to traditional cognitive behavioral therapy for insomnia.
Plus, you've got the benefit of it being on a smartphone or mobile device, so you can
set your own sleep prescription based on when you need to be on-duty, based on when your
kids are going to sleep, those kinds of things.
And it helps you slowly move towards better sleeping habits.
It helps you with sleep hygiene, helps you with relaxation, and helps you identify the
cognitions of thoughts that are keeping you awake.
It is meant to be used with a provider, but as we learned in our recent episode with Dr.
Jason Owen at the VA, they're developing Insomnia Coach, which is a self-help app, that by the
time this episode comes out might be on the market.
That will help users with some of these tools that don't require a clinician too.
So I would check out CBT-i Coach just to even learn about CBT-i and to use some of the tools.
And once it's out, Insomnia Coach, I think, is going to be tremendously helpful.
[Armstrong] Yeah.
The CBT-i Coach is one of my favorites.
The things I like best about it is there's a whole learn section, so if you're experiencing
sleep problems, you can go in there, and even if it's not insomnia specific, if you're just
having sleeping problems, you can go in and look through, "Hey, how is caffeine maybe
impacting my sleep?
How does alcohol affect my sleep?"
How if you're experiencing symptoms, of maybe anxiety or post-traumatic stress, how does
that play into this whole thing?
And so it's really interesting.
And I do love the sleep prescription.
And so you enter a sleep diary every day, and then when you get a few entries in your
sleep diary, it comes up with a sleep prescription for you.
It's a recommendation of what you should be doing based on how you're sleeping.
One of the really cool things that I like to do, because I've dealt with insomnia in
the past and I use this as a tool to help myself as well as patients, I like to wear
-- I have a wearable that tracks my sleep because it's hard for me.
So entering that information in the sleep diary is great, but I find I cannot remember
how many times I necessarily woke up in a night, but then, with my wearable device,
it lets me know, "Oh, you woke up four times."
And then I say, "Oh, that's right."
And so I enter the data from my wearable device into the sleep diary.
Ideally, that would all kind of flow smoothly together, and eventually, it will, but for
now, that's how I like to kind of step up the tech game for tracking sleep.
[Kinn] And you make a good point that one size doesn't fit all.
For some people, the CBT-i Coach is going to be the tool that just unlocks better sleep.
For other people, it could be in-person treatment; it could be podcasts; it could be other apps,
and it could be paying attention to other disorders that are interfering with sleep
like PTSD and post-traumatic stress.
[Armstrong] Oh, speaking of PTSD, Julie, a common problem that comes along with PTSD
is nightmares.
And so let's talk about a tool that was developed to help with those individuals that are diagnosed
with PTSD and are experiencing nightmares.
[Kinn] Best treatment these days for nightmares specifically, is imagery rehearsal therapy
for nightmares.
Prolonged exposure is one of the best treatments for PTSD.
But for patients who really just want to focus on the nightmares specifically, either they're
due to a specific trauma or they're just general nightmares, imagery rehearsal therapy is phenomenal
and it's evidence-based.
So we created the Dream EZ app to help with it, and it's ream and the letters E and Z.
And you'll recognize it in the store because it's got a cute little owl on it.
But basically, what the app does is it teaches you how to do imagery rehearsal therapy.
We created it in conjunction with experts in the field to be used with a provider.
But just like the CBT-i Coach, it's useful just for learning about the treatment on your
own, and there's lots of self-help tools in it.
So I highly recommend this app, especially since it can give you a sense of what it would
be like to go see a provider about the nightmares.
And again, although it's useful for those with PTSD, it's also a good app for folks
who just have nightmares not related to a specific trauma.
And the treatment's good, and the app itself is very easy to use.
[Armstrong] Some things I really love about this is that all those tools, the recording,
all the information on how to do it, step-by-step, is all in the app.
Also, I really love that you can record those nightmare experiences in the app, and then
all your data is safe and secure within the app and is not just going to be uploaded into
the cloud when you connect your device to your computer.
So I love all that, that DoD and VA apps take that extra special precaution to secure the
information that's inside of it.
[Kinn] A thing I like about it is it doesn't have you jump right into nightmares.
You start practicing the tools with really innocuous, easy little exercises, and then
learn the skill, and then you apply that to your nightmares.
I learned a lot just from testing out this app.
[silence] [Kinn] Those are the main points we wanted
to hit in our "Sleep Technology" episode.
But also, our email address is in the show notes.
We want to hear from you and we want to hear your feedback and your questions.
Let us know what's stopping you or your colleagues from using technology to help your clients
and patients.
What questions can we answer for you?
[Armstrong] Thank you for joining us today on "Next Generation Behavioral Health"
and learning about sleep technology tools to support you and your patients.
[Kinn] You can connect with us on Facebook and Twitter @MilitaryHealth.
[Armstrong] "Next Generation Behavioral Health" is produced by the Defense Health
Agency.
[music]
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