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  Episode: 140 Taking Charge After Stroke: Self-Determination and Recovery with Vivian Fu   In this episode you will discover: ● The Conversation Is the Intervention — A structured, facilitated conversation that centers a person's identity, hopes, and vision for their best day produces measurable improvements in quality of life and independence a year after stroke. Connection isn't soft — it's evidence-based. ● Reframe the Expert in the Room — Take Charge asks clinicians to resist offering advice, validation, or direction — and to trust that the person with stroke already holds the wisdom they need. The hardest part of the facilitator role is staying out of the way. ● Self-Determination Is Not a Luxury — When people with stroke are supported to set their own direction, outcomes improve, costs decrease, and the effects last for years. Building systems that protect that autonomy isn't idealistic — it's what the data demands.   Welcome to the Aphasia Access Aphasia Conversations Podcast. I'm Katie Strong from Central Michigan University and a member of the Aphasia Access Podcast Working Group, a community dedicated to supporting better aphasia care.   Today I'm speaking with Dr. Vivian Fu, a stroke neurologist living and working in Kelowna, British Columbia, the unceded territories of the Syilx / Okanagan people. Vivian trained in Aotearoa New Zealand, where she completed her PhD running the Taking Charge After Stroke trial. Take Charge showed that people with stroke who were supported to follow their own self-determination had much better quality of life and independence a year after their stroke. The second Take Charge RCT showed that two sessions about six weeks apart produce better outcomes than one session. Vivian strives to embed the Take Charge philosophy in her daily practice, and is focused on improving access to high quality stroke care for rural, regional, and underrepresented populations.   I have been looking forward to this conversation. What drew me to Take Charge was how it reframes the question entirely — from what does the clinician do for this person to what does this person want for their own life. That shift is deceptively simple, and as you'll hear, the evidence behind it is anything but.   Let's get into it.   Katie Strong:  Welcome, Vivian. Vivian Fu: Thank you so much for having me, Katie. I'd like to start off with my Pepeha. This is an introduction in Te Reo Māori, which is the indigenous language of the people of Aotearoa New Zealand, and I'll just translate each line. Nō Hong Kong ōku tīpuna. My ancestors come from Hong Kong. I tipu ake au ki Aotearoa. I grew up in Aotearoa, New Zealand. E noho ana au ki Ki-Low-Na. I live in Kelowna, British Columbia. Ko tēnei taku mihi ki ngā tāngata whenua o te rohe nei. I like to pay my deepest respects to the first peoples of this land. I live on the unceded territories of the Syilx and Okanagan peoples. Ko tēnei taku mihi ki ngā maunga, ki ngā awa, ki ngā roto, ki ngā Papatuānuku, o te rohe nei. I'd like to pay my deepest respects to the mountains, rivers, and the lakes, and to Mother Earth. All these important landmarks that have been here for millennia. Nō reira, tēna koutou, tēna koutou, tēna koutou katoa. Therefore, hello, hello, hello, Ko Vivian Fu tōku ingoa. Lovely to be here. Katie Strong:  Well, I'm so glad you're here. And I wanted to start off today asking about the Take Charge program that you've been working with, and talk to me about how that began. What was the origin of that? Vivian Fu:  Sure, so really this work began in probably the late 90s early 2000s when clinicians in Aotearoa New Zealand realized that there were different outcomes for people who were Māori compared with non-Māori, and I guess an important point to illustrate is that in Aotearoa society we view things in a very bicultural lens, and by that I mean Tangata Whenua, who are the people of the land, so indigenous people of the Māori and Tangata Tiriti, so everyone else are people of the treaty. It doesn't really matter where you come from, but you are a person of the treaty if you live in Aotearoa, and so it's a bicultural lens, and so we always look at things in that way, and that's how our kind of entire society is grounded upon that. And so when we look at health outcomes, what we could see back then, and unfortunately what we, in a way, still see now is that Māori were experiencing a stroke at about 20 years younger than non-Māori, and they were more likely to die from their stroke, and also more likely to be severely disabled. And so there was a difference in life expectancy, a difference in overall rehabilitation access, difference in overall outcomes, and so it started off with Professor Matire Harwood's work. She is Tangata Whenua, and in her PhD, she was looking at why there were these differences in outcomes and wanting to address them. And so that started off with the Māori and Pacific Stroke Study, which was essentially conducted in just Māori and Pacific people in Aotearoa, New Zealand, out of many different centers around the country. It was a four arm study.. It was a randomized control trial, and it looked at a conversation, which was labeled as the "Take Charge" session, but it was, it was really a connection and a conversation versus a professionally made DVD from the New Zealand Stroke Foundation about people's experiences and stories after stroke. And then the fourth arm of the trial was getting both of those interventions, and there was a control group. So there were three active groups in one control group. And what the researchers basically found was that anybody who had received this session of discussion and connection did much better a year after stroke in terms of quality of life, independence, and caregiver strain. And so that was the first sort of indication that there was something in that conversation that was really important. Unfortunately, it didn't really take off in terms of being able to be implemented, and so then Dr. Harry McNaughton, who was Dr. Harwood's supervisor wrote multiple grants and tried to get this session into much more of a bigger trial with some some type of implementation, and that's where I came along and we essentially did two things. We operationalized the intervention into something that had a bit of a framework, so with a bit of a booklet and a bit of a structure to follow. Really looking into what was it about that conversation that was so powerful and made such a difference to people, and tried to put those things into practice. Then, secondly, to conduct a second trial in New Zealand out of seven centers for people with stroke who were non-Māori and non-Pacific, because the struggle that we came across was that it was only shown to be effective in a small group of people, but not in everybody, and so we had to do things backwards. And so that was really where it all began, from these principles of self-determination, so Tino Rangatiratanga, which is a really important principle in Te Ao Māori, and in the world of Māori, but also knowing that Māori and a lot of indigenous peoples, we think of health as this concept called Te Whare Tapa Whā, for example, which is the house with four walls. So a person is never just their body and their physical health, there are other walls that keep the house upright. So mental health, spiritual health, and family health, whānau is so important, and feeling as though you have strong foundations in where you belong is also really important. So it's that really holistic look at health of an individual and how we can address all of those things in an intervention is really where it all came from. Katie Strong:  Thank you for sharing. I appreciate the backstory, and also just the idea of what you're thinking about from a holistic health standpoint. I know our listeners are probably curious, some of them might not have heard about Take Charge before, so this is the first time of them hearing about this, and so I was hoping, Vivian, you could give us an overview of what the intervention is, and then maybe walk us through what a session actually looks like in practice. Vivian Fu: Yeah, absolutely. So I'll talk you through the session in the way that it was done in the larger Take Charge trial. So this was done in 400 non-Māori, non-Pacific people with stroke, and our trial there had three arms. So there was a control group, there was a group that received just one session, and then there was a group that received two sessions six weeks apart roughly. The sessions were provided by a trained facilitator, and they were timed roughly somewhere between three to 18 weeks after stroke. So quite a large window, really, depending on when the person with stroke was ready to receive it. So the short version of what it looks like is it's based off the booklet and it's done face to face. It's a conversation and the facilitator is trained at the beginning to really try and establish a relationship…to build a relationship. There's a concept in Te Ao Māori called Whakawhanaungatanga, which is really sort of seeking another person's identity, recognizing who they are as a person, and trying to build connections. And so I guess in English, we think of that as building rapport, building trust. And so it in our trial was done face to face. We have also looked at ways of doing this via telehealth as well, which is, you can imagine, is a little bit different. But that step is really important, and we knew that it was important also in the initial Māori and Pacific trial, because the facilitators who were trained were actually ethnicity matched. So that's something where I think it came quite naturally in that trial, but in the second trial we really wanted to ensure that a relationship was built, and then there are three pages, initial pages in the booklet that look at different things. So the first page is looking at how the person has been affected by the stroke, and then asking them to think about actually who they really are as a person. It's a very simple concept, and a very sort of simple question, but for many people that's the first time they've really been asked that and have had to think about that. So anything that comes to mind that they can relate to, you know, who they are. An individual, and what it is that they love, so for example, for me, I would say, "I'm a mum, and I'm, I'm a stroke neurologist, I am a painter, I'm a poet, I'm someone who loves going for walks in hikes," and, you know, so those kinds of things, and it, and it kind of really builds on on that person's identity and who they are in the world. And so that's that sort of page one. It's really about establishing identity and sense of self. And then the second page is talking then about my hopes and fears. And that might be a tricky one, really, for a lot of people to start talking about and thinking about. They may not want to express that, they may not have been asked that. Sometimes it brings out a lot of emotion, and that's why that initial beginning part of establishing trust and in a kind of a psychological safety space is really important. And then the third page is imagining or envisioning what my best day looks like. And you can be as wild and fantastical about that as you like. When we train our facilitators, we asked them to do these exercises as well themselves, so they can get a really good sense of what that's like, and I had a lovely training session with community health workers from Tanaha First Nation in Cranbrook, BC, and one of one of the attendees in the group said she'd love to have breakfast with a Sasquatch, and so that was absolutely, you know, it was so culturally relevant, so important. Katie Strong:  That makes my Pacific Northwest roots just smile there! Vivian Fu: Exactly! Just so unique to that individual and to where they are in the world. And it's not something you can, you can pluck out of a textbook or pluck out of anything, right. It's where they are. I love that activity. It's quite magical what comes out. And then after those three pages are done, then there are some pages that are specifically related to goal setting, which may or may not be relevant to the person in front of you, things like a physical page, emotional, social, financial, health management type pages. And that really is a way to think about or encourage the person to think about, or we know what are the things that do matter to you, and and what are the things you would like to achieve in the long run, and what are some ways you might be able to break that down into achievable steps that you would personally want to do. But the session in practice can look like anything out of that. It can look from a person at session one being completely clammed up about not wanting to dig deep or not not being ready to engage in that. Or just kind of being, you know, keeping it all to themselves, and thinking about it, and ruminating about it, and then session two, looking very different after they've had that six weeks to think about it themselves. It can look like blank pages, or it could look like a person coming up with all sorts of brilliant ideas. Hopefully, you know, we always encourage if they can write the person with stroke as the one who is writing in the notebook. They keep it. They stick it on their fridge. They do whatever they like with it. They write in it in their own time, but it's completely fine to have blank pages. It's completely fine to have nothing come out of that conversation, nothing verbal, but it's just a space to an invitation to dig deep, and if there's something to say to feel heard. And I guess there was another question. I think that's quite important with regards to what the facilitator is doing, what are they not doing, and the facilitator is trained specifically to listen and ask questions and reflect the ideas that are being expressed by the person with stroke, but what they're not doing is they're not offering any advice or suggestions or pathways forward or how abouts or what abouts. They are not, and this is probably the hardest part. They're not passing any judgment, and that includes good judgment. So, by saying something like, "oh, that sounds like a really good idea", which seems like a really normal response from most people, it kind of implies that there are other ideas that are less good. Or the person with stroke might feel as though they are needing to have that kind of external validation, that external approval, and, and what we don't want is to for them to feel like they're doing this or saying this or thinking these things for the facilitator. We want them to think about it for themselves. And so all we encourage people to respond, is "oh, so you'd like to ride your bike, that's really interesting. How, how do you think you'll, you'll go about doing that?" You know, it's, it's much more neutral, but reflective way of speaking and listening, I guess. Katie Strong:  I am curious, how long is the training, or you know, what kinds of.. what we didn't talk about this, but I know people are going to want to know. So, what does it take to be trained? Vivian Fu: This is quite funny. This is a thing that sort of been on my mind ever since we've started implementation around the world, and I have this ultimate goal of operate like actually making the training have some type of qualification and fidelity, and some structure. There is structure, but it's essentially myself or Harry doing a Zoom with people, and it takes maybe say four hours. But ideally, what we'd love to do is to have sort of recorded videos, and then we'd have live sessions, and then we'd have assessments, and then you get a certificate at the end. I have neither the budget or the… Katie Strong: There's always the next step, for sure. Vivian Fu: I'd love to be for people to be able to say, "Oh, I'm Take Charge trained" and for them to be able to like "Look, I've got this qualification, I'm Take Charge trained, I know how to do this," and especially for if we were thinking about doing it in more clinical trial settings, I think that's really important, but also, you know, for people, you know, to have on their CV, if they're moving between jobs and things, I think it's so useful. But yeah, basically people get in touch with myself or Harry and say, "Hi, we'd like to be trained, can you fit us in?" And we just do it for free. Katie Strong:  Lovely, I love it. And the other question I had as you were talking was how long is a typical session or or is there is there length? Vivian Fu: So in the trial what our facilitators did was they because it was face to face and they had to drive between people's houses, they booked in the session, usually at 10:30 in the morning, and then another session, I think, if I remember correctly, either maybe it was 1:30 in the afternoon. And so you can probably surmise that for people with stroke, usually the 10:30 slot is the most popular. And you know, some people would would prefer to wake up earlier and be ready earlier, so they might ask for something like 9 o'clock and then they might usually go for about an hour and a half to two hours if it's a good going session, and they're really digging deep, and there's a lot to say. And often you know that first half an hour is, "Here's a cup of tea and a biscuit. Let's get to know each other. Tell me all about what happened with your stroke." That kind of stuff, so that listening and connecting stuff actually takes takes a while to establish, and I think people just allowed for that time. Then they'd do a second session in the afternoon again. There are lots of things, you know, cognitive problems, fatigue is a big one. So, if people felt like they couldn't keep going, the facilitator would say , "That's totally fine, we'll book in for, you know, do the rest of this another time, is that okay?" It was fine to really just, you can truncate it and break it up as much as the person really wants. Katie Strong:  Thank you. I appreciate the extra information. You had a recent publication in 2025 with some colleagues that looked at this work from a qualitative lens.  You came up with some themes about doing things my way, coming to my own wisdom, and they're just so deeply related to identity, and what struck me was the contrast participants drew between Take Charge care and standard care, where they described being put in a box receiving scripted advice that had really nothing to do with who they were as a person. And when someone gets to tell the story of who they are to a genuinely good listener, something shifts. I was just curious, if you could think about what you think is happening there, or what you found in your study. Vivian Fu: Well, I think for the most part, as a, you know, as a clinician, if we think about from the moment the person has a stroke, they disempowered from that very moment.  Something happens where they just aren't themselves, and they are brought into a merge. A bunch of things happen to them that they can't really even speak up about. You know, they're popped in a scanner. They might get thrombolised, you know, all these things are happening. And the person doesn't really know what's going on. There are a lot of important qualitative studies that have been done, looking at that element of feeling disempowered, and what somebody in New Zealand study described as feeling gut-wrenchingly emotional. You know, experiences that that aren't heard and aren't ever expressed to to anyone in the healthcare side and aren't dealt with, and so, if you think about that, just that trauma of having a stroke and then going through all of that stuff, and you know, ending up in a bed somewhere on a ward with strangers on the other side of a curtain, and it's really pretty traumatic. And so I think what was powerful with Take Charge was it's an it's an opportunity for someone to finally tell their story and feel heard and for all that stuff to just come out. And a lot of the time you know people might say, "Oh, well, you could talk to your family, you can talk to your kids, or, you know, whatever. Once you get home" but actually, a lot of people don't feel like talking to those who are closest to them about how much it affected them, and there is still an element of stigma. There's still an element of, "Oh, you know, you look great physically, you to someone we know having had a big health scare, and then kind of coming back into that. But there's there's a real dissonance between what is going on inside a person and and how other people are reacting to them coming back into "normal spaces". And so I think the ability to tell your story from the very get go. You know, all of the messiness of it. All the things that went wrong, and then to have somebody listen to that really gives meaning to it and makes it real, but it also helps that person really reestablish their sense of power to regain some power from that that they had lost. And there's a lot of power in story, and I think the kind of, you know, lovely thing about it is that sort of all indigenous cultures sort of be like, you know, First Nations, Māori, Gaelic, a lot of cultures really put a lot of value in the power of storytelling. And that is how historically things were really passed down, and so I think it's through that ability to be able to feel heard and to tell your story that then the person who is speaking can actually hear themselves say things out loud for the first time. And then understand the power and the value and the worth in their words and their experience, and that is that process of coming to my own wisdom, is "Oh, actually, you know, I do know about my body. I am, I am the expert, not these people in their white coats, or you know, with their expertise, I am the expert. I know what I need. I can plan my rehabilitation. I can go back to the things that I want to do, and this is how I'm going to do it." And it's that, that kind of reestablishment of confidence and strength and hope that is so powerful. I think. Katie Strong: I agree. I agree, Vivian. As you know, our listeners are primarily speech language pathologists working with people with aphasia. We also have people with aphasia that are listening, and researchers as well. But you know, the capacity for language being disrupted by aphasia. I was just curious, with Take Charge, as you've studied it, is you know, really a talking therapy with writing, and, and those sorts of things, and so I was just curious, you know, what would it take to extend this kind of intervention to people with aphasia, and what principles would you want to most preserve in the adaptation. Vivian Fu: Yeah, thank you. That's such an important question. We certainly, in the Take Charge trial, included people with aphasia in the trial, and the way that we sort of just included them was if they could understand or the consent form and could mark an "x" on the form, we'd be happy to to have them included, and so we had people with mild to moderate and moderate to severe aphasia in the trial. And we hadn't made any specific changes or tweaks to the intervention, the facilitator just did what they could with what we had. But I think what has come out of reviews of the implementation of Take Charge now in New Zealand is that it is really important for us to look at how we can adapt the intervention for people with aphasia. I think for the facilitators in the trial, what they did was they allowed a lot more time, so the usual two and a half hours became three and a half hours, and that was fine if the person could continue. But also I think from the report we need to look at alternative ways of how we can complete some of these activities, whether it's providing images where people can point, whether it's a lot more inclusion of their family, their whānau important people to them who can help with, you know, subtle guidance, and, and, and having sort of lived with the person now, can read their non-verbal expressions a lot better than a stranger, a facilitator can and can help with the guidance of participating. And really, while Take Charge has been translated, I think, now into seven or eight different languages, we really need to adapt Take Charge to other communication needs and other languages, but what I.. so my role.. sorry, I didn't.. I'd actually say this, but my role in the in the large trial was as the blinded outcomes assessor, so I went around at one year after stroke. I traveled around to the 400 or so different other people, participants' homes around the country, and I sat in their living rooms, and I listened to their stories again. And then I did all of their outcome instruments and got all of their outcomes done, but I did not know which group they were allocated to. And then I locked all the data, and then I'd say, "Hey, so which group did you get Take Charge or not?" And it was really, it was good. I think out of the 400 there were only two people who, when I turned up, actually had the booklet on the table, and so you know, I just ignored it, and then, but yeah, it was, it was really good in terms of sort of blinding and masking, and then sort of having a guess as I was going through and checking where things were at. It was such a privilege for me to, as a stroke doctor, I think you know people don't usually get to do this as a physician, but to, to meet so many different people with so many different stories, and a number of people who still had moderate to severe aphasia, and and were telling me about the impacts of that on their life. But we were still able to communicate a year after stroke, and so I think it is so important that we don't exclude people with cognitive and communication difficulties. We have to adapt the things that we have to make it work for them. What I'd love is to be able to have some kind of focus group with people with aphasia, and, and show them Take Charge, and realize, oh, what can we do? How would this work better for you? Katie Strong:  I love that, and well. Well, and we haven't talked about the materials yet, but I do have to say they're so accessible, or they're very accessible from a visual standpoint as well. Vivian Fu: Thank you. Yes, we are actually modifying them and making the font bigger and having better graphics. We started off with stick figures that Harry drew, and then I think we're actually making them a lot nicer in terms of the graphics, but what we do have at the moment is actually available online for free, and you can just download them as a package. It's if you Google it, it's the Medical Research Institute of New Zealand, or www.mrinz.ac.nz  and then under programs, and we spell that as p r o g r a m m e s, and then under programs slash forward slash stroke, I think is where it lives, and at the bottom of the page you should be able to download, a training package and the booklet itself. Katie Strong: Yes, lovely, and we'll have the links on our show notes as well, so you can check those out, listeners, if you're interested. So, thank you. You have two randomized controlled trials that you've talked a little bit about, and a cost effectiveness analysis and qualitative work, all pointing in the same direction that the cost data suggests that Take Charge actually might save money, and that is remarkable, and lots of evidence showing that, but still, it's a challenge in implementing into standard practice, and I was curious if you could talk with us about what you think stands between what the evidence shows and what actually gets implemented. Vivian Fu: Sure, gosh, I love this question. It's it applies for so many interventions, I think, specifically for Take Charge, it's a number of things. So definitely the stuff that affects other interventions being implemented, but for Take Charge itself, it started off with a huge amount of disbelief bias, so people, you know, even after I presented the main results of the second trial at the European Stroke Conference in gosh, when was that? 2019 pre-COVID in Milan. So this is a huge international stroke conference, and this was a plenary session. People stood up and took photos of the results and went, you know, there was this collective gasp throughout the audience of 6000 odd people, but there's just this disbelief that something as simple as a conversation can make a difference to people's objective quality quantitative outcomes, like the, you know, Bartel or the FIM, what they, you know, what their physical outcomes are like at a year. And what their quality of life is like. I think for people who are stroke researchers, a lot of the focus is on that initial 24 to 48 hours after stroke. And you know, that that's kind of where that's kind of where all the funding goes, isn't it? So it's the pre-hospital stuff, and then the interventional things you can stick catheters into and thrombolysis, and you know that's, and that's all great. You know, I, as a stroke physician, I love that part of stroke as well, but to think that you could possibly do something at three to 18 weeks after stroke that could change a person's outcome by a year, and actually we've got a long-term follow-up study now that says that those those same magnitude of changes are still present at five years between the groups is, you know, kind of gobsmacking. And people just go, surely you've fudged this, or surely this can't be true. And so there's this huge disbelief bias that stopped us from being able to publish initially, and it was only after I presented the results in Milan that that we got accepted into a journal. And we'd been trying for about a year beforehand, and, and so there's, there's that disbelief. But also in the way that it has to be provided, you know, it's probably considered quite labor intensive. You know, one on one home visits, and that's why people of other researchers who do believe in Take Charge are now looking at providing take charge in different ways. Like I did a telehealth trial in Canada, in southern Alberta, when I was there as a fellow in Calgary, and there's potential other work that's being. Done in Australia with Take Charge, looking at providing it by computer avatars, by even maybe even AI, and maybe in a larger sort of telehealth format. And so you know other ways of doing it, but I think ultimately it's kind of cultural inertia, because you know, "We've never done this, this is not part of who we are. Why would we need to start something new?" There's probably kind of an established way of thinking about clinician and, and patient, rather than person with stroke, in still in how we practice, and this idea that the therapist and doctor are experts. And so I think it really challenges that dogma and challenges clinician's role, and therefore there's a resistance to accept that this is something that is useful and helpful, and actually doesn't, you know, you don't need to take it personally. You're still doing great work. Take Charge is just a tool that helps supplement everything else that's going on, and so there's a lack of time, and I think we also get quite, as practicing clinicians, we get quite tunnel visioned into this, you know, hamster wheel of go to work, treat all these people, go home. We just keep doing it. Hoping that things will get better for them, but, you know, we, it's only when we start looking at alternative interventions and alternative things that work and start trialing them and being open to that, that I think things will really start to change. We've certainly had interest from random little parts around the world. I think it's been translated into Latvian. I've got people from Sweden who are interested. A little hospital in Germany, and then parts of it's been trialed in pilot studies in the UK. And Harry and I last year trained a whole bunch of occupational therapists in Hong Kong, so you know it is, it is kind of picking up, slowly but surely. Katie Strong: Well to me, you know, most stroke survivors, or people with stroke, as you're referring to them, have chronic challenges, and so all of the early intervention, while important, doesn't necessarily help somebody navigate that longer term change. And so I love that this is just such an empowering way of putting that power back into the person's life, which it seems like it is showing up n in the results that you're sharing. Vivian Fu: Oh, absolutely. I mean, if we think about it, if we just think about thrombectomy and thrombolysis, somewhere between five to 15% of all people with stroke are eligible, and then receive the treatment. That leaves what?, 85 to 95% of people who don't get to receive that. And even after they receive the treatment, there are consequences of stroke that are beyond the physical that don't you know don't have any other thing to address them apart from our routine care, so I completely agree with you. Katie Strong: Well, thinking about what clinicians might be able to do tomorrow or you know, in the near future, for our speech-language pathologists or other practitioners who are listening today and are feeling the pull of this work, and you know, really encouraged by it, but are you know working in an embedded productivity driven impairment focused system, what's one thing that they could do differently in the very next clinical encounter that they have? Vivian Fu:  We have a paper, I think it's written. Oh gosh, where did it.. where did it get published? I think it was published in Practical Neurology. It's titled something, something intrinsic motivation. I should know better. Katie Strong: I'm going find out, and I don't think I read that one, so I'm gonna find it, and I'll put the link in the show notes for everybody. Vivian Fu: Sorry,Harry about the promo, but yeah, I'll send it to you, but essentially it's written to give some guidance on how you can embed Take Charge into your daily clinical practice. And it's written for neurologists, but honestly it applies to everybody.  One of the key things is when you have that next encounter, obviously you know therapists do this a lot better than doctors do, but they ask a lot about, you know, what's outside of the person's life and what's important to them, but maybe move away just, you know, from the very practical questions like "How many steps do you have going in and out of your house?, and How do you hang up your washing?", or whatever, but it's, you know, really much less functional, but more, "Who are you? Tell me a bit more about yourself. What do you love doing? What gets you out of bed?" You know, if I might, the one that I like to use a lot on my ward rounds is, "If you weren't in this hospital bed right now, where would you rather be? What would you rather be doing?", and I do that on my rounds, and it's incredible, because you know, I'll hear all sorts of things, "I'll, you know, be on my boat fishing out on the lake", or I think this lady was like 84 or something. "I'll be with my girlfriends, we'll be having coffee at Tim Hortons", you know, and it's just, I don't know, it's something so unique to that person that I could never, you know, they're in their hospital pajamas with a whole bunch of stuff stuck to them, and I can't envisage them doing that, and yet I'm like, I want you to imagine yourself there. Where would you rather be? Okay, so everybody, that's our goal. It's not to get her home or to get her walking again. Our goal is to get her back in Tim Hortons with her eight friends, having coffee, like that is what this person loves to do. And I think that you know that inquiry, that it shows you care, it shows you see them as an individual, and I think it completely shifts your rehab focus, and then you can ask more questions about that, and they, you know, then you have this whole conversation about about what their life is like. And I think that part of being seen, even if it's only within 60 seconds, makes such a difference to that person. So that's one thing. The second thing I'd be, you know, doing is I'm trying to involve family as much as possible, as much as the person wants, and basically, just seeing them as an individual makes a huge difference already to the way you practice, that would be what I'd focus on. Katie Strong: Agreed, agreed. Well, Vivian, is there something you wish people asked you about this work that they rarely do, something about Take Charge or stroke recovery more broadly that you think the field hasn't quite caught up to yet. Vivian Fu:  Oh gosh, this is a tricky one. I think one thing we ought to recognize is that everybody is doing the best that they can with what they have. And you know, we're not as clinicians on the ground on the front line, we're not involved with funding decisions, and what projects get funded and which ones don't. And there will be the ambitious amongst your listeners, who I really hope will be like, "Oh my gosh, I can apply for this little grant, and I'm going to pilot this, and I think we should give this a go with our people." and I think that is absolutely a great idea to have. And, and I would, myself and Harry will do everything that we possibly can to help support such projects from where we are. I think the important thing to think about is that every little bit that you do makes a difference, and to not feel as though, because you know your funding runs out, or you don't get it, or the world is such a bleak place that you know it's not worth continuing to try. Because people with stroke who see you do this work, they will be grateful for it. And also the patient partners I've met that I've spoken with, and all of the people whom I've interviewed with the qualitative work, they're also happy to be part of something like this. And so even if it's a pilot project. Even if it's, you know, something that may not last, you'd be so surprised at how much momentum you can build with a movement of people who see the value in this and then take it further and further, And that's what I've been really impressed by, and kind of stunned by in all these different locations around the world who have contacted me. I've just been like, "Wow, can't believe [this]." There's this wonderful group in Hunter Medical Research Institute down in Australia, who basically took Take Charge back to their own unique Aboriginal community, the Gamilaroi peoples of that particular area of Australia. They have, like Canada and like the States, they have 1000s of tribes and lots of different groups that all speak completely different languages, but they took it to their local group, and they broke down, take charge into little bits, and then rebuilt it into an intervention that just works for them, and it's called "Yarning Up after Stroke", because what they do is they have a yarn. They yarn, and that's the way they tell their stories. It's yarning, and so you know, I just think it's incredible. Like, they got funding for it, they did it, and now it's an ongoing project that just keeps on in the community being provided to their people, and it's fantastic. So, I think it'll evolve. I love to see how it evolves, and I certainly don't think of, you know, this isn't the kind of intervention that we go around patenting and making a ton of money out of. It's the kind of intervention that everybody makes their own, and hopefully with a lot of input by people with stroke, Katie Strong: I love it. Thank you. Thank you so much for being our guest today, and sharing about Take Charge, and your generosity in sharing about the intervention, and if people are interested in reaching out to contact you, so thank you so much, Vivian. Vivian Fu:  Thank you so much for having me. I hope I haven't spoken too long. Katie Strong: Oh no, it's perfect. Vivian Fu: I'm always happy to be contacted, and yeah, very happy to support anyone who'd like to explore this further. Katie Strong: Thanks so much. On behalf of Aphasia Access, thank you for listening. For references and resources mentioned in today's show, please see our show notes, available on our website at www.aphasiaaccess.org. There you can also become a member of our organization, browse our growing library of materials, and find out about the Aphasia Access Academy. If you have an idea for a future podcast episode, email us at info@aphasiaaccess.org. For Aphasia Access Conversations, here at Central Michigan University in the Strong Story Lab, I'm Katie Strong. Dr. Fu's Email  dr.vivianfu@gmail.com  Resources and Readings Fu, V. (2019). Taking Charge After Stroke: A novel, community-based intervention to improve the lives of people with stroke. https://www.semanticscholar.org/paper/Taking-Charge-After-Stroke:-A-novel,-intervention-Fu/3bc1dbb271f425c72e146510088856e3aad8683e  Fu, V., Fernando, K. M., Bright, F., Riley, J., McPherson, K., & McNaughton, H. (2025). Coming to my own wisdom: A qualitative study exploring the role of the Take Charge intervention in stroke recovery. Clinical Rehabilitation, 39(3), 377–387. https://doi.org/10.1177/02692155241310770 Fu, V., Weatherall, M., McPherson, K., Taylor, W., McRae, A., Thomson, T., Gommans, J., Green, G., Harwood, M., Ranta, A., Hanger, C., Riley, J., & McNaughton, H. (2020). Taking Charge after stroke: A randomized controlled trial of a person-centered, self-directed rehabilitation intervention. International Journal of Stroke, 15(9), 954–964. https://doi.org/10.1177/1747493020915144 Fu, V., Thompson, S., Kayes, N., & Bright, F. (2025). Supporting long-term meaningful outcomes in stroke rehabilitation. Current Neurology and Neuroscience Reports, 25, 17. https://doi.org/10.1007/s11910-025-01403-z Harwood, M., Weatherall, M., Talemaitoga, A., Barber, P. A., Gommans, J., Taylor, W., McPherson, K., & McNaughton, H. (2011). Taking charge after stroke: Promoting self-directed rehabilitation to improve quality of life - a randomized controlled trial. Clinical Rehabilitation, 26(6), 493-501. https://doi.org/10.1177/0269215511426017  Te Ao, B., Harwood, M., Fu, V., Weatherall, M., McPherson, K., Taylor, W. J., McRae, A., Thomson, T., Gommans, J., Green, G., Ranta, A., Hanger, C., Riley, J., & McNaughton, H. (2022). Economic analysis of the 'Take Charge' intervention for people following stroke: Results from a randomised trial. Clinical Rehabilitation, 36(2), 240–250. https://doi.org/10.1177/02692155211040727 McNaughton, H., & Fu, V. (2023). Intrinsic motivation. Practical Neurology, 23(6), 489-492.  https://pn.bmj.com/content/23/6/489  McNaughton, H., Gommans, J., McPherson, K., Harwood, M., & Fu, V. (2023). A cohesive, person-centric evidence-based model for successful rehabilitation after stroke and other disabling conditions. Clinical Rehabilitation, 37(7), 975-985. https://doi.org/10.1177/02692155221145433   Medical Research Institute of New Zealand. (n.d.). Take Charge rehabilitation resources. https://www.mrinz.ac.nz/take-charge-rehabilitation-resources World Stroke Organization. (n.d.). Taking Charge after stroke: A person-centred approach to life after stroke [Webinar]. https://www.world-stroke.org/what-we-do/education-and-research/education/webinars/taking-charge-after-stroke-a-person-centred-approach-to-life-after-stroke  

Tim Bartel is a multi-generational beekeeper and part-owner of Bartel Honey Farms in Kleefeld, Manitoba, a commercial operation running roughly 1,500 hives focused on honey production and the import of package bees and queens.Cornerstone Forum 26'https://shaunnewmanpodcast.substack.com/Silver Gold Bull Links:Website: https://silvergoldbull.ca/Email: SNP@silvergoldbull.comText Grahame: (587) 441-9100Bow Valley Credit UnionBitcoin: www.bowvalleycu.com/en/personal/investing-wealth/bitcoin-gatewayEmail: welcome@BowValleycu.com Get your voice heard: Text Shaun 587-217-8500

We're joined by U.S. Air Force veteran Christopher Bartel, a former employee of both Area 51 and Skinwalker Ranch, for a candid look behind the curtain of two of the world's most enigmatic locations. After eight years with Robert Bigelow's BAASS, including six stationed at Skinwalker Ranch, Bartel recounts the extraordinary events he witnessed, the Native American history he documented through his acclaimed Skinwalker Ranch Series photographs, and his unfiltered assessment of the investigations conducted there. He also confronts one of the ranch's most controversial claims: were he and his colleagues unknowingly used as human test subjects to measure the ranch's physical effects? It's a revealing conversation with someone who lived the mystery from the inside. Join us at ANOMACON on September 12th: http://www.anomacon.com Send us a voicemail: https://www.speakpipe.com/SomewhereSkiesPod Patreon: http://www.patreon.com/somewhereskies ByMeACoffee: http://www.buymeacoffee.com/UFxzyzHOaQ Substack: https://ryansprague.substack.com/ All socials and books: https://linktr.ee/somewhereskiespod Email: ryan.sprague51@gmail.com Opening theme song by Septembryo Closing song by Per Kiilstofte Livestream music by Punch Deck: https://www.youtube.com/@PunchDeck Copyright © 2026 Ryan Sprague. All rights reserved. #Area51 #SkinwalkerRanch #Skinwalker #UFO #UFOs #UAP #Utah #SomewhereintheSkies Learn more about your ad choices. Visit megaphone.fm/adchoices

Text a question to Victoria!Have you ever felt like you need to live in a big, thriving city to build a premium brand? Do you struggle with wanting to discount your services every time your business hits a slow season? Emily Bartel is the founder of West Medical Aesthetics, located in Oklahoma City, and a Sciton Luminary. She has over 13 years of experience in the aesthetics industry and has worked in several of Oklahoma City's leading medical aesthetic practices, specializing in laser treatments, injectables, and medical-grade skincare.In this episode, Victoria and Emily sit down at the mic to discuss what it actually takes to build a premium aesthetics brand, no matter where you're located. They talk about how Emily built her business strategically, so that she was positioned as a luxury brand from the start.  If you'd love to build a more premium reputation for your business but don't know how to get there, this episode will give you practical steps on how to move forward more intentionally. You'll walk away with the foundations you need to build a premium brand with a strong reputation, regardless of where you're located. Whether you're in the carpool pickup line or running off to your next meeting, you don't want to miss this honest and actionable conversation.Links Mentioned in Today's Episode: Watch The Episode on YouTubeVisit & Book at West Medical AestheticsConnect With Emily on InstagramLearn More About Sciton Work With BrandWellFor show notes, head to www.thebrandingbusinessschool.com/thepodcast/Show notes for episodes 1-91 can be found at www.brandwelldesigns.com/thepodcast/Follow BrandWell on Instagram. Follow The Branding Business School on Instagram.Save on your first year of Honeybook using this link! Save 50% off your first year of Flodesk using this link! Get $30 off your first month of Nuuly using this link!Get up to $150 off your first box of Factor Meals using this link!

Talk to KimSue Bartel shares her inspiring journey through midlife health challenges, including her experience with hysterectomy, brain fog, and hormone changes. She discusses how she took control of her health with research, supplements, and community support, empowering women to embrace their midlife with courage and confidence.Chapters00:00 Introduction and Guest Welcome00:15 The Impact of Medical Advice to Stop Searching for Problems00:41 Discovering Supplements and Their Role in Transformation02:03 Realizing the Silence of Women in Midlife Health02:23 Symptoms Leading to Hysterectomy at 3802:52 Post-Surgery Challenges and Misdiagnosis03:47 Understanding Perimenopause and Its Effects04:30 The Uncertainty of Ovarian Removal and Menopause05:31 Lack of Communication in Medical Procedures06:15 Recognizing Brain Fog and Its Impact06:52 The Power of Community and Shared Experiences07:21 Partner's Observation of Cognitive Changes07:46 Hiding Symptoms and Societal Expectations08:15 Exhaustion and Burnout in Midlife Women09:01 The Turning Point: Research and Self-Discovery09:45 The Transformation Through Supplements11:04 Science and Research in Supplement Development12:41 Addressing Brain Fog and Cognitive Symptoms13:19 Benefits of the Custom Supplement Formula14:03 Restoring Confidence and Self-Identity15:07 Sue's Most Courageous Moment: Quitting a Secure Job16:20 Following Dreams and Overcoming Fear18:04 The Power of Following Your Passion19:19 Helping Women Find Courage and Self-Discovery20:36 The Wisdom and Charisma of Women in Their 40s21:21 Overcoming Fear and Speaking Up in Healthcare22:22 The Importance of Self-Advocacy and Asking Questions23:18 Connecting Courage, Confidence, and Community24:02 Encouraging Women to Push Boundaries24:59 Resources: Sue's Coaching and Supplements26:08 Simple Self-Care Practices for Midlife Wellbeing26:41 Final Words of Encouragement and EmpowermentFind Sue here:Website - https://myunmess.com/Support the showKim Benoy is a retired RN, Certified Aromatherapist, wife and mom who is passionate about inspiring and encouraging women over 40. She wants you to see your own beauty, value and worth through sharing stories of other women just like you.****************************************************If you are looking for deeper connection, encouragement, and support, you should join my free online community. It's a safe, uplifting space to be inspired, share honestly, and grow alongside women who truly get this season of life.Midlife with Courage™ Community*****************************************************Want to be a guest on Midlife with Courage™-Bold Women Thriving After Forty with Kim Benoy? Send Kim Benoy a message on PodMatch, here: Podmatch Link NEWSLETTER WEBSITEFACEBOOK

Kim Bartel is with the Alcohol and Drug Awareness Council here in East Texas.  In this episode we talk with Kim about the popularity of vaping, especially among the youth in East Texas and how vape shops are practically everywhere now.  We'll also examine other substances being abused today.

"I need a doctor. Know of any, Mrs. Mott?" We watched "The Hand That Rocks the Cradle" with our friend Chris Gallo, and you'll have to excuse us while we take down this wind chime. This movie is firing on all cylinders from jump, and we were caught off guard more than a couple of times with some of the twists and turns. Rebecca De Mornay slays (literally) as the revenge-seeking "nanny from hell" unleashed upon the unsuspecting Bartel family. Annabella Sciorra plays asthmatic new mom Claire Bartel with a nervous energy that we're still trying to reconcile, and Julianne Moore eats up every scene as '90s businesswoman Marlene Craven. Ernie Hudson is doing the best he can with a role that would never be in a film these days, and Matt McCoy is there as Claire's husband, but this film is really about the women. Maybe the scorned woman trope is well-worn territory, but De Mornay, Sciorra, and Moore are just so much fun to watch in this soapy psychological drama. We thought we'd seen everything at that movies until Rebecca De Mornay sashayed across that playground and showed that (child) bully who's boss. No notes.  Thank you for listening, and don't forget to subscribe, rate, and review us on Apple Podcasts! www.patreon.com/moviesthatmadeusgay Facebook/Instagram: @moviesthatmadeusgay Bluesky: @MTMUGPod.bsky.social Scott Youngbauer: Twitter @oscarscott / Instagram @scottyoungballer Peter Lozano: Twitter/Instagram @peterlasagna Cover Art by Shaun Piela 

Geelong have beaten the reigning premiers Brisbane by 41. points in the Grand Final rematch at the Gabba.See omnystudio.com/listener for privacy information.

Automate to Accelerate | How AI Can Cut Your Sales Cycle in Half with Mark Bartel Description: What if you could cut your sales cycle in half — without hiring more staff?   In this episode of the Find Your Leadership Confidence Podcast, host Vicki Noethling sits down with AI strategist Mark Bartel to explore how customized AI tools built directly into your social media platforms can eliminate inquiry backlog, reduce repetitive messaging, and accelerate your sales pipeline. Mark works with real estate agents, coaches, advisors, and entrepreneurs to design AI systems that streamline engagement while preserving authenticity and trust. In this episode, you'll learn: • How AI can shorten your sales cycle • Why most small businesses lose leads during follow-up • The biggest automation mistakes to avoid • How to balance automation and authenticity • The first practical AI step to implement today • What the future of AI in sales really looks like AI isn't about replacing people — it's about accelerating impact.

“Papa, je bent zo vaak weg. Ik zou eigenlijk eens willen meegaan. Dat was voor mij de trigger: ik moet de sprong wagen.”In deze aflevering praten we met Bartel Puelinckx over zijn carrièrepad binnen KBC. Hij begon er op zijn 27ste op de dienst Buitenlandse handel, bij de toenmalige Kredietbank. Vandaag, 33 jaar later, zet hij als CFO de financiële lijnen uit.Een gesprek over de schakelmomenten in zijn carrière. En hoe zijn oudste zoon daar blijkbaar een belangrijke rol in speelde.

Christopher Bartel, a 10-year U.S. Air Force veteran with an extraordinary background in high-security operations across some of the most secretive and mysterious sites in the world.Chris served with the Air Force Security Forces, including time at Nellis Air Force Base in Nevada. He later took on critical security roles with the Department of Energy at the Nevada Test Site and provided security at the legendary Area 51 test range. In 2010, he was hired by Bigelow Aerospace Advanced Space Studies (BAASS) as a security officer and investigator, where he spent the next eight years — six of them living and working full-time at the infamous Skinwalker Ranch in Utah. During that time, he patrolled the property (often alone), documented its remote landscape through photography, and witnessed events that continue to fuel discussions about the unexplained.Chris is also an accomplished photographer whose work from the ranch, known as The Skinwalker Ranch Portfolio, has been exhibited in art galleries and serves as a unique visual record of his years there. His perspective offers rare, firsthand insight into these restricted worlds, blending professional security experience with personal encounters at the edges of the known.https://artgallery.umd.edu/news/washington-post-review-christopher-bartel-skinwalker-ranch-portfolio Patreon - https://patreon.com/strangerecon?utm_medium=unknown&utm_source=join_link&utm_campaign=creatorshare_creator&utm_content=copyLink

The biblical story of the Gerasene demoniac offers a powerful lens through which to understand modern addiction. This ancient narrative reveals how isolation, the futility of willpower, and the loss of identity are hallmarks of being captive to destructive forces. In this message, our guest Blaine Bartel shares his own 23-year struggle with addiction, drawing parallels to the demoniac's experience and highlighting the profound impact of secrecy.Discover how Jesus confronts these strongholds, not by waiting for us to clean up our mess, but by meeting us in our brokenness. This message explores the path to true freedom and resurrection, offering hope for anyone seeking to break free from what controls them.If you're new to 7 City Church, we'd love to get to know you and help you take your next step. You can find our digital connect card and discover ways to get connected at 7city.info.Join us in person on Sundays at 9:30 or 11:00 AM at 2900 W Lancaster Ave, Fort Worth, TX.Connect with us throughout the week on social media:Facebook | YouTube: 7 City ChurchInstagram | TikTok: @7citychurch

RSS/iTunes/Spotify Check out the full Bartel Me Something Good archive right here On this free-wheeling episode of BARTEL ME SOMETHING GOOD we’re doubling up with two films featuring notable Paul Bartel ACTING performances. Uh.. kinda. We start with the cult-classic killer robots in a mall horror film CHOPPING MALL, directed by Jim Wynorski. With an all-star cast including Kelli Maroney, Barbara Crampton, DICK MILLER, Gerrit Graham, Mel Welles, Angus Scrimm and – of course – Paul Bartel and Mary Woronov, reprising their roles from EATING RAOUL! Then we put on our deerstalker hats and pull out our magnifying glasses as we solve the mystery of WHERE IS PAUL BARTEL (as “Twister Master”) IN GREGG ARAKI’S THE LIVING END?! The record will be changed PERMANANTLY as we discuss Araki’s transgressive 1992 road comedy-drama ALSO featuring an appearance by Mary Woronov. Have a listen, friends!The post Episode 321 – Bartel Me Something Good – Chopping Mall (1986) & The Living End (1992) first appeared on Cinema Smorgasbord.

Thanks to our Partners, NAPA TRACS, Today's Class, KUKUI, and Pit Crew Loyalty Watch Full Video Episode In this episode, Melissa Parker, Amy Bartel, and Sara Abrecht join Carm Capriotto to discuss why women are the automotive industry's “secret weapon.” The panel explores the concept of automotive hospitality, focusing on relationships, empathy, and customer experience as key drivers of trust, loyalty, and profitability. They share how hospitality driven environments, strong listening skills, and hiring from service focused industries elevate the customer experience and strengthen shop performance. Sara also reveals data showing female-led shops achieve higher average repair orders, highlighting the business impact of communication and relationship building. The conversation challenges outdated industry perceptions and calls for a shift toward hospitality centered operations, encouraging shop owners to embrace these principles and inspiring more women to pursue leadership roles in this evolving, people first profession. Timestamps (00:00:00) - Introduction and Guest Welcome (00:03:15) - Defining "Automotive Hospitality" (00:06:00) - The "Ritz-Carlton" Standard (00:09:45) - Men vs. Women: Fixers vs. Listeners (00:14:15) - Hiring Outside the Industry (00:18:20) - The Role of the Customer Service Rep (CSR) (00:21:00) - The "Anytime" Presentation (00:27:45) - The Financial Case: Women Drive Higher ARO (00:30:15) - The "Secret Weapon" & Workplace Culture (00:34:30) - The Household Decision Maker (00:37:45) - Rebranding: From "Trade" to "Skilled Career" Melissa Parker, COO, Harrell's Tire and Auto Amy Bartel, Owner, Bartel's Auto Clinic Sara Abrecht, CFO, Dynamic Automotive Thanks to our Partner, NAPA TRACS NAPA TRACS will move your shop into the SMS fast lane with onsite training and six days a week of support and local representation. Find NAPA TRACS on the Web at http://napatracs.com/ Thanks to our Partner, Today's Class Optimize training with Today's Class: In just 5 minutes daily, boost knowledge retention and improve team performance. Find Today's Class on the web at https://www.todaysclass.com/ Thanks to our Partner, KUKUI Stop juggling multiple marketing tools. KUKUI's integrated platform delivers 4x better website conversions, automated follow-up, and real-time ROI tracking. Get industry-leading customer support with KUKUI at https://www.kukui.com/ Thanks to our Partner, Pit Crew Loyalty You're probably tired of chasing new customers who never return. We understand. Pit Crew Loyalty ends the one-and-done cycle, turning first visits into lasting, reliable revenue at https://www.pitcrewloyalty.com/ Connect with the Podcast: - Follow on Facebook: https://www.facebook.com/RemarkableResultsRadioPodcast/ - Join Our Virtual Toastmasters Club: https://remarkableresults.biz/toastmasters - Join Our Private Facebook Community: https://www.facebook.com/groups/1734687266778976 - Subscribe on YouTube: https://www.youtube.com/carmcapriotto - Follow on LinkedIn: https://www.linkedin.com/in/carmcapriotto/ - Follow on Instagram: https://www.instagram.com/remarkableresultsradiopodcast/ - Follow on Twitter: https://twitter.com/RResultsBiz - Visit the Website: https://remarkableresults.biz/ - Join our Insider List: https://remarkableresults.biz/insider - All books mentioned on our podcasts: https://remarkableresults.biz/books - Our Classroom page for personal or team learning: https://remarkableresults.biz/classroom - Buy Me a Coffee: https://www.buymeacoffee.com/carm - Special episode collections: https://remarkableresults.biz/collections - The Automotive Repair Podcast Network: https://automotiverepairpodcastnetwork.com/ - Remarkable Results Radio Podcast with Carm Capriotto: Advancing the Aftermarket by Facilitating Wisdom Through Story Telling and Open Discussion. https://remarkableresults.biz/ - Diagnosing the Aftermarket A to Z with Matt Fanslow: From Diagnostics to Metallica and Mental Health, Matt Fanslow is Lifting the Hood on Life. https://mattfanslow.captivate.fm/ - Business by the Numbers with Hunt Demarest: Understand the Numbers of Your Business with CPA Hunt Demarest. https://huntdemarest.captivate.fm/ - The Auto Repair Marketing Podcast with Kim and Brian Walker: Marketing Experts Brian & Kim Walker Work with Shop Owners to Take it to the Next Level. https://autorepairmarketing.captivate.fm/ - The Weekly Blitz with Chris Cotton: Weekly Inspiration with Business Coach Chris Cotton from AutoFix - Auto Shop Coaching. https://chriscotton.captivate.fm/ - Speak Up! Effective Communication with Craig O'Neill: Develop Interpersonal and Professional Communication Skills when Speaking to Audiences of Any Size. https://craigoneill.captivate.fm

What if the reason you don't want to be touched at the end of the day… isn't rejection - but nervous system overload?In this honest, hope-filled conversation, I sit down with Dr. Sarah Bartel, moral theologian and Catholic sex & marriage coach, to talk about what it really means to feel touched out - especially as a wife and mom - and how couples can rebuild loving intimacy without pressure, guilt, or shame.We explore the science of the nervous system, the theology of mutual self-gift, and practical steps couples can take this week to create safe touch that builds desire instead of shutting it down.If you've ever loved your husband deeply but felt completely overstimulated by the end of the day… this episode will feel like a deep exhale.We had some major tech issues with this episode, so thank you for your understanding if you notice some minor issues! We did our best to repair & restore the audio!

 1️⃣ Best Coaching Advice Received“Your presence is a present.”Presence is active, not passive — it requires intention and effort.Yoga and meditation built her ability to refocus repeatedly.Being fully seen and heard is itself support. 2️⃣ What She's Still ImprovingChoosing what thread to follow when clients offer many entry points.Prioritizing the question that creates the greatest impact.Staying deep without chasing every possible avenue.Discipline in focus inside complexity. 3️⃣ Most Courageous MomentStopped a recorded PCC session mid-way because it felt performative.Recognized she was coaching for assessment rather than authenticity.Restarted the session to return to intuitive presence.Refused to compromise integrity for performance. 4️⃣ What Makes Her UncomfortableVery little — discomfort energizes her.She thrives when clients go deep.Challenge excites her, especially when clients feel hopeless.Real change happens below the surface. 5️⃣ Advice for New CoachesLearn business skills — coaching skill alone isn't enough.Be ready to wear marketing, logistics, and operations hats.You need very little to start — just begin.Start before you feel ready. 6️⃣ Something She Had to ConquerLetting go of performance mentality.Learning to trust intuitive coaching.Separating empathy from emotional absorption.Feeling with clients, not for them. 7️⃣ Using AI in CoachingDoes not use AI note-takers in sessions — protects presence.Uses AI for idea generation and blog structuring.Believes AI coaching increases accessibility.Human presence and intuition remain irreplaceable.Sees AI as enhancement, not replacement. 8️⃣ What She's Learned About HerselfShe can put people at ease quickly.She holds space well, especially in emotional moments.Silence is powerful and intentional.Deep listening changes relationships beyond coaching. 

Wer den Schaden hat, braucht für den Spott nicht zu sorgen. Mit: Lara Körte (Anuschka), Oriana Schrage (Patrizia), Michael Witte (Hüttenstetter) und Oliver Reinhard (Sternemann) Tontechnik: Tom Willen Regie: Johannes Mayr Produktion: SRF 2024 Dauer: 11:20

This week Sean and Jeff talk about James Cameron's strange press tour. The director of Avatar has trouble letting go of perceived slights, pettily trying to settle scores only he cares about. Actor James Ransone has died Avatar: Fire and Ash Directed by James Cameron Starring Sam Worthington, Zoe Saldana, Kate Winslet, Sigourney Weaver The conflict on Pandora escalates as Jake and Neytiri's family encounter a new, aggressive Na'vi tribe. The Housemaid Directed by Paul Feig Starring Amanda Seyfried, Sydney Sweeney, and Brandon Sklenar Hoping for a fresh start, a young woman becomes a live-in maid for a wealthy couple who harbour sinister secrets. Classic The Hand that Rocks the Cradle Directed by Curtis Hanson Starring Rebecca DeMornay, Annabella Sciorra When she was assaulted by her doctor, Claire Bartel (Annabella Sciorra) reported him to the police, and rather than go to prison for his crime, he killed himself. The shock of the accusations and suicide caused the doctor's pregnant wife, Peyton (Rebecca De Mornay), to have a miscarriage. Driven mad with rage, Peyton poses as a nanny for the Bartel family. Her plan: to tear Claire's life apart, seduce her husband (Matt McCoy) and eventually murder the woman she blames for ruining her life.

Join host James Mackey and Steve Bartel, CEO of Gem, to explore what's happening in today's hiring market - inbound is up 3x, time to hire has grown by eight days, and recruiters are carrying 55% more reqs. They discuss where AI genuinely reduces workload and boosts efficiency, along with the rise in fraud and interview cheating. Thank you to our sponsor, SecureVision, for making this show possible! Our host James Mackey Follow us:https://www.linkedin.com/company/82436841/#1 Rated Embedded Recruitment Firm on G2!https://www.g2.com/products/securevision/reviewsThanks for listening!

Joe Bartel, a fantasy football expert at Rotowire.com, joined Sports Talk. Bartel broke down his top pickups in fantasy football, the Falcons' passing attack without Drake London or Michael Penix, and Saints TE Juwan Johnson.

Steve and Charlie discussed the Saints' matchup with the Falcons and the Pelicans' miserable 2-12 start to the 2025-26 season. The guys listened to locker room audio from Saints safety Justin Reid. Joe Bartel, a fantasy football expert at Rotowire.com, joined Sports Talk. Bartel broke down his top pickups in fantasy football, the Falcons' passing attack without Drake London or Michael Penix, and Saints TE Juwan Johnson.

Joe Bartel, a fantasy football expert at Rotowire.com, joined Sports Talk. Bartel previewed the 11th week of the fantasy football season. He shared his thoughts on the Broncos, Steelers, Texans, and Cowboys.

Steve and Charlie interviewed David Grubb, the host of "The Post Up" podcast, and Joe Bartel, a fantasy football expert at Rotowire.com. Grubb discussed the Pelicans' miserable 2-8 start to the season and previewed their upcoming gauntlet. Grubb also explained that firing head coach Willie Green won't fix all of New Orleans' issues. Bartel previewed the 11th week of the fantasy football season.

Joe Bartel, a fantasy football expert for Rotowire.com, joined Sports Talk. Bartel lamented Packers TE Tucker Kraft's season-ending injury. He discussed the impact of the NFL's trade deadline on fantasy football.

Steve and Charlie interviewed Oleh Kosel, a credentialed NBA reporter covering the Pelicans, and Joe Bartel, a fantasy football expert for Rotowire.com. Kosel broke down the Pelicans' miserable 0-6 start to the season, explaining their losses are on the players as much as the coaching staff. Bartel discussed the impact of the NFL's trade deadline on fantasy football.

“I just went there for a routine knee replacement, or so I thought.” In this inspiring episode, Rosie Bartel, a patient partner and advocate, educator, and survivor, shares her journey from a devastating MRSA infection acquired during a routine knee replacement to becoming a global voice for patient safety and health care reform. After surviving 58 surgeries, more than 200 hospitalizations, and multiple amputations, she transformed her pain into a mission to prevent others from enduring the same experience. Rosie explains how being invited to her hospital's root-cause investigation empowered her to advocate for systemic change and demonstrate the power of storytelling with purpose. She reminds health care professionals that patients seek healing, not lawsuits, urging both providers and patients to share their stories because, as she powerfully states, stories aren't just anecdotes; they're data that inspire action. Tune in and learn how courage, compassion, and the patient's voice can light the path toward a safer, more humane health care system! Resources: Connect with and follow Rosie Bartel on LinkedIn. Learn more about The Beryl Institute on their LinkedIn and website. Watch here Rosie's “One Is Too Many” video. Learn more about your ad choices. Visit megaphone.fm/adchoices

Joe Bartel, a fantasy football expert for Rotowire, joined Sports Talk. Bartel discussed Broncos QB Bo Nix's awful season. Bartel shared his thoughts on "buy-now" candidates, the Cowboys' passing attack, and "streaming" positions.

Jeff and Charlie interviewed Oleh Kosel, a credentialed NBA reporter covering the Pelicans, and Joe Bartel, a fantasy football expert for Rotowire. Kosel broke down the expectations for New Orleans entering the upcoming season. He previewed the Pelicans' first matchup on the road against the Memphis Grizzlies. Kosel also shared his thoughts on Zion Williamson, the Pelicans' depth, and their young rookies. Bartel discussed "buy-now" candidates, the Cowboys' passing attack, and "streaming" positions.

We continue with #VIDtober 2, where we explore the Canadian movies released by New World Video with an important Canadian film: 1967's PLAYGIRL KILLER! The first Canadian horror movie made in color shares a good amount of DNA with Herschel Gordon Lewis' BLOOD FEAST and TWO THOUSAND MANIACS! and also doesn't share some DNA too! Most prominently is actor Bill Kerwin, who starred in both of those films from Lewis but opted out of the third entry in Lewis' "Blood Trilogy" so he could head to Canada and shoot this, a film about a artist who just wants his models to hold their pose without fail for hours on end. Diving into a stranger's pool with us is Doug Tilley, host of a variety of podcasts on Cinema Smorgasbord including You Don't Know Dick, Eric Roberts is the Man, Bartel me Something Good, and so many more! Being a Canadian himself, Doug helps us fill in some gaps we lack in Canadian culture. This also has plenty of music! Crooner Neil Sedaka appears in the film, until he doesn't, and even sings a little bit! We discuss whether Sedaka was too famous for this movie, as well as other topics, such as the stylistics choice of socks with sandals, how we might "pull a Bob" on our won podcasts, and the importance of having an industrial-size freezer in your house. For all the shows in Someone's Favorite Productions Podcast Network, head here: https://www.someonesfavoriteproductions.com/.

Joe Bartel, a fantasy football expert at Rotowire, joined Sports Talk. Bartel evaluated the Jets' passing attack without Garrett Wilson. Bartel also discussed Saquon Barkley's slow start, the Buccaneers' passing attack, and Derrick Henry's projection for the second half of the season.

Steve and Charlie interviewed Jake Madison, the host of the "Locked On Pelicans" podcast, and Joe Bartel, a fantasy football expert at Rotowire. Madison recapped the Pelicans' trip to Australia and the team's early practice sessions. Madison also shared his thoughts on Jordan Poole, the Pelicans' preseason matchup against the Houston Rockets, and New Orleans' roster depth. Bartel discussed Saquon Barkley's slow start, the Buccaneers' passing game, and Derrick Henry's second-half projection.

Joe Bartel, a fantasy football expert at Rotowire, joined Sports Talk. Bartel recapped the fantasy battle between Jaxon Smith-Njigba and Emeka Egbuka in week five. He questioned the fantasy value of Eagles WR AJ Brown and discussed the week six waiver wire.

Jeff and Charlie spoke to a WWL listener about Saints LB Pete Werner. Joe Bartel, a fantasy football expert at Rotowire, joined Sports Talk. Bartel recapped the fantasy battle between Jaxon Smith-Njigba and Emeka Egbuka in week five. He questioned the fantasy value of Eagles WR AJ Brown and discussed the week six waiver wire. Jeff and Charlie discussed Cardinals RB Emari Demercado's ridiculous fumble against the Titans, the Buccaneers' early-season luck, and the Saints' "red flags."

In this conversation, Will leads us through the available research on the effectiveness of predator bounty programs.   Our lab is primarily funded by donations. If you would like to help support our work, please donate here: http://UFgive.to/UFGameLab   Resources:   Ditchkoff, S. S., et al. (2017). Effectiveness of a bounty program for reducing wild pig densities. Wildlife Society Bulletin, 41(3), 548-555.   Bartel, R. A., & Brunson, M. W. (2003). Effects of Utah's coyote bounty program on harvester behavior. Wildlife Society Bulletin, 736-743.   Gosling, L. M., & Baker, S. J. (1989). The eradication of muskrats and coypus from Britain. Biological Journal of the Linnean Society, 38(1), 39-51.   Lelli, B., et al. (2009). Seal bounties in Maine and Massachusetts, 1888 to 1962. Northeastern Naturalist, 16(2), 239-254.   We've launched a comprehensive online wild turkey course featuring experts across multiple institutions that specialize in habitat management and population management for wild turkeys. Earn up to 20.5 CFE hours! Enroll Now!    Dr. Marcus Lashley @DrDisturbance, Publications Dr. Will Gulsby @dr_will_gulsby, Publications Turkeys for Tomorrow @turkeysfortomorrow  UF Game Lab @ufgamelab, YouTube   Donate to our wild turkey research: UF Turkey Donation Fund , Auburn Turkey Donation Fund    Want to help wild turkey conservation? Please take our quick survey to take part in our research!   Do you have a topic you'd like us to cover? Leave us a review or send us an email at wildturkeyscience@gmail.com!   Watch these podcasts on YouTube   Please help us by taking our (quick) listener survey - Thank you!    Check out the DrDisturbance YouTube channel! DrDisturbance YouTube   Want to help support the podcast? Our friends at Grounded Brand have an option to donate directly to Wild Turkey Science at checkout. Thank you in advance for your support!   Leave a podcast rating for a chance to win free gear!   This podcast is made possible by Turkeys for Tomorrow, a grassroots organization dedicated to the wild turkey. To learn more about TFT, go to turkeysfortomorrow.org.    Music by Artlist.io Produced & edited by Charlotte Nowak  

Steve and Charlie discussed the Saints' upcoming matchup against the Giants and gave an update on the first round of the 2025 MLB Postseason. The guys listened to Saints RB Kendre Miller's press conference audio about his "next game" mentality, relationship with Alvin Kamara, and impression of Spencer Rattler. Joe Bartel, a fantasy football expert at Rotowire, joined Sports Talk. Bartel shared his thoughts on Texans rookie RB Woody Marks, the Saints' running back room, and Cowboys WR George Pickens.

Joe Bartel, a fantasy football expert at Rotowire, joined Sports Talk. Bartel shared his thoughts on Texans rookie RB Woody Marks, the Saints' running back room, and Cowboys WR George Pickens.

Steve and Charlie listened to Pelicans head coach Willie Green's comments at the team's annual Media Day. Joe Bartel, a fantasy football expert at Rotowire, joined Sports Talk. Bartel broke down the week four waiver wire. Bartel also shared his thoughts on the NFL's rookie RB class and Jaxson Dart.

Joe Bartel, a fantasy football expert at Rotowire, joined Sports Talk. Bartel broke down the week four waiver wire. Bartel also shared his thoughts on the NFL's rookie RB class and Jaxson Dart.

Zum Fressen gern. Mit: Barbara Falter (Margret Sawney), Michael von Burg (John Pearce), Jeanne Devos (Janet) Tontechnik: Björn Müller Regie: Simone Karpf Produktion: SRF 2021 Dauer: 11:49

Trade season is heating up and the Wide World of Sports team went through all the big names being talked about right now. See omnystudio.com/listener for privacy information.

In this episode of the Greater Than Podcast, host Elijah Murrell sits down with former pastor Blaine Bartel, who opens up about living a double life—preaching on stage while hiding a 23-year secret addiction. Blaine shares the shocking moment when God exposed his sin, what he calls “God's terrifying grace,” and how that exposure led to true freedom and a resurrected life.He explains the difference between recovery and resurrection, why community is essential in breaking free, and how embracing consequences can lead to lasting transformation. Blaine also discusses his work with the House of Resurrection, where he now helps others find the same hope, healing, and purpose he discovered through Christ.

Uh oh! The gang is back talking all things Paul Bartel on another episode of BARTEL ME SOMETHING GOOD and this time not only are we yacking about 1976's HOLLYWOOD BOULEVARD, the made-for-a-bet directing debut of both Joe Dante AND Alan Arkush (and featuring Paul Bartel, Dick Miller and Mary Woronov among many other familiar faces), but we also start with a very special episode of Alfred Hitchcock Presents from 1985 directed by Tim Burton(!), featuring music by Danny Elfman(!) and starring Griffin Dunne, Laraine Newman and - wait for it - Paul Bartel as a pretentious art critic. It's even.. uh.. sort of an adaptation of a Ray Bradbury story. All that and so much more, so enjoy! The post Episode 290 – Bartel Me Something Good – Hollywood Boulevard (1976) first appeared on Cinema Smorgasbord.

Schimmeck, Tom www.deutschlandfunk.de, Andruck - Das Magazin für Politische Literatur

Kayla Bartel is the founder of Humanity HR Consulting, who helps small and medium businesses create positive workplaces by providing fractional HR services and leadership development.Through her company's comprehensive approach to human resources, Kayla guides leaders to understand diverse perspectives in their workforce and harness these differences as strengths, offering everything from ongoing HR support to leadership retreats.Now, Kayla's journey as a single mom building a successful business demonstrates how entrepreneurship can provide the flexibility and freedom to work on your own terms.And while balancing life as a newlywed with two teenagers, she's working toward her goal of transitioning client work to her team of employees and contractors while continuing to grow her business that generates $55,000-90,000 monthly.Here's where to find more:www.humanityhr.comIG @humanityhrconsultingFB Humanity HR ConsultingLinkedIn https://www.linkedin.com/in/kayla-bartel-0429a353?utm_source=s…___________________________________________________________Welcome to The Unforget Yourself Show where we use the power of woo and the proof of science to help you identify your blind spots, and get over your own bullshit so that you can do the fucking thing you ACTUALLY want to do!We're Mark and Katie, the founders of Unforget Yourself and the creators of the Unforget Yourself System and on this podcast, we're here to share REAL conversations about what goes on inside the heart and minds of those brave and crazy enough to start their own business. From the accidental entrepreneur to the laser-focused CEO, we find out how they got to where they are today, not by hearing the go-to story of their success, but talking about how we all have our own BS to deal with and it's through facing ourselves that we find a way to do the fucking thing.Along the way, we hope to show you that YOU are the most important asset in your business (and your life - duh!). Being a business owner is tough! With vulnerability and humor, we get to the real story behind their success and show you that you're not alone._____________________Find all our links to all the things like the socials, how to work with us and how to apply to be on the podcast here: https://linktr.ee/unforgetyourself

Y'all, when you've been in this industry as long as I have, you can feel the big shifts coming. But even I wasn't prepared for the Pilates explosion we're witnessing right now. It's unlike anything we've seen before, and if you're not paying attention, you're missing the boat on the biggest opportunity in boutique fitness. Tune in to our new series of conversations with amazing industry leaders: Episode 663: The Pilates Explosion - Global Growth with STOTT Pilates' Beth Gibbs-Bartel. ● Education empire: STOTT Pilates has trained 80,000+ instructors across 100 countries with unmatched anatomical focus ● Asia domination: unprecedented growth in China, Middle East, and APAC regions driving global expansion ● Reformer revolution: studios shifting from 6-machine comprehensive setups to 20+ reformer-only concepts ● Know your limits: instructors finding their sweet spot for class sizes (hint: it's probably around 16 max) ● Chair emergence: stability chair group classes becoming the next big trend, especially in innovative markets like Australia ● Silver surge: aging population will drive return to privates and semi-privates as boomers seek personalized attention ● Social media catalyst: TikTok trends directly correlating to studio boom 3-6 months later ● Content creation: new facilities incorporating influencer and content spaces into studio design Whether you're thinking about adding Pilates to your offerings or you're already in the space, Beth's insights on global trends, equipment evolution, and the future of Pilates education will help you ride this wave instead of getting swept away by it. And meet Beth (who's about to take her own company's certification!), after you hear from her in Episode 663. Catch you there, Lise PS: Join 2,000+ studio owners who've decided to take control of their studio business and build their freedom empire. Subscribe HERE and join the party! www.studiogrow.co www.linkedin.com/company/studio-growco/

With markets reacting to global uncertainty and AI transforming the hiring landscape, both job seekers and recruiters are recalibrating their strategies. Join host James Mackey and Steve Bartel, CEO of Gem, as they discuss how automation is changing resume screening, interview prep, and rediscovery of existing talent. As companies look to cut costs and boost efficiency, the challenge becomes clear: how do you hire smarter without losing the human signal in all the noise? Thank you to our sponsor, SecureVision, for making this show possible! Our host James Mackey Follow us:https://www.linkedin.com/company/82436841/#1 Rated Embedded Recruitment Firm on G2!https://www.g2.com/products/securevision/reviewsThanks for listening!

After a lengthy break, your favorite Bartel-casting comrades return with BARTEL ME SOMETHING GOOD, featuring the second episode of the Steven Spielberg-produced anthology series AMAZING STORIES directed by Paul Bartel, as well as the 1988 slasher comedy OUT OF THE DARK, produced by Bartel and featuring a wild cast including Karen Black, Bud Cort, Geoffrey Lewis, Tracey Walter, Divine, Tab Hunter and - of course - Paul Bartel! It's a packed episode, so check it out! The post Episode 275 – Bartel Me Something Good – Out of the Dark (1988) & Amazing Stories “Gershwin's Trunk” first appeared on Cinema Smorgasbord.

SummaryIn this conversation, Chris Butler and Lon Bartel discuss the critical intersection of human performance research and law enforcement training. They explore the importance of understanding the time it takes for officers to stop shooting in high-stress situations. The conversation includes the critical human factors involved in the stop-shooting process. Bartel shares insights from his research, highlighting the need for training methodologies and analysis of officer involved use of force events to evolve based on empirical findings. The discussion emphasizes the necessity of bridging the gap between academic research and practical application in law enforcement, ultimately aiming to enhance officer safety and public trust.Takeaways• Understanding the time it takes to stop a shooting response is crucial for ensuring fair and neutral investigations take place.• The psychological refractory period affects decision-making in high-stress situations and can slow down decision making.• The ‘Flankers Effect' demonstrates how attention can be diverted in critical moments when important decisions need to be made.• Training methodologies in law enforcement need to evolve based on research findings.• Real-world conditions differ significantly from controlled lab settings. Lab research is helpful but should not be transferred directly to operational incident analysis.• The study found an average of two additional shots fired after a stop signal.• Future research should focus on realistic threat scenarios for better training outcomes.For more information about the research or the amazing technology and research by Virtra, contact Lon Bartel at lbartel@virtra.com

A conversation with Rosie BartelNurturing the patient-physician partnership is the only way to heal healthcare.Sharing her lived experience with openness and honesty is Rosie Bartel, a patient advocate and survivor of preventable medical error. Since contracting MRSA after a routine knee replacement surgery, Rosie has channelled a hugely difficult and prolonged healthcare experience into a mission for systemic change.As she states, patient safety is a bipartisan issue, and we must ensure continued collaboration and communication between physicians, policymakers, executives and most importantly, patients themselves.——We spoke about Rosie's journey, why she believes patient advocacy is so important, the importance of breaking down silos that prevent communication, how patients can become their own advocates, and her solutions for developing relationships in healthcare that are rooted in trust.Follow me on Instagram and Facebook @ericfethkemd and checkout my website at www.EricFethkeMD.com. My brand new book, The Privilege of Caring, is out now on Amazon! https://www.amazon.com/dp/B0CP6H6QN4