Podcasts about BMS

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Best podcasts about BMS

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Latest podcast episodes about BMS

A Boy Named Pseu
QPOL 005 Read Along - Davos Is Losing - The SUM Report 1-22 | QPOL Issue #33

A Boy Named Pseu

Play Episode Listen Later Jan 23, 2023 24:34


A Read Along to my substack article Davos Is Losing - The SUM Report 1-22 | QPOL Issue #33 Follow my work on Substack and Twitter @MrPseu. Check out the BitBox02 Hardware Wallet Go to https://shiftcrypto.ch/bitcoinmadesimple and use the promo code "bitcoinmadesimple" to get 5% off standard products. Movies Plus - go to www.myMoviesPlus.com and get 20% OFF an annual subscription with promo code CORY, and you can watch "Hard Money with Natalie Brunell" and the documentaries "The Great Reset and the Rise of Bitcoin", "Bitcoin FUD", "Bitcoin: The End of Money as We Know It", and "Cryptopia: Bitcoin, Blockchains and the Future of the Internet."   Watch them all on Movies Plus. Bitcoin Day www.bitcoinday.io use promo code BMS to get a discount on your tickets to a Bitcoin Day event near you.

Bitcoin Made Simple Podcast
QPOL 005 Read Along - Davos Is Losing - The SUM Report 1-22 | QPOL Issue #33

Bitcoin Made Simple Podcast

Play Episode Listen Later Jan 23, 2023 25:57


A Read Along to my substack article Davos Is Losing - The SUM Report 1-22 | QPOL Issue #33 Follow my work on Substack and Twitter @MrPseu. Check out the BitBox02 Hardware Wallet Go to https://shiftcrypto.ch/bitcoinmadesimple and use the promo code "bitcoinmadesimple" to get 5% off standard products. Movies Plus - go to www.myMoviesPlus.com and get 20% OFF an annual subscription with promo code CORY, and you can watch "Hard Money with Natalie Brunell" and the documentaries "The Great Reset and the Rise of Bitcoin", "Bitcoin FUD", "Bitcoin: The End of Money as We Know It", and "Cryptopia: Bitcoin, Blockchains and the Future of the Internet." Watch them all on Movies Plus. Bitcoin Day www.bitcoinday.io use promo code BMS to get a discount on your tickets to a Bitcoin Day event near you. --- Support this podcast: https://anchor.fm/bitcoinmadesimple/support

Bob Murphy Show
Ep. 258 Responding to the Dave Smith/Curtis Yarvin Discussion on Libertarianism, Part 1

Bob Murphy Show

Play Episode Listen Later Jan 19, 2023 57:27


Bob addresses Curtis Yarvin's claim that free trade policy has hurt America, and that libertarians don't have a good response to it.Mentioned in the Episode and Other Links of Interest:The Michael Malice episode featuring Yarvin vs. Smith.FRED charts showing manufacturing employment, index of total manufacturing production, components of manufacturing, and domestic auto production.A previous BMS episode that critiqued Yarvin.A Yarvin post that Bob liked.Bob's warning about free traders going too far.Bob explains the social function of call and put options.Help support the Bob Murphy Show.The audio production for this episode was provided by Podsworth Media.

Bitcoin Made Simple Podcast
QPOL 004 Read Along - Coping For The Trees

Bitcoin Made Simple Podcast

Play Episode Listen Later Jan 19, 2023 15:01


A Boy Named Pseu
QPOL 004 Read Along - Coping For The Trees

A Boy Named Pseu

Play Episode Listen Later Jan 19, 2023 13:39


A Read Along to my substack article - Reality Distortions - The SUM Report 1-13 | QPOL Issue #32 Follow my work on Substack and Twitter @MrPseu. Check out the BitBox02 Hardware Wallet Go to https://shiftcrypto.ch/bitcoinmadesimple and use the promo code "bitcoinmadesimple" to get 5% off standard products. Movies Plus - go to www.myMoviesPlus.com and get 20% OFF an annual subscription with promo code CORY, and you can watch "Hard Money with Natalie Brunell" and the documentaries "The Great Reset and the Rise of Bitcoin", "Bitcoin FUD", "Bitcoin: The End of Money as We Know It", and "Cryptopia: Bitcoin, Blockchains and the Future of the Internet."   Watch them all on Movies Plus. Bitcoin Day www.bitcoinday.io use promo code BMS to get a discount on your tickets to a Bitcoin Day event near you.  

Bitcoin Made Simple Podcast
BMS 085 - Bitcoin Price Pump, Mining Off Your Own Gas?

Bitcoin Made Simple Podcast

Play Episode Listen Later Jan 18, 2023 31:32


Cory talks about the recent Bitcoin price pump, using natural gas to mine Bitcoin, recognizing whats a pot hole and whats a rabbit hole, Movies Plus stuff and more. Check out the BitBox02 Hardware Wallet Go to https://shiftcrypto.ch/bitcoinmadesimple and use the promo code "bitcoinmadesimple" to get 5% off standard products. Movies Plus - go to www.myMoviesPlus.com and get 20% OFF an annual subscription with promo code CORY, and you can watch "Hard Money with Natalie Brunell" and the documentaries "The Great Reset and the Rise of Bitcoin", "Bitcoin FUD", "Bitcoin: The End of Money as We Know It", and "Cryptopia: Bitcoin, Blockchains and the Future of the Internet." Watch them all on Movies Plus. Bitcoin Day www.bitcoinday.io use promo code BMS to get a discount on your tickets to a Bitcoin Day event near you. --- Support this podcast: https://anchor.fm/bitcoinmadesimple/support

Bitcoin Made Simple Podcast
QPOL 004 Read Along - Reality Distortions - The SUM Report 1-13 | QPOL Issue #31

Bitcoin Made Simple Podcast

Play Episode Listen Later Jan 17, 2023 20:58


A Read Along to my substack article - Reality Distortions - The SUM Report 1-13 | QPOL Issue #32 Follow my work on Substack and Twitter @MrPseu. Check out the BitBox02 Hardware Wallet Go to https://shiftcrypto.ch/bitcoinmadesimple and use the promo code "bitcoinmadesimple" to get 5% off standard products. Movies Plus - go to www.myMoviesPlus.com and get 20% OFF an annual subscription with promo code CORY, and you can watch "Hard Money with Natalie Brunell" and the documentaries "The Great Reset and the Rise of Bitcoin", "Bitcoin FUD", "Bitcoin: The End of Money as We Know It", and "Cryptopia: Bitcoin, Blockchains and the Future of the Internet." Watch them all on Movies Plus. Bitcoin Day www.bitcoinday.io use promo code BMS to get a discount on your tickets to a Bitcoin Day event near you. --- Support this podcast: https://anchor.fm/bitcoinmadesimple/support

A Boy Named Pseu
QPOL 004 Read Along - Reality Distortions - The SUM Report 1-13 | QPOL Issue #32

A Boy Named Pseu

Play Episode Listen Later Jan 17, 2023 19:36


A Read Along to my substack article - Reality Distortions - The SUM Report 1-13 | QPOL Issue #32 Follow my work on Substack and Twitter @MrPseu. Check out the BitBox02 Hardware Wallet Go to https://shiftcrypto.ch/bitcoinmadesimple and use the promo code "bitcoinmadesimple" to get 5% off standard products. Movies Plus - go to www.myMoviesPlus.com and get 20% OFF an annual subscription with promo code CORY, and you can watch "Hard Money with Natalie Brunell" and the documentaries "The Great Reset and the Rise of Bitcoin", "Bitcoin FUD", "Bitcoin: The End of Money as We Know It", and "Cryptopia: Bitcoin, Blockchains and the Future of the Internet."   Watch them all on Movies Plus. Bitcoin Day www.bitcoinday.io use promo code BMS to get a discount on your tickets to a Bitcoin Day event near you.  

Bitcoin Made Simple Podcast
BMS 084 - I don't care that you don't like Bitcoin.

Bitcoin Made Simple Podcast

Play Episode Listen Later Jan 11, 2023 33:38


Cory talks about a handful of things, but rants about how he doesn't care if you don't like Bitcoin. To all the Bitcoin detractors, he doesn't care what your opinion of it is, he doesn't care that you think it will fail, because he knows you're wrong. Check out the BitBox02 Hardware Wallet Go to https://shiftcrypto.ch/bitcoinmadesimple and use the promo code "bitcoinmadesimple" to get 5% off standard products. Movies Plus - go to www.myMoviesPlus.com and get 20% OFF an annual subscription with promo code CORY, and you can watch "Hard Money with Natalie Brunell" and the documentaries "The Great Reset and the Rise of Bitcoin", "Bitcoin FUD", "Bitcoin: The End of Money as We Know It", and "Cryptopia: Bitcoin, Blockchains and the Future of the Internet." Watch them all on Movies Plus. Bitcoin Day www.bitcoinday.io use promo code BMS to get a discount on your tickets to a Bitcoin Day event near you. --- Support this podcast: https://anchor.fm/bitcoinmadesimple/support

Agency Intelligence
Digital Insurance Pint: Sam “the BMS” Man

Agency Intelligence

Play Episode Listen Later Jan 8, 2023 43:57


Sam Jazayeri is the Producer Team Lead at PrimeService Insurance. Over the past few years, the brokerage has been focused on getting digitized and changing its BMS to drive their business forward and Sam has played a major role in this transformation.  Yep, we know that calling him Sam “the BMS” Man is corny (you can blame Jeff for that one), but it definitely fits. Sam is taking what he's learned from PrimeService's journey and using it to help other brokers through webinars and chats with folks like Tom, Jeff, Steve, and Adam. Brokers helping brokers is something we can definitely get behind! Changing BMSes is a lot of work and expensive. Tom calls it a traumatic experience … and he's not wrong! Sam discusses some of his learnings along with the challenges and benefits PrimeService has seen. He shares advice for any other brokerages considering going down this path and stresses the importance of defining what you want to achieve. Knowing what you're chasing and what you're trying to fix is vital. Pour yourself a pint, hit play, and listen to what Sam “the BMS” Man has to say. Resources: Tom Reid Jeff Roy Steve Earle Adam Mitchell Digital Insurance Pint Podcast

Bitcoin Made Simple Podcast
QPOL 003 Read Along - New Year, New Doom-Porn, Same Hawkish Fed | QPOL Issue #31

Bitcoin Made Simple Podcast

Play Episode Listen Later Jan 7, 2023 23:11


A Read Along to my substack article - New Year, New Doom-Porn, Same Hawkish Fed | QPOL Issue #31 Follow my work on Substack and Twitter @MrPseu. Check out the BitBox02 Hardware Wallet Go to https://shiftcrypto.ch/bitcoinmadesimple and use the promo code "bitcoinmadesimple" to get 5% off standard products. Movies Plus - go to www.myMoviesPlus.com and get 20% OFF an annual subscription with promo code CORY, and you can watch "Hard Money with Natalie Brunell" and the documentaries "The Great Reset and the Rise of Bitcoin", "Bitcoin FUD", "Bitcoin: The End of Money as We Know It", and "Cryptopia: Bitcoin, Blockchains and the Future of the Internet." Watch them all on Movies Plus. Bitcoin Day www.bitcoinday.io use promo code BMS to get a discount on your tickets to a Bitcoin Day event near you. --- Support this podcast: https://anchor.fm/bitcoinmadesimple/support

Brian Mørk Show
Brian Mørk Show #454: Best of BMS 2022 del 2

Brian Mørk Show

Play Episode Listen Later Jan 6, 2023 62:03


Vinderen er fundet. Vi ved nu hvilke afsnit af BMS der har været årets 10 mest populære og der er både overraskelser og åbenlysheder. Vi slutter med afsnit 5-1 og vi lyttes forhåbentligt videre i ’23!

La Minute Rhumato
Sélection de trois articles marquants dans les maladies auto-immunes systémiques

La Minute Rhumato

Play Episode Listen Later Jan 5, 2023 6:27


Quelle est l'importance de la prise en charge des maladies auto-immunes systémiques par les rhumatologues ? Quel article portant sur le lupus systémique a marqué l'année 2022 ? Quel article portant sur le syndrome de Sjögren a marqué 2022 ? Quel article portant sur la sclérodermie a marqué 2022 ? Quelle conclusion apporter sur ces trois articles ? Le Pr Xavier Mariette, rhumatologue dans le service de Rhumatologie à l'hôpital du Kremlin-Bicêtre (Université Paris Saclay), et médecin coordonnateur du Centre National de Référence des Maladies Auto-Immunes Systémiques Rares constitutif pour le syndrome de Sjögren, répond à vos questions.   Invité : Pr Xavier Mariette – Hôpital Bicêtre – Le Kremlin-Bicêtre https://www.aphp.fr/service/service-04-010  https://maladiesrares-paris-saclay.aphp.fr/centre-de-reference-des-maladies-auto-immunes-systemiques-rares/  Le Pr Mariette déclare des liens d'intérêts avec les laboratoires Astra Zenaca, BMS, Galapagos, GSK Novartis, Pfizer. L'équipe :
 Comité scientifique : Pr Jérémie Sellam, Pr Thao Pham, Dr Catherine Beauvais, Dr Véronique Gaud-Listrat, Dr Céline Vidal, Dr Sophie Hecquet Animation :  Pyramidale Communication Production : Pyramidale Communication Soutien institutionnel : Pfizer Crédits : Pyramidale Communication, Sonacom   Articles cités : 1. Vital EM, Merrill JT, Morand EF, Furie RA, Bruce IN, Tanaka Y, Manzi S, Kalunian KC, Kalyani RN, Streicher K, Abreu G, Tummala R. Anifrolumab efficacy and safety by type I interferon gene signature and clinical subgroups in patients with SLE: post hoc analysis of pooled data from two phase III trials. Ann Rheum Dis. 2022 Jul;81(7):951-961. doi: 10.1136/annrheumdis-2021-221425. Epub 2022 Mar 25. PMID: 35338035; PMCID: PMC9213795. 2. Mariette X, Barone F, Baldini C, Bootsma H, Clark KL, De Vita S, Gardner DH, Henderson RB, Herdman M, Lerang K, Mistry P, Punwaney R, Seror R, Stone J, van Daele P, van Maurik A, Wisniacki N, Roth DA, Tak PP. A randomized, phase II study of sequential belimumab and rituximab in primary Sjögren's syndrome. JCI Insight. 2022 Dec 8;7(23):e163030. doi: 10.1172/jci.insight.163030. PMID: 36477362. 3. Maher TM, Tudor VA, Saunders P, Gibbons MA, Fletcher SV, Denton CP, Hoyles RK, Parfrey H, Renzoni EA, Kokosi M, Wells AU, Ashby D, Szigeti M, Molyneaux PL; RECITAL Investigators. Rituximab versus intravenous cyclophosphamide in patients with connective tissue disease-associated interstitial lung disease in the UK (RECITAL): a double-blind, double-dummy, randomised, controlled, phase 2b trial. Lancet Respir Med. 2022 Nov 11:S2213-2600(22)00359-9. doi: 10.1016/S2213-2600(22)00359-9. Epub ahead of print. PMID: 36375479

Bitcoin Made Simple Podcast
BMS 083 - 2022 Year In Review/Self Custody/Sick for the holidays

Bitcoin Made Simple Podcast

Play Episode Listen Later Jan 2, 2023 28:44


Cory talks about 2022 kicking him in the groin, importance of self custody, and whats going on at Movies Plus. Check out the BitBox02 Hardware Wallet Go to https://shiftcrypto.ch/bitcoinmadesimple and use the promo code "bitcoinmadesimple" to get 5% off standard products. Movies Plus - go to www.myMoviesPlus.com and get 20% OFF an annual subscription with promo code CORY, and you can watch "Hard Money with Natalie Brunell" and the documentaries "The Great Reset and the Rise of Bitcoin", "Bitcoin FUD", "Bitcoin: The End of Money as We Know It", and "Cryptopia: Bitcoin, Blockchains and the Future of the Internet." Watch them all on Movies Plus. Bitcoin Day www.bitcoinday.io use promo code BMS to get a discount on your tickets to a Bitcoin Day event near you. --- Support this podcast: https://anchor.fm/bitcoinmadesimple/support

Between the Biotech Waves
A Between the Biotech Waves Conversation with Jeremy Levin, Chair & CEO of Ovid Therapeutics

Between the Biotech Waves

Play Episode Listen Later Jan 1, 2023 71:32


Today we are talking to Jeremy Levin. Jeremy is chairman and CEO of Ovid Therapeutics, focused on rare and orphan disease of the CNS. He is the immediate past chair of BIO. Jeremy has a storied career in biotech having served as president and CEO of Teva Pharmaceutica's, a member of the exec committee of BMS where he had global responsibilities for strategy, alliances and transactions. There he devised the “String of Pearls” BD strategy which led to the acquisition of Medarex and opened the path to the successful development of the first i-onc drugs. Prior to BMS Jeremy was head of global BD and strategic alliances at Novartis. In his spare time, amazing he has any, he runs a successful Black Angus farm from which, as I understand it, many biotech CEOs get their steaks!

Brian Mørk Show
Brian Mørk Show #452: Best of BMS 2022 del1.

Brian Mørk Show

Play Episode Listen Later Dec 30, 2022 54:29


2022′s dage er talte og det gælder også Brian Mørk Show lytternes stemmer. Vi ved nu hvilke afsnit af BMS der har været årets 10 mest populære og der er både overraskelser og åbenlysheder. Vi starter med afsnit 10-6 og godt nytår. Vi ses i 2023!

DipShips: The ”Legitimate” Boating Podcast
DipShips - EP 60: Happy Holidays from 4Kids

DipShips: The ”Legitimate” Boating Podcast

Play Episode Listen Later Dec 24, 2022 100:03


Welcome to DipShips, the "Legitimate" Boating Podcast! On this festive episode, the crew talks about the joys of BMs, The Glizzard, the trials of Duk, and answering a cavalcade of Christmas questions! Also RIP Christmas Boat, gone but not forgotten. | DipShips is a totally Legitimate Boating Podcast hosted by some friends who love to talk facts about boats after retelling the events of their weeks, sharing a few stories, and answering some questions. | If you wanna support us, check us out on Patreon! https://www.patreon.com/m/DipShipsPod | Have any questions for us, or topics to talk about? Send them to Questions@DipShips.Boats | Check out our podbean for more links: https://dipships.podbean.com/ | Follow us on TikTok: https://www.tiktok.com/@dipshipspod | Follow us on Twitter: https://twitter.com/DipShipsPod Carl: https://twitter.com/TheCalamityCarl PM: https://twitter.com/GFPPM Metty: https://twitter.com/MettaurMan Nick: https://twitter.com/Ekko_Fetish Edited by Mischa: https://twitter.com/themischer Intro and additional music by Vidazen: https://twitter.com/_VidaZen_ Logo by ShibuyaGato: https://twitter.com/shibuyagato Art assets by Shorah: https://twitter.com/Shorah_Art 

Bitcoin Made Simple Podcast
QPOL 002 - The Fourth Annual Rollo McFloogle Christmas Special

Bitcoin Made Simple Podcast

Play Episode Listen Later Dec 22, 2022 72:51


If you know, you know. If you don't, STFU and listen. Merry Christmas. Follow my work on Substack and Twitter @MrPseu. Check out the BitBox02 Hardware Wallet Go to https://shiftcrypto.ch/bitcoinmadesimple and use the promo code "bitcoinmadesimple" to get 5% off standard products. Movies Plus - go to www.myMoviesPlus.com and get 20% OFF an annual subscription with promo code CORY, and you can watch "Hard Money with Natalie Brunell" and the documentaries "The Great Reset and the Rise of Bitcoin", "Bitcoin FUD", "Bitcoin: The End of Money as We Know It", and "Cryptopia: Bitcoin, Blockchains and the Future of the Internet." Watch them all on Movies Plus. Bitcoin Day www.bitcoinday.io use promo code BMS to get a discount on your tickets to a Bitcoin Day event near you. --- Support this podcast: https://anchor.fm/bitcoinmadesimple/support

A Boy Named Pseu
QPOL - 001 - Tom Luongo on the Counter Revolution

A Boy Named Pseu

Play Episode Listen Later Dec 22, 2022 108:09


Follow my work on Substack and Twitter @MrPseu. Tom Luongo joins me to discuss: - The Fed's "pivot" - Meloni exposing French Mercantilism - SBF/FTX conspiracy - who's really behind Tether - winning the cultural revolution Check out the BitBox02 Hardware Wallet Go to https://shiftcrypto.ch/bitcoinmadesimple and use the promo code "bitcoinmadesimple" to get 5% off standard products. Movies Plus - go to www.myMoviesPlus.com and get 20% OFF an annual subscription with promo code CORY, and you can watch "Hard Money with Natalie Brunell" and the documentaries "The Great Reset and the Rise of Bitcoin", "Bitcoin FUD", "Bitcoin: The End of Money as We Know It", and "Cryptopia: Bitcoin, Blockchains and the Future of the Internet."   Watch them all on Movies Plus. Bitcoin Day www.bitcoinday.io use promo code BMS to get a discount on your tickets to a Bitcoin Day event near you.

The MM+M Podcast
HLTH 2022 Takeouts: BMS's Dr. Nivee Amin

The MM+M Podcast

Play Episode Listen Later Dec 21, 2022 13:03


In this mini episode of the podcast, Jack O'Brien speaks with BMS's Dr. Nivee Amin, cardiologist and senior director/lead for its cardiovascular digital health team, about how BMS engaged with the startup community via a Cardio Innovation Challenge at HLTH in Las Vegas, the value of focusing on medically underserved communities, and the “science fiction” of layering innovations like AI to supercharge existing diagnostic, treatment and monitoring technologies. Follow us on twitter: @MMMnews www.mmm-online.com

Bitcoin Made Simple Podcast
BMS 082 - Was buying a Bitcoin Miner my Biggest Mistake of 2022?

Bitcoin Made Simple Podcast

Play Episode Listen Later Dec 21, 2022 36:29


Cory wonders if buying a Bitcoin Miner was his biggest mistake of 2022? Also discusses how early we are, and whats going on at Movies Plus. Check out the BitBox02 Hardware Wallet Go to https://shiftcrypto.ch/bitcoinmadesimple and use the promo code "bitcoinmadesimple" to get 5% off standard products. Movies Plus - go to www.myMoviesPlus.com and get 20% OFF an annual subscription with promo code CORY, and you can watch "Hard Money with Natalie Brunell" and the documentaries "The Great Reset and the Rise of Bitcoin", "Bitcoin FUD", "Bitcoin: The End of Money as We Know It", and "Cryptopia: Bitcoin, Blockchains and the Future of the Internet." Watch them all on Movies Plus. Bitcoin Day www.bitcoinday.io use promo code BMS to get a discount on your tickets to a Bitcoin Day event near you. --- Support this podcast: https://anchor.fm/bitcoinmadesimple/support

The Big Bid Theory
Air Purification Solutions Are a Breath of Fresh Air

The Big Bid Theory

Play Episode Listen Later Dec 21, 2022 33:03


Ending Season 8 with a bang and a deep breath. We wrap up the season by visiting with Aaron Aylsworth, SDVOSB, to learn about options available to businesses, agencies, education, etc., looking to ensure safe, clean air within their facilities. Aylsworth shares his important insights on the problems and what air purification systems provide. Spoiler alert: it's more than just protection from COVID. With so much interest from public sector entities in air quality and air purification products, solutions, and service, this is a busy industry for you to watch closely.Aaron goes on to reveal other solutions important to many across the private and public sectors, to include utmost important options to address and improve school safety. Do not miss it.Aylsworth wraps up the conversation by relaying the story on how his original business was able to pivot in response to the global pandemic that forced so many businesses to quickly adapt. Truly, this is a story of overcoming challenges and hardship.Rick Jennings shares a Crazy Bids that will have all of us looking forward to what's to come in Season 9.All of that and more. A lot more!Our Guest: Mr. Aaron Aylsworth, SDVOSBPure Air Solutions of PAMOPP ZeroBio from guest: “I served in the Air Force from 2010-2016 as a hydraulics mechanic on F-16s and A-10s. After the Air Force, I joined my father and mother inlaw's company, Advanced Floor Care. We cleaned carpet, ceramic tile, and upholstery in the hospitality industry and serviced over 50 hotels across several states. At the start of 2020, we were opening our first two franchises, and two weeks before they opened, Covid 19 hit. Advanced Floor Care then pivoted the business to find an answer for hotels to reopen and service their guests. In our search, we discovered a way to offer all commercial facilities, air purification, energy monitoring, air quality monitoring, and security monitoring. From there, I opened MOPP Zero (a disabled veteran-owned business), and my inlaws opened Pure Air Solutions of PA (a woman and Native American-owned business), offering the answer to Covid 19 and facility maintenance.”Pure Air Solutions of PA: https://pureairofpa.com/H.R.7671 - Airborne Act: https://www.congress.gov/bill/117th-congress/house-bill/7671?s=1&r=36

ASCO Guidelines Podcast Series
Therapy for Stage IV NSCLC Without Driver Alterations: ASCO Living Guideline Update 2022.2 Part 1

ASCO Guidelines Podcast Series

Play Episode Listen Later Dec 19, 2022 7:53


Dr. Dwight Owen presents the first update to the ASCO living guideline on stage IV NSCLC without driver alterations. He reviews the new evidence identified by the panel along with the updated recommendation regarding the role of bevacizumab in pemetrexed maintenance therapy. Dr. Owen also discusses exciting trials the panel is looking forward to seeing results of to drive future updates to the living guidelines. Read the update, “Therapy for Stage IV Non–Small-Cell Lung Cancer Without Driver Alterations: ASCO Living Guideline, Version 2022.2“ and view all recommendations at www.asco.org/living-guidelines. Listen to Part 2 for recommendations for patients with stage IV NSCLC with driver alterations. TRANSCRIPT Brittany Harvey: Hello, and welcome to the ASCO Guidelines podcast series, brought to you by the ASCO Podcast Network; a collection of nine programs covering a range of educational and scientific content and offering enriching insight into the world of cancer care. You can find all the shows, including this one, at: asco.org/podcasts. My name is Brittany Harvey, and today I'm interviewing Dr. Dwight Owen, from Ohio State University in Columbus, Ohio, lead author on, 'Therapy for Stage IV Non-Small-Cell Lung Cancer Without Driver Alterations: ASCO Living Guideline, version 2022.2.' Thank you for being here, Dr. Owen. Dr. Dwight Owen: Thanks very much, Brittany, for having me. Brittany Harvey: First, I'd like to note the ASCO takes great care in the development of its guidelines and ensuring that the ASCO Conflict of Interest policy is followed for each guideline. The full Conflict of Interest information for this guideline panel is available online with the publication of the guideline in the Journal of Clinical Oncology. Dr. Owen, do you have any relevant disclosures that are directly related to the guideline topic? Dr. Dwight Owen: I have research funding to my institution to conduct clinical trials from several companies, including Merck, Pfizer, Genentech, BMS, and Palobiofarma, but no ownership, no stock, and no employment history. Brittany Harvey: Okay, Thank you for those disclosures. Then let's get into the content of this living guideline update. So, this is the first update to the living clinical practice guideline for systemic therapy for patients with stage IV non-small cell lung cancer without driver alterations. What new evidence was identified by the routine literature searches to prompt an update to the guideline? Dr. Dwight Owen: Yeah, so this is a really exciting time for patients with stage IV non-small cell lung cancer. We are anxiously awaiting the results of some ongoing immunotherapy combination studies. However, for this update, we focused on a specific paper and study that evaluated a treatment that is not our first option anymore, but maybe the first option for a subset of patients. So, before the standard introduction of immunotherapy for patients with stage IV non-small cell lung cancer, we often offered platinum-based doublet chemotherapy, and for years, we studied ways to make that better. So, we might introduce maintenance therapy where we continue a treatment after the first line of induction chemotherapy. We did either continuation maintenance, which is where you continue a treatment that seemed to be effective, or switch maintenance, where you were introduced to new therapy. For many folks with non-squamous non-small cell lung cancer, the standard treatment options included carboplatin or cisplatin with pemetrexed, which is an antifolate chemotherapy, or carboplatin and paclitaxel with or without a VEGF inhibitor, such as bevacizumab. One of the big questions was whether there was a benefit for continuing maintenance therapy with something besides pemetrexed, in this case, bevacizumab, and if bevacizumab was given in combination with pemetrexed, whether continuing that as a maintenance would offer benefit. Now, it's important to point out that the current FDA approval, at least in the United States, is for bevacizumab to be given with carboplatin and paclitaxel. However, several studies looked at the combination with pemetrexed and there were several issues with those studies. So, in one study they used a different agent, so ramucirumab instead of bevacizumab, both VEGF, but slightly different. In one study, the combination that was compared of pemetrexed plus bevacizumab was only compared to bevacizumab maintenance. And so, we really had a sort of hodgepodge of different trials that never answered the question of whether bevacizumab or VEGF therapy, given as maintenance offered any benefit to our patients. What Dr. Garon and co-authors did in a study that we evaluated was conduct a meta-analysis of four of those randomized trials, focusing on the question of comparing pemetrexed maintenance therapy alone versus in combination with bevacizumab. And what they found is that there was no significant difference in overall survival with the addition of bevacizumab compared to pemetrexed by itself, and there were higher rates of toxicity in those patients, including serious and higher-grade toxicities. So, I felt that it was really important to point out that the addition of bevacizumab or other VEGF therapies does not seem to add to a survival benefit when given as maintenance. And even though this is a subset of patients who perhaps could not get immunotherapy as a first-line treatment, maybe because of a pre-existing autoimmune disorder, but for those patients, it doesn't seem that the addition of VEGF as maintenance offers what we were hoping for. Brittany Harvey: Understood, and I appreciate you laying out the landscape of the data in this area. So then, based off this new data and the meta-analysis that you just described, what is the updated recommendation from the expert panel? Dr. Dwight Owen: So, the updated recommendation is a tweak to the established recommendation, which is essentially that for patients who are not candidates for immunotherapy for any reason, that platinum doublet chemotherapy is really the mainstay, and that if maintenance is offered, that it should not include VEGF therapy in combination with pemetrexed as compared to pemetrexed by itself. Brittany Harvey: Understood. And then, what should clinicians know as they implement this updated recommendation? Dr. Dwight Owen: I think, again, this should be a relatively uncommon scenario. Most of our patients are candidates for immune therapy. Many patients are offered platinum pemetrexed by itself. But when thinking about continuing maintenance therapy, we would recommend that most clinicians avoid the addition of therapies that haven't seemed to offer a survival benefit and incur higher rates of toxicity. Brittany Harvey: Great. That's helpful to know. And then you've just mentioned that this doesn't apply to a lot of patients, but what does this change mean for patients with stage IV non-small cell lung cancer without driver alterations? Dr. Dwight Owen: I think, hopefully, for the subset of patients where we're really thinking about here that we can at least avoid additional toxicity if there isn't a trade-off in terms of benefit, in terms of survival. Brittany Harvey: Great. Definitely, that's helpful. And then finally, what ongoing research is the panel keeping an eye on for future living guideline updates? Dr. Dwight Owen: So, there are a lot of exciting trials that are ongoing, and hopefully, we'll be able to read out soon, that would offer us updates for really how to manage these patients in the frontline setting with stage IV non-small cell lung cancer. We have multiple options now. This discussion that we've had today really focuses on the pre-immunotherapy era, but of course, bevacizumab is utilized in a regimen along with carboplatin, paclitaxel, and atezolizumab, compared to monotherapy with checkpoint inhibitors compared to chemoimmunotherapy and dual checkpoint inhibitors. And we don't really have any head-to-head trials yet, or strategies on how to identify which patients need more aggressive combination therapies versus which patients could potentially do without chemotherapy, or with single-agent checkpoint inhibitor by itself. So, while we wait for those studies like the ECOG and Cigna study, we're really looking forward to having those to be able to help decide and tailor our treatment options for our patients. Brittany Harvey: Great. Well, we'll look forward to the ongoing review of the literature by the panel and any future guideline updates to recommendations in the meantime. So, thank you so much for your work on this update and thank you for your time today, Dr. Owen. Dr. Dwight Owen: Thanks for having me. Brittany Harvey: And thank you to all of our listeners for tuning in to the ASCO Guidelines podcast series. To read the full guideline, go to: www.asco.org/thoracic-cancer-guidelines. There's also a companion living guideline update on Therapy for Stage IV Non-Small-Cell Lung Cancer With Driver Alterations, available there and in the JCO. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app available in iTunes, or the Google Play store. If you have enjoyed what you've heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode.   The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy, should not be construed as an ASCO endorsement.  

ASCO Guidelines Podcast Series
Therapy for Stage IV NSCLC With Driver Alterations: ASCO Living Guideline Update 2022.2 Part 2

ASCO Guidelines Podcast Series

Play Episode Listen Later Dec 19, 2022 8:24


Dr. Dwight Owen presents the first update to the ASCO living guideline on stage IV NSCLC with driver alterations. He identifies the latest trials that informed this update, and the updated evidence-based options for second- or later-line therapies for patients with advanced non-small cell lung cancer and an activating HER2 mutation or a KRAS-G12C mutation. Additionally, he provides important context on the reported toxicities associated with these therapeutics. Read the update, “Therapy for Stage IV Non–Small-Cell Lung Cancer Without Driver Alterations: ASCO Living Guideline, Version 2022.2“ and view all recommendations at www.asco.org/living-guidelines. Listen to Part 1 for recommendations for patients with stage IV NSCLC without driver alterations. TRANSCRIPT Brittany Harvey: Hello, and welcome to the ASCO Guidelines podcast series, brought to you by the ASCO Podcast Network; a collection of nine programs covering a range of educational and scientific content and offering enriching insight into the world of cancer care. You can find all the shows, including this one, at: asco.org/podcasts. My name is Brittany Harvey, and in our last episode, we addressed the living guideline updates for ‘Therapy for Stage IV Non-Small-Cell Lung Cancer Without Driver Alterations.' Today, Dr. Dwight Owen from Ohio State University in Columbus, Ohio, is joining us again to discuss the updates for therapy for stage IV non-small cell lung cancer with driver alterations, as the lead author on, 'Therapy for Stage IV Non–Small-Cell Lung Cancer With Driver Alterations: ASCO Living Guideline, version 2022.2.' Thank you for being here, Dr. Owen. Dr. Dwight Owen: Thanks for having me. Brittany Harvey: First, I'd like to note the ASCO takes great care in the development of its guidelines and ensuring that the ASCO Conflict of Interest policy is followed for each guideline. The full Conflict of Interest information for this guideline panel is available online with the publication of the guideline in the Journal of Clinical Oncology. Dr. Owen, do you have any relevant disclosures that are directly related to this guideline topic? Dr. Dwight Owen: Yeah, thanks for asking that really important question. My institution has received research funding for me to conduct clinical trials from Merck, BMS, Pfizer, and Genentech and Palobiofarma. I have no employment, stocks, stock options, or other disclosures to declare. Brittany Harvey: Thank you for those disclosures. Then getting into the content of this update, this is the first update to the living clinical practice guideline for systemic therapy for patients with stage IV non-small-cell lung cancer with driver alterations. What new studies were reviewed by the panel to prompt an update to this guideline? Dr. Dwight Owen: Thanks for that question. This is a particularly exciting update because as we were preparing for this update, reviewing two manuscripts that we think offer new options for our patients with driver alterations, there were actually updated presentations at a recent meeting that showed us even more data for these targets. So, it's really an ongoing and dynamic place. So, we really focused on two updates; one was for KRAS-G12C alterations, and then one was for HER2 alteration-positive non-small cell lung cancer. So, I'll take them one at a time; for KRAS-G12C, we included an updated recommendation based on the CodeBreak 100 study - this was a multi-center, single group, open-label, phase II study of sotorasib, which is a KRAS-G12C inhibitor, in patients with non-small cell lung cancer positive for KRAS-G12C, who had received prior systemic therapy that could either be with chemotherapy or immune therapy, and the majority of patients had received both. 124 patients were evaluable for response, and the objective response rate was 37%, with the impressive median overall survival of over 12 months, of 12.5 months, specifically. Now, there were some notable toxicities. There's GI toxicities such as diarrhea and nausea, as well as some elevations in LFTs. We also heard recently at ESMO about CodeBreak 200, which was a randomized study of sotorasib compared to docetaxel in previously treated patients with KRAS-G12C non-small cell lung cancer. And that study did meet its primary endpoint of improvement in PFS for sotorasib-treated patients compared to docetaxel, and we are very much looking forward to seeing that final publication. For HER2 alteration-positive non-small cell lung cancer, we really focused our efforts on DESTINY-Lung01. Now, this was a multi-center, multinational, open-label, phase II study evaluating trastuzumab deruxtecan in patients with previously treated HER2-positive non-small cell lung cancer. In this study, 91 patients were evaluable for response, and 50, which was 55%, had a confirmed objective response, and the median survival was presented at 17.8 months. A pretty unique toxicity was observed here. So, drug-related interstitial lung disease or pneumonitis occurred in just over a quarter of patients, and there were two deaths related to this. So, this needs to certainly be monitored for. Also at ESMO, we heard results for DESTINY-Lung02, which was a multi-center, multi cohort, randomized blinded study, which was also a dose optimization study. And this study eventually led to the accelerated approval of the 5.4 milligrams per kilogram dose that seemed to be just as effective as other doses, but perhaps with less toxicity. Again, we're currently awaiting the final publication of DESTINY-Lung02. However, these results are particularly impressive and especially leading to the FDA accelerated approval for a new treatment option for our patients with HER2 alteration positive non-small cell lung cancer. Brittany Harvey: I appreciate you reviewing that data and the new updates for both of these drugs and targets in this population. So then, I'd like to review the recommendations that the panel updated for our listeners. First, what is the new recommendation for patients with advanced non-small cell lung cancer and in activating HER2 mutation? Dr. Dwight Owen: So currently, these patients should continue to receive standard first-line treatment as we do not have head-to-head trials for HER2-directed therapy in the first line. However, for patients who have previously received systemic therapy and have a HER2-activating mutation, trastuzumab deruxtecan certainly should be offered to these patients. Brittany Harvey: Understood. And then the second category of patients that you identified, what does the expert panel recommend for patients with advanced non-small cell lung cancer and a KRAS-G12C mutation? Dr. Dwight Owen: So, similarly, these patients should continue to receive standard first-line treatment, as we do not have head-to-head trials for KRAS-directed therapy in the first line. However, for patients who have previously received systemic therapy and have a KRAS-G12C mutation, sotorasib can be offered as a subsequent therapy. Keep in mind that this is only approved in patients with the KRAS-G12C mutation, and not other KRAS alterations. Brittany Harvey: Thank you for reviewing those two recommendations for second or later-line therapies. What should clinicians know as they implement these updated recommendations? Dr. Dwight Owen: So, I think what we're really excited about is that both of these agents offer new treatment options for patients who historically did not have a personalized targeted treatment option. We are awaiting publication of additional studies to help interpret these data, but for now, clinicians should discuss these treatment options with their patients, and also keep in mind the pattern of toxicities that seem to be unique to each treatment. Brittany Harvey: Great. And then, you've just addressed some of this in your last response, but what does this change mean for patients with stage IV non-small lung cancer with a HER2 or KRAS-G12C mutation? Dr. Dwight Owen: I think the bottom line is that our patients for whom their cancer does not respond, or where it progresses after first-line treatment, will now have additional effective and approved treatment options that are really tailored to the unique characteristics of their tumor and cancer cells. Brittany Harvey: Absolutely. It's great to have new options for patients in this field. So then finally, are there future research developments that the panel is considering for future living guideline updates? Dr. Dwight Owen: So, we're particularly looking forward to the final publication of the studies that were recently presented, including the CodeBreak 200, and DESTINY-Lung02 trials. There are multiple ongoing studies for additional targets, including in the targets that we talked about; so, KRAS-G12C as well as HER2, as well as a number of other targeted options that may benefit subsets of our patients with metastatic non-small cell lung cancer. Brittany Harvey: Great. Well, I appreciate you reviewing all this data and the updated recommendations, and thank you for your time today, Dr. Owen. Dr. Dwight Owen: Thanks for having me. Brittany Harvey: And thank you to all of our listeners for tuning into the ASCO Guidelines podcast series. To read the full guideline, go to: www.asco.org/thoracic-cancer-guidelines.  There's a companion living guideline update on therapy for stage IV non-small-cell lung cancer without driver alterations, available there and in the JCO. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app, available on iTunes, or the Google Play store. If you have enjoyed what you've heard today, please rate and review the podcast, and be sure to subscribe so you never miss an episode.   The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy, should not be construed as an ASCO endorsement.  

Let Go & Lead with Maril MacDonald
Wendy Short Bartie | How leadership can benefit all of humanity

Let Go & Lead with Maril MacDonald

Play Episode Listen Later Dec 13, 2022 45:49


In this episode of Let Go & Lead, Maril talks with Wendy Short Bartie, Senior Vice President & Chief of Staff to the CEO at Bristol Myers Squibb. The gift for leadership that has made Wendy such a fast riser in the pharmaceutical industry, since leaving her original legal career, shines throughout this vibrant conversation. They discuss Wendy's journey as a leader, and how her focus has shifted, over time, from practicing leadership to preparing others to be great leaders; why empathy has a lot to do with understanding gaps between intention and impact; and the crucial role of the leader as “air traffic controller” — the person who actively creates space for a diversity of perspectives and opinions — during meetings. Learn about: 4:58 Building a leadership legacy in an organization 8:32 Leading using the skill of influence 9:16 The power of listening 11:09 The power to S.P.E.A.K. like a leader 16:09 Mentoring and growing great leaders 19:34: The power of an “I Love Me” letter 23:36 The critical leadership art of meeting management 26:04 Being attentive on mental health 36:32 Teambuilding in a hybrid/remote environment —  Wendy Short Bartie is the Senior Vice President and Head of US Oncology.  In this capacity, Wendy is responsible for leading the strategy and operations for solid tumor program in the US market.  A compassionate and strategic leader, her career journey has taken many turns, but her path has always been clear – the commitment to help people - first as a lawyer/public defender, and then as a pharmaceutical industry professional, continuing to act as a voice for those with unmet needs and unequal access. Prior to joining BMS, Wendy was Vice President and Head of Commercial Operations for US Oncology at Merck.  In this capacity, Wendy was responsible for leading the Sales, Key Accounts, Market Access, Pricing and Policy organizations within the US Business Unit.  Previously, Wendy served as Associate Vice-President of Global Marketing for Genitourinary Cancers (GU), including renal cell carcinoma, prostate cancer and bladder cancer and as the Global Disease Lead for Women's Cancer.  Prior to joining Merck, Wendy held a range of commercial roles with increasing responsibility in sales, business analytics and marketing in cardiovascular neuroscience, osteoporosis, lung cancer, supportive care and chronic myeloid leukemia at various companies including Novartis, Heron Therapeutics, Johnson and Johnson, Pharmacia and Abbott Labs.   Prior to her career in pharma, Wendy was a Public Defender in Washington, DC and Bronx, New York. Wendy received her Bachelor of Arts from Clark Atlanta University and her Juris Doctor from Loyola University Chicago, School of Law.   Wendy is an HBA Rising Star and was recognized by HBA as a Luminary in 2020. Wendy's favorite hobbies include painting and reading.  When Wendy isn't working, painting and reading, she is serving as Vice President for the Greater Essex County Chapter of Jack and Jill Incorporated and doing philanthropic work to limit the digital divide for children without access to personal computers or internet. Wendy, her husband, Jared, an attorney, and her daughter, Madison, and the family dog, Joy reside in West Orange, New Jersey. ABOUT LET GO & LEAD Let Go & Lead is a leadership community created by Maril MacDonald, founder and CEO of Gagen MacDonald. Maril brings together provocateurs, pioneers, thought leaders and those leading the conversation around culture, transformation and change.  Over the course of the past 12 years, Let Go & Lead has existed in many forms, from video interviews to resource guides to its current iteration as a podcast. At its core, it remains a place where people can access a diversity of perspectives on interdisciplinary approaches to leadership. Maril is also working on a book incorporating these insights gathered over the past several years from global leaders and change makers.   Maril has interviewed over 120 leaders — from business to academia and nonprofits to the arts — through the years. In each conversation, from personal anecdotes to ground-breaking scientific analysis, she has probed the lessons learned in leadership. From these conversations, the Let Go & Lead framework has emerged. It is both a personal and organizational resource that aims to serve the individual leader or leadership at scale.  ABOUT GAGEN MACDONALD At Gagen MacDonald, we are dedicated to helping organizations navigate the human struggle of change. We are a people-focused consulting firm and our passion is improving the employee experience — for everyone. For almost 25 years, we have been working with companies to create clarity from chaos by uniting employees across all levels around a single vision so they can achieve results and realize their future. We have been a pioneer in bringing humanity to strategy execution, leading in areas such as organizational communication, culture, leadership, and employee engagement. Our Vision is to lift all humanity by transforming the companies that transform the world. Full episodes also available on:   Apple Podcasts: https://podcasts.apple.com/us/podcast/let-go-lead-with-maril-macdonald/id1454869525   Spotify: https://open.spotify.com/show/5Gaf7JXOckZMtkpsMtnjAj?si=WZjZkvfLTX2T4eaeB1PO2A   Google Podcasts: https://podcasts.google.com/feed/aHR0cHM6Ly9sZXRnb2xlYWQubGlic3luLmNvbS9yc3M   Stitcher: https://www.stitcher.com/show/let-go-lead   —   Gagen MacDonald is a strategy execution consulting firm that specializes in employee engagement, culture change and leadership development. Learn more at http://www.gagenmacdonald.com.

Bitcoin Made Simple Podcast
BMS 081 - Will Reeves Interview: Fold Debit Card Bitcoin Rewards

Bitcoin Made Simple Podcast

Play Episode Listen Later Dec 12, 2022 57:42


Cory interviews Will Reeves, CEO of Fold. Fold offers a debit card that gives you Bitcoin rewards instead of cash back. Now you can also buy Bitcoin in the Fold App. Cory and Will discuss his pre-fold life, his Bitcoin origin story, and how Fold manifested into the company it is today. Check out the BitBox02 Hardware Wallet Go to https://shiftcrypto.ch/bitcoinmadesimple and use the promo code "bitcoinmadesimple" to get 5% off standard products. Movies Plus - go to www.myMoviesPlus.com and get 20% OFF an annual subscription with promo code CORY, and you can watch "Hard Money with Natalie Brunell" and the documentaries "The Great Reset and the Rise of Bitcoin", "Bitcoin FUD", "Bitcoin: The End of Money as We Know It", and "Cryptopia: Bitcoin, Blockchains and the Future of the Internet." Watch them all on Movies Plus. Bitcoin Day www.bitcoinday.io use promo code BMS to get a discount on your tickets to a Bitcoin Day event near you. --- Support this podcast: https://anchor.fm/bitcoinmadesimple/support

Feeling Good Podcast | TEAM-CBT - The New Mood Therapy
322 How Skillful is your Shrink Featuring Kevin Cornelius LMFT

Feeling Good Podcast | TEAM-CBT - The New Mood Therapy

Play Episode Listen Later Dec 12, 2022 81:27


How Skillful is your Shrink! Now you can find out! The Exciting Recovery Coefficient-- and the FEAR the grips the hearts of the therapists who are afraid to use it! People often wonder how skillful or effective their therapist is, but until now, there was no very valid or precise way to know. But now there is, and it has fantastic implications for psychotherapy. Today, we feature an interview with Kevin Cornelius, a therapist at the Feeling Good Institute in Mountain View, California.  Kevin Cornelius is a Licensed Marriage and Family Therapist in private practice at Feeling Good Institute, with in-person counseling for teens .Kevin is a Certified Level 4 Advanced TEAM-CBT Therapist and Trainer. I asked Kevin to write a brief description of his evolution from a career in acting to his career as a shrink. Here's what he wrote: After many years of working as an actor I was ready for a change. After some painful personal events, I saw a therapist who was quite helpful to me. She helped me see that changing to a career as a therapist could be a great thing for me. I went to school and got my Master's in Marriage and Family Therapy. Just before I began applying for internships to complete licensure, I learned that the children's theatre group I had grown up in was looking for a new supervisor to lead the group following the death of its beloved founder and leader. This was a wonderful opportunity for me to use my theatre skills and my desire to help young people in their growth and development. I was very fortunate to be hired and worked as the director of the children's theatre group for 19 years. Towards the end of my years with the children's theatre, I was ready for a change and thought it might be time for me to finish getting my therapy license. It had been 15 years since I had worked with a patient in a therapy session, so I had a lot to learn! I was so lucky to discover David Burns and his amazing TEAM-CBT. The testing element of TEAM enabled me to see right away where I needed to improve so I could focus my efforts on improving specific skills. Being able to study with David in his Tuesday group at Stanford was a golden opportunity. Here was a framework designed to make therapy as effective as possible being taught (for free!) by one of the world's greatest therapists. I'm so happy I followed David's advice to get involved at Feeling Good Institute while I was still pre-licensed. Learning TEAM while I was completing the process to earn my license as a therapist enabled me to start my career in private practice with confidence and a stable foundation. Now, I get to continue learning from mentors at Feeling Good Institute, from the wonderful Feeling Good Podcast, and the valuable lessons I get from my patients. I'll sum up my good fortune with a theatre reference and quote the Gershwins: "Who could ask for anything more?" Kevin recently made the courageous decision to find out exactly how he was doing as a therapist. And the results surprised him tremendously. Background Information for today's podcast Outcome studies with competing schools of psychotherapy in the treatment of depression have been disappointing. They all seem to come out about the same, slightly better than placebos, but not much. For example, in the British CoBalT study of 469 depressed patients treated with antidepressants vs antidepressants plus CBT, only 44% of the patients treated with antidepressants plus CBT experienced a 50% improvement in depression after six months of treatment, and the multi-year follow-up results weren't any better. This was better than the patients treated with antidepressants alone, (only 22% experienced a 50% improvement), but still—to my way of thinking—very poor. We see more improvement than that in just one day in patients using the Feeling Good App. Here are just two of many online references to that landmark study: https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(15)00495-2/fulltext https://www.thelancet.com/pdfs/journals/lanpsy/PIIS2215-0366(15)00495-2.pdf Because of the disappointing results of research on the so-called "schools" of psychotherapy, the focus is switching, to some extent, to the effects of individual therapists, since even within a school of therapy, there can be huge differences in therapists' effectiveness. Some therapists seem to have the proverbial “green thumb,” with many patients improving rapidly, while others seem much less effective. Is there a way to measure this? Now there is! And do patients have a right to know how effective their shrinks are? That's what I'm proposing! For at least twenty years or more, I've been trying to sell therapists on my Brief Mood Survey with every patient at every session. That's because you can see exactly and immediately how depressed, anxious, or angry, etc. your patient was at the start and end of today's session. This allows therapists to see, for the first time, exactly how much the patient improved in various dimensions within the session, as well as how much the patient relapsed or continued to improve between sessions. Here's a simple example. To make things really clear, let's imagine that your depression test goes from 0 (not at all depressed) to 100 (the worst depression imaginable, and your patient has an 80 at the start of today's session. That would indicate a horrendously severe depression, similar to patients hospitalized with depression. And yet, your patient might be functioning effectively, and might appear reasonably happy. So, bonus #1, you can see exactly how your patient was feeling at the start of the session. You might think of the BMS as an “emotional X-ray machine.” Now, let's assume you have an excellent session, and feel like you're clicking with the patient, and the patient scores 40 on the end-of-session BMS. That would be a phenomenal 50% improvement. Of course, a score of 40 means that the patient is still moderately depressed, and has a way to go, still the goal is a score of 0 on the depression test and a huge boost in the patient's score on the happiness test on the BMS. Keep in mind that in the dozens of psychotherapy outcome studies that have been published worldwide, the very highest levels of improvement in months and months of therapy are  never higher than this. So, I call this the Recovery Coefficient (RC), and it is a very precise measure of any therapist's effectiveness in treating anything you can measure accurately. In an informal study of de-identified data of more than 10,000 therapy sessions at a local treatment center about two years ago. I discovered that the RC the first time therapists met with their patients predicted the improvement over the entire course of therapy. In addition, different therapists had vastly different initial RC scores, which can range from -100% in a single session (meaning a complete elimination of symptoms)  to +100% in a single session (meaning severe worsening.) Sadly, because all patient or therapist identifying information was removed to protect identities, I had no way of letting the therapists know their skill levels! But today, we are joined by a therapist who had the guts to calculate his RC in ten patients to see how he was doing. He was initial incredibly demoralize with his percent reductions (RC) of 45% for depression and 47% for anxiety in 50 minute sessions,  He reasoned that a 44% in a class would be a failing grade, but I pointed out that this isn't the right comparison. After all, if you had a contract to build the Brooklyn Bridge, and could complete nearly half of it in 50 minutes, you'd be doing something incredibly amazing. Kevin's Depression and Anxiety Recovery Coefficient Calculations     Depression Anxiety Empathy 1 Before 6 14 20 After 3 1   % Change -50.00% -92.86%       Depression Anxiety Empathy 2 Before 5 6 20 After 1 3   % Change -80.00% -50.00%       Depression Anxiety Empathy 3 Before 12 10 20 After 9 9   % Change -25.00% -10.00%       Depression Anxiety Empathy 4 Before 10 5 20 After 5 3   % Change -50.00% -40.00%       Depression Anxiety Empathy 5 Before 5 9 18 After 3 5   % Change -40.00% -44.44%       Depression Anxiety Empathy 6 Before 18 15 20 After 10 9   % Change -44.44% -40.00%       Depression Anxiety Empathy 7 Before 14 12 20 After 10 6   % Change -28.57% -50.00%       Depression Anxiety Empathy 8 Before 2 9 18 After 4 5   % Change 50.00% -44.44%       Depression Anxiety Empathy 9 Before 2 1 20 After 0 1   % Change -100.00% 0.00%       Depression Anxiety Empathy 10 Before 6 5 20 After 1 0   % Change -83.33% -100.00%       Depression Anxiety Empathy Recovery Coefficient   -45.13% -47.17% 19.6                     And indeed, Kevin's scores actually showed he was outperforming all the published outcome studies on depression by a factor of several hundred. Which was, I think, a well-deserved pleasant shock to his system! I've always had tremendous admiration and respect for Keven because of his obvious great skill and intelligence combined with world-class compassion and humility. In addition, patients complete the Evaluation of Therapy Session (ETS) immediately after the session, and rate the therapist on Empathy, Helpfulness, and other crucially important dimensions. Kevin's Empathy score was 19.6 (96.5%), indicating near perfect empathy ratings from his patients. This is extremely impressive, since most therapists get failing Empathy scores from nearly all of their patients when they start using the ETS scales. However, what was really cool is that Kevin brought the Daily Mood Log he prepared prior to the podcast. As you can see if you check the link, recording his intense negative feelings and self-critical thoughts when he initially completed his calculations. This helps to explain the fear that so many therapists—nearly all—feel when it comes to being accountable for the first time in the history of psychotherapy. Here's what he was telling himself: I'm not doing well enough. I'm fooling myself. I'm letting my patients down. I'm a fraud. I should be better. I should charge less. I suck! During the podcast, we used some TEAM-CBT to deal with these concerns live, in real time, using Positive Reframing, Identify the Distortions, Examine the Evidence, and Externalization of Voices to smash these thoughts. If you'd like to see the Positive Reframing Table he brought to the session, you can check here. In Kevin's case, the RC calculations, which are simple and only take a minute, gave him a huge gift—the confirmation of his immense technical therapeutic skills as well as his empathy. But what if you're not like Kevin, and you discover that your RCs are not so great, and that your Empathy ratings are in the failing range. Isn't that kind of terrible? Well, it depends on how big your ego is, and how motivated you are to improve. I've gotten plenty of horrible ratings on the ETS, and have had lots of sessions with poor outcomes, including sessions when I wrongly believed I was doing a great job. It DOES hurt. But over the years, my patients have dramatically shaped my therapy approach, and have become my greatest teachers by far. I now enjoy pretty tremendous outcomes with the vast majority of the people I treat, but could never have improved without the constant feedback. Psychotherapy skills are a lot like athletic workouts, and they say, “no pain, no gain.” This is definitely just as true for shrinks. Are you a shrink? Do you have the courage to check out your skills? Here are a couple more random comments. Over the years I've seen the scores of many therapists in training, and many established shrinks in the community. And sometimes I've been surprised that some of the big name, flashy people were actually very unskilled in real therapy situations. And I've also seen that some of the giants of our field, were humble, kindly individuals, like Kevin, who were quietly working miracles, but not even realizing it. And I also had this brainstorm. If you're a patient, and your shrink refuses to use the BMS and ETS, for whatever reason, you could take the test prior to and after each session, and calculate your therapist's Empathy Scores and Recovery Coefficient scores. Mmm. I am thinking there might be a business model in here somewhere! Like a website where you could take the tests and get all the calculations automatically. And maybe that type of information could be published... After all, wouldn't patients LOVE to have this information BEFORE going to a new shrink for treatment. And isn't that EXACTLY where our field should be moving? Accountability and transparency? I hope you enjoyed meeting the incredible Kevin Cornelius today. Thank you for listening and supporting our Feeling Good Podcasts! Warmly, david

Bitcoin Made Simple Podcast
BMS 080 - Bitcoin Bringing the Heat & Being Banned From Social Media

Bitcoin Made Simple Podcast

Play Episode Listen Later Dec 8, 2022 32:58


Cory talks updates on Bitcoin Mining heating his house. Also gets into whats going on at Movies Plus, and how they've been banned from social media for simply supporting free speech. Check out the BitBox02 Hardware Wallet Go to https://shiftcrypto.ch/bitcoinmadesimple and use the promo code "bitcoinmadesimple" to get 5% off standard products. Movies Plus - go to www.myMoviesPlus.com and get 20% OFF an annual subscription with promo code CORY, and you can watch "Hard Money with Natalie Brunell" and the documentaries "The Great Reset and the Rise of Bitcoin", "Bitcoin FUD", "Bitcoin: The End of Money as We Know It", and "Cryptopia: Bitcoin, Blockchains and the Future of the Internet." Watch them all on Movies Plus. Bitcoin Day www.bitcoinday.io use promo code BMS to get a discount on your tickets to a Bitcoin Day event near you. --- Support this podcast: https://anchor.fm/bitcoinmadesimple/support

Feeling Good Podcast | TEAM-CBT - The New Mood Therapy
321: Help I'm Having Panic Attacks pt 2 of 2

Feeling Good Podcast | TEAM-CBT - The New Mood Therapy

Play Episode Listen Later Dec 5, 2022 105:58


Yikes! Do I REALLY have to share my feelings?  Last week, we featured Part 1 of a live therapy session with Keren Shemesh, PhD,  a licensed clinical psychologist who began having intense panic attacks when her mother and father visited from Israel.  Today, we feature the exciting conclusion of that session, with follow-up. If you are interested, you can listen to the follow-up with Keren and Jill who joined us st the end of today's podcast. They comment on the session as well as the details of what happened following the session. I (David) raised the question of why so many of us have trouble being honest and open with our feelings, especially anger. Jill suggested that it might be due to the false dichotomy people see, contrasting aggression with love. But you can be honest and loving at the same time, including when you express feelings of anger. Of course, we make the Five Secrets of Effective Communication sound easy, but these powerful tools actually require an enormous level of skill as well as commitment. Part 2 of the Keren session: M = Methods We began the Methods part of the session with a bit more Paradoxical Agenda Setting, and listed some really GOOD reasons NOT to open up more to her mother. I want to protect her because it may be hard and upsetting to her. I'm not used to being vulnerable with my parents. I don't want to rock the boat or change the status quo. I'm not sure I want a closer relationship with my mother. NOTE: David and Jill were thinking that we often resist intimacy because we have negative pictures in our mind of what real closeness is. For example, if you think it means something yucky and upsetting, you obviously won't want to get “close.” Jill tried to finesse around this by suggesting Keren might aim for a more “honest” relationship instead of a “closer” relationship. There are things about me that they've rejected, like the fact that I don't really want children. And I'm not so sure I want to make myself vulnerable and get rejected again! I'm afraid I'll get swallowed up and enmeshed. We asked Keren what kinds of feelings she was hiding from her mother. My feelings of nervousness and intense anxiety, and the intense somatic symptoms, like the knot in my stomach. I am scared for her future, since she is not in good health and she's not taking care of herself. I have feelings of anger and resentment about the fact that I'm not the kind of daughter they wanted. I'm sad about her health and seeing her struggle. I feel hurt when I think how I have failed them and let them down. I sometimes feel like I don't really belong. At this point, I became so absorbed in the session that I stopped taking notes, so you will have to listen carefully to the recording of the session which was fascinating. I do recall, however, that we began working on communication, using the Five Secrets of Effective Communication (LINK), as well as tips on how to proceed, taking it one step at a time and not trying to do it all at once, and role playing practice. Then we did some Externalization of Voices with the thoughts on Keren's Daily Mood Log, using several strategies: Self-Defense, the Acceptance Paradox, and the CAT, or Counter-Attack Technique. You can see the Daily Mood Log she completed after the session, based on the work we did in the session, at this LINK. Keren's end-or-session Brief Mood Survey and Evaluation of Therapy Session In addition, Keren and Jill will be with us to record the follow-up. T = End-of-Session Testing You can review Keren's BMS and EOTS (Patient's Evaluation of Therapy Session) at the end of the session at this LINK. Keren's end-or-session Brief Mood Survey and Evaluation of Therapy Session As you can see, her depression score fell to 1, indicating substantial improvement, while her suicidal thoughts and urges remained at 0. Her feelings of anxiety vanished, but her feelings of anger remained fairly elevated, falling from 7 to 4. We would not expect further improvement in this dimension until she's had the chance to share more of her feelings with her mom. Her feelings of happiness only increased from 10 to 13, again any further improvement would not be expected until she's had the chance to do her “homework” following the session. However, her satisfaction with her relationship with her mom increased from 19 to 26 out of 30, which is substantial, while still leaving some room for improvement. On the EOTs, you will see that our Empathy and Helpfulness scores were perfect, along with our scores on the Satisfaction with Session, Commitment to homework, unexpressed Negative Feelings, and honesty scales. Here's what she like “the least” about the session: “Nothing. This has been a powerful experience.” Here's what she like “the best” about the session: “This has been empowering. The hidden emotion is like a blind spot. I know it is there, but I cannot see it. I loved when David pointed to my avoidance, and I am glad we focused on the hidden emotion. Jill and David were able to see the depth in situation and I feel seen and understood.” Follow-Up We exchanged a number of emails following the session, and will also talk to Keren and Jill live on the podcast so you can catch up on what happened. But here is an excerpt from one of Keren's emails: Here is what has happened so far: On Friday morning, she made some comments about my gray hair and that the fridge gasket was not properly clean. I got really annoyed, but did not say anything. To be honest, I was too angry to use the 5 secrets and needed time to cool off. About after half an hour later, on our way to the acupuncturist, I told her that I love having her over and that it is special to me that we spend time together. She thanked me for everything that I am doing for her on this trip. Then I added: "this morning, when I came to check on you, you commented on my hair and then you told me to clean the fridge gasket..." I was going to follow up with 5 secrets, but before I was able to finish, she interrupted me and said "Gosh, I am so critical! I am sorry, I didn't mean it that way. I can see now why your sister gets upset with me. I can't believe myself." I told her that I love her honesty and while her criticism comes from a caring loving place the how and when she says things sets tone. This was a breakthrough because even though I did not finish using the 5 secrets I got through to her and felt heard. It was encouraging for me to feel that I could be understood and accepted by her.  I have clients who say that they love the 5 secrets, but like to call it the 3 secrets because they find it effective enough to use only 3. (I still encouraged them to use all 5). I can see now what they mean, I did not finish my 5 secrets spiel and got some good results. I believe that my conservation with my mother will further trickle during her stay. Perhaps because there is a lot to cover, or perhaps it's the way we communicate. In either case, I feel good about having the talks that I previously dreaded. I have not had any panic attacks since, but I don't think they have completely gone. I believe they will be there to remind me to address certain emotions that need addressing.. . . I will keep you posted and may even send this to the group. Just need to think about it a bit longer. Responses from the Tuesday Group who observed our work with Keren Here are just a few of the comments from the 35 therapists who observed the session. This is part of the feedback we get on the quality of our teaching at the end of every Tuesday training group. Please describe what you specifically disliked about the training/ Nothing. The live work was fascinating to watch. David and Jill were masterful as always! This was a truly moving and inspiring and helpful session. I can't think of anything I didn't like about it. Nothing I disliked. I think I would have liked to see Keren do more deliberate practice with the 5 secrets with grading and more roleplaying. Conceptualization was a bit hard to follow. Please describe what you specifically liked about the training. Thank you for such an authentic, moving, beautiful session. And tour-de-force demonstration of TEAM therapy. Observing David and Jill as co therapists in service of Keren was an amazing learning opportunity! The power between them was exponential and felt like they successfully addressed every angle. . .  I had not considered using EOV and loved how effective that was in crushing Keren's thoughts. I also loved how Jill finessed gently guiding her to address Hidden Emotion, having clear conviction that this was where the "action" was. I can understand what Keren said that she wants to be closer but does not want to be enmeshed. I think that it helped us in our work with immigrants and those who live away from where they were born. The discussion about the desire to be a parent or not, was another aspect of the work that I really respected. Excellent class tonight! Keren's gift to the class was priceless and David and Jill's masterful teaching was outstanding as always. Thank you!!! I got to feel closer to her and to several group members through their sharing. David touched me with the notion that opening up to one's parents is an important gift that many of them don't get to receive. Thanks for listening today! Rhonda, Keren, Jill, and David

Anticipating The Unintended
#193 No Country For Young Men?

Anticipating The Unintended

Play Episode Listen Later Dec 4, 2022 30:25


India Policy Watch #1: Winning The Long GameInsights on current policy issues in India — RSJMany moons ago I sat down for lunch with someone who is often referred to in the media as a ‘doyen of the industry'. Among other things, I asked him the single most important advice he would give to anyone who is at the start of their career. I didn't have any burning desire to succeed in the corporate rat race. So, I wasn't looking for a life-changing insight. I asked it because custom demanded you ask such questions of doyens like him over a meal. Also, even back then I was aware that I should fill my pitaara with such stories because sometime in future I could use them to make myself appear interesting. Anyway, he squinted at me and with something that appeared close to conviction told me, “always defer gratification”. I nodded and pronged a moody forkful of Aglio e Olio. Instant gratification.Over the years I have come to appreciate that piece of advice. Running a successful business over the long term is all about how well you trade off short-term gains with doing what's right for long-term sustainability. The odds are stacked against you because most of your shareholders, the analysts and the media are measuring you on quarterly performance. You can put out a convincing long-term story that will deliver a big, deferred outcome but how can anyone be sure you're headed that way? Any short-term wobble can have people question you. It is tough to live a life of deferred gratification. I haven't followed it to any meaningful extent in my life. Nor do I think even the doyen has done so since that meeting. But having understood how difficult deferring gratification could be, I appreciate how important it is for long-term success in any field of human endeavour. And, of course, that includes public policy in case you are wondering why am I channelling my inner Deepak Chopra and inflicting random truisms on you. OPS versus NPSThis problem of grasping short-term gains while jeopardising the long-term has been running on my mind for the past few months as I see the spectre of the Old Pension Scheme (OPS) returning as a key election promise in the manifestos of Congress and AAP in state elections. There are two issues that I have been thinking about. First, what drives a political party to make a bonfire of the future for a questionable short-term electoral gain? And I'm picking on the OPS issue and these two parties only to illustrate this point. Every party in India has done this in the past. The abandoning of the farm laws was an instance of this. So, the question is what prompts a political party to do this and, importantly, why does the average voter get seduced by this? The other question is what can be done to change the incentives of the parties to do this? In other words, how can we make sure political parties learn to defer gratification? But before I get into them, let me give you a short overview of what's happening with the demand for OPS and the problem with states returning to it while abandoning the New pension Scheme (NPS). The Congress governments in Rajasthan and Chhattisgarh have already gone back to OPS and it has promised the same in its manifesto in Himachal and Gujarat. Not to be outdone, AAP plans to return to OPS in Punjab and might make it a plank in Gujarat. Nothing catches the imagination of our politicians like a bad economic idea, so we now have the Bharatiya Mazdoor Sangh, the RSS-affiliated trade union wing of the ruling BJP, demanding the same from the FM. As Business Standard reports:“National General Secretary of BMS, Ravindra Himte told IANS that during the meeting with Sitharaman, the organisation has urged the Finance Minister to restore the old pension system, increase the amount of minimum pension from Rs 1,000 to Rs 5,000 and to provide better health facilities to retired people under the Ayushman Bharat scheme.The BMS has also urged the Finance Minister to strengthen the social security scheme for workers and to take various other steps to protect the interests of the weaker section of the society.”For context, there are nine state elections scheduled for 2023. Pension of state government workers is a state subject. They can claim they have the mandate of the people to change this if they win using this as one of their key poll planks. Pension is a way to provide social security to workers following their retirement. A simple way to design a pension scheme is for an organisation to promise workers: upon retirement, we will continue paying, say 50 per cent, of your last drawn salary till you die. This is simple and intuitive. The worker has served the organisation for long and you reciprocate that loyalty by taking care of them after retirement. A few years of this scheme and you will soon have a reasonable request from the retired workers. The pension provided isn't keeping up with the inflation. The last drawn wage about a decade back is hardly worth anything now and a pension indexed to that is unfair to the worker. What do you do as a welfare-minded employer? You offer to index the wage to the revised pay scale that's prevalent now. So, the pension drawn by a worker is no longer 50 per cent of their wage when they were last working in the organisation. It is now 50 per cent of the wage of anyone doing the same job now to keep up with inflation. This is all good though a bit onerous. However, if you fast-forward this by a couple of decades, you will reach an uncomfortable scenario. The number of people who have retired from the organisation is now, say, equal to the number of people who are currently working. Those who have retired are drawing a pension that's 50 per cent of the existing pay scale. Simply put, if the total wages paid to working employees is Rs. 100, the pension paid to retired employees is Rs. 50. A third of the total wage bill is allocated to pension. Another decade and you might have two-thirds of the wage bill being taken up by pension. This is a problem in many ways. First, the working employee is continuing to take additional burden to pay for the ever-increasing number of retired employees. The incentive to be productive for the current employee keeps going down when they know the lion's share of any productivity gain will go to the retired pool. The organization continues to be weighed down by the pension bill. It finds it difficult to attract new talent because it cannot match market wage rates offered by newer companies that don't have such a pension bill. It also cannot invest in new products and innovations because the pension bill keeps rising. Unless the employer is the State, in which case, it can print money, increase its debt and keep paying for pension, there's really only one end state to this. The organization will go bankrupt because of its pension burden. This is not a hypothetical scenario. A whole generation of great American companies went down this path including the giant automakers of Detroit. The OPS that is being revived in many states in India is exactly this scheme. In 2004, the Union government introduced a New Pension Scheme (NPS) to avoid exactly this fate. The NPS model is quite simple. It is what is called a defined contribution model. The worker sets aside a small percentage of their salary every year towards a pension fund. The government matches that amount by making its own contribution from its coffers. This means there's an additional wage burden for the government during that year. This amount goes into a pension fund which is managed by professional fund houses regulated by the PFRDA. The fund houses have fairly rigid investment rules that prohibit them from investing in speculative assets. This ‘accumulation phase' continues till the employee retires. At the time of retirement, there's a nice little corpus that's built up. The employee can then take out, say 40 per cent of the corpus for their immediate need, the remaining amount moves into an annuity product where a fixed amount is paid out every year like a salary. Over the years the NPS scheme has been taken up by all Union government employees and gradually all state governments adopted it too. The professional fund houses that manage the NPS funds report annualised returns that have always been better than the Provident Fund (managed by the government) returns or even the best of mutual fund managers. And the first generation of retirees who use the NPS can vouch that the annuity they get has kept pace with inflation without having to wage-index their pension to the revised pay scale. This a beautiful solution that frees up the government from having a pension burden on its balance sheet after the retirement of the worker. No longer are current employees paying for the pension of the previous generation. In fact, we have often quoted the transition to NPS as one of the more successful public policy examples in India.Now, we want to undo it. There's really never been a clamour for OPS. But if you go around telling retired or near-to-retirement employees that we will give you a higher-paying pension scheme by taking you back to OPS, you might find some traction. Even if the numbers don't bear you out. Few voters will ask you how will you foot the bill. If the current and future employees don't see that eventually, they will be paying for this largesse, you might be able to convince every working employee that this will work better for them. I don't think we are there yet but I never bet against the popularity of a bad economic policy. They have tremendous seductive appeal. The Difficulty In Choosing Deferred GratificationThis is just another example where there are short-term pains in implementing a policy that will yield outsized long-term benefits. We could do that by implementing the NPS in 2004. Now, we are on the reverse. We want to implement a policy that might have short-term gains for a few but huge long-term costs for everyone. There are other similar policy questions in a democracy. How should we think about climate change? Should we take costly actions now by punishing polluting industries and impacting job creation while waiting for the benefits of these actions to pan out over decades? Or, how about increasing taxes today to rebuild roads and public infrastructure that will benefit society thirty years later? How should a political party think about these issues when their incentive is to win elections that happen every four or five years? Are democracies doomed to pick policies that are good in the short run but damaging in the long term because of this flaw?This intertemporal trade-off between maximizing societal welfare now and investing for the future is a vexing issue for political parties in a democracy. What I want to do is to understand the reasons for this trade-off being skewed in favour of short-term value maximisation and see if there's a way to engineer a choice architecture for the public that redresses it. I can think of four reasons why the skew exists.Firstly, there's the commitment problem among political parties. People are never convinced that a political party will stay the course on a particular policy. This is borne out of experience. Parties are less guided by economic ideology these days. The same set of politicians who might advocate a higher tax today and ask you to tighten your belts may change their tune tomorrow when they sense a change in the air. Also, politicians aren't permanent. There is turnover among them within a party itself. And the newer set might renege on previous commitments. So, for the citizens, paying short-term costs because you believe in the political commitment of a party now is fraught with risks.Secondly, forecasting is difficult. There's the fog of uncertainty and lack of adequate information to accurately predict these benefits. It is easier for a voter to use past performance as a guide to the future than predict it based on the impact of a new policy. The average voter anyway has only limited cognitive mind space for public policy. They might be able to think only about present outcomes with some clarity. This encourages politicians to think of policies that are typically myopic. Further, this information challenge means even if voters and the government say they care about the future, their actions will continue to be shortsighted. Separately, even those who are trained in public policy to think about the intertemporal trade-off can struggle to make accurate assumptions about the future. We live in a world that's more volatile and ambiguous than before. To predict the future and the societal context that will emerge then is a risky proposition. For the policymaker, it is optimal to maximise a more certain near-term than go out on a limb for the distant future. Thirdly, we have the old problem of concentrated benefits and diffused costs. It is natural for a smaller group for whom the benefits of a policy are concentrated to organise themselves and demand its implementation. The converse of this is also true. Any policy action where the short-term costs are to be borne by a small but organised group while the benefits will emerge over time for the wider society will get scuttled by this group. The repeal of the farm laws was an example of this. Even if the short-term pain and the long-term gains both accrue to this small group, they will oppose it. Because a better alternative for them is to redistribute the short-term pain to everyone while securing the long-term benefits for themselves. Or, to continue with the status quo.Finally, we have the problem of political parties that have either run out of ideas or who want to make a dent in new electoral terrain. To them getting a foothold through the aid of a myopic policy is worth the price. After all, they have many other policies that are better for society, which they might rationalise. Or, it is a question of survival and how does long-term matter if you will cease to exist then. This is what explains the actions of AAP and Congress on OPS. Is There A Way Out?So how does a policymaker counter these? I have a few suggestions, some of which might seem Machiavellian.First, there are ways to take the sting out of short-term costs. A deft policymaker can obfuscate some of the costs by making their calculations more complex (say, in the design of an auction or a tax) that is difficult for the voter to understand. The idea is to reduce the overt display of the cost to be paid in the short-term. The other option is to impose the short-term costs in a phased manner or in specific cohorts (‘grandfathering' certain beneficiaries for some time). There is a whole field of behavioural economics that can be used to nudge the voter towards a certain action like loss avoidance. The other way to do this is to diffuse the responsibility of who is imposing the short-term costs among many agents of the state including the government, independent regulators, corporates, local bodies or international treaties. This fragmentation of power and diffusion of the blame can make it easier to take difficult calls. They can take the sting out of the costs to be paid for future benefits. Second, there are ways in which the long-term gains can be crystallised into something more tangible in the present. There are ways in which some of the future payoffs can be advanced through well-choreographed pilots. This is particularly true for infrastructure investments where the example of a few recent successes can be talked up and few well-timed benefits early on in the investment process can convince the citizens of the long-term benefits. The other way to think about it is to play up the huge long-term consequences of not acting now with any small evidence in the present being used to project a terrible future. This is how climate change activists are playing the game today where any minor aberration in weather patterns anywhere in the world is used to proclaim ‘climate change is real'. You might disagree with them on principle but their approach to building public support is right. Third, we come to making political commitments sticky for the future so that voters are more willing to support taking short-term pain. The way to go about is to make any reversal of course difficult by making a policy difficult to dismantle. This can be achieved by placing exit barriers while implementing a policy that could include multiple players and steps whose consent would be needed to roll back a policy. They could have veto powers to stop such rollbacks. The more the institutional fragmentation, the higher the barrier to exit. Other means could be adopted too like making an amendment to the law or constitution or setting up a new independent authority to institutionalise a policy. By having such players whose incentives are aligned with long-term benefits promised in the policy, one can create a significant hurdle. The costs of reneging on a commitment go up significantly. Lastly, how do we counter the small but organised interests that might scuttle a policy because they don't want to take the short-term pain? In most cases, the problem here is how do we mobilise the larger group for whom the benefits are diffused and in the long-term to counter the smaller but highly motivated group? One of the ways to think about this is to choose a smaller subset from the larger group whose benefits (or costs in case the policy isn't chosen) might have greater salience for the group. For instance, talking about children and the future of our planet makes it easier to focus on the costs of not making climate change investments today. The ability to show with clarity that the redistribution of benefits of a policy that imposes costs on current beneficiaries and favours a future group is crucial in winning the battle of minds. The benefits are often spoken in abstract terms over a larger group than making it very specific for a focused smaller group. If that's done well, you get a countervailing force against the small, organised group that wants to retain the status quo.The intertemporal policy choice is crucial to ensure democracies don't lapse into the most shortsighted policy recommendations because that's what gets instant mass approval. The wise man who told me to ‘always defer gratification' gave me the best career advice. Unfortunately, he didn't tell me how to do it. I suspect he didn't know it too. Because it is tough.    For more on the Pension issue, check these editions:* Pension Tension in edition #174* Pension Troubles are Back in edition#162* A Framework a Week: Understanding Cognitive Maps in edition #62Thanks for reading Anticipating the Unintended! Subscribe for free to receive new posts and support our work.India Policy Watch #2: The Cats See Through the Monkey's TrickInsights on domestic policy issues— Pranay KotasthaneIn edition #131, I wrote that India's fiscal federalism resembles the monkey and the two cats fable. While states fight amongst each other to corner a higher share of the total money devolved to them, the Union government can go scot-free even as it appropriates nearly 60 per cent of the divisible pool resources, raises new cesses, and uses a part of these funds to run its own centrally sponsored schemes. This focus on horizontal devolution (the formula used for sharing resources between states) masks the far more serious problems of vertical devolution (how money is split between the Union government and all states as a whole).Given this starting point, one news item from the past week caught my attention. State Finance Ministers (FMs) in the pre-budget consultation meeting with the Union FM highlighted the problems with the vertical devolution regime. Their criticisms and suggestions can be summarised as follows:* Increase states' share in goods and services tax (GST) to 60 per cent from 50 per cent at present. * Merge cesses and surcharges with the existing taxes so that states are not deprived of their share, and* Rationalise the expenditure under centrally sponsored schemes. The Tamil Nadu FM said that "All states, irrespective of political parties, expressed a common theme -- states' fiscal autonomy is greatly constrained by the extent of centrally sponsored schemes, by the extent of changing ratios of funding of such schemes”.Let's focus on the first suggestion, which seems to be a reform pathway for India's fiscal federalism. What should we make of it? First up, a clarification. The 50 per cent share that the state FMs highlighted refers to the rate of taxation and not the share of total GST collections. If you check any bill, the GST is split equally into two halves — SGST (which remains with the states) and IGST (which goes into the total divisible pool to be split between Union and state governments). Since 42 per cent of IGST is again devolved to states using the Finance Commission formula for vertical devolution, states already get about 70 per cent of the total GST collections. If the proposed change were to be made, the states' share in GST will further rise to 76.8 per cent, according to former J&K Finance Minister Haseeb Drabu. Keeping this important clarification aside, the suggestion to increase the share of SGST by 10 per cent is excellent. As I have argued earlier, any fiscal reform that increases general purpose transfers to states increases their autonomy and allows them to decide their own priorities. In a country where the GSDP per capita of the richest state (Goa) is nearly ten times that of the poorest (Bihar), one-size-fits-all schemes run from Delhi can hardly be expected to be effective. However, the proposed reform in its current form will be dead on arrival. There's nothing in it that would motivate the Union government to change its stance, and nor are states promising anything at their end in return. With some conditionalities, this reform can be made to work in the overall interest of citizens.One, states should commit to sharing a fixed percentage of their increased SGST share with local governments. State governments cannot always play victims. They are simultaneously culpable in strangling the finances of local governments. An increase in the SGST share can act as a useful incentive mechanism to fix this crucial flaw in our fiscal federalism.Two, states should commit to a fixed increase in capital expenditure. The increased fiscal space can easily be frittered away by states. Three states switching back to the costly Old Pension System that burdens future generations is a case in point. Hence, an increase in the states' GST share should be made conditional on improving the quality of expenditure.Three, the increased SGST share should be accompanied by a sunsetting of centrally sponsored schemes. This will create fiscal space for the Union government to focus on higher-level functions: defence, trade, manufacturing competitiveness, higher education, and R&D. Admittedly, this change would be the toughest part of the bargain. The Union government runs so many centrally sponsored schemes precisely because it is politically beneficial for parties to portray that our day-to-day requirements are solved directly only by the largesse of the occupant of the 7, Lok Kalyan Marg. A move away from this low-level equilibrium would need immense political capital. To make this idea palatable, a move to the 60:40 sharing can be made optional. Only states that agree to the above three conditions can transition to the new regime. The rest can continue to be stuck with the older compromise. In sum, the proposed reform merits serious discussion. Advertisement: Here's an awesome opportunity for mid-career professionals who missed out on learning the liberal arts.Global Policy Watch: Myth-busting Reservations About Global Supply ChainsInsights on global issues relevant to India— Pranay KotasthaneGeopolitics is trumping geoeconomics the world over. The good old days when international trade was unapologetically perceived as a positive-sum game are past us. Countries are pursuing expensive industrial policies across sectors, by labelling everything from the display screen of your phone to the apps on it as “strategic”. In this worldview, one constant villain is Global Supply Chains (GSCs). The dominant narrative seems to be that shorter and more domestic GSCs are more reliable, and hence government intervention to snip these GSCs is desirable.But what does the evidence suggest? A few recent papers inject some sense into the ongoing debate. In this section, I will summarise key insights from them, and link out to more readings on GSCs.The one economist to read on GSCs is Richard Baldwin. His 2012 paper Global supply chains: why they emerged, why they matter, and where they are going covers the foundational concepts lucidly. It delivers one insight after another, busting many myths in the process. Sample this:“Globalisation is often viewed as driven by the gradual lowering of natural and man-made trade costs. This is a serious misunderstanding. Globalisation has been driven by advances in two very different types of ‘connective' technologies: transportation and transmission.” …In Balwin's view, the first unbundling of globalisation was made possible by steam and made profitable by scale economies and comparative-advantage-led separation. The second unbundling was made possible by information communication technologies and made profitable by wage differences. There's a lot more in the paper that I'm still processing. Do give it a read.Meanwhile, his latest paper with Rebecca Freeman investigates if the current structure of GSCs is too “risky”. They acknowledge that the recent challenges—COVID-19, climate change and geopolitical tussles—are of a global scale and will likely reshape GSCs. They add that all firms make a risk-reward trade-off. Recent events have already driven firms to invest more in building resilience. Thus, there are just two cases where a government intervention makes sense. First, when the social evaluation of this trade-off puts greater stress on the “risk” compared to the firm's evaluation of this trade-off, there's a case for market failure. The higher the gap between these two perceptions, the higher the likelihood of government intervention. From an Indian perspective, China's recent actions have widened this gap.Second, the complexity of GSCs might make firms (especially the smaller ones) underestimate the true risks involved. This lack of information can be another justification for government action in the form of mapping and making this information public. On the issue of which interventions might actually reshape GSCs, they suggest: Locational equilibriums are unlikely to shift unless firms perceive a permanent shock and governments commit to substantial, long-term production subsidies (as with agriculture), massive regulation (as in banking), or massive state-lead interventions (as in defense). Policies on essential medical supplies and semiconductors may well prove to be more durable and effective given their critical nature. Arguments that these sectors are part of today's national defense, broadly defined, are more credible, and thus more likely to endure long enough to reshape production structures. Going beyond government interventions, they identify a trend that's of importance to us in India. Given the improvements in industrial automation and AI, future manufacturing GVCs might become shorter. At the same time, future services GVCs might become longer and more widespread, given the multilateral agreements on services trade, which are far less protectionist than those in manufacturing trade. From an Indian perspective, these propositions mean that India (or any other country) is not likely to displace China in the manufacturing of goods which are not considered “strategic”. Instead, it is automation that's more likely to reduce other countries' dependence on China. On the other hand, India's opportunity lies in the services trade. Policies such as data localisation or restrictions on human capital movements will only dampen India's chances. Perhaps, the far more important lesson from the US export controls on China is not that the US might do something similar to India, but how difficult it is to displace a country of China's size once it's embedded itself in GVCs. India's strategy should therefore be to embed itself in services GVCs. HomeWorkReading and listening recommendations on public policy matters* [Podcast] DO NOT MISS this Puliyabaazi with Ajay Shah in Hindi/English on state capacity and public policy. While you are there, subscribe to our channel :). * [Report] The State of State Finances report by Saket Surya and Tushar Chakrabarty of PRS is useful reference material for anyone interested in contemporary Indian public policy.* [Twitter Thread] For a simple explanation of the central issue in India's fiscal federalism, read Pranay's thread. * [Explainer] This Trade Deficit-101 is worth your time. It asks: What is a trade deficit and how does it affect the economy? This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit publicpolicy.substack.com

Business Of Biotech
In-Vivo CAR T Update With Umoja Biopharma's David Fontana, Ph.D.

Business Of Biotech

Play Episode Listen Later Nov 28, 2022 53:07


2023 is just around the corner, and it's shaping up to be a big year for Umoja Biopharma. The company is on the leading edge of the effort to break the solid tumor barrier with in vivo CAR T-cell therapies, with one such effort currently enrolling patients for a phase 1 trial. It's planning two more INDs in the coming year.  This episode of the Business of Biotech finds us getting the inside story from Umoja Chief Operating Officer David Fontana, whose storied career includes leadership positions at heavyweights including Sanofi, SeaGen, Pfizer, Juno, and BMS. Fontana shares on how he applies his experience playing a lead role in the success of Breyanzi, Adcetris, Bavencio, and  Relatlimab in his new role at Umoja, the outsourcing battle scars that motivated the company to build its own 146,000 square foot development and manufacturing facility, and much more. Subscribe to the NEW #BusinessofBiotech newsletter at bioprocessonline.com/bob for more real, honest, transparent interactions with the leaders of emerging biotech. It's a once-per-month dose of insight and intel that you'll actually look forward to receiving! Check it out at bioprocessonline.com/bob!

Feeling Good Podcast | TEAM-CBT - The New Mood Therapy
320 Help I'm Having Panic Attacks pt 1 of 2

Feeling Good Podcast | TEAM-CBT - The New Mood Therapy

Play Episode Listen Later Nov 28, 2022 57:22


When the Hidden Emotion isn't Hidden! Today's podcast will feature a live therapy session on September 13, 2022 with Keren Shemesh, PhD,  a licensed clinical psychologist and certified TEAM-CBT therapist. The entire session was recorded and will be presented in two consecutive podcasts. The two co-therapists are Jill Levitt, PhD, a clinical psychologist, and Director of Clinical Training at the FeelingGoodInsititute.com. Part 1 of the Keren session I will summarize the work that Dr. Jill Levitt and I did with Keren according to the familiar sequence of a TEAM-CBT Session: T = Testing, E = Empathy, A = Assessment of Resistance (formerly Paradoxical Agenda Setting), and M = Methods, with a final round of T = end-of-session Testing. In today's podcast, we will include the T, E, and A. In Part 2, we will include M = Methods and the final T = Testing. T = Testing Just before the start of the session, Keren completed the Brief Mood Survey (BMS) which you can review at this link: Keren's Pre-Session BMS As you can see, her depression score was only 3 out of 20, indicating minimal to mild depression. There were no suicidal thoughts, and her anxiety score was 10 out of 20, indicating moderate anxiety. She was also moderately angry (7 out of 20) and her happiness score was 10 out of 20, indicating very little happiness. Her relationship satisfaction level with her mother was 19 out of 30, indicating lots of room for improvement. However, she rated “degree of affection and caring” at 6 for “very satisfied,” which is the highest rating on this important item. We will ask her to take the BMS again at the end of the session, along with the Evaluation of Therapy Session, so we can see what the impact of the session was on her symptoms, as well as how empathic and helpful we were during the session. These ratings will be important, because the perceptions of therapists can be way off base, but the perceptions of our patients will nearly always be spot-on. Keren also brought a partially completed Daily Mood Log, which you can see at this link: Keren's Daily Mood Log (DML) at the start of the session As you can see, the upsetting event was her mother's visit from Israel. She had moderately to severely elevated negative feelings in nine categories, along with 17 negative thoughts, along with her rather strong beliefs in all of them. Most of her thoughts were of a self-critical nature, with lots of Hidden Should Statements as well. E = Empathy At the start of our session, which took place in front of our Tuesday evening training group at Stanford, Keren described her struggles like this: On Wednesday I woke up at 3 AM with panic attacks, one after another, and no way of getting back to sleep. I get somatic symptoms, I felt weak, nauseated, with no strength, almost paralyzed, and emotionally unstable. This was four days after my mother arrived form Israel. In the last 20 years, she and my dad visited me only once, on my graduation. I always had to visit them in Israel every year and was frustrated they none came to visit me in the Bat Area. On my last visit in May, I expressed my frustration about them not visiting me. They took it to heart and made plans to come for the Jewish high Holidays. My mom arrived first a few days ago and It's my first time alone with her. She's a Jewish mom and she stresses me out. Of course, I was really excited when she first arrived, but after four days I feel overwhelmed. This is SO MUCH WORK! I feel sad. I'm afraid I won't be able to function. I just cannot seem to enjoy my time with her. I feel fragile, but I'm hiding it. She's 73, and the signs of aging are obvious now. She needs more care, and it's tough to see her aging. Dad has always been super athletic, and he's in great shape, but she doesn't exercise or take care of herself. She's frustrated about aging and is angry with us for not accepting her as she is. I don't want to seem unhappy. I'm overwhelmed and just feel bad! David and Jill empathized, and Jill emphasized how much her parents must love her, coming from such a great distance to be with her, but also acknowledged how hard it must be for them and for Keren to be living at such a great distance. Jill pointed out that one of the issues Keren may be struggling with is the belief that their time together should be fun and conflict-free, since the time is so precious. Keren continued: My biggest problem is that I feel I cannot be me when I'm around them . . . . They want me to be a different version of myself. . . . They want me to be a mother, and they want grandchildren. But I'm in the 5% of women who don't have any interest in having children. I'm 46 years old now, and I guess I could see myself adopting, but having a family is a big job, and I've never had the passion. So, I feel like I'm a disappointment to them. But we never talk about it. I sometimes feel invisible and unseen when I'm around them. They'd be so much prouder of me if I had children they could brag about. Keren also shared her frustration and anger with her mom for not taking better care of her health. Since her mom has been in town, Keren has arranged all kinds of fun activities for them to do together, but Keren's joy is dampened by the many unspoken feelings she is constantly trying to hide, for fear of conflict and upsetting her parents. A = Assessment of Resistance Keren gave us an A+ in Empathy, so we went on to the Assessment of Resistance phase of the session, where we set the Agenda. Keren's goal was to get over her panic attacks, and we discussed three possible treatment strategies with Keren: The Hidden Emotion Technique: This technique would be based on our hunch that Keren's panic attacks are the direct result of the many feelings she is consciously, and subconscious trying to hide and sweep under the rug. Dealing with the self-critical thoughts on the Daily Mood Log she provided at the start of the session. LINK Using Forced Empathy to help her see the world through her mother's eyes, as we did in a fairly recent podcast with Zeina, another member of our Tuesday training group who was in conflict with her mother. Keren expressed considerable enthusiasm for options 2 and 3. I (David) pointed out that she appeared to be ignoring / avoiding the first option, and raised the question of whether that meant it might be the most productive, but scariest, of the three options. Keren conceded that this rang true, and wanted to start out with learning to express her feelings more openly and directly, but in a respectful and loving way. In next week's podcast, you'll find out what happened! Part 2 of the Keren session: M = Methods We began the Methods part of the session with a bit more Paradoxical Agenda Setting, and listed some really GOOD reasons NOT to open up more to her mother. I want to protect her because it may be hard and upsetting to her. I'm not used to being vulnerable with my parents. I don't want to rock the boat or change the status quo. I'm not sure I want a closer relationship with my mother. NOTE: David and Jill were thinking that we often resist intimacy because we have negative pictures in our mind of what real closeness is. For example, if you think it means something yucky and upsetting, you obviously won't want to get “close.” Jill tried to finesse around this by suggesting Keren might aim for a more “honest” relationship instead of a “closer” relationship. There are things about me that they've rejected, like the fact that I don't really want children. And I'm not so sure I want to make myself vulnerable and get rejected again! I'm afraid I'll get swallowed up and enmeshed. We asked Keren what kinds of feelings she was hiding from her mother. My feelings of nervousness and intense anxiety, and the intense somatic symptoms, like the knot in my stomach. I am scared for her future, since she is not in good health and she's not taking care of herself. I have feelings of anger and resentment about the fact that I'm not the kind of daughter they wanted. I'm sad about her health and seeing her struggle. I feel hurt when I think how I have failed them and let them down. I sometimes feel like I don't really belong. At this point, I became so absorbed in the session that I stopped taking notes, so you will have to listen carefully to the recording of the session which was fascinating. I do recall, however, that we began working on communication, using the Five Secrets of Effective Communication (LINK), as well as tips on how to proceed, taking it one step at a time and not trying to do it all at once, and role playing practice. Then we did some Externalization of Voices with the thoughts on Keren's Daily Mood Log, using several strategies: Self-Defense, the Acceptance Paradox, and the CAT, or Counter-Attack Technique. You can see the Daily Mood Log she completed after the session, based on the work we did in the session, at this LINK. Keren's end-or-session Brief Mood Survey and Evaluation of Therapy Session In addition, Keren and Jill will be with us to record the follow-up. T = End-of-Session Testing You can review Keren's BMS and EOTS (Patient's Evaluation of Therapy Session) at the end of the session at this LINK. Keren's end-or-session Brief Mood Survey and Evaluation of Therapy Session As you can see, her depression score fell to 1, indicating substantial improvement, while her suicidal thoughts and urges remained at 0. Her feelings of anxiety vanished, but her feelings of anger remained fairly elevated, falling from 7 to 4. We would not expect further improvement in this dimension until she's had the chance to share more of her feelings with her mom. Her feelings of happiness only increased from 10 to 13, again any further improvement would not be expected until she's had the chance to do her “homework” following the session. However, her satisfaction with her relationship with her mom increased from 19 to 26 out of 30, which is substantial, while still leaving some room for improvement. On the EOTs, you will see that our Empathy and Helpfulness scores were perfect, along with our scores on the Satisfaction with Session, Commitment to homework, unexpressed Negative Feelings, and honesty scales. Here's what she like “the least” about the session: “Nothing. This has been a powerful experience.” Here's what she like “the best” about the session: “This has been empowering. The hidden emotion is like a blind spot. I know it is there, but I cannot see it. I loved when David pointed to my avoidance, and I am glad we focused on the hidden emotion. Jill and David were able to see the depth in situation and I feel seen and understood.” Follow-Up We exchanged a number of emails following the session, and will also talk to Keren and Jill live on the podcast so you can catch up on what happened. But here is an excerpt from one of Keren's emails: Here is what has happened so far: On Friday morning, she made some comments about my gray hair and that the fridge gasket was not properly clean. I got really annoyed, but did not say anything. To be honest, I was too angry to use the 5 secrets and needed time to cool off. About after half an hour later, on our way to the acupuncturist, I told her that I love having her over and that it is special to me that we spend time together. She thanked me for everything that I am doing for her on this trip. Then I added: "this morning, when I came to check on you, you commented on my hair and then you told me to clean the fridge gasket..." I was going to follow up with 5 secrets, but before I was able to finish, she interrupted me and said "Gosh, I am so critical! I am sorry, I didn't mean it that way. I can see now why your sister gets upset with me. I can't believe myself." I told her that I love her honesty and while her criticism comes from a caring loving place the how and when she says things sets tone. This was a breakthrough because even though I did not finish using the 5 secrets I got through to her and felt heard. It was encouraging for me to feel that I could be understood and accepted by her.  I have clients who say that they love the 5 secrets, but like to call it the 3 secrets because they find it effective enough to use only 3. (I still encouraged them to use all 5). I can see now what they mean, I did not finish my 5 secrets spiel and got some good results. I believe that my conservation with my mother will further trickle during her stay. Perhaps because there is a lot to cover, or perhaps it's the way we communicate. In either case, I feel good about having the talks that I previously dreaded. I have not had any panic attacks since, but I don't think they have completely gone. I believe they will be there to remind me to address certain emotions that need addressing.. . . I will keep you posted and may even send this to the group. Just need to think about it a bit longer. Responses from the Tuesday Group who observed our work with Keren Here are just a few of the comments from the 35 therapists who observed the session. This is part of the feedback we get on the quality of our teaching at the end of every Tuesday training group. Please describe what you specifically disliked about the training/ Nothing. The live work was fascinating to watch. David and Jill were masterful as always! This was a truly moving and inspiring and helpful session. I can't think of anything I didn't like about it. Nothing I disliked. I think I would have liked to see Keren do more deliberate practice with the 5 secrets with grading and more roleplaying. Conceptualization was a bit hard to follow. Please describe what you specifically liked about the training. Thank you for such an authentic, moving, beautiful session. And tour-de-force demonstration of TEAM therapy. Observing David and Jill as co therapists in service of Keren was an amazing learning opportunity! The power between them was exponential and felt like they successfully addressed every angle. . .  I had not considered using EOV and loved how effective that was in crushing Keren's thoughts. I also loved how Jill finessed gently guiding her to address Hidden Emotion, having clear conviction that this was where the "action" was. I can understand what Keren said that she wants to be closer but does not want to be enmeshed. I think that it helped us in our work with immigrants and those who live away from where they were born. The discussion about the desire to be a parent or not, was another aspect of the work that I really respected. Excellent class tonight! Keren's gift to the class was priceless and David and Jill's masterful teaching was outstanding as always. Thank you!!! I got to feel closer to her and to several group members through their sharing. David touched me with the notion that opening up to one's parents is an important gift that many of them don't get to receive. Thanks for listening today! Rhonda, Keren, Jill, and David

Bitcoin Made Simple Podcast
News Made Simple 11-18-2022

Bitcoin Made Simple Podcast

Play Episode Listen Later Nov 18, 2022 31:54


Cory, Luke, & Phil discuss FTX/False Flages/Interest Rates and more. Check out the BitBox02 Hardware Wallet Go to https://shiftcrypto.ch/bitcoinmadesimple and use the promo code "bitcoinmadesimple" to get 5% off standard products. Movies Plus - go to www.myMoviesPlus.com and get 20% OFF an annual subscription with promo code CORY, and you can watch "Hard Money with Natalie Brunell" and the documentaries "The Great Reset and the Rise of Bitcoin", "Bitcoin FUD", "Bitcoin: The End of Money as We Know It", and "Cryptopia: Bitcoin, Blockchains and the Future of the Internet." Watch them all on Movies Plus. Bitcoin Day www.bitcoinday.io use promo code BMS to get a discount on your tickets to a Bitcoin Day event near you. --- Support this podcast: https://anchor.fm/bitcoinmadesimple/support

Bitcoin Made Simple Podcast
BMS 079 - Who was behind the FTX & SBF collapse? Phil Gibson joins to share his theory

Bitcoin Made Simple Podcast

Play Episode Listen Later Nov 17, 2022 67:09


Cory talks with Phil about his article detailing why he thinks the Fed collapsed FTX to hurt the Euro Off Shore Dollar market. Buckle up, theres a lot to unpack in this debacle. Check out Phil's article here: https://qpol.substack.com/p/the-rise-and-fall-of-sam-bankman Check out the BitBox02 Hardware Wallet Go to https://shiftcrypto.ch/bitcoinmadesimple and use the promo code "bitcoinmadesimple" to get 5% off standard products. Movies Plus - go to www.myMoviesPlus.com and get 20% OFF an annual subscription with promo code CORY, and you can watch "Hard Money with Natalie Brunell" and the documentaries "The Great Reset and the Rise of Bitcoin", "Bitcoin FUD", "Bitcoin: The End of Money as We Know It", and "Cryptopia: Bitcoin, Blockchains and the Future of the Internet." Watch them all on Movies Plus. Bitcoin Day www.bitcoinday.io use promo code BMS to get a discount on your tickets to a Bitcoin Day event near you. --- Support this podcast: https://anchor.fm/bitcoinmadesimple/support

Technovation with Peter High (CIO, CTO, CDO, CXO Interviews)
Accelerating the Pace of Drug Discovery through A.I. with BMS CDTO Greg Meyers

Technovation with Peter High (CIO, CTO, CDO, CXO Interviews)

Play Episode Listen Later Nov 17, 2022 27:08


716: Greg Meyers, Chief Digital and Technology Officer of Bristol Myers Squibb (BMS), discusses the innovations in digital health that he is driving and how they have accelerated the pace of drug discovery. He gives an overview of BMS's business and the company's digital health program as well as how collaboration with physicians and hiring for various skills have been critical in developing game-changing innovations. Greg also covers the way his team collaborates internally across the silos within the organization and leverages technologies like artificial intelligence to increase the speed at which drugs are tested and developed. Finally, he explains why he chooses to immerse himself deeply in more technical aspects of the business, looks ahead at what trends in technology he believes will continue to make important contributions to healthcare, and reflects on the keys to his career success.

Bitcoin Made Simple Podcast
News Made Simple 11-11-2022

Bitcoin Made Simple Podcast

Play Episode Listen Later Nov 15, 2022 34:43


The FTX debacle and more. Check out the BitBox02 Hardware Wallet Go to https://shiftcrypto.ch/bitcoinmadesimple and use the promo code "bitcoinmadesimple" to get 5% off standard products. Movies Plus - go to www.myMoviesPlus.com and get 20% OFF an annual subscription with promo code CORY, and you can watch "Hard Money with Natalie Brunell" and the documentaries "The Great Reset and the Rise of Bitcoin", "Bitcoin FUD", "Bitcoin: The End of Money as We Know It", and "Cryptopia: Bitcoin, Blockchains and the Future of the Internet." Watch them all on Movies Plus. Bitcoin Day www.bitcoinday.io use promo code BMS to get a discount on your tickets to a Bitcoin Day event near you. --- Support this podcast: https://anchor.fm/bitcoinmadesimple/support

One Radio Network
11.11.22 PJT

One Radio Network

Play Episode Listen Later Nov 11, 2022 126:39


ORN It Takes A Long Time To Get Young 11/11/22 Not only not in the box but not believing there is a box. It's been a lie – govt, wars, power players, germ theory, etc.. The inner knowing that it's false makes life better. Are there parasites, and do we need to kill them? Or do they benefit us? The pain happens during the healing process. Veteran's Day sale 15% off on Surthrival. Storewide on 11/11. Use code VETERANS. All wars are bankers' wars. They've never been about what “they” say. Did veterans protect our freedom, or did they protect “their” stuff? Need someone to listen to you? Try Patrick In Your Pocket. 1 hr. zoom coaching plus unlimited email support, for a low one-time charge. Big sale on X3 Bands. Maintain continuous pressure on the muscle when using them. Become fit without soreness with a X3 15 minute daily exercise routine . Patrick explains why he doesn't counter his guests when they espouse something he doesn't agree with. The 7 Deadly Sins are what cause disease. How much to eat? Eat when hungry, eat until full, pay attention to satiety. During the interval when not eating, the body goes into autophagy. What is eating away the damaged material? Parasites. Eat enough fat: butter cheese cream tallow ghee. It eases BMs. Bloating comes from eating indigestible food, e.g. vegetables. Intern that worked for Patrick 50 years ago at a radio station rediscovers him. Blushield 10% off with ONERADIO code. 5G transmitters blanketing New York City. Omica has great shower filters and water filters. See ORN store. What will be the impact of this election? Stay connected, get stronger on all levels to be able to overcome. True Earth virtual summit starting today, continuing tomorrow. Code FEDAVE50 for $50 off. David Weiss, Peggy Hall, David Avocado Wolfe, many others. What does Patrick feed Doodle? Raw beef, eggs, extra fat. Supplemental organic canned foods from CornucopiaPetFoods.com. Is it safe to deep-fry in olive oil? No, no, no. Best fat to fry in is beef tallow. McDonald's used it 60 years ago. Is the most stable fat. Coconut oil a good cooking oil, also avocado oil, ghee. Why do listener's son seizures only occur on the full moon? Are parasites really the cause? Election fallout. More power coming to the red states. Strong governors have a lot of power in their state. Don't have to do anything Washington tells them to do. Voting is powerful locally - county sheriff, city council, school boards. Pushback against the woke. Listener says not all parasites, either internally or externally, can be handled without treatment. Patrick says: Which ones do you need to kill? Listener comments on creating and shaping our reality and being in the Matrix. A stormy morning ended the ORN broadcast prematurely.

Bitcoin Made Simple Podcast
BMS 077 - Traveling - LA - FTX - Movies Plus

Bitcoin Made Simple Podcast

Play Episode Listen Later Nov 7, 2022 34:53


Cory talks about the first Movies Plus Original Series, Traveling to LA and missing flights, whats going on with FTX, and being in normieland. Check out the BitBox02 Hardware Wallet Go to https://shiftcrypto.ch/bitcoinmadesimple and use the promo code "bitcoinmadesimple" to get 5% off standard products. Movies Plus - go to www.myMoviesPlus.com and get 20% OFF an annual subscription with promo code CORY, and you can watch "Hard Money with Natalie Brunell" and the documentaries "The Great Reset and the Rise of Bitcoin", "Bitcoin FUD", "Bitcoin: The End of Money as We Know It", and "Cryptopia: Bitcoin, Blockchains and the Future of the Internet." Watch them all on Movies Plus. Bitcoin Day www.bitcoinday.io use promo code BMS to get a discount on your tickets to a Bitcoin Day event near you. --- Support this podcast: https://anchor.fm/bitcoinmadesimple/support

What's Up Everybody
Episode 113

What's Up Everybody

Play Episode Listen Later Nov 6, 2022 61:04


This week Evan talks about the new terp hammers and teases about upcoming collabs and store drop ideas. He also touches on personal growth through the year, a quick studio update, innovative glass blowers on the come up in the scene and the idea of potential BMS classes.

Dirty Glove Bastard: Off The Porch
G-Cess DGB Off The Porch Interview

Dirty Glove Bastard: Off The Porch

Play Episode Listen Later Nov 6, 2022 23:41


Interview by Haze https://www.instagram.com/mike_tall Recently we sat down with Atlanta native G-Cess for an exclusive “Off The Porch” interview! During our conversation he talked about Bowen Homes, his childhood, jumping off the porch, his reaction when they tore down Bowen Homes, his upcoming book, what inspired him to start rapping, being in the group BMS, the changes in the rap game & music industry, working with Shawty Lo on “Bankhead Mine”, Lo's legacy, Bankhead's influence on the culture & rap game, his new project ‘Welcome 2 Bankhead', his single “Patient”, his clothing line Never Stress Again, his web series ‘A T Hell', upcoming films, his podcast Faxtz, and much more!

What's Up Everybody
Episode 111

What's Up Everybody

Play Episode Listen Later Nov 4, 2022 53:30


First episode in the new studio break room. Lots of catching up and idea projections for the future of BMS. Evan talks about what this means for where BMS is headed and how excited he is.

What's Up Everybody
Episode 112

What's Up Everybody

Play Episode Listen Later Nov 4, 2022 53:21


Back at the home studio for this episode. Evan continues to catch up on what's been going on with the new studio build, and shows off the new “mini” pump station piece and function with side-by-side comparisons to the OG pump station. He also brainstorms some ideas for what BMS could offer for the coming drops during the holiday season.

Inside the Lab
The Molecular Biomarker Revolution in Metastatic NSCLC

Inside the Lab

Play Episode Listen Later Nov 3, 2022 44:16


During this recorded 2022 ASCP Annual Meeting session, multidisciplinary faculty will discuss the science and latest evidence on emerging biomarkers, resistance mutations, immuno-oncology (I-O) resistance mechanisms, and I-O treatment options (e.g., combination therapy involving CTLA-4 inhibitors) in metastatic NSCLC.  In addition, they will address how to integrate next generation sequencing (NGS) into your biomarker testing workflows and optimize its use for patients.  Finally, they will share best practices in biomarker testing, reporting, and communication to help pathologists and laboratory professionals guide medical oncologists and other team members in the appropriate diagnosis, testing, and treatment for patients.  The activity offers 1.0 CME/CMLE credit.  The American Society for Clinical Pathology (ASCP) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education (CME) for physicians.   Learning ObjectivesUpon completion of this activity, you should be able to:·         Describe ongoing investigational efforts regarding emerging biomarkers in metastatic NSCLC ·         Utilize NGS to identify current and emerging biomarkers to predict response to personalized therapies for patients with metastatic NSCLC ·         Employ strategies for optimizing workflows and turnaround times for NGS ·         Discuss the science behind resistance mechanisms in patients with metastatic NSCLC ·         Recognize the use of emerging I-O combination therapies and potential biomarkers in patients with metastatic NSCLC ·         Develop ways to improve communication among pathologists, oncologists, and other members of the multidisciplinary lung cancer care team FacultyDiana N. Ionescu MD, FRCPC, FCAP Consultant Pathologist and Medical Lead Anatomical Pathology Medical Director BC Cervical Cancer Screening Laboratory Medical Director Clinical Trials, BC Cancer Laboratories Clinical Professor of Pathology, University of British Columbia Doru Paul, MD, PhDAttending Physician, Division of Hematology and Medical Oncology Weill Cornell and New York Presbyterian Hospital  Faculty DisclosuresThe following Panel/Faculty members have relevant financial relationships to disclose:  | Faculty Member | Ineligible Company | For what role? | Diana Ionescu, MD | AstraZeneca, Bayer, BMS, Merck, Pfizer, Roche | Consultant, Consultant, Consultant, Consultant, Consultant, Consultant Dr. Paul has no relevant financial relationships to disclose All of the relevant financial relationships listed for these individuals have been mitigated  Commercial SupportFunded by an independent educational grant from AstraZeneca Pharmaceuticals

Bitcoin Made Simple Podcast
News Made Simple 10-28-22

Bitcoin Made Simple Podcast

Play Episode Listen Later Nov 1, 2022 56:12


The gang is back together! (Disclaimer, first minute or so of me talking has an echo, then our engineer fixed it and it was all good). Cory, Luke, and Phil discuss all the goings on in Bitcoin and geo politics the week of 10/20/2022. TECH DIFFICULTIES the first time Cory talks, there is an echo, then it was fixed so bear with us for that one blip, the audio works itself out! Check out the BitBox02 Hardware Wallet Go to https://shiftcrypto.ch/bitcoinmadesimple and use the promo code "bitcoinmadesimple" to get 5% off standard products. Movies Plus - go to www.myMoviesPlus.com and get 20% OFF an annual subscription with promo code CORY, and you can watch "Hard Money with Natalie Brunell" and the documentaries "The Great Reset and the Rise of Bitcoin", "Bitcoin FUD", "Bitcoin: The End of Money as We Know It", and "Cryptopia: Bitcoin, Blockchains and the Future of the Internet." Watch them all on Movies Plus. Bitcoin Day www.bitcoinday.io use promo code BMS to get a discount on your tickets to a Bitcoin Day event near you. --- Support this podcast: https://anchor.fm/bitcoinmadesimple/support

Retronauts
491: Blaster Master

Retronauts

Play Episode Listen Later Oct 31, 2022 106:58 Very Popular


Jeremy Parish, Stuart Gipp, and Todd Ciolek talk about BMs. But no! This is not a scatological episode. Well, no more than usual, anyway. These BMs are Blaster Masters, the frog-savin' franchise that Sunsoft kicked off back in 1988 on NES. Edits by Greg Leahy; cover art by Greg Melo. Retronauts is made possible by listener support through Patreon! Support the show to enjoy ad-free early access, better audio quality, and great exclusive content. Learn more at http://www.patreon.com/retronauts

Content creator to Money Maker podcast with Michelle Gifford
Ep 224 The Mental Gym: I Can Almost Do a Pull-Up

Content creator to Money Maker podcast with Michelle Gifford

Play Episode Listen Later Oct 31, 2022 20:37


For the past three months, I've had a goal to do a pull-up and I'm almost there! I've been going to the gym and weightlifting for the last year and I have learned a lot about myself. It was my birthday last week, so I have been thinking about what I have accomplished in the last year and what I'm most proud of. In this episode, I'm sharing 7 life lessons I've learned from a year of lifting weights and how it can apply to your business. Let me know what stuck out to you and DM me on Instagram. https://www.instagram.com/iammichellegifford/ If you're ready for someone to help you run your business, check out my agency. We would love to help you run your content and social media. iammichellegifford.com/pricing#content-management Join Business Mom School by texting "BMS" to 951-309-7885 or by going here: iammichellegifford.com/business-mom-school-opt-in Find the full show notes and blog post here: https://iammichellegifford.com/7-biz-lessons-i-learned-at-the-gym

Corridor Cast
EP#159 | How to Build Your Own Open Source Onewheel

Corridor Cast

Play Episode Listen Later Oct 31, 2022 124:24


Niko, Wren, and Jan sit down to talk about the new open-source Onewheel, the VESC, and the process/resources should you want to build your own. How to Build a VESC - All the Resources and Links You'll Need: Welcome to the cutting edge of personal electric vehicles! If you want to jump in, here's where to get started; GENERAL INFO AND GUIDES; Forums: https://pev.dev/ Onewheel VESC Facebook group: https://www.facebook.com/groups/231469878541536/ Surfdado's YouTube channel: https://www.youtube.com/channel/UClhp0J195HBXm6p6KN8nE4Q VESC ONEWHEEL PARTS; THE BRAIN/CONTROLLER: The electronics from Makers PEV- https://www.makerspev.com/collections/bundles The lid and kit for the controller box: https://www.flowglider.com/index.php/product/lid-mount-version-of-wtfoc-mk2-hardware-pack-for-little-focer-v3/ 3d printed controller box: https://www.littimber.com/product/wtfoc-mk2-controller-box-for-little-focer-v3-1-lid-mount-version/ Video on how to assemble the controller box: https://www.youtube.com/watch?v=3Olnt5r63JU You will also need this connector cover! https://www.flowglider.com/index.php/product/wtfoc-connector-cover/ RAILS: Float life: https://thefloatlife.com/collections/sidekicks Thunder Rails: https://fungineers.tech/products/rails-and-adapter-3d-printed-filed-for-enclosures-and-bumpers MOTOR: Superflux motor: https://fungineers.tech/products/superflux Or buy a used Hypercore motor from an XR! BATTERY: Torquebox: https://www.badgerwheel.com/shop-online/torquebox-pre-order (or use an XR battery box or print your own) Torque Pack: https://chibatterysystems.com/collections/diyonewheel/products/torquepack Indy Speed Control 84v pack with BMS: https://indyspeedcontrol.com/shop/p/hnehknph64ts8dm5xlf4liyicob9el (or use an XR battery and follow a guide on how to add your own BMS) Don't forget to buy a charger too! You will also need this battery cable if you don't have one from a gutted XR: https://www.makerspev.com/products/16-pin-molex-battery-harness-for-flowglider FOOTPADS: https://onewheel.com/products/surestance Good luck and happy building! SUPPORT ► Join Our Website: https://bit.ly/Crew_Membership Instagram: http://bit.ly/_Corridor_Instagram Sub-Reddit: http://bit.ly/_Corridor_Sub-Reddit Buy Merch: http://bit.ly/Corridor_Store OUR GEAR, SOFTWARE & PARTNERS ► Our Go-To Gear: https://bhpho.to/3r0wEnt Puget Systems Computers: http://bit.ly/PC_Puget_Workstations ActionVFX: https://bit.ly/TheBest_ActionVFX Lighting by Aputure: http://bit.ly/CORRIDOR_LIGHTS Cinema4D: http://bit.ly/Try_Cinema4D Insydium: https://bit.ly/Insydium_Plugins Octane Render by OTOY: http://bit.ly/Octane_Wrender Boris FX - Mocha, Sapphire & Continuum: https://bit.ly/2Y0XLUX Motion Captured with Xsens Suit: http://bit.ly/Xsens_MoCap_Suit Reallusion: https://corridor.video/Reallusion_3Dsoftware Unreal MegaGrant: http://bit.ly/Unreal_MegaGrant CHAPTERS; 0:00 - Intro / Open Source One Wheels 9:15 - OneWheel Mods / Liability 10:17 - Established Titles 12:17 - OneWheel Mods / Liability (cont.) 17:18 - The Onewheel GT 24:15 - Right to Repair 31:45 - Why we made VESCs 41:03 - Special Thanks 43:04 - Resources and Overview on How to Build a VESC

Bitcoin Made Simple Podcast
BMS 077 - the Butt-hurt Bear Market, Bitcoin Fixing Dental Problems and more...

Bitcoin Made Simple Podcast

Play Episode Listen Later Oct 24, 2022 45:16


Cory talks about getting dental help from a Bitcoiner, where is this hashing coming from that is putting Bitcoin Miners on edge, whats going on at Movies Plus and more. Check out the BitBox02 Hardware Wallet Go to https://shiftcrypto.ch/bitcoinmadesimple and use the promo code "bitcoinmadesimple" to get 5% off standard products. Movies Plus - go to www.myMoviesPlus.com and get 20% OFF an annual subscription with promo code CORY, and you can watch "Hard Money with Natalie Brunell" and the documentaries "The Great Reset and the Rise of Bitcoin", "Bitcoin FUD", "Bitcoin: The End of Money as We Know It", and "Cryptopia: Bitcoin, Blockchains and the Future of the Internet." Watch them all on Movies Plus. Bitcoin Day www.bitcoinday.io use promo code BMS to get a discount on your tickets to a Bitcoin Day event near you. --- Support this podcast: https://anchor.fm/bitcoinmadesimple/support

Content creator to Money Maker podcast with Michelle Gifford
Ep 219 How One Money Maker Doubled Her Income and Following in a Year

Content creator to Money Maker podcast with Michelle Gifford

Play Episode Listen Later Oct 13, 2022 19:32


Have you ever wondered if you had a business coach and if you had a community of people who really were there to help you with your business, would you be able to grow your business further? I have a coaching group called Money Makers. It opens for enrollment twice a year and will open on October 18th. So in this episode, I brought in some of my Money Makers because I want you to hear who they are and the things that they're experiencing by being in Money Makers. You're going to meet some of my favorite friends and my hope is that you will see how much fun and how much good Money Makers can do for your business because this is your chance to get in. Join Money Makers! If you're ready to take the next step in your business, I would love to have you in my coaching group. Money Makers will open from October 18-October 25. This only happens twice a year, so don't wait! Join Business Mom School by texting "BMS" to 951-309-7885 or by going here: iammichellegifford.com/business-mom-school-opt-in You can find the full show notes and blog post here: https://iammichellegifford.com/4-signs-its-worth-joining-a-business-coaching-group

Content creator to Money Maker podcast with Michelle Gifford
Ep 218 Case Study: How Are People Growing On Instagram Right Now?

Content creator to Money Maker podcast with Michelle Gifford

Play Episode Listen Later Oct 11, 2022 14:01


Are people really growing on Instagram? Who are these people and what are they doing? In this episode, I'm going to walk you through the people who are actually growing on Instagram. We're going to break down their strategies and see how we can apply these strategies to your business so that you can use Instagram to grow your business and make you more money. Join Business Mom School by texting "BMS" to 951-309-7885 or by going here: iammichellegifford.com/business-mom-school-opt-in Join Money Makers! If you're ready to take the next step in your business, I would love to have you in my coaching group. Money Makers will open from October 18-October 25. This only happens twice a year, so don't wait!