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No Frango Fino dessa semana, Doug Bezerra, Doug Lira e Rafa Louzada mergulham no universo bizarro e inesquecível da TV brasileira reagindo ao clássico “Em Nome do Amor”, apresentado por Silvio Santos. Entre cantadas constrangedoras, declarações exageradas e coreografias duvidosas, eles analisam esse verdadeiro ritual do amor nos anos 90.Comente no post da FreeCo, falando do Troféu Cocô e nos ajude a trazer mais esse anunciante para o Franguinho!!!EVERYDAY SHORTS, HEAVY PULLOVER E CALÇA STUDIO: NOVAS CORES, MESMA PERFORMANCE – USE O CUPOM FRANGOFINO E LEVE ATÉ 35% OFF!Arte do episódio por Vinicius Laureano (@vinil_ilustra)Apoie o Frango!! NOVO PIX: pixdofrangofino@gmail.com Apoia.se: https://apoia.se/frangofinoOrelo: https://orelo.cc/frangofinoPatreon: https://patreon.com/frangofino Comentado durante o programa:Dentro da minha cabeça - Frango FinoVídeo que reagimosMaquininha Philips para depilação (boa para regiões rugosas)Maquininha Philips para depilação das moças (mas pode usar se você se considerar rapaz também)INSCREVA-SE NO CANAL DO FRANGO NO YOUTUBEReddit do Frango FinoO retorno da banda Diezel!! Diezel - Insano (ao vivo)Loja do FrangoPlaylist musical do FrangoNão perca mais nossas lives! Siga o Bezerra em twitch.tv/dougbezerraTIKTOK DO FRANGO!Instagram dos Frangos:Doug Bezerra (@dougbezerra), Doug Lira (@liradoug) e Rafa Louzada (@rafaelouzada)Para falar com a gente:E-mail:frangofinopodcast@gmail.comInstagram:@frangofinopodcastWhatsapp: 11 94547-3377
No Troféu Cocô dessa semana, Doug Bezerra (@dougbezerra) e André Rocca (@roccailustra) contam a história de um office-boy que viveu uma verdadeira saga para recuperar um cheque perdido.CAMISA FUTUREFORM: DESAMASSA NO CORPO, MANTÉM FRESCOR E TEM VISUAL SOFISTICADO – USE O CUPOM FRANGOFINO E LEVE ATÉ 50% OFF!INSCREVA-SE NO CANAL DO FRANGO NO YOUTUBEArte do episódio por André Rocca.Apoie o Frango!!PIX: frangofinopodcast@gmail.comApoia.se: https://apoia.se/frangofinoOrelo: https://orelo.cc/frangofinoPatreon: https://patreon.com/frangofinoCLIQUE AQUI E MANDE SUA HISTÓRIA NO WHATSAPP ou frangofinopodcast@gmail.comPara falar com a gente:E-mail:frangofinopodcast@gmail.comInstagram:@frango.finoWhatsapp: 11 94547-3377
Welcome to Citipointe Church Online. We love that you're joining us for our online experience.Scripture V. Culture | Ps Ronan PaulosOctober 12th - 5:00pm ServiceTo connect with or contact us, visit https://citipointechurch.com/connectTo GIVE online, visit https://citipointechurch.com/givingIf you have made a decision today to follow Jesus, please let us know by filling out the form found here: https://citipointechurch.com/i-have-decided/Citipointe Church exists to unmistakably influence our world for good and for God.
Welcome to Citipointe Church Online. We love that you're joining us for our online experience.Prepare the Way For the Lord | Ps Al GordanOctober 12th - 10:15am ServiceTo connect with or contact us, visit https://citipointechurch.com/connectTo GIVE online, visit https://citipointechurch.com/givingIf you have made a decision today to follow Jesus, please let us know by filling out the form found here: https://citipointechurch.com/i-have-decided/Citipointe Church exists to unmistakably influence our world for good and for God.
No Ciscadinhas dessa semana, respondemos os comentários do Troféu Cocô #72 e Frango Fino #550.SÓ HOJE: 20% DE DESCONTO EM TODO O SITE DA INSIDER COM O CUPOM FRANGOFINOINSCREVA-SE NO CANAL DO FRANGO NO YOUTUBEArte do episódio por Eddy Fortunato (@eddy_fortunato)Apoie o Frango!! NOVO PIX: pixdofrangofino@gmail.com Apoia.se: https://apoia.se/frangofinoOrelo: https://orelo.cc/frangofinoPatreon: https://patreon.com/frangofino Comentado durante o programa:Rocca e os integrantes do Frango quando eram criançasMaquininha Philips para depilação (boa para regiões rugosas)Maquininha Philips para depilação das moças (mas pode usar se você se considerar rapaz também)INSCREVA-SE NO CANAL DO FRANGO NO YOUTUBEReddit do Frango FinoO retorno da banda Diezel!! Diezel - Insano (ao vivo)Loja do FrangoPlaylist musical do FrangoNão perca mais nossas lives! Siga o Bezerra em twitch.tv/dougbezerraTIKTOK DO FRANGO!Instagram dos Frangos:Doug Bezerra (@dougbezerra), Doug Lira (@liradoug) e Rafa Louzada (@rafaelouzada)Para falar com a gente:E-mail:frangofinopodcast@gmail.comInstagram:@frangofinopodcastWhatsapp: 11 94547-3377
Community of Christ (CoC) President Stassi Cramm, the church's first female prophet, addressed pointed questions regarding the role of the Book of Mormon, the pursuit of consensus and faithful disagreement, her prophetic vision for the church, and the ongoing debate over infant baptism. https://youtu.be/M6kOcByONr8 Don't miss our other conversations with Stassi: https://gospeltangents.com/people/stassi-cramm/ Copyright © 2025 Gospel Tangents All Rights Reserved Book of Mormon: Upholding Scripture President Cramm emphatically denied the accusation that the Community of Christ is "moving away from the Book of Mormon.” Key points regarding the Book of Mormon's status include: Official Position: The church's belief statement upholds the Book of Mormon and the Doctrine and Covenants as two additional books of scripture supporting the testimony of the Bible. Cramm noted that eliminating the Book of Mormon from scripture would require rewriting this belief statement, which is not currently on the World Church Leadership Council's docket. Non-Creedal Approach: The perception that the Book of Mormon plays a smaller role stems from the CoC being non-creedal; they do not require members to use specific scriptures when preaching or teaching. Therefore, some congregations in the United States may never use the Book of Mormon. Historicity: The Community of Christ has not taken an absolute stance on the historicity of the Book of Mormon. Cramm suggested this lack of a firm requirement—unlike some who view belief in the Book of Mormon's specific historical origins as a "test of faith"—is what causes the perception that the church has "pulled away from it.” Translation Challenges: The CoC's version of the Book of Mormon (chaptered and versed differently than the LDS version) is not available in French and Spanish. Cramm noted that French might be the dominant language spoken globally in Community of Christ on any given Sunday morning, meaning large segments of the church lack easy access to it. This unavailability was a factor cited in the defeat of a prior resolution to put the Book of Mormon online, primarily due to significant cost associated with translation and formatting. Cramm emphasized that regardless of historical origins, the Book of Mormon contains important gospel lessons and "long-term stories" demonstrating the continuous cycle of reaching peace only to fall apart due to human tendencies like greed and power. Navigating Baptism and Sacramental Practice The discussion shifted to the contentious issue of baptism. The Community of Christ practices believer's baptism for those 8 years or older. Historically, they accept baptism from other denominations only if the person was 8 or older when baptized. Infant Baptism Proposal: Multiple resolutions have come forward asking the President to give prayerful consideration to accepting infant baptism from other denominations for membership, followed by confirmation. Divisive Issue: This issue elicits very strong feelings. While many members, particularly in Europe where infant baptism is common, wish to avoid re-baptism after joining from another denomination, lifelong members argue that the Doctrine and Covenants mandates the age-eight requirement. Current Action: President Cramm confirmed that the church is currently engaged in an exploration process using reading material and an online survey to gather perspectives before the Presidency makes a determination. Leadership, Consensus, & Prophetic Voice Cramm shared her perspective on her new leadership role, which she entered at an older age than some predecessors. Role as Prophet: Cramm views her tenure as standing in a "liminal space" to help the church navigate current hurdles and prepare emerging leaders. Empowerment: Her emphasis is on the empowerment of the prophetic voice of the people. Leaders are committed to engaging the imagination of the whole church on important t...
No Troféu Cocô dessa semana, Doug Bezerra (@dougbezerra) e André Rocca (@roccailustra) contam a história de uma criança que viu toda a sua curta vida passar diante dos olhos durante um passeio ao Beto Carrero.TECH T-SHIRT QUE NÃO DESBOTA: PERFORMANCE, CONFORTO TÉRMICO E CAIMENTO PREMIUM – USE O CUPOM FRANGOFINO E LEVE ATÉ 50% OFF!INSCREVA-SE NO CANAL DO FRANGO NO YOUTUBEArte do episódio por André Rocca.Apoie o Frango!!PIX: frangofinopodcast@gmail.comApoia.se: https://apoia.se/frangofinoOrelo: https://orelo.cc/frangofinoPatreon: https://patreon.com/frangofinoCLIQUE AQUI E MANDE SUA HISTÓRIA NO WHATSAPP ou frangofinopodcast@gmail.comPara falar com a gente:E-mail:frangofinopodcast@gmail.comInstagram:@frango.finoWhatsapp: 11 94547-3377
Welcome to Citipointe Church Online. We love that you're joining us for our online experience.More Than a Moment | Ps Liam BarlowOctober 5th - 5:00pm ServiceTo connect with or contact us, visit https://citipointechurch.com/connectTo GIVE online, visit https://citipointechurch.com/givingIf you have made a decision today to follow Jesus, please let us know by filling out the form found here: https://citipointechurch.com/i-have-decided/Citipointe Church exists to unmistakably influence our world for good and for God.
Welcome to Citipointe Church Online. We love that you're joining us for our online experience.From Twisted to Triumphant | Ps Chris EnsbeyOctober 5th - 5:00pm ServiceTo connect with or contact us, visit https://citipointechurch.com/connectTo GIVE online, visit https://citipointechurch.com/givingIf you have made a decision today to follow Jesus, please let us know by filling out the form found here: https://citipointechurch.com/i-have-decided/Citipointe Church exists to unmistakably influence our world for good and for God.
Sim! Tá no ar o primeiro programa de comentar comentários do Frango! No Ciscadinhas dessa semana, respondemos os comentários do Troféu Cocô #71 e Frango FIno #549.NOVO PIX: pixdofrangofino@gmail.com INSCREVA-SE NO CANAL DO FRANGO NO YOUTUBEArte do episódio por Eddy Fortunato (@eddy_fortunato)Apoie o Frango!! NOVO PIX: pixdofrangofino@gmail.com Apoia.se: https://apoia.se/frangofinoOrelo: https://orelo.cc/frangofinoPatreon: https://patreon.com/frangofino Comentado durante o programa:Maquininha Philips para depilação (boa para regiões rugosas)Maquininha Philips para depilação das moças (mas pode usar se você se considerar rapaz também)INSCREVA-SE NO CANAL DO FRANGO NO YOUTUBEReddit do Frango FinoO retorno da banda Diezel!! Diezel - Insano (ao vivo)Loja do FrangoPlaylist musical do FrangoNão perca mais nossas lives! Siga o Bezerra em twitch.tv/dougbezerraTIKTOK DO FRANGO!Instagram dos Frangos:Doug Bezerra (@dougbezerra), Doug Lira (@liradoug) e Rafa Louzada (@rafaelouzada)Para falar com a gente:E-mail:frangofinopodcast@gmail.comInstagram:@frangofinopodcastWhatsapp: 11 94547-3377
The BMW 3-series turns 50 this year, and we celebrate it. We know that it didn't arrive in the US until 2 years later, but that's ok, it's still 50 years old.Our trauma surgeon, Dr Stephan Moran, talks about older cars and how they're not safe compared with new vehicles. He also addresses the particular challenges of teenage and older drivers.CoC addresses the rumored 2027 Toyota Supra V8. We hope Toyota actually makes it, and that if they do, they use a Toyota engine, not something from BMW.Audi will be phasing out the RS3 sedan, which means they will no longer sell an in-line 5-cylinder engine. That's a big deal, because those engines have been critical to the brand for more than 40 years. We get into it.#carsoncallpodcast #automobile #audiquattro #5cylinder #traumasurgeonsafety #toyotasupra #bmw3series #bmwm3
Welcome to Citipointe Church Online. We love that you're joining us for our online experience.Only the Consecrated Cut Deep | Ps Matt CruzSeptember 28th - 10:15am ServiceTo connect with or contact us, visit https://citipointechurch.com/connectTo GIVE online, visit https://citipointechurch.com/givingIf you have made a decision today to follow Jesus, please let us know by filling out the form found here: https://citipointechurch.com/i-have-decided/Citipointe Church exists to unmistakably influence our world for good and for God.
Yesterday's Fire is Not Enough | Ps Matt Cruz
No Troféu Cocô dessa semana, Doug Bezerra (@dougbezerra) e André Rocca (@roccailustra) mergulham na história de um arqueólogo brasileiro que, graças a uma bolsa de pesquisa, foi parar em Israel e acumulou uma sequência de perrengues.Arte do episódio por André Rocca.Apoie o Frango!!PIX: frangofinopodcast@gmail.comApoia.se: https://apoia.se/frangofinoOrelo: https://orelo.cc/frangofinoPatreon: https://patreon.com/frangofinoCLIQUE AQUI E MANDE SUA HISTÓRIA NO WHATSAPP ou frangofinopodcast@gmail.comPara falar com a gente:E-mail:frangofinopodcast@gmail.comInstagram:@frango.finoWhatsapp: 11 94547-3377
Theo một báo cáo của tổ chức Sáng kiến Minh bạch Hàng hải Châu Á AMTI, thuộc Trung tâm Nghiên cứu Chiến lược và Quốc tế CSIS ( Mỹ), được công bố ngày 22/08/2025, Việt Nam đã mở rộng đáng kể hoạt động xây dựng đảo tại các khu vực mà Hà Nội tuyên bố chủ quyền thuộc quần đảo Trường Sa ở Biển Đông. Theo báo cáo, những hoạt động này của Việt Nam “sẽ nhanh chóng ngang bằng, thậm chí có thể vượt qua” quy mô hoạt động tương tự của Trung Quốc tại khu vực đó. Các ảnh vệ tinh gần đây cho thấy, kể từ đầu năm nay, Việt Nam đã mở rộng hoạt động xây dựng đảo trên 8 thực thể, cụ thể là đã tiến hành nạo vét và san lấp tại Bãi Tốc Tan ( Alison Reef ), Đá Cô Lin ( Collins Reef ), Đá Đông ( East Reef ), Đá Len Đao ( Lansdowne Reef ) và Đá Núi Thị ( Petley Reef ). Như vậy là toàn bộ 21 bãi đá và bãi cạn lúc triều thấp mà Việt Nam chiếm hữu trong quần đảo Trường Sa hiện đã được mở rộng để bao gồm cả đất nhân tạo, trong khi bốn năm trước phần lớn chỉ là các công trình bê tông cốt thép biệt lập. Báo cáo cho biết hoạt động mở rộng mới cũng đã bắt đầu tại những đảo nhân tạo cỡ trung đã được xây dựng trong các đợt nạo vét trước đó: Đảo An Bang ( Amboyna Cay), Đảo Sinh Tồn Đông ( Grierson Reef ) và Đá Tây ( West Reef ). Theo báo cáo, "tính đến tháng 3 năm 2025, Việt Nam đã tạo ra khoảng 70% diện tích đất nhân tạo ở quần đảo Trường Sa so với Trung Quốc". Việc cải tạo tại tám thực thể mới này gần như đảm bảo rằng Việt Nam "sẽ ngang bằng - và có thể vượt qua - quy mô xây dựng đảo của Bắc Kinh." Theo báo cáo của AMTI, các hình ảnh cho thấy cơ sở hạ tầng, bao gồm các container chứa đạn dược, đang bắt đầu xuất hiện trên các rạn san hô mà Việt Nam tuyên bố chủ quyền, những nơi mà công việc nạo vét sắp hoàn tất, chẳng hạn như Bãi Thuyền Chài ( Barque Canada ), Đá Lớn ( Discovery Great Reef ), Đá Lát ( Ladd Reef ), Đảo Nam Yết ( Namyit Reef ), Đảo Phan Vinh ( Pearson Reef ), Đảo Sơn Ca ( Sand Cay ) và Đá Tiên Nữ ( Tennent Reef ). Việt Nam chưa đưa ra bình luận công khai nào về hoạt động cải tạo mới nhất của mình, một sự im lặng phù hợp với cách tiếp cận kín đáo của Hà Nội ở Biển Đông. Trả lời RFI Việt ngữ ngày 27/08/2025, nhà nghiên cứu về Biển Đông Hoàng Việt nhận định: “Về chuyện này có vẻ chắc chắn là Việt Nam không bao giờ lên tiếng. Năm trước, Việt Nam đã bồi lấp và mở rộng, năm nay họ cũng đang làm như vậy thì tôi nghĩ cũng là hợp lý, bình thường thôi. Hiện nay, tất cả các công trình đó, theo AMTI, đã bằng 70% so với Trung Quốc. Có lẽ Việt Nam sẽ là một đối thủ quan trọng đối với Trung Quốc. Điều này đối với Việt Nam có thể là vừa có lợi và có hại. Cái lợi là Việt Nam có thể chống đỡ được khá nhiều với Trung Quốc, có thể mở rộng và cạnh tranh với Trung Quốc. Nhưng mặt khác, có thể Trung Quốc sẽ có phản ứng, thì Việt Nam cũng phải hứng chịu. Trên khu vực Biển Đông thì chúng ta biết quan điểm Trung Quốc từ xưa đến nay: Bao giờ họ cũng khẳng định toàn bộ Biển Đông đều thuộc chủ quyền của Trung Quốc. Trung Quốc cũng không dựa trên cái gì cả, mà chỉ dựa trên cái gọi là đường chín đoạn, chiếm khoảng chừng 80% Biển Đông. Và gần đây thì họ còn mở rộng hơn rất nhiều. Theo thông tin của Mỹ, họ đã mở rộng đến khoảng 90% Biển Đông. Việt Nam cùng với nhiều quốc gia khác ở Đông Nam Á cũng đã đòi những vùng biển thuộc về họ, nhưng có lẽ chỉ có Việt Nam là tập trung sức lực và đủ sức cạnh tranh với Trung Quốc trên Biển Đông. Trung Quốc nói là không ai có quyền mở rộng Biển Đông ngoài họ, nhưng Trung Quốc không có cơ sở pháp lý nào hết, bởi vì từ những năm 1935, Trung Quốc còn chưa nghĩ tới chuyện đi buôn xa hơn và một số bản đồ của nhà Thanh cũng cho thấy Trung Quốc chỉ ở trong vùng phụ cận thôi chứ không có đi ra xa. Có lẽ sau này Trung Quốc cảm thấy những đảo này cần thiết, cho nên họ tìm mọi cách để đưa vào trong bản đồ, trong sách lịch sử cho trẻ con học, khiến cho người dân Trung Quốc cảm thấy Biển Đông là của họ, mặc dù họ không có bằng chứng nào cả và thậm chí bằng chứng của họ đã bị tòa án quốc tế năm 2016 ra phán quyết bác bỏ trong vụ Philippines kiện Trung Quốc năm 2013. Tuy nhiên chúng ta thấy rằng là Trung Quốc chưa bao giờ từ bỏ đường lưỡi bò. Gần đây, bản đồ của họ còn vẽ thêm thành 10 đoạn chứ không phải 9 đoạn, với một đoạn ở khu vực Đài Loan nữa. Họ vẫn cho thấy luật pháp quốc tế không là cái gì cả.” Báo cáo mới của AMTI được đưa ra trong bối cảnh căng thẳng gia tăng giữa Trung Quốc và Philippines trên Biển Đông. Gần đây nhất, vào tháng 7, ở phía bắc quần đảo Trường Sa gần Bãi cạn Scarborough, một tàu khu trục của hải quân Trung Quốc đã va chạm với một tàu Hải cảnh Trung Quốc khi các tàu này đang quấy rối một tàu của lực lượng tuần duyên Philippines trong vùng biển tranh chấp. Các nhà phân tích được kênh truyền hình Mỹ CNN trích dẫn ngày 29/08 cho rằng các xung đột giữa Trung Quốc và Philippines có thể đã tạo cho Việt Nam "một vỏ bọc tuyệt vời" cho hoạt động xây dựng trên các đảo mà họ kiểm soát. Collin Koh, nghiên cứu viên tại Trường Nghiên cứu Quốc tế S. Rajaratnam (RSIS) ở Singapore, ghi nhận: “Hiện tại, phần lớn sự chú ý của Trung Quốc đang hướng về Philippines, và họ muốn duy trì một mặt trận ổn định với các đối thủ Đông Nam Á khác ở Biển Đông”. Ray Powell, giám đốc của SeaLight, một dự án minh bạch hàng hải tại Trung tâm Đổi mới An ninh Quốc gia Gordian Knot, thuộc Đại học Stanford, đồng tình với nhận xét của Collin Koh: “Dường như Bắc Kinh đã tính toán rằng nên giữ Philippines cô lập khỏi các bên có tuyên bố chủ quyền khác ở Biển Đông hơn là ngăn cản Việt Nam đạt được những bước tiến đáng kể về lãnh thổ”. Thật ra thì Trung Quốc đã có lên tiếng phản đối Việt Nam về những hoạt động xây dựng đảo theo như báo cáo của AMTI. Ngày 25/08, phát ngôn viên bộ Ngoại Giao Trung Quốc Ông Quách Gia Khôn tuyên bố: "Quần đảo Nam Sa (Trường Sa) là lãnh thổ cố hữu của Trung Quốc và Trung Quốc kiên quyết phản đối các hoạt động xây dựng của các quốc gia liên quan trên các đảo và rạn san hô bị chiếm đóng trái phép, đồng thời sẽ thực hiện các biện pháp cần thiết để bảo vệ chủ quyền lãnh thổ và quyền hàng hải của mình." Như vậy là sau báo cáo của AMTI, Biển Đông có thể sẽ khiến quan hệ Việt - Trung căng thẳng trở lại, trong lúc bang giao giữa hai nước đang trong giai đoạn nồng ấm. Tuy vậy, các nhà phân tích như Collin Koh, nghiên cứu viên cao cấp tại Trường Nghiên cứu Quốc tế S. Rajaratnam ở Singapore, cho rằng chỉ riêng quy mô của những đảo nhân tạo này sẽ không làm thay đổi cán cân chiến lược của khu vực. Theo các nhà quan sát, Hà Nội có thể sẽ coi các hoạt động nói trên là mang tính phòng thủ, củng cố các thực thể mà họ đã chiếm hữu để đáp trả nhiều năm mà Trung Quốc quân sự hóa các đảo mà Bắc Kinh đang kiểm soát. Nhà nghiên cứu Hoàng Việt cũng có nhận định tương tự: “Chúng ta biết Việt Nam là một quốc gia kiên trì đấu tranh ở Biển Đông từ rất lâu. Nhiều năm trước, những năm 1980, Việt Nam cũng đã chịu nhiều áp bức từ phía Trung Quốc. Thế nhưng Việt Nam vẫn cố gắng và vẫn nghĩ có đầy đủ bằng chứng lịch sử, pháp lý để khẳng định chủ quyền của mình trên các đảo này. Cho nên Việt Nam hết sức bảo vệ. Hiện nay, quần đảo Hoàng Sa thì Việt Nam không thể giữ được nữa, nhưng ở quần đảo Trường Sa thì Việt Nam đã giữ khá nhiều cơ sở ở đó. Theo những con số mà của AMTI đưa ra, phía Việt Nam cũng đã mở rộng rất nhiều và thứ nhất là sẽ khiến cho ngư dân Việt Nam an tâm hơn. Khi đánh bắt xa bờ, nếu có chuyện gì thì họ có thể quay về trở về để tránh bão. Thứ hai, Việt Nam cũng nghĩ rằng những công trình xây dựng trên biển hay bị hư hại, không giống như trên đất liền, cho nên Việt Nam cũng phải sửa chữa. Và thứ ba là Việt Nam cũng muốn thể hiện cho Trung Quốc thấy rằng Việt Nam mạnh mẽ nhắc đến chủ quyền. Tôi nghĩ rằng nếu chúng ta có đủ bằng chứng, đủ căn cứ pháp lý để xây dựng, thì tại sao không xây dựng?” Tuy nhiên, theo nhật báo Hồng Kông South China Morning Post ngày 27/08, các nhà phân tích cảnh báo rằng việc Việt Nam mở rộng hoạt động xây dựng đảo ở Trường Sa “có thể làm gia tăng căng thẳng trong nội bộ ASEAN, khi các quốc gia thành viên và các bên có yêu sách đối nghịch nhau tìm cách cân bằng giữa tranh chấp chủ quyền với sự đoàn kết, thống nhất trong khối." Ngoài Việt Nam, các thành viên ASEAN khác là Philippines, Malaysia và Brunei đều có các tuyên bố chủ quyền đối lập, trong khi Bắc Kinh khẳng định chủ quyền đối với gần như toàn bộ Biển Đông. South China Morning Post trích dẫn ông Tô Minh Sơn, nghiên cứu sinh tiến sĩ tại Đại học Quốc gia Úc, chuyên nghiên cứu về quan hệ quốc tế Đông Nam Á: cho biết: "Hà Nội sẽ kết hợp điều đó với việc ủng hộ các cuộc đàm phán về Công ước Liên Hiệp Quốc về Luật Biển (UNCLOS) và về Bộ quy tắc ứng xử trên Biển Đông (COC), cùng với việc quản lý song phương một cách kín đáo với các bên có yêu sách khác, đồng thời duy trì các kênh liên lạc với Trung Quốc". Ông Tô Minh Sơn nói thêm, mặc dù hoạt động nạo vét của Việt Nam "sẽ khiến việc truyền tải thông điệp của ASEAN trở nên khó khăn hơn [...] nhưng nó sẽ không chia rẽ khối này". Đồng thời ông lưu ý rằng các bên yêu sách khác như Philippines cũng tập trung vào hành vi của Trung Quốc. Việc thắt chặt quan hệ giữa Hà Nội và Manila - bao gồm đường dây nóng của lực lượng bảo vệ bờ biển và các giao thức phòng ngừa sự cố - có thể giúp cả hai quốc gia quản lý tốt các yêu sách chồng chéo, đồng thời thể hiện một mặt trận thống nhất hơn đối với Trung Quốc. Còn theo nhận định của ông Vũ Lâm, một nhà phân tích chính sách và quan sát viên ASEAN, cũng được South China Morning Post trích dẫn, nhìn chung, Việt Nam “không muốn làm xáo trộn mối quan hệ với ASEAN, vốn vẫn là một trong những thành tựu về chính sách đối ngoại quan trọng nhất mà họ đã đạt được trong lịch sử gần đây". Đối với chuyên gia Biển Đông Hoàng Việt, phản ứng của các bên tranh chấp khác trong khối Đông Nam Á sẽ chỉ có mức độ nào đó thôi: Chúng ta biết là giữa các nước Đông Nam Á vừa có hợp tác, vừa có đấu tranh. Có những điều mà chúng ta có thể hợp tác được, nhưng cũng có những điều mà chúng ta phải đấu tranh với nhau, như Philippines cũng có những cái đấu tranh với Việt Nam. Đương nhiên là giữa các quốc gia nhỏ thì nói chuyện dễ dàng hơn. Thực ra việc bồi lấp một số đảo này có lẽ không phải là vấn đề quá quan trọng. Việt Nam cũng đã bằng lòng với nhiều quốc gia rồi. Hiện nay cũng thấy ít quốc gia lên tiếng. Tôi nghĩ rằng cũng sẽ có một số quốc gia phản đối, nhưng phản đối có mức độ thôi, chứ còn đáng lo ngại nhất vẫn là từ phía Bắc Kinh. Trung Quốc vẫn quen làm trùm khu vực rồi. Họ lớn, họ mạnh, cho nên họ là luật quốc tế. Thế nhưng quan trọng nhất là Trung Quốc lại không có cơ sở hợp lý để bảo vệ chủ quyền của họ trên Biển Đông. Trung Quốc đưa ra những lập luận hết sức là mơ hồ và trái với luật pháp quốc tế, như là đường 9 đoạn. Thế nhưng, việc này đã được đưa ra tòa án quốc tế một lần rồi và nếu các quốc gia tiếp tục đưa ra tòa thì Trung Quốc cũng sẽ bị những phán quyết tương tự như vậy. Trung Quốc nghĩ rằng làm mạnh như vậy thì họ có thể làm thay đổi cả thế giới. Tôi nghĩ sẽ khó đấy. Sức mạnh là sức mạnh, nhưng không phải lúc nào muốn là làm được, mà luật pháp quốc tế có giá trị của nó.”
Welcome to Citipointe Church Online. We love that you're joining us for our online experience.You Can't Borrow Pentecost | Ps Chris EnsbeySeptember 21st - 10:15am ServiceTo connect with or contact us, visit https://citipointechurch.com/connectTo GIVE online, visit https://citipointechurch.com/givingIf you have made a decision today to follow Jesus, please let us know by filling out the form found here: https://citipointechurch.com/i-have-decided/Citipointe Church exists to unmistakably influence our world for good and for God.
Welcome to Citipointe Church Online. We love that you're joining us for our online experience.Glory Eternal | Ps Ronan PaulosSeptember 21st - 5:00pm ServiceTo connect with or contact us, visit https://citipointechurch.com/connectTo GIVE online, visit https://citipointechurch.com/givingIf you have made a decision today to follow Jesus, please let us know by filling out the form found here: https://citipointechurch.com/i-have-decided/Citipointe Church exists to unmistakably influence our world for good and for God.
No Troféu Cocô dessa semana, Doug Bezerra (@dougbezerra) e André Rocca (@roccailustra) mergulham na história de um ouvinte que ganhou uma corrente suspeita e entrou numa sequência digna de novela.TREINO SEM BOLHA: A MEIA SPECTRUM PROTEGE, RESPIRA E DÁ CONFORTO DO COMEÇO AO FIM – USE O CUPOM FRANGOFINO E LEVE ATÉ 50% OFF!Arte do episódio por André Rocca.Apoie o Frango!!PIX: frangofinopodcast@gmail.comApoia.se: https://apoia.se/frangofinoOrelo: https://orelo.cc/frangofinoPatreon: https://patreon.com/frangofinoMANDE SUA HISTÓRIA NO WHATSAPP 11 94547-3377 ou frangofinopodcast@gmail.comPara falar com a gente:E-mail:frangofinopodcast@gmail.comInstagram:@frangofinopodcastWhatsapp: 11 94547-3377
Is the BMW X5 the most successful vehicle over the last 25yrs? Seems like it to me. It's been a trailblazer in its segment since its launch in 2000, and it's a financial juggernaut making BMW NA an estimated $1billion dollars of profit every year. We get into it.CoC trauma surgeon Dr Stephan Moran discusses whiplash and its cost both to victims' health and our economy. Then he teaches us how to minimize the risk of getting whiplash if you're ever in a vehicle that's hit from behind.Nissan is in big trouble and may not survive. While it appears the company has some good products coming, Nissan has released very little details. No problem Nissan, CoC has a bunch of ideas that will certainly turn everything around, starting with a Raptor-ized Frontier pickup and ending with a Crosstrek-ized Sentra, with many other recommendations in between. And yes, we have ways to fix Infiniti too.Rumors say the GMC Syclone and Typhoon from the early '90s may be returning. We are psyched and discuss in detail.#carsoncallpodcast #traumasurgeonsafety #BMWX5 #BMWNA #BMWUSA
Welcome to Citipointe Church Online. We love that you're joining us for our online experience.Run To Win (Part 1) | Ps Mark RamseySeptember 14th - 10:15am ServiceTo connect with or contact us, visit https://citipointechurch.com/connectTo GIVE online, visit https://citipointechurch.com/givingIf you have made a decision today to follow Jesus, please let us know by filling out the form found here: https://citipointechurch.com/i-have-decided/Citipointe Church exists to unmistakably influence our world for good and for God.
Welcome to Citipointe Church Online. We love that you're joining us for our online experience.Run To Win (Part 1) | Ps Mark RamseySeptember 14th - 10:15am ServiceTo connect with or contact us, visit https://citipointechurch.com/connectTo GIVE online, visit https://citipointechurch.com/givingIf you have made a decision today to follow Jesus, please let us know by filling out the form found here: https://citipointechurch.com/i-have-decided/Citipointe Church exists to unmistakably influence our world for good and for God.
No Troféu Cocô dessa semana, Doug Bezerra (@dougbezerra) e Jhonatan Marques (@ojhonatanmarques) mergulham na história de um ouvinte que transformou a falta de um dente em uma cena inesquecível.CORRIDA SEM AJUSTAR A CUECA: A PERFORMANCE NÃO ENROLA, NÃO ESQUENTA E NÃO INCOMODA – USE O CUPOM FRANGOFINO E LEVE ATÉ 50% OFF!Arte do episódio por Emi Kiyan (@emi.kiyan)Apoie o Frango!! PIX: frangofinopodcast@gmail.com Apoia.se: https://apoia.se/frangofinoOrelo: https://orelo.cc/frangofinoPatreon: https://patreon.com/frangofino MANDE SUA HISTÓRIA NO WHATSAPP 11 94547-3377 ou frangofinopodcast@gmail.comPara falar com a gente:E-mail:frangofinopodcast@gmail.comInstagram:@frangofinopodcastWhatsapp: 11 94547-3377
David Feheley is a technical director, with 20 years of experience, specializing in producing opera and productions in repertory. He is currently the technical director for the Metropolitan Opera.David studied theatrical production at York University in his native Toronto before joining the newly opened York University Student Centre as its production manager. He managed all aspects of the Centre's program of concerts and events in its multi-use facility.He later branched out into the freelance world as a technical director before joining the production department at the Stratford Festival of Canada. He started as the Assistant Technical Director for the Festival Stage, and finished his time at the Festival as the assistant director of production.David moved into the world of opera when he joined the Canadian Opera Company in 2003. While there, he was part of the opening of the Four Seasons Centre for the Performing Arts, Canada's first purpose-built opera house, and the COC's Ring Cycle, Canada's first home-grown production of the Ring.David moved to the United States in 2013 to assume the position of technical and production director for the Houston Grand Opera. While in Houston, he continued his association with Wagner's Ring Cycle, as Houston produced its first Ring, the La Fura dels Baus production from Barcelona.Since 2016, David has been the technical director for the Met, overseeing all backstage operations as well as the construction work done in the scenery and scenic shops. The Met's season of 19 productions running in repertory also includes building and producing 6 new productions each year.The Ring Cycle has played a prominent role in his time at the Met. A major technical overhaul of Robert Lepage's 2010 production and its presentation as part of the 2019 season marked David's third Ring.
Welcome to Citipointe Church Online. We love that you're joining us for our online experience.Run To Win (Part 1) | Ps Mark RamseySeptember 7th - 10:15am ServiceTo connect with or contact us, visit https://citipointechurch.com/connectTo GIVE online, visit https://citipointechurch.com/givingIf you have made a decision today to follow Jesus, please let us know by filling out the form found here: https://citipointechurch.com/i-have-decided/Citipointe Church exists to unmistakably influence our world for good and for God.
Welcome to Citipointe Church Online. We love that you're joining us for our online experience.The Promise of the Holy Spirit | Ps Reuben SowahSeptember 7th - 5:00pm ServiceTo connect with or contact us, visit https://citipointechurch.com/connectTo GIVE online, visit https://citipointechurch.com/givingIf you have made a decision today to follow Jesus, please let us know by filling out the form found here: https://citipointechurch.com/i-have-decided/Citipointe Church exists to unmistakably influence our world for good and for God.
No Troféu Cocô dessa semana, Doug Bezerra (@dougbezerra) e André Rocca (@roccailustra) contam a história da menina que se esforçava demais para fazer amigos.POLO QUE VESTE CERTO: ESQUECE AQUELE CAIMENTO LARGO – A POLO INSIDER TEM GOLA FIRME E AJUSTE PERFEITO. USE O CUPOM FRANGOFINO E LEVE ATÉ 50% OFF!Arte do episódio por Emi Kiyan (@emi.kiyan)Apoie o Frango!! PIX: frangofinopodcast@gmail.com Apoia.se: https://apoia.se/frangofinoOrelo: https://orelo.cc/frangofinoPatreon: https://patreon.com/frangofino MANDE SUA HISTÓRIA NO WHATSAPP 11 94547-3377 ou frangofinopodcast@gmail.comPara falar com a gente:E-mail:frangofinopodcast@gmail.comInstagram:@frangofinopodcastWhatsapp: 11 94547-3377
Krunching Gears - The Rally Podcast, 2025 Season, episode 35. This week, we look ahead to the Lakeland Stages Rally with Alan Cullinan, the CoC, and then we are joined by Sinéad Canny, PRO for the Clare Motor Club, to tell us about the upcoming Clare Stages Rally.
Welcome to Citipointe Church Online. We love that you're joining us for our online experience.Guest Speaker 5:00pm Service | Rex CrainAugust 31st - 5:00pm ServiceTo connect with or contact us, visit https://citipointechurch.com/connectTo GIVE online, visit https://citipointechurch.com/givingIf you have made a decision today to follow Jesus, please let us know by filling out the form found here: https://citipointechurch.com/i-have-decided/Citipointe Church exists to unmistakably influence our world for good and for God.
Jeremy Sanders, Youth Director and an elder at COC, continues our series in the gospel of John with "The Reappearance" from John 20:19-29.
Welcome to Citipointe Church Online. We love that you're joining us for our online experience.Guest Speaker 10:15am Service | Rex CrainAugust 31st - 10:15am ServiceTo connect with or contact us, visit https://citipointechurch.com/connectTo GIVE online, visit https://citipointechurch.com/givingIf you have made a decision today to follow Jesus, please let us know by filling out the form found here: https://citipointechurch.com/i-have-decided/Citipointe Church exists to unmistakably influence our world for good and for God.
No Troféu Cocô dessa semana, Doug Bezerra (@dougbezerra) e André Rocca (@roccailustra) leem a história de um ouvinte sobre a cirurgia na adolescência que acabou rendendo o exame mais constrangedor da vida dele.Arte do episódio por André Rocca.Apoie o Frango!!PIX: frangofinopodcast@gmail.comApoia.se: https://apoia.se/frangofinoOrelo: https://orelo.cc/frangofinoPatreon: https://patreon.com/frangofinoMANDE SUA HISTÓRIA NO WHATSAPP 11 94547-3377 ou frangofinopodcast@gmail.comPara falar com a gente:E-mail:frangofinopodcast@gmail.comInstagram:@frangofinopodcastWhatsapp: 11 94547-3377
Dr. Eric Zeller, COC's missionary in the Middle East, continues our series in the Gospel of John with "The Tomb" from John 20:1-18.
Welcome to Citipointe Church Online. We love that you're joining us for our online experience.Crushed And Blessed | Ps Chris EnsbeyAugust 17th - 10:15am ServiceTo connect with or contact us, visit https://citipointechurch.com/connectTo GIVE online, visit https://citipointechurch.com/givingIf you have made a decision today to follow Jesus, please let us know by filling out the form found here: https://citipointechurch.com/i-have-decided/Citipointe Church exists to unmistakably influence our world for good and for God.
Welcome to Citipointe Church Online. We love that you're joining us for our online experience.Building Spiritual Altars | Ps Reuben SowahAugust 24th - 5:00pm ServiceTo connect with or contact us, visit https://citipointechurch.com/connectTo GIVE online, visit https://citipointechurch.com/givingIf you have made a decision today to follow Jesus, please let us know by filling out the form found here: https://citipointechurch.com/i-have-decided/Citipointe Church exists to unmistakably influence our world for good and for God.
No Troféu Cocô dessa semana, Doug Bezerra (@dougbezerra) e André Rocca (@roccailustra) leem a história de um ouvinte sobre as férias de verão que tinham tudo pra ser tranquilas, mas viraram uma verdadeira prova de paciência graças à teimosia do pai dele.ESTILO QUE JOGA JUNTO: GARANTA SUA POLO GAME CHANGER COM 15% OFF USANDO O CUPOM FRANGOFINO – E AINDA LEVE BRINDES EXCLUSIVOS NA FAIXA!Arte do episódio por André Rocca.Apoie o Frango!!PIX: frangofinopodcast@gmail.comApoia.se: https://apoia.se/frangofinoOrelo: https://orelo.cc/frangofinoPatreon: https://patreon.com/frangofinoMANDE SUA HISTÓRIA NO WHATSAPP 11 94547-3377 ou frangofinopodcast@gmail.comPara falar com a gente:E-mail:frangofinopodcast@gmail.comInstagram:@frangofinopodcastWhatsapp: 11 94547-3377
A No-BS Framework to Build a Profitable STR Portfolio (Part 1: The Airbnb Buy Box)Most hosts fail before they even start — not because they don't work hard, but because they don't define their Buy Box. In this episode, I'm breaking down Step 1 of my no-BS framework to build a profitable short-term rental portfolio: how to set your investor thesis, choose your markets, and build a buy box that keeps you disciplined and profitable deal after deal.You'll learn:Why the Buy Box is the compass for your entire STR journeyThe guardrails you need (CoC, DSCR, breakeven occupancy) so you don't buy a money pitHow to filter markets, property types, and returns into a one-page decision toolIf you're serious about scaling, you need to nail this step first.
Welcome to Citipointe Church Online. We love that you're joining us for our online experience.Peace In A Prison | Ps Liam BarlowAugust 17th - 10:15am ServiceTo connect with or contact us, visit https://citipointechurch.com/connectTo GIVE online, visit https://citipointechurch.com/givingIf you have made a decision today to follow Jesus, please let us know by filling out the form found here: https://citipointechurch.com/i-have-decided/Citipointe Church exists to unmistakably influence our world for good and for God.
Welcome to Citipointe Church Online. We love that you're joining us for our online experience.The Power of Not Giving Up | Ps Ronan PaulosAugust 17th - 5:00pm ServiceTo connect with or contact us, visit https://citipointechurch.com/connectTo GIVE online, visit https://citipointechurch.com/givingIf you have made a decision today to follow Jesus, please let us know by filling out the form found here: https://citipointechurch.com/i-have-decided/Citipointe Church exists to unmistakably influence our world for good and for God.
No Troféu Cocô dessa semana, Doug Bezerra (@dougbezerra) e André Rocca (@roccailustra) leem a história de um ouvinte sobre o sonho do pai de ter a própria oficina… que acabou virando um caos com direito a treta em família, reviravolta e um final que ninguém esperava.CLÁSSICO COM VANTAGEM: COMPRE NA INSIDER E GANHE BRINDES EXCLUSIVOS – USE O CUPOM FRANGOFINO E GARANTA 15% OFF + PRESENTE NA FAIXA!Arte do episódio por André Rocca.Apoie o Frango!!PIX: frangofinopodcast@gmail.comApoia.se: https://apoia.se/frangofinoOrelo: https://orelo.cc/frangofinoPatreon: https://patreon.com/frangofinoMANDE SUA HISTÓRIA NO WHATSAPP 11 94547-3377 ou frangofinopodcast@gmail.comPara falar com a gente:E-mail:frangofinopodcast@gmail.comInstagram:@frangofinopodcastWhatsapp: 11 94547-3377
Welcome to Citipointe Church Online. We love that you're joining us for our online experience.Who Are You Living For? | Ps Liam BarlowAugust 10th - 5:00pm ServiceTo connect with or contact us, visit https://citipointechurch.com/connectTo GIVE online, visit https://citipointechurch.com/givingIf you have made a decision today to follow Jesus, please let us know by filling out the form found here: https://citipointechurch.com/i-have-decided/Citipointe Church exists to unmistakably influence our world for good and for God.
Pastor Thomas Hodzi, COC's Missionary in Zimbabwe, continues our series in the Gospel of John with "The Crucifixion" from John 19:16-30
Welcome to Citipointe Church Online. We love that you're joining us for our online experience.Discover Develop Deploy | Ps Mark RamseyAugust 10th - 10:15am ServiceTo connect with or contact us, visit https://citipointechurch.com/connectTo GIVE online, visit https://citipointechurch.com/givingIf you have made a decision today to follow Jesus, please let us know by filling out the form found here: https://citipointechurch.com/i-have-decided/Citipointe Church exists to unmistakably influence our world for good and for God.
No Troféu Cocô dessa semana, Doug Bezerra (@dougbezerra) e André Rocca (@roccailustra) leem a história de um ouvinte que resolveu dar um rolê inocente com os amigos... e acabou protagonizando um episódio digno de roteiro de filme: com vergonha, tensão e um pai que mais pareceu um personagem lendário.ELEVANDO O BÁSICO AO ESSENCIAL: GARANTA SUA CORE T-SHIRT INSIDER COM 15% OFF USANDO O CUPOM FRANGOFINOArte do episódio por André Rocca.Comentado no episódio:Instagram da Nutricionista do Doug e do Rocca: @andrea_metzger_nutriApoie o Frango!!PIX: frangofinopodcast@gmail.comApoia.se: https://apoia.se/frangofinoOrelo: https://orelo.cc/frangofinoPatreon: https://patreon.com/frangofinoMANDE SUA HISTÓRIA NO WHATSAPP 11 94547-3377 ou frangofinopodcast@gmail.comPara falar com a gente:E-mail:frangofinopodcast@gmail.comInstagram:@frangofinopodcastWhatsapp: 11 94547-3377
Welcome to Citipointe Church Online. We love that you're joining us for our online experience.Uncontainable | Ps Mike MulheranAugust 3rd - 10:15am ServiceTo connect with or contact us, visit https://citipointechurch.com/connectTo GIVE online, visit https://citipointechurch.com/givingIf you have made a decision today to follow Jesus, please let us know by filling out the form found here: https://citipointechurch.com/i-have-decided/Citipointe Church exists to unmistakably influence our world for good and for God.
Welcome to Citipointe Church Online. We love that you're joining us for our online experience.Anchored In Christ | Ps Joel RamseyAugust 3rd - 5:00pm ServiceTo connect with or contact us, visit https://citipointechurch.com/connectTo GIVE online, visit https://citipointechurch.com/givingIf you have made a decision today to follow Jesus, please let us know by filling out the form found here: https://citipointechurch.com/i-have-decided/Citipointe Church exists to unmistakably influence our world for good and for God.
No Troféu Cocô dessa semana, Doug Bezerra (@dougbezerra) e André Rocca (@roccailustra) acompanham a história de um ouvinte que decidiu cuidar da saúde íntima... e acabou vivendo uma das experiências mais constrangedoras da sua vida.TECNOLOGIA QUE VESTE BEM: GARANTA SUA TECH T-SHIRT INSIDER COM 15% OFF USANDO O CUPOM FRANGOFINOArte do episódio por André Rocca.Comentado no episódio:Instagram da Nutricionista do Doug e do Rocca: @andrea_metzger_nutriApoie o Frango!!PIX: frangofinopodcast@gmail.comApoia.se: https://apoia.se/frangofinoOrelo: https://orelo.cc/frangofinoPatreon: https://patreon.com/frangofinoMANDE SUA HISTÓRIA NO WHATSAPP 11 94547-3377 ou frangofinopodcast@gmail.comPara falar com a gente:E-mail:frangofinopodcast@gmail.comInstagram:@frangofinopodcastWhatsapp: 11 94547-3377
Dr. Joseph McCollom and Dr. Ramy Sedhom discuss precision palliative care, a new strategy that aims to align palliative care delivery with patient and caregiver needs instead of diagnosis alone. TRANSCRIPT ADN Podcast Episode 8-22 Transcript: What Is Precision Palliative Care? Rethinking a Care Delivery Problem Dr. Joseph McCollom: Hello and welcome to the ASCO Daily News Podcast. I'm your guest host, Dr. Joseph McCollom. I'm a GI medical oncologist and palliative oncologist at the Parkview Packnett Family Cancer Institute here in Fort Wayne, Indiana. So, the early benefits of palliative care for patients with cancer have been well documented, but there are challenges in terms of bandwidth to how do we provide this care, given the workforce shortages in the oncology field. So today, we'll be exploring a new opportunity known as precision palliative care, a strategy that aims to align care delivery with patient and caregiver needs and not just diagnosis alone. Joining me for this discussion is Dr. Ramy Sedhom. He is the medical director of oncology and palliative care at Penn Medicine Princeton Health and a clinical assistant professor of medicine at the University of Pennsylvania Perelman School of Medicine. Our full disclosures are available in the transcript of this episode. Dr. Sedhom, it's great to have you on the podcast today. Thank you so much for being here. Dr. Ramy Sedhom: Thank you, Joe. It's a pleasure to be here and lucky me to be in conversation with a colleague and friend. Yes, many of us have heard about the benefits of early palliative care. Trials have shown better quality of life, reduced symptoms, and potentially even improved survival. But as we know, the reality is translating that evidence into practice, which is really, really challenging. So Joe, both you and I know that not every patient can see palliative care, or I'd even argue should see palliative care, but that also means there are still many people with real needs who still fall through the cracks. That's why I'm really excited about today's topic, which we'll be discussing, which is precision palliative care. It's a growing shift in mindset from what's this patient's diagnosis or what's this patient's prognosis, to what matters most for this person in front of me right now and what are their individual care needs. I think, Joe, it's very exciting because the field is moving from a blanket approach to one tailored to meet people where they actually are. Dr. Joseph McCollom: Absolutely, Ramy. And I think from the early days when palliative care was kind of being introduced and trying to distinguish itself, I think one of the first models that came to clinicians' eyes was Jennifer Temel's paper in The New England Journal of Medicine in 2010. And her colleagues had really looked at early palliative care integration for patients with advanced non–small cell lung cancer. And in that era – this is a pre-immunotherapy era, very early targeted therapy era – the overall prognosis for those patients are similar to the population I serve as a GI medical oncologist, pancreatic cancer today. Typically, median overall survival of a year or less. And so, a lot of her colleagues really wanted her to track overall survival alongside quality of life and depression scores as a result of that. And it really was a landmark publication because not only did it show an improvement of quality of life, but it actually showed an improvement of overall survival. And that was really, I think, revolutionary at the time. You know, a lot of folks had talked about if this was a drug, the FDA would approve it. We all in GI oncology laugh about erlotinib, which got an FDA approval for a 2-week overall survival advantage. And so, it really kind of set the stage for a lot of us in early career who had a passion in the integration of palliative care and oncology. And I think a lot of the subsequent ASCO, NCCN, COC, Commission on Cancer, guidelines followed through with that. But I think what we realized is now we're kind of sitting center stage, there's still a lot of resource issues that if we sent a referral to palliative care for every single patient diagnosed with even an advanced cancer, we would have a significant workforce shortage issue. And so, Ramy, I was wondering if you could talk a little bit about how do we help center in on who are the right patients that are going to have the greatest benefit from a palliative care specialist intervention? Dr. Ramy Sedhom: Thanks, Joe. Great question. So you mentioned Dr. Temel's landmark 2010 trial published in the New England Journal of Medicine. And it is still a game changer in our field. The results of her work showed not only improved quality of life and mood, but I think very surprisingly at the time, a survival benefit for patients with lung cancer who had received early palliative care. That work, of course, has helped shape national guidelines, as you've shared, and it also helped define early, as within 8 weeks of diagnosis. But unfortunately, there remains a disconnect. So in clinical practice, using diagnosis or stage as the only referral trigger doesn't really match the needs that we see show up. And I think unfortunately, the other part is that approach creates a supply demand mismatch. We end up either referring more patients than palliative care teams can handle, or at the opposite extreme, we end up referring no one at all. So, I actually just wanted to quickly give, for example, two real world contrasts. So one center that I actually have friends who work in, tried as a very good quality improvement incentive, auto-refer all patients with stage IV pancreas cancer to palliative care teams. And while very well intentioned, they saw very quickly that in a two-month period, they had 30 new referrals. And on the palliative care side, there were only 15 available new patient slots. On the other hand, something that I often see in practice, is a situation where, for example, consider the case of a 90-year-old with a low-grade B-cell lymphoma. On paper, low-risk disease, but unfortunately, when you look under the microscope, this gentleman is isolated, has symptoms from his bulky adenopathy, and feels very overwhelmed by many competing illnesses. This is someone who, of course, may benefit from palliative care, but probably doesn't check the box. And I think this is where the model of precision palliative care steps in. It's not really about when was someone diagnosed or what is the prognosis or time-based criteria of their cancer, but it's really fundamentally asking the question of who needs help, what kind of help do they need, and how urgently do we need to provide this help? And I think precision palliative care really mirrors the logic and the philosophy of precision oncology. So just like we've made strides trying to match therapies to tumor biology, we also need to have the same attention and the same precision to match support to symptoms, to context of a patient situation and their caregiver, and also to their personal goals. So I think instead of a blanket referral, we really need to tailor care, the right support at the right moment for the right person to the right care teams. And I think to be more precise, there's really four core elements to allow us to do this well. So first, we really need to implement systematic screening. Let's use what we already have. Many of our centers have patient reported outcomes. The Commission on Cancer motivates us to use distress screening tools. And the EHR is there, but we do very little to flag and to surface unmet care needs. We have seen amazing work from people like Dr. Ethan Bash, who is the pioneer on patient-reported outcomes, and Dr. Ravi Parikh, who used to be my colleague at Penn, now at Emory, who show that you could use structured data and machine learning to identify some of these patient needs in real time. The second piece is after a systematic screening, we really need to build very clear referral pathways. One very good example is what the supportive care team at MD Anderson has done, of course, led by Dr. Eduardo Brera and Dr. David Huey, where they have, for example, designed condition-specific triggers. Urgent referrals, for example, to palliative care for severe symptoms, where they talk about it like a rapid response team. They will see them within 72 hours of the flag. But at the same time, if the unmet need is a caregiver distress, perhaps the social work referral is the first part of the palliative care intervention that needs to be placed. And I think this helps create both clarity and consistency but also it pays attention to that provider and availability demand mismatch. Third, I really think we need to triage smartly. As mentioned in the prior example, not every patient needs every team member of the palliative care team. Some benefit most from the behavioral health intervention. Others might benefit from chaplaincy or the clinician for symptom management. And I think aligning intensity with complexity helps us use our teams wisely. Unfortunately, the greatest barrier in all of our health care systems is time and time availability. And I think this is one strategic approach that I have not yet seen used very wisely. And fourth, I really think we need to embrace interdisciplinary care and change our healthcare systems to focus more on value. So this isn't about more consults or RVUs. I think it's really about leveraging our team strengths. Palliative care teams or supportive care teams usually are multidisciplinary in their core. They often have psychologists, social workers, sometimes they have nurse navigators. And I think all of these are really part of that engine of whole person care. But unfortunately, we still are not set up in care delivery systems that unfortunately to this day still model fee for service where the clinician or the physician visit is the only quote unquote real value add. Hopefully as our healthcare systems focus more on delivery and on value, this might help really embrace the structure to bring through the precision palliative care approach. Dr. Joseph McCollom: No, I love those points. You know, we talk frequently in the interdisciplinary team about how a social worker can spend 5 minutes doing something that I could not as a physician spend an hour doing. But does every patient need every member every time? And how do we work as a unified body to deliver that dose of palliative care, specialized palliative care to those right patients and match them? And I think that perfect analogy is in oncology as a medical oncologist, frequently I'm running complex next-generation sequencing paneling on patients' tumors, trying to find out is there a genetic weakness? Is there a susceptibility to a targeted therapy or an immunotherapy so that I can match and do that precision oncology, right patient to the right drug? Similarly, we need to continue to analyze and find these innovative ways like you've talked about, PROs, EHR flags, machine learning tools, to find those right patients and match them to the right palliative care interdisciplinary team members for them. I know we both get to work in oncology spaces and palliative and supportive spaces in our clinical practice. Share a little bit, if you could, Ramy, about what that looks like for your practice. How do you find those right patients? And how do you then intervene with that right palliative oncology dose? Dr. Ramy Sedhom: So Joe, when I first started in this space as a junior faculty, one thing became immediately clear. I think if we rely solely on physicians to identify the patients for palliative care, we're unfortunately going to be very limited by what we individually, personally observe. And I think that's what reflects the reality that many patients have real needs that go unseen. So over the past few years, I've really worked with a lot of my colleagues to really work the health system to change that. The greatest partnership I've personally had has been working with our informatics team to build a real time EHR integrated dashboard that I think helps us give us a broader view of patient needs. What we really think of as the population health perspective. Our dashboard at Penn, for example, pulls in structured data like geriatric assessment results, PHQ-4 screens, patient reported outcomes, whether or not they've been hospitalized, whether or not these hospitalizations are frequent and recurrent. And I think it's allowed us to really move from a reactive approach to one that's more proactive. So let me give you a practical example. So we have embedded in our cancer care team, psycho-oncologists. They share the same clinic space, they're right down the hall. And we actually use this shared dashboard to review weekly trends in distress scores and patient reported outcomes. And oftentimes, if they see a spike in anxiety or worsening symptoms like depression, they'll reach out to me and say, “Hey, I noticed Mrs. Smith reported feeling very anxious today. Do you think it'd be helpful if I joined you for her visit?” And I think that's how we could really use data and teamwork to offer and maximize the right support at the right time. Like many of our other healthcare systems, we also have real-time alerts for hospitalizations. And I think like Dr. Temel's most recent trial, which we'll discuss at some point, I'm sure, it's another key trigger for vulnerability. I think whenever someone's admitted or discharged, we try to coordinate with our palliative care colleagues to assess do they need follow-up and in what timeline. And we know that these are common triggers, progression of disease, hospitalizations, drops in quality-of-life. And it's actually surprisingly simple to implement once you set up the right care structures. And I think these systems don't just help patients, which is what I quickly learned. They also help us as clinicians too. Before we expanded our team, I often felt this weight, especially as someone dual trained in oncology and palliative medicine, as trying to be everything to everyone. I remember one patient in particular, a young woman with metastatic breast cancer who was scheduled for a routine pre-chemo visit with me. Unfortunately, on that day, she had a very dramatic change in function. We whisked her down to x-ray and it revealed a pretty large pathologic fracture in her femur. And suddenly what was scheduled as a 30-minute visit became a very complex conversation around prognosis, urgent need for surgery and many, many life changes. And when I looked at my Epic list, I had a full waiting room. And thankfully, because we have embedded palliative care in our team, I was able to bring in Dr. Collins, the physician who I work with closely, immediately. She spent the full hour with the patient while I was able to continue seeing other patients that morning. And I think that's what team-based care makes possible. It's not just more hands on deck but really optimizing the support the patient needs on each individual day. And I think last, we're also learning a lot from behavioral science. So many institutions like Penn, Stanford, Massachusetts General, they've experimented with a lot of really interesting prompts in the EHR. One of them, for example, is the concept of nodes or the concept of prompt questions. Like, do you think this patient would benefit from a supportive care referral? And I think these low-level nudges, in a sense, can actually really dramatically increase the uptake of palliative care because it makes what's relevant immediately salient and visible to the practicing physician. So I think the key, if I had to maybe finish off with a simple message: It's not flashy tech, it's not massive change against staffing, but it's having a local champion and it's working smarter. It's asking the questions of how can we do this better and setting up the systems to make them more sustainable. Dr. Joseph McCollom: I appreciate you talking about this because I think a lot of folks want to put the wheels on in some way and they don't know where to get started. And so I think some of the models that you've been able to create, being able to track patients, screen your population, find the right individuals, and then work within that team to be able to extend, I think when you have an embedded palliative care specialist in your clinic, they expand your practice as a medical oncologist. And so you can make that warm handoff. And that patient and that caregiver, when they view the experience, they don't view you as a medical oncologist, someone else as a palliative care specialist, they view that team approach. And they said, "The team, my cancer team took care of me." And I think we can really harness a lot of the innovative technological advancements in our EHR to be able to prompt us in this work. I know that Dr. Temel had kind of set the stage for early palliative care intervention, and you did mention her stepped palliative care trial. Where do you see some of the future opportunities as we continue to push the needle forward as oncologists and palliative care specialists? What do you see as being the next step? Dr. Ramy Sedhom: So for those who are not familiar with the stepped palliative care trial, again, work by Dr. Temel, I think it's really important to explain not just the study itself, but I think more importantly, what it's representing for the future of our field. First, I really want to acknowledge Dr. Temel, who is a trailblazer in palliative oncology. Her work has not only shaped how we think about timing and delivery, but really about the value of supportive care. And more importantly, I think for all the young trainees listening, she had shown that rigorous randomized trials in palliative care are possible and meaningful. And I think for me, one quick learning point is that you could be an oncologist and lead this impactful research. And she's inspired many and many of us. Now let's quickly transition to her study. So in this trial, the stepped palliative care trial, patients with advanced lung cancer were randomized into two groups. One group followed the model from her landmark 2010 New England Journal of Medicine paper, which was structured monthly palliative care visits, again, within eight weeks of diagnosis. The second group, which is in this study, the intervention or the stepped palliative care group, received a single early palliative care visit. Think of this as a meet and greet. And then care was actually stepped up. If one of three clinical triggers happened. One, a decline in patient reported quality of life as measured by PROs. Two, disease progression, or three, hospitalization. And the findings which were presented at ASCO 2024 were striking. Clinical outcomes, very similar between the two groups. And this included quality-of-life, end-of-life communication, and resource use. But I think the take-home point is that the number of palliative care visits in the stepped group was significantly lower. So in other words, same impact and fewer visits. This was a very elegant example of how we can model precision palliative care, right sizing patient care based on patient need. So where do we go from here? I think if we want this model to take root nationally, we really need to pull on three key levers: healthcare systems, healthcare payment, and healthcare culture. So from a system alignment, unfortunately, as mentioned too often, the solution to gaps in palliative care is we need more clinicians. And while yes, that's partly true, it's actually not the full picture. I think what we first need to do and what's more likely to be achieved is to develop systems that focus on building the infrastructure that maximizes the reach of our existing care teams. So this means investing in nurse navigation, real-time dashboards with patient-reported outcomes and EHR flags, and again, matching triage protocols where intensity matches complexity. And the goal, as mentioned, isn't to maximize consults, but to really maximize deployment of expertise based on need. The second piece is, of course, we need payment reform. So the stepped palliative care model only works when it allows continuous patient engagement. But unfortunately, current pay models don't reward or incentivize that. In fact, electronic PROs require a very high upfront financial investment and ongoing clinician time with little to no reimbursement. Imagine if we offered bundled payments or value-based incentives for teams that integrated PROs. Or imagine if we reimbursed palliative care based on impact or infrastructure instead of just fee-for-service volume. There is a lot of clear evidence that tele-palliative care is effective. In fact, it was the Plenary at ASCO 2024. Yet we're still battling these conversations around inconsistent reimbursement, and we're always waiting on whether or not telehealth waivers are gonna continue. So I think most importantly is we really need to recognize the broader scope of what palliative care offers, which is caregiver support, improving navigation, coordinating very complex transitions. To me, and what I've always prioritized as a champion at Penn, is that palliative care is not a nice to have, and neither are all of these infrastructures, but they're really essential to whole person care, and they need to be financially supported. And last, we really need a culture shift. We need to change from how palliative care is perceived, and it can't be something other. It can't be something outside of oncology, but it really needs to be embraced as this is part of cancer care itself. I often see hesitancy from many oncologists about introducing palliative care early. But it doesn't need to be a dramatic shift. I think small changes in language, how we introduce the palliative care team, and co-management models can really go a very long way in normalizing this part of patient care. And I'm particularly encouraged, Joe, by one particular innovation in this space, which is really the growth of many startups. And one startup, for example, is Thyme Care, where I've seen them working with many, many private practices across the country, alongside partnerships with payers to really build tech-enabled navigation that tries to basically maximize triage support with electronic PROs. And to me, I really think these models can help scale access without overwhelming current care teams. So precision palliative care, Joe, in summary, I think should be flexible, scalable, and really needs to align based on what patients need. Dr. Joseph McCollom: No, I really appreciate, Ramy, you talking about that it really takes a village to get oncology care in both a competent and a compassionate way. And we need buy-in champions at all levels: the system level, the administrative level, the policy level, the tech level. And we need to change culture. I kind of want to just get your final impressions and also make sure that we make our listeners aware of our article. We should be able to have this in the show notes here as well to find additional tools and resources, all the studies that were discussed in today's episode. But, Ramy, what are some of your kind of final takeaways and conclusions? Dr. Ramy Sedhom: Before we wrap up, I just want to make sure we highlight a very exciting opportunity for residents considering a future in oncology and palliative medicine. Thanks to the leadership of Dr. Jamie Von Roen, who truly championed this cause, ASCO and the ABIM (American Board of Internal Medicine) have partnered to create the first truly integrated palliative care oncology fellowship. Trainees can now double board in just two years or triple board in three with palliative care, oncology, and hematology. And I think, Joe, as you and I both know, it's incredibly rewarding and meaningful to work at this intersection. To close our message, if there's one message I think listeners should carry with them, it's that palliative care is about helping people live as well as possible for as long as possible. And precision palliative care simply helps us do that better. We need to really develop systems that tailor support to individual need, value, and individual goals. Just like our colleagues in precision oncology mentioned, getting the right care to the right patient at the right time, and I would add in the right way. For those who want to learn more, I encourage you to read our full article in JCO, which is “Precision Palliative Care As a Pragmatic Solution for a Care Delivery Problem.” Joe, thank you so, so much for this thoughtful conversation and for your leadership in our field. And thank you to everyone for listening. Thank you all for being champions of this essential part of cancer care. If you haven't yet joined the ASCO Palliative Care Communities of Practice, membership is free, and we'd love to have you. Dr. Joseph McCollom: Thank you, Ramy, not only for sharing your insights today, but the pioneering work that you have done in our field. You are truly an inspiration to me in clinical practice, and it is an honor to call you both a colleague and friend. And thank you for our listeners for joining us today. If you value the insights that you've heard on the ASCO Daily News Podcast, please subscribe, rate, and review wherever you get your podcasts. Thanks again. Disclaimer: 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. Follow today's speakers: Dr. Joseph McCollom @realbowtiedoc Dr. Ramy Sedhom @ramsedhom Follow ASCO on social media: @ASCO on X (formerly Twitter) ASCO on Bluesky ASCO on Facebook ASCO on LinkedIn Disclaimer: Dr. Joseph McCollom: No relationships to disclose Dr. Ramy Sedhom: No relationships to disclose
The Pathway to a Blessed Life | Ps Joel RamseyWelcome to Citipointe Church Online. We love that you're joining us for our online experience.The Sermon On The Mount | Ps Joel RamseyJuly 27th - 10:15am ServiceTo connect with or contact us, visit https://citipointechurch.com/connectTo GIVE online, visit https://citipointechurch.com/givingIf you have made a decision today to follow Jesus, please let us know by filling out the form found here: https://citipointechurch.com/i-have-decided/Citipointe Church exists to unmistakably influence our world for good and for God.
Welcome to Citipointe Church Online. We love that you're joining us for our online experience.The Sound of Heaven Breaking Through | Ps Aaron LucasJuly 27th - 8:30 am ServiceTo connect with or contact us, visit https://citipointechurch.com/connectTo GIVE online, visit https://citipointechurch.com/givingIf you have made a decision today to follow Jesus, please let us know by filling out the form found here: https://citipointechurch.com/i-have-decided/Citipointe Church exists to unmistakably influence our world for good and for God.
No Troféu Cocô dessa semana, Doug Bezerra (@dougbezerra) e Jhonatan Marques (@ojhonatanmarques) contam a história de um ouvinte cuja primeira vez foi interrompida por um clima pesado… e não estamos falando de tensão sexual.Apoie o Frango!!PIX: frangofinopodcast@gmail.comApoia.se: https://apoia.se/frangofinoOrelo: https://orelo.cc/frangofinoPatreon: https://patreon.com/frangofinoMANDE SUA HISTÓRIA NO WHATSAPP 11 94547-3377 ou frangofinopodcast@gmail.comPara falar com a gente:E-mail:frangofinopodcast@gmail.comInstagram:@frangofinopodcastWhatsapp: 11 94547-3377
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