Podcasts about csfs

Dr. Bishal Gyawali and Dr. Tessa Cigler share the new, comprehensive, evidence-based update of the ASCO guideline on the use of hematopoietic colony-stimulating factors in patients with cancer. They discuss recommendations on primary prophylaxis, secondary prophylaxis, and treatment of febrile neutropenia along with stem cell mobilization, efficacy, safety, duration, dosing, and administration of CSFs – including biosimilars. They highlight where it is appropriate to use a CSF, and importantly, when not to use a CSF. They touch on the significance of individual patient considerations and cost implications, and future work to refine the risk factors for the development of complications of febrile neutropenia. Read the full guideline, "White Blood Cell Growth Factors: ASCO Guideline Update" at www.asco.org/supportive-care-guidelines TRANSCRIPT This guideline, clinical tools and resources are available at www.asco.org/supportive-care-guidelines. Read the full text of the guideline and review authors' disclosures of potential conflicts of interest in the Journal of Clinical Oncology,  https://ascopubs.org/doi/10.1200/JCO-25-02938     Brittany Harvey: Hello and welcome to the ASCO Guidelines podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges, and advances in oncology. You can find all the shows, including this one, at asco.org/podcasts. My name is Brittany Harvey, and today I'm interviewing Dr. Bishal Gyawali from Queen's University in Kingston, Ontario, Canada, and Dr. Tessa Cigler from Weill Cornell Medicine in New York, New York, co-chairs on "White Blood Cell Growth Factors: ASCO Guideline Update." Thank you for being here today, Dr. Gyawali and Dr. Cigler. Dr. Bishal Gyawali: Thank you very much for having me. It's a pleasure. Dr. Tessa Cigler: Hi there. Nice to be here as well. Brittany Harvey: Great. And then before we discuss this guideline, I'd like to note that 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 disclosures of potential conflicts of interest for the guideline panel, including Dr. Cigler and Dr. Gyawali, who have joined us here today, are available online with the publication of the guideline in the Journal of Clinical Oncology, which is linked in the show notes. So then I'd like to dive into the guideline that we're here today to talk about. So first, what prompted an update to this guideline on the use of hematopoietic colony-stimulating factors in patients with cancer, and what is the scope of this updated guideline? Dr. Bishal Gyawali: The last version of the guidelines from ASCO on this topic was back in 2015, so it has been more than a decade since ASCO had a guideline on the use of G-CSF in patients with cancer receiving treatment. So it was due for an update because there has been a lot more evidence based on not necessarily new drugs, but evidence for proper timing of these agents and the duration of these agents, as well as there have been a lot of new biosimilars, and there are questions about are these biosimilars equivalent or how do we choose among these different options. One is that content of the evidence that has evolved over time in the last decade, but also I think the last time we had these guidelines, the ASCO guidelines were not incorporated to have those evidence GRADE tables. So the quality of the ASCO guidelines itself has evolved over the years, so we wanted to have a new version of the guideline that includes not only the new evidence, but also contains those evidence GRADE tables that will help to quantify the benefits. And so I think it was high time, and even more than that, the newer ASCO guidelines for any guideline, they also include considerations of cost, access, equity, and all these factors that were not included in the previous version of the guideline. So I think it's only natural that with time the guideline should also evolve. Dr. Tessa Cigler: I agree completely, and just as a framework, as we all know, neutropenia and its complications, including febrile neutropenia and infections, are still an important toxicity of many myelosuppressive chemotherapies. And these neutropenic complications do require prompt evaluation and treatment and often hospitalization, and we know that hematopoietic colony-stimulating factors, which I'm going to refer to as growth factors, can reduce the duration and severity of neutropenia and the risk of febrile neutropenia, so it remains an important topic in the practice of clinical oncology. Brittany Harvey: Absolutely. It's an important topic for both clinicians and for patients who are receiving treatment for their cancer. And as you said, there was a substantial amount of literature to review here and updating everything to be in line with the GRADE evidence rating system, so there was a lot of work that you both put into this. So then next, I'd like to review the key recommendations of this guideline by clinical question. So first, what factors did the expert panel identify that should influence the decision to administer primary prophylaxis of febrile neutropenia with a CSF? Dr. Bishal Gyawali: Yeah, so I think that constitutes one of the most important recommendations in our guidelines about primary prophylaxis with G-CSF. And this is important because not only it's about when to use it, it's also about when not to use it, as in the ASCO "Choosing Wisely" campaign has also made some recommendations about this. So our guideline recommendations are also aligned with that. So first of all, we recommend that primary prophylaxis with G-CSF is recommended when the risk of febrile neutropenia because of the chemotherapy regimen is equal to or more than 20% unless an alternative chemotherapy regimen with comparable efficacy and safety that does not need G-CSF is available. And the quality of evidence to make this recommendation is high, so we give a strong strength of recommendation for this. Having said that, even for patients where the risk of febrile neutropenia is not necessarily 20%, it's a little lower, but because of other patient-related factors, the patient is at a higher risk of complications from febrile neutropenia, such as age, comorbidities, and other factors, in such case primary prophylaxis with G-CSF should be offered. And we also make a recommendation that if G-CSF is not affordable or available, then antibiotic prophylaxis can also be offered, but the evidence quality for this is low, and the strength of recommendation is very conditional. A couple of things to highlight here would be that, I think Dr. Cigler can attest to that, we ran into lots of problems about finding the data for the evidence base to say what are the patient-related factors that actually make them at a higher risk of febrile neutropenia, you know, like how did that 20% benchmark come about? Why 20%? Or when we say even if it's less than 20%, if based on other comorbidities, if the risk is higher, we tried to dig into that evidence. For example, we're talking about our "Box 1" in the guideline, what is the evidence for each item we have included under that "Box 1"? And we tried to do a lot of search to find the evidence for that, and some of them do have strong evidence, and that will tie into our future research ideas as well. And some of them actually don't have such solid evidence too, so that was one of the reasons why we ran into lots of problems about how do we quantify whether someone is at a high risk of febrile neutropenia and where that 20% benchmark comes from. Dr. Tessa Cigler: And definitely, because there's not very clear data, our guidelines definitely leave room for physician discretion in all these situations. Brittany Harvey: Absolutely. I find that in a lot of these guidelines the key point is that there's a lot of shared decision-making with patients after talking through what risk factors they may have and what is best for them in their individual clinical scenario. So then moving on to secondary prophylaxis, what factors did the expert panel identify that should influence the decision to administer secondary prophylaxis of febrile neutropenia with a CSF? Dr. Tessa Cigler: So for patients who've already experienced a neutropenic complication from a previous cycle of chemotherapy, the question is which patients should then receive prophylactic G-CSF for subsequent cycles of chemotherapy. And without a lot of evidence again to guide us, the panel really felt strongly that secondary prophylaxis should be used when a treatment delay or when a reduced dose of chemotherapy would be thought to compromise cure rates or survival outcomes. We do note that in many situations, certainly a dose reduction or a delay would be a very reasonable alternative or an additional strategy to G-CSF administration. Dr. Bishal Gyawali: Yeah, I think it's more like if there is going to be compromise in outcomes without using G-CSF, as in if we can't maintain the dose intensity and that's going to lead to inferior outcomes, then we should. But if we can reduce the dose intensity and treatment frequency and still have the same outcomes, then I guess in simple words, we're just trying to say use it when it's absolutely needed, or you can also look into other alternatives that might not need G-CSF but you could maintain the same outcomes. Brittany Harvey: Understood. It's helpful to review those options for clinicians and showing that there's not just one way to address potential neutropenic complications for later cycles of chemotherapy. So then following those recommendations for prophylaxis, what does the expert panel recommend regarding CSFs for the treatment of febrile neutropenia? Dr. Bishal Gyawali: This is an important question because this ties strongly with the "Choosing Wisely" campaign. In other words, primary and secondary prophylaxis we talked about when CSF should be used; here we make a sort of negative recommendation in that we say when CSF should not be used, because this is where we see most overuse or overtreatment with G-CSF. So first, we say that we should not be using a CSF routinely simply because a patient has neutropenia. If they are afebrile but they only have neutropenia, we recommend against using CSF just to boost neutrophil counts; that's not a meaningful metric. Then the second recommendation we make is CSF should not be routinely used as an adjunctive treatment with antibiotic therapy for patients with fever and neutropenia. So the first one was neutropenia, no fever, don't use it. The second one is okay, there is neutropenia and fever, but the treatment for that is use of antibiotic therapy, and so in such situations routinely we should not be using G-CSF just to boost the neutrophil count. And that is tied on to the third recommendation where if the patient has fever and neutropenia but is also at a very high risk for infection-related complications or who have other prognostic factors that we think will lead to poor outcomes for the patient, then in such situations, a CSF can be used as an adjunctive treatment. But we talk about the data in the manuscript, but the data show that the most that this will do is reduce the days of hospitalization by a couple of days. It actually does not have any data that it's going to improve the mortality rates. So as of now, we use the word "may be offered," it's not "should be offered," it's "may be offered" if there are other factors that we think will make the patient at the very poor risk of mortality outcomes, and the evidence quality here therefore is low and our strength of recommendation is conditional. And we also have a box that lists those items that we think might be associated with poor prognosis for the patients, but again the data for those, are they really hard evidence? No. And that is also tied with our future research recommendation that we should study more about these factors that might lead to these poor outcomes. Dr. Tessa Cigler: And again, allowing for discretion of the treating physician. Brittany Harvey: Absolutely. It's just as important to know when not to use CSFs routinely, and those risk factor boxes that you mentioned are available in the full manuscript along with the full list of recommendations, and our listeners can refer to that; a link will be in the show notes of the episode . Dr. Tessa Cigler: Just so you know, the panel, we really discussed those criteria a lot and agonized over them and gave you our best recommendations. Brittany Harvey: Definitely, and it sounds like there was varying degrees of evidence to support a lot of those risk factors, and so it's really important that the evidence supports those, but also there was expert consensus of the panel in reviewing each of those factors individually to come up with recommendations that can be applicable for all clinicians. Dr. Bishal Gyawali: If I may add, we're proud of our panel because I think our panel is quite inclusive of people representing different specialties within cancer care, as in we had radiation oncologist, we had infectious disease expert, pharmacists, and most importantly, we also had patient partners. Brittany Harvey: Absolutely. Having a multidisciplinary panel is really important for each and every guideline. So then, this is probably relevant now, but addressing a few more specific sections addressed in the guideline, what is the role of CSFs as adjuncts to progenitor cell transplantation? Dr. Tessa Sigler: Great question, and so, as solid tumor oncologists, Dr. Gyawali and I really leaned heavily on our hematology experts within the panel. The panel decided that a CSF should be used alone after chemotherapy or in combination with a CXCR4 inhibitor to mobilize peripheral blood progenitor cells. Clearly the choice of mobilization strategy depends on the type of cancer and the type of transplantation. The panel noted that a CSF should be routinely administered after autologous stem cell transplantation to reduce the risk of severe neutropenia, and that a CSF may be administered after allogeneic stem cell transplant to reduce the duration of severe neutropenia. Again, this last recommendation has not a lot of evidence to support it, and so we kind of tempered our language that it may be administered or can be considered based on clinical judgment of the physician and the clinical status of the patient. Brittany Harvey: And that really highlights the need for a multidisciplinary panel, because as you are solid tumor oncologists, you need the hematologists to make recommendations for all sorts of patients and make sure that these guidelines are comprehensive.   So then moving on to another smaller subset population, for patients receiving concomitant chemotherapy and radiation therapy, are CSFs recommended? Dr. Bishal Gyawali: I think there is very little evidence for patients who are receiving radiation therapy alone, so there is no evidence to suggest the use of CSF in patients with radiation therapy alone. The bigger question is in patients who are receiving both chemo and radiation together, chemoradiotherapy. In those patients, up until now, the classical recommendation has been to avoid G-CSF use. I think in our updated guidelines we discuss a couple newer trials that are trying to address this issue, but in the totality of evidence, we still stick with the same recommendation as before, which is CSFs are not recommended in patients receiving concomitant chemotherapy and radiation therapy, especially those involving the mediastinum because the biggest evidence of harm is for these patients. Dr. Tessa Cigler: I agree completely. Brittany Harvey: Definitely. It's important to recognize when that balance of benefits and harms leans more towards harms, and so that this should not be recommended for those patients. So there are several different CSFs that are recommended in the guideline, including biosimilars. So do the recommended CSFs differ in efficacy or safety? Dr. Tessa Cigler: So as supported by evidence, and the panel all agreed, that the various forms of CSFs, including the biosimilars, really have the same evidence for efficacy and for safety, and that the choice of agent really should depend on cost, availability, accessibility, patient convenience, and sometimes disease subtypes and treatment regimens. But, in essence, these can be used interchangeably without concern for efficacy or toxicity differences. Dr. Bishal Gyawali: I completely agree. I think in terms of efficacy outcomes, I don't think there is anything to choose between these agents. The choice between these agents would largely depend on different patient and treatment-related factors: cost, availability, affordability, feasibility. We even discuss things like where does the patient live, as in how frequently the patient can commit to the cancer center, and we also discussed things like even for the daily shots of filgrastim, patients can be taught and they can get it by themselves at home. So we discussed all these factors, but in a nutshell, the choice within these agents primarily depends not on efficacy factors, but simply based on all these other factors that are equally important but which can lead to informed decision-making about what is best for a given patient. But we mention it explicitly that the biosimilars, there is nothing to choose between them, especially the biosimilars; it's about price competition and what you can get at an affordable rate. Brittany Harvey: Understood. It's great to have many different options for patients so that there's something that can work for them based off access, cost, and all these factors that you listed. As you mentioned, it may be easier for some patients to get their treatment at home rather than in clinic, and so having different options and reviewing those with patients is very important. Dr. Bishal Gyawali: As we are having this conversation, I'm thinking that we might be a very unique guideline in that I don't think in many other settings you have this many options that you are asking about, you know, choices between equally good options and making decisions based on cost. I don't think there are any other areas in oncology where we have the privilege of making these decisions based on cost and convenience and all these factors, as well as we might be one of those guidelines where we have, as discussed before, so many recommendations about when not to do things and trying to promote judicial use of treatments. Dr. Tessa Cigler: As you might imagine, our panel discussions were very lively. Dr. Bishal Gyawali: Yes. But Dr. Cigler, do you recall any other guideline where there is so much discussion about when not to use things and how we have so many biosimilar options and we can choose the one that's most appropriate? I don't recall any other. Dr. Tessa Cigler: I agree with you. Brittany Harvey: It's certainly a unique guideline in that regard. So we'll move into the last clinical question that the expert panel addressed. But what does the expert panel recommend for the initiation, duration, dosing, and administration of CSFs? Dr. Bishal Gyawali: Yeah, I think there has been some new data in this regard that were not available in the previous guideline. For example, we have new trials testing a shorter duration of filgrastim injections compared to the standard of care. So we have some data, we call this 'de-escalation of treatment'. So we have more data supporting de-escalation of treatment. We have some data for lower dose of pegfilgrastim, we have data for lower duration of filgrastim, we have also some new data about timing of treatment, as in there has been some newer data presented about the relationship of timing of the drug and the frequency of adverse events from G-CSF such as bone pain. There is also the question about, for patients who don't live near the cancer center, can they get their pegfilgrastim shot on the day of chemo while they are in the cancer center? So all these questions that are very pragmatic and important questions, but were not answered before, we're glad that we had more evidence to talk about all these factors and give a more solid recommendation to our users of the guideline. Brittany Harvey: Definitely. And listeners can review the full list of dosing and administration recommendations in Table 2 in the guideline, and that will be linked in the show notes of the episode. So then I really want to thank you both for reviewing all of these recommendations. There's certainly a large amount of clinical questions and recommendations that you went through. I'd like to next ask, in your view, what is the importance of this updated guideline and how will it impact both clinicians and patients? Dr. Bishal Gyawali: I think the importance of this updated guideline is that, as mentioned before, we talk about newer data that have come up with regards to not just the most important two questions as in when to use it as primary prophylaxis and when to use it as secondary prophylaxis and when to use it as treatment, but also with regards to the duration and timing and dosing and multiple options and how these all factors as well as patient-related factors should be combined to make an informed decision, the most appropriate decision for the patient. And as mentioned before, we have the GRADE tables that were not in the previous version of this guideline. So I think even those users that are familiar with the 2015 guideline, I think they will find very novel content in this new updated guideline, and they will find it useful for their practice. I would encourage the readers to not only read the headlines of the box recommendations, but also read the full text of these guidelines because we have worked really hard to incorporate the latest evidence and also interpret them contextually. The discussion regarding de-escalation, patient considerations, cost implications; usually, people just skip these portions when they read a guideline. But I think these are also one of the most important paragraphs in our guideline, so they have been written with very careful thought, and I think reading the whole guideline is very much worth your time. Dr. Tessa Cigler: As you can imagine, I agree completely, having just spent several months thinking about these guidelines and all their nuances. Brittany Harvey: Certainly, this guideline is definitely a very comprehensive update, and that nuance in the manuscript is really important for clinicians to understand and read through and understand when it's appropriate to make certain decisions. So then to wrap us up, I'd like to ask, what are the outstanding questions and active research areas regarding the use of white blood cell growth factors in patients with cancer? Dr. Tessa Cigler: As you all know from clinical practice and that we've said several times already in this podcast is that the risk factors for the development of complications of febrile neutropenia are still not clearly worked out. And one of the things that is, I think, really needed in clinical practice is the development of predictive algorithms or biomarkers to really allow us to understand who might be more at risk and to allow for the clinician to be able to tailor the use of G-CSF as needed. Brittany Harvey: Yes, and so we'll look forward to future updates in this space to inform new recommendations and an updated guideline in the future. So I want to thank you both so much for your work to develop this comprehensive guideline. It was certainly a lot of effort, and thank you for your time today, Dr. Gyawali and Dr. Cigler. Dr. Tessa Cigler: Oh, my pleasure. It's nice to be here and to speak with you all. Dr. Bishal Gyawali: Yeah, it was great to speak with both of you but also through you to the audience, and we had a great time. Thank you. Brittany Harvey: And then finally, thank you to all of our listeners for tuning in to the ASCO Guidelines podcast. To read the full guideline, go to www.asco.org/supportive-care-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app, available in the Apple App Store 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.

In this episode, Jeffrey discusses how leaders can evaluate projectsEach week, Jeffrey will be sharing his knowledge on Service Delivery (Mondays) and Service Management (Thursdays). Jeffrey is the founder of Service Management Leadership, an IT consulting firm specializing in Service Management, Asset Management, CIO Advisory, and Business Continuity services.  The firm's website is www.servicemanagement.us.  Jeffrey has been in the industry for 30 years and brings a practical perspective to the discussions. He is an accomplished author with seven acclaimed books in the subject area and a popular YouTube channel with approximately 1,500 videos on various topics.  Also, please follow the Service Management Leadership LinkedIn page.

In this episode, Jeffrey encourages leaders to consider two unspoken critical success factors for their next initiative.Each week, Jeffrey will be sharing his knowledge on Service Delivery (Mondays) and Service Management (Thursdays). Jeffrey is the founder of Service Management Leadership, an IT consulting firm specializing in Service Management, Asset Management, CIO Advisory, and Business Continuity services.  The firm's website is www.servicemanagement.us.  Jeffrey has been in the industry for 30 years and brings a practical perspective to the discussions. He is an accomplished author with seven acclaimed books in the subject area and a popular YouTube channel with approximately 1,500 videos on various topics.  Also, please follow the Service Management Leadership LinkedIn page.

Self-insuring can feel complicated—especially when you get into contract provisions or health insurance captives.In Part 2 of our 3-part series with the Podfather himself, Spencer Smith, CSFS®, we break down:What a health insurance captive actually isWhen a captive might be the right fit for your group Key contract nuances every employer should understandPractical insights for anyone dealing with group benefitsThis series was a blast to record and is packed with value for employers, HR pros, and benefits decision-makers. If you missed Part 1, go check it out—and don't miss this episode if you want to take your self-funding knowledge to the next level.HIT LinkedIn: https://www.linkedin.com/company/the-h-i-t-podcast/about/HIT IG: https://www.instagram.com/the_hitpodcast/HIT Spotify: https://open.spotify.com/show/3bZ4GyZEm8Acmo60BetLHm?si=7f59f1b218b14ef6&nd=1&dlsi=cba58f30269a4c34HIT iTunes: https://podcasts.apple.com/us/podcast/the-h-i-t-podcast/id1685677680?i=1000611317315About the Show:The H.I.T. Podcast (Powered by Montage Insurance Solutions): A thought leader in the space, curating the top news and information to deliver a brief, high impact overview designed specifically for the Human Resources professional, business person, and company executive.#TheHITPodcast #SelfFunding #StopLoss #CaptiveInsurance #GroupBenefits #SpencerSmith #Healthcare #HRLeadership #EmployerBenefits

Mark “Murch” Erhardt and Mike Schmidt discuss Newsletter #368.News● Draft BIP for block template sharing (0:30) ● Trusted delegation of script evaluation (28:07) Changes to services and client software● ZEUS v0.11.3 released (33:07) ● Rust Utreexo resources (33:25) ● Peer-observer tooling and call to action (34:11) ● Bitcoin Core Kernel-based node announced (37:22) ● SimplicityHL released (38:23) ● LSP plugin for BTCPay Server (39:17) ● Proto mining hardware and software announced (39:42) ● Oracle resolution demo using CSFS (40:46) ● Relai adds taproot support (41:11) Releases and release candidates● LND v0.19.3-beta (43:09) ● Bitcoin Core 29.1rc1 (43:29) ● Core Lightning v25.09rc2 (43:55) Notable code and documentation changes● Bitcoin Core #32896 (44:33) ● Bitcoin Core #33106 (46:57) ● Core Lightning #8467 (1:02:49) ● Core Lightning #8354 (1:03:26) ● Eclair #3103 (1:04:07) ● Eclair #3134 (1:04:43) ● LDK #3897 (1:05:56)

On this episode, host Adam Russo welcomes Richard Hardin, CSFS, President of Edison Health Solutions, a Third-Party Administrator (TPA) putting the SELF back in their self-funded healthcare plans. They discuss the customizable solution with a patient-focused mindset and concierge client service model. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

Sanket Kanjalkar, Jonas Nick, Tadge Dryja, Steven Roose, and Brandon Black join Mark “Murch” Erhardt and Mike Schmidt to discuss Newsletter #361.News● Separating onion message relay from HTLC relay (2:06) Changing consensus● CTV+CSFS advantages for PTLCs (5:45) ● Vault output script descriptor (15:21) ● Continued discussion about CTV+CSFS advantages for BitVM (22:57) ● Open letter about CTV and CSFS (27:59) ● OP_CAT enables Winternitz signatures (1:12:27) ● Commit/reveal function for post-quantum recovery (1:22:46) ● OP_TXHASH variant with support for transaction sponsorship (1:53:31) Notable code and documentation changes● Bitcoin Core #32540 (2:13:29) ● Bitcoin Core #32638 (2:14:47) ● Bitcoin Core #32819 (2:15:25) ● LDK #3618 (2:17:41)

The Bitcoin Brief is a biweekly program hosted by Max and QnA that delivers the latest updates and news on Bitcoin and freedom-oriented technologies, keeping you informed and in the loop.AOBEaster holidaysQ having a few days offPrime/Core shipping updatesOver a year legal purgatory for Samourai devs NEWSTwenty One Capital set to launchUnchained launches Bitcoin Legacy projecteXch to close downVoltage announces 'Voltage payments'Panama city approves BTC for taxesSpar supermarket Switzerland now accepts BTC via LNAshigaru fundUPDATES/RELEASESBitcoin keeper rebrand and v2.2.0Fidelity bond calculatorErk on ArkAwesome CTV + CSFS curationRockstar dev video on BTCPay multisigCoinswap v0.1.1Aegis signer for Nostr iOSIMPORTANT LINKS https://freesamourai.comhttps://p2prights.org/donate.htmlhttps://ungovernablemisfits.comVALUE FOR VALUEThanks for listening you Ungovernable Misfits, we appreciate your continued support and hope you enjoy the shows.You can support this episode using your time, talent or treasure.TIME:- create fountain clips for the show- create a meetup- help boost the signal on social mediaTALENT:- create ungovernable misfit inspired art, animation or music- design or implement some software that can make the podcast better- use whatever talents you have to make a contribution to the show!TREASURE:- BOOST IT OR STREAM SATS on the Podcasting 2.0 apps @ https://podcastapps.com- DONATE via Paynym @ https://paynym.rs/+misfit- DONATE via Monero @ https://xmrchat.com/ugmf- BUY SOME STICKERS @ https://www.ungovernablemisfits.com/shop/FOUNDATIONhttps://foundation.xyz/ungovernableFoundation builds Bitcoin-centric tools that empower you to reclaim your digital sovereignty.As a sovereign computing company, Foundation is the antithesis of today's tech conglomerates. Returning to cypherpunk principles, they build open source technology that “can't be evil”.Thank you Foundation Devices for sponsoring the show!Use code: Ungovernable for $10 off of your purchaseCAKE WALLEThttps://cakewallet.comCake Wallet is an open-source, non-custodial wallet available on Android, iOS, macOS, and Linux.Features:- Built-in Exchange: Swap easily between Bitcoin and Monero.- User-Friendly: Simple interface for all users.Monero Users:- Batch Transactions: Send multiple payments at once.- Faster Syncing: Optimized syncing via specified restore heights- Proxy Support: Enhance privacy with proxy node options.Bitcoin Users:- Coin Control: Manage your transactions effectively.- Silent Payments: Static bitcoin addresses- Batch Transactions: Streamline your payment process.Thank you Cake Wallet for sponsoring the show!(00:00:00) INTRO(00:00:41) THANK YOU FOUNDATION(00:01:38) THANK YOU CAKE WALLET(00:02:44) How've You Been?(00:06:36) Tariff Tumult(00:08:58) 1 Year of Legal Purgatory for Samourai Wallet(00:10:40) NEWS(00:10:45) The Suitconomy Adds Another Business(00:14:18) Unchained Launches Bitcoin Legacy(00:15:07) exch Shuts Down(00:18:25) Voltage Announces Voltage Payments(00:25:52) Bitcoin Approved for Taxes in Panama City(00:27:43) Spar Supermarket Accepts LN(00:31:46) Ashigaru Fund(00:33:55) Is Jonny D Okay!?(00:35:29) BOOSTS(00:49:12) UPDATES & RELEASES(00:49:30) Bitcoin Keeper Rebrand with 2.2(00:51:23) Fidelity Bond Calculator(00:52:12) Erk on Ark(01:01:00) Awesome CTV and CSFS(01:01:29) BTCPay Multisig Video(01:01:52) Coinswap 0.1.1(01:07:02) Aegis Nostr Signer(01:08:15) QUESTIONS

James O'Beirne is a Bitcoin developer who's not afraid to support unpopular improvement proposals: recently, he spoke about increasing the block size on the stage of OP_NEXT. He also works on CTV & CSFS, and tends to favor technical data over clout. Time stamps: 00:00:52 - Introducing James O'Beirne 00:02:00 - James O'Beirne's Current Bitcoin Core Contributions (CTV/CSFS) 00:02:55 - Shared Motivations and Concerns About Bitcoin Scaling & Financialization 00:05:24 - Discussing New Opcodes (CTV, CSFS, CAT) and MEV Risk 00:06:45 - OP_CAT: Existing Implementations, Unknown Unknowns, and Layer 2 Scaling Needs 00:08:26 - Ordinals Controversy, Permissionless Transactions, and Miner Security Budget 00:11:11 - Security Budget Concerns and Potential Miner Manipulation Risks 00:13:48 - Fee Smoothing (CTV) and Doubts About MEV's Relevance to Bitcoin 00:15:13 - Exploring Citrea, ZK Rollups, and Trustless DeFi on Bitcoin 00:19:08 - Bitcoin's Disintermediation Goal vs. Custodial Layer 2 Solutions 00:20:50 - Starkware Airdrop, GitHub Censorship Claims, and Ordinals Filtering Debate 00:25:03 - Analyzing Luke Dash Jr., Ocean Pool, and Blockstream's Influence 00:29:57 - Blockstream's History, Funding, and Impact on Bitcoin Scaling Debate 00:33:37 - Evaluating SegWit/Taproot Complexity vs. Current Soft Fork Hurdles 00:37:23 - Discussing BIP 300 Drivechains: Concept, Implementation, and Potential 00:40:40 - Re-evaluating the Case for Bigger Bitcoin Blocks 00:44:20 - Block Size Increase Mechanisms (Soft Forks) and Future Demand Scenarios 00:48:05 - Privacy Solutions: MimbleWimble, ZK-SNARKs, and Learning from Other Chains 00:53:19 - Ignoring Real-World Usage: The Danger of Bitcoin Maximalist Echo Chambers 00:57:45 - Sponsor Message: Sideshift.ai 00:59:11 - Block Size War Fallout and the Risk of Institutional Capture 01:01:51 - Bitcoin's Future: Potential Capture vs. Seeding Future Alternatives 01:03:34 - Necessary Hard Forks vs. Closing Window for Desirable Soft Forks 01:07:35 - The Evolution of Covenant Proposals: From CTV to OP_Vault and Back 01:18:03 - Comparing Activation Prospects: CTV/CSFS vs. OP_CAT 01:20:40 - Sponsor Messages: Bitcoin.com News, NoOnes.com, Hodling.ch 01:24:27 - CTV Explained: Functionality, Use Cases (Vaults, L2s, DLCs), and Simplicity 01:27:47 - Layer 2 Unilateral Exit Problem and CTV's Congestion Control Solution 01:33:21 - CTV's Benefits for Lightning, Programmability, and Miner Revenue 01:37:30 - Will CTV/CSFS Bring Users Back? Bitcoin vs. Solana/Ethereum Niches 01:41:19 - The Security Budget Problem, On-Chain Culture, and Tail Emission Debate 01:45:40 - High Fees Fallacy, Ivory Tower Mentality, and Being Bought Off 01:49:37 - Self-Custody Challenges, Developer Frustration, and the Politics of Bitcoin Core 01:54:18 - Bitcoin as Religion/Politics, Core Developer Motivations, and Tail Emission Revisited 01:58:40 - BIP 42, Tail Emission as Inflation, and the 21 Million Cap Dilemma 02:02:21 - Analyzing the Roger Ver Case and Political Persecution in Crypto 02:10:31 - Deconstructing the "Never Sell Bitcoin" Meme and Collateralized Loans 02:13:32 - James O'Beirne's 10-Year Bitcoin Prediction (Post-CTV/CSFS) 02:17:34 - Reception to James's Big Blocks Talk at OP_Next 02:19:06 - Learning from Bitcoin Cash: Big Blocks and Covenant Implementations 02:22:33 - James O'Beirne's Current Work and Where to Follow Him 02:23:38 - Closing Remarks and Sponsor Plugs

Are you interested in public-private partnerships for improved urban futures? Summary of the article titled Critical success factors for public-private partnerships in urban regeneration projects from 2024 by Paula Vale de Paula, Rui Cunha Marques, and Jorge Manuel Goncalves, published in the MDPI Infrastructures journal. This is a great preparation to our next interview with Sally Capp in episode 296 talking about the importance of the public-private partnership endeavours for urban futures. Since we are investigating the future of cities, I thought it would be interesting to see how can this structure enhance regenerative development. This article investigates the critical success factors for public-private partnerships for urban regeneration projects. Find the article through this link. Abstract: Public–Private Partnership (PPP) arrangements are used in different sectors in the provision of infrastructure and public services. The use of PPP agreements in urban regeneration projects, although more recent, has been gaining prominence in different contexts. However, in many cases, PPP projects have a controversial implementation, often not achieving the proposed objectives and presenting negative results. Their controversial implementation is the result of a lack of knowledge and lack of application of the best practices and Critical Success Factors (CSFs) associated with them. Based on this, the present study aims to identify and analyze the CSFs for PPP arrangements in urban regeneration projects. The study was conducted in two distinct parts. The first part consists of a literature review on the PPP CSFs in general. The second part consists of the development of a questionnaire seeking to identify the CSFs of PPP arrangements for urban regeneration projects. Based on the literature review and the questionnaire answers, the main success factors of PPP projects for urban regeneration were identified and structured in the framework with five main clusters: two related to the external environment (enabling environment and exogenous factors) and three related to the internal environment (preparation phase, procurement phase, and contract management phase). Connecting episodes you might be interested in: No.165 - Interview with Michael Healy about actual projects between public and private No.203R - Too risky – The role of finance as a driver of sustainability transitions You can find the transcript through ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠th⁠i⁠s link⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠. What wast the most interesting part for you? What questions did arise for you? Let me know on Twitter ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@WTF4Cities⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ or on the ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠wtf4cities.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ website where the⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠showno⁠t⁠es⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠are also available. I hope this was an interesting episode for you and thanks for tuning in. Music by ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Lesfm ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠from ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Pixabay⁠

000:00 Graham's investment approach 04:15 Macro update (re CPI, bond yields, interest rates & GDP) 13:20 Key takeaways from Q4'23 US earnings season 19:45 Water Intelligence 24:15 Argentex Group  28:15 Close Brothers 33:40 Cornerstone FS 39:45 Jarvis Securities 44:10 Maintel 50:25 Watches of Switzerland Group 56:25 Audience questions and Graham's personal holdings. Disclosure: I own AGFX & WATR, whilst CSFS is a Vox client.

In this interview, CEO James Hickman of Cornerstone FS #CSFS takes me through the business': 00:00 Successful turnaround. 04:50 Their outstanding trading update (FY'23 revs up +100% to £9.6m), key USPs & improving profit margins. 13:40 International expansion strategy, tech/service roadmap & cash generation. 17:10 Outlook for 2024 and longer term, aspirational growth target.

The world of health insurance is very complicated. There are many different companies out there. There is one changing the game called ParetoHealth, and Spencer Smith is in the studio right now to talk about that.

Mark “Murch” Erhardt and Mike Schmidt are joined by Matt Corallo, Brandon Black, Gregory Sanders, and James O'Beirne to discuss Newsletter #266. News Disclosure of past LN vulnerability related to fake funding (21:11) Covenant mashup using `TXHASH` and `CSFS` (1:30) Selected Q&A from Bitcoin Stack Exchange Is there an economic incentive to switch from P2WPKH to P2TR? (34:44) What is the BIP324 encrypted packet structure? (37:31) What is the false positive rate for compact block filters? (39:23) What opcodes are part of the MATT proposal? (40:27) Is there a well defined last Bitcoin block? (41:40) Why are miners setting the locktime in coinbase transactions? (46:10) Why doesn't Bitcoin Core use auxiliary randomness when performing Schnorr signatures? (47:40) Releases and release candidates Core Lightning 23.08 (49:21) LND v0.17.0-beta.rc1 (50:24) Notable code and documentation changes Bitcoin Core #27460 (51:16) LDK #2248 (53:43) LDK #2337 (55:00) LDK #2411 (1:00:16) LDK #2507 (1:04:46) LDK #2478 (1:07:22) LND #7904 (1:09:07)

In this episode, I share some of my work related to lung health in partnership with Carrier Sekani Family Services and First Nations communities in north central British Columbia. I talk a bit about why I am doing this work, then described some of the activities we did on our recent trip a couple of weeks ago. I mention some of the principles I bring as the researcher to this work, in terms of responsibility, opportunity, flexibility and accountability, and why I'm drawn to the unpredictable nature of research down outside of the hospital or university setting. If you'd like to know more about Carrier Sekani Family Services, their website is www.csfs.org If you'd like to hear me speak about this work in more detail, feel free to email me at pat.camp@hli.ubc.ca If you'd like to read a couple of papers which describe this work, you can find them here: 1. Scoping Review of Telehealth Use by Indigenous Populations in Australia, Canada, New Zealand, and the United States. https://journals.sagepub.com/doi/full/10.1177/1357633X231158835 2. “Bayis Ilh Tus – A Strong Breath: a community-based research project to estimate the prevalence of chronic obstructive pulmonary disease in remote and rural First Nations communities in Canada: research protocol. https://link.springer.com/article/10.1186/s12939-020-01240-1 I welcome your feedback about the show or ideas for future episodes. You can contact me via the comments section here on the LungFIT website. If you listen to the LungFIT podcast on iTunes, please take a moment to review the show. Click here to be directed.

The topics, stocks and shares mentions / discussed include: TwinPetesInvesting Challenge May winner A potential winning gaming stock How to win Robbie Burns aka The Naked Trader's new book Nikkei/ Japanese stock winners Japanese stocks including Nippon, Sony, Softbank, Toyota, Honda, Could Thames Water debts be a re-across to Severn Trent / SVT Debt / Indebtedness A Future turnaround Dividend risks Gravity co / GRVY Frontier Development / FDEV Team 17 / TM17 Devolver Digital / DEVO ITV Mast Energy / MAST Cornestone FS / CSFS Active Energy Group / AEG Venture Life Group / VLG Technology Minerals / TM1 Future / FUTR Softcat / SCT Convatec / CTEC FTSE 100 AIM All-share Investing Trading Kindness Matters Harriman House books Powder Monkey Brewing Co 5% discount code : TWINPETES Menphys Charity Appeal please make a donation on the TwinPetes Investing Challenge 2023 Just Giving Page Investing Trading & much more The Twin Petes Challenge 2023 / Charity fundraise for the MENPHYS Charity. Have you enjoyed one or more of these podcasts. Yes . Then please make a donation , every pound will help. JUST GIVING TWIN PETES FUNDRAISING FOR THE MENPHYS CHARITY https://www.justgiving.com/fundraising/twinpeteschallenge23 Thank you. The Twin Petes Investing podcasts will be linked to and written about on the Conkers3 website and also on the WheelieDealer website . Thank you for reading this article and listening to this podcast, we hope you enjoyed it. Please share this article with others that you know will find it of interest. PLEASE SUBSCRIBE TO THE TWIN PETES INVESTING PLATFORM THAT YOU ARE LISTENING TO THIS PODCAST ON. THANK YOU.

Dennis chats with Spencer Smith about how benefits advisors can leverage social media to grow their pipeline and increase sales. Find Spencer on LinkedIn: https://www.linkedin.com/in/spencer-smith-self-funded/ Check out Spencer's podcast here: https://spencerharlansmith.com/ YouTube: https://www.youtube.com/c/SpencerSmithSelfFunded For more info on Plansight visit: https://www.plansight.com/        

Phil Carroll and Kevin Hornsby talk to James regarding the recent trading update which exceeded expectations and which saw revenues of £4.8m were reported. Disclaimer & Declaration of Interest The information, investment views, and recommendations in this podcast are provided for general information purposes only. Nothing in this podcast should be construed as a solicitation to buy or sell any financial product relating to any companies under discussion or to engage in or refrain from doing so or engaging in any other transaction. Any opinions or comments are made to the best of the knowledge and belief of the commentator but no responsibility is accepted for actions based on such opinions or comments. The commentators may or may not hold investments in the companies under discussion.

Show Notes Intro G'day Sponsored beer Dan's silence reducing efforts - no need for 1.2x Dan's field trip Top 4 News Items Person to ask questionQuestion StoryDanWhat's your favourite Red Hill Brewery memory?Red Hill Brewery for sale - https://craftypint.com/news/3016/red-hill-brewery-goes-on-the-market HendoHow to you feel about this years record number of CSFs and what you you think 2023 holds?Black Flag CSF ending this week plus the others over the past month. What are the numbers?DanPeter Larlor beers of the year - https://www.theaustralian.com.au/the-oz/lifestyle/australias-best-20-beers-of-the-year/news-story/e71b3e62af0668a15c5bf88e2979e582 HendoI continue to speak with breweries all over Australia who are having difficulties hiring production and hospitality staff. What do you think it will take in order for this stress in the labour market to be relieved.DanIf the review achieves one thing what would it be?New IBA board and review underway - https://www.brewsnews.com.au/2022/11/25/new-board-members-at-iba/ Potential topics Abbie Chatfield Beer - https://www.brewsnews.com.au/2022/11/17/influencer-led-launch-continues-push-to-broaden-beers-appeal/ Coopers biggest ad campaign yet - https://www.beerandbrewer.com/coopers-rolls-out-its-biggest-ad-campaign-yet First non alc beer fest - https://www.beerandbrewer.com/australias-first-nolo-drinks-festival-announced/ Red Hill Brewery for sale - https://craftypint.com/news/3016/red-hill-brewery-goes-on-the-market Peter Larlor beers of the year - https://www.theaustralian.com.au/the-oz/lifestyle/australias-best-20-beers-of-the-year/news-story/e71b3e62af0668a15c5bf88e2979e582 ABAC compliance data - https://www.brewsnews.com.au/2022/11/29/abac-releases-social-media-compliance-audit-data/ https://www.brewsnews.com.au/2022/11/25/new-board-members-at-iba/ Wanna come to the F1 in Melbourne next year, Dan? 12 questions

Phil Carroll and Kevin Hornsby talk to James regarding the recent trading update and look forward to 2023. Disclaimer & Declaration of Interest The information, investment views, and recommendations in this podcast are provided for general information purposes only. Nothing in this podcast should be construed as a solicitation to buy or sell any financial product relating to any companies under discussion or to engage in or refrain from doing so or engaging in any other transaction. Any opinions or comments are made to the best of the knowledge and belief of the commentator but no responsibility is accepted for actions based on such opinions or comments. The commentators may or may not hold investments in the companies under discussion.

Most people by now have heard of a CSA, community supported agriculture, where you commit to purchase local farm produce on a regular basis, assuring the farmer of a stable source of income and the consumer of a regular source of fresh, local produce. But have you heard of a CSF? That's a community supported fishery and operates on the same concept. In 2010, our next guest and her husband actually started one of the first CSFs in the nation in our Lowcountry. Mike Switzer interviews Kerry Marhefka, co-owner of Abundant Seafood in Mt. Pleasant, SC.

Sonia Strobel is the co-founder and CEO of Skipper Otto, a Community Supported Fishery based on Coast Salish territory in Vancouver, BC. Sonia was recently appointed to the Executive of the Local Catch Network, and serves as an Advisor for both the Fisheries for Communities Coalition and Slow Fish Canada. She is president of the Friends of Granville Island Society, a fellow of the Royal Canadian Geographical Society, and a business mentor with The Forum. We are excited to have Sonia as a guest on The Blue Fish Radio Show. We discuss the growing importance of CSFs as food insecurity increases across Canada and around the world causing people to seek out more reliable sources of truly sustainably caught seafood.

Phil Carroll and Kevin Hornsby talk to Julian about the unaudited results and strong growth in Q1 and how the Asia team has excelled. Disclaimer & Declaration of Interest The information, investment views, and recommendations in this podcast are provided for general information purposes only. Nothing in this podcast should be construed as a solicitation to buy or sell any financial product relating to any companies under discussion or to engage in or refrain from doing so or engaging in any other transaction. Any opinions or comments are made to the best of the knowledge and belief of the commentator but no responsibility is accepted for actions based on such opinions or comments. The commentators may or may not hold investments in the companies under discussion.

Phil Carroll and Kevin Hornsby talk to Julian regarding SMEs, international payments and electronic account services using a proprietary cloud-based multi-currency payments platform. Zak joins them for a weekly roundup.   Companies mentioned (in no particular order): #CGO #BEN #EME #LIFE #HUI #PHE #CSFS #HUI #HMI #GST Disclaimer & Declaration of Interest The information, investment views, and recommendations in this podcast are provided for general information purposes only. Nothing in this podcast should be construed as a solicitation to buy or sell any financial product relating to any companies under discussion or to engage in or refrain from doing so or engaging in any other transaction. Any opinions or comments are made to the best of the knowledge and belief of the commentator but no responsibility is accepted for actions based on such opinions or comments. The commentators may or may not hold investments in the companies under discussion. 

In this episode of Inside Modular, Dr. Jin Ouk Choi, assistant professor at the University of Nevada, Las Vegas, discusses his research into the critical success factors (CSFs) of modular construction projects and identifies the key CSFs that modular stakeholders should be utilizing. Dr. Choi also discusses the benefits large modular companies are seeing from incorporating these CSFs into their projects.Lastly, Dr. Choi previews his upcoming session at the 2022 World of Modular conference.Support the show (https://www.modular.org/HtmlPage.aspx?name=application)

Justin Futrell, CSFS, Benefits Advisor at TrueNorth Companies, was interviewed by Adam Torres on Mission Matters Business Podcast.  Justin Futrell talks with Mission Matters about his clean water initiatives for Tanzania, along with his efforts to introduce higher-quality healthcare benefits to the workplace.  Follow Adam on Instagram at https://www.instagram.com/askadamtorres/ for up to date information on book releases and tour schedule.Apply to be interviewed by Adam on our podcast:https://missionmatters.lpages.co/podcastguest/Visit our website:https://missionmatters.com/

Justin Futrell, CSFS, Benefits Advisor at TrueNorth Companies, was interviewed by Adam Torres on Mission Matters Money Podcast.  Justin Futrell talks with Mission Matters about his clean water initiatives for Tanzania, along with his efforts to introduce higher-quality healthcare benefits to the workplace.  Follow Adam on Instagram at https://www.instagram.com/askadamtorres/ for up to date information on book releases and tour schedule.Apply to be interviewed by Adam on our podcast:https://missionmatters.lpages.co/podcastguest/Visit our website:https://missionmatters.com/

We have featured community-supported fisheries (or CSFs) frequently in this podcast, especially since this fisheries model has shown remarkable resilience in the wake of COVID19. In this episode, we welcome guest co-host Dr. Joshua Stoll from the University of Maine, who is also a co-founder of the Local Catch network. We talk with Josh about what CSFs are, where they came from, and what they do, and hear from a variety of CSF models. We also feature some important critiques of CSFs, and explore how they are changing in a pandemic world. In this episode, we talk to: Linda Behnken of Alaskans Own (https://alaskansown.com/) Marsh Skeele of Sitka Salmon Shares (https://sitkasalmonshares.com/) Alan Lovewell of Real Good Fish (https://www.realgoodfish.com/) Dan Donovan of Hooked Inc. (hookedinc.ca/) Ben Martens of Maine Coast Fishermen’s Association (https://www.mainecoastfishermen.org/) This episode's music is "Austin 1" by Manwomanchild, available on the Free Music Archive (https://freemusicarchive.org/music/MANWOMANCHILD/Austin_1_single/Austin_1_instrumental) We love to hear your feedback. Follow the Coastal Routes Project www.twitter.com/@Coastal_Routes Philip Loring www.twitter.com/@ConserveChange Hannah Harrison www.twitter.com/@fishpeopleplace Emily De Sousa www.twitter.com/@airplaneavocado If you have a story to share with us, send us an email at stories@coastalroutes.org.

All-Stars MMA Podcast with Josh Gudgeon & Danny Mitchell. This week's guest is Pro MMA Fighter Adam Bramhald who's coming off a lovely early TKO win on CSFS to secure himself a Title shot against Dec Williams And Up and coming Amateur Jack Holt  Sponsored by Muscle Medicine https://www.facebook.com/pages/catego... Sponsored by Amazing Green CBD https://www.facebook.com/Amazing-green-798416740519428/ use discount code AVT10 for 10% off Amazing Green products Follow Josh & Danny on Facebook, Twitter & Instagram @thejoshgudgeon & @DannyMicthellMMA This podcast was recorded at Get Your Media Studios in Leeds. More information at www.getyourmedia.co.uk

All-Stars MMA Podcast with Josh Gudgeon & Danny Mitchell. This week's guest is Pro MMA Fighter Adam Bramhald who's coming off a lovely early TKO win on CSFS to secure himself a Title shot against Dec Williams And Up and coming Amateur Jack Holt  Sponsored by Muscle Medicine https://www.facebook.com/pages/catego... Sponsored by Amazing Green CBD https://www.facebook.com/Amazing-green-798416740519428/ use discount code AVT10 for 10% off Amazing Green products Follow Josh & Danny on Facebook, Twitter & Instagram @thejoshgudgeon & @DannyMicthellMMA This podcast was recorded at Get Your Media Studios in Leeds. More information at www.getyourmedia.co.uk

Meet Richie Mann, a Salmon Steward and the MN Community Manager for Sitka Salmon Shares, a Community Supported Fishery that provides salmon and seafood shares delivered right to your door. Richie shares the importance of CSFs, the impact on the environment and the local communities, and why integrating responsibly harvested seafood into your diet is…

Marketing is a contest for people's attention, according to Seth Godin, so create a compelling Marketing and Sales strategy that will win it.  Involve Marketing and Sales from the beginning and align all strategies to the Business Goals. By knowing who your target audience is, you will be able to create messaging that supports your goals while driving the actions you want.

[Ep 189] When I feel my writing getting a little stale, I start looking around for a teacher. Now, I don't mean I'm looking for a class with an instructor, although that's certainly another way to learn and grow as a writer. I mean I start looking around for an author and text that has something to teach me. In this way, I can continually improve my skills as a writer. Develop a Customized Course of Study A lot of writers feel a strong urge to enter an MFA program to do this. If you feel compelled to pursue that, by all means, research it and see if that's the best next step for you. But you don't have to embark on a pre-planned course of study. You can develop your own path to establish a writing foundation, to build on an existing set of skills and experience, or to refresh your techniques after falling into a writing rut. Without spending a dime, you can invent an efficient, customized writing course using resources readily available online or at your local library to build your skills and style. By including reading, study, analysis, and practice pertaining to your biggest areas of struggle or weakness, you can write to discover the skills and techniques you're lacking and integrate them into your work. Discover New Skills the Ben Franklin Way Novelist James Scott Bell wrote an article about how to strengthen your fiction the Ben Franklin way.1 He explains how Ben Franklin came up with his own self-study course to grow in virtues. Franklin made a grid and evaluated whether or not he was successful in his pursuit of a given virtue each week. In The Autobiography of Benjamin Franklin, the Founding Father concluded he did not attain perfection, as he had hoped, but “was, by the endeavor, a better and happier man than I otherwise should have been if I had not attempted it.”2 James Scott Bell proposes the fiction writer identify key areas to develop into a stronger writer much as Franklin identified his list of virtues. Bell calls these key areas “critical success factors,” or CSFs.3 He explains: Business and sales folk have been using Franklin's system for decades to improve their own performance. Not via Franklin's virtues, but by determining their own areas of competence. These are called critical success factors.4 Bell goes through each CSF a fiction author would want to develop and points to related resources: if the reader wants to learn about scenes, voice, or other aspects of fiction, Bell provides links to articles or books that can address each of those. By tapping into these resources, the writer develops his own self-study course.5 You can do the same. Discover Your Critical Success Factors You can make a list of what you feel are your personal CSFs related to the writing you do. In this way, any of us can identify an area to improve in and find instruction and models pertaining to that exact skill or technique and we can learn from them. For fiction, you could check out James Scott Bell's list in that article, where he cites the seven key elements a fiction writer could focus on: plot structure characters scenes dialogue voice meaning (theme).6 You could make a list of CSFs for nonfiction writers. This might include research, idea development and organization, sentence fluency and word choice, grammar skills, or something as focused as transitions. Find Mentor Texts Find some “mentors,” or more accurately, some “mentor texts” you can study and learn from—mentors who excel in the areas where you feel you're weak. Some of these mentor texts may be instructional, explaining how to do things. Others may simply serve as models. When you find a mentor text like that—that's a model—it's time for close reading. And I've found that close reading is achieved easily with a practice we normally think of for children: copy work. Any adult ready to develop stronger skills can practice copy work. It forces close reading.

[Ep 189] When I feel my writing getting a little stale, I start looking around for a teacher. Now, I don’t mean I’m looking for a class with an instructor, although that’s certainly another way to learn and grow as a writer. I mean I start looking around for an author and text that has something to teach me. In this way, I can continually improve my skills as a writer. Develop a Customized Course of Study A lot of writers feel a strong urge to enter an MFA program to do this. If you feel compelled to pursue that, by all means, research it and see if that’s the best next step for you. But you don’t have to embark on a pre-planned course of study. You can develop your own path to establish a writing foundation, to build on an existing set of skills and experience, or to refresh your techniques after falling into a writing rut. Without spending a dime, you can invent an efficient, customized writing course using resources readily available online or at your local library to build your skills and style. By including reading, study, analysis, and practice pertaining to your biggest areas of struggle or weakness, you can write to discover the skills and techniques you’re lacking and integrate them into your work. Discover New Skills the Ben Franklin Way Novelist James Scott Bell wrote an article about how to strengthen your fiction the Ben Franklin way.1 He explains how Ben Franklin came up with his own self-study course to grow in virtues. Franklin made a grid and evaluated whether or not he was successful in his pursuit of a given virtue each week. In The Autobiography of Benjamin Franklin, the Founding Father concluded he did not attain perfection, as he had hoped, but “was, by the endeavor, a better and happier man than I otherwise should have been if I had not attempted it.”2 James Scott Bell proposes the fiction writer identify key areas to develop into a stronger writer much as Franklin identified his list of virtues. Bell calls these key areas “critical success factors,” or CSFs.3 He explains: Business and sales folk have been using Franklin’s system for decades to improve their own performance. Not via Franklin’s virtues, but by determining their own areas of competence. These are called critical success factors.4 Bell goes through each CSF a fiction author would want to develop and points to related resources: if the reader wants to learn about scenes, voice, or other aspects of fiction, Bell provides links to articles or books that can address each of those. By tapping into these resources, the writer develops his own self-study course.5 You can do the same. Discover Your Critical Success Factors You can make a list of what you feel are your personal CSFs related to the writing you do. In this way, any of us can identify an area to improve in and find instruction and models pertaining to that exact skill or technique and we can learn from them. For fiction, you could check out James Scott Bell’s list in that article, where he cites the seven key elements a fiction writer could focus on: plot structure characters scenes dialogue voice meaning (theme).6 You could make a list of CSFs for nonfiction writers. This might include research, idea development and organization, sentence fluency and word choice, grammar skills, or something as focused as transitions. Find Mentor Texts Find some “mentors,” or more accurately, some “mentor texts” you can study and learn from—mentors who excel in the areas where you feel you’re weak. Some of these mentor texts may be instructional, explaining how to do things. Others may simply serve as models. When you find a mentor text like that—that’s a model—it’s time for close reading. And I’ve found that close reading is achieved easily with a practice we normally think of for children: copy work. Any adult ready to develop stronger skills can practice copy work. It forces close reading.

Even if you know about Community Supported Agriculture, or CSAs, you might not be aware that there is something called Community Supported Fisheries, or CSFs. One of them is Sitka Salmon Shares. CEO Nicolaas Mink explains how they are working to keep ocean fishing sustainable, and he reveals some things you probably should know about the fish you're buying now.

KPIs, metrics, and CSFs are all related. But how and what do they mean?? Listen to this podcast to find out!

We discuss the following topics in our exclusive interview: + The Research & Data + Impact to Employers + Impact to Providers + Medicare Participation and Employers + The Challenges Doctors Face When Selling DPC to Employers + Impact to Patients and Community + Workers Comp Data/Summary + Other Notable Stats + Can this data be replicated in other markets and extracted easily in the future On The DocPreneur Podcast Today: + Michael Tetreault, Editor, The DPC Journal/CMT/Host, DocPreneur Podcast + Michael Hein, MD, MS, MHCM, FACP Co-Founder, KPI Ninja + Vineeth Yeddula, PMP, CLSSMBB, CMQ/OE, Co-Founder, KPI Ninja + Justin Horn, CSFS, SENIOR CONSULTANT, HEALTHCARE STRATEGY/Employee Benefits/Group Health Risk Consultant, Holmes Murphy & Associates KPI Ninja, a leader in healthcare analytics and performance improvement, is a healthcare technology and consulting company that accelerates the achievement of strategic goals through a better means of managing Key Performance Indicators (KPI's). KPI Ninja is one of the fastest growing healthcare analytics company in the Midwest region. Founded in 2014, KPI Ninja's mission is to improve the health of the communities. We do that by partnering with Health Information Exchange (HIE) companies, Health Systems, Critical Access Hospitals, Clinics, and Direct Primary Care (DPC) organizations. We also partner with other healthcare technology companies to build custom analytics applications to solve their data needs. Michael Hein, MD, MS, MHCM, FACP is co-owner and co-founder of KPI Ninja, a healthcare analytics as a service company where he provides strategic leadership direction and operational support. Vineeth Yeddula, PMP, CLSSMBB, CMQ/OE is co-founder of KPI Ninja, a leader in healthcare analytics and performance improvement. Mr. Yeddula is responsible for setting the strategies for the organization and overseeing the business operations to produce the desired results that are consistent with the overall strategy and direction. Justin Horn is a highly experienced insurance, marketing, and leadership executive who has proven his ability to lead diverse teams of professionals and clients to new levels of success in the ever-changing employee benefit industry and in fast paced economic and political environments. Justin's approach to healthcare and employee benefits is to constantly challenge the status quo and focus on innovation and new thinking. He has done this through his extensive work in the self-funded industry, through work with stop loss and reinsurance, captives, cost containment and risk management companies, Direct Primary Care organizations, and other alternative risk transfer programs.

We discuss the following topics in our exclusive interview: + The Research & Data + Impact to Employers + Impact to Providers + Medicare Participation and Employers + The Challenges Doctors Face When Selling DPC to Employers + Impact to Patients and Community + Workers Comp Data/Summary + Other Notable Stats + Can this data be replicated in other markets and extracted easily in the future On The DocPreneur Podcast Today: + Michael Tetreault, Editor, The DPC Journal/CMT/Host, DocPreneur Podcast + Michael Hein, MD, MS, MHCM, FACP Co-Founder, KPI Ninja + Vineeth Yeddula, PMP, CLSSMBB, CMQ/OE, Co-Founder, KPI Ninja + Justin Horn, CSFS, SENIOR CONSULTANT, HEALTHCARE STRATEGY/Employee Benefits/Group Health Risk Consultant, Holmes Murphy & Associates KPI Ninja, a leader in healthcare analytics and performance improvement, is a healthcare technology and consulting company that accelerates the achievement of strategic goals through a better means of managing Key Performance Indicators (KPI's). KPI Ninja is one of the fastest growing healthcare analytics company in the Midwest region. Founded in 2014, KPI Ninja's mission is to improve the health of the communities. We do that by partnering with Health Information Exchange (HIE) companies, Health Systems, Critical Access Hospitals, Clinics, and Direct Primary Care (DPC) organizations. We also partner with other healthcare technology companies to build custom analytics applications to solve their data needs. Michael Hein, MD, MS, MHCM, FACP is co-owner and co-founder of KPI Ninja, a healthcare analytics as a service company where he provides strategic leadership direction and operational support. Vineeth Yeddula, PMP, CLSSMBB, CMQ/OE is co-founder of KPI Ninja, a leader in healthcare analytics and performance improvement. Mr. Yeddula is responsible for setting the strategies for the organization and overseeing the business operations to produce the desired results that are consistent with the overall strategy and direction. Justin Horn is a highly experienced insurance, marketing, and leadership executive who has proven his ability to lead diverse teams of professionals and clients to new levels of success in the ever-changing employee benefit industry and in fast paced economic and political environments. Justin's approach to healthcare and employee benefits is to constantly challenge the status quo and focus on innovation and new thinking. He has done this through his extensive work in the self-funded industry, through work with stop loss and reinsurance, captives, cost containment and risk management companies, Direct Primary Care organizations, and other alternative risk transfer programs.

When dose dense treatment was first described we were greatly enthusiastic for all women with breast cancer. As the experience has matured we now realize that the benefit is confined to women with ER negative cancers. We think it is time to question our use of CSFs and dose dense treatment in ER+ women based on 2 large trials and a conclusive meta-analysis.

This week on The Farm Report Erin and Heather talk to Sabrina Wilensky of Corbin Hill Farms. Sabrina explains the difference between Community Shareholder Farms and CSA (Community Supported Agriculture). It turns out CSFs may be equally if not more important to growing the good food movement, as they don’t entail some of the deal-breaking features found in CSAs (like steep initial membership fees). Tune in to hear yet another great idea to improve our food system! This episode was sponsored by Whole Foods Market. Rebecca Wilk grabs hay to mulch vegetable plants at the Corbin Hill Farm

Deconstructing Dinner in our Schools III (Ryerson University) The G. Raymond Chang School of Continuing Education, in partnership with Ryerson's School of Nutrition and the Centre for Studies in Food Security, offers a post-degree Certificate in Food Security. This unique program is offered nowhere else in the world, and can be completed entirely through the convenience of distance education. The Certificate in Food Security introduces students to topics of hunger and poverty, food policy and programs, community development, urban food security and global nutrition. The schools teaching team is recognized internationally in the field and having lived and worked around the globe, they understand the challenges of implementing food security in Canada and the developing world. Backyard Chickens VII (Farming in the City IX) On part VII of our ongoing Backyard Chickens series (a sub-series of Farming in the City, Bucky Buckaw of Radio Boise shares his wisdom on the topics of swine flu and approaching neighbours about your backyard chicken plans, and he introduces listeners to the smallest chicken in the world - the Serama. Guests/Voices Cecilia Rocha, Director, Centre for Studies in Food Security at Ryerson University (Toronto, ON) - Cecilia Rocha, PhD in Economics, is an Associate Professor in the School of Nutrition of Ryerson University where she teaches Food Policy and Economics of Food Security. Dr. Rocha is a Research Associate of the Reference Centre for Food and Nutrition Security in Rio de Janeiro, Brazil. Dr. Rocha is very active in initiatives involving collaboration between academia and practitioners in the area of food security in Canada and in Brazil. She has volunteered as a member of the Oxfam-Canada Food and Trade Policy Working Group (2003-2005), is a member of the Toronto Food Policy Council (since 2006), and the coordinator of the Betinho Project, a partnership between the CSFS, the Stop Community Food Centre, Toronto Food Policy Council, FoodShare Toronto, and a number of volunteers from the Brazilian community in Canada. Her current research interests include assessing the social efficiency of food security initiatives and programs, the role of civil society in governance for food security, and food security issues among immigrant groups in Toronto. Dr. Rocha is also the Director of the CIDA-UPCD project Building Capacity in Food Security in Brazil and Angola, and is a collaborator in the CIDA-UPCD project Urban Food Security and HIV-AIDS in Southern Africa, led by the Southern African Research Centre at Queen's University. Bucky Buckaw - Host, Bucky Buckaw's Backyard Chicken Broadcast (Boise, ID) - Bucky Buckaw gives advice on raising backyard chickens as just one example of how a locally based economy can work. Through this segment, he informs listeners about the downside of factory farming and what kinds of toxic chemicals you can expect to find in the resultant livestock. He promotes organic gardening and composting, and supporting local farmers.