Podcasts about Destination

Leila Rahimi and Mark Grote explained how quarterback Caleb Williams is helping make the Bears a free-agent destination.

On this episode of Destination on the Left, Joshua Harrell, Chief Revenue Officer at WorldVia, joins me to discuss the evolution of travel advisors in the United States in a post-pandemic world. Joshua shares his insights on how content creation can help travel advisors build their businesses, and he offers some fantastic practical tips for sharing great content with your audience. What You Will Learn in This Episode: How Joshua transitioned from a background in marketing and entrepreneurship into the travel advisor industry How the travel advisor profession has evolved to provide personalized value for travelers What content creation means for travel advisors and how becoming a content creator at any level can help build an audience and demonstrate expertise How Joshua encourages travel advisors to overcome the fear of content creation with his mantra: "get going, get smart, then get good" Why he advises advisors to align their business with personal passion and interests How collaboration between travel advisors and supplier partners leads to mutual business growth Marketing systems and foundational strategies Joshua recommends to help advisors streamline their marketing The Modern Travel Advisor Once upon a time, the idea of a travel agency conjured images of mall storefronts and swivel chairs. But today's travel advisor is a totally different breed, part consultant, part marketer, and 100% expert. Pre-2020, many Americans believed DIY online booking made travel advisors obsolete. But it was really the post-pandemic world that revealed just how valuable a travel professional can be. Whether unraveling complex travel restrictions or finding that off-the-beaten-path experience, advisors offer insider knowledge and advocacy that algorithms simply cannot replicate. Building Authority and Community Successful advisors aren't just travel experts; they're also storytellers, educators, and digital community builders, whether they do it by sending curated newsletters, going live on platforms like TikTok and YouTube, or sharing firsthand travel experiences on social channels. Don't be fooled into thinking only "influencers" can play the content game. Most successful travel advisors are content creators at some level. The key is helping potential clients see not just what you know, but how you think, your personality, experience, and specializations shining through. Start where you're comfortable, learn as you go, and trust that consistency breeds improvement and audience growth. The perfect lighting or equipment can wait. What matters is showing up and sharing your expertise. The Secret Sauce for Sustainable Growth The real magic happens in collaboration. Joshua backs this up with real stories, discussing the power of reaching out to suppliers, account managers, and fellow advisors. Whether joining mastermind calls, exploring new product lines, or simply sharing best practices, these partnerships unlock opportunities you might never have considered. He shares an example of an advisor who built a thriving business creating group trips for botanical societies, all sparked by a single phone conversation with a tour operator's representative. Resources: Website: https://worldviatravelnetwork.com/ LinkedIn Personal: https://www.linkedin.com/in/joshuaharrell/ LinkedIn Business: https://www.linkedin.com/company/worldvia/ We value your thoughts and feedback and would love to hear from you. Leave us a review on your favorite streaming platform to let us know what you want to hear more o​f. Here is a quick tutorial on how to leave us a rating and review on iTunes!

In this episode of Inside Startup Investing, Chris Lustrino speaks with Jordan Taylor, managing member of Atari Hotels, about the development of a $124 million Atari-themed destination hotel planned for downtown Phoenix. (00:00–02:14) The project combines real estate development with immersive gaming culture, featuring a 91-room hotel, gaming-inspired experiences, and a venue for esports events, concerts, and creator gatherings. (03:21–13:14) Jordan explains how the team secured licensing rights from Atari, why Phoenix's population growth and urban revitalization make it an ideal location, and how the hotel is designed to serve both travelers and the local community. (06:34–10:01) The conversation also dives into the investment structure behind the project, where investors acquire a majority interest in the physical real estate rather than just a brand concept. (04:39–05:36) Jordan walks through the $124 million capital stack, including equity from investors and family offices alongside construction financing. (05:42–06:16) Finally, they discuss how stabilization and refinancing could provide early liquidity for investors, followed by ongoing cash flow distributions and potential exit scenarios down the road. (19:28–21:10)

TSA callouts are hitting Hobby Airport hard - check wait times at fly2houston.comBookings in Houston are up 12% this year meaning more $$$ for our cityMajority of travelers say trying new local cuisine tops the list of favorite part of travel 

We start by catching up with Alyssa McElheny after her attempt to get a 2nd race in before the cutoff for The HYROX Warsaw Major. Saliva slowed her down, let's find out why. Then the Not So Live Show with Cheryl, Matt and Dave. Old people talk: seatbelts, 8-tracks, and riding in the back of cars HYROX Cancun: race, vacation, or full racecation The "I could go sub-60" guy who ran 1:25 Why HYROX is harder than people think (Murph denial included) Cancun race setup: one lap course, rain, platforms, fireworks Destination races and the rise of the HYROX racecation Fall North America cities announced: Nashville, Tampa, Salt Lake City, Denver Altitude debates and racing for fun vs chasing PRs HYROX growth moment in America and the viral schedule post New women emerging with fast times and the next Elite 15 contenders Alyssa's penalty, judging standards, and the "benefit of the doubt" debate Elite 15 rule enforcement and communication issues The role of media in covering the sport honestly New Worlds qualification rule: no roll-downs after the initial offer Quick preview of the European Championship race and who we want to win We start with some old-school nostalgia before getting into HYROX Cancun and the idea of a true racecation. The conversation moves quickly into how hard HYROX actually is, sparked by the classic "I could go sub-60" claim, and what the Cancun course setup revealed about race design. From there, we get into the bigger picture. HYROX growth in North America, the newly announced fall cities, and the ongoing debate between racing for PRs versus racing for the experience. We also look at emerging athletes, especially on the women's side, and what the next version of the Elite 15 could look like. The back half of the episode focuses on rules and governance. Alyssa's penalty, judging consistency, and the broader issue of communication from HYROX all come up, along with the newly announced Worlds qualification rule removing roll-downs after the initial offer. We wrap with a quick look ahead to the European Championship and who we think could take it. Listen on Apple or Spotify Support us through The Cup Of Coffee Follow Hybrid Fitness Media on IG  

Use Code DWKT at https://HungryRoot.com/DWKT and get 40% off your first box!If you're 21 or older, get 40% OFF your first order + free shipping @IndaCloud with code DWKT at https://inda.shop/DWKT! #indacloudpodIn today's episode, we look into a scam that seems to be picking up steam recently where people are receiving phone calls claiming that they didn't show up to jury duty and now have a warrant out for their arrest. Naturally, you can take care of it by … you know… giving them thousands of dollars. Speaking of being scammed out of thousands of dollars, we have an update regarding Unc aka Mr. Tendernism and Destination Smokehouse. Apparently he and his “brother” & “partner” have parted ways and Unc is venturing out on his own (much to everyone's delight/encouragement). 00:00 Introduction1:05 Jury Duty Scam37:31 Unc Tenderness Update58:04 We Love The InternetWe Love the Internets:https://www.tiktok.com/t/ZTh3ALFHn/https://www.instagram.com/reel/DVZ7MXyjGlxWe hope you enjoyed this episode! Please let us know on Twitter or Instagram if you have any topic suggestions for a future episode! (@lily_marston & @jessismiles__)PS. The girlies have officially entered their short form content era! Follow our official accounts: https://instagram.com/doweknowthempodcast & https://tiktok.com/@doweknowthempodcastBusiness Inquiries: doweknowthempodcast@gmail.comDo We Know Them PodcastHosted by Lily Marston & Jessi Smiles

What if your event menu was the most powerful branding tool your destination has? In this episode, Tracy is joined by Erik Wolf, Founder and Executive Director of the World Food Travel Association and the pioneer behind the global "Taste of Place" movement. We talk about why food and beverage should no longer be treated as a banquet line item—but as the way destinations, hotels, and convention centers express identity, protect culture, and drive measurable economic impact. Erik shares insights from the 2026 Taste of Place Report and explains how culinary heritage, terroir, ethical eating, and storytelling are reshaping tourism—and what that means for meetings and events. If you're a: • Destination marketing organization trying to differentiate your city • Hotel or convention center leader looking to move beyond generic banquet menus • Event planner wanting your program to actually reflect where it's hosted This conversation will challenge how you think about menu design, sourcing, storytelling, and guest engagement. Because when attendees travel for a conference, they don't just want to learn. They want to understand where they are. And sometimes, the fastest way to create a sense of place… is through what's on the plate.

A caller tells us what its like to reside in a spring break destination and how she deals with the crowds.See omnystudio.com/listener for privacy information.

Satisfaction, Provision, Restoration, Direction, Protection, Accommodation, Destination—in 6 verses?

Watering the scented hedgerows of news to see if any green shoots appear. And they do, in the form of … … the most effective protest song ever written … the commendable box-ticking life of Country Joe McDonald … the Timothée Chalamet ding-dong: is it still safe to voice an opinion? … Harry Styles' 67 dates in just 7 locations: how ‘Destination gigs' throttle the competition … was Wings a worse name than the Beatles? And McCartney as a shepherd: discuss … what makes a song work as a football chant? ... the most unusual things we've heard sung by crowds …. Stormfront, Gothic Serpent, Midnight Hammer, Rolling Thunder … album title or US military campaign? … why we love improv theatre … when Champion Jack Dupree lived in Halifax and Kid Creole in Rotherham … plus barrelhouse blues piano, ‘inflicting' music on people and birthday guest Avi Chaudhuri & rock music as community singing.Help us to keep the conversation going: https://www.patreon.com/wordinyourear Hosted on Acast. See acast.com/privacy for more information.

Choosing where to go is one of the most exciting parts of travel—but it can also be the most overwhelming. In this episode, Art shares a simple, practical framework to help you confidently select the right destination for your next trip. Drawing from decades of travel experience, you'll learn how to balance time, budget, logistics, and personal interests so you can plan a trip that truly fits your goals—without second-guessing your decision later. Whether you're planning a quick weekend getaway or a bucket-list international adventure, this episode will help you choose wisely and travel better. ✈️ What You'll Learn How your available time shapes your destination options Why budget matters—and how to make your money go further The importance of safety and personal comfort when traveling How to align your destination with your travel style and interests Tips for evaluating travel logistics, flights, and accessibility Why weather and seasonality can make or break your trip How to narrow your options and confidently choose the best destination

6. Lorenzo Fiori: Addresses Italy's stance on the Middle East conflict before highlighting Tropea, a scenic coastal destination,. He provides local culinary insights, including recipes for the region's famous red onions and wine pairings,. (35 words) (6)1550 ROME

We’re celebrating St. Patrick’s Day in Galway, Donegal, and Ireland’s Wild Atlantic Way. Mickela Mallozzi from the TV show Bare Feet talks about Ireland’s Wild Atlantic Way and enjoying oysters right out of the sea and a much needed Guinness. Then, Gráinne Lawlor from Flavour Trails talks about some lesser-known places to visit in Ireland like Donegal and Wicklow as well as “Irish Wine.” And, we finish up with Sheena Dignam from Galway Food Tours giving tons of beer recommendations in her city! [Ep 380] Show Notes: Destination Eat Drink food and travel guides Destination Eat Drink YouTube channel Mickela Mallozzi Bare Feet website Gráinne Lawlor’s Flavour Trails website Galway Food Tours with Sheena website

In this episode, conceptual artist Ahmet Öğüt travels by train through Ottoman Turkey, the former Yugoslavia and Western Balkans, to the London Underground today, navigating histories and contemporary expressions of solidarity via the 2025 programme, Revolutionary Roads. Destination: Comradeship.Revolutionary Roads. Destination: Comradeship was organised by the Moderna galerija in Ljubljana, the Museum of African Art in Belgrade, and the Museum of Contemporary Art of Montenegro in Podgorica in August 2025.Ahmet Öğüt: Saved by the Whale's Tail, Saved by Art is at Stratford Station in London until December 2026, commissioned by Art on the Underground and New Contemporaries.Museum Yet to Be is at the Museum of Contemporary Art of Montenegro in Pogdorica until 15 March 2026.Translated into Socialism was at the Moderna galerija in Ljubljana until 8 February 2026.The East Remains Possible is at the Museum of Contemporary Art in Skopje (MoCA – Skopje) until March 29, 2026.For more from Art on the Underground, listen to contemporary artist Barby Asante on her collective choral performance, Declaration of Independence (2023), at Stratford Station in London: pod.link/1533637675/episode/aa2803b68933ab974ca584cf6a18479cAnd on migrations between Turkey and France, hear Nil Yalter, awardee of the Golden Lion for Lifetime Achievement at the Venice Biennale in 2024, at Ab-Anbar Galleryduring London Gallery Weekend 2023, with Exile is a Hard Job (1974-Now): pod.link/1533637675/episode/36b8c7d8d613b78262e54e38ac62e70fPRODUCER: Jelena Sofronijevic.Follow EMPIRE LINES on Twitter: twitter.com/jelsofron/status/1306563558063271936And Instagram: instagram.com/empirelinespodcastSupport EMPIRE LINES on Patreon: patreon.com/empirelines

Ever wonder why some flights from Redding cost more than Sacramento—or how new destinations get added to the schedule?In this episode, Steve and Katie sit down with the manager of Redding Airports Manager Andrew Solsvig to talk about what it really takes to bring airlines and routes to a regional airport. They dive into the convenience of flying local, how connections through Los Angeles, San Francisco, Seattle, and Denver open up travel across the country and around the world, and why pricing doesn't always work the way travelers expect.They also tackle some of the community's most-asked questions—including rumors about new airlines, potential new destinations, and whether a direct flight to San Diego could one day take off.If you've ever debated driving to Sacramento or flying out of Redding, this episode will give you a behind-the-scenes look at how your hometown airport works—and what the future of air travel in the North State might look like.Contact the City of Redding Podcast Team Email us at podcast@cityofredding.org Connect with us on Facebook, Twitter and Instagram Visit the City of Redding website Love the podcast? The best way to spread the word is to rate and review!

Nick Chabarria with AAA Missouri joins Debbie Monterrey as Spring Breakers start heading out of town. Where is the top spot?

On this episode of Destination on the Left, I talk with Dan Flores, Head of Tourism at Satisfi Labs, all about using AI in the travel industry. We discuss how conversational artificial intelligence can help drive revenue and operational efficiency, and Dan offers real examples of where this AI is being deployed and how it has had real impacts. We also talk about adoption rates of AI within the tourism industry, and Dan shares a framework for approaching this new technology in your organization. What You Will Learn in This Episode: How Dan Flores transitioned from a long career in tourism operations to leading strategy in conversational AI at Satisfi Labs Why understanding operational efficiency is important when adopting new technology in the tourism industry What conversational AI can do to improve visitor experience and drive revenue How changes in consumer behavior and expectations are encouraging the tourism industry to embrace AI-powered solutions Why it's important to identify pain points and define goals before implementing AI technology in your organization Examples of real-world successful AI adoption, including collaborative projects like Connected City and integrated chatbots for DMOs, attractions, and tour operators How a strategic plan and incremental steps can help tourism businesses navigate the AI landscape The Power of Conversational AI in Tourism The tourism industry has always relied heavily on storytelling and connection, and Satisfi Labs' conversational AI platform gives destinations the ability to amplify their story and interact with customers in real-time. Unlike static websites and traditional ads, conversational AI provides dynamic interactions, it can answer questions, qualify leads, and even facilitate transactions 24/7, in dozens of languages. This delivers not only improved customer service but also a seamless path from inquiry to purchase. Driving Operational Efficiency and Revenue Operational efficiency is a cornerstone in the tourism sector, where staff often wear a lot of hats and resources are limited. Satisfi Labs' conversational agents can automate routine inquiries, freeing up staff to focus on high-value tasks and sales. Using AI turns businesses into round-the-clock operations without needing to scale human teams. A case in point is Dan's personal experience using a Satisfi Labs chatbot to resolve a ticket issue for a college basketball game in minutes, a process he expected would take much longer. The technology goes beyond simple customer service. AI-driven agents are also powerful tools for lead qualification, routing sales queries to the right person after gathering the right information, resulting in improved conversion rates and more effective use of resources. Making AI Work for You AI adoption is happening at a breakneck pace, so fast that Dan warns companies risk being left behind if they don't get on board. He suggests tourism businesses create a strategic AI plan that identifies departmental pain points and assesses if AI can offer a solution, then they can decide whether to build in-house or engage a vendor, and start small. This framework helps organizations prioritize efforts, minimize risk, and ensure resources are being used where they matter most. A key piece of advice is top-down adoption. Leadership should empower staff with resources, education, and freedom to experiment with AI tools, ensuring the culture embraces innovation. Resources: Website: www.satisfilabs.com LinkedIn Personal: https://www.linkedin.com/in/dan-flores2022/ LinkedIn Business: https://www.linkedin.com/company/satisfi-labs/ We value your thoughts and feedback and would love to hear from you. Leave us a review on your favorite streaming platform to let us know what you want to hear more o​f. Here is a quick tutorial on how to leave us a rating and review on iTunes!

Destination 2026: Houston's Countdown to the Cup! Updates on World Cup, Sergino Dest, USMNT Pro's and Con's Phil Ebner talks Scotland national team, and growing up in the culture, Tartan Army, and Scottish history Olivier Finidori on French Italian National, growing up in France, and his favorite French players. We talk current team led by Mbappe and breakout star Doue.

Guest BioAzdean Elmoustaquim is the creator and host of the Destination Morocco Podcast, an immersive audio series that explores the heart of Moroccan culture, travel, and hospitality. Originally from the vibrant city of Marrakech, Azdean grew up with strong family ties to the nearby village of Telouet. After moving to the United States in 1995, he eventually settled in Houston and began finding new ways to reconnect with and share the richness of his homeland.Launched in 2022, the Destination Morocco Podcast offers a behind-the-scenes look at Moroccan life — with practical travel tips, cultural insights, and real conversations with locals and travelers alike. In 2023, Azdean returned to Morocco to capture authentic on-location audio, bringing listeners even closer to the sounds and soul of the country. The podcast is a powerful extension of his passion for storytelling and cultural connection.Azdean is also the founder of Destination Morocco, a boutique travel company he co-runs with his wife, Khadija Elomari. Together, they design personalized itineraries that help travelers explore Morocco not as tourists, but as welcomed guests. Whether through sound or experience, Azdean's mission is to help people discover Morocco deeply and meaningfully.Show SummaryIn this episode of the Big World Made Small Adventure Travel Podcast, host Jason Elkins speaks with Azdean about his journey from Morocco to the U.S. and how that path eventually led to the creation of both a travel company and a popular podcast. Azdean shares stories from his early life in Marrakech, his immigration experience, and how time away helped him fall back in love with the land he left behind.The episode highlights the evolution of the Destination Morocco Podcast — from its humble beginnings during the pandemic to its current form as an immersive storytelling experience. Jason and Azdean discuss the power of capturing ambient sounds, the beauty of cultural imperfections, and the importance of open-minded travel. They also unpack the common misconceptions about Morocco and reflect on the country's growing popularity as a world-class destination.Key Takeaways✓ The Destination Morocco Podcast brings Moroccan culture to life through immersive audio storytelling.✓ Azdean's journey from Marrakech to Houston reflects the richness of the immigrant experience.✓ The podcast began as a pandemic project and has grown into a cultural travel guide.✓ Real background sounds and on-location interviews make the podcast feel truly authentic.✓ Travel is a powerful way to reconnect with one's roots and rediscover identity.✓ Morocco's hospitality is a highlight for travelers and a theme throughout the podcast.✓ Storytelling plays a central role in both the podcast and the tour business.✓ Embracing imperfections in podcasting adds charm and relatability.✓ Morocco is full of hidden gems and diverse cultural experiences beyond the tourist track.✓ The podcast is a bridge between travelers and the real Morocco, inspiring deeper connections. Learn more about Big World Made Small Adventure Travel Marketing and join our private community to get episode updates, special access to our guests, and exclusive adventure travel offers on our website.

A to Z Sports NFL Draft Analyst Joe DeLeone joins Afternoon Drive on The Fan. He talks about the Browns signings in free agency, how likely they are to draft a wide receiver at No. 6, destinations for Kyler Murray, and more.

Project Mindfully Outdoors Black Beard Fire Starters Promo Code Mindfully  In this episode of Project Mindfully Outdoors, Mike shares a personal story from a quiet hike that became an unexpected lesson in mindfulness, presence, and belonging. This episode explores how time on the trail can shift us out of constant striving and back into direct experience — where effort becomes honest, the body leads, and we remember we don't have to earn our place in the moment. You'll hear: A real trail story about walking without a goal or destination How nature teaches mindfulness without techniques or pressure Why presence isn't something you achieve — it's something you stop resisting A short, guided mindfulness moment you can practice outdoors or anywhere A reflection on belonging, effort, and letting the body lead This episode is for anyone feeling mentally busy, emotionally heavy, or disconnected — and looking for a way back that doesn't require fixing anything.

Project Mindfully Outdoors Black Beard Fire Starters Promo Code Mindfully  In this episode of Project Mindfully Outdoors, Mike shares a personal story from a quiet hike that became an unexpected lesson in mindfulness, presence, and belonging. This episode explores how time on the trail can shift us out of constant striving and back into direct experience — where effort becomes honest, the body leads, and we remember we don't have to earn our place in the moment. You'll hear: A real trail story about walking without a goal or destination How nature teaches mindfulness without techniques or pressure Why presence isn't something you achieve — it's something you stop resisting A short, guided mindfulness moment you can practice outdoors or anywhere A reflection on belonging, effort, and letting the body lead This episode is for anyone feeling mentally busy, emotionally heavy, or disconnected — and looking for a way back that doesn't require fixing anything.

LOUNGE LIZARDS PRESENTED BY FABRICA5 - Brilliant Honduran Cigars - Visit Fabrica005.com and use code LIZARDPOD at checkout for 10% off THE ENTIRE STORE! Free worldwide shipping from Miami on all orders over $125. See website for more information and terms.SMALL BATCH CIGAR - SAVE 15% - Exclusive Cigar Retail Partner of the Lizards - Visit SmallBatchCigar.com and use code LIZARD15 for 15% off your order. Free shipping and 5% rewards back always. Standard exclusions apply. Simple. Fast. Small Batch Cigar.Recorded at Ten86 Cigars in Hawthorne, New Jersey, the Lizards pair the Cohiba Ambar with twelve year aged Abuelo rum. The guys answer a listener email on their favorite destination smoking spots, they discuss the Tabaclera S.L.U. bankruptcy and they somehow find their way into Bam's use of handkerchiefs and sinus maintenance.PLUS: Lizard Favorite Destination Smoking Spots, Cuba's Blending Process Debate, New Ratings Guide Announcement, LOTW Winners Update, Tabacalera S.L.U. Insolvency, Hoyo's 160th & MoreJoin the Lounge Lizards for a weekly discussion on all things cigars (both Cuban and non-Cuban), whiskey, food, travel, life and work. This is your formal invitation to join us in a relaxing discussion amongst friends and become a card-carrying Lounge Lizard yourself. This is not your typical cigar podcast. We're a group of friends who love sharing cigars, whiskey and a good laugh.website/merch/rating archive: loungelizardspod.comemail: hello@loungelizardspod.com to join the conversation and be featured on an upcoming episode!instagram: @loungelizardspodGizmo HQ: LizardGizmo.com

Discover all of the podcasts in our network, search for specific episodes, get the Optimal Living Daily workbook, and learn more at: OLDPodcast.com. Episode 3939: Chalene Johnson redefines success by shifting the focus from chasing material milestones to prioritizing the feelings that truly create happiness, offering a powerful framework for setting goals with intention and freedom of choice. She pairs this mindset with practical time management strategies, like identifying “destination procrastination,” prioritizing your top three tasks, and building accountability, to help you stay focused on what truly matters. Together, these insights create a clear, actionable path toward greater productivity, balance, and lasting fulfillment. Read along with the original article(s) here: https://www.chalenejohnson.com/a-new-approach-to-goal-setting/  &  https://www.chalenejohnson.com/why-is-time-management-so-important/ Quotes to ponder: "Destination procrastination is anything you do or 'go to' that feels productive but really isn't." "If you want to get better at time management, to-do lists are a must." "The best approach to to-do lists in my opinion, is to write out your top 3 tasks of the day and then follow up with 3-5 secondary tasks you'd like to accomplish." Learn more about your ad choices. Visit megaphone.fm/adchoices

Mitch Bach talks with Jenn Barbee, co-founder of Destination Innovate, about the real inner workings of DMOs, those three letters that every tour operator has an opinion about but few actually understand. Jenn has spent 30 years inside destination marketing, from a shoestring US Department of Commerce team trying to promote America on a $50,000 budget to her current work closing the gap between DMOs and the small businesses they are supposed to serve. The conversation covers how DMOs get funded, why they sit on valuable visitor data, and what tour operators can actually do to get beyond the dead-end website listing.It goes further than the typical "how to work with your tourism board" advice. Jenn and Mitch get into the identity crisis hitting tour operators and DMOs at the same time: both are losing ground to OTA platforms, both need direct guest relationships, and neither is building enough local partnerships to fight back. They talk short-term rental hosts as untapped referral channels, guerrilla marketing tactics that cost almost nothing, and the hard truth about inbound tourism to the US heading into World Cup and the 250th anniversary.Key TakeawaysYour DMO has expensive visitor data that could sharpen your product, pricing, and ads, but they will not hand it over unless you ask. 06:14 – 07:19 DMOs invest in data about visitor appetite, competing markets, and traveler clusters by neighborhood and interest type. That information rarely trickles down to small tour businesses because DMOs feel pressure to contextualize it or fear judgment on their numbers. Frame your ask around strengthening the destination's tourism product, not just helping your business, and you stand a real chance of getting access to insights you could never afford on your own.The single best first move with your DMO is to find the community manager and introduce yourself with specific visitor language, not a sales pitch. 11:48 – 12:58 Audit your tour product against what the destination website is promoting in terms of itineraries or themes, then reach out where you see a match or a gap. Lead with collaboration. Once you have that baseline, you can inch toward higher-value asks like data sharing or co-promotion, but only after you have earned the relationship through showing up and being useful.Survey your customers about whether they booked the experience before the hotel, then bring that data to the DMO. 56:29 – 56:39 If you can show a DMO that your tour attracted bed nights, you are speaking their only real language: occupancy and bed tax justification. Most tour operators never collect this data, and most DMOs have never seen it from a small business. It positions you as a strategic asset rather than another name on a listings page.DMOs are shifting from marketing organizations to stewardship organizations, and that tension is something you can use. 08:50 – 09:59 Many DMOs now describe themselves as "destination management" or "stewardship" organizations, moving toward what is right for their communities. Their boards and bed tax collectors still want heads-in-beds KPIs. If your tour disperses visitors into underserved neighborhoods, supports local businesses, or tells a more honest destination story, you become the kind of partner that helps a DMO justify its new direction to the people holding the purse strings.Getting listed on the DMO website is a win. Stop underestimating it. 13:10 – 13:45 Many operators treat a listing as table stakes, but some DMOs do not even offer that without a paid membership. If you are listed, follow up by tagging the DMO constantly on social media and feeding them content they can reshare within their brand guidelines. The social media managers have more flexibility than the executive staff and will amplify content that feels fresh or on-brand.If your local DMO is stuck promoting only the marquee attractions, skip them and go to the state level. 17:38 – 18:32 A DMO locked into bread-and-butter promotion is usually in protection mode, worried about occupancy numbers. State tourism offices have embraced experience-driven programming and are more open to working with operators who tell a broader story. For most small tour businesses, the state governor's conference on tourism is where accessible DMO relationships start.Short-term rental hosts are closer to the guest than any DMO, and tour operators should be building direct relationships with them now. 24:31 – 26:00 Short-term rentals nationally overtook hotels in occupancy as of September 2025. Those hosts talk directly to guests about what to do in town. A recommendation from a local Airbnb host is warmer than any OTA listing and costs zero commission. Finding them is manual (social media DMs, local searches), but the payoff is a direct referral channel with no middleman.Stop chasing first-time visitors. Loyal, repeat visitors spend more, stay longer, and sustain the businesses that matter. 32:49 – 33:32 DMOs and operators both fixate on acquiring new customers while ignoring the people who already love the destination. Repeat visitors become patrons of smaller, niche experiences and local businesses. For multi-day operators especially, a returning guest who books a deeper or different tour is more profitable than constantly feeding the top of the funnel.Identity beats branding. Know who you are and say no to the rest. 38:44 – 41:27 Jenn draws a hard line between brand (what you market) and identity (who you actually are and who you serve). When you lead with identity, you market less because the right people find you. That means turning down some customers and product ideas, which is terrifying for newer operators, but it prevents the bland, generic positioning that makes you invisible on platforms like Viator and GetYourGuide.The "book direct" movement matters for tour operators just as much as it does for short-term rentals and hotels. 42:58 – 44:28 Hotels lost roughly 80% of their distribution to OTAs. Tours and activities sit around 40% OTA-controlled, which means there is still time to build direct channels. DMOs missed the OTA boat the first time and are caught in a relevancy crisis. That creates a shared interest: both of you need to reclaim the guest relationship before the platforms own it entirely.Guerrilla, person-to-person marketing is the only thing worth betting on in this environment. 34:16 – 35:03 Replace coffee sleeves at a local shop for a week with a message like "next time mama's in town, try this." That costs almost nothing and puts your name in front of a local audience in a real, physical moment. Operators burning money on flashy ad campaigns and agencies are losing to the ones doing the manual work of building one relationship at a time.Bring tour operators, short-term rental hosts, and local businesses into the same room. The collaboration that comes out of it is worth more than any campaign. 30:35 – 32:17 A 12-person Tourpreneur meetup in Dallas turned competitors into collaborators planning joint tours before they left the room. Those rooms should include short-term rental hosts, restaurants, coffee shops. Nobody is organizing these cross-sector local gatherings yet. That is the opportunity.Rethink the "travel presentation at the library" model. Gather local people around something that is not your tour. 53:23 – 54:46 Jenn pitches a revival of the house-party model for travel: 10 to 15 people, food, conversation, then introduce the experience. For multi-day operators, this replaces the stale slide deck. Book clubs are surging. House gatherings are surging. The sale happens because you built trust in a personal setting, not because you ran a Facebook ad.Quirky, unpolished video cuts through. But virality does not equal business success. 36:32 – 37:38 Behind-the-scenes, day-in-the-life content is what is actually getting traction on social right now. The less templated and less AI-generated it feels, the better it performs. Use that attention as a hook, then shift to collaborative content and real relationship-building that converts. A weird 30-second clip of your tour prep is worth more than a polished banner ad.The inbound tourism situation in the US is worse than most operators realize, and pretending otherwise is a losing strategy. 48:28 – 50:43 Canadian airlines are pulling US routes for summer 2026. Sixteen countries now have travel advisories against

You've arrived at your destination…Books Mentioned:The Great Alone by Kristin HannahWinter Garden by Kristin HannahThe Simple Wild by KA TuckerThe Tourist Attraction by Sarah MorganthalerNorthern Lights by Nora RobertsA Cold Day for Murder by Dana StabenowHalf His Age by Jeanette McCurdyCold As Ice by Toni AndersonRight Motive by Christina DoddWrong Alibi by Christina DoddThe Unsinkable Greta James by Jennifer E. SmithThe Smell of Other People's Houses by Bonnie-Sue HitchcockA Winter of Sweet Secrets by Heidi McCahanThe Other Side of Goodbye by Heidi McCahanCrave by Tracy WolffNot If I Save You First by Ally CarterAny Trope But You by Victoria LavineThe Gathering by CJ TudorFalling for Alaska by Belle CalhouneOne Last Shot by Susan May WarrenThin Ice by Paige SheltonA Long Dark Night by Lilli SuttonPatreon https://www.patreon.com/talkbookishpodcastInstagram https://www.instagram.com/talkbookishpodcast/Merch https://www.bonfire.com/store/talkbookishpodcast/Interested in being a guest on the podcast? https://forms.gle/KtaEnr2Z8eKi6E1x8

Where does unbelief lead? In Numbers 14, the people of Israel stand at the edge of the Promised Land. God had promised them victory, yet they chose to trust their own understanding instead of trusting Him. That single decision led them into forty years of wandering in the wilderness. In this message, we explore the destination of unbelief. Unbelief doesn't simply mean a lack of faith—it often means trusting our own judgment more than God's Word. When we rely on ourselves instead of the Lord, it leads to frustration, loss, and missed opportunities. The challenge of this passage is simple but powerful: Will we trust our understanding, or will we trust God?

Romans 8: 1-2

Discover all of the podcasts in our network, search for specific episodes, get the Optimal Living Daily workbook, and learn more at: OLDPodcast.com. Episode 3939: Chalene Johnson redefines success by shifting the focus from chasing material milestones to prioritizing the feelings that truly create happiness, offering a powerful framework for setting goals with intention and freedom of choice. She pairs this mindset with practical time management strategies, like identifying “destination procrastination,” prioritizing your top three tasks, and building accountability, to help you stay focused on what truly matters. Together, these insights create a clear, actionable path toward greater productivity, balance, and lasting fulfillment. Read along with the original article(s) here: https://www.chalenejohnson.com/a-new-approach-to-goal-setting/  &  https://www.chalenejohnson.com/why-is-time-management-so-important/ Quotes to ponder: "Destination procrastination is anything you do or 'go to' that feels productive but really isn't." "If you want to get better at time management, to-do lists are a must." "The best approach to to-do lists in my opinion, is to write out your top 3 tasks of the day and then follow up with 3-5 secondary tasks you'd like to accomplish." Learn more about your ad choices. Visit megaphone.fm/adchoices

Discover all of the podcasts in our network, search for specific episodes, get the Optimal Living Daily workbook, and learn more at: OLDPodcast.com. Episode 3939: Chalene Johnson redefines success by shifting the focus from chasing material milestones to prioritizing the feelings that truly create happiness, offering a powerful framework for setting goals with intention and freedom of choice. She pairs this mindset with practical time management strategies, like identifying “destination procrastination,” prioritizing your top three tasks, and building accountability, to help you stay focused on what truly matters. Together, these insights create a clear, actionable path toward greater productivity, balance, and lasting fulfillment. Read along with the original article(s) here: https://www.chalenejohnson.com/a-new-approach-to-goal-setting/  &  https://www.chalenejohnson.com/why-is-time-management-so-important/ Quotes to ponder: "Destination procrastination is anything you do or 'go to' that feels productive but really isn't." "If you want to get better at time management, to-do lists are a must." "The best approach to to-do lists in my opinion, is to write out your top 3 tasks of the day and then follow up with 3-5 secondary tasks you'd like to accomplish." Learn more about your ad choices. Visit megaphone.fm/adchoices

Après les îles, la famille s'envole vers le nord de la Thaïlande. À Chiang Mai, ils découvrent temples, cérémonies bouddhistes et villages nichés dans les montagnes. Une journée avec un guide francophone les mène jusqu'à une communauté mong.Pour écouter l'épisode en entierEntre îles du sud et montagnes du nord, le voyage en famille de Marie-----------Si l'épisode vous a plu, laissez-moi une note 5 ⭐️ ou un commentaire sur Apple Podcasts ou Spotify

Aaron Torres and Jason Martin open this week's edition of the show discussing College Basketball's final weekend including UConn's embarrassing loss to Marquette (which will cost them a #1 seed in the Tournament), and Arizona and Duke's dominance. Aaron and Jason then discuss the Maxx Crosby trade and whether or not that puts more pressure on new HC Jesse Minter to win a Super Bowl in his first year as HC. The guys then discuss who's on their Mount Rushmore of NBA players that need to retire already including Russell Westbrook and Draymond Green, before finishing the show discussing whether or not Kyler Murray can stay in the NFL after next season. See omnystudio.com/listener for privacy information.

À Koh Lanta, l'ambiance change. L'île est plus sauvage, les routes plus calmes, et la journée se passe à explorer plages et villages. À Krabi, l'atmosphère devient plus animée… et les filles vivent un moment marquant avec des éléphants.Pour écouter l'épisode en entierEntre îles du sud et montagnes du nord, le voyage en famille de Marie-----------Si l'épisode vous a plu, laissez-moi une note 5 ⭐️ ou un commentaire sur Apple Podcasts ou Spotify

Homeland Security Secretary, Kristi Noem gets dumped by Trump after a grilling on Capitol Hill. Speaking of grilling, Mr. Tendernism is back and maybe even better than ever. It's a new grill for Unc after his former employer, Destination Smokehouse, continuously fumbled the bag with him. They not getting out of those 'taking advantage of unc' allegations. Paramount/Skydance somehow beats Netflix for the custody of WB Pictures. It's been major bags being dropped all around this week. Instructors BK Spades and Novacaine are back to talk about it all. Even an impromptu BET Uncut conversation sparked up from our Student Section.Last Things:1. Jim Carrey looks.....different!2. World At War? Not Yet? But Iran aint playing no games with US. Us being the United States of America. Not sure if that was clear because Iran hit way more countries in the clap back. #MrTendernism #Paramount #WB #Netflix #KristiNoem #BETUncut

Après l'arrivée à Phuket, Marie et sa famille prennent directement la route vers Khao Lak. Entre jungle, lac de montagne et grotte peuplée de chauves-souris, les premiers jours donnent le ton du voyage. Puis vient Koh Phi Phi, ses eaux turquoise et Maya Bay… aussi belle que fréquentée.Pour écouter l'épisode en entierEntre îles du sud et montagnes du nord, le voyage en famille de Marie-----------Si l'épisode vous a plu, laissez-moi une note 5 ⭐️ ou un commentaire sur Apple Podcasts ou Spotify

Planning a trip to Italy? We’ve got some of the best things to eat in Rome, drink in Venice, as well as enjoying the bounty of Abruzzo. There’s the reason why you should get your Suppli hot out of the fryer, the best wines from Abruzzo, and whether a gondola ride is worth splurge. Katie Parla joins Brent to talk about the tradition of organ meat in Rome, Monica Ceserato gives great tips on gondola rides, Sammy Dunham tells us the best wines to try in Abruzzo, and Marta Udalowa shares the edible flowers of Italy, including poppy petals! [Ep 379] Show Notes: Destination Eat Drink food and travel guides Destination Eat Drink YouTube channel Katie Parla website Monica Cerserato website Life in Abruzzo website Forager in Italy facebook page

Julie Gilbert is the new Chief Marketing Officer for Explore St Louis, she joins Megan Lynch in-studio. She's been on the job for just a week. She has a plateful of roles. She points out that 'data' drives the marketing of St Louis. She comes from Door County, Wisconsin, an area that many St Louisans travel to quite frequently. She talks about the importance of marketing St Louis to European travelers as well as utilizing the film office for exposure.

Destination 2026 with Glenn Davis included... World Cup roster updates and injury challenge Claudio Pizarro former Peruvian International, FC Bayern in a can't miss interview Updates on German National team who open the World Cup up in Houston.

In today's devotional, Pastor Kerrick shares encouragement to help you navigate the storms of life and walk on impossible situations. Stream today's devotional to learn more!----Order your copy of the Rhythm of Rest today:https://www2.fccga.com/storeSubscribe to the Faith in the Morning Newsletter:https://www.kerrickbutler.com/subscribe

In life, it's easy to wind up in the wrong place. God can re-route you today to get where God wants you to be.

UNC Tendernism FIRED! Keith Lee Speaks Out+The Destination Smokehouse Owner Nick Responds!

On this episode of Destination on the Left, Juanita Marois, CEO of Métis Crossing, shares her personal experience in developing a tourism destination tied to her roots as a Métis Indigenous person from Canada. She shares in detail how the destination engages visitors by sharing what makes them special, including the experiences Métis Crossing offers—from paddling down the North Saskatchewan River in voyageur canoes to wandering historic buffalo habitats, indulging in Indigenous cuisine, and soon, relaxing at a uniquely Métis-inspired wellness spa. We also talk about collaboration and how Métis Crossing is making a positive impact for both visitors and local residents. What You Will Learn in This Episode: How Juanita's personal journey as a Métis woman influenced her path from consultant to CEO of Métis Crossing Why community collaboration and inclusivity are central to the successful development of Métis Crossing The creation of immersive, cultural, and seasonal experiences that engage visitors' heads, hearts, hands, and hunger How Métis Crossing uses storytelling, land-based learning, and nature to educate visitors about Métis history, Indigenous relationships to land, and sustainability Why collaboration is key in Indigenous tourism, and how Métis Crossing works with other attractions to build itineraries How the philosophy of shared benefit guides partnerships with local government and other cultural destinations What the future holds for Métis Crossing, including innovative projects like the Sage and Spruce Indigenous spa and expanded cultural experiences that honor both Indigenous and European Métis heritage Elevating Métis Crossing as a Destination Building Métis Crossing as a premier Indigenous destination was no accident. By leading with culture and encompassing accommodation and culinary experiences, Métis Crossing provides a one-of-a-kind, immersive journey. Visitors come not just for a vacation, but also to learn about the area's history and traditions. Signature experiences include "Paddle into the Past", a river voyage retracing Métis fur trade routes, and the Wildlife Park, where guests see buffalo up close and learn about historic buffalo hunts, essential to the Métis nation's evolution. The destination engages travelers' head, heart, hands, and hunger, ensuring every visitor leaves with a deeper connection to Métis culture and the Alberta landscape. Creativity and Collaboration Developing Métis Crossing wasn't without obstacles. Juanita describes how collaboration became a creative solution and how she worked with local municipalities, the provincial government, and destination organizations to address regulatory hurdles and land-use challenges. By involving partners early and often, Métis Crossing became a model for inclusive development, proving that transformational change happens when stakeholders unite around shared goals. Infrastructure, Innovation, and Meaningful Impact From its origins as a hay field and historic homesteads, Métis Crossing now spans over 1,800 acres with restored buildings, a cultural gathering center, boutique lodge, skywatching domes, a wildlife park, and even a solar field. These fabulous offerings attract locals and visitors, and recent developments include the Sage and Spruce Indigenous spa, where both Indigenous and European wellness traditions are honored in pursuit of holistic well-being. One powerful impact is that Métis Crossing is now the region's largest employer, revitalizing a once-declining rural area. Juanita's intentional approach ensures tourism benefits residents as much as visitors, creating economic opportunities and supporting cultural revitalization. Resources: Website: https://metiscrossing.com/ LinkedIn Personal: https://metiscrossing.com/ LinkedIn Business: https://www.linkedin.com/company/m%C3%A9tis-crossing/ Indigenous Tourism Alberta: https://indigenoustourismalberta.ca/ Destination Indigenous: https://destinationindigenous.ca/ We value your thoughts and feedback and would love to hear from you. Leave us a review on your favorite streaming platform to let us know what you want to hear more o​f. Here is a quick tutorial on how to leave us a rating and review on iTunes!

Draft tandem Jeremy Nygaard and JD Cameron team up for a podcast to discuss prospects on their way to the big leagues and the MLB draft, produced by Theo Tollefson. 0:00 Intro 4:45 Housekeeping 6:27 Full episode of mailbag questions! You can support the show by downloading it from wherever you get your podcasts, including iTunes and Spotify. If you enjoy the content, consider leaving us a five-star rating and review in addition to sharing or retweeting DTS-related content. You can follow us on Twitter @DTS_POD1, @Jeremynygaard, @J_D_Cameron, and @TheodoreTollef1. We're now on Bluesky @destinationtheshow.bsky.social. You can also find full episodes and clips of our shows on our YouTube page @DestinationTheShow.  

Today I want to talk about learning AI, and why it's fundamentally different from learning most other professional skills.If you decide you want to become a doctor, you commit to a long, structured journey. Years of study, exams, residency, and then a licensing body tells the world, “Yes, this person meets the standard.” Same thing with engineering, law, accounting, IT security, even trades like electrical. You put in the reps, you cross the stage, you get the credential.And yes, the world changes. Doctors have continuing education. Lawyers track case law. Engineers adapt to new codes. But the underlying framework, the language, the standards of practice, those evolve slowly enough that your investment in learning compounds over a career.AI is different. In AI, what worked 90 days ago can be obsolete today. Not because the fundamentals changed, but because the toolset changed. The interface changed. The capabilities changed. The cost changed. The workflow changed. And the people around you, your competitors, your employees, your vendors, they are all adapting in real time. If you learned “the way” to do something with an AI model last quarter, there's a decent chance you are already working off an outdated playbook.So what does that mean if you're serious about learning it?It means you're not learning a profession with a stable body of knowledge. You're learning to operate inside a moving river.-------------**Real Estate Espresso Podcast:** Spotify: [The Real Estate Espresso Podcast](https://open.spotify.com/show/3GvtwRmTq4r3es8cbw8jW0?si=c75ea506a6694ef1)   iTunes: [The Real Estate Espresso Podcast](https://podcasts.apple.com/ca/podcast/the-real-estate-espresso-podcast/id1340482613)   Website: [www.victorjm.com](http://www.victorjm.com)   LinkedIn: [Victor Menasce](http://www.linkedin.com/in/vmenasce)   YouTube: [The Real Estate Espresso Podcast](http://www.youtube.com/@victorjmenasce6734)   Facebook: [www.facebook.com/realestateespresso](http://www.facebook.com/realestateespresso)   Email: [podcast@victorjm.com](mailto:podcast@victorjm.com)  **Y Street Capital:** Website: [www.ystreetcapital.com](http://www.ystreetcapital.com)   Facebook: [www.facebook.com/YStreetCapital](https://www.facebook.com/YStreetCapital)   Instagram: [@ystreetcapital](http://www.instagram.com/ystreetcapital)  

This live episode of the Destination Marketing Podcast features a special crossover session with Destination Discourse, recorded in front of a live audience at the South Carolina Governor's Conference (SC Gov Con). Hosts Adam Stoker and Stuart Butler ditch the PowerPoints for a candid, interactive discussion about the "uncomfortable truths" facing the tourism industry today. Subscribe to our ⁠⁠⁠⁠newsletter⁠⁠⁠⁠! The ⁠⁠⁠⁠Destination Marketing Podcast⁠⁠⁠⁠ is a part of the ⁠⁠⁠⁠Destination Marketing Podcast Network⁠⁠⁠⁠. It is hosted by Adam Stoker and produced by Brand Revolt. If you are interested in any of Brand Revolt's services, please email ⁠⁠⁠⁠adam@thebrandrevolt.com⁠⁠⁠⁠ or visit ⁠⁠⁠⁠www.thebrandrevolt.com⁠⁠⁠⁠. To learn more about the Destination Marketing Podcast network and to listen to our other shows, please visit ⁠⁠⁠⁠www.thedmpn.com⁠⁠⁠⁠. If you are interested in joining the network, please email ⁠⁠⁠⁠adam@thebrandrevolt.com⁠⁠⁠⁠.

Shoot us a Text.Episode #1282: Honda leads the nation in fuel economy, destination charges quietly climb to $1,600 per vehicle, and a new Gallup report shows staffing shortages may be holding back customer experience across retail.If you had to guess the most fuel-efficient automaker in America, who would you pick? According to the EPA's newly released 2025 Automotive Trends Report, Honda just claimed the top spot—blending hybrids, smart engineering, and affordability into a winning formula.Honda posted a 31.0 mpg “real-world” fleet average for 2024—3.8 mpg higher than the industry average among full-line brands.The EPA ranking looks at automakers offering a complete mix of gas and electrified vehiclesHonda's efficiency dominance isn't new. The Civic topped the EPA's very first fuel economy rankings back in 1976.The average Honda transaction price in 2025 was $35,060—roughly $10,000 below the industry average.Honda also set a third straight annual electrified sales record, surpassing 400,000 units, led by CR-V, Accord, and Civic hybrids.There's a new line on the Monroney that's getting a second look: destination charges. These once-overlooked shipping fees are quietly adding billions to vehicle costs without technically raising MSRP.Buyers spent more than $26 billion on destination charges this year, an average of $1,600, according to Edmunds.Some increases are steep: F-150 fees jumped to $2,595, Tahoe rose to nearly $2,000; Toyota Sequoia's fee is up more than 50%.Automakers say the hikes reflect higher fuel, logistics, heavier SUVs and trucks—and now tariffs. Stellantis alone expects $1.9B in tariff costs in 2026.The charge is the same whether the vehicle traveled 10 miles or 1,000, and courts have ruled consumers shouldn't be surprised that it includes profit.John Morrill, Massachusetts dealer: “It's a way to raise prices that is, shall we say, less transparent to the consumer. Carmakers have raised them a lot, certainly faster than they've raised prices.”A new Gallup report highlights a growing gap in retail and beyond: employees feel deeply responsible for customer experience—but don't believe their companies can actually deliver on promises. And staffing cuts appear to be the biggest culprit.43% of workers strongly agree they feel responsible for customer experience (up from 38% last year), but only 23% believe their organization consistently delivers on its promises.Leadership is 10 points more confident than frontline employees that promises are being kept.Staffing is the top barrier to service, cited by 37% of workers—more than training, tools, or unclear standards combined.Today's show is brought to you by iPacket Value. From accurate MSRP validation to smarter merchandisJoin Paul J Daly and Kyle Mountsier every morning for the Automotive State of the Union podcast as they connect the dots across car dealerships, retail trends, emerging tech like AI, and cultural shifts—bringing clarity, speed, and people-first insight to automotive leaders navigating a rapidly changing industry.Get the Daily Push Back email at https://www.asotu.com/ JOIN the conversation on LinkedIn at: https://www.linkedin.com/company/asotu/

CardioNerds (Dr. Jenna Skowronski [Heart Failure Council Chair], Dr. Shazli Khan, and Dr. Josh Longinow) are joined by renowned leaders in the field of AHFTC (Advanced Heart Failure and Transplant Cardiology) and mechanical circulatory support, Dr. Jeff Teuteberg and Dr. Mani Daneshmand to continue the discussion of advanced heart failure therapies by taking a deep dive into the world of durable LVADs (Left Ventricular Assist Devices). In this episode, we will review the history of ventricular assist devices, the basics of LVAD function, selection criteria for LVAD therapy, and surgical nuances of LVAD implantation. Audio Editing by CardioNerds intern, Joshua Khorsandi. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. CardioNerds Heart Success Series PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls There have been significant advances in the field of MCS/LVAD therapy since the first implanted LVAD in the 1960s, to the first FDA approved device in the early 2000's, to now the HM3 LVAD, with the most important change being a centrifugal flow/magnetically levitated design that led to minimized hemocompatibility-related adverse events (HRAE's) (MOMENTUM 3 trial comparing HM2 and HM3).  The REMATCH trial in 2001 was a pivotal trial for LVAD therapy, demonstrating that in a population of patients with advanced HF (70% IV inotrope dependent), LVAD therapy significantly improved survival at both 1 and 2 years as compared to medical therapy alone.    MOMENTUM 3 trial was a landmark trial for the HM3 device, showing that in a population of end stage HF patients (86% inotrope dependent, 32% INTERMACS 1-2, and 60% DT strategy), 5-year survival with HM3 was 58% and HM3 had lower HRAE's compared with HM2.  There are both patient-specific factors and surgical considerations when it comes to candidacy for LVAD therapy.  RV function prior to LVAD is a key determinant for success post-LVAD  Many patients being considered for LVAD may not have robust RV function, however, predicting RV failure after LVAD is exceedingly difficult.   In general, it doesn’t matter how bad the RV may look on imaging; we care more about the pre-LVAD hemodynamics (look at the PAPi and RA/wedge ratio).   What happens in the OR may be the most important determinant of how the RV will do with the LVAD!  Notes Notes drafted by Dr. Josh Longinow.  1. Historical background of heart pumps and LVADs  LVAD Evolution   FDA approval year  2001  2008  2012  2017  Pump  HeartMate XVE   HeartMate II  Heartware HVAD  HeartMate III  Flow/Design Features  Pulsatile Technology   Continuous flow Axial design  Continuous flow  Centrifugal design  Continuous flow   Full MagLev + Centrifugal design  The 1960's ushered in the first ‘LVADs', when the first air-powered ‘LVAD' was implanted. It kept the patient alive for four days before the patient expired.   The first generation of LVADs were pulsatile pumps   The first nationally recognized, FDA approved LVAD was the HeartMate XVE (late 1990s to early 2000s, REMATCH trial). The XVE pump used compressed air (pneumatically driven) to power the pump.   Prior to the XVE, OHT was the standard of care for patients with advanced, end-stage heart failure.   The second and third generations of LVADs were non-pulsatile, continuous flow devices and included the HVAD, HM2, and HM3 devices.   MOMENTUM 3 was a landmark trial for the HM3 device, showing that in a population of sick patients with end stage HF (86% inotrope dependent, 32% INTERMACS 1-2, and 60% DT strategy), 5-year survival with HM3 was 58% and HM3 had lower HRAE's compared with HM2.   The only pump that is currently FDA approved for implant is the HM3, although other pumps are in clinical trials (BrioVAD system, INNOVATE Trial).  2. What are LVADs, and how do they work?   In simplest terms, the LVAD is a heart pump comprised of several key mechanistic components:   Inflow cannula  Mechanical pump   Outflow cannula  Driveline  Controller/Power source  The HM3 differs from its predecessors (HM2 and HVAD) in several key ways;   HM3 is placed intrapericardial whereas the HM2 was placed pre-peritoneal.   Perhaps most importantly, the HM3 is a fully magnetically levitated, centrifugal flow pump, whereas the HM2 is an axial flow device.  Axial flow pumps are not magnetically levitated, leading to more friction produced between the ruby bearing's contact with the pump rotors, and higher rates of hemocompatibility related adverse events (HRAEs, i.e. pump thrombosis) and the HM2 was ultimately discontinued in favor of the HM3 (MOMENTUM 3 trial).  3. What do the terms ‘Destination Therapy' (DT) or ‘Bridge to Transplant' (BTT) mean when it comes to LVADs?   When LVADs first came on the stage, EVERYONE was a BTT; these early pumps weren't designed for long term use (I.e. REMATCH Trial, Heartmate XVE)  Destination therapy means the LVAD was placed in leu of transplant because there are contraindications to transplant   REMATCH trial brought about the concept of “Destination therapy”, comparing outcomes in patients (with contraindications for transplant) who received an LVAD vs optimal medical therapy  Bridge to transplant means we are placing the LVAD in a patient who may not be a transplant candidate at this moment in time (is too sick, or conversely, not sick enough), but may be down the line   Bridge to recovery is another term used when the LVAD is being placed for a patient we think may have a recoverable cardiomyopathy  4. What are some factors we should consider when assessing a patient’s candidacy for LVAD, in general, and from a surgical perspective?   Patient factors   Older age might push us towards thinking LVAD rather than transplant  In general, age > 70 is the cutoff for transplant, but this is not a hard cut off and varies institution to institution    In general, think about things that help predict recovery after a major surgery; Frailty and Nutritional status are important, we try to optimize these prior to LVAD implant   Right ventricular function remains the Achilles heel of LV support  We know that needing temporary RV support post LVAD puts you on a different survival curve than patients who don’t need RVAD support  Studies have not been able to successfully predict who will develop RV failure after LVAD implantation  What happens in the time between when the patient goes to the OR and when they get back to the ICU is an important determinant who might develop RV failure post LVAD   Surgical techniques such as implanting the HM3 in the intra-thoracic cavity, rather than intra-pericardial may help maintain LV/RV geometry to help optimize the RV post LVAD   Surgical considerations for LVAD candidacy  Small, hypertrophied LV: HM3 inflow cannula is small, but small hypertrophied ventricles tend towards chamber collapse during systole causing suction, needing to run slower with lower flow rates  Chest size/diameter: pumps have gotten so small now, that for adults, these have become less of a consideration  BMI: low BMI used to be more of a concern with the older pumps due to where they were placed, and the relative size of the pump itself, not so much now with the smaller HM 3 pumps  Calcified LV apex: would increase risk of stroke, bleeding   Driveline tunneling becomes a concern in the super obese population, higher risk for driveline infections (might tunnel these driveline's shorter, and to a less fatty region of the abdomen, could even tunnel out the thoracic cavity in the super obese to limit skin motion)    5. Is there a role for MCS (i.e. temporary LVAD such as Impella) in pre-habilitation of patients prior to LVAD surgery?   The theory of being able to improve systemic perfusion, decongest the organs, and make the patient feel better prior to surgery makes sense, but becomes problematic due to the lack of a hard end point/time for prehabilitation which might risk delays in surgery   More likely that it can lead to delay in the surgery, with less-than-optimal benefit; you don't want to prolong the wait for surgery and increase the risk for complications prior to surgery    An Impella 5.5 is currently FDA approved for 2 weeks of support, not 2 months so timing is important to keep in mind  It’s unlikely that you will take a patient and convert them from a malnourished, cachectic person in 2 weeks’ time   6. Is there a role for LVAD therapy in the younger patient population? Should we be thinking of LVAD up front for these patients, with the goal of transplanting down the line?   Recovery may be more likely in certain populations, particularly younger females with smaller LV's; in those populations, perhaps bridge to recovery should be the focus, optimizing them on GDMT etc.   The replacement of transplant, with MCS (LVAD) in young patients has become a topic of discussion, because these pumps have become better and better, with the thinking that an LVAD could bridge a patient for 10 years or so, and they could get a transplant later   It is still a big unknown, but several concerns exist  Patients who get LVADs might end up with complications that become contraindication to transplant down the line (stroke, sensitization etc)   Patients and providers are more hesitant because of the more recent iteration for the UNOS criteria for OHT listing which no longer gives patients with an uncomplicated LVAD higher priority, and therefore they could end up waiting a longer time for a heart after undergoing LVAD  References Rose EA, Gelijns AC, Moskowitz AJ, et al. 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