Podcasts about inr

V Sloveniji živimo relativno dobro. Imamo visoko kakovost življenja, dostop do narave, športno infrastrukturo in močno regionalno povezanost. A hkrati vse več ljudi skrbi prihodnost. Stopnja nezaupanja v politične institucije je izjemno visoka, zdravstveni sistem se sooča z resnimi težavami z dostopnostjo, absentizem narašča, mladi so vse bolj negotovi glede perspektive, vprašanja dolgoročne vzdržnosti pokojnin pa ostajajo odprta. Kaj vse to pomeni za prihodnost Slovenije? Kako bo umetna inteligenca transformirala slovenska podjetja in ali bomo ujeli ta vlak? Katere veščine bodo sploh prinašale višje plače v prihodnosti in zakaj slovenska politika namesto dolgoročne strategije še vedno raje vlada na podlagi javnomnenjskih anket in nagrajevanja z "bombončki"? Vse to in še več razkriva poročilo o kakovosti življenja v Sloveniji, ki so ga pripravili na Uradu za makroekonomske analize in razvoj (Umar)? Pred mikrofonom: dr. Peter Wostner, Umar Naroči se na YouTube in nas spremljaj v živo https://www.youtube.com/marjamilic Pridruži se pobudi Nula ni dovolj! Preveri na www.money-how.si/nula-ni-dovolj ______________________ Denis Avdić & Marja Milič predstavljata Psihologija denarja z avtorjem uspešnice Morganom Houslom 19.oktober 2026 I Hala Tivoli Podrobneje o dogodku https://psihologija-denarja.si/ ______________________ PRENOVLJENA DELAVNICA: Investiranje za začetnike Prijava: https://money-how.si/izobrazevanja ___________________ Spletna delavnica INR: kako izbrati račun, naložbe in strategije https://money-how.si/izobrazevanja/ ______________________ PONATIS KNJIGE: Mami, oči, ali smo mi bogati? Od žepnine do investiranja. Vodnik za starše, ki želijo razumeti upravljanje denarja in to znanje samozavestno prenesti na otroke. Tiskana knjiga https://money-how.si/knjiga/mami-oci-ali-smo-mi-bogati/ ____________________________ Money-How Premium: https://money-how.si/narocnine/ vključuje: - Modri AI - Finančni asistent, ki pomaga pri raznih finančnih dilemah https://money-how.si/modri-ai/ - Taxistent - Davčni asistent, ki pomaga pri oddaji davčne napovedi https://money-how.si/taxistent/ (deluje za IBKR; Revolut, Trade Republic... in kombinacijo vseh) - poglobljene članke -- vsa INR orodja (primerjalnik, iskalnik, strategije) ____________________________ Finančna delavnica je lahko čudovito darilo. Več preveri https://money-how.si/izobrazevanja ______________________ (delavnica) Investiranje v delnice: Kaj moram vedeti, ko se odločam za investiranje v delnice Prijava: https://money-how.si/izobrazevanja _____________________ DISCORD skupnost: V finančnih zagatah nismo sami, pridružite se nam na Discord Money-How / discord ______________________________ Več o Money-How na https://money-how.si/

Der Zürcher Ständerat Daniel Jositsch verlässt die SP und will 2027 als Parteiloser wieder antreten. Wenige Stunden nach seiner Ankündigung liess SVP-Regierungsrätin Natalie Rickli verlauten, sie überlege sich eine Ständerats-Kandidatur. Weitere Themen: · Falscher Botox-Doktor zu Gefängnis verurteilt. · In Rümlang hat die Glatt nun wieder Kurven.

SpaceX naj bi izvedel največji IPO (prvo izdajo delnic) v zgodovini, hkrati pa indeks Nasdaq100 zaradi prihoda novih tehnoloških velikanov spreminja pravila vključevanja v indekse. Kaj to pomeni za pasivne vlagatelje, ETF-je in koncentracijo trgov, zakaj tehnološki giganti še naprej beležijo rekordne dobičke ter ali umetna inteligenca ustvarja nov borzni balon. Se še splača staviti na Alphabet, Nvidio, Microsoft, Amazon, je še smiselna strategija buy-and-hold, kako geopolitika vpliva na trge ter ali so ameriške delnice še vedno smiselna dolgoročna naložba. Pred mikrofonom: Matej Pejič, NLB Skladi V epizodi omenjamo ETF Robinhood Ventures Fund I (RVI), ki od aprila drži tudi OpenAI ter DXYZ, ki ima 18 odstotkov v Anthropicu. Naroči se na YouTube in nas spremljaj v živo https://www.youtube.com/marjamilic Pridruži se pobudi Nula ni dovolj! Preveri na www.money-how.si/nula-ni-dovolj ______________________ Denis Avdić & Marja Milič predstavljata Psihologija denarja z avtorjem uspešnice Morganom Houslom 19.oktober 2026 I Hala Tivoli Podrobneje o dogodku https://psihologija-denarja.si/ ______________________ PRENOVLJENA DELAVNICA: Investiranje za začetnike Prijava: https://money-how.si/izobrazevanja ___________________ Spletna delavnica INR: kako izbrati račun, naložbe in strategije https://money-how.si/izobrazevanja/ ______________________ PONATIS KNJIGE: Mami, oči, ali smo mi bogati? Od žepnine do investiranja. Vodnik za starše, ki želijo razumeti upravljanje denarja in to znanje samozavestno prenesti na otroke. Tiskana knjiga https://money-how.si/knjiga/mami-oci-ali-smo-mi-bogati/ ____________________________ Money-How Premium: https://money-how.si/narocnine/ vključuje: - Modri AI - Finančni asistent, ki pomaga pri raznih finančnih dilemah https://money-how.si/modri-ai/ - Taxistent - Davčni asistent, ki pomaga pri oddaji davčne napovedi https://money-how.si/taxistent/ (deluje za IBKR; Revolut, Trade Republic... in kombinacijo vseh) - poglobljene članke -- vsa INR orodja (primerjalnik, iskalnik, strategije) ____________________________ Finančna delavnica je lahko čudovito darilo. Več preveri https://money-how.si/izobrazevanja ______________________ (delavnica) Investiranje v delnice: Kaj moram vedeti, ko se odločam za investiranje v delnice Prijava: https://money-how.si/izobrazevanja _____________________ DISCORD skupnost: V finančnih zagatah nismo sami, pridružite se nam na Discord Money-How / discord _____________________________ Več o Money-How na https://money-how.si/

A Suíça é o destino de muitas famílias brasileiras que buscam segurança e preservação de patrimônio. Mas para que a mudança seja bem-sucedida, o planejamento jurídico e fiscal é essencial. No novo episódio do podcast Jus 360, Anneliese Eger, sócia do Gaia Silva Gaede Advogados, recebe três especialistas para mapear essa jornada:

Zakaj Slovenci še vedno držimo milijarde evrov na računih z nizkimi obrestmi, medtem ko inflacija vztrajno znižuje kupno moč denarja? Kako delujejo banke, zakaj ustvarjajo rekordne dobičke, kaj pomeni neto obrestna marža in zakaj so depozitne obresti pogosto precej nižje od obresti, ki jih banke zaračunavajo za kredite? Zakaj smo zagnali akcijo Nula ni dovolj? V drugem delu pogovora odgovarjamo na vprašanje, kako v letu dni ustvariti 60-odstotni donos in zakaj takšen donos na dolgi rok ni vzdržen. Pred mikrofonom: Andraž Grahek, redni gost Money-How, partner Tivoli Venture in Capital Genetics Naroči se na YouTube in nas spremljaj v živo https://www.youtube.com/marjamilic Pridruži se pobudi Nula ni dovolj! Preveri na www.money-how.si/nula-ni-dovolj ______________________ PARTNERSKA POVEZAVA: V epizodi omenjamo tudi Trade Republic (https://trade.re/moneyhow_ie), platformo za investiranje in varčevanje, ki jo uporabljajo številni mali vlagatelji za nakup ETF-jev, delnic in upravljanje denarja. Del povezav pod videom je partnerskih. Če jih uporabite, lahko podprete neodvisno ustvarjanje vsebin Money-How, brez dodatnega stroška za vas. ______________________ Denis Avdić & Marja Milič predstavljata Psihologija denarja z avtorjem uspešnice Morganom Houslom 19.oktober 2026 I Hala Tivoli Podrobneje o dogodku https://psihologija-denarja.si/ ______________________ PRENOVLJENA DELAVNICA: Investiranje za začetnike Prijava: https://money-how.si/izobrazevanja ___________________ Spletna delavnica INR: kako izbrati račun, naložbe in strategije https://money-how.si/izobrazevanja/ ______________________ PONATIS KNJIGE: Mami, oči, ali smo mi bogati? Od žepnine do investiranja. Vodnik za starše, ki želijo razumeti upravljanje denarja in to znanje samozavestno prenesti na otroke. Tiskana knjiga https://money-how.si/knjiga/mami-oci-ali-smo-mi-bogati/ ____________________________ Money-How Premium: https://money-how.si/narocnine/ vključuje: - Modri AI - Finančni asistent, ki pomaga pri raznih finančnih dilemah https://money-how.si/modri-ai/ - Taxistent - Davčni asistent, ki pomaga pri oddaji davčne napovedi https://money-how.si/taxistent/ (deluje za IBKR; Revolut, Trade Republic... in kombinacijo vseh) - poglobljene članke -- vsa INR orodja (primerjalnik, iskalnik, strategije) ____________________________ Finančna delavnica je lahko čudovito darilo. Več preveri https://money-how.si/izobrazevanja ______________________ (delavnica) Investiranje v delnice: Kaj moram vedeti, ko se odločam za investiranje v delnice Prijava: https://money-how.si/izobrazevanja _____________________ DISCORD skupnost: V finančnih zagatah nismo sami, pridružite se nam na Discord Money-How / discord ______________________________ Več o Money-How na https://money-how.si/

It's the start of a new series: The Most Fundamental Therapy Skills Explained. Woo! Today we're kicking off the series by talking about active listening.Thank you to Paubox for sponsoring this episode. Paubox makes HIPAA-secure email easy and streamlined. Check them out here:https://bit.ly/pps_paubox_spotify*Get $250 off your first year with Paubox with coupon code "SKILLS"*Bonus Deal:* If you add the Paubox badge to your website you get an extra $100 off your first year - that means you can get your whole first year free if you apply both deals!Links Mentioned:Video: My Story of Sudden Hearing Loss:https://youtu.be/DYQJKKnbxFkAPA's Definition of Active Listening:https://dictionary.apa.org/active-listeningRogers, C. R., & Farson, R. E. (1987). Active listening. In R. G. Newman, M. A. Danzinger, & M. Cohen (Eds.), Communicating in business today (pp. 580–593). D. C. Heath & Company.https://books.google.com/books/about/Communicating_in_Business_Today.html?id=PJ24PAAACAAJArticle: “Active Listening”https://www.ncbi.nlm.nih.gov/books/NBK442015/Article: "Coregulation of therapist and client emotion during psychotherapy”https://pmc.ncbi.nlm.nih.gov/articles/PMC7233481/LINKS:*Some links are affiliate links. A percentage of purchases come back to me and help my channel immensely!

Please support this podcast by pressing the follow button and support Chinmaya Mission Mumbai projects taken up by Swami Swatmananda, through generous donations. Contribution by Indians in INR can be made online using this link: https://bit.ly/gdswatmanDonors outside India who would like to offer any Gurudakshina/donation can send an email to enquiry@chinmayamissionmumbai.com with a cc to sswatmananda@gmail.com to get further details.These podcasts @ChinmayaShivam are also available on Spotify, Apple iTunes, Apple Podcasts, Podomatic, Amazon music and Google PodcastFB page: https://www.facebook.com/ChinmayaShivampageInsta: https://instagram.com/chinmayashivam?igshid=1twbki0v3vomtTwitter: https://twitter.com/chinmayashivamBlog: https://notesnmusings.blogspot.comLinkedIN: www.linkedin.com/in/swatmananda

What if the anxiety, overthinking, people pleasing, emotional shutdown, hypervigilance, burnout, and relationship struggles you experience today… were never actually "you" to begin with? In this deeply personal and profoundly eye-opening solo episode, Darin Olien dives into the hidden nervous system programming formed between the ages of 0 and 8 that silently shapes our adult lives. Drawing from neuroscience, trauma research, attachment theory, epigenetics, somatic healing, and his own emotional breakthroughs, Darin explores how childhood experiences become subconscious operating systems that influence everything from relationships and stress responses to chronic disease and self-worth. This episode is a powerful roadmap toward healing. Darin breaks down the science behind trauma, the ACE study, nervous system dysregulation, emotional patterning, and neuroplasticity, while also sharing practical tools like somatic experiencing, expressive writing, EMDR, and Internal Family Systems to help listeners begin rewiring their emotional lives from the inside out. What You'll Learn How childhood experiences program the nervous system Why most adult emotional reactions are subconscious survival patterns The connection between trauma, stress hormones, and chronic disease How the nervous system stores emotional experiences in the body Why people pleasing, hypervigilance, burnout, and emotional shutdown develop The science behind neuroplasticity and rewiring the brain What the ACE Study revealed about childhood trauma and adult health How trauma impacts the amygdala, hippocampus, and stress-response systems Why emotional patterns are adaptations, not character flaws How epigenetics can pass trauma responses across generations The role of somatic experiencing in trauma healing Practical tools for emotional regulation and nervous system repair Chapters 00:00:03 – Welcome to SuperLife 00:00:32 – Sponsor: Bite Toothpaste and eliminating toxic plastic exposure 00:02:47 – Darin introduces emotional reactions and nervous system triggers 00:03:15 – A personal story about reacting vs responding in conflict 00:03:50 – Emotional shutdowns, rage, withdrawal, people pleasing, and overcorrection 00:04:19 – Darin's physical pain journey and emotional discoveries in 2025 00:04:42 – Birth trauma, childhood conditioning, and nervous system programming 00:05:04 – Why the ages of 0–8 are the most neurologically influential years 00:05:18 – Theta and delta brainwave states during childhood 00:05:55 – How children absorb emotional patterns without filters 00:06:22 – Childhood experiences becoming subconscious operating systems 00:06:44 – Adults unknowingly living through a 5-year-old nervous system 00:07:12 – Why this episode became deeply personal for Darin 00:07:35 – The neuroscience behind stress responses and emotional conditioning 00:08:17 – Brain development, neuroplasticity, and subconscious programming 00:09:13 – How the HPA axis, amygdala, and prefrontal cortex are shaped early in life 00:09:45 – Core childhood questions that program the nervous system 00:10:29 – Why adult stress responses originate in childhood environments 00:11:05 – Research showing childhood adversity alters brain structure and chemistry 00:11:18 – The ACE Study explained 00:11:49 – Why patients losing weight became emotionally overwhelmed 00:12:18 – The ten categories of adverse childhood experiences 00:13:02 – "The health crisis of America begins in childhood" 00:13:36 – How adverse childhood experiences increase disease risk 00:14:03 – Suicide, alcoholism, autoimmune disease, depression, and trauma correlations 00:14:37 – Chronic disease as a nervous system issue 00:15:04 – Survival mode, inflammation, hormonal dysregulation, and emotional scarcity 00:15:42 – Self-sabotage and emotional coping patterns explained 00:16:02 – Why your emotional patterns are not character flaws 00:16:22 – Childhood survival adaptations and nervous system intelligence 00:16:52 – Hypervigilance, people pleasing, rage, emotional shutdown, and fear 00:17:05 – Sponsor: Manna Vitality and frequency-based wellness 00:18:59 – Epigenetics and inherited trauma responses 00:19:22 – Cortisol regulation genes and hyperactive stress responses 00:19:51 – Holocaust survivors, inherited trauma, and generational nervous systems 00:20:19 – Why healing requires nervous system awareness—not just intellectual understanding 00:20:45 – "You were never supposed to get over it—you were supposed to heal from it" 00:21:01 – Real-life examples of subconscious nervous system programming 00:21:16 – Why receiving compliments can feel unsafe 00:21:30 – Darin's personal struggle with overachievement and scarcity programming 00:22:03 – Emotional neglect, chronic striving, and feeling "not enough" 00:22:16 – The nervous system roots of burnout and exhaustion 00:22:23 – Hair-trigger emotional reactions and hyperactive amygdala responses 00:22:38 – Chronic self-abandonment and losing personal boundaries 00:22:52 – Fear of intimacy, trust issues, and emotional safety 00:23:02 – "The body keeps the score" explained 00:23:22 – Trauma stored in posture, breath, digestion, immunity, and emotional regulation 00:23:43 – Harvard research on trauma-related brain changes 00:24:19 – The radical power of neuroplasticity and nervous system rewiring 00:24:48 – Why healing requires conscious participation 00:25:01 – Darin shares how healing changed decades of emotional pain 00:25:33 – Somatic Experiencing and Peter Levine's trauma work 00:25:57 – How animals discharge stress naturally 00:26:23 – Trauma as incomplete physiological responses frozen in the body 00:26:42 – Why humans suppress emotional discharge 00:27:16 – PTSD research and the effectiveness of somatic experiencing 00:27:41 – A step-by-step somatic grounding practice 00:28:14 – Why healing is more powerful with a regulated person beside you 00:28:38 – EMDR and reprocessing traumatic experiences 00:28:55 – Internal Family Systems and the "parts" inside the psyche 00:29:13 – Inner critics, overachievers, and nervous system adaptations 00:29:39 – Compassionately listening to emotional parts instead of suppressing them 00:29:51 – Expressive writing as a trauma healing practice 00:30:22 – The neuroscience behind emotional journaling 00:30:48 – A four-day expressive writing protocol for healing 00:31:05 – "You are not broken" 00:31:16 – Reprogramming the nervous system through love and safety 00:31:37 – Why deep healing happens in the presence of another regulated person 00:31:52 – Darin considers creating a future healing workshop 00:32:04 – Final reflections: "You are not what happened to you" 00:32:12 – Peace. Love. SuperLife. Thank You to Our Sponsors Bite Toothpaste: Go to trybite.com/DARIN20 or use code DARIN20 for 20% off your first order Manna Vitality: Go to mannavitality.com/ and use code DARIN12 for 12% off your order. Join the SuperLife Patreon: This is where Darin now shares the deeper work: - weekly voice notes - ingredient trackers - wellness challenges - extended conversations - community accountability - sovereignty practices Join now for only $7.49/month at https://patreon.com/darinolien     Connect with Darin Olien: Website: darinolien.com Instagram: @darinolien Book: Fatal Conveniences Platform & Products: superlife.com New Show: Roadmap to Happiness Key Takeaway "The emotional patterns, fears, reactions, and coping mechanisms that run your adult life are often survival adaptations created by your nervous system during childhood. They are not your identity. They are not permanent. And through awareness, somatic healing, emotional processing, nervous system regulation, and conscious repetition, those deeply rooted patterns can be rewritten into something healthier, freer, and more aligned with who you truly are." Bibliography/Sources Neuroscience & Early Programming Agorastos, A., Pervanidou, P., Chrousos, G. P., & Baker, D. G. (2019). Developmental trajectories of early life stress and trauma: A narrative review on neurobiological aspects beyond stress system dysregulation. Frontiers in Psychiatry, 10, Article 118. https://doi.org/10.3389/fpsyt.2019.00118 Bolton, J. L., Short, A. K., Simeone, K. A., Daglian, J., & Baram, T. Z. (2019). Programming of stress-sensitive neurons and circuits by early-life experiences. Frontiers in Behavioral Neuroscience, 13, Article 30. https://doi.org/10.3389/fnbeh.2019.00030 Shonkoff, J. P., & Boyce, W. T. (2024). Toxic stress and developmental programming of the HPA axis. Annual Review of Developmental Psychology. https://www.annualreviews.org/journal/devpsych Teicher, M. H., & Ohashi, K. (2023). Childhood trauma and reduced hippocampal, anterior cingulate, and corpus callosum volumes. JAMA Psychiatry. https://jamanetwork.com/journals/jamapsychiatry van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Viking / Penguin. https://www.penguinrandomhouse.com/books/313183/the-body-keeps-the-score-by-bessel-van-der-kolk-md/ ACE Study & Adverse Childhood Experiences Felitti, V. J. (2002). The relation between adverse childhood experiences and adult health: Turning gold into lead. The Permanente Journal, 6(1), 44–47. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6112216/ Felitti, V. J., & Anda, R. F. (2010). The relationship of adverse childhood experiences to adult health, well-being, social function, and healthcare. In R. Lanius, E. Vermetten, & C. Pain (Eds.), The impact of early life trauma on health and disease (pp. 77–87). Cambridge University Press. https://doi.org/10.1017/CBO9780511777042 Hillis, S., Mercy, J., Amobi, A., & Kress, H. (2023). Economic burden of health conditions associated with adverse childhood experiences among U.S. adults. JAMA Network Open, 6(12). https://jamanetwork.com/journals/jamanetworkopen Liu, Y., Croft, J. B., Chapman, D. P., et al. (2013). Associations between adverse childhood experiences and health outcomes in adults aged 18–59 years. PLOS ONE, 8(3), e58625. https://doi.org/10.1371/journal.pone.0058625 Epigenetics & Trauma Baratta, M. V., et al. (2021). Epigenetics of childhood trauma: Long term sequelae and potential for treatment. Neuroscience & Biobehavioral Reviews, 132, 1049–1063. https://doi.org/10.1016/j.neubiorev.2021.09.043 Jiang, S., Postovit, L., Cattaneo, A., Binder, E. B., & Aitchison, K. J. (2019). Epigenetic modifications in stress response genes associated with childhood trauma. Frontiers in Psychiatry, 10, Article 808. https://doi.org/10.3389/fpsyt.2019.00808 Provençal, N., & Binder, E. B. (2015). The effects of early life stress on the epigenome: From the womb to adulthood and even before. Experimental Neurology, 268, 10–20. https://doi.org/10.1016/j.expneurol.2014.12.001 Healing Modalities — Research Brom, D., Stokar, Y., Lawi, C., et al. (2017). Somatic experiencing for posttraumatic stress disorder: A randomized controlled outcome study. Journal of Traumatic Stress, 30(3), 304–312. https://doi.org/10.1002/jts.22189 Fratarolli, J. (2006). Experimental disclosure and its moderators: A meta-analysis. Psychological Bulletin, 132(6), 823–865. https://doi.org/10.1037/0033-2909.132.6.823 Gilbert, P. (2009). The compassionate mind: A new approach to life's challenges. New Harbinger Publications. https://www.newharbinger.com/9781572248403/the-compassionate-mind/ Justice Resource Institute. (2022). Evaluation of the efficacy of Internal Family Systems (IFS) therapy for trauma-related symptoms among complexly traumatized adults. ClinicalTrials.gov Identifier: NCT05155930. https://clinicaltrials.gov/ct2/show/NCT05155930 Kuhfuß, M., Maldei, T., Hetmanek, A., & Baumann, N. (2021). Somatic experiencing — effectiveness and key factors of a body-oriented trauma therapy. European Journal of Psychotraumatology, 12(1), Article 1929023. https://doi.org/10.1080/20008198.2021.1929023 Levine, P. A. (2010). In an unspoken voice: How the body releases trauma and restores goodness. North Atlantic Books. https://www.northatlanticbooks.com/shop/in-an-unspoken-voice/ Neff, K. D., & Germer, C. K. (2013). A pilot study and randomized controlled trial of the Mindful Self-Compassion Program. Journal of Clinical Psychology, 69(1), 28–44. https://doi.org/10.1002/jclp.21923 Pennebaker, J. W. (1997). Writing about emotional experiences as a therapeutic process. Psychological Science, 8(3), 162–166. https://doi.org/10.1111/j.1467-9280.1997.tb00403.x Rodenburg, R., Benjamin, A., de Roos, C., Meijer, A. M., & Stams, G. J. (2009). Efficacy of EMDR in children: A meta-analysis. Clinical Psychology Review, 29(7), 599–606. https://doi.org/10.1016/j.cpr.2009.06.008 Schwartz, R. C. (2021). No bad parts: Healing trauma and restoring wholeness with the Internal Family Systems model. Sounds True. https://www.soundstrue.com/products/no-bad-parts Shapiro, F. (2017). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures (3rd ed.). Guilford Press. https://www.guilford.com/books/Eye-Movement-Desensitization-and-Reprocessing/Francine-Shapiro/9781462532766  

Kaj vse lahko vpliva na trg? Največji izziv je regulacija. Ali je strategija postopnih nakupov smiselna tudi, ko govorimo o investiranju v bitcoin? Do kam se lahko povzpne cena? Preverili smo tudi dogajanje okrog stabilnih kovancev, saj v ZDA bančni lobiji poskušajo preprečiti visoke obresti na stabilne kovance. Pred mikrofonom: Toni Čepon, predsednik Bitcoin društva Slovenije Naroči se na YouTube in nas spremljaj v živo https://www.youtube.com/marjamilic Pridruži se pobudi Nula ni dovolj! Preveri na www.money-how.si/nula-ni-dovolj ______________________ Denis Avdić & Marja Milič predstavljata Psihologija denarja z avtorjem uspešnice Morganom Houslom 19.oktober 2026 I Hala Tivoli Podrobneje o dogodku https://psihologija-denarja.si/ ______________________ Spletna delavnica INR: kako izbrati račun, naložbe in strategije https://money-how.si/izobrazevanja/spletna-delavnica-o-inr-kako-izbrati-racun-nalozbe-in-strategije/ ___________________ Bootcamp za začetnike Termini: 21.maj 2026 med 17:00 - 20.00 (v živo on-line) Info: https://money-how.si/dogodki/ ______________________ PONATIS KNJIGE: Mami, oči, ali smo mi bogati? Od žepnine do investiranja. Vodnik za starše, ki želijo razumeti upravljanje denarja in to znanje samozavestno prenesti na otroke. Tiskana knjiga https://money-how.si/knjiga/mami-oci-ali-smo-mi-bogati/ ____________________________ Money-How Premium: https://money-how.si/narocnine/ vključuje: - Modri AI - Finančni asistent, ki pomaga pri raznih finančnih dilemah https://money-how.si/modri-ai/ - Taxistent - Davčni asistent, ki pomaga pri oddaji davčne napovedi https://money-how.si/taxistent/ (deluje za IBKR; Revolut, Trade Republic... in kombinacijo vseh) - poglobljene članke -- vsa INR orodja (primerjalnik, iskalnik, strategije) ____________________________ Finančna delavnica je lahko čudovito darilo. Več preveri https://money-how.si/izobrazevanja ______________________ (delavnica) Investiranje v delnice: Kaj moram vedeti, ko se odločam za investiranje v delnice Prijava: https://money-how.si/izobrazevanja _____________________ (delavnica) Investiranje za začetnike. Praktično o osnovah investiranja. Prijava: https://money-how.si/izobrazevanja _________________________________ DISCORD skupnost: V finančnih zagatah nismo sami, pridružite se nam na Discord Money-How / discord ______________________________ Več o Money-How na https://money-how.si/

Trois cultures. Un territoire. Et visiblement, pas assez de place pour tout le monde en Scandinavie vers -2800. Dans cet épisode de La Dent Bleue, on plonge dans le clash entre Indo-Européens, fermiers néolithiques et chasseurs-cueilleurs, entre migrations, génétique et… bonnes vieilles haches de guerre. Spoiler : ça discute peu, mais ça laisse des traces dans les crânes.Retrouvez le script, la bibliographie complète et les crédits sonores et graphiques sur : https://ladentbleue.fr/migration-indo-europeens-scandinavie-tombes-individuelles-haches-bataillesSuivez La Dent Bleue sur :

Zakaj Slovenci kopičimo denar na bankah? Ali imajo zaradi tega banke rekordne dobičke? Zakaj imajo slovenske banke eno najvišjih neto obrestnih marž v evrskem območju in kaj to pomeni za varčevalce? Kaj bi se zgodilo, če bi prenesli 10 ali 20 odstotkov svojih prihrankov v ETF-je, obveznice, na neobanke in druge bolj produktivne naložbe? Bi se zaradi tega res lahko podražila posojila? V pogovoru tudi o tem, zakaj Slovenci ostajamo med najbolj konservativnimi varčevalci v Evropi, kako Banka Slovenije gleda na neobanke, kaj prinaša digitalni evro in zakaj centralne banke vse bolj kopičijo zlato. Kako Banka Slovenije upravlja svoje rezerve in ali del sredstev investira tudi v ETF-je. Pred mikrofonom: guverner Banke Slovenije dr. Primož Dolenc Naroči se na YouTube in nas spremljaj v živo. Pridruži se pobudi Nula ni dovolj! Preveri na www.money-how.si/nula-ni-dovolj ______________________ Denis Avdić & Marja Milič predstavljata Psihologija denarja z avtorjem uspešnice Morganom Houslom 19.oktober 2026 I Hala Tivoli Podrobneje o dogodku https://psihologija-denarja.si/ ______________________ Spletna delavnica INR: kako izbrati račun, naložbe in strategije https://money-how.si/izobrazevanja/spletna-delavnica-o-inr-kako-izbrati-racun-nalozbe-in-strategije/ ___________________ Bootcamp za začetnike Termini: 21.maj 2026 med 17:00 - 20.00 (v živo on-line) Info: https://money-how.si/dogodki/ ______________________ PONATIS KNJIGE: Mami, oči, ali smo mi bogati? Od žepnine do investiranja. Vodnik za starše, ki želijo razumeti upravljanje denarja in to znanje samozavestno prenesti na otroke. Tiskana knjiga https://money-how.si/knjiga/mami-oci-ali-smo-mi-bogati/ E-knjiga + bootcamp https://money-how.si/knjiga/mami-oci-ali-smo-mi-bogati-2/ ____________________________ Money-How Premium: https://money-how.si/narocnine/ vključuje: - Modri AI - Finančni asistent, ki pomaga pri raznih finančnih dilemah https://money-how.si/modri-ai/ - Taxistent - Davčni asistent, ki pomaga pri oddaji davčne napovedi https://money-how.si/taxistent/ (deluje za IBKR; Revolut, Trade Republic... in kombinacijo vseh) - poglobljene članke -- vsa INR orodja (primerjalnik, iskalnik, strategije) ____________________________ Finančna delavnica je lahko čudovito darilo. Več preveri https://money-how.si/izobrazevanja ______________________ (delavnica) Investiranje v delnice: Kaj moram vedeti, ko se odločam za investiranje v delnice Prijava: https://money-how.si/izobrazevanja _____________________ (delavnica) Investiranje za začetnike. Praktično o osnovah investiranja. Prijava: https://money-how.si/izobrazevanja _________________________________ DISCORD skupnost: V finančnih zagatah nismo sami, pridružite se nam na Discord Money-How / discord ______________________________ Več o Money-How na https://money-how.si/

A high-functioning HCC tumor board can turn complex transplant decisions into coordinated treatment plans that account for liver reserve, tumor biology, and evolving biomarkers. In this episode of the BackTable Podcast 2026 HCC Creator Weekend™, abdominal transplant surgeon Dr. Ari Cohen (Ochsner Health) and transplant hepatologist Dr. Neil Mehta (UCSF) join host Dr. Kavi Krishnasamy to map out strategies for effective multidisciplinary treatment and transplantation planning in HCC. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Sirtex and Boston Scientific. --- Timestamps 00:00 - Introduction00:51 - Starting a Tumor Board06:39 - Building Referral Streams09:03 - Academic and Community Practice Integration14:31 - Treatment Selection Criteria20:38 - Modern HCC Biomarkers25:24 - Role of ctDNA and Biopsy29:37 - Bridging Therapy on Transplant Waitlist32:34 - Downstaging Strategy and Risks39:25 - Final Thoughts and Closing Remarks --- More about this episode The physicians discuss what it takes to build a robust tumor board, from fostering hospital buy-in to engaging leaders across specialties and utilizing virtual formats for consistent participation. The conversation explores clinical decision-making, emphasizing the integration of AFP-L3 and DCP biomarkers alongside AFP to better understand tumor biology and predict post-transplant recurrence. Dr. Mehta and Dr. Cohen also share their patient selection criteria, discussing how bilirubin, liver disease etiology, and INR influence decisions. While radiographic guidance remains central to HCC management, they highlight the growing potential of reliable ctDNA analysis and other biomarkers. The specialists conclude by emphasizing that an integrated, communicative tumor board is the most effective way to navigate the nuances of liver reserve and HCC biology to achieve the best possible patient outcomes. --- Resources Sustained AFP-L3 or DCP expression is associated with progression risk and inferior outcomes in unresectable hepatocellular carcinoma.https://doi.org/10.1007/s10238-025-01877-8 --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

Dan 10 años de inhabilitación a exdirector de Segalmex Aseguran 761 kilos de marihuana en carretera de CoahuilaExplosión en mina de Colombia deja nueve muertosMás información en nuestro Podcast#grc

Slovenci smo rekorderji v kopičenju denarja na bančnih računih. Po zadnjih podatkih Banke Slovenije imajo Slovenci na bankah skoraj 33 milijard evrov, skupaj z gotovino v nogavici pa še bistveno več. Zakaj ta denar ostaja neaktiven in kaj to pove o vlagateljih? Kako poiskati varne naložbe za naš denar? Kaj je obveznica, zakladna menica, kako lahko investiramo v obvezniške sklade, ter kakšna so tveganja, stroški in davčna obravnava. Ali je smiselno še naprej puščati denar na banki? Pred mikrofonom: Domen Granda, Prva pokojninska družba *epizoda se je prenašala v živo na YouTube 5. maja ob 16:00 Naroči se na YouTube in nas spremljaj v živo. Pridruži se pobudi Nula ni dovolj! Preveri na www.money-how.si ______________________ Denis Avdić & Marja Milič predstavljata Psihologija denarja z avtorjem uspešnice Morganom Houslom 19.oktober 2026 I Hala Tivoli Podrobneje o dogodku https://psihologija-denarja.si/ ______________________ Spletna delavnica INR: kako izbrati račun, naložbe in strategije https://money-how.si/izobrazevanja/spletna-delavnica-o-inr-kako-izbrati-racun-nalozbe-in-strategije/ ___________________ Bootcamp za začetnike Termini: 21.maja 2026 med 17:00 - 20.00 (v živo on-line) Info: https://money-how.si/dogodki/ ____________________________ PONATIS KNJIGE: Mami, oči, ali smo mi bogati? Od žepnine do investiranja. Vodnik za starše, ki želijo razumeti upravljanje denarja in to znanje samozavestno prenesti na otroke. Tiskana knjiga https://money-how.si/knjiga/mami-oci-ali-smo-mi-bogati/ E-knjiga + bootcamp https://money-how.si/knjiga/mami-oci-ali-smo-mi-bogati-2/ ____________________________ Money-How Premium: https://money-how.si/narocnine/ vključuje: - Modri AI - Finančni asistent, ki pomaga pri raznih finančnih dilemah https://money-how.si/modri-ai/ - Taxistent - Davčni asistent, ki pomaga pri oddaji davčne napovedi https://money-how.si/taxistent/ (deluje za IBKR; Revolut, Trade Republic... in kombinacijo vseh) - poglobljene članke -- vsa INR orodja (primerjalnik, iskalnik, strategije) ____________________________ Finančna delavnica je lahko čudovito darilo. Več preveri https://money-how.si/izobrazevanja ______________________ (delavnica) Investiranje v delnice: Kaj moram vedeti, ko se odločam za investiranje v delnice Prijava: https://money-how.si/izobrazevanja _____________________ (delavnica) Investiranje za začetnike. Praktično o osnovah investiranja. Prijava: https://money-how.si/izobrazevanja _________________________________ DISCORD skupnost: V finančnih zagatah nismo sami, pridružite se nam na Discord Money-How / discord ______________________________ Več o Money-How na https://money-how.si/

INR se suma a red global de hospitales sustentables Alimentación para el Bienestar no tiene fines de lucroEU reconoce cooperación de México contra el narcotráficoMás información en nuestro podcast#grc

Laborwerte sind aus der Diagnostik nicht wegzudenken und spielen auch für die Steuerung von Therapien eine zentrale Rolle. Auch wenn wir in der Präklinik selbst nur begrenzt Laboranalytik durchführen, ist ein grundlegendes Verständnis der wichtigsten Parameter entscheidend. In dieser Folge von Rettungsdienst LUKS – der Notfallmedizin Podcast sprechen wir über die wichtigsten Laborwerte für die Präklinik, ordnen sie ein und zeigen, worauf es in der Interpretation wirklich ankommt. Ausserdem gehen wir auf typische Fallstricke ein: von Einheitenchaos bis zu verschiedenen Abkürzungen für die jeweiligen Werte. Rettungsdienst LUKS – Der Notfallmedizin Podcast mit dem Thema: Von Hb bis Troponin – Laborwerte für den RettungsdienstIn dieser Folge: - Hämatologie: Leukozyten, Hb, Thrombozyten- Klugscheisserwissen mit Urobilinogen und Order of Draw- Gerinnung: aPTT, Anit Faktor Xa, D-Dimere- Honorable Mentions: eGFR, Laktat und CRP - Kardiovaskuläre Marker: Troponin T(hs), NT-pro BNPHb: Mann 134 - 170 g/L & Frau 118 - 152 g/LLeukozyten: 3,7 - 9,2 G/LThrombozyten: 150 - 380 G/LaPTT: 26 - 36 SekundenAnti-Faktor Xa: 0,3–0,7 IE/mL (Therapeutischer Zielwert bei Heparintherapie mit UFH)Quick Wert: 70% - 130%INR: 0,85 - 1,15D-Dimere: unter 500 ng/,LTroponin T (hs): unter 14 ng/LNT-proBNP: unter 300 ng/L Nützliche LinksHomepage des Rettungsdienst LUKSLink zur letzten Folge zum Thema: Wenig vorwärts, viel rückwärts - Herzinsuffizienz systematisch erklärt  (und zu allen anderen Folgen)Englische Bezeichnungen und Abkürzungen hier: https://www.nbt.nhs.uk/severn-pathology/requesting/test-informationAlle Evidenzen zu dieser Folge findest du hier:Kearon, C., de Wit, K., Parpia, S., et al. (2019). Diagnosis of pulmonary embolism with D-dimer adjusted to clinical probability. New England Journal of Medicine, 381(22), 2125–2134. https://doi.org/10.1056/nejmoa1909159Clinical and Laboratory Standards Institute (CLSI). (o. J.). Order of blood draw tubes and additives. https://clsi.org/resources/insights-blog/order-of-blood-draw-tubes-and-additives/AMBOSS. (o. J.). Laboratoriumsmedizin. https://next.amboss.com/de/article/Ln0wFg?q=laboratoriumsmedizinHengesbach, S., Hinkelbein, J., Genzwürker, H., et al. (Hrsg.). (2024). Checkliste medical skills (3., unveränderte Auflage). Thieme. https://doi.org/10.1055/b000001057Luzerner Kantonsspital. (o. J.). Analysenverzeichnis. https://analysenverzeichnis.luks.ch/ 

Plačujemo premije zavarovanja in na koncu nič ne dobimo, si pogosto rečemo. Potem sledi: ah, meni se to ne bo zgodilo. Nekateri se zato ne odločajo za zavarovanja ali pa so podzavarovani, ker ne dobijo nečesa materialnega ali pa ne vidijo rasti ali upada portfelja kot pri vlaganju v vrednostne papirje — skratka nimajo občutka, da so si s tem kupili zaščito. Velikokrat se zgodi, da plačujemo premije za stvari, ki jih zlahka nadomestimo, pustimo pa nezavarovano tisto, kar nam lahko pokuri naše prihranke. Denimo: 5.000 evrov na dan v bolnišnici v tujini. Hiša zavarovana za 150 tisoč evrov, obnova stane 300 tisoč. Potres povzroči požar, zavarovalnica pa potem ne izplača zavarovalnine. Kaj moramo vedeti o zavarovanjih? Pred mikrofonom: Maja Krumberger, direktorica Slovenskega zavarovalnega združenja *epizoda se je prenašala v živo na YouTube 14. aprila ob 14:00 Naroči se na YouTube in nas spremljaj v živo. Koliko kapitala je treba imeti, da mesečno prejemamo 500 ali 1.000 evrov neto dividend? Poigrajte se z dividendnim simulatorjem za SBITOP. Simulator je prosto dostopen. ______________________ Denis Avdić & Marja Milič predstavljata Psihologija denarja z avtorjem uspešnice Morganom Houslom 19.oktober 2026 I Hala Tivoli Podrobneje o dogodku https://psihologija-denarja.si/ ______________________ Bootcamp INR v živo: kako izbrati račun, naložbe in strategije Termini: Ljubljana - 23. april 2026 med 17.00 in 20:00 Info: https://money-how.si/dogodki/ ___________________ Bootcamp za začetnike Termini: 21. april 2026 med 17.00 - 20:00 (v živo na Ekonomski fakulteti v Ljubljani) 21.maja 2026 med 17:00 - 20.00 (v živo on-line) Info: https://money-how.si/dogodki/ ______________________ Bootcamp za mlade Vse, kar mora vaš otrok vedeti o upravljanju denarja Termini: Ljubljana - 28. april 2026 med 10.00 Info: https://money-how.si/dogodki/ ____________________________ PONATIS KNJIGE: Mami, oči, ali smo mi bogati? Od žepnine do investiranja. Vodnik za starše, ki želijo razumeti upravljanje denarja in to znanje samozavestno prenesti na otroke. Tiskana knjiga https://money-how.si/knjiga/mami-oci-ali-smo-mi-bogati/ E-knjiga + bootcamp https://money-how.si/knjiga/mami-oci-ali-smo-mi-bogati-2/ ____________________________ Money-How Premium: https://money-how.si/narocnine/ vključuje: - Modri AI - Finančni asistent, ki pomaga pri raznih finančnih dilemah https://money-how.si/modri-ai/ - Taxistent - Davčni asistent, ki pomaga pri oddaji davčne napovedi https://money-how.si/taxistent/ (deluje za IBKR; Revolut, Trade Republic... in kombinacijo vseh) - poglobljene članke - vsa INR orodja (primerjalnik, iskalnik, strategije) ____________________________ Bootcamp v živo: Investiranje – kako sploh začeti Že dolgo razmišljaš o vlaganju in ne veš, kje in kako začeti? Nimaš energije, da bi raziskoval vse podrobnosti. Skrbijo te davki? Presekaj in se nam pridruži v živo, kjer bomo skupaj naredili prvi korak v svet investiranja! Termini: Ljubljana - 21. april 2026 med 17.00 in 20.30 Info: www.money-how.si/dogodki/ __________________ Finančna delavnica je lahko čudovito darilo. Več preveri https://money-how.si/izobrazevanja ______________________ (delavnica) Investiranje v delnice: Kaj moram vedeti, ko se odločam za investiranje v delnice Prijava: https://money-how.si/izobrazevanja ____________________ (delavnica) Investiranje za začetnike. Praktično o osnovah investiranja. Prijava: https://money-how.si/izobrazevanja _________________________________ DISCORD skupnost: V finančnih zagatah nismo sami, pridružite se nam na Discord Money-How / discord ______________________________ Več o Money-How na https://money-how.si/

In this episode of The Activist Lawyer, we're joined by barrister Ifé Thompson, whose ground breaking work is reshaping criminal defence through a racial justice and linguistic lens. Ifé is the host of the Black British English Podcast and is widely recognised by communities and by her peers as a champion for linguistic, cultural and human rights.  From challenging the criminalisation of rap and drill lyrics in court to defending the cultural context of Black language, Ifé's work pushes the boundaries of how the law understands evidence and harm. We also explore her wider advocacy as a movement lawyer and how centring community can transform legal practice. Links to cases, organisations, and Ife's work are included in the show notes.   Ifé Thompson is a barrister at Nexus Chambers practising criminal defence, family law and human rights, nationally and internationally recognised for her pioneering work at the intersection of crime, racial justice, and human rights. Her practice focuses on youth justice, protest law, and racially aggravated matters, with a specialist emphasis on language-based injustice and the use of racial trauma within criminal defence matters. Her legal practice challenges how Black British English (BBE), African American Vernacular English (AAVE), and rap or drill lyrics are misrepresented in court as evidence of criminality rather than being recognised as cultural and linguistic rights.   She has transformed defence strategies by centring linguistic expertise and racial justice with now many lawyers using this strategy in their cases. In R v LZ (2024), she successfully defended a Black child prosecuted for using AAVE, and in R v L (2022), she successfully challenged the misinterpretation of Jamaican Patois by a non-linguist witness. In the widely publicised March 2025 “N-word trial,” she secured the withdrawal of charges against a Black woman accused of obscene communication for using the N-word, arguing that intra-community use of the term must be understood within its cultural and historical context.   She describes herself as a movement lawyer committed to confronting injustice at its roots. She treats the courtroom as a site of struggle in exposing state violence and systemic harm all while wielding legal tools in creative, disruptive ways. She believes the law, though shaped by oppressive systems, can be repurposed as a tool in the hands of communities fighting for liberation.   Prior to coming to the Bar, she founded two civil society organisations, one being BLAM UK, which supports Black cultural education and wellbeing alongside advocacy rights of Black children in UK schools and a legal observing group focused on protecting protest rights during Black Lives Matter. She was also a United Nations Human Rights Fellow in 2020 and continues to contribute to both international and domestic efforts to challenge systemic racism within the criminal justice system.     In April 2025, she was invited to deliver training to second-six pupils and junior tenants on challenging systemic racism in youth courts, as part of the Youth Practitioners' Association. She was also commissioned to update the Youth Justice Legal Centre's Rap & Drill Guide, introducing new sections on the criminalisation of Black language, relevant human rights arguments, and how to use international and ECHR case law when responding to challenges about the admissibility of expert evidence. The updated guide is now considered an authoritative resource for criminal defence practitioners.   Her presence on Legal Twitter has also had a significant professional impact. Lawyers frequently approach her in court after recognising her from social media, sharing how much they've learned from her case insights. Her tweets about the racial justice lens she applies in her criminal defence cases have led to requests from her peers for draft sentencing notes and strategic guidance when raising issues of race. These exchanges have contributed to a steady stream of professional instructions, recognition from her peers and have helped her grow a criminal practice grounded in accessibility and innovation. She is also a member of the Art Not Evidence campaign and has spoken on Represent Radio on the issue of the criminalisation of Rap and Drill music. Through her community organising and research, Ifé continues to champion linguistic rights and human rights. Her deep ties to her community give her a unique and grounded understanding of how systemic anti-Blackness operates, knowledge she uses to craft new and innovative legal arguments in the courtroom. Whether through challenging the racialised policing of language, integrating racial trauma experts into defence strategy, or advancing human rights frameworks in youth justice cases, Ifé's creative legal approaches are rooted in real-world insight and community accountability. Her ability to synthesise grassroots realities in criminal matters allows her to challenge discrimination in powerful and effective ways that stand out within her criminal defence practice.   Her work has been recognised through prestigious nominations, including: BBC! 1Xtra Future Figures Award 2025 Legal Aid Newcomer of the Year (Finalist), LALY Awards 2023 Outstanding Individual Award, 2020, for contributions to racial justice in the criminal justice system. Through innovative casework, strategic litigation, and public legal education, Ife Thompson is shaping a new and necessary direction for racial justice within criminal defence.    R V LZ – Bromley Youth Court 2024 – Crown offered no evidence to racially aggravated charges against Black child who used the AAVE ( African American Vernacular English) terms “Nigga” and “Cracka”. Defence instructed an AAVE linguists and wrote length representation as to the importance of respecting and honouring Black Language speakers rights. The crown on the day of trial offered no evidence. R v X, Wimbledon Magistrates Court 2023 – Defending on a case where the client was charged with calling a prospective Tory MP Candidate a “coon” on Twitter. The defence included complex human rights points on freedom of expression and Black political thought. 2024 – Currently being instructed on the N-Word Trial that has already gained media attention. R v L (Magistrates Court) 2022 Successfully raised issue of language injustice in closing speech as Crown sought to rely on a non-Jamaican patois speaker's wrong interpretation of a word used by the defendant. Client was found not guilty.   R v LZ – Bromley Youth Court 2024 and other cases: https://nexuschambers.com/barristers/ife-thompson/   Instagram: @ifedior   Twitter: @fufuisonme   BLAM UK – https://blamuk.org/   The Black British English Podcast - https://open.spotify.com/show/2caDrziJlWOtppmAdXl5ss   Guardian Newspaper - https://www.theguardian.com/world/2025/mar/21/black-student-police-cps-hate-speech-laws-n-word   ABC News Law Report (Australia)  - https://www.abc.net.au/listen/programs/lawreport/race-language-and-the-law/105012404   Hyphen Newspaper - https://hyphenonline.com/2025/03/07/case-dropped-over-black-muslim-womans-n-word-tweet-about-alexander-isak/   Canary Newspaper - https://www.thecanary.co/uk/analysis/2025/03/07/jamila-abdi-charges-dropped/   The Voice Newspaper - https://www.voice-online.co.uk/news/uk-news/2025/03/14/charges-dropped-against-black-woman-who-used-n-word-on-social-media/    

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In this episode of *PICU Doc on Call*, Drs. Monica Gray, Pradip Kamat, and Rahul Damania chat about a 17-year-old girl who ended up with acute liver failure after she intentionally took 22.5 grams of acetaminophen. She came in 48 hours later with really high transaminases and an INR of 5.5, so she was admitted to the PICU. The hosts break down how acetaminophen affects the body, walk through its four clinical stages, and discuss how to manage it—focusing on N-acetylcysteine as the primary antidote. They also touch on other treatments, like fomepizole. Thankfully, this patient recovered without needing a liver transplant, which really shows how important it is to have a team approach with intensivists, hepatologists, toxicologists, and psychiatry all working together.Show Highlights:Clinical case presentation of a 17-year-old girl with acetaminophen ingestion leading to acute liver failureMechanism of acetaminophen toxicity and its metabolic pathwaysEpidemiology of acetaminophen toxicity in pediatric populationsPathophysiology of acetaminophen overdose and its effects on liver functionClinical manifestations and progression of acetaminophen toxicity through various stagesEvaluation and diagnostic criteria for assessing acetaminophen toxicityManagement strategies for acetaminophen overdose, including the use of N-acetylcysteine (NAC).Discussion of adjunctive therapies such as fomepizole in severe cases.Importance of supportive care in managing complications of acute liver failureAn interdisciplinary approach to treatment involving various medical specialtiesReferences:Fuhrman & Zimmerman - Textbook of Pediatric Critical Care Chapter ***.Reference 1: 2019 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 37th Annual Report. Gummin DD, Mowry JB, Beuhler MC, Spyker DA, Brooks DE, Dibert KW, Rivers LJ, Pham NPT, Ryan ML. Clin Toxicol (Phila). 2020;58(12):1360.Reference 2: Pepin L, Matsler N, Fontes A, Heard K, Flaherty BF, Monte AA. Fomepizole Therapy for Acetaminophen-Induced Liver Failure in an Infant. Pediatrics. 2023 Oct 1;152(4):e2022061033. doi:10.1542/peds. 2022-061033. PMID: 37681263.Reference 3. Chiew AL, Buckley NA. Acetaminophen Poisoning. Crit Care Clin. 2021 Jul;37(3):543-561.Reference 4. Squires JE, Alonso EM, Ibrahim SH, Kasper V, Kehar M, Martinez M, Squires RH. North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Position Paper on the Diagnosis and Management of Pediatric Acute Liver Failure. J Pediatr Gastroenterol Nutr. 2022 Jan 1;74(1):138-158. doi: 10.1097/MPG.0000000000003268. PMID: 34347674.

Please join Amrita Ganguly and me for our follow up call as we talk about The Wealth Capacity Code: Decoding Your Body for Money Expansion. Join us as Amrita facilitates more processes so that we can create our dream life. Amrita shared practical tools including creating "I want/I don't want" lists, focusing on specific emotions like joy or peace for a month, and using body awareness to identify capacity blocks. She demonstrated an EFT tapping technique to help Cindy with grief, and offered a special journal called "Manifest Like an Empress" as a gift to participants. The session covered how childhood experiences and wounds can impact financial capacity, with Amrita explaining the concept of "freeze/fawn" versus "fight/flight" reactions to money goals. Shefali announced two package options from Amrita: a 3-week guided class for $22 US or $1,999 INR, and a 3-week certification program for $44 US or $3,999 INR, both starting in April. The conversation ended with Amrita sharing simple daily practices including saying "I'm safe to have this" and "I don't want this" to shift negative emotions. The special bonus journal is only available in the Telegram group: https://t.me/+EDVYH5baTtU0MmI0 Amrita's Special Offers: https://www.divineshaktirising.com/s1amrita  #shefaliburns , #awakentohappinessnow, #healing, #energy, #transformation, #consciousness, #love, #consciousliving, #joy, #empowerment, #wellness, #spirituality, #spiritualawakening, #awareness, #podcast #ancestors #ancestralhealing #amritaganguly #capacity #receiving #money #india #indian

The science of reading has made real progress in how schools think about decoding and language comprehension. But for a significant number of struggling readers, those two buckets don't explain what's getting in the way. Dr. Kelly Cartwright, Spangler Distinguished Professor of Early Child Literacy at UNC Charlotte, has spent her career mapping the territory other reading models leave out — specifically, the role executive functions play in coordinating what skilled readers do.In this conversation, Dr. Cartwright explains what executive functions (EF) actually are, why they matter for every reader and not just students with ADHD, and what her research reveals about the kind of EF interventions that actually move the needle on reading outcomes. She also makes the case that the field's tendency toward dichotomous thinking — decoding over here, comprehension over there — may be leaving a large group of students without the support they need.Check out the video recording of this conversation below, available to full subscribers. Join the community today!Show NotesResearch and Articles (links embedded in title)* Duke, N. K., & Cartwright, K. B. (2021). The Science of Reading Progresses: Communicating Advances Beyond the Simple View of Reading. Reading Research Quarterly, 56(S1), S25–S44.* Cartwright, K. B., & Palian, S. R. (2024). Considering Roles of Executive Functions in the Science of Reading: A Meta-Analysis Highlighting Promises and Challenges of Reading-Specific Executive Functions. Educational Psychologist, 59(4), 263–290.* Wagner, R. K., et al. (2021). A Model-Based Meta-Analytic Examination of Specific Reading Comprehension Deficit. Annals of Dyslexia, 71(2), 260–281.* Austin, C. R., Vaughn, S., Clemens, N. H., Pustejovsky, J. E., & Boucher, A. N. (2022). The relative effects of instruction linking word reading and word meaning compared to word reading instruction alone on the accuracy, fluency, and word meaning knowledge of 4th-5th grade students with dyslexia. Scientific Studies of Reading, 26(3), 204-222.* Chi, M. T. H. (1978). Knowledge structures and memory development. In R. S. Siegler (Ed.), Children's thinking: What develops? (pp. 73–96). Lawrence Erlbaum Associates, Inc.Assessments Mentioned* Graphophonological Semantic Flexibility (GSF) Assessment — freely accessible; measures cognitive flexibility in managing letter-sound and meaning features of words simultaneously (from Chapter 4 of Executive Skills and Reading Comprehension - see below)Books Mentioned (embedded Bookshop links are an affiliate account)* Cartwright, K. B. (2023). Executive Skills and Reading Comprehension: A Guide for Educators (2nd ed.). Guilford Press. (Bookshop) (Guilford Press - download flyer for 25% discount)* Adams, M. J. (1990). Beginning to Read: Thinking and Learning About Print. MIT Press. (Bookshop)* Page, L. This Book Made Me Think of You (Bookshop) — recommended by Kelly Cartwright* Weir, A. Project Hail Mary (Bookshop) — recommended by Matt Renwick* Richtel, M. How We Grow Up (Bookshop) — recommended by Debra CrouchModel Referenced* The Active View of Reading (Duke & Cartwright, 2021) — diagram available via the Reading Research Quarterly article linked above (and below).Full TranscriptMatt RenwickHi, I'm Matt. Welcome to Read by Example, where teachers are leaders, and leaders know literacy. I am excited to have someone that I've been reading about in a pretty specific, but I think important subject area. I'm joined by Kelly Cartwright. Dr. Cartwright is the Spangler Distinguished Professor of Early Child Literacy at the University of North Carolina, Charlotte. She is the author of Executive Skills, Reading and Reading Comprehension, second edition through Guilford. Welcome, Kelly.Kelly CartwrightThank you. I'm so excited to be here with you today.Matt RenwickAnd Debra Crouch, author and co-author of Made for Learning with Brian Camborne, is also here. Excited to see Debra again. Are you in the classroom still, Debra?Debra CrouchNo, not right now. I'm actually supervising a couple of student teachers right now. That's what I'm up to.Matt RenwickAlright, but you were teaching second grade, right?Debra CrouchYes, second and third grade. Both grades.Kelly CartwrightAnd technically, you're in classrooms, so…Debra CrouchYes, always in classrooms.Matt RenwickSame here. Whenever I can get in, it's a treat. So, Kelly, I want to start with curiosity. Executive functions have not been a prominent part of the conversation around reading instruction. What made you think they should be? What about this field captured your interest and focus for your research?Kelly CartwrightThat's a great question. I started out in psychology, but I was interested in how reading works — how reading works in the brain, how our cognitive processes support our ability to read. I was learning about executive functions, learning about the fact that kids, when they are young, are learning to be flexible in thinking about things. It occurred to me that reading is super complex, and it requires that we think about words in lots of ways. I was reading Marilyn Adams' book, Beginning to Read, while in graduate school, and learning about all of these wonderful executive functions, and realizing that kids have to manage a ton. Grown-ups have to manage a ton of things in their heads, and I wondered about this connection. So, I started off my work in the area of looking at cognitive flexibility specific to reading — flexibility in thinking about words, sounds, and meanings — because kids have to think about words in a lot of ways to learn to be good readers, and we do it without thinking about it. Lots of people are looking at it now and realizing that being able to manage your thinking and manage your reading processes is a really important part of being a good reader.Matt RenwickAre you seeing more interest in this due to the world we currently live in, with constant connection and distraction? Do you see that contributing to this interest?Kelly CartwrightMaybe. I think that people are aware of executive functions in the context of special education, or when a child has ADHD in your classroom and the school psychologist has done assessments and says, “This child has a working memory problem,” or, “This child has an inhibition problem.” We've seen more and more diagnoses of executive skill difficulties, like ADHD, over the past few years. Is it connected to technology? I don't have data on that. But I think the piece that we don't always think about is that for a child who has executive skill difficulties, we see evidence that there's a problem — but when everything's going well, and your working memory and flexibility are supporting your reading processes, it's invisible. We don't see them. We see evidence for difficulty, not evidence for success. But being a successful reader means that you have those things in place.Matt RenwickADHD has been referred to as an invisible disability — or difference, however you want to term it — and that resonates with me, because kids don't always demonstrate it. It's often an internal kind of thing.Kelly CartwrightExactly.Matt RenwickYou mentioned executive functions, and I think when people hear that, they sometimes just resort to ADHD as a rule of thumb. But they're different. How would you describe executive functions in a way that's separate from a diagnosis like ADHD, and connects it to what every reader is trying to do?Kelly CartwrightExecutive functions, when you have difficulties with them, people see evidence of those things when you have a child who can't focus, or can't inhibit attention to all the things that are so interesting. But we recruit executive functions in all of our daily activities. Think about going to the supermarket. You need to keep your list of needed items in mind — you don't want to get home without the noodles for the spaghetti — and that's working memory, having to hold all that stuff in your head. You might make a list, but that kind of offloads the thinking onto a piece of paper. And you're still going to have to use it in a flexible way: you're looking at the shelf, you're looking at the list, maybe they don't have the brand you usually buy, or they're out of the fruit you were going to buy, and you have to flex the week's menu. You're also having to use that list to inhibit your attention to the shiny Oreos on the end cap, and not buy the things that are not on the list. That working memory, that cognitive flexibility, that inhibition — they play out in everything we do.In reading, we're building a mental model of text meaning in our head. As I make my way through a text and learn about a new event, or a character does something unexpected, I'm updating my mental model of the text's meaning as I go, while still hanging on to the things I've learned before. That's working memory. While we're doing that, we're also decoding — shifting between word reading and meaning-making constantly. Even as adults, we process all the letters and sounds. If we come upon a multisyllabic word we haven't seen, we're totally using our decoding processes, but we're doing those things under the level of conscious awareness and switching between them, and that takes flexibility. Or coming upon a word like “wind” — W-I-N-D — if you're reading about a mechanical toy, it becomes “wind,” but if you're reading about weather patterns, it's “wind,” and knowing how to flex that vowel pronunciation is another instance of cognitive flexibility specific to reading.Inhibition plays out in reading when you encounter words with multiple meanings, like “jam” and “traffic jam.” You can't think about the sticky stuff you put on toast — you have to only think about the congested traffic. All of those things are happening for skilled readers automatically. We don't notice them. But when children don't have the working memory capacity, they're not able to hold in mind the text pieces they need and supply their prior knowledge in order to make an inference. We can support that kind of thinking — put it on paper, use a graphic organizer like an inference map — but as skilled readers, we often expect kids to have the ability to do the things that we can do. Making inferences is so obvious to us, but it's not obvious when you don't have the ability to hold all the relevant pieces in your mind.Matt RenwickIf I'm reading a novel and trying to keep track of all these characters, I'm not going to pull out a character map — maybe I might, if it's a complex novel. But you're right, we don't reverse ourselves back to when we were learning to read when we teach. That's where these external tools can be really helpful to support that cognition.I personally have a hard time remembering all these different systems — it's hard to visualize. When you teach this, do you use some kind of mental model, metaphor, or imagery to help teachers hold that idea in mind?Kelly CartwrightYou've identified something the field probably needs. Models of reading are starting to incorporate executive functions. Nell Duke and I proposed the Active View of Reading — for those of you listening, maybe we can link this in the show notes. There's a green bubble off to the left that has your executive function and self-regulation abilities, and they are helping drive your ability to recognize words, that word recognition piece, and that language comprehension piece, and your ability to put it all together in service of reading comprehension. That visual heuristic helps teachers to think about the fact that these invisible things actually undergird and support the processes we know readers need. But if I continue to try to teach inference-making in all the typical ways to a child who has working memory difficulties, without thinking about how working memory shows up within reading or how I can support and strengthen those reading-specific working memory skills, then the child may not make the progress I need them to.For kids with ADHD, or adults with ADHD, all of these executive functions show up as difficulties in organization and planning. The child who comes with a backpack that isn't as organized as we'd like — with an executive function difficulty, the organization isn't there, and they may not be able to make that mental model of a text's meaning without concrete support, or a story map, or explicit text structure instruction, so that they can use that heuristic — putting that thinking on the table — to support the working memory where they can't do it all in their head.Matt RenwickI've used the Active View in presentations for school leaders on what they need to know about the science of reading. I'll start with the Simple View, and then go to your Active View, just to show how complex reading really is. And I like where you positioned executive function — before word recognition and language comprehension. I assume that's intentional. If you need executive functioning, you need strategic use of strategies. You can't just teach phonics.Kelly CartwrightYou have to know what to do with the phonics. The Simple View is amazing. It's elegant. It's 40 years old now, which is remarkable, and it has longevity in the field because it provides an amazing heuristic to help teachers understand that reading is more than just loving books. It came out at the height of the whole language movement, when phonics was not favored, and the Simple View does an excellent job of demonstrating that if our phonics knowledge — our ability to recognize words using that phonics knowledge systematically — if it's not there, we are not going to understand what we read. You can't understand what you read if you don't pull the words off the page. But likewise, if you can't understand what people say to you, you're not going to understand what you read.The Simple View does an excellent job with that. It's a great place for teachers to begin to see how that complexity works. But what I've seen in practice is phonics instruction happening over here in this part of the day, and instruction in language comprehension happening over there in that other part of the day, and never the twain shall meet. But when I'm a skilled reader, I'm doing these at the same time, and I'm having to put it all together. The Simple View — and the rope model is similar — shows these two buckets of skills. The rope goes further to say we do weave them together, but it doesn't say how. I think that's where executive functions come in. Executive functions and self-regulation help you to strategically deploy that word recognition knowledge and that language comprehension knowledge and weave them together in service of comprehension — which is a piece that's over and above each of those alone.I like to use the analogy of that old pat-your-head, rub-your-tummy thing we used to do as kids. I can pat my head by itself, just like I can decode — when assessed independently I do well. I can rub my tummy, and I can do well when assessed on language comprehension independently. But if I have to put them together, it requires some third coordination ability that's over and above the individual skills. That bridging or integration is represented in the Active View but isn't represented in the Simple View. The Simple View initially alluded to this idea that kids decode and then comprehend — like a sequential thing — but it's not. It's very much an all-at-the-same-time kind of thing.Matt RenwickYou're multitasking in some ways. It's why reading is so difficult for some kids.Kelly CartwrightAnd for grown-ups when we are tired.Matt RenwickRight — I've hit many mental roadblocks, and I'm like, I need a break, I need to go walk the dog. Movement helps me reset my thinking.We see new resources that are still referring to the Simple View, still framing things as decoding over here, language comprehension over there. Why has this binary been so sticky? Why has the field not progressed to what you're describing?Kelly CartwrightThis is what happens in fields all over the place — it's not just education. We like to group things. Cognitively, we like to sort things into groups. There's the old nature-nurture debate from human development: is a particular trait caused by nature, or is it caused by nurture? People tend to think about that in a really dichotomous way, when the truth is very much intertwined. Even reading disabilities are a great example. Reading disabilities have a heritable component, but environment plays a role too. If you get explicit, systematic phonics instruction, that's going to move the needle in a way that an environmental factor — not getting that instruction — won't.Another example: kids with lower socioeconomic resources tend to have more difficulty with reading, and with executive functions. Experience plays a role; heredity plays a role. It's not a simple either-or. But when we're thinking about doing something super complicated — Louisa Moats characterized teaching reading as rocket science — not only are we having to do all of those things at once as readers, but as an educator, you are having to help little people who have never understood how letters make words. You've got to help them decode, know what the words mean, know how to weave them into phrases and sentences and paragraphs, make mental pictures, make the inferences, deal with syntax and morphology. That's a lot. And so, to be able to group the things that I need to do as an educator into two buckets simplifies things and helps us organize our day. But it may not always be beneficial for students, because we know that multi-component interventions help students learn to do that integration.Matt RenwickI wish we would pay teachers like rocket scientists.Kelly CartwrightHear, hear. I agree.Matt RenwickIn your meta-analysis, you were looking at executive function interventions isolated from reading instruction and then asking: what's the effect? And you found that for EF interventions to be effective, they need to be embedded in reading instruction. You can't do executive functioning interventions in isolation and then expect them to generalize into reading. Why is that, and why does that matter for educators?Kelly CartwrightThere's a super basic study in cognitive psychology called the chess study. What they did was compare children who were chess experts with adults who were chess novices on two tasks: memory for chessboard arrangements, and memory for strings of numbers. Both are memory tasks, but one is specific to an area the kids have experience with and the adults do not. What they found — and this was a big deal at the time — is that the children outperformed the adults on chessboard arrangements. Children are not supposed to have better memory than adults, but they did on chess-specific memory. And on memory for letter strings, the adults outperformed the kids, as we would expect. That illustrates this idea of domain-specific or task-specific cognition: the thinking within that task gets better. Over time, playing chess helped those kids get better and better at remembering chessboard arrangements. That doesn't really relate to reading — I'm not saying go out and have people play chess — but within reading, it's requiring you to do a lot of mental work, a lot of mental gymnastics. Being flexible about pronunciations of words — there's something called “set for variability” — or being able to shift between thinking about words' sounds and words' meanings, or being able to hold aspects of text in mind and update them as you continue to make your way through. That's reading-specific working memory.So, if I'm doing an intervention that helps to strengthen the kinds of reading-specific executive skills, or the way executive skills show up within reading, that's going to help the child's reading — and also their executive skills within reading. But if I put a child over here on a working memory task that looks kind of like that Simon game we used to play as kids, where you're pushing buttons to remember sequences of tones — that's not going to help reading. It might help them remember sequences of colored buttons, but it's not going to transfer. The field went for a while, when executive functions and reading were shown to be related, toward: let's do executive function interventions, have them do computerized tasks, and it will transfer to reading. But we're not seeing that happen, because the work was being done in separate areas. When educators can identify the ways that working memory shows up within reading — like inference-making, or the flexibility we've talked about, or inhibiting inappropriate word meanings for context — and then intervene in those things to strengthen both the executive skills and the reading skills, then both improve.Matt RenwickWhen you talk about that, what comes up for me is “neurons that fire together wire together.” Is that why we see that?Kelly CartwrightI don't have all the data we need yet, but we know that reading interventions strengthen connectivity in the reading network. And we know that executive function networks help to connect up the hubs in the reading network in the brain. In a sense, yes, you're having them fire together — just like an intervention for a child with dyslexia. They need more explicit, systematic phonics instruction to get that letter-word form area in the visual cortex — that part of the brain we repurposed to become reading brain — to build up. When we give them more practice, it improves the connections and the processing. Interventions change brains, yes. But we do need more work to really say definitively, here's study after study. We don't have all of that yet.Matt RenwickI'm thinking about kids who have gone through a very isolated phonics intervention and come out as good word callers, but their comprehension hasn't kept up. It seems like a similar issue — we want the bridging processes, we want to bridge these activities so that kids are fully growing as readers.Kelly CartwrightThat brings up something for me, just thinking about reading difficulties. Dyslexia is one — those kids have word-reading difficulties. But the kids we typically call “word callers,” where they sound like great readers and fly under the radar because they sound awesome — the teacher hears them and thinks everything's going well, and then the end-of-grade assessment comes and they can't comprehend, and you're like, what's going on? Those children are children where executive skills show up as a difficulty. Kids with dyslexia also have executive skill difficulties, in different ways.A recent meta-analysis by Rick Wagner and colleagues at the Florida Center for Reading Research looked at kids with great word-reading ability but surprisingly poor comprehension. Using the Simple View framework, they examined how much word recognition and language comprehension contribute to reading comprehension for these kids. Those two buckets of skills explain about half of the variance in reading comprehension, and what they concluded was: there's got to be something else. We know that these students have executive skill difficulties — study after study shows it. This work matters for educators because, historically, we haven't known what to do with those children. You know what to do when they can't read the words. But when they can read the words and comprehension just isn't happening — executive skill-infused instruction helps these kids in ways that typical instruction sometimes does not.Matt RenwickAnd this is an equity issue. You mentioned that low socioeconomic status has an influence on executive functioning as well. I mean, I'm thinking about schools and their intervention banks — they're almost 100% either language comprehension or word recognition interventions. We are really potentially missing a lot of kids if we're not thinking about executive functioning.Kelly CartwrightAnd you said “either-or,” and that points to some new work that's coming out. I'll point to one particular study — Austin and colleagues out of University of Texas at Austin. They did an intervention study with 4th and 5th graders with dyslexia. One condition had 45-minute intensive phonics lessons — a series of lessons with multisyllabic words — and students learned to decode those words to fluency. The other group, randomly assigned, had 25 minutes of explicit phonics instruction for the same series of lessons, but also 20 minutes of meaning-focused instruction — so they learned what the words meant and were working with the meanings as well as the decoding. And as you might expect, the students with the multi-component intervention — dealing with both the sounds and the meanings of the words — actually outperformed their peers who received phonics alone. It's important to give kids the opportunities to deal with both at the same time.Matt RenwickWhat steps could an interventionist, or a classroom teacher, take to start redesigning core instruction and interventions with executive functions in mind? What might be a first good step or two?Kelly CartwrightOne way that we approach instruction is to put an anchor chart on the board or have an organizational tool for the child on the desk. There are certain graphic organizers that can help take cognitive load for students, and using them in that way — helping kids put the thinking on the table — really supports kids with working memory difficulties.You can also assess cognitive flexibility. I have an assessment — a Graphophonological Semantic Flexibility Assessment — that measures flexibility in thinking about letter sounds and meanings. It shows how well someone can shift back and forth between the word recognition piece and the meaning-focused piece. Kids and adults who are more flexible in considering both sounds and meanings of words are better comprehenders. Word-calling types of kids, kids with dyslexia, are not good at managing both. It's freely accessible, so that's another thing to think about.Fluency is another area. The way we operationalize and measure fluency — we're looking at rate. Rate just means they can decode automatically. Rate doesn't tell us whether they're also managing meaning at the same time. But prosody, or expressiveness, is harder to measure. We don't always measure it, but that's an indicator that they're weaving meaning together with their decoding. The old school thinking is: you get more automatic with word recognition, and it makes mental space for comprehension. But that doesn't mean you fill that space with comprehension if you don't know how. Matt RenwickSo oral reading fluency by itself may not be enough. It's a screener, but we want to investigate further — especially for our right-to-read states where reading fluency is the primary measure.Kelly CartwrightThere are options for examining prosody and expressiveness, but we don't always do that because it's just harder to assess. When I'm talking to students, I'll talk about it as expressiveness, or using your “movie star voices” and putting the feeling in — but you have to know what the text means to put the feeling in the right way.Matt RenwickLet's talk about a harder part of this conversation. You've expressed your position on the popular science of reading discourse. You note in the Active View of Reading article that popular SoR discourse, as currently practiced, may actually be masking complexity in ways that can hurt kids — particularly kids whose reading difficulties don't fit the decoding-or-comprehension frame. The walls come up, egos get hurt, resistance arises. How do you communicate these critiques effectively, so that people are actually hearing them and are willing to be responsive?Kelly CartwrightIt's difficult, because educators have put so, so much time and effort into retooling and learning and understanding. But the science — just like any science — is ever-evolving, and we continue to learn more so we can meet the needs of all learners. If we all share that goal, then we just have to keep working toward figuring out why all learners aren't growing the way we expect them to.If we're teaching word recognition over here and language comprehension over there in different parts of the school day, and not giving students the opportunity to put them together — to bridge them, as we know skilled readers need to do — then that doesn't help them do what they need to do as skilled readers. We're not equipping them in the same way. Like the Austin intervention study with 4th and 5th grade students with dyslexia: the ones who had the opportunity to deal with explicit, systematic phonics instruction and meaning did better on all of the outcome measures than the students who got the explicit systematic phonics instruction alone. If we look at word recognition and language comprehension, we'd say, “Oh, those kids need word recognition!” But the word recognition alone didn't lift them up as much as helping them learn to do that alongside other things. We have to look at the data on the kids and what they need, and try to avoid compartmentalized thinking. We need more work on multi-component interventions.Matt RenwickSharing the research and being a learner yourself. I've found similar results where I've shared a study, and the response is usually not defensive — it's more like, “Okay, I'll think about it,” and then they circle back around and I do see change in their practice. They may not admit that what they did in the past was not as effective, but I would agree: just share the research and be a learner. So, fun question to close things out. What are you reading right now?Kelly CartwrightI always have a fiction book on my bedside table — that's my break at the end of the day. I may only read two sentences and fall asleep, as we do sometimes. A literacy professor friend recommended a book titled This Book Made Me Think of You by Libby Page. It's great — I highly recommend it. I haven't finished it yet, but it's a great book.Matt RenwickI'm writing that down. I am reading Project Hail Mary. It just came out as a movie — science fiction. It's one of those “we gotta save the planet” kind of books. I always try to read the book before I see the movie, because once I see the movie, I picture that person as the character.Kelly CartwrightYou want to develop your own visual imagery — yes.Matt RenwickYes. Debra, what are you reading?Debra CrouchI am reading a book called How We Grow Up by Matt Richtel. It's all about adolescence and all the science and research coming out now about the brain. He's got some really interesting things to say, and he's just a fabulous writer — it doesn't matter what his topic is, I will always read him.Matt RenwickI'll put them in the notes. Well, thank you, Kelly, for being here. This was really informative. You read what someone writes and studies, but to hear them explain it is super helpful. I'm imagining your students really appreciate your instruction. Thank you for being here.Kelly CartwrightThank you so much. It was a pleasure. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit readbyexample.substack.com/subscribe

The USD has strengthened significantly against the INR since the beginning of the Middle East conflict. Today, we cover the RBI's announcement on Net Open Dollar rupee positions (NOP): some context to it, understanding what exactly is NOP and its relevance.Speaker:Shaily GangChief Investment Strategist 

Neunzehn Jahre. Es ist eine dieser Zahlen, die man ansieht und sofort wieder vergisst, weil sie unmöglich richtig sein kann. Als hätte jemand die Zeit unbemerkt gefaltet. Die Jahre mit Teddy kommen mir nicht vor wie eine Strecke, eher wie ein Zustand: ein langer, heller Durchzug aus Unsinn, Treue und sehr speziellen Gedanken. Und nun stehe ich in dieser stillen Ladenpassage, in der alles ein wenig aufgeladen wirkt, als hielte die Welt selbst den Atem an vor diesem 19-jährigen Jubiläum. Links das Partygeschäft mit seinem übermütigen Kitsch aus Ballons, Kerzen und Dingen, die für einen Abend gemacht sind und dann für immer in Erinnerung bleiben. Daneben der Bäcker, warm, golden, leicht erschöpft, als hätte auch er all die Jahre mitgezählt. Weiter der Blumenladen, kühl und feierlich, voller Sträuße, Vasen und jener schönen Vergänglichkeit, die immer so tut, als sei sie nur Dekoration. Irgendwo glänzen Flaschen im Getränkeladen hinter verschlossenen Dingen, und im Musikgeschäft scheint selbst das Schweigen auf etwas zu warten. Alles ist vertraut und zugleich seltsam entrückt, als läge über den Geschäften ein Rätsel, das nur heute sichtbar wird. Ich gehe durch diese kleine Welt mit echter Vorfreude und einer Dankbarkeit, die sich kaum verbergen lässt. Denn hinter der Glasfront ist Teddy, und endlich will ich zu ihm. Man spürt, dass hier nichts zufällig platziert wurde. Jedes Schaufenster, jede Tür, jeder Laden scheint ein leises Geheimnis zu kennen. Ein Bäcker bewahrt mehr als Backwaren, ein Blumenladen mehr als Blüten, und selbst die unscheinbarsten Gegenstände wirken, als hätten sie auf diesen Tag gewartet. Vielleicht ist das das Merkwürdige an neunzehn Jahren: dass sie im Rückblick wie im Flug vergangen sind und trotzdem überall Spuren hinterlassen haben. In Räumen. In Stimmen. In Blicken durch Glas. Und in dieser freudigen Gewissheit, dass hinter all dem Teddy wartet. Hier zum Nachspielen der Link zum Spiel: https://www.esel-und-teddy.de/wp-content/uploads/2026/03/eut_19_jahre_adventure.zip

Individualni naložbeni računi (INR), ljudske obveznice, stanje na Ljubljanski borzi, pokojninski sistem ter vloga javnih financ. Omejeni so novoizvoljeni nacionalni ambasadorji finančne pismenosti, ki jih je Slovenija imenovala na pobudo Evropske komisije. Epizodo smo snemali v živo 18. aprila preko Youtube. Pred mikrofonom: Aljoša Valentinčič, Saša Jazbec in Marja Milič, novoizvoljeni nacionalni ambasadorji finančne pismenosti ______________________ Denis Avdić & Marja Milič predstavljata Psihologija denarja z avtorjem uspešnice Morganom Houslom 19.oktober 2026 I Hala Tivoli Podrobneje o dogodku https://psihologija-denarja.si/ ______________________ Bootcamp INR v živo: kako izbrati račun, naložbe in strategije Termini: Ljubljana - 23. april 2026 med 17.00 Info: https://money-how.si/dogodki/ ______________________ Bootcamp za mlade Vse, kar mora vaš otrok vedeti o upravljanju denarja Termini: Ljubljana - 27. april 2026 med 10.00 Info: https://money-how.si/dogodki/ ____________________________ PONATIS KNJIGE: Mami, oči, ali smo mi bogati? Od žepnine do investiranja. Vodnik za starše, ki želijo razumeti upravljanje denarja in to znanje samozavestno prenesti na otroke. Tiskana knjiga https://money-how.si/knjiga/mami-oci-ali-smo-mi-bogati/ E-knjiga + bootcamp https://money-how.si/knjiga/mami-oci-ali-smo-mi-bogati-2/ ____________________________ Money-How Premium: https://money-how.si/narocnine/ vključuje: - Modri AI - Finančni asistent, ki pomaga pri raznih finančnih dilemah https://money-how.si/modri-ai/ - Taxistent - Davčni asistent, ki pomaga pri oddaji davčne napovedi https://money-how.si/taxistent/ (deluje za IBKR; Revolut, Trade Republic... in kombinacijo vseh) - poglobljene članke ____________________________ Bootcamp v živo: Investiranje – kako sploh začeti Že dolgo razmišljaš o vlaganju in ne veš, kje in kako začeti? Nimaš energije, da bi raziskoval vse podrobnosti. Skrbijo te davki? Presekaj in se nam pridruži v živo, kjer bomo skupaj naredili prvi korak v svet investiranja! Termini: Ljubljana - 19. marec 2026 med 17.00 in 20.30 Info: www.money-how.si/dogodki/ __________________ Finančna delavnica je lahko čudovito darilo. Več preveri https://money-how.si/izobrazevanja ______________________ (delavnica) Investiranje v delnice: Kaj moram vedeti, ko se odločam za investiranje v delnice Prijava: https://money-how.si/izobrazevanja _____________________ (delavnica) Investiranje za začetnike. Praktično o osnovah investiranja. Prijava: https://money-how.si/izobrazevanja _________________________________ DISCORD skupnost: V finančnih zagatah nismo sami, pridružite se nam na Discord Money-How / discord ______________________________ Več o Money-How na https://money-how.si/

Večina vlagateljev vidi le svojega brokerja, vendar je v ozadju celoten sistem finančne infrastrukture. Pomembno vlogo ima Klirinško depotna družba (KDD), ki skrbi za poravnavo poslov, centralni register vrednostnih papirjev in pravno varnost lastništva delnic. V tej epizodi podcasta Money-How z Davorjem Pavićem, članom uprave KDD, seciramo: - kdo dejansko zaračunava največ provizij pri trgovanju, - kako poteka poravnava borznega posla (T+2), - zakaj pri tujih brokerjih pogosto niste neposredno vpisani v delniško knjigo, - koliko trgovalnih računov ima Slovenija, - kakšen potencial imajo novi individualni naložbeni računi (INR). ______________________ Denis Avdić & Marja Milič predstavljata Psihologija denarja z avtorjem uspešnice Morganom Houslom 19.oktober 2026 I Hala Tivoli Podrobneje o dogodku https://psihologija-denarja.si/ ______________________ Bootcamp INR v živo: kako izbrati račun, naložbe in strategije Termini: Ljubljana - 23. april 2026 med 17.00 Info: https://money-how.si/dogodki/ ______________________ Bootcamp za mlade Vse, kar mora vaš otrok vedeti o upravljanju denarja Termini: Ljubljana - 27. april 2026 med 10.00 Info: https://money-how.si/dogodki/ ____________________________ PONATIS KNJIGE: Mami, oči, ali smo mi bogati? Od žepnine do investiranja. Vodnik za starše, ki želijo razumeti upravljanje denarja in to znanje samozavestno prenesti na otroke. Tiskana knjiga https://money-how.si/knjiga/mami-oci-ali-smo-mi-bogati/ E-knjiga + bootcamp https://money-how.si/knjiga/mami-oci-ali-smo-mi-bogati-2/ ____________________________ Money-How Premium: https://money-how.si/narocnine/ vključuje: - Modri AI - Finančni asistent, ki pomaga pri raznih finančnih dilemah https://money-how.si/modri-ai/ - Taxistent - Davčni asistent, ki pomaga pri oddaji davčne napovedi https://money-how.si/taxistent/ (deluje za IBKR; Revolut, Trade Republic... in kombinacijo vseh) - poglobljene članke ____________________________ Bootcamp v živo: Investiranje – kako sploh začeti Že dolgo razmišljaš o vlaganju in ne veš, kje in kako začeti? Nimaš energije, da bi raziskoval vse podrobnosti. Skrbijo te davki? Presekaj in se nam pridruži v živo, kjer bomo skupaj naredili prvi korak v svet investiranja! Termini: Ljubljana - 19. marec 2026 med 17.00 in 20.30 Info: www.money-how.si/dogodki/ __________________ Finančna delavnica je lahko čudovito darilo. Več preveri https://money-how.si/izobrazevanja ______________________ (delavnica) Investiranje v delnice: Kaj moram vedeti, ko se odločam za investiranje v delnice Prijava: https://money-how.si/izobrazevanja _____________________ (delavnica) Investiranje za začetnike. Praktično o osnovah investiranja. Prijava: https://money-how.si/izobrazevanja _________________________________ DISCORD skupnost: V finančnih zagatah nismo sami, pridružite se nam na Discord Money-How / discord ______________________________ Več o Money-How na https://money-how.si/

INR prinaša davčne ugodnosti, a odpira tudi praktično vprašanje, kateri ponudnik je najbolj optimalen za nas? V ta namen smo na Money-How pripravili tudi INR primerjalnik https://money-how.si/inr-primerjalnik/ Posebno poglavje epizode je tudi vprašanje investicijske strategije. Je INR namenjen aktivnemu trgovanju ali dolgoročnemu investiranju? Ali je smiselna pasivna ali aktivna strategija? Pred mikrofonom so: - Mitja Tomažinčič, NLB - Daniel Medved, OTP banka - Blaž Gorše, Ilirika ______________________ Bootcamp INR v živo: kako izbrati račun, naložbe in strategije Termini: Ljubljana - 23. april 2026 med 17.00 Info: https://money-how.si/dogodki/ ______________________ Bootcamp za mlade Vse, kar mora vaš otrok vedeti o upravljanju denarja Termini: Ljubljana - 27. april 2026 med 10.00 Info: https://money-how.si/dogodki/ ____________________________ PONATIS KNJIGE: Mami, oči, ali smo mi bogati? Od žepnine do investiranja. Vodnik za starše, ki želijo razumeti upravljanje denarja in to znanje samozavestno prenesti na otroke. Tiskana knjiga https://money-how.si/knjiga/mami-oci-ali-smo-mi-bogati/ E-knjiga + bootcamp https://money-how.si/knjiga/mami-oci-ali-smo-mi-bogati-2/ ____________________________ Money-How Premium: https://money-how.si/narocnine/ vključuje: - Modri AI - Finančni asistent, ki pomaga pri raznih finančnih dilemah https://money-how.si/modri-ai/ - Taxistent - Davčni asistent, ki pomaga pri oddaji davčne napovedi https://money-how.si/taxistent/ (deluje za IBKR; Revolut, Trade Republic... in kombinacijo vseh) - poglobljene članke ____________________________ Bootcamp v živo: Investiranje – kako sploh začeti Že dolgo razmišljaš o vlaganju in ne veš, kje in kako začeti? Nimaš energije, da bi raziskoval vse podrobnosti. Skrbijo te davki? Presekaj in se nam pridruži v živo, kjer bomo skupaj naredili prvi korak v svet investiranja! Termini: Ljubljana - 19. marec 2026 med 17.00 in 20.30 Info: www.money-how.si/dogodki/ __________________ Finančna delavnica je lahko čudovito darilo. Več preveri https://money-how.si/izobrazevanja ______________________ (delavnica) Investiranje v delnice: Kaj moram vedeti, ko se odločam za investiranje v delnice Prijava: https://money-how.si/izobrazevanja _____________________ (delavnica) Investiranje za začetnike. Praktično o osnovah investiranja. Prijava: https://money-how.si/izobrazevanja _________________________________ DISCORD skupnost: V finančnih zagatah nismo sami, pridružite se nam na Discord Money-How / discord ______________________________ Več o Money-How na https://money-how.si/

Today, we are continuing our series, entitled Developer Chats - hearing from the large scale system builders themselves.In this episode, we are talking with Oleksandr Piekhota, Principal Software Engineer at Teaching Strategies. Oleksandr helps to show us at what point of scale platform approaches are required, when to run experiments and when to stop, and perhaps more importantly - engineering ownership beyond the code.QuestionsYou've moved from hands-on engineering into principal and technical leadership roles, working on architecture and platforms.At what point did you realize your work was no longer about individual features, but about the system as a wholeAcross several projects, growth didn't break functionality — it exposed architectural limits.Can you recall a moment when it became clear that shipping more features wouldn't solve the problem, and a platform approach was required?You've designed and supported APIs end-to-end, from architecture to real customers. How do you distinguish between an API that simply works and one that can truly support business scale?Internal systems like invoicing and HR workflows began as automation, but evolved into real products.What tells you that an internal tool is worth developing seriously rather than treating as a temporary workaround?In R&D, you explored CI/CD automation, server-less, and infrastructure experiments — not all reached production. How do you decide when an experiment should continue, and when it's no longer worth the engineering cost?You've hired teams, set standards, and shaped long-term technical direction. At what point does an engineer stop being a contributor and start owning business-level outcomes?You contributed to open-source tools that later became part of your company's infrastructure. Why do you see open source contributions as part of serious engineering work rather than a side activity?Looking across your projects, how do you now recognize a truly mature engineering system? Is it code quality, process, or how teams respond when things go wrong?If we look five to seven years into the future, which architectural assumptions we treat as “standard” today are most likely to turn out to be naive or limiting?SponsorsIncogniLinkshttps://www.linkedin.com/in/oleksandr-piekhota-b675ba53/https://teachingstrategies.com/Support this podcast at — https://redcircle.com/codestory/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Se napihuje balon umetne inteligence? Kaj pomeni korekcija v primerjavi z medvedjim trgom? Zakaj psihologija pogosto premaga razum? Kako naj vlagatelj reagira na hrup, ki ga ustvarjajo mediji, algoritmi in vplivni glasovi z Wall Streeta? Je v takšnem okolju bolj smiselna aktivna ali pasivna strategija? Kam danes investirati 20.000 evrov – tudi v luči prihajajočih individualnih naložbenih računov (INR)? Katere so TOP delnice, na katere se splača biti pozoren? Pred mikrofonom: Izidor Jerman, direktor področja individualnega upravljanja premoženja pri Triglav Investments “Negotovost ni razlog za umik, je pa razlog za disciplino.“ ______________________ Bootcamp za mlade Vse, kar mora vaš otrok vedeti o upravljanju denarja Termini: Ljubljana - 27. april 2026 med 10.00 Info: https://money-how.si/dogodki/ ____________________________ KNJIGA: Mami, oči, ali smo mi bogati? Od žepnine do investiranja. Vodnik za starše, ki želijo razumeti upravljanje denarja in to znanje samozavestno prenesti na otroke. Tiskana knjiga https://money-how.si/knjiga/mami-oci-ali-smo-mi-bogati/ E-knjiga + bootcamp https://money-how.si/knjiga/mami-oci-ali-smo-mi-bogati-2/ ____________________________ Money-How Premium: https://money-how.si/narocnine/ vključuje: - Modri AI - Finančni asistent, ki pomaga pri raznih finančnih dilemah https://money-how.si/modri-ai/ - Taxistent - Davčni asistent, ki pomaga pri oddaji davčne napovedi https://money-how.si/taxistent/ (deluje za IBKR; Revolut, Trade Republic... in kombinacijo vseh) - poglobljene članke ____________________________ Bootcamp v živo: Investiranje – kako sploh začeti Že dolgo razmišljaš o vlaganju in ne veš, kje in kako začeti? Nimaš energije, da bi raziskoval vse podrobnosti. Skrbijo te davki? Presekaj in se nam pridruži v živo, kjer bomo skupaj naredili prvi korak v svet investiranja! Termini: Ljubljana - 22. april 2026 med 17.00 in 20.30 Info: www.money-how.si/dogodki/ __________________ Finančna delavnica je lahko čudovito darilo. Več preveri https://money-how.si/izobrazevanja ______________________ (delavnica) Investiranje v delnice: Kaj moram vedeti, ko se odločam za investiranje v delnice Prijava: https://money-how.si/izobrazevanja _____________________ (delavnica) Investiranje za začetnike. Praktično o osnovah investiranja. Prijava: https://money-how.si/izobrazevanja _________________________________ DISCORD skupnost: V finančnih zagatah nismo sami, pridružite se nam na Discord Money-How / discord ______________________________ Več o Money-How na https://money-how.si/

Neurologic complications of hematologic disorders are frequently encountered in clinical practice and can involve both the central and peripheral nervous systems. Early recognition and appropriate management in collaboration with a hematologist are essential to reduce morbidity and mortality. In this episode, Kait Nevel, MD, speaks with Lauren Patrick, MD, and Mark Terrelonge, MD, MPH, authors of the article "Neurologic Complications of Hematologic Disorders" in the Continuum® February 2026 Neurology of Systemic Disease issue. Dr. Nevel is a Continuum® Audio interviewer and a neurologist and neuro-oncologist at Indiana University School of Medicine in Indianapolis, Indiana. Dr. Patrick is an assistant professor of neurology at the University of California, San Francisco, in San Francisco, California. Dr. Terrelonge is an associate professor of neurology at the University of California, San Francisco, in San Francisco, California. Additional Resources Read the article: Neurologic Complications of Hematologic Disorders Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @IUneurodocmom Full episode transcript available here Dr Nevel: Thick blood, thin blood. These are terms often used by patients and caregivers to describe some of the hematologic disorders that can lead to neurological diseases such as stroke. So, when should we consider a hematologic disorder as a potential cause for neurological conditions, such as stroke or neuropathy. Today I have the opportunity to interview Drs Lauren Patrick and Mark Terrelonge to learn more about neurologic complications of hematologic disorders in their recent article in Continuum. Dr Jones: This is Dr Lyell Jones, editor-in-chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Nevel: Hello, this is Dr Kate Nevel. Today I'm interviewing Drs Lauren Patrick and Mark Terrelonge about their article on neurologic complications of hematologic disorders. This article appears in the February 2026 Continuum issue on neurology of systemic disease. Welcome to the podcast, and please introduce yourself to the audience. Dr Patrick: Thank you for having us. We're both thrilled to be here. I'm Lauren Patrick, a vascular neurologist and assistant professor at the University of California, San Francisco, and program director for the Vascular Neurology Fellowship here. Dr Terrelonge: And I'm Mark Terrelonge, I'm an associate professor of neurology and neuromuscular medicine here at UCSF and one of the associate program directors for the adult neurology residency. Nice to meet you. Dr Nevel: Nice to meet you both. Really looking forward to getting into your article and learning more. So, to kind of kick us off, I always like to ask what do you think is the most important takeaway from your article for the practicing neurologist? And maybe since there are two of you and I suspect you covered slightly different aspects of this article, maybe you could give us two most important takeaways. Dr Patrick: Sure. I think the biggest takeaway is to keep hematologic disorders on the differential when evaluating patients with neurologic symptoms. Conditions like sickle cell disease, myeloproliferative neoplasms, or plasma cell dyscrasias and paraproteinemia can cause strokes or peripheral neuropathies, and many have specific and targetable treatments. The early recognition and collaboration with our hematology colleagues can truly change patient outcomes, whether that's by initiating cytoreductive therapy, managing thrombocytopenia, or optimizing antithrombotic therapy. Dr Nevel: Great. So, this is a really big and diverse topic. As always, I'm going to urge our listeners to read the article because there is a lot of really good stuff in your article that we just don't have time to get into during this interview today. But you cover a lot of different hematological disorders and how they can cause neurological complications. One of the major neurological complications of hematological disorders is cerebral vascular events. So, I'm hoping, Warren, that you can walk us through a little bit. When should we consider workup of potential hematologic disorder as a cause when we see a patient with ischemic stroke, because certainly not all patients with ischemic stroke should be getting a broad hematological disorder work up. So how can we kind of identify early on that there might be something else at play? Dr Patrick: Absolutely, great question. So, in many cases, the underlying hematologic disorder is already known, such as sickle cell disease or polycythemia vera. But sometimes stroke is the initial presentation or manifestation of the disease. So red flags can include young age, recurrent cryptogenic strokes or thrombosis, and unusual locations like the cerebral venous system. Laboratory clues such as unexplained erythrocytosis, thrombocytosis, thrombocytopenia, or hemolytic anemia should raise suspicion for an occult hematologic disorder. In the setting of acute illness, immune-mediated or heparin-induced thrombocytopenia or thrombotic microangiopathies should be suspected in patients that have hemorrhagic and or thrombotic complications, particularly when relevant lab disturbances are present. Acquired thrombophilia such as anti-phospholipid antibody syndrome should be considered in young patients with autoimmune disease, prior venous or arterial thrombotic complications, or pregnancy morbidity. Now, these are rare causes overall, but they're important to catch because the management can differ dramatically from our typical stroke care. Dr Nevel: Great. And what are some of the most common inherited or acquired thrombophilias and when should we be sending these labs? Dr Patrick: The hematologic causes really account for small minority of arterial strokes approximately one to two percent, but among those, sickle cell disease, anti-phospholipid antibody syndrome and the myeloproliferative neoplasms are the most common. Timing of testing is key. So, the genetic thrombophilia panels can be drawn at presentation, but lab values such as protein C, protein S, and antithrombin levels may be falsely low during acute thrombosis, so they're often repeated weeks later. Similarly, for anti-phospholipid antibody testing that should be done at presentation and when positive, confirmed at twelve weeks, since transient positivity can occur with affections or acute events. So, in patients that are already anticoagulated for anti-phospholipid antibody syndrome, testing becomes particularly tricky, especially with lupus anticoagulant assays. Some results need to be interpreted carefully or repeated when feasible. The main message is to collaborate early with our hematology colleagues to guide the timing and interpretation of these studies. Dr Nevel: Yeah, wonderful. Thank you. I'll ask some similar questions about neuropathy. So when should we consider an underlying hematologic disorder as being the cause for someone's neuropathy? Dr Terrelonge: So, luckily for a neurologist, then serum protein electrophoresis or an SPEP is already a part of the first pass evaluation for even the most common neuropathies we see, technically already considered every time we do an evaluation. However, we do know that most neuropathies progress very slowly and don't really lead to significant limitations in patient activities of daily living. And for those, the initial workup step, you may not need to do any additional search for any hematologic diseases after that first step. Within patients who start to have more unusual features with their neuropathy, including a rapid progression, early proximal weakness, significant and extremely painful neuropathies, significant ataxia, or new tremor or anything that's kind of outside of the garden variety neuropathy, then you should start to think about a hematologic cause. Additionally, if a patient already has a known hematologic malignancy or process before their neuropathy, there should be some form of assessment to see through exam or electrodiagnostically if the two are correlated. I do have to add one caveat, though, and that's just because someone has a hematologic malignancy or a paraprotein seen in their blood, their neuropathy and the neurologic syndrome don't necessarily have to be causally related. So, we have to do some additional testing to determine if the patient's presentation of the paraprotein are actually linked. Dr Nevel: Can you walk us through a little bit how we determine if they're associated or just coincidental? Dr Terrelonge: Yeah. So, for some of the proteins, there's a specific phenotype that will come with the specific protein. For example, an anti MAG proteinopathies or MAG standing for a myelin associated glycoprotein, it usually leads to a distal sensor and motor polyneuropathy where the most distal portions of nerves are affected. So, in that case, people might notice that they have numbness and weakness in their toes and their fingers, and it doesn't follow that typical length dependent pattern. So, in that case, if you have the anti mag neuropathy and the electrodiagnostic signature of an anti mag neuropathy along with the symptoms, you're more likely to think that the two are related then if not. Dr Nevel: Great. Thank you. And I was hoping you could speak a little bit more about amyloidosis just because I think that that's one that can be really tricky to diagnose. And I see patients, you know, have sometimes more drawn out evaluations or see multiple providers before a diagnosis is reached. So, can you speak a little bit more to how we diagnose amyloidosis in relationship to neuropathy or other neurological conditions and when we should push for more invasive testing like a nerve biopsy? Dr Terrelonge: So, amyloidosis certainly is a tricky diagnosis. I've been tricked by it and I think most of my neuromuscular colleagues have probably been tricked by it at least once. It's a hard diagnosis to make is it usually requires a pretty high index of suspicion, and also requires a tissue diagnosis to cinch. There're some patients who will come in with a prior history of amyloidosis and they're a little bit easier to figure out if the neuropathy is related. Maybe it's started in their heart or their kidney first and then you can just see if the type of amyloid they have usually deposits in nerve, and that may be enough. But if there's any diagnostic uncertainty, you could go forward with tissue biopsy. But it's patients in which the neuropathy is the first symptom that amyloidosis can be especially tricky to diagnose. It's a primarily light chain disease. So, if you do only an SPEP as a part of your initial neuropathy evaluation, you could miss it. But usually, the patients will have either a severely painful neuropathy, early autonomic dysfunction, or really prominent bilateral carpal tunnel syndrome. So, if they have any of those, usually we'll add in an amyloid workup as a part of that of the rest of the workup, which would include both light chain evaluations to see if there's any increase in Lambda or Kappa light chains and then also biopsy. Biopsy can be of the skin or fat pad first, which have reasonable sensitivity for picking up disease, but they're not necessarily a hundred percent. So if the suspicion remains high in those cases, a nerve biopsy should be considered. And the reason why this is important is that the chemotherapeutic agents that we have now can actually help arrest a lot of these diseases and stop further organ involvement. So, if you think about it, it is important to keep pushing and looking until you find it. Dr Nevel: Thank you so much for that. And a follow up question to that, once patients are started on appropriate therapy, the diagnosis is made, chemotherapy is started, what's the typical clinical course that you see in terms of their neuropathy? Do you ever see improvement or is it arrest of worsening? Dr Terrelonge: Usually for amyloid, there is an arrest of disease, but in some patients, they could have some improvement, not necessarily a dramatic improvement, but some patients could see some reversal of symptoms. That may not necessarily be because nerves injured nerves are regrowing, but because of reorganization of nerves to muscle, they could have some strength increases or at least less pain. Dr Nevel: Yeah, thank you. So, when should we involve a hematologist in aiding in the evaluation of patients we suspect may have an underlying hematological disorder? You guys really outlined very nicely in your article some of the laboratory workup or other workup like you just talked about with amyloidosis. But at what point in that workup should we reach out to our hematology colleagues? Dr Patrick: I would say almost always. So, these disorders are inherently multi-system and benefit from early co-management. In acute sickle cell stroke, for example, hematology helps direct emergent exchange transfusion. For myeloproliferative disorders they guide cyto reduction and long term antithrombotic strategy. And for antibody mediated or plasma cell disorders, hematology determines disease specific therapies. So, neurology may help with identifying the presentation, but the definitive management is almost always shared with our hematology colleagues. Dr Nevel: And as you both have mentioned that a lot of times in these cases, their hematologic disorder may be already known before they present with their neurological symptoms. So, I imagine obviously in those cases that a hematologist hopefully is already heavily involved in their care. What do you think is the most difficult aspect of identifying and diagnosing patients with neurologic illness as having an underlying hematological disorder? Dr Patrick: The hardest part is maintaining a high index of suspicion, especially since hematologic causes account for a very small minority of arterial strokes. Most strokes are from traditional vascular risk factors like you mentioned, or cardio embolism, so it's easy to stop diagnostic evaluation after standard studies have been performed. An example of a challenging case is a patient that's young, they've had recurrent cryptogenic stroke, and they could have antiphospholipid antibody syndrome, but it can be easy to miss if their antibody titers are borderline or if they're already anticoagulated, which would complicate retesting. So, it's about balancing the urge to over-test with recognizing the few cases where identifying A hematologic cause truly changes that management. Dr Terrelonge: And then on the neuropathy side, probably the hardest part is deciding what's causal and what's coincidence. Monoclonal gammopathy of unknown significance, or MGUS, is really common in older adults, so not every M-spike on an SPEP explains a neuropathy. And even sometimes there's times when the neurologic picture will develop a little bit faster than the hematologic one. So, it's hard to put the two together. Dr Nevel: Yeah. What's the most rewarding aspect of taking care of patients with complications from their hematologic disorders? Dr Patrick: It's deeply rewarding when a targeted diagnosis leads to a tangible improvement in that patient's care. For example, identifying A cryptogenic stroke is being due to myeloproliferative neoplasm or an inherited thrombophilia allows us to move from empiric treatment to possible disease specific strategy. It's really gratifying to give patients that clarity, to give them a diagnosis and in some cases prevent future events. Dr Terrelonge: Agreed. And even on the neuropathy side, almost all of the neuropathies that are hematologically related are treatable. So, it's so satisfying whenever you have a patient with say an anti-MAG neuropathy or Waldenström can start the patient on therapy, and you can see someone who's been having a progressive decline to stability and in those cases sometimes even significant recovery. Dr Nevel: Yeah, absolutely. Very rewarding when you can identify the problem and make it better. That's what it's all about. So, what are the future areas of research in this area? What do we still need to learn? Dr Patrick: There's still a lot to learn. I think we need better data on the safety of acute reperfusion therapy and antithrombotic agents, particularly in patients that are at dual risk for bleeding and thrombosis. Other examples, secondary prevention strategies and anti-phospholipid antibody syndrome. What's the best target INR? Do you add aspirin to warfarin or not? All of that is often left up to expert opinion. What's the best management for adults with sickle cell stroke? There are many open questions there. A lot of the protocols that we have in place for sickle cell patients that are adults as derived from pediatric literature and there's vast potential in terms of disease modifying therapies, especially in the fields of sickle cell disease and amyloidosis. And we'll need to reassess how those treatments may change neurologic outcomes. Dr Terrelonge: I think on the neuropathy side that having some form of new biomarkers to help us clearly know of the neuropathy and that hematologic illness are associated would be very helpful. On the treatment side, a lot of this is really being driven by the hematology space, but new therapies that treat hematologic plasma cell disorders, including some of the new BTK inhibitor, may be incorporated relatively soon into the algorithm for how we treat many of our patients. I'm excited to see what's to come from this. Dr Nevel: Wonderful. Thank you so much for sharing your knowledge with us today. I know I've certainly learned a lot by reading your article and through our discussion today. Highly encourage our listeners to read your wonderful article, which is a very thorough review of hematologic disorders and neurological complications. Again, today I've been interviewing Dr Lauren Patrick and Dr Mark Terrelonge on their article Neurologic Complications of Hematologic Disorders, which appears in the February 2026 Continuum issue on Neurology of Systemic Disease. Please be sure to check out Continuum Audio episodes from this and other issues. And as always, thank you so much to our listeners for joining today, and thank you so much to Lauren and Mark. Dr Terrelonge: Yeah, thank you so much for having us. Dr Patrick: Thank you so much for having us and for highlighting this topic. We hope the issue encourages clinicians to think broadly about hematologic causes of neurologic disease and to continue collaborating closely with our hematology colleagues. It's a complex but very fascinating intersection for both of our fields. Dr Monteith: This is Dr Teshamae Monteith, associate editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in depth and clinically relevant information important for neurology practitioners. Use this link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/AudioCME. Thank you for listening to Continuum Audio.

In this episode of the RCP Medicine Podcast, transplant hepatologist Dr Mhairi Donnelly joins gastroenterology trainee Dr Jennifer Tham to explore the high‑stakes world of acute liver failure.Through a detailed case of a young woman presenting with severe transaminitis and paracetamol toxicity, Mhairi and Jennifer guide listeners through the crucial steps in recognising acute liver injury, identifying early markers of deterioration, and escalating care at the right time.The discussion covers the most common causes of acute liver failure in the UK, how to interpret markedly raised transaminases, the role of NAC beyond confirmed paracetamol toxicity, the importance of monitoring lactate and INR trends, management of hepatic encephalopathy in acute liver failure, and how psychiatric assessment influences transplant suitability. A must‑listen for anyone managing acutely unwell medical patients or seeking to deepen their understanding of this life‑threatening condition.RCP Links Education Events Membership Improving care Policy and campaigns RCP Social Media Instagram LinkedIn Facebook X Bluesky Music: Episode 50 onward - Bensound.com Episodes 1 - 49 'Impressive Deals' - Nicolai Heidlas

Bomo Slovenke in Slovenci spremenili varčevalne navade in prihrankov ne bomo kopičili le v bankah, ampak tudi na donosnejših finančnih trgih? Država nam z letošnjim marcem za ta namen ponuja individualne naložbene račune. Namenjeni bodo samo fizičnim osebam in bodo davčno prijaznejši od obstoječih trgovalnih računov. Kakšne so prednosti odprtja tako imenovanega INR, kolikšni bodo stroški, povezani s tem, zakaj ne bo mogoče nanje prenesti že pridobljenih vrednostnih papirjev? O vsem tem pa tudi o pomembnosti razvitega kapitalskega trga v tokratnem Studiu ob 17.00. Gostje: Nikolina Prah, državna sekretarka na finančnem ministrstvu; dr. Aljoša Valentinčič, Ekonomska fakulteta Univerze v Ljubljani; Mitja Tomažinčič, direktor investicijskega bančništva v NLB; Daniel Medved, direktor oddelka investicijskega bančništva v OTP.

The global ship recycling market saw another shift in Week 7 of 2026 as key fundamentals moved in different directions across the sub-continent. The Baltic Dry Index declined by 0.6 percent, mainly due to weaker Capesize and Panamax performance, while Supramax rates improved. Oil prices held near USD 62.8 per barrel as markets continued to monitor U.S. and Iran tensions. In this week's episode, Ingrid and Henning discuss how the U.S. Dollar strengthened against most recycling nation currencies, with India being the exception as the Rupee improved to around INR 90.6. Steel plate prices reversed course in India, falling nearly USD 10 per ton, while Pakistan maintained the strongest fundamentals in the region with plate prices holding near USD 594 per ton. Bangladesh reached a political milestone as the BNP secured a more than two-thirds majority in the general elections. The result is expected to support long-delayed infrastructure projects and could improve domestic steel demand in the months ahead. The country also adopted the International Ready for Recycling Certificate framework, aligning with regional compliance requirements under the Hong Kong Convention. Steel plate prices in Bangladesh remained flat near USD 494 per ton, while the Taka weakened slightly. Pakistan continued to lead pricing tables, supported by firm steel levels, stable currency performance near PKR 279.6, and rising anchorage activity totaling nearly 30,000 LDT across multiple bulk carriers. India's anchorage activity also remained active with more than 47,000 LDT present, despite softer steel prices. Turkey remained quiet, with limited activity in Aliaga and the Lira weakening toward TRY 44. This episode covers demolition pricing direction, steel and currency movements, port activity in Alang, Chattogram, and Gadani, and the ongoing shortage of recycling candidates. The discussion is intended for shipowners, cash buyers, recyclers, brokers, and maritime professionals following developments in the global demolition market

Anticoagulation therapy can feel complex, but nurses play a vital role in keeping patients safe. In this episode, we break down the key differences between warfarin and direct oral anticoagulants (DOACs), including how they work, when they're used, and what makes each unique. You'll review important monitoring parameters like INR for warfarin, renal function considerations for DOACs, major drug and food interactions, and bleeding risk assessment. We'll also cover reversal strategies and practical patient education pearls. Whether you're preparing for exams or managing patients on anticoagulation, this episode will simplify the essentials and strengthen your confidence in safely caring for patients on warfarin and DOAC therapy. Your support helps me provide more free resources like this! Consider supporting and getting more amazing pharmacology content! Head on over to meded101.com/nurse

Please support this podcast by pressing the follow button and support Chinmaya Mission Mumbai projects taken up by Swami Swatmananda, through generous donations. Contribution by Indians in INR can be made online using this link: https://bit.ly/gdswatmanDonors outside India who would like to offer any Gurudakshina/donation can send an email to enquiry@chinmayamissionmumbai.com with a cc to sswatmananda@gmail.com to get further details.These podcasts @ChinmayaShivam are also available on Spotify, Apple iTunes, Apple Podcasts, Podomatic, Amazon music and Google PodcastFB page: https://www.facebook.com/ChinmayaShivampageInsta: https://instagram.com/chinmayashivam?igshid=1twbki0v3vomtTwitter: https://twitter.com/chinmayashivamBlog: https://notesnmusings.blogspot.comLinkedIN: www.linkedin.com/in/swatmananda

Individualni naložbeni računi (INR) prinašajo davčne ugodnosti za dolgoročne vlagatelje. Komu so namenjeni, kakšne so omejitve vplačil in kako deluje 15-letni davčni cikel? Pred mikrofonom: Nikolina Prah, državna sekretarka na ministrstvu za finance ______________________ Bootcamp za mlade Vse, kar mora vaš otrok vedeti o upravljanju denarja Termini: Ljubljana - 19. februar 2026 med 10.00 Info: https://money-how.si/dogodki/ ____________________________ KNJIGA: Mami, oči, ali smo mi bogati? Od žepnine do investiranja. Vodnik za starše, ki želijo razumeti upravljanje denarja in to znanje samozavestno prenesti na otroke. Tiskana knjiga https://money-how.si/knjiga/mami-oci-ali-smo-mi-bogati/ E-knjiga + bootcamp https://money-how.si/knjiga/mami-oci-ali-smo-mi-bogati-2/ ____________________________ Money-How Premium: https://money-how.si/narocnine/ vključuje: - Modri AI - Finančni asistent, ki pomaga pri raznih finančnih dilemah https://money-how.si/modri-ai/ - Taxistent - Davčni asistent, ki pomaga pri oddaji davčne napovedi https://money-how.si/taxistent/ (deluje za IBKR; Revolut, Trade Republic... in kombinacijo vseh) - poglobljene članke ____________________________ Bootcamp v živo: Investiranje – kako sploh začeti Že dolgo razmišljaš o vlaganju in ne veš, kje in kako začeti? Nimaš energije, da bi raziskoval vse podrobnosti. Skrbijo te davki? Presekaj in se nam pridruži v živo, kjer bomo skupaj naredili prvi korak v svet investiranja! Termini: Ljubljana - 19. marec 2026 med 17.00 in 20.30 Info: www.money-how.si/dogodki/ ______________________ Finančna delavnica je lahko čudovito darilo. Več preveri https://money-how.si/izobrazevanja ______________________ (delavnica) Investiranje v delnice: Kaj moram vedeti, ko se odločam za investiranje v delnice Prijava: https://money-how.si/izobrazevanja ______________________ (delavnica) Investiranje za začetnike. Praktično o osnovah investiranja. Prijava: https://money-how.si/izobrazevanja _________________________________ DISCORD skupnost: V finančnih zagatah nismo sami, pridružite se nam na Discord Money-How / discord ______________________________ Več o Money-How na https://money-how.si/

Please support this podcast by pressing the follow button and support Chinmaya Mission Mumbai projects taken up by Swami Swatmananda, through generous donations. Contribution by Indians in INR can be made online using this link: https://bit.ly/gdswatmanDonors outside India who would like to offer any Gurudakshina/donation can send an email to enquiry@chinmayamissionmumbai.com with a cc to sswatmananda@gmail.com to get further details.These podcasts @ChinmayaShivam are also available on Spotify, Apple iTunes, Apple Podcasts, Podomatic, Amazon music and Google PodcastFB page: https://www.facebook.com/ChinmayaShivampageInsta: https://instagram.com/chinmayashivam?igshid=1twbki0v3vomtTwitter: https://twitter.com/chinmayashivamBlog: https://notesnmusings.blogspot.comLinkedIN: www.linkedin.com/in/swatmananda

Please support this podcast by pressing the follow button and support Chinmaya Mission Mumbai projects taken up by Swami Swatmananda, through generous donations. Contribution by Indians in INR can be made online using this link: https://bit.ly/gdswatmanDonors outside India who would like to offer any Gurudakshina/donation can send an email to enquiry@chinmayamissionmumbai.com with a cc to sswatmananda@gmail.com to get further details.These podcasts @ChinmayaShivam are also available on Spotify, Apple iTunes, Apple Podcasts, Podomatic, Amazon music and Google PodcastFB page: https://www.facebook.com/ChinmayaShivampageInsta: https://instagram.com/chinmayashivam?igshid=1twbki0v3vomtTwitter: https://twitter.com/chinmayashivamBlog: https://notesnmusings.blogspot.comLinkedIN: www.linkedin.com/in/swatmananda

In "R is for Repentance," TJ and Tory go on an adventure to learn the difference between confession and repentance. They discover that true repentance is more than saying sorry—it means turning around, going the other way, and walking toward God in obedience.Follow along as TJ and Tory learn about the God's unchanging character week after week with the ABCs of Theology! Season 5 and 6 follow this best-selling card set, and we just know your kids are going to love them. Shop all discipleship tools for kids ages 2 to 12 at tinytheologians.shop, and join our email list to be among the first to know about sales, new releases, and get all the podcast updates right in your inbox!Resources: The ABCs of TheologyFollow Us:Instagram | Website | NewsletterEditing and support by The Good Podcast Co. Editing and support by The Good Podcast Co. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Kiera is joined by the tooth-healer himself, Jason Dent! Jason has an extensive background in pharmacy, and shares with Kiera where his pharmaceutical experience has bled over into dentistry. This includes the difference between anti-quag and anti-platelet and which medications are probably safe, what to do to shorten the drag time in the pharmacy, how to write prescriptions most efficiently, and more. Episode resources: Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Transcript: The Dental A Team (00:00) Hello, Dental A Team listeners. This is Kiera and today is a really awesome and unique day. It is, think the second time I've had somebody in the podcast studio with me live for a podcast and it's the one and only Jason Dent. Jason, how are you? I'm doing well. Good morning. Thanks for having me. It is crazy. I I watch Instagram real like this all the time where people are like in the podcast and they're hanging out on two chairs and couches and now look at us. We're doing it. Cheers. Cheers.   That was a mic cheer for those of you who are only listening, but yeah, Jace, how does this feel to be on the podcast? It's weird. Like I was not nervous at all talking about it. I got really nervous as soon as you hit play. So if I stumble over my words, please forgive me ahead of time. Well, Jason, I appreciate you being on the podcast because marketing had asked me to do a topic about teledentistry and I was like, oh shoot, that's like not my forte at all. so   You and I were actually chatting in the hot tub. call it Think Tank session and you and I, we have a lot of good ideas that come from that Think Tank. A lot of business. no phones. That's why. We do leave our phones out. But I was talking to Jason and this is actually a podcast we had talked about quite a while ago. Jason has a lot of information on pharmacy. And if you don't know, Jason isn't really, we were going through all of it last night. It's kind of a mock in the tub. And I think it's going to be great because I feel like this is an area, I'm working at Midwestern and   knowing about how dentists, pharmacology was surely not your favorite one. Jason actually helps a lot of dentists with their clearances. And so we were talking about it and I like it will just be a really awesome podcast for you guys to brush up on pharmacology, different things from a pharmacist's side. So Jason, welcome. Thank you. Yeah, no, we were talking about it and here's like, what should I talk about on the podcast next? I have all these different topics and she's like, what do you know? And the only real interaction I have with dentists is doing clearances for procedures. We get them all the time, which makes sense.   Lots of people are on blood thinner, I've always told Kiera, like, hey, I could talk about that. Like, that's kind of a passion of mine. I'm not a dentist. Or my name is Jason Dent. So in Hebrew, Jason means tooth. No, no, no, sorry. Nerves are getting to me. Jason means healer and Dent means tooth. So my name means tooth healer. So, here's a little set. Hold on, on, hold Can we just talk about? I brought that up before you could talk about it more. So.   My name means tooth healer but I did not become a dentist. I know you wanted me to become a dentist. did. I don't know why. I enjoy medicine. I know what you're going to get to already. The things you're going to ask me. There's been years of this. But nevertheless, that's my name. We'll get that out of the way. But you did give me a great last name. So I mean, it's OK. You're All is fair and love here. SEO's up for that. But yeah, Jason, I'm going to get you right into the show. And I'm going to be the host. And we're going to welcome to the podcast show. Jace, how are you?   Good, good, good. Good, good, good. So by getting into clearances, right? This is what you're kinda talking about with you know, before we get to clearances, I actually wanted Jason, for the listeners who don't know you, who haven't talked to you, who don't know, let's kinda just give them like, how did you go from, Kiera wanted you to be a dentist, to now Jason, you are on the podcast talking as our expert on pharmacy. fantastic. I've always really loved medicine, a ton. As a kid getting headaches and taking Excedrin, like you just feel like a miserable pile of crap.   and then you take two pills and all of a sudden you feel better. Like that's amazing, like how does that happen? Also getting ear aches as a kid, just being in so much pain and then taking some medicine and you start feeling a lot better. I always had a lot of appreciation for that. I've always been mechanically inclined. I went to, started doing my undergrad and took biology and learned about ATP synthase, which is a spinning enzyme that's inside the mitochondria, like a turbine engine. I used to work on small engines on my dirt bike and thought that is so cool. So I really got wrapped up into chemistry.   All the mechanics of chemistry really pulled me in. I'm not getting goosebumps. checking. I usually get goosebumps when I think about chemistry. But it's so cool. You think an engine's awesome, like pistons and camshafts and pressures, the cell is the same thing. It's not as loud, so it's not as cool. But it's fascinating. that's why we're like. ⁓   chemistry and really got into coagulation. So I did my residency after pharmacy school. we went to Arizona for three years. ⁓ You did and your main focus, you were never wanting to be the guy behind the counter. No, I haven't done that. Yeah. No, I love them though. I've always really want to go clinical. ⁓ But I love my retail ⁓ pharmacists. They're amazing resources. And ⁓ I use the retail pharmacist every day still to this day, but I went more the clinical route, really love the chemistry aspect of it.   did my doctorate degree and then I did my residency in Reno. Reno's kind That's how we got here everybody. Welcome to Reno. Strategically placed because I was really interested in critical medicine and where we're located we cover a huge area. So we pull in to almost clear, we go clear to Utah, clear to California, all of Northern Nevada. We get cases from all over. So we actually are kind like the first hub of care for lot of areas. So we really get an eclectic mixture of patients that come in that need-   all kinds of different cases that are coming to them. So it's what I really wanted. So I did my residency in critical care there. And then for the next 10 years, I worked in vascular medicine with my final five years being the supervisor of the clinic. Ran all the ins and outs of that. So my providers, two doctors were on our view. So when we talk about dentistry, talk about production, those kinds of things, totally get it. My doctors were the exact same way, my vascular providers. ⁓   There's some pains there, right? You wanna be seeing patients as much as possible, being able to help as many people, keeping the billing up. And had other nurse practitioners, four practitioners, a fleet of MAs, eight pharmacists. We also had that one location we had, going off the top of my head, I think we had eight locations running as well. And we took care of all the different kinds of vascular cases that came to us. Most common was blood clots, ⁓ which is just a...   which is an easier way of saying VTE. There's so many different ways to say a blood clot. Like you might hear patients say, I've had a PE or a DVT or a venous thromboembolism or a clot in my leg, right? They're all clots, but in different locations. Same with an MI, and MI can be a clot as well. ⁓ there's a lot of, everybody's kind of saying the same thing, but sometimes the nomenclature can make it sound hard, but it really is actually pretty simple.   No. And Jason, I love that you went through, you've been in like, and even in your, ⁓ when you were getting your doctorate, you were in the ER. You also worked in retail pharmacy. remember you having a little sticker on your hand. And retail pharmacy, I have a lot of respect for those guys. They have a lot of pressure on them. and then you also, ⁓ what was that test that you had to take that? I don't know. You were like studying forever for it. ⁓ board certification for, ⁓ NABP. Yeah. So I did that board certification as well.   And now you've moved out of the hospital side onto another section in your career. Now in the insurance, right? So it's really, really interesting. So now I'm on the other side reading notes and evaluating clinical appropriateness and trying to help patients with getting coverage and making those kinds of determinations. So yeah, I've really jumped all over. Really love my clinical days. I know. don't I don't I do miss them. But yeah, kind of had a good exposure to a lot of.   pharmacy a lot a lot of dentists actually with all the places that come through which Jason I really appreciate that and honestly I know you are my spouse and so it's fun to have you on but when I go into conversations like this I don't know any of this information and so finding experts and Jason I think here's me talk more about dentistry and my business than I do hear about him on pharmacy so as we were chatting about this I really realized you are a wealth of knowledge because you've been on the clinical side so you've done a lot of patient care and you've seen how   medications interact and I know you've had a few scares in your career and ⁓ you've known some physicians that have had a few scares and ⁓ you've seen plenty of patients pass away working in the ER and gosh in Arizona drownings were such a big deal. I remember when you were in the ER on your rotations I'd be like who died today? Like tell me the stories and you've really seen and now going on to the insurance side I felt like you could just be such a good wealth of knowledge because I know dentists are sometimes so   I would say like maybe just a little more anxious when it comes to medications. I know that dental students from Midwestern were like here was like four months and we had to like pass it, learn it. And Jason, you've done four years plus clinical residency, plus you've been in it. And something I really love about Nevada Medicine is they've been so collaborative with you.   like your heart, your cardiologist, they diagnose and then they send to you to treat with medicine and... Yeah, I've been really lucky being here in Reno too. The cardiology team has been amazing to work with. We started a CHF program, sorry, congestive heart failure program for patients. So we would collaborate with cardiologists. They'd see the cardiologists and then they send them to the pharmacist to really manage all the medications. So there's pillars of therapy ⁓ called guideline directed medical therapy and the pharmacist would take care of all that. So that's gonna be your...   your beta blockers, your ACEs, your ARBs, your Entresto, which would be a little bit better, spironolactone. So just making sure that all these things are dosed appropriately, really monitoring the heart, and make sure that patients are getting better. we've had real positive outcomes when the, sorry, this is totally off topic. do, talk about that study. When we looked at when patients were coming to see our pharmacists in our clinic that we started up, the patients were half as likely to be readmitted. And this was in 2018, and our pharmacists,   We're thinking about all the medications. We're usually adjusting diabetes medications too at the same time. Just kind of naturally just taking care of all the medications because we kind of got a go ahead from the providers, a collaborative practice agreement that we could make adjustments to certain medications within certain parameters. So we weren't going rogue or maverick, but we were definitely trying to optimize our medications as much as possible. And then years later, some studies came out with, I'm sure you've seen Jardins and Farseegh. not trying to, I'm not.   I don't get any kickback from them. I have no conflicts to share. But because our pharmacists were really optimizing that medication, those medications were later shown to reduce hospitalizations and heart failure, even though they're diabetes medications. Fascinating. So it wasn't really the pharmacists. It was just the pharmacists doing as much as they can with all the tools that were in front of them. And then we found out that the patients were going back to the hospital.   half as much as regular patients. So, yeah, being here, it's been so amazing to work with providers here. the providers here want help, want to help patients, don't have an ego. I mean, I just, it's awesome. I love it. I do love how much I think Jason sees me geek out about dentistry and I watching Jay's geek about his pharmacy and how much he loves helping patients. And ⁓ really that was the whole idea of, all right.   Dentistry has pharmacy as a part of it. And I know a lot of dentists are sending in clearances and I know working in a chair side, it would be like, oh no, if they're on warfarin or on their own blood clot, you guys, honestly don't even know half of what I'm talking about because this is not my jam, which is why Jason's here. But I do know that there was always like, well, we got to talk with their provider. And so having Jason come in and just kind of explain being the pharmacist that is approving or denying or saying yes or no to take them off the blood thinners in different parts, because you have seen several dental   I don't know what they're called. What is it? Clarence's? that what comes to you? don't even know. All day my mind, it's like, here is the piece of paper that gets mailed to you to the pharmacist and then you mail it back. So whatever that is. But Chase, let's talk about it because I think you can give the dentist a lot of confidence coming from a pharmacist. What you guys see on that side. When do you actually need to approve or disapprove? Let's kind of dig into that. Yeah. Well, first of all, I think I'm not a replacement for any kind of clinical judgment whatsoever. Every patient's different. But the American Diabetes Association, you   I work with diabetes a lot. American Dental Association has some really great guidelines on blood thinners and I would always reference them. I actually looked at their website today. Make sure I'm up to speed before I get back on this again. They have resources all around making decisions for blood thinners. And I think the one real important thing in putting myself in the shoes of a dentist or any kind of staff that's around a patient that's in a chair, if they say I'm on a blood thinner, right, a flag goes up. At least in my mind, that's what goes up.   Like, okay, how do we get across this bridge? And I think the important thing to really distinct right then when they say they're on a blood thinner is that is kind of a slang word for a lot of different medications, right? Like it's the overarching word that everybody pulls up saying, I'm on a blood thinner. It's like, okay, but I don't know what say. It's like, I have a car. You're like, okay, do you have a Mazda? Do you have?   Toyota, Honda, what do you have? or even worse it'd be like saying I have a vehicle, right? So when somebody says they're on a blood thinner, it opens up a whole box of possibilities of what they're Blood thinners are also, doesn't, when they're taking these types of medications that are quote unquote a blood thinner, it doesn't actually thin the blood, like adding water to the blood, if that makes sense, or like thinning paint, or like thinning out a gravy, right? It doesn't do the same thing. Blood thinners, really what they're doing is they're working on the blood, which.   which is really cool, try not to tangent on that. ⁓ When they're working on the blood, it's not thinning it per se, but it's making it so that the proteins or platelets that are in it can't stick together and make a cloth quite as easy. So whenever somebody's on a blood thinner, I usually ask, what's the name of the blood thinner that you're on? It's not bad that they use that slang, that's okay, on the same page, but it's really broken into two different classes. There's anticoagulant and antiplatelet.   And a way to kind of remember which is which, when residents would come through our clinics, the way that I teach them is a clot is like a brick wall. You know, it's not always a brick wall. Usually the blood is a liquid going through. But once they receive some kind of chemical message, it starts making a brick wall with the mortar, which is the concrete between the and the bricks, the two parts. When it's an anti-quagent, it's working on that mortar part. When it's an anti-platelet, it's working on the bricks part, right? You need both to make a strong clot or strong brick wall.   But if you can make one of them not work, obviously like if your mortar is just water, it's not working, right? You're not gonna make a strong brick wall. So that's kind of the two deviants right there. So that's what I do in my mind real quickly to find out because antiplatelets are usually, so that's gonna be like your Plavix, Ticagrelor, Brilinta. And hold on, antiplatelets are bricks? Good job, bricks. They're the bricks. And so the reason I was thinking you could remember this because I'm, antiplatelets, it's a plate and a plate is more like a brick.   And anti coagulant, I don't know why quag feels like mortar to me, like quag, like, know, it's like slushy in the blood, like it's coagulating. It's a little bit of that, like, honestly, I'm just thinking like coagulated blood is a little bit more mortar-ish. And so platelet is your plate, like a brick, and anti-quag is like.   the gilly between the bricks. Okay, okay, I got it. Yeah, so there's an exception to every rule, but when they're on that Don't worry, this is Kiera, just like very basic. You guys are way smarter listening to this, and that's why Jason's here. No, no, you helped me pass pharmacy school. When we were doing all the top 200, you helped me memorize all know what flexorill is, all right? That's a muscle relaxant. Cyclo? I don't know that part. It's a cyclo, because you guys are cycling and flexing. I don't actually know. just know it's a muscle relaxant, so that's about as far as I got. When we're looking at antitick platelets, so that's the brick part, so that's going to be your, you know,   Hecagrelor, Breitlingta, Clopidogrel is the most common one. It's the cheapest one, so probably see that one the most. Those, I mean, there's an exception to every rule, but that's generally being used after like a stent's placed in the heart. It can be used for VTE, there's some out there, but that's pretty rare. But also for some valves that are placed in the hearts, it can be used for that as well. So antiplatelet, really thinking more like a cardiac event, right? Like I said, there's always an exception to every rule, but that's kind of where my mind goes real quickly, because we're gathering information from the patient.   They're on anticoagulant. Those are like going to be the new ones that you see commercials for all the time. So Xeralto, Alequis, those are the two big ones right now. They're replacing the older one. And also we were supposed to do a disclaimer of this is current as of today because the ADA guidelines do change. this will be current as of today. And Jason, as a pharmacist, is always looking up on that. I had no clue that you are that up to speed on dental knowledge. so just throwing it out there that if you happen to catch his podcast,   a few years back that obviously check those guidelines for sure. But the new ones are the Xarelto and Eloquist. They're replacing the older ones of warfarin. Warfarin's been around for a really long time. We've seen that one. Those are anti-coagulants. So when you're looking, when a patient says that, generally they're on that medication because they've possibly had a clot in the past or they have a heart condition called atrial fibrillation. Those are kind of the two big ones. Like I said, there's always caveats to it, but that's kind of where my mind goes real quickly. And then,   as far as getting patients cleared, the American Dental Association has really good resources on their website. You can look at those and they're always refreshing that up. They even say in their own words that there's limited data around studying patients in the dental chair and with anticoagulants or anti-platelets. It's pretty limited. There's a few studies, some from 2015, some from 2018. There's one as recent as 2021, which is nice. But really, all of those studies come together and it's really more of an expert consensus.   And with that expert consensus, they have kind of simplified things for dentistry, which is really nice. ⁓ comparing that to, we have more data for like total hip replacement, total knee replacement. We have a lot of data and we know really what we should be doing around then. But going back to dentistry, we don't have as much information, so they always say use clinical judgment, but they do give some really great expert guidance on that. So if a patient's on an anticoagulant, ⁓   they generally recommend that it doesn't need to be stopped unless there's a high bleeding risk for a patient. as a provider or as a clinician in the practice, you can be looking at high bleeding risk. Some things that make an oral procedure a little bit lower risk is one, it's in the compressible site, right? Like we can actually put pressure on that site. That's the number one way to stop bleeding is adding pressure. It's not like it's in the abdominal cavity where we can't get in and can't apply pressure. So number one, that kind of reduces the bleeding risk.   is number one. Two, we can add topical hemostatic agents. Dentists would know that better than me. There's a lot of topical ways to do that. So not only pressure, but there's those things as well. And also, but there are some procedures that are a little bit more likely to bleed. And that's where you and dentists would come in hand in What's the word in APO? Oh, the APOectomy. I got it right. Good job. like, didn't you tell me last night that the ADA guideline was like what?   three or four or more teeth? great question. So you can extract one to three teeth is what their expert consensus One to three teeth without. Without really managing or stopping anticoagulation or doing anything like that. I think that's some good guidance from them. I'm gonna add a Jasonism on that though. So with warfarin, I do see why dentists would be a little bit more conservative or worried about stopping the warfarin because warfarin isn't as stable as these newer agents. Warfarin, the levels.   quote unquote levels can go really high, they can go really low. And if the warfarin levels are high, they're more likely to bleed. So I do think it makes sense to have a really recent INR. That's how we measure what the warfarin's doing. I think that makes a lot of sense, but the ADA guidelines really go into the simplification version of all these blood thinners. Generally, it's recommended to not stop them because the risk of stopping them outweighs the benefit of stopping them in almost every case. Almost every case.   ⁓ So when you're with that patient, right, they say I'm on a blood thinner, finding out which kind of blood thinner that they're on, you find out that they're on Xeralto, right? How long have you been on Xeralto for? I've been on it for years. You don't know exactly why, but if they haven't had any recent bleeding, you're only gonna remove one tooth. ⁓ You can do what's called a HasBlood score. That kind of looks at the bleeding risk that they'd have. That'd be kind of going a notch above, but in my mind, removing one tooth isn't a real serious bleeding risk. I'd love to hear from my dentist friends if they...   disagree, right, but ADA says one to three tooth removals, extractions, that's the fancy word. Extractions, yeah, for extracting teeth out. Is not really that invasive. Sure. It's not that high risk, so it's usually perfectly fine. So if a patient was on Xarelto, ⁓ no other, this is in a vacuum, right? I'm not looking at any other factors, which you should be looking at other factors. I would be perfectly fine to just remove one to two.   And when those clearances come in, because dentists do send them, talk about what happens. You guys were working in the hospital and you guys would get these clearances all the time. do. We get them so often. I mean, we get like four or five a day. We'd love to give it to our students, student pharmacists, and ask them what to do. And they would usually look up the American Dental Association guidelines and come up with something. We're like, yep, that's what we say too. In fact, we say it so many times a day that we have a smart phrase.   which just blows in the information real quickly and faxes it right back to the So it's like a copy paste real quick. So what I wanted to point out when Jason told me this is dentists like hearing this and learning this, this can actually save you guys a ton of time to be able to be more confident, to not need to send those clearances on. And we were actually talking last night about how I think this might be a CYA for dentists. like, as we were talking, I think Jason, you seeing so many other aspects of medicine, like you've literally seen patients die, you've seen other areas.   And so coming from that clinical vantage point, we were realizing that dentists, we are so blessed to live in an injury. I enjoy dentistry because possibly there's someone dying, not super high, luckily in dentistry. The only time that I have actually had a doctor have a patient pass away, and it was only when they were completely sedated and doing ⁓ some other things, but that was under the care of an anesthesiologist. And so that's really our high, high risk. And so hearing this, Jason,   That was one of the reasons I wanted him to come on is to give you doctors more confidence of do we have to always send to a pharmacist? I mean, hearing that on the pharmacy side, they're just sending these back and not to say to not see why a to not cover this because you might be questioning like, well, do I really need to? But you also were talking about some other ways of so number one, you guys are just going to copy back the 88 guidelines. So so 88 guidelines. Yeah. And I think that that gives a lot of confidence to a provider or a dentist is that you can go to the 88 guidelines and read them, right? Like you're listening to some   nasally monotone pharmacist on a podcast. Rumor has it, people love him at the hospital. were like, you're the voice, he's been told he has a good radio So for the clinic, I was the voice. Like, yeah, you've reached the vascular clinic, right? And they're like, oh my gosh, you're the voice. But sorry, you me distracted. That'll be your next career, Jace. You're going to be a radio host. OK. I would love that. I love music. But you're hearing from a nasally guy, but you can actually read the ADA guidelines. You just go right to the ADA, click on Resources, and under Resources, it has the   around anticoagulants, I think that's the best way to get a lot of confidence about it because they have dentists who are the experts making calls on these. I'm just reiterating what they say, but I think it makes a lot of sense to help providers. And the reason why my heart goes out to you as well is having the providers that used to work underneath me, they're always looking for our views, which is a fancy way of making sure that they're drilling and filling. Can I say that? Yeah, can say drilling and filling. They're being productive, right? They're being productive, right?   They're always looking to make sure if a patient's canceling, like get somebody in here. Like I need to be helping people all day long. That's how I, we keep the lights on. That's how I help as many people. And so if you have a patient coming in the chair and it has an issue, they say I'm on Xeralto. Well, you can ask real quickly, why are you on Xeralto? I had a clot 10 years ago. my gosh. Well, yeah, we're pretty good to go. Then I'm not worried. We're only removing one tooth or we're just doing a cavity or a cleaning. Something like that. Shouldn't be an issue whatsoever because there's experts in the dental. ⁓   in the dental society, the ADA guidelines that recommend three teeth or less, minimally invasive. They really recommend if it's gonna be really high bleeding risk. And clinically, that's where you would come in, ⁓ or yourself. know, apioectomy is one that's like on the fence line. I don't know where implants set. though, and like we were talking, implants aren't usually like a date of procedure. Most people aren't popping in, having tooth pain, and we're like, let's do an implant. Now sometimes that can be the case, but typically that one's gonna have   a few other pieces involved. And so that is where you can get a clearance if you want to. ⁓ But we were really looking at this of like so many dentists that I know that you've seen will just send in these clearances because they are. And I think maybe a way to help dentists have more confidence is because you know, I love routines. I love to not have to remember things. So why don't we throw it in, have the team member set it up where every quarter we just double check the ADA guidelines. Are there any updates? Are there any other things that we need to do on that? That way you can just see like   getting into the language of this, of what do I need to do? Because honestly, you guys, know pharmacy was not a big portion for it, so, recommending different parts, but I think this is such a space where you can have confidence, and there's a few other things I wanna get to, and I you- I some pearls too. Okay, go. I'm so when she get me into talking about drugs, I'm not gonna stop. So, some other things around that too is these newer blood thinners like Xarelto Eloquist, they now have reversal agents, so a lot of providers in the past were really worried about bleeding because we can't turn it off. We can turn those off. Warfarin has reversal as well, right?   So I'm looking at these patients. It's really low risk. It's in the mouth, generally speaking. Very rarely are they a high bleeding risk. Now if you're doing maxillofacial surgery, this does not apply, right? This does not apply whatsoever. you're like general dentist, you're pediatric dentist. Yeah, yeah, and it's kind of on the fly. So just trying to really help you to be able to take care of those patients on the moment, have that confidence, look at the ADA guidelines, have that in front of you. I don't think it's a bad thing to ever...   check with their provider if you need to. If you're thinking, I feel like I should just check with the provider, I would never take that away from you. But I just want to kind of steer towards those guidelines that I have to help. But what did you want to share? No, yeah, I love that. And I think there were just a few other nuggets that we were chatting about last night that can help dentists just kind of get things passed a little bit easier. So you were mentioning that if they were named to their cardiologist, what was it? was like, who is the last? Great question. Yeah, when a patient's on a blood thinner,   It could be prescribed by the cardiologist. It could be prescribed by the family provider or could have been punted to like a vascular clinic like where I was working. It can go to any of those. And when you send that fax, right, if it goes to the cardiologist and it's supposed to go to the family care provider, like it just kind of goes, goes nowhere, right, from there. So I think it's a really good idea to find out who prescribed it last. If the patient doesn't know who prescribed their blood thinner last, you can call their pharmacy. I call pharmacies all day long.   I have noticed in the last year, they are way easier to get a hold of, which has made my job a lot easier, working on the insurance portion. So reaching out to the pharmacy, finding out who that provider is and sending it to them, because they should be able to help with that. I thought that was a good shift in verbiage that you had of asking instead of like the cardiologist, because that's who you would assume was the one. But you said like so many times you guys would take care of them, and then they go back to family practitioner, and you guys would get the clearances, but you couldn't clear because you weren't overseeing. So just asking the patient.   who prescribed their medication for them last time. That way you can send the clearance to the correct provider. then- And they might not know. You know patients, right? They're like, I don't know, my mom's or else, I don't know who gave it to me. Somebody told me I need to be on this. But at least that could be another quick thing. And then also we were talking last night about-   ⁓ What are some other things that dentists can do when like writing scripts to help them get what I think like overarching theme of everything we discussed is one how to help dentists have less I think drag through pharmacy. ⁓ Because pharmacy can take a little while and so perfect we now know the difference between anti-quag and anti-platelet. We know which medications are probably safe. We know we can check the ADA guidelines so that we were not having to do as many clearances. We also know if they're on a medication to find out and we do need a clearance.   who we can go to for the fastest, easiest result. And now, in talking about prescriptions, you had some really interesting tips that you could share with them. Yeah, so with writing prescriptions, right, pharmacies are pharmacies. So I'm not gonna say good thing or bad thing. There are challenges working with pharmacies. I'm not gonna play that down at all. ⁓ If you're writing prescriptions and having issues and kickbacks from pharmacies, there's some interesting laws around ⁓ writing prescriptions. Say that you're trying to ⁓ prescribe   augmentin, you know, 875 BID, and you tell the patient, hey, I want you to take this twice a day for seven days, and then you put quantity of seven, because you're moving fast, right? You want it for seven days, quantity of seven. Quantity would actually be 14, right? It's not that big of a deal. Anybody with common sense would say if you're taking a pill for twice a day for seven days, you need 14 tablets. But LAHA doesn't allow pharmacists to make that kind of a change, unfortunately. They have to follow what you're saying there. So you're going to get a...   An annoying callback that says, you wrote for seven tablets. I know you need 14. Is that OK? Just delays things, right? So ⁓ I really like the two letters QS. That's Q isn't queen. S isn't Sam. Yeah. It stands for quantity sufficient. So you don't have to calculate the amount of any medication that you're doing. So for me, as a pharmacist, when I was taking care of patients, I hated calculating the amount of insulin they would need for an entire month. So I would say.   Mrs. Jones needs 15, I'd say 15 units ⁓ QD daily. ⁓ And then I say QS, quantity sufficient, ⁓ 90 day supply through refills. So the pharmacy can then go calculate how much insulin that they need. I don't have to even do that. So anytime you're prescribing anything, I like that QS personally. So that lets the pharmacy use ⁓ common sense, as I like to call it, instead of giving you a call. I think that's super helpful. I also thought of one thing too.   going back to blood thinners is when it's kind of like a real quick, like they're not gonna have you stop the blood thinner at all. like you're seeing if you can stop the blood thinner for a patient, there's some instances it's just not gonna happen. And that's whenever they've been, they've had a clot or a stroke or a heart attack within the last three months. Three months. Yeah, that's kind of like the.   Because so many people are like, they had a heart thing like six years ago. And so I think a lot of my dentists that I worked with were like, we got to stop the blood thinners. But it sounds like it's within three months. Yeah, well, I'm just the time. Like this is general broad strokes. What I'm just trying to say is when you want to expect a no real quick. Got it. Right. So because benefits of stopping a blood thinner within those first three months of an event is very, very risky versus the, you know, the benefit of reducing a little bit of blood coming out of the mouth. Right. Like that's not that bad.   when somebody's had a stroke or a heart attack or pulmonary embolism, a clot in the lung, like we can't replace the lung, heart or brain very easily. We can replace blood a lot better. We've got buckets of it at most hospitals have buckets of it, right? So I'm always kind of leaning towards I'd rather replace blood than tissue at all times. So that's kind of a quick no. If they've had one those events in the last three months, we are really, really gonna watch their brain instead of getting.   root canal, right? Like really worried about them. So you'll just say no. And they could the dentist still proceed with the procedure or would you recommend like a three month wait? Or is it provider specific way the pros and cons because sometimes you need to get that tooth out. Great question. think then it's going to come into clinical. That's that's when you send in the clearance, right? Like, and it's great to reach out to the provider who's managing it for you. But I think it's kind of good to know exactly when you get a quick no quick no is going to be less than three months.   ⁓ Or when it's going to be like a kind of a typical, yeah, no problem. If it's been no greater than six months, they're on the typical anticoagulants or alto eloquence. Nothing crazy is going on for them. You're only removing two teeth. This is very, very low risk. But again, I'd urge everybody to read the ADA guidelines. That way you feel more comfortable with it. I'm not as eloquent as they do. They do a real good job. So I don't want to take any of their credit. I think they do a real good job of simplifying that and making you feel confident with providing.   more timely care for patients. Which is amazing. And Jayce, one last thing. I don't remember what it was. You were talking about the DEA and like six month rule. yeah. Let's just quickly talk about that and then we'll wrap this because this is such a fascinating thing for me last night. Yeah. So when comes to prescribing controlled substances, most providers have to have a DEA license. OK. First of all, though, what's your take on dentist prescribing controlled substances? ⁓ I don't think, you know, I worked on the insurance side of things. Right. And I look at the requirements for the   as the authorizations, what a patient, the criteria a patient needs to hit in order to qualify for certain medications. A lot of times for those controlled substances, they have pretty significant issues going on, like fibromyalgia or cancer-related pain or end-of-life care versus we don't, in all my scanning thread, I don't have a ⁓ perfect picture memory. Sure. But I don't usually see oral.   pain in there. There is some post-operative pain that can be covered for those kind of medications but I really recommend to keep those lower and in fact in a lot of our criteria it recommends you know have they tried Tylenol first, they tried, have they filled NSAIDs or are they contraindicated with the patient. So really they should be last line for patients in my two cents but there's always going to be a caveat to the rule right? Of course. comes through that has oral cancer and you're taking   like that would make sense to me. Got it, so then back to the DEA. Yeah, okay. Okay, ready. So as a provider, you should be checking the, if you're doing controlled substances, you should be checking the prescription drug monitoring program, or sometimes called the PDMP, looking to see if patients are getting ⁓ controlled substances from another provider. So it's really just a check and balance to make sure that they're not going from provider to provider to getting too many narcotics and causing self harm or harm to others.   And so with checking that PDMP before prescribing, I think a lot of providers do that. A lot of softwares that I'm aware of, EMRs, electronic medical records, sometimes have links so that you can do that more quickly. However, I don't think it's as intuitive that they need to be checking that every six months in some states. And like here in Nevada, you're supposed to be checking it every six months, not for a patient, but for your actual DEA registration to see if anybody else is prescribing underneath you. Because if you don't check that every six months, you could get in some serious trouble with...   not only DEA, but even more the Board of Pharmacy and your state. Now, I don't know all 50 states, so I check with your state to see if you need to be checking that every six months, but set an alarm just to check that real quickly, keep your nose clean. ⁓ I've had providers, I've had to remind to do that. And if somebody was using your account, prescribing narcotics, you'd never know unless you went and checked that PDMP.   Yeah, I remember last night you were like, and if that was you, I would not want to be you. The Board of Pharmacy is going to be real excited to find you. So that was something where I was like, got it. So, and we all know I'm big on let's make it easy. And Jason, I love that you love this so much and you just brought so much value today. And like also for me, it's just fun to podcast. fun. Yeah. But I got a nerd out on my world a little bit. Bring it into yours. I work with dentists or at least you know, when I was working in Vascular Clinic all day long. Great questions that would come through. Yeah.   So I think for all of us, as a recap on this is number one, I think setting yourself ⁓ some cadences. So maybe every quarter we check our ADA guidelines and we check our, what is it, PDMP. PDMP. so each state, so they call it Prescription Drug Monitoring Program. We need that. Yeah, but there are different acronyms in different states, though. That's just what it's called in Nevada. I forget what it is in California, but you can check your state's prescription monitoring program, make sure that opioids aren't being prescribed under your name. Got it. So we just set that as a cadence.   We know one to three teeth most likely if they're on a blood thinner is According to the 88 as of today is good to go You know things that are going to get a quick know are going to be within the last three months of the stroke the heart attack or the Clot I'm thinking like the pulmonary embolus. Yeah, that's what we're trying to prevent   Those are gonna be quick knows and then if we're prescribing, let's do QS. We've got quantity is sufficient so that we're not getting phone calls back on those medications that we are. And then on narcotics, just being a bit more cautious. Of course, this is provider specific and in no way, or form did Jason come on here to tell you you are the clinical expert.   Jason's the clinical expert on medications. And if you guys ever have questions, I know Jason, you geek out and you want to talk to people so that anyone wants to chat shop. Be sure to reach out and we'll be able to connect you in. we've even talked about possibly, so let me know listeners. You can email in Hello@TheDentalATeam.com of ask a pharmacist anything. I talked to Jason. I was like,   We'll just have them like send in questions and maybe get you back on the podcast or we do a webinar. But any last thoughts, Jace, you've got of pharmacy and dentistry as we as we wrap up today? No, I think that's pretty much it. So check the ADA guidelines. I think it's really good to have cross communication between professions. Right. If you're working with the pharmacy, CVS, Walgreens or something like that or Walmart, I know that it can be challenging. Right. They're under different pressures. You're under different pressure. So I think ⁓ just coming in with an understanding, not being angry at each other.   you know what mean, is super beneficial and working together. When it comes to it, every dentist that I've talked to is actually worried about their patient. Every pharmacist that I've worked with is really worried about the patient as well. So we're trying to accomplish the same thing, but we have different rules and our hands are bound in different ways that annoy each other, right? Like I know Dr. Jones, want 14 tablets, but you said seven. And I know Common Sense says I should give them 14, but I've got to make that change.   knowing that their hands are tied by the law. They can't use as much common sense, which is aggravating. I mean, that's why I love what I gotta do here. I gotta just kind of help a lot more and use common sense and improve patient care. But those kinds of things I think are really beneficial as you work together and then not being so afraid of blood thinners, right? So I think those guidelines do a great job of giving you confidence and not worrying about the side effects. And there's a lot of things that you can do locally for bleeding.   You have a lot of control over that. I think that's pretty cool, the tools they have. Yeah. And at the end of the day, yes, you are the clinician. You are the one who is responsible for this. so obviously, chat, but I think collaborating, talking to other pharmacists, talking to them in your state, finding out what are the state laws, things like that I think can be really beneficial just to give you peace of mind and confidence. And again, dentistry, are maybe a bit more risk adverse because luckily we don't have patients dying That's great thing. Yeah, that's fantastic. I want my dentists to be risk adverse. I think so too. But Jason, I appreciate you being on the podcast today.   And for all of you listening, ⁓ more confidence, more clarity, more streamline to be able to serve and help our patients better. if we can help you in any way or you've got more questions, reach out Hello@TheDentalATeam.com. And as always, thanks for listening. I'll catch you next time on the Dental A Team podcast.  

In this conversation, Awab Abdel-Jalil discusses the evolution and significance of the constructional approach in behavior analysis. Awab Abdel-Jalil is the Associate Vice President of Applied Research at Upstate Caring Partners in Utica, NY, and a doctoral candidate at Endicott College under the mentorship of Dr. Joe Layng. He emphasizes the importance of understanding historical context, the role of ascent in learning, and the scrutiny faced by ABA, which can lead to positive changes. Awab shares his personal journey into the field, the influence of mentorship, and the legacy of Israel Gold Diamond. He also addresses common misunderstandings of nonlinear contingency analysis and highlights the growing resources available for practitioners. The conversation concludes with insights into future directions in constructional therapy and the importance of harnessing negative reinforcers in practice. Continuing Education Credits (https://www.cbiconsultants.com/shop) BACB: 1.5 Learning IBAO:  1.5 ABA Topics QABA: 1.5 General CBA/CPD:    1.5 Learning   Follow us! Instagram: https://www.instagram.com/behaviourspeak/ LinkedIn:  https://www.linkedin.com/in/behaviourspeak/ Contact LinkedIn: https://www.linkedin.com/in/awab-abdel-jalil-64541a196/ Upstate Caring Partners: https://www.upstatecp.org/ The Institute for Applied Behavior Science at Endicott College https://www.endicott.edu/academics/schools/institute-for-applied-behavioral-science   Links: The Constructional Approach Website https://theconstructionalapproach.com/ The Constructional Approach Facebook Group https://www.facebook.com/groups/700952357829957 Claire St. Peter on The Behavioral Observations Podcast https://open.spotify.com/episode/5NLz4wfAT9paQfzvut11K1 Articles and Books Discussed Abdel-Jalil, A., Linnehan, A. M., Yeich, R., Hetzel, K., Amey, J., & Klick, S. (2023). Can there be compassion without assent? A nonlinear constructional approach. Behavior Analysis in Practice, 1-12. https://doi.org/10.1007/s40617-023-00850-9  Goldiamond, I. (2002). Toward a constructional approach to social problems: Ethical and constitutional issues raised by Applied Behavior Analysis. Behavior and Social Issues, 11(2), 108-197. https://doi.org/10.5210/bsi.v11i2.92 (Original work published in 1974). Goldiamond, I. (1984). Training parents and ethicists in nonlinear behavior analysis. In R. F. Dangel & R. A. Polster (Eds.), Parent training: Foundations of research and practice (pp. 504–546). Guilford.   Layng, T. V. J., & Abdel-Jalil, A. (2022). Toward a constructional exposure therapy. Advances in Cognitive Therapy, Fall, 8–11. https://www.researchgate.net/publication/373767631_TOWARD_A_CONSTRUCTIONAL_EXPOSURE_THERAPY Layng, T. V. J., Andronis, P. T., Codd III, R. T., & Abdel-Jalil, A. (2022). Nonlinear contingency analysis: Going beyond cognition and behavior in clinical practice. Routledge.  Liden, T. A., & Rosales-Ruiz, J. (2024a). Constructional parent coaching: A collaborative approach to improve the lives of parents of children with autism. Behavior Analysis in Practice. https://doi.org/10.1007/s40617-024-00944-y Linnehan, A. M., Abdel-Jalil, A., Klick, S., Amey, J., Yeich, R., & Hetzel, K. (2023). Foundations of preemptive compassion: A behavioral concept analysis of compulsion, consent, and assent. Behavior Analysis in Practice. https://doi.org/10.1007/s40617-023-00890-1  Scallan, C. M., & Rosales-Ruiz, J. (2023). The constructional approach: A compassionate approach to behavior change. Behavior Analysis in Practice. https://doi.org/10.1007/s40617-023-00811-2   Wilder, D. A., Ingram, G., & Hodges, A. C. (2021). Evaluation of shoe inserts to reduce toe walking in young children with autism. Behavioral Interventions, 37(3), 754–765. https://doi.org/10.1002/bin.1860   Books coming this summer:  Nonlinear Contingency Analysis: Going Beyond Cognition and Behavior in Clinical Practice. Second Edition.  Layng, T. V. J., Andronis, P. T., Codd III, R. T., & Abdel-Jalil, A. Applications in Nonlinear Contingency Analysis.  Abdel-Jalil, A., & Linnehan, A. (Editors)  

Please support this podcast by pressing the follow button and support Chinmaya Mission Mumbai projects taken up by Swami Swatmananda, through generous donations. Contribution by Indians in INR can be made online using this link: https://bit.ly/gdswatmanDonors outside India who would like to offer any Gurudakshina/donation can send an email to enquiry@chinmayamissionmumbai.com with a cc to sswatmananda@gmail.com to get further details.These podcasts @ChinmayaShivam are also available on Spotify, Apple iTunes, Apple Podcasts, Podomatic, Amazon music and Google PodcastFB page: https://www.facebook.com/ChinmayaShivampageInsta: https://instagram.com/chinmayashivam?igshid=1twbki0v3vomtTwitter: https://twitter.com/chinmayashivamBlog: https://notesnmusings.blogspot.comLinkedIN: www.linkedin.com/in/swatmananda

Get ready for a massive week in the world of cricket! In this episode, we dive deep into the upcoming 3rd Ashes Test at the Adelaide Oval, exploring the crucial matchups and who needs to step up to keep the series alive. With Australia currently leading the Ashes 2025/26 series, the pressure is mounting on England's key players. Our experts break down the pitch conditions, team changes, and provide their bold predictions for the decisive day/night Test match. The action isn't just Down Under; it's also about to explode at the IPL auction! The podcast shifts gears to preview the highly anticipated IPL 2026 mini-auction in Abu Dhabi. Is Australian all-rounder Cameron Green really set to break all previous auction records and surpass Rishabh Pant's massive INR 27 crore bid? We analyze which franchises have the biggest war chests, the key players available for bidding, and predict where the biggest surprises might land. Tune in for expert analysis on the Ashes, IPL news, and all the T20 buzz you need! Want to create live streams like this? Check out StreamYard: https://streamyard.com/pal/d/6313687373840384 Learn more about your ad choices. Visit podcastchoices.com/adchoices

Please support this podcast by pressing the follow button and support Chinmaya Mission Mumbai projects taken up by Swami Swatmananda, through generous donations. Contribution by Indians in INR can be made online using this link: https://bit.ly/gdswatmanDonors outside India who would like to offer any Gurudakshina/donation can send an email to enquiry@chinmayamissionmumbai.com with a cc to sswatmananda@gmail.com to get further details.These podcasts @ChinmayaShivam are also available on Spotify, Apple iTunes, Apple Podcasts, Podomatic, Amazon music and Google PodcastFB page: https://www.facebook.com/ChinmayaShivampageInsta: https://instagram.com/chinmayashivam?igshid=1twbki0v3vomtTwitter: https://twitter.com/chinmayashivamBlog: https://notesnmusings.blogspot.comLinkedIN: www.linkedin.com/in/swatmananda

La Mesa - Jueves 04.12.2025 - Negro compareció en Diputados por atentados a Fiscal Ferrero e INR by En Perspectiva

(Seminarhaus Engl) Der mittlere Weg vermittelt zwischen Extremen. Dadurch entstehen Räumen, in denen wir uns bewegen können, flexibel reagieren können. Das Gleiche gilt für die Übung der Brahmavihara durch die wir unser Herz weit für alle Wesen öffnen. Achtsamkeit öffnet Raum indem sie allen Erfahrungen gleichermaßen ohne Werten begegnet und sein lässt. Weisheit kann dann unheilsames aus den Raum heraustragen und heilsames hineinbringen. In Räumen können wir uns entwickeln, verändern, wie können sie gestalten. Räume ermöglichen, dass wir uns weiten können, atmen können, frei fühlen können, wohin die Fesseln des Anhaftens uns limitieren und beschränken. In diesen Räumen können sich Freude, Kreativität, Spontanität entfalten.

(Seminarhaus Engl) Der mittlere Weg vermittelt zwischen Extremen. Dadurch entstehen Räumen, in denen wir uns bewegen können, flexibel reagieren können. Das Gleiche gilt für die Übung der Brahmavihara durch die wir unser Herz weit für alle Wesen öffnen. Achtsamkeit öffnet Raum indem sie allen Erfahrungen gleichermaßen ohne Werten begegnet und sein lässt. Weisheit kann dann unheilsames aus den Raum heraustragen und heilsames hineinbringen. In Räumen können wir uns entwickeln, verändern, wie können sie gestalten. Räume ermöglichen, dass wir uns weiten können, atmen können, frei fühlen können, wohin die Fesseln des Anhaftens uns limitieren und beschränken. In diesen Räumen können sich Freude, Kreativität, Spontanität entfalten.

Contributors: Travis Barlock MD, Jeffrey Olson MS4 Feel free to use the cases below for your own practice. All of the scenarios are completely made up and designed to hit several teaching points. Case 1 25 M, presents to the ED with chest pain. Stabbing, started a few hours ago, substernal. Thinks it is GERD. After 2-3 minutes, pain worsens and radiates to the back. VS: BP 125/50 (Right arm 190/110). HR 120. RR of 18. Sat 98% on RA. Additional VS: Temp of 37.2, height of 6'5”, BMI of 18. PMH: None, doesn't see a doctor. Meds: None FH: Weird heart thing (Mitral Valve Prolapse), weird lung thing (spontaneous pneumothorax), tall family members with long fingers and toes Physical Exam: Cards: Diastolic decrescendo at the RUSB, diminished S2. UE pulses are asymmetric, LE pulses are asymmetric, carotid pulses are asymmetric, BP is asymmetric MSK: Knees, elbows, and wrists are hypermobile. Imaging: CXR #1 normal, #2 widened mediastinum (no read yet but shows widened mediastinum), POCUS shows small effusion CTA/MRA doesn't come back until after the case.  ECG: Sinus Tach Labs: NT-proBNP 500 pg/mL D-Dimer: 7000 ng/L CBC: Hemoglobin: 13.5 g/dL, WBC: 20,000/µL, Platelets: 250,000/µL Chem 7: Na 138, K, 5.7, Cl 102, Bicarb 17, BUN 45, Creatinine: 3.5 mg/dL, Glucose: 180 LFTs: Albumin 2.4, Total protein 5.5, ALP: 140, AST: 3500, ALT: 2800, TBili: 3.2, DirectBili: 2.4, Ca: 7.8 LDH: 2200 PT: 20.5, INR: 2.2, Fibrinogen: 170 5th gen High-Sensitivity Troponin:

*****To sign up and get started with GlintPay, go to glintpay.com and make sure to use the code SNIDER.*****The dollar is surging again. And while it's primary the euro taking the other side, just as importantly, if not more importantly, currencies like the rupee are tanking worse. INR hit another record low and that along with the euro's sharp reverse is a canary singing in the eurodollar coalmine...perhaps gasping. Eurodollar University's Money & Macro Analysishttps://www.eurodollar.universityTwitter: https://twitter.com/JeffSnider_EDU