Podcasts about iob

We're celebrating a major milestone with the return of our very first guests: Kristen Mackey, Director of Arizona Combined, and Natasha Jerde, Director of Minnesota Blind. As Vocational Rehabilitation leaders navigate rising demands, shifting funding, and major structural change, Kristen and Natasha join us again to reflect on the post-pandemic landscape—and how it's testing directors like never before. From managing centralized services to sustaining staffing under fiscal strain, they share the real-world challenges that keep them up at night—and the strategies they're using to adapt. With transparency, persistence, and a mission-first mindset, these leaders dive into: ·       Navigating state and federal priorities ·       Responding to workforce volatility ·       Staying connected to data and purpose Their insights are a must-listen for anyone leading in today's VR environment. Tune in and be inspired to lead with clarity and resilience.   Listen Here   Full Transcript:   Natasha: Our program income is significantly dropping. The inflation, the cost of services. We've had four and a half and 5.5% salary increases with no additional state appropriations. So all of these things together keep me up every single night.   Kristen: We want job placements, we want employment, we want independence. If somebody's saying increase your job placements, fine, we can do that. It's how do we then take what they're giving us and make it not be a distraction, and we can mold to the thing that they want, but still do it at the base level.   {Music} Intro Voice: Manager Minute brought to you by the VRTAC for Quality Management, Conversations powered by VR, one manager at a time, one minute at a time. Here is your host Carol Pankow.   Carol: Well, welcome to the manager minute. Joining me in the studio today is Kristen Mackey, director of Arizona Combined, and Natasha Jurdi, director of Minnesota Blinds. So how are things going in Minnesota, Natasha?   Natasha: I think the Minnesota word for today is going to be interesting. It's interesting. How about I leave it at that and I'll talk a little bit more as we dive into the questions.   Carol: Awesome. That is interesting. I want to know about that. How about you Kristen? How's it going in Arizona?   Kristen: You know what? I think I might steal Natasha's word. There's so much happening. We're trying to keep managing and keep abreast of all of the changes that come out on the news and everywhere, trying to keep centered and just keep doing what we do to get the work done. It's been a lot of fun.   Carol: Well, I couldn't think of two better people to bring on because this is super exciting. This is actually our 50th episode of The Manager Minute, and I couldn't think of a better way to celebrate the milestone than by bringing back my two incredible guests from episode number one in May four years ago. It's so crazy. And back then I just laughed. We were diving into the world of post-pandemic VR. What's it gonna look like? How are we going to navigate all these changes? You guys were working on things like electronic signatures and how you equipped your staff, you know, to work remotely and all of that. So a lot has changed since those early days, and I'm excited to catch up with you both to see how far that you've all come. So just reflecting back to my time as a director, I remember many a sleepless night and Natasha can attest to that. I remember coming to a meeting like, I don't sleep at night and I keep a pad of paper by my bed. And it was so funny. I heard a director tell me they did the same thing. This was a month or so ago. They were like, you know, I keep this pad of paper by my bed because, you know, we were worried about so many things. There was WIOA implementation back then, and we had a less than stellar monitoring report and a financial picture that was super tough and it just wasn't very pretty. And so I kept that notepad because in the middle of the night was always my best thinking I'd wake up, I'm like, oh, I gotta write this down. And so I can remember in the morning. So I know now, four years later, from talking to you all last on the podcast, the pendulum has certainly swung in a new direction, and I'm really eager to see how things have evolved for the both of you. You know, like what's changed, what's stayed the same, and what lessons have you learned? So let's dive in. So, Natasha, will you kick us off and just give our listeners a little snapshot about yourself and the agency that you lead?   Natasha: Sure. So I have worked at State services for the blind since I was a baby intern 2008. I have been a deaf blind counselor, a supervisor, the director of our policy and program administration, and I became the director in August 2019. Our agency, we have about 140 staff across the state. We have a Voc Rehab program, an older blind program, our Randolph-sheppard program. But we also have a communication center where we do braille audio transcription and have a radio reading service. So we have a little bit of everything at State Services for the blind. We've grown a bit since 2019. Yeah, there's a lot of fun.   Carol: It is a lot of fun. Blind agencies are always near and dear to my heart. And since I came from Minnesota blind, Natasha knows that I just love that whole variety and all of the work. It's so fun. Kristen, how about you give our listeners a little snapshot about yourself and the agency that you lead?   Kristen: Sure. Similar to Natasha, I started as a VR counselor in the field transition. That was my first job in first entrance into VR. I moved into policy manager policy and then became the director of the Arizona Combined Unit in 2016. Arizona is combined and we are also under a safety net agency. All of the VR, IL OIB, BEP is in a division. That division is in a department. So our DSA is really rather large and we are kind of shuffled 3 or 4 deep down. So we have enterprise services, shared services, which makes things a little bit more difficult to manage than it was when I started the job, when we didn't have some of those other items. So it's been a learning lesson and trying to figure out how do we get done what we need to get done with all these people involved now.   Carol: Yeah, your structure makes me nuts. I'm just saying, full disclosure, but having gone on site with you and your team several times, I'm like, what? You have to always explain. We had DIRs and we have this other thing and all these different levels. I'm like, oh my Lord, I just don't even know how you do it. So I know there's been a lot of big changes since we spoke last, so I'm going to kick it to you first. Natasha, what are some of the biggest changes you've seen in your program since we last spoke?   Natasha: I was actually talking to one of my outreach coordinators, Lisa Larges, and she's like, I think you brought some bad juju because the timing when I started and then everything that happened since I started has just been wild. So since we last met, I've experienced a global pandemic, a civil rights movement that essentially started literally down the street and around the corner from our headquarters. A roller coaster ride of funding at both the federal and state level. We went from having too much to now we don't have enough. We have a new federal administration with very different priorities than we have seen before. We have settled into this new hybrid work, which isn't new anymore. It's kind of our new normal. It's just been, I think you name it, it has changed or it's different or it feels different or it looks different. I think the biggest question right now that we're all faced with is, in light of all of these changes and challenges and opportunities, how do we maintain the integrity of the program, continue to provide high quality services that get people into competitive careers and retain the staff that we have worked so hard to get. While these past few years that's been a focus of a lot of our agencies is how do we recruit? And now with everything happening, is all of that recruitment efforts going to go to waste?   Carol: You know what's kind of funny when you talk about that? Because I look back to when I started at SSB, you know, and so in 2013 I become director. You go at the very end of the year, I was the interim and then made permanent in 14. And you just go, okay, I thought I brought bad juju with me to because WIOA went into play and then we had all this wacky stuff going on. We owed all this money for the case management system. So now, you know, just hearing you, it's like, well, maybe it's just the cycle of the program. Like there is no spot in time where everything is ever just copacetic and all smooth sailing. I think it just continues on.   Kristen: I think that I really feel like that's so good to remember because I think you can in this position, you can take a lot of things like, oh my gosh, am I not doing this right? What skills don't I have? How am I not doing this, that or the other. And it just is a constant. Like it just changes constant. And you have to constantly readjust your focus and your priorities and your strategy. And so it's helpful to remember that our environment is constantly changing at state and federal level. And we just have to be able to manage and navigate and not beat ourselves up over it.   Carol: Oh, that's a super good point. Natasha's going to laugh at this, but I'm actually going to hold up so our listeners won't see it. But I still have my Strengths Finder. So we used to always do strengths Finder at SSB. I still have my top five strengths. And staff used to ask me one of them is adaptability. So my fifth strength was adaptability because people would be like, how can you just roll with the flow? Like you need to just tell like Central Office, we're not going to do that thing that they want for the legislative session. And I'd be like, okay, we're going to pick our battles. That is not the battle we're going to pick right now. We're going to answer the question they need, because the sooner you do that, you get that off your back and then you get back to your business and do your things. And so for me, it's easier because in me is adaptability. I've always been able to kind of go with the flow, whether administration changes or, you know, any of that, where that is more difficult for other people when you want things to be very set and it's hard for you to pivot and make that move. So, Kristen, what are some of the biggest changes you've seen in your program in the last four years?   Kristen: Wow. Well, as I indicated, the state was kind of in that move and shift to centralized services, you know, some of those shared service models. So, you know, it started with our training department and, you know, but we got to keep our policy and we got to keep our contracts and procurement. And the next thing you know, like air moves out and then, oh, we're going to move out all of your facilities management. And so slowly, piece by piece, the staff that you had working with. You have been now pulled to a different reporting structure and a different requirements to do their job. And so when, you know, we used to have a staff of like 500 people that were fully dedicated on board, directly connected with me, I had direct relationships with them. I was able to really work with them. And over the last five years, I've seen that direct connection and relationship with people fade out because those folks are no longer in those positions. They've graduated or moved to other things. They didn't stay within the agency. So, you know, within our VR program, IOB program, BEP, those program staff super dedicated and want to really fulfill the mission of the work in serving individuals with disabilities. And then we have all of our shared service team dedicated to their job to don't necessarily have the same focus on the mission and the outcome of serving individuals with disabilities. It's been very difficult to try to figure out how to play nice with them, because they got to do stuff for you, right? I need you to manage my budgets. I need you to manage my contract. But I also, you know, don't quite like the way you're doing it or you're not doing it fast enough or you're not following my vision for how that would work. So it's just been a real challenge to see how to grow and manage the different structures that are in play now.   Carol: I think you hit the nail on the head on that with that centralization, because it's happening across the country. I mean, we see it everywhere. Every director like just struggling as your people move out from under you, whether it's the IT, the HR, the whoever you had. And now they're centralized, which Congress allows. It was written in the rehab Act, like you can structure that way. But they lose that connection to the mission and what you're trying to do. So when you're doing that work sort of in isolation of what's the end game and how you impact, you know, the staff person having their computer so they can do the work with the customer. You don't see that urgency in it. So it's like, yeah, so we get to you in two weeks, you know, really need your computer or whatever. It's just hard. It makes the job so much harder. So I know not only those changes have happened, the financial landscape is shifting drastically for the VR program. How has this impacted your ability to serve individuals? And Kristen, I'll send it your way first.   Kristen: We've been fortunate in that Arizona with the formula grant. You know, we still receive a little increases every year. So the not getting the cost of living this last year was not as impactful as it had been to some other agencies. So I do, you know, knock on wood for that a bit. Now if that continues we're going to have another, you know, constantly evolving story there. We have had to take a look at for our cases. How do we spend more money faster. And that's been again the challenge of working with shared service opportunities is, well, they don't have capacity to put these contracts in place that I need in order to be able to spend the money that we have, right? We have been successful in keeping it in the VR bucket, but now we need to spend it on our consumers and our clients. But I need a contract to do that and don't have the resources or the capacity from that team to be able to put that out the door. So it's super challenging to know that you're sitting on money that you could spend and do a lot of good things with, but there's then that external factor of not having the capacity to put all of that together to get that money spent.   Carol: So you're in actually a pretty lucky position. You know, other people listening to this podcast are going, What? Kristen Mackey, you've got all this, you've got all this money. Because almost all the calls I get on a daily basis with my list of people all going on the order of selection, I keep a little sticky note, you know, and everybody calling and just frantic. They are literally like tapped out. There is no money, but yet you're trying to spend your money and you don't have the resources to really help you get some of the plans in place.   Kristen: It is challenging, but I feel fortunate that I'm challenged on that end of the spectrum versus the end, where there's not enough money or capacity or staff resources. One of the other pieces, too, is, you know, in this current landscape, budget wise, can't bring on as many people as we would like to, you know. Can't do all of the support services that we or support staff that we would like to. So downsizing your footprint, right? All of that, those are our major expenditures. And we're asked to shrink that. It creates a really kind of a nightmare for projection and and budgets all of that.   Carol: Oh, 100%. How about you, Natasha? How's the finances looking at SSB?   Natasha: It's getting tight. It's getting tight. We were on the other side of that a few years ago. We had more money than we could spend, and we used that as an opportunity to do things that we've always wanted to do or needed to do, and we never had the funding to do it, but we always did things that we could course correct quickly on them or aren't forever. So we didn't make a lot of permanent decisions with that money because the writing was on the wall. We knew that once the pandemic shifted, we were going to see an influx in applications. Inflation was already on the wall that prices were increasing. So we made some, I think, pretty strategic and smart decisions with the money we had and how we spent it. However, it's still tight because we are getting an increase in applications. The cost of services is increasing. We ended our order of selection September 2021. I have no desire to go back there for me. I don't even want to speak it out loud. I know it's an option. I know I may need to use it one day. I can't say never, but I don't think that is the best direction for us because people need our services just as much as before, if not more. And for individuals who are blind or low vision or deaf blind, there really aren't any comparable options available, at least in Minnesota. And we're here for a very specific reason. And so I have always said it's my responsibility to ensure that we can continue doing what we are here for. That may mean that services are going to take a little bit longer to get started. We are increasing our supervisory oversight. We have a ton of financial reports, which I'll talk about in another question that have helped us get ahead of sudden spikes that we're seeing so we can do those course corrections. This also may mean that we're not backfilling or we're freezing some of those positions for a little bit that aren't essential. I'm using the term we're going to freeze, flick or fill, and every position that's our litmus test will freeze it, meaning we don't need it right now. It's not essential for service delivery. We'll revisit this. Flick means you know what? This position really isn't serving its purpose anymore. Let's figure out a different way of doing the work or fill. And we've prioritized counselors and VR techs and anyone doing direct service provision. But it's also all of this is going to force us and continues to force us to find new ways of doing things, which I don't think is a bad thing. One of the goals I've put in place this year is that all of the extra noise. You know, that can happen when you're working in a state government agency. Things that pretty much distract you from what you're supposed to be doing. My goal is we don't do those things if it doesn't stem back to our mission and actually help people get jobs or live independently, we're not going to do it. And I told that to the commissioner's office. You can ask me all day long to do all of this extra stuff, but it's not serving a purpose for us. I'm sorry. I'm not going to do it. And they've been okay with it so far.   Carol: That's awesome. Until you get a legislative request that they need you to answer in ten minutes and analyze.   Natasha: Yeah, I can't say no to those. Yeah, all these extra work groups and task forces and let's do this and that. We got other things we gotta do.   Carol: So what's the biggest thing, Natasha, that's keeping you up at night right now? Because I know there's always something, something is niggling somewhere. What would you say is the biggest thing keeping you up at night?   Natasha: Well, I have a few, but the biggest one is that. So we're not a combined agency. We have a separate general agency and that separate general agency is an incredibly tight budgetary situation. I would go so far as to say they're in a budgetary crisis, and because match maintenance of effort and carry forward determinations are at the state level, not agency, it is very possible that their constraints will impact our funding. And specifically I am very worried are Carryforward is in jeopardy. And we had a scare where we had a very high chance of losing all of our carryforward this last end of the federal fiscal year. Because of those budgetary constraints, the general agency is doing workforce reductions and doing layoffs, and they have the same type of staff classifications that we do. And we are a union state, which means bumping, which means my staff are in jeopardy. And so I'm up every night between 2 and 3 a.m. thinking of ways that we can help in any way possible. Our program income is significantly dropping. I think I've heard other states experience something similar. The inflation, the cost of services. We've had four and a half and 5.5% salary increases with no additional state appropriations. So all of these things together keep me up every single night trying to figure out how do we sustain.   Carol: Now they're going to keep me up at night, too, because of course, I worry about you all. And of course, I really worry about SSB. So I always hold that near and dear to my heart. But oh man, that is a lot. But I know you instituted some things, though, between you and the general agency, just to make sure you guys were communicating better about those financial reports and such, didn't you? Like, what did you do?   Natasha: We have an amazing relationship. We review our federal reports together. I sat closely with the VA's fiscal team, walking through what I know about the fiscal processes, the federal regulations. That's something that Carol taught me very well. I understand it quite well. So we worked hand in hand. We've been doing that since October.   Carol: That's good. Good stuff. How about you, Kristen? What's keeping you up at night?   Kristen: We had a recent monitoring that monitoring. We get through it, Right? And, you know, you haven't always have an inkling of things that need to be fixed and things that we should address, right? And sometimes those get shuffled because priority is whatever. So we had the monitoring very much highlighted certain areas that we need to address and take care of. And one of those was our fiscal management and continue as managed outside of my direct staff and even two and three layers above me. So it's one of those concerns of like, I wonder what's going to happen next. I never quite know what the fiscal situation is going to be. Emails flying around, you know, I'll get an email at the end of the day and it's I need more information. What is this about? How did you come to this conclusion? Who was involved in making this decision? It's kind of just a plethora of items that, you know, any given night, and mine is usually between 3 and 4. Like, oh, wake up and go like, oh, shoot, that sticky note fell off the roster somewhere. I need to go and send that email or this project. We started it, but now it's like kind of hanging, languishing. I need to poke somebody about getting that back on the roll again. I don't know that it's one specific thing, but it's just kind of just the size of the job is not a 40 hour a week job. It is a all encompassing. I dream about work. I it wakes me up at night, you know.   Carol: Well, my newest trick with not having my notepad beside my bed, but I actually been waking up more just because I've had so many more phone calls. Things have been really crazy lately with our fiscal team and people just reaching out. And so maybe end of the day or, you know, people's time change, you could get a call from Guam. You know, it's a way different time. So people are calling all the time. So now at night when I wake up, I text myself, you know, a note like, just so I remember, like remember to get back to so and so tomorrow. So now I just am picking up my phone. I don't have the pad there anymore, but I had two messages from last night for today that I didn't want to forget.   Kristen: I sent texts because I don't put my work phone by my side, but I have my personal. So my work cell phone is embedded in my personal and I just send text to myself.   Carol: Yeah, my work and my personal are all together, so it makes it a little challenging. So I know we're going through an administration change on the federal level right now. And a lot of state administration, you know, that changes every four years to with governors, sometimes you keep a governor twice in a row, but a lot of times not. And it will bring these shifts in priorities and just all of this change. How do you guys navigate and adapt to those changes, whether it's on the state level or federal level, when you're approaching your work? And I'm going to kick that to you, Natasha, first.   Natasha: I think the biggest thing, at least for us, has been a lot of communication and transparency, not only with our staff, but our customers, our community partners and stakeholders in the face of unknowns. People look to steadiness and information even if you don't have a lot to share. The absence of information often speaks very loudly, and people will fill in the blanks, sometimes not in a way you want them to. So we are communicating frequently, even if we don't have information. People look to me, am I panicked or am I calm? And know if I am panicked, it will not be good. People feed off of that and so I am always calm. I am always just. I can't guarantee or promise anything, but I can say we're in this together and I remind everyone why we're here. We have a mission. As Carol knows, the mission is on the wall. We look at it frequently and nothing has changed. No matter what happens federally or at the state level, that mission has not changed. We have proved that during a global pandemic. VR agencies are adaptable, creative for us in Minnesota, SSB was one of the first agencies, if not the first, allowed to go back into people's homes and provide services. That's because we know how to do things quickly and strategically to respond to whatever comes our way. We don't wait for people to tell us what to do or how to do it. We take charge and we lead the way. And I feel that is how VR is across the country. We tend to be leaders in faces of crisis and urgency. We tend to step up when others don't.   Carol: Yeah, good advice. That's all good advice. Kristen, how about you? Because you've had major shifts. I mean, you've already alluded to this, this whole like take away your people. And that's been all shifts in the structure within the state government and such. You know we've got the federal different priorities. So how do you navigate and adapt to those changes in your work and for yourself, even, like how are you taking care of yourself through all this.   Kristen: Being able to adapt the work that we do? Natasha says that we have a mission. We have a very clear outcome that we have whatever side, whoever's telling you what they want to do or how they want to do it. You need to be able to mold what that strategy looks like so you can speak to it. And I always talk about it. It's a spin. I don't like the terminology of spinning, you know, for the sake of trying to hoodwink anybody or not be transparent. But at the end of the day, we want job placements, we want employment, we want independence. So if somebody's saying increase your job placements, fine, that we can do that. It's how do we then take what they're giving us and make it not be a distraction and we can mold, you know, whatever we're measuring to the thing that they want, but still do what we are doing at the base level. And so I do feel like that's really part of our job as leaders is to and Natasha spoke to this earlier is take that noise and then see how we can like get it to stop with us and push it back in a way that still supports the work we're doing, whatever comes to us in terms of work group where you need to measure this, or we want some kind of change in X, Y, or Z. Okay. I can give you this back that will meet your needs. And it doesn't change or distract from what I'm doing in our department or in our programs. I think it's just being flexible in your thinking, being able to not have to have a certain way of approaching things, because you got to understand what that landscape is. You got to speak the words that they're speaking in order to get them to listen to you and kind of play with you so that we can all get to the same end goal.   Carol: One thing I've seen from you, Kristen, just working with you these past years in my TA capacity is I'm like, I love your persistence because you've had to navigate this really tough, internal, weird structure. It just is weird. And you are super persistent in messaging. Okay. Like you send a message to this person, oh, I'm not the person. Okay, then who is the person? Okay, I'm going to go to this person and you will not let it go till you find till the end the little trail of crumbs you get to and you're like, all right, I'm finally getting to the person because I have to get this thing answered. Some people just give up. They're like, oh, I don't know. And then staff ask and you're like, well, I don't know. We don't know who's doing what. Oh not you, you. You don't let that happen.   Kristen: That is one piece of advice I give to people when they come on. This is a state government, federal government, there are all sorts of red tape, barriers, hoops. Everything will get in your way if you let it. You're going to have to be persistent. Don't get jaded with it. Don't give up. Just know that you're going to have to be persistent with getting to the thing that you want to get done.   Carol: So switching a little bit. There's a lot of different structures in hiring VR agency leaders. I mean, you can be a political appointee. You can be more of a career professional where maybe you have some protections, maybe it's not a full blown union, but you got something. And we've had 14 new directors in the last less than ten months. Again, 14 new directors in VR. You know, people don't always realize like, how does that and each of you represents a different bucket here. How does that distinction, whether you're a political appointee or you have a little more protection influence your agency. Kind of how you approach the operations and your decision making. And I'll ask you first, Natasha.   Natasha: I am a career professional. I'm the highest level you can go before you start hitting the politically appointed positions. So that means I get the privilege of bringing some stability to the agency. Granted, that doesn't mean I can't get fired or laid off, but I am not politically appointed. So when the administration changes, I don't change with it. So that means staff can expect some consistency, and they don't have to wonder who's going to be coming in now to shake things up with their own ideas and views. They know what my priorities and goals are. They know how I work and they know what to expect. And so I have the luxury of time to create a culture that will sustain anything that comes our way. I have the time to develop that succession plan, offer professional development and mentorship opportunities. But when I was thinking of this, I can see the value of Having fresh new faces, coming in with different perspectives and experiences, and that they may have a better idea for how we do things. You know, we talk about people who have been in the position for 30, 40 years. Is there some value to having that new life coming into an agency? So I recognize that being a career professional could also be a limitation of mine, which means that I really need to surround myself with people who think differently from me, and I can't get stagnant.   Carol: Yeah, that's a really good point. Although there are very few 30 year or 40 year career leaders in the VR program anymore, I think we got Diane Delmas out in Vermont and Greg Trapp, those are the two I always think of. Otherwise, boy, people have been coming and going pretty fast, but that is good advice because you can get a little stuck. Now, Kristen, you're on the other end of the spectrum because you are a political appointee.   Kristen: I am not a political appointee, but I am an at will employee.   Carol: Oh, you're an at will though.   Kristen: Yeah,.   Carol: So it's very similar. So you're an at will person, does that impact you at all, like in decision making or as you go about doing your job?   Kristen: Well, certainly. You think, you know, is this decision going to make me the scapegoat for something that goes south, right? So, you know, it does impact my thinking. I don't let it impact whether it's right or wrong. To do that is just my base. You know, you just have to have that gut kind of commitment to. This is what I said. It's the truth. I don't have any qualms about how I do the work or the transparency that I have in the work that I do. So keeping it all above board, hope that that serves you in the end. Natasha, you had a very positive outlook on new people coming in. In my tenure, I've experienced a lot of changes in different people at different levels coming in and not having any idea about the rehabilitation programs that we run. And so it is a kind of a continuing education of individuals who are coming and going to have them see the value of the programs and the way that they need to operate.   Carol: Yeah, I appreciate that. So let's look a little bit at kind of leveraging both of you like this leveraging your data. And we're kind of skipping around a little bit here. But how do you guys like to leverage data to inform your financial and programmatic decisions? Now remember we've got a lot of new directors. We have listeners out there that are they don't know we I get this question all the time. You know, we talk about data informed decision making. People are like, yeah, we talk about it, but what does that mean? And how do you really do it in practicality? So Kristen, what would you say do you have like an example or how do you like to best leverage data when you're looking at making decisions, whether programmatically or financially?   Kristen: Just because I have a little bit more programmatic data that I have access to and ability to manipulate, we really look at that in terms of, you know, when we're setting our annual strategic goals, what is our five year goal? Take a look at what have the last three years look like. You know what the percentage of increase or decrease is? How are we adjusting those things? Use the data to understand where are the gaps, what's not working, and something we expected the needle to move and it didn't. What's not working in that process. And so you know, what lever do we pull to say this is going to be quote unquote a countermeasure for that thing, and then measure that data over the next three, six months. And if there's a change, then we can kind of understand then did that work or didn't it work? I think far too often in our workforce we say, well, this is a problem, but we don't really have any data around it. Should we gather a ton of data for the program to being able to use that data to help inform what decisions or what changes to processes should we be making and how should we make those. And then we can track it to see did it make a difference or what difference did it make? And is it something we should replicate? Is it something we should pull back. So I really like to use our data from our program, you know, participant program data to inform our strategy on what we're going to be doing in the next 1 to 5 years.   Carol: I know before you have presented at CSAVR and showed like you had some really cool ways you were able to look at data and you did a lot of it by your region so you could start narrowing in, because you can have this tendency to go, oh, you look at the data broadly and then you're like, oh, we must have this problem everywhere. Well, you realized you had regions, you know, in your state you're like, well, why am I like spanking everybody? What we write, we need to focus over here.   Kristen: Yeah, we have those metrics. And it's a metric per counselor, per rehab tech, per purchasing specialist. That unit of counselors rolls up to the supervisor. The supervisor rolls up to the program manager. So I can drill down from a state level perspective to a region perspective. Is it a supervisor office problem? Is it a person problem? And that has really helped us understand. Also, where do we need to direct the energies and efforts in terms of making changes.   Carol: Yeah, I really like that. That was really good stuff. How about you, Natasha? What are you doing with leveraging data? Because I know that's in your wheelhouse, too.   Natasha: We actually hired within, like, the last year or so, a data analyst who is skilled in data visualization and being able to take a bunch of raw numbers and tell a story. And we have been working with her to develop not only the programmatic data, which we now have a ton of that we can look at, but also our fiscal forecasting and what's happening on a budgetary level. It is because of those reports which I am getting weekly, monthly and quarterly reports, depending on the nature that we were able to suddenly see this huge, unexpected spike in case services authorizations. Within just a month of it happening, we were able to drill in. What exactly is going on? What are the bucket items that are the red flags we were able to look at by staff member by region, and we found that our interpreters have gone up over 300%, which then led us down to, okay, what's going on with that? What's the story behind the data? We also are every week meeting as a fiscal team. So the three fiscal staff that I have and myself, we meet every single week. I am intimately involved in our federal reporting. I look at every single report that they put together before we submit our 17. We walk through it. I know where we're at with match. I know where we're at with maintenance of effort. I know exactly where our 15% set aside is, and I can tell you that every single month how we're doing and what issues we're going to be facing. And that's because we have the data. If a director never looks at data and doesn't know what's happening in their programs, they're not going to be able to spot issues. You have to know whether you're doing good or you're not doing good. You need to be able to catch those things.   Carol: Yeah. And unfortunately, you have many colleagues across the country. And I will come in and they're being told by like the DSA fiscal staff, hey, don't worry about it. We got it. And so there have been directors of programs of 150 plus million dollars, have never seen a budget report. Zero idea. So literally anything they want to do. Hey, can we send a staff to training? They're asking this group of fiscal people sitting over here because they don't even know what's in the budget. It is the most insane thing I've ever seen. So you really hit the nail on the head. Like, you have to have access and it is required in the law, in the act, in setting up the agency org structure, you have the sole responsibility over the allocation and expenditure of your funds. And how can you have that sole responsibility and not have any data that goes with it? So I preach. Natasha: I will say, data is if you have a legislative ask and you are requesting more funding, the stories are important, but they also want to see the data behind it.   Carol: 100%. And it can't be data that's changing by the day. Oops, we forgot this because I've seen people get burned on that as well. And then the legislators are going, okay, well, this data now is suspect, and I think they need a legislative audit report and review because what are they doing over there?   Kristen: From a data reporting perspective, like having historical data to the same reports they pull, they cannot keep changing the reports that you're changing the methodology of that. That was a lesson learned for us is we had to understand what data we were pulling, how were we calculating the numbers we were calculating. And now we have data since 2018, and we can tell when we've made any changes. And so then we can see what are our trends. What does that look like. How can we use that to help us predict in the future. So that was a lesson learned for me. We came in and it wasn't much in terms of data. We built some reports and then it was like, oh, but now we need to kind of be able to track, oh, well, this thing happened. And that's why maybe that spiked or dipped or we did this thing and here's the change we saw. So we were able to speak to that year over year as well.   Carol: Well super cool. So what advice would you guys have for other leaders out there? All the lessons you all have learned. We can try to read the tea leaves, like where is VR heading in the next few years? But what do you all think? Like what do you think where's VR going? And what advice would you have for other leaders? And Kristen, I'll go to you.   Kristen: I just think remain committed to the mission and the purpose of the programs that we have. we're here to serve individuals with disabilities. We'd keep that at the forefront. And, you know, I heard Natasha say to you, the mission is on the wall, right? We all have our missions. We all have our visions. Just don't let that get buried in all of the craziness that is happening and continue to be persistent. Carol mentioned the persistence. I think that is key. You don't let it drag you down. Don't let it burn you out. Just be persistent and know that all of the work that you're doing is for a good reason, good outcomes.   Carol: Good stuff. Natasha, I'm going to give you the last word.   Natasha: Don't get comfortable with how things are going right now. Speaking to what Kristen said earlier? Things will change, and probably for reasons completely outside of your control. And also remember that easy decisions aren't always the best decisions, and the best decisions aren't always the popular ones.   Carol: Well said. Very true. Well, I appreciate you both. Oh my gosh, I'm so excited to see what you all have done. You're two of my favorite directors. Don't tell the, don't tell the other directors that are listening.   Natasha: Yeah, cut that out, Jeff. Don't have that in there.   Carol: Thanks for joining me today. Sure appreciate it.   Kristen: Thank you.   Natasha: Bye.   {Music} Outro Voice: Conversations powered by VR, one manager at a time, one minute at a time, brought to you by the VR TAC for Quality Management. Catch all of our podcast episodes by subscribing on Apple Podcasts, Google Podcasts or wherever you listen to podcasts. Thanks for listening!

This is a bitesize episode of 'The insuleoin Podcast - Redefining Diabetes'. Each week we'll take a look back into the archive of episodes and get you to think and reflective once more about some of the things we've learned over the past few years. In this week's BITESIZE:You can do anything you want. IOB. Easy way to increase carb intake. To hear the full episode check out episode #170: How To Prepare Blood Sugar For Extended Cardio Sessions. Hosted on Acast. See acast.com/privacy for more information.

Scopri la Bibbia un versetto per volta con semplici commenti dell'insegnante Egidio Annunziata.LETTURA DELLA SACRA BIBBIAGenesi 46 - https://www.bible.com/it/bible...1 Israele partì con tutto quello che aveva e, giunto a Beer-Sceba, offrì sacrifici al Dio d'Isacco suo padre.2 Dio parlò a Israele in visioni notturne e disse: «Giacobbe, Giacobbe!» Ed egli rispose: «Eccomi».3 Dio disse: «Io sono Dio, il Dio di tuo padre. Non temere di scendere in Egitto, perché là ti farò diventare una grande nazione.4 Io scenderò con te in Egitto, te ne farò anche sicuramente risalire e Giuseppe ti chiuderà gli occhi».5 Allora Giacobbe partì da Beer-Sceba; e i figli d'Israele fecero salire Giacobbe loro padre, i loro bambini e le loro mogli sui carri che il faraone aveva mandati per trasportarli.6 Essi presero il loro bestiame e i beni che avevano acquisiti nel paese di Canaan e scesero in Egitto: Giacobbe con tutta la sua famiglia.7 Egli fece venire con sé in Egitto i suoi figli, i figli dei suoi figli, le sue figlie, le figlie dei suoi figli e tutta la sua famiglia.8 Questi sono i nomi dei figli d'Israele che vennero in Egitto: Giacobbe e i suoi figli. Il primogenito di Giacobbe: Ruben.9 I figli di Ruben: Chenoc, Pallu, Chesron e Carmi.10 I figli di Simeone: Iemuel, Iamin, Oad, Iachin, Soar e Saul, figlio di una Cananea.11 I figli di Levi: Gherson, Cheat e Merari.12 I figli di Giuda: Er, Onan, Sela, Perez e Zarac; ma Er e Onan morirono nel paese di Canaan; i figli di Perez furono: Chesron e Camul.13 I figli d'Issacar: Tola, Puva, Iob e Simron.14 I figli di Zabulon: Sered, Elon e Ialeel.15 Questi sono i figli che Lea partorì a Giacobbe a Paddan-Aram, oltre a Dina, figlia di lui. I suoi figli e le sue figlie erano in tutto trentatré persone.16 I figli di Gad: Sifion, Agghi, Suni, Esbon, Eri, Arodi e Areli.17 I figli di Ascer: Imna, Tisva, Tisvi, Beria e Serac loro sorella; i figli di Beria: Eber e Malchiel.18 Questi furono i figli di Zilpa che Labano aveva dato a sua figlia Lea; lei li partorì a Giacobbe: in tutto sedici persone.19 I figli di Rachele, moglie di Giacobbe: Giuseppe e Beniamino.20 A Giuseppe, nel paese d'Egitto, nacquero Manasse ed Efraim, i quali Asenat, figlia di Potifera, sacerdote di On, gli partorì.21 I figli di Beniamino: Bela, Becher, Asbel, Ghera, Naaman, Ei, Ros, Muppim, Cuppim e Ard.22 Questi sono i figli di Rachele che nacquero a Giacobbe: in tutto quattordici persone.23 I figli di Dan: Cusim.24 I figli di Neftali: Iacseel, Guni, Ieser e Sillem.25 Questi sono i figli di Bila, che Labano aveva dato a sua figlia Rachele; lei li partorì a Giacobbe: in tutto sette persone.26 Le persone che vennero con Giacobbe in Egitto, discendenti da lui, senza contare le mogli dei figli di Giacobbe, erano in tutto sessantasei.27 I figli di Giuseppe, natigli in Egitto, erano due. Il totale delle persone della famiglia di Giacobbe che vennero in Egitto era di settanta.Salmi 34 - https://www.bible.com/it/bible...Episodio: Genesi 46Conduttore: Egidio AnnunziataLuogo: Nocera Inferiore, Salerno - ItalyEvento: Incontro domenicale della comunità Essere Un CristianoData: 05/11/2023Lingua: ItalianaProduzione: © Essere Un Cristiano 2023

Neste episódio do Contábeis News, o Diretor da IOB, André Copetti, fala sobre so aspectos fundamentais da contabilidade colaborativa.

In this weeks episode of the Compliance Files Podcast, Kathy Jacobs, former President, Compliance Institute speaks with Ann Shiels, founder of sustainable finance regulatory firm, FinLexSus and Ann is also the Program Director for the Compliance Institute's Professional Diploma in Sustainable Finance for Compliance Professionals delivered in partnership with the IOB.    In this episode, we revisit a familiar topic, and that is ESG Sustainability. There is a language and vocabulary growing up around sustainability. So in this episode, we are taking a helicopter view by doing a stock take on the regulation, and to explain some of the terms, acronyms to come to an understanding of the current position, and we  explore what a Compliance Framework for sustainability look like. Since the podcast was recorded, the CSDDD has been endorsed by the European Council in March 2024.

In this weeks episode of the Compliance Files Podcast, Kathy Jacobs, former President, Compliance Institute speaks with Ann Shiels, founder of sustainable finance regulatory firm, FinLexSus and Ann is also the Program Director for the Compliance Institute's Professional Diploma in Sustainable Finance for Compliance Professionals delivered in partnership with the IOB.  In this episode, we revisit a familiar topic, and that is ESG Sustainability. There is a language and vocabulary growing up around sustainability. So in this episode, we are taking a helicopter view by doing a stock take on the regulation, and to explain some of the terms, acronyms to come to an understanding of the current position, and we  explore what a Compliance Framework for sustainability look like. Since the podcast was recorded, the CSDDD has been endorsed by the European Council in March 2024.

The internet of bodies - or IOB - is a term that refers to the continual merging of humans and technology. It spans everything from smartwatches to chips implanted in your brain, with the promise of helping people affected by afflictions from epilepsy to paralysis. But there are risks associated with the technology. CNBC's Tom Chitty and Arjun Kharpal discuss the rapidly evolving world of IOB.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

In this week's episode of the Compliance Files Podcast, Kathy Jacobs, former President, Compliance Institute speaks with Ann Shiels, founder of sustainable finance regulatory firm, FinLexSus and Ann is also the Program Director for the Compliance Institute's Professional Diploma in Sustainable Finance for Compliance Professionals delivered in partnership with the IOB. In this episode, we revisit a familiar topic, and that is ESG / Sustainability`. There is a language and vocabulary growing up around sustainability. So in this episode, we are taking a helicopter view by doing a stocktake on the regulation, and to explain some of the terms, acronyms to come to an understanding of the current position, and we will explore what does a Compliance Framework for sustainability look like. Since the podcast was recorded, the CSDDD has been endorsed by the European Council in March 2024.

In this episode we review the numbers of the first Infinite Banking policy we bought. We have owned the policy for 18 years now so you could say it's an adult policy now. Over the years, We have paid lots of premiums on this policy and we have also used policy loans against the cash value for many things. We go over all of it in this episode, episode 463, of The Wealth Talks Podcast. Resources:  2 Ways to pay the most hated tax in America: https://www.youtube.com/watch?v=dBG9Gk8lGTw   Get a good Infinite Banking policy for yourself:  https://mcfieinsurance.com/  702-660-7000 mailto: team@mcfieinsurance.com   Follow the Wealth Talks Podcast on: Instagram: https://www.instagram.com/wealthtalkspodcast/?utm_source=ig_web_button_share_sheet&igshid=OGQ5ZDc2ODk2ZA==   Facebook: https://www.facebook.com/profile.php?id=61554798231074   Watch on YouTube: https://youtu.be/iOb_5_It0b4

An t-Urramach Seumas Maciomhair a searmonachadh air Iob 1:21-22

Show Notes: WEF 2024 New World Draconian Order, Sorcery, Magic & Mind Control Programmes and Initiatives part 1, The Matrix. ID 2030, DNA

It's been more than seven years since entrepreneur Darren Fife sat behind the IOB microphone and during that time his company Eco Source has expanded greatly. Here we talk about his humble beginnings, a major environmental accident that his team cleaned up, what he does to help educate businesses about caring for the environment and more. No matter where you are at in the nation...we think you'll enjoy this conversation.  Meet Darren Fife: Thanks for listening! The award winning Insight on Business the News Hour with Michael Libbie is the only weekday business news podcast in the Midwest. The national, regional and some local business news along with long-form business interviews can be heard Monday - Friday. You can subscribe on  PlayerFM, Podbean, iTunes, Spotify, Stitcher or TuneIn Radio. And you can catch The Business News Hour Week in Review each Sunday Noon on News/Talk 1540 KXEL. The Business News Hour is a production of Insight Advertising, Marketing & Communications. You can follow us on Twitter @IoB_NewsHour...and on Threads @Insight_On_Business.

Why Department of Energy Funded Genome Project Linked to Eugenics Inst.? We cover Eugenics Institutes projects, one is called NeuroAI, which stands for the integration of neuroscience and artificial intelligence. NeuroAI is a multidisciplinary field that aims to understand how the brain works and how to improve AI systems by incorporating biological principles and mechanisms – Brain Tissue in Ai Computers. How does this fit the fake Ai God and Fake 6G Holy Ghose. Is the DOE trying to tap into human energy with the MOTB system? The Average human body, at rest, can produce around 100 watts of power on average. This is enough electricity to power up a light bulb. Some humans have the ability to output over 2,000 watts of power, for instance if sprinting. The 3 stated goals of the DOE genome project are as follows and notice how the last one is wicked: 1. Determine the molecular mechanisms, regulatory elements, and integrated networks needed to understand genome-scale functional properties of microbes, plants, and interactive biological communities. 2. Develop -omics experimental capabilities and enabling technologies needed to achieve dynamic, systems-level understanding of organism and/or community function. 3. Develop the knowledgebase, computational infrastructure, and modeling capabilities to advance predictive understanding and manipulation of biological systems. We cover MIT saying Radio Frequencies can control objects in you and how companies can use humans as a power source for 6 G. They will use humans as antennas, by harvesting the waste energy from Visible Light Communication (VLC). VLC is a wireless version of fiberoptics, which uses light from LEDs to transmit information. - Think Graphene in the poke. Is this the DOE's goal? Nokia CEO Pekka Lundmark at the World Economic Forum in Davos said: “By then (2030), definitely the smartphone as we know it today will not anymore be the most common interface, many of these things will be built directly into our bodies” Difference of Internet of Bodies and WBAN IoB is a broad term covering networks of smart objects linked to the internet that interact with the human body. WBANs are a subset of IoB, focusing on low-power wireless communication within, on, and around the body. IoB devices use various wireless technologies like RF, Bluetooth, Wi-Fi, or cellular networks for communication. WBANs mainly employ Body Channel Communication (BCC), using harmless electrical signals through the human body for secure and efficient communication. IoB devices serve multiple functions like tracking, diagnosing, treating, enhancing, or augmenting the human body. WBAN devices primarily monitor, sense, or stimulate physiological signals like heart rate, blood pressure, temperature, or brain activity. We end with scripture and connect some Dots.

In questa puntataNews dal futurocrittografia quantistica ed RSAtelecomunicazioni satellitari (com comuni smartphone)la Net Zero Roadmap dell'Agenzia Internazionale per l'EnergiaOpenAI e Anthropicstudi sui sogniExtreme future:l'internet dei comportamentidati, scienza del comportamento ed AIpregi e applicazionirischiLe 10 grandi domande sul futuroSteve Jobs "parla" di intelligenza artificialeHome - The Future Of (the-future-of.it)Le 10 grandi domande sul futuro: Conversazioni virtuali con i Maestri dell'innovazione del passato eBook : Ferrante, Andrea Marco: Amazon.it: Kindle Store

Wissen Sie, was mit dem „Internet der Körper“ gemeint ist? Oder gehören Sie zu denjenigen, die noch nichts vom „Internet of Bodies“, kurz „IoB“, gehört haben? Mag sein, das klingt für Sie wie eine weitere verrückte Silicon-Valley-Idee. Aber die Realität hat die Fiktion längst überholt. Web: https://www.epochtimes.de Probeabo der Epoch Times Wochenzeitung: https://bit.ly/EpochProbeabo Twitter: https://twitter.com/EpochTimesDE YouTube: https://www.youtube.com/channel/UC81ACRSbWNgmnVSK6M1p_Ug Telegram: https://t.me/epochtimesde Gettr: https://gettr.com/user/epochtimesde Facebook: https://www.facebook.com/EpochTimesWelt/ Unseren Podcast finden Sie unter anderem auch hier: iTunes: https://podcasts.apple.com/at/podcast/etdpodcast/id1496589910 Spotify: https://open.spotify.com/show/277zmVduHgYooQyFIxPH97 Unterstützen Sie unabhängigen Journalismus: Per Paypal: http://bit.ly/SpendenEpochTimesDeutsch Per Banküberweisung (Epoch Times Europe GmbH, IBAN: DE 2110 0700 2405 2550 5400, BIC/SWIFT: DEUTDEDBBER, Verwendungszweck: Spenden) Vielen Dank! (c) 2023 Epoch Times

Master insulin on board calculations and you've solved half of the “game” with type 1 diabetes.For YEARS, IOB (insulin on board) was causing me so much pain and frustration without me even knowing why…And in today's podcast episode, I break down one of my most simplest (and life-changing) blood sugar formula pieces to show exactly how I calculate IOB…While reducing the risk of lows…And increasing the FUN I'm able to have in life (by saying YES to more spontaneous invites with family and friends).Listen Now!Grab your free ticket to this advanced T1D training here:https://diabetesinaction.com---------Welcome to the Pardon My Pancreas podcast!! This show is all about REAL life with type 1 diabetes, understanding fluctuations, and how to stabilize your blood sugar for good. Your host is Matt Vande Vegte is a certified personal trainer, nutritionist, and type 1 diabetic whose biggest goal in life is to help people with diabetes around the world live their lives fearlessly. Looking for an online health coaching program to help you live your best life? Go to https://www.ftfwarrior.com to learn more about his program for diabetics only that is focused on helping you reach your goals while living a happier and healthier life. Join the Tribe today!This podcast is sponsored by FTF Warrior - An online health and fitness coaching company for type 1 diabetics dedicated to helping them master their blood sugars through any activity, exercise, or meal!https://www.ftfwarrior.comFollow Matt here:Instagram: https://www.instagram.com/ftfwarrior/Facebook: https://www.facebook.com/ftfwarrior/Youtube: https://www.youtube.com/c/ftfwarrior------------------------------------------------------Disclaimer: While we share our experiences with diabetes, nothing we discuss should be taken as medical advice. Please consult your doctor or medical professional for your health and diabetes management.

In today's episode Eoin and Graham go through more ways we can benefit our Diabetes management.Exercise while living with Type 1 Diabetes can be ‘tricky' at times. Eoin believes that having confidence around your preparation for exercise, gives you confidence for the exercise itself.In this episode, Eoin goes through three tips that he uses to ensure his blood sugar stays in the place he wants, while doing extended cardio sessions (runs, walks, swims etc). In this episode specifically, he outlines the 3 step process for a recent 1.5km swim he did.3 step process that Eoin covers:Managing active IOB (insulin on board).Increasing carbohydrate intake prior to exercise.Setting times for pre exercise / food ‘window'.As always, be sure to rate, comment, subscribe and share. Your interaction and feedback really helps the podcast. The more Diabetics that we reach, the bigger impact we can make!Questions & Stories for the Podcast?:theinsuleoinpodcast@gmail.comConnect, Learn & Work with Eoin:https://linktr.ee/insuleoin Hosted on Acast. See acast.com/privacy for more information.

Blocks for Head, Neck, and Spinal Surgeries Claim CME Credit: The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/t3z3kR In this episode, we will explore the various regional anesthesia techniques used in neurosurgery, specifically focusing on blocks for head, neck, and spinal surgeries. Segment 1: Blocks used in Head and Neck Surgeries Scalp Block: The scalp block involves blocking six nerves that provide sensory innervation to the scalp. It is performed by subcutaneous infiltration of local anesthetics (such as bupivacaine, ropivacaine, or levobupivacaine) for each nerve. Ultrasound guidance has improved the precision of block administration. The main indication for a scalp block is awake craniotomy, but it is also used in other procedures like deep brain stimulation and cranioplasty surgery. Scalp block offers advantages such as accurate neurological evaluation, pre-emptive analgesia, and hemodynamic stability during surgery. It also reduces postoperative pain, the need for rescue analgesics, and pain scores in the early postoperative period. Infraorbital Block (IOB): The infraorbital nerve block targets the infraorbital nerve, which supplies the skin and mucous membrane of the upper lip, lower eyelid, and cheek. The IOB can be performed using the classical landmark technique or ultrasound guidance. Ultrasound guidance provides real-time visualization and accurate needle placement. IOB combined with general anesthesia is beneficial for postoperative pain relief in procedures like endoscopic trans-nasal trans-sphenoidal (TNTS) approach for pituitary tumor excision. Other regional techniques like sphenopalatine ganglion block and maxillary nerve blocks have also been attempted for transsphenoidal surgeries. Trigeminal Nerve Block: Trigeminal nerve block is used for patients unresponsive to medical management of trigeminal neuralgia. Traditionally performed using the paresthesia technique, ultrasound guidance allows real-time visualization and confirmation of local anesthetic spread. Ultrasound guidance helps locate the Gasserian ganglion and visualize the trigeminal ganglion, providing a safe and radiation-free procedure for pain relief. Segment 2: Blocks used for Spinal Surgeries Cervical Plexus Block (CPB): CPB is commonly used in carotid endarterectomy (CEA) and cervical spine surgery. Different levels of CPB can be performed depending on the depth of injection. Superficial CPB involves injecting local anesthetic superficially into the deep cervical fascia. Deep CPB requires depositing local anesthetic deep to the prevertebral fascia. CPB helps in monitoring cerebral blood flow during CEA and provides postoperative pain relief. Ultrasound guidance can be used for superficial CPB, ensuring accurate needle placement and local anesthetic spread. Erector Spinae Block (ESB): ESB is used for pain control in spinal surgeries. It involves depositing local anesthetic in the plane between the erector spinae muscle and the transverse process. ESB provides effective postoperative analgesia and reduces opioid consumption. Regional anesthesia techniques play a crucial role in neurosurgery, providing effective pain relief and improving patient outcomes. Blocks like scalp block, infraorbital block, trigeminal nerve block, cervical plexus block, and erector spinae block offer numerous advantages in specific procedures. Ultrasound guidance has enhanced the precision and safety of block administration. These techniques contribute to improved surgical outcomes and patient satisfaction in neurosurgical procedures. Upcoming Courses and Workshops! Course Calendar Practice Management Webinar: The End of the Public Health Emergency. What's Changed and what Opportunities Remain! Pain Management Board Review/Refresher Course/ Ultrasound Training NYC- June 9-11, 2023 Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- July 19, 2023 Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- August 19th, 2023 Ultrasound Guided Regional Anesthesia and Pain Medicine- Sept 15, 2023, San Juan, PR For  up to date Calendar, Click Here! References Kaushal A, Haldar R. Regional Anesthesia in Neuroanesthesia Practice. Discoveries (Craiova). 2020 Jun 29;8(2):e111. doi: 10.15190/d.2020.8. PMID: 32637571; PMCID: PMC7332314.

Neurosurgery and Regional Anesthesia Claim CME Credit: The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/t3z3kR In this episode, we will explore the various regional anesthesia techniques used in neurosurgery, specifically focusing on blocks for head, neck, and spinal surgeries. Segment 1: Blocks used in Head and Neck Surgeries Scalp Block: The scalp block involves blocking six nerves that provide sensory innervation to the scalp. It is performed by subcutaneous infiltration of local anesthetics (such as bupivacaine, ropivacaine, or levobupivacaine) for each nerve. Ultrasound guidance has improved the precision of block administration. The main indication for a scalp block is awake craniotomy, but it is also used in other procedures like deep brain stimulation and cranioplasty surgery. Scalp block offers advantages such as accurate neurological evaluation, pre-emptive analgesia, and hemodynamic stability during surgery. It also reduces postoperative pain, the need for rescue analgesics, and pain scores in the early postoperative period. Infraorbital Block (IOB): The infraorbital nerve block targets the infraorbital nerve, which supplies the skin and mucous membrane of the upper lip, lower eyelid, and cheek. The IOB can be performed using the classical landmark technique or ultrasound guidance. Ultrasound guidance provides real-time visualization and accurate needle placement. IOB combined with general anesthesia is beneficial for postoperative pain relief in procedures like endoscopic trans-nasal trans-sphenoidal (TNTS) approach for pituitary tumor excision. Other regional techniques like sphenopalatine ganglion block and maxillary nerve blocks have also been attempted for transsphenoidal surgeries. Trigeminal Nerve Block: Trigeminal nerve block is used for patients unresponsive to medical management of trigeminal neuralgia. Traditionally performed using the paresthesia technique, ultrasound guidance allows real-time visualization and confirmation of local anesthetic spread. Ultrasound guidance helps locate the Gasserian ganglion and visualize the trigeminal ganglion, providing a safe and radiation-free procedure for pain relief. Segment 2: Blocks used for Spinal Surgeries Cervical Plexus Block (CPB): CPB is commonly used in carotid endarterectomy (CEA) and cervical spine surgery. Different levels of CPB can be performed depending on the depth of injection. Superficial CPB involves injecting local anesthetic superficially into the deep cervical fascia. Deep CPB requires depositing local anesthetic deep to the prevertebral fascia. CPB helps in monitoring cerebral blood flow during CEA and provides postoperative pain relief. Ultrasound guidance can be used for superficial CPB, ensuring accurate needle placement and local anesthetic spread. Erector Spinae Block (ESB): ESB is used for pain control in spinal surgeries. It involves depositing local anesthetic in the plane between the erector spinae muscle and the transverse process. ESB provides effective postoperative analgesia and reduces opioid consumption. Regional anesthesia techniques play a crucial role in neurosurgery, providing effective pain relief and improving patient outcomes. Blocks like scalp block, infraorbital block, trigeminal nerve block, cervical plexus block, and erector spinae block offer numerous advantages in specific procedures. Ultrasound guidance has enhanced the precision and safety of block administration. These techniques contribute to improved surgical outcomes and patient satisfaction in neurosurgical procedures. Upcoming Courses and Workshops! Course Calendar Practice Management Webinar: The End of the Public Health Emergency. What's Changed and what Opportunities Remain! Pain Management Board Review/Refresher Course/ Ultrasound Training NYC- June 9-11, 2023 Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- July 19, 2023 Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- August 19th, 2023 Ultrasound Guided Regional Anesthesia and Pain Medicine- Sept 15, 2023, San Juan, PR For  up to date Calendar, Click Here! References Kaushal A, Haldar R. Regional Anesthesia in Neuroanesthesia Practice. Discoveries (Craiova). 2020 Jun 29;8(2):e111. doi: 10.15190/d.2020.8. PMID: 32637571; PMCID: PMC7332314.

Welcome back to the Business News Headlines for Tuesday the 2nd day of May.  Great to be back in the studio after being on vacation for nearly two weeks. Hope that you enjoyed the many business interviews that we shared over the time we were gone.  Some of those conversations went back some five to seven years.  This was the first time since launching IoB that we actually took more than a day away.  It was great and thanks for coming by. Also, remember that you can hook up with us all day on Twitter @IOB_NewsHour and on Instagram.  Here's what we've got for you today:    Yet another retail chain calls it quits; It's official TV and Film writers our on strike; Wall Street had a tough day and why; Airline pilots vote to strike but...there is a but; The number of job openings dipped yet again; Times are great if you are an oil company counting profit; The Wall Street Report; Ford cuts the price of an EV and...why. Thanks for listening! The award winning Insight on Business the News Hour with Michael Libbie is the only weekday business news podcast in the Midwest. The national, regional and some local business news along with long-form business interviews can be heard Monday - Friday. You can subscribe on PlayerFM, Podbean, iTunes, Spotify, Stitcher or TuneIn Radio. And you can catch The Business News Hour Week in Review each Sunday Noon on News/Talk 1540 KXEL. The Business News Hour is a production of Insight Advertising, Marketing & Communications. You can follow us on Twitter @IoB_NewsHour.

Episode 135: Exercise in Diabetes    Kishan and Princess explain how exercise lowers or raises blood glucose levels in diabetes. Dr. Arreaza adds some comments about insulin resistance.  Written by Kishan Ghadiya, MSIV, Ross University School of Medicine. Comments by Princess Enuka, MSIV, Ross University School of Medicine; and Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Today is April 7, 2023. Ep. 135.Intro:It is widely known exercise is paramount for all individuals. The American Heart Association recommends at least 150 minutes of moderate-intensity exercise weekly for general health. Exercise is particularly important in patients with diabetes, who require extensive lifestyle modification to manage their sugar levels. However, it is not well known how glucose metabolism changes when patients with diabetes exercise.My patient in the clinic.I recently saw in the clinic a young patient newly diagnosed with type 2 diabetes who asked about how his exercise was helping his sugar levels. He was confused because he heard that exercising allows for better glucose control but complained that his sugar levels were higher after exercising.To understand what is going on in this patient, it is important to understand the underlying pathophysiology of diabetes. First off, the two most common types of diabetes are type 1 and type 2. Type 1 occurs when the pancreas stops producing insulin altogether. Type 2 occurs when the insulin secreted by the pancreas is no longer effective in normalizing blood sugar levels; the body is not able to utilize glucose efficiently, the number of calories consumed exceeds the body's demands, and thus increasing body weight, which leads to insulin resistance and eventually pancreatic beta-cell exhaustion. Diabetes is thus a disease state of prolonged hyperglycemia and confers many long-term complications such as accelerated cardiovascular disease, neuropathy, nephropathy, and retinopathy.How does exercise lower blood glucose? Once patients are diagnosed with diabetes, management is lifelong, and it takes considerable mental and physical effort to manage this change in health. Exercise is a key metric in diabetic management because lowering blood sugar is as simple as using excess glucose to create energy in our muscles. There are two main mechanisms in how exercise has a positive effect on diabetes. The first mechanism is that exercise directly increases insulin sensitivity by enhancing the muscles' ability to effectively respond to insulin, thus allowing for better use of insulin on board (IOB). This benefit is not only seen during exercise itself but also up to 24 hours after exercise is complete. This means many patients with controlled diabetes can see a euglycemic effect up to 1 day after exercise.The second mechanism is that increased glucose uptake into muscle does not require insulin secretion. In other words, active muscle use during exercise allows for glucose uptake even without the use of any insulin and is very effective in lowering blood sugar levels. Muscles have a higher metabolic rate than fat tissue. It means that even without exercising, a person with a higher muscle mass has a higher basal metabolic rate.What type of exercise would be the most effective in controlling blood sugar? The data is very clear that there is no relationship between exercise technique and glucose level, but there is a relationship between exercise intensity and glucose levels. In other words, patients wanting better blood sugar outcomes may choose whatever exercise regimen as long as they are able to do high-intensity exercise (i.e., resistance training, strength training, High-intensity interval training, HIIT).Anaerobic vs. aerobicBlood sugar levels during exercise will be different based on the types of exercise patients choose. For example, high-intensity anaerobic exercise (such as weightlifting) causes large spikes of blood sugar because the liver creates large amounts of glucose for anaerobic glycolysis. On the other hand, high-intensity aerobic exercise (such as running) confers lower blood glucose. Keep in mind both types of exercise confer excellent long-term patient outcomes, but the disparity in blood sugar is important to note as it can lead to confusion in patients that are very actively monitoring their sugar levels.Hyperglycemia after anaerobic exercise.So, returning to my patient mentioned above, further history revealed that he does weightlifting two or three times a week. Hyperglycemia would therefore be expected during and immediately after anaerobic exercise due to large amounts of glycolysis requiring the liver to create sugar. This patient's increased blood sugar seen after exercising would not be a cause for concern as this is part of normal human body physiology.___________________________________Conclusion:  Now we conclude episode number 135, “Exercise in Diabetes.” Kishan explained that exercise improves insulin sensitivity and promotes muscle growth for improved glucose metabolism. Princess explained that anaerobic exercise may cause a transient rise in glucose while aerobic exercise causes glucose control over a longer period. Dr. Arreaza explained that insulin sensitivity is lost when we give frequent “high shots of sugar” to our body.This week we thank Hector Arreaza, Kishan Ghadiya, and Princess Enuka. Audio editing by Adrianne Silva.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:Kirwan JP, Sacks J, Nieuwoudt S. The essential role of exercise in the management of type 2 diabetes. Cleve Clin J Med. 2017 Jul;84(7 Suppl 1):S15-S21. doi: 10.3949/ccjm.84.s1.03. PMID: 28708479; PMCID: PMC5846677. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5846677/Riddell M, Perkins BA. Exercise and glucose metabolism in persons with diabetes mellitus: perspectives on the role for continuous glucose monitoring. J Diabetes Sci Technol. 2009 Jul 1;3(4):914-23. doi: 10.1177/193229680900300439. PMID: 20144341; PMCID: PMC2769951. https://pubmed.ncbi.nlm.nih.gov/20144341/Zahalka SJ, Abushamat LA, Scalzo RL, et al. The Role of Exercise in Diabetes. [Updated 2023 Jan 6]. In: Feingold KR, Anawalt B, Blackman MR, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from  https://www.ncbi.nlm.nih.gov/books/NBK549946/Royalty-free music used for this episode: “Gushito - Burn Flow." Downloaded on October 13, 2022, from https://www.videvo.net/

Lifelong learning is broadly defined as the ongoing, voluntary, and self-motivated pursuit of knowledge for either personal or professional reasons. Lifelong learning is about developing your full potential, and will provide you with the possibility of discovery, skills and rewards, both professionally and personally. Developing an attitude of continuous learning is one of the best ways to prosper in today's evolving world. To understand the importance of upskilling, reskilling and continuous learning, we spoke to Evelyn Cregan, Company Secretary, Director of Executive Education in the IOB and a Lifelong Learner herself.

I'm the kind of guy that looks ahead to understand what's coming at us. I want to know what those changes will be so I can adapt accordingly. In this episode, I discuss some of the developing trends in IT that I expect to see occurring in the coming years. These changes are already underway, and if you're going to be a part of this industry, you should start paying attention - as they'll all have a significant impact on your business or job (if you have one). Some of the links I talked about: Hyperledger: https://www.hyperledger.org/learn/blo... Augmented AI: https://www.okta.com/identity-101/aug... IoB: https://www.bmc.com/blogs/iob-interne... Digital Stability: https://www.jstor.org/stable/resrep24... Cyber-Physical Systems: https://ptolemy.berkeley.edu/projects... Edge Computing: https://www.cloudflare.com/learning/s... #predicting #futurepredictions #ITpredictions #future #technology

This is a bitesize episode of 'The insuleoin Podcast - Redefining Diabetes'. Each week we'll take a look back into the archive of episodes and get you to think and reflective once more about some of the things we've learned over the past few years. In this week's BITESIZE:Talking more about IOB.Timing your insulin.Adjusting your insulin to fit your life.To hear the full episode check out episode #53: Understanding Insulin on Board. Hosted on Acast. See acast.com/privacy for more information.

Arcana Coelestia 6024. Verses 8-27. And these are the names of the sons of Israel, who came into Egypt, of Jacob and of his sons: Reuben, Jacob's firstborn. And the sons of Reuben: Hanoch, and Pallu, and Hezron, and Carmi. And the sons of Simeon: Jemuel, and Jamin, and Ohad, and Jachin, and Zohar, and Shaul the son of a Canaanitish woman. And the sons of Levi: Gershon, and Kohath, and Merari. And the sons of Judah: Er, and Onan, and Shelah, and Perez, and Zerah; but Er and Onan died in the land of Canaan. And the sons of Perez were Hezron and Hamul. And the sons of Issachar: Tola, and Puvah, and Iob, and Shimron. And the sons of Zebulun: Sered, and Elon, and Jahleel. These are the sons of Leah, whom she bare unto Jacob in Paddan-aram, and his daughter Dinah: all the souls of his sons and of his daughters were thirty and three. And the sons of Gad: Ziphion, and Haggi, Shuni, and Ezbon, Eri, and Arodi, and Areli. And the sons of Asher: Imnah, and Ishvah, and Ishvi, and Beriah, and Serah their sister; and the sons of Beriah: Ber, and Malchiel. These are the sons of Zilpah, whom Laban gave to Leah his daughter, and these she bare to Jacob: sixteen souls. The sons of Rachel, Jacob's wife: Joseph and Benjamin. And to Joseph were born in the land of Egypt, whom Asenath the daughter of Potiphera priest of On bare unto him, Manasseh and Ephraim. And the sons of Benjamin: Bela, and Becher, and Ashbel, Gera, and Naaman, Ehi, and Rosh, Muppim, and Huppim, and Ard. These are the sons of Rachel, who were born to Jacob: all the souls were fourteen. And the sons of Dan: Hushim. And the sons of Naphtali: Jahzeel, and Guni, and Jezer, and Shillem. These are the sons of Bilhah, whom Laban gave unto Rachel his daughter, and these she bare to Jacob: all the souls were seven. All the souls that came with Jacob into Egypt, that came out of his thigh, besides Jacob's sons' women, all the souls were sixty and six. And the sons of Joseph, who were born to him in Egypt, were two souls. All the souls of the house of Jacob, that came into Egypt, were seventy. [2] “And these are the names of the sons of Israel, who came into Egypt,” signifies the quality of truths from the spiritual in order, which were brought into the memory-knowledges of the church; “of Jacob and his sons,” signifies the truth of the natural in general, and the truths of the natural in particular; “Reuben, Jacob's firstborn,” signifies faith in the understanding, which is apparently in the first place. “And the sons of Reuben; Hanoch, and Pallu, and Hezron, and Carmi,” signifies the doctrinals of faith in general. “And the sons of Simeon; Jemuel, and Jamin, and Ohad, and Jachin, and Zohar,” signifies faith in the will and its doctrinals in general; “and Shaul the son of a Canaanitish woman,” signifies a doctrinal not from a genuine origin. “And the sons of Levi; Gershon, and Kohath, and Merari,” signifies spiritual love and its doctrinals in general. [3] “And the sons of Judah; Er, and Onan, and Shelah, and Perez, and Zerah,” signifies celestial love and its doctrinals; “but Er and Onan died in the land of Canaan,” signifies that falsity and evil were extirpated. “And the sons of Perez were Hezron and Hamul,” signifies the truths of that good, which are goods of charity. “And the sons of Issachar; Tola, and Puvah, and Iob, and Shimron,” signifies celestial conjugial love and its doctrinals. “And the sons of Zebulun; Sered, and Elon, and Jahleel,” signifies the heavenly marriage and its doctrinals. “These are the sons of Leah, whom she bare unto Jacob in Paddan-aram,” signifies that these doctrinals were from spiritual affection in the natural through the knowledges of good and truth; “and his daughter Dinah,” signifies the church; “all the souls of his sons and of his daughters were thirty and three,” signifies the state of spiritual life and its quality. [4] “And the sons of Gad; Ziphion, and Haggi, Shuni, and Ezbon, Eri, and Arodi, and Areli,

The We Know Show's host Rinat Strahlhofer takes a deep deep dive into why remaining human in our tech-obsessed world is key to a healthy and free future. Rinat unpacks how technology has been engineered to disrupt our connection to the natural web of life (with an artificial web)–  and it all starts with the dummy SAM! Connecting the dots between smart phone addiction, the recent pandemic , surveillance, connecting our bodies to the internet (IoB), and why this anti-life agenda is propelling us to harness our inner Apocaloptimist to reclaim bodily sovereignty and continue following our truth.   Show Notes 1:40 Meet SAM the Dummy 12:09 Addiction 16:25 Pandemic 20:15 Surveillance 26:00 Anti-life agenda 30:00 Solutions For more information on how to stay human in a technology-obsessed world, check out We Are Not SAM Join the conversation on Instagram & Telegram.   Thank you for tuning in. To help spread this content, please rate, subscribe and share! 

Powodem, dla którego zaprosiłem Sebastiana Młodzińskiego, Prezesa Timate, do wspólnego nagrania 697 odcinka podcastu BSS bez tajemnic było rozwinięcie skrótu RCP. Jak się okazało słowa, które kryją się za tym trzyliterowym skrótem nie są niczym skomplikowanym, a wręcz banalnym. Zaczęliśmy od Rejestracji Czasu Pracy, ale nasza rozmowa poszła w kierunku systemów monitorujących bezpieczeństwo pracowników, a skończyliśmy na Internecie Rzeczy, czyli IoT, a nawet Internecie Zachowań, czyli IoB. O ważnych tematach biznesowych rozmawialiśmy z lekką dawką humoru. Zapraszam do wysłuchania podcastu o nowym podejściu do rejestracji czasu pracy.Więcej o Timate znajdziecie na stronie - https://timatesystem.com/Sebastian Młodziński jest także na LinkedIn - https://www.linkedin.com/in/sebastian-mlodzinski-b7b2b21/****************************Nazywam się Wiktor Doktór i na co dzień prowadzę Klub Pro Progressio https://klub.proprogressio.pl/pl – to społeczność wielu firm prywatnych i organizacji sektora publicznego, którym zależy na rozwoju relacji biznesowych w modelu B2B. W podcaście BSS bez tajemnic poza odcinkami solowymi, zamieszczam rozmowy z ekspertami i specjalistami z różnych dziedzin przedsiębiorczości.Jeśli chcesz się o mnie więcej dowiedzieć, to zapraszam do odwiedzin moich kanałów w mediach społecznościowych:YouTube - https://bit.ly/BSSbeztajemnicYT Facebook - https://bit.ly/BSSbtFB LinkedIn - https://www.linkedin.com/in/wiktordoktor/ Możesz też do mnie napisać. Mój adres email to - wiktor.doktor(@)proprogressio.pl****************************Patronami Podcastu “BSS bez tajemnic” są: Marzena Sawicka (https://www.linkedin.com/in/marzena-sawicka-a9644a23/), Przemysław Sławiński (https://www.linkedin.com/in/przemys%C5%82aw-s%C5%82awi%C5%84ski-155a4426/), Damian Ruciński (https://www.linkedin.com/in/damian-ruci%C5%84ski/) Szymon Kryczka (https://www.linkedin.com/in/szymonkryczka/)Grzegorz Ludwin (https://www.linkedin.com/in/gludwin/). Wspaniali ludzie, dzięki którym pojawiają się kolejne odcinki tego podcastu. Jeśli i Ty chcesz dołączyć do grona Patronów, to możesz to zrobić przez serwis Patronite - https://patronite.pl/wiktordoktor Możesz także wspierać rozwój tego podcastu przez Patreon - https://www.patreon.com/wiktordoktor Jeśli podoba Ci się to co robię, możesz, przez ten link https://www.buymeacoffee.com/wiktordoktor, kupić mi kawę i tym samym wesprzeć rozwój tego podcastu.

After spending 2.5 years in Kingston, Tony Iob was traded to the Sault Ste. Marie Greyhounds where he won two straight Ontario Hockey League Championships. After failing to win a game in his first trip to the Memorial Cup, Iob and the Hounds made it to a heartbreaking Memorial Cup Final against Scott Niedermayer and the Kamloops Blazers. Iob would go on to play a couple seasons pro in North America before heading overseas. After an 18 year pro career, representing Italy in the Olympics, and many World Championships the love of the game still runs deep in the former OHL tough guy Learn more about your ad choices. Visit megaphone.fm/adchoices

After spending 2.5 years in Kingston, Tony Iob was traded to the Sault Ste. Marie Greyhounds where he won two straight Ontario Hockey League Championships. After failing to win a game in his first trip to the Memorial Cup, Iob and the Hounds made it to a heartbreaking Memorial Cup Final against Scott Niedermayer and the Kamloops Blazers. Iob would go on to play a couple seasons pro in North America before heading overseas. After an 18 year pro career, representing Italy in the Olympics, and many World Championships the love of the game still runs deep in the former OHL tough guy

At the core of Compliance Institute's mission is to educate its members to ensure they have the skills required to undertake their roles in a professional and effective manner. From the beginning, 20 years ago, the Compliance Institute's partner in the delivery of its programme of education has been the IOB, formerly known as the Institute of Banking.  In the latest episode of the Compliance Files podcast series, Kathy Jacobs, former President of Compliance Institute speaks to Mary O'Dea, Chief Executive of IOB as part of our 20th anniversary series, on the topics of career development, education, leadership, challenges and priorities for the future.

Abbiamo dedicato diverse puntate per parlare e approfondire il tema dei dati che ognuno di noi produce, sia su Internet, ma anche nelle azioni quotidiane. Nell'ultimo periodo sta prendendo sempre più piede un nuovo modo di usare queste enormi quantità di dati, cioè l'Internet of Behavior, che racchiude in sé una vasta gamma di tecnologie e ambiti che collaborano tra loro, dall'Internet of Things, all'analisi dei dati e all'intelligenza artificiale, alla psicologia. Nella puntata di oggi cercheremo di capire qual è lo scopo di questa tecnologia. Nella sezione delle notizie parliamo dell'esclusione della Russia dal laboratorio del CERN, dell'evento Apple in cui è stato presentato il nuovo Mac Studio e infine del compimento della prima fase dello Switch Off TV in Italia. --Indice-- • La Russia esclusa da CERN di Ginevra (01:00) - Science.org - Luca Martinelli • Apple presenta il nuovo Mac Studio (02:11) - Apple.com - Davide Fasoli • Conclusa la prima fase dello Switch Off TV (03:59) - DDay.it - Matteo Gallo • Internet of Behavior: il costo per una vita migliore (05:26) - Luca Martinelli --Contatti-- • www.dentrolatecnologia.it • Instagram (@dentrolatecnologia) • Telegram (@dentrolatecnologia) • YouTube • redazione@dentrolatecnologia.it --Immagini-- • Foto copertina: upklyak per Freepik --Brani-- • Ecstasy by Rabbit Theft • Electric by Vaance & Deerock (feat. Robbie Rosen)

ABG owes from some these banks ICICI - 7089 Cr. SBI - 2425 Cr. , IDBI - 1614 Cr , BOB - 1244 Cr. , IOB -1228 Cr. Some what I been able collect from news.

Den vollständigen Tagesdosis-Text (inkl. ggf. Quellenhinweisen und Links) finden Sie hier: https://apolut.net/genetisch-vernetzt-von-jens-bernertBereits 2020 wurde das Internet der Körper auf Gen-Ebene vorgestellt — heute koordiniert die WHO die DNA-Manipulation aller Menschen.Ein Kommentar von Jens Bernert.Der menschliche Körper soll der neue Router werden. So das Vorhaben des Weltwirtschaftsforums und der Digital- und Gesundheitsindustrie, die mit ihrer „Internet der Körper“-Initiative genau diese Entwicklung vorantreibt. Es genügt den Datenkraken nicht mehr, dass die Menschen nur in einer Mensch-Maschinen-Interaktion Big Data füttern. Die Krake möchte mit ihren Tentakeln unter unsere Haut und die Daten unseres Körpers, unsere Gene abgreifen.Die naturwissenschaftliche Fachzeitschrift „Nature“ veröffentlichte im Juni 2020 einen Beitrag, der den elektronischen Anschluss auf Gen-Ebene an das „Internet der Körper“ (IOB) beinhaltet. Das IOB wird vom Weltwirtschaftsforum – zusammen mit dem Great Reset – und der Gesundheitsindustrie forciert und ist verzahnt mit ID2020, GAVI sowie mit der von der WHO im Juli 2021 vorgestellten Manipulation aller Menschen auf Erbgut-Ebene zu „Gesundheitszwecken“ und „Pandemiebekämpfung". ... hier weiterlesen: https://apolut.net/genetisch-vernetzt-von-jens-bernert+++ Apolut ist auch als kostenlose App für Android- und iOS-Geräte verfügbar! Über unsere Homepage kommen Sie zu den Stores von Apple, Google und Huawei. Hier der Link: https://apolut.net/app +++ Abonnieren Sie jetzt den apolut-Newsletter: https://apolut.net/newsletter/ +++ Ihnen gefällt unser Programm? Informationen zu Unterstützungsmöglichkeiten finden Sie hier: https://apolut.net/unterstuetzen/ +++ Unterstützung für apolut kann auch als Kleidung getragen werden! Hier der Link zu unserem Fan-Shop: https://harlekinshop.com/pages/apolut +++ Website und Social Media: Website: https://apolut.net/ Odysee: https://odysee.com/@apolut Instagram: https://www.instagram.com/apolut_net/ Twitter: https://twitter.com/apolut_net Telegram: https://t.me/s/apolut Facebook: https://www.facebook.com/apolut/ Soundcloud: https://soundcloud.com/apolut Our GDPR privacy policy was updated on August 8, 2022. Visit acast.com/privacy for more information.

Cuando navegamos por Internet o usamos cualquier producto digital entregamos datos de forma voluntaria e involuntaria. A partir de esto surge la posibilidad de que las empresas estudien el comportamiento o hábito de las personas para luego impulsar cambios en ellas. De eso se trata el concepto Internet of Behaviour (IoB). Soy Débora Slotnisky, y conversé sobre este tema con Sergio Mastrogiovanni, que es Head of Data and Innovation en Nubiral. Algunos de los temas que abordamos en este episodio son: · Qué tipo de actividades individuales ya son traqueadas en forma digital por las empresas · Ejemplos concretos de cómo cambiamos nuestros hábitos a partir del IoB · ¿Las empresas nos piden nuestros datos o nos roban nuestros datos? · Cuál es el límite de los datos que nos pueden pedir las empresas · Los tres pilares del IoB para poder conocer nuestros comportamientos y cambiarlos Este podcast cuenta con el apoyo de Universidad Siglo 21.

VIDEO VERSION:https://www.youtube.com/watch?v=ZVx_GvAIV8Y&t=7sIn this episode we will be discussing "The Heart Attack Grill" founded by Jon Basso and currently operating out of Las Vegas, NV. Weird Renown Theme - Black Tar by Karl Casey at White Bat AudioRemixed by Zach Spencer (Arcade) **Visit my website for more content from mehttp://heathershouse.life​​​​​​SOURCES:https://en.wikipedia.org/wiki/Heart_A...https://vitalvegas.com/dude-breaks-re...https://www.grubstreet.com/2013/10/he...https://www.sciencetimes.com/articles...https://www.youtube.com/watch?v=d-DDb...https://www.youtube.com/watch?v=Wcw5P...https://www.youtube.com/watch?v=ASkUA...MATT STONIE'S VIDEO EATING THE OCTUPLE BYPASS IN 4 MINUTES: https://www.youtube.com/watch?v=e-IoB...Support the show (https://paypal.me/hshouse2?locale.x=en_US)

Equity markets snapped their four-day losing run and ended near day's high on Friday as gains in pharma and banking counters, along with select heavyweights, lent support to the indices. Breaking away from a lackluster trade, the frontline indices picked pace in the second half of the session as ICICI Bank, Reliance Industries, SBI, and HDFC gained between 0.7 per cent and 1.6 per cent. The S&P BSE Sensex closed with gains of 166 points, or 0.32 per cent, at 52,485 levels while the NSE's Nifty50 settled at 15,722 levels, up 42 points or 0.27 per cent. However, trading action was skewed towards small-cap stocks as hefty buying in Mangalam Cement, Omaxe, OnMobile Global, Route Mobile, and Indoco Remedies, pushed the BSE SmallCap index up 1 per cent. Gains in mid-cap index remained capped amid sell-off in Adani Transmission, Adani Enterprises, Adani Green Energy, JSW Energy, SAIL, and Vodafone Idea. The BSE MidCap index thus ended flat. Individually, shares of Route Mobile surged 20 per cent to Rs 2,126 on the BSE in intra-day trade on Friday after the company announced the signing of definitive agreements to acquire the artificial intelligence-driven email communication platform Sendclean from Sarv Webs Private Limited. The stock had hit a 52-week high of Rs 1,979 on February 17, 2021. That apart, shares of Nucleus Software Exports hit an all-time high of Rs 765.35 after rallying 9 per cent on the BSE in intra-day deal on the back of heavy volumes. The stock surpassed its previous high of Rs 754, touched on October 7, 2020. The trading volumes on the counter jumped nearly three-fold with a combined 1.56 million shares changing hands on the NSE and BSE today. Lastly, Indian Overseas Bank (IOB), on Friday, became the second most-valued listed public sector bank with a market-capitalisation of over Rs 50,000 crore. The Street has been betting on the privatisation of the state-owned lender, which has pushed its shares over 50 per cent higher on the BSE in the past one month. By close, IOB stood with an m-cap of Rs 51,887 crore, pushing PNB and BOB to third and fourth position with m-cap of Rs 46,411 crore and Rs 44,112 crore, respectively. Globally, European shares rose on Friday on a boost from semiconductor makers, while investors awaited a closely watched monthly jobs report from the United States later in the day. The pan-European STOXX 600 index rose 0.5 per cent, with technology stocks rising 1 per cent. In Asia, Japan's Nikkei added 0.3 per cent and Australia's ASX 200 advanced 0.6 per cent. As regards the US, Nasdaq Futures were up 0.17 per cent while those of S&P 500 and Dow Jones were unchanged. Top news of the day: >> Christopher Wood, global head of equity strategy at Jefferies has launched India long-only equity portfolio with 16 stocks, which include marquee stocks such as ICICI Bank, HDFC, Bajaj Finance, Reliance Industries (RIL), ONGC, Maruti Suzuki India, Tata Steel and Jubilant FoodWorks. While Wood said this is certainly not a perfect time to start an Indian portfolio since the Sensex is near an all-time high, he still remains convinced that India is at the start of a new housing cycle after a seven-year downturn, which is why there will be a 17 per cent weight in the property sector. >> Meanwhile, in the primary market, state-run NTPC Ltd., India's largest power generator, aims to take its renewables unit public to help fund a Rs 2.5 trillion clean energy expansion. The New Delhi-based producer wants to list its NTPC Renewable Energy Ltd. unit in the next fiscal year, which begins in April 2022.

เมื่อปัจจุบันดิจิตอลเข้ามาเป็นส่วนหนึ่งของชีวิตประจำวันมากยิ่งขึ้น จึงเป็นอีกแรงผลักดันให้มนุษย์จำเป็นต้องพึ่งพาเทคโนโลยีมากกว่าเดิม Internet of Behavior หรือ Iob เทรนด์เทคโนโลยีที่กำลังมีบทบาทสำคัญต่อพฤติกรรมของผู้บริโภคที่กำลังเปลี่ยนแปลงไป Iob คืออะไร? และมีความสำคัญอย่างไร?

ABOUT THE EPISODE In this episode of PodCatalyst, IABC Executive Director Peter Finn catches up with IABC Trends Watch Task Force member Donna Itzoe, senior vice president of communications and marketing for Global Medical Response. At the virtual IABC World Conference 2021, Itzoe, along with Trends Watch Task Force Chair Joanne Henry, will deep dive into the role of the communicator in relation to artificial intelligence (AI) and the Internet of Behaviors (IoB) — one of the six leading trends from the task force's recent research report. The insights from this panel discussion will keep you thinking long after the conference ends. Listen to this episode to hear more about: What communicators can learn from AI and the IoB Real-life examples of how data from AI and the IoB were being used during the pandemic The influence communicators can have when this technology is used properly What attendees will learn from Itzoe and Henry's World Conference presentation Like what you hear? Don't miss “It's Time to See and Manage the Impact of Global Trends,” 4:40–5:10 p.m. PDT on 28 June (12:40–1:10 a.m. BST, 29 June; 9:40–10:10 a.m. AEST, 29 June), plus many other inspiring sessions during the virtual IABC World Conference 2021, 28–30 June. Register now to secure your spot for this top-tier virtual event, and look forward to connecting with communication professionals from around the globe. || LINKS *Episode* https://www.iabc.com/ | https://catalyst.iabc.com/ | https://wc.iabc.com/ | https://catalyst.iabc.com/Innovation/Innovation-Article/the-future-of-communications-6-trends-to-watch| https://catalyst.iabc.com/Innovation/Innovation-Article/communicators-as-the-ultimate-integrators-of-the-human-experience| https://catalyst.iabc.com/Innovation/Innovation-Article/disinformation-and-deepfakes-fuel-growing-mistrust| https://wc.iabc.com/Conference-Information/Schedule-of-Events/| https://wc.iabc.com/Registration/Attendee-Registration *Social Media* https://twitter.com/iabc | https://www.linkedin.com/company/iabc/ | https://www.facebook.com/IABCWorld| https://www.youtube.com/user/IABClive | https://www.instagram.com/iabcsnaps/ *IABC Websites* https://www.iabc.com/ | https://catalyst.iabc.com/ | https://wc.iabc.com/ --- Send in a voice message: https://anchor.fm/iabc/message

Csinos Tamás, a Clico Hungary Country Managere előadásában a nagyvállalati biztonság jelenlegi helyzetére reflektált, és kitért arra, hogy a szervezeten belüli fenyegetettségeken túl a „várfalon” kívül eső kitettségekre is oda kell figyelni. A CTI, TPI APT, IoC, IoB kifejezések mögött meghúzódó rendszerekbe is bepillantást engedett, amiből kiderült, hogy bizonyos megoldások mivel tudják támogatni a biztonsági szakembereket a megfelelő védelmi döntések meghozatalában.

In this episode, Katie chats with Mattie who has been living with T1D for the past 20 years. Mattie tells us all about the Medtronic InPen that she uses. The In Pen is a smart insulin pen with Bluetooth technology  that helps you dose for your meals and keep track of IOB with a handy mobile app so you can keep a tighter reign on your blood glucose numbers and avoid those pesky lows and stubborn highs. If you feel that pumping insulin is not for you or your child but want the latest in pen technology, then the InPen is it! Mattie has also chose to be on a plant based diet. She explains the reasoning behind her choice and how it has helped with her diabetes management. You can find Mattie on Instagram at @plantbased.pancreas. I hope you enjoy the show!Find Mattie on Instagram! @plantbased.pancreasLearn more about the Medtronic InPen! https://www.medtronicdiabetes.com/products/inpen-smart-insulin-pen-systemAmazon affiliate link for the book Mastering Diabetes: Mastering Diabetes Support the show (https://www.buymeacoffee.com/sugarmama)

In today's episode Eoin chats with Christel Oerum (@diabetesstrong_ig).Christel has been living with Type 1 Diabetes since 1997, and throughout these years she has become an expert on the subject. She is the creator of Diabetes Strong (diabetesstrong.com), a public speaker, Youtuber, Diabetic coach, personal trainer and blogger - there are few things Christel doesn't do!Eoin and Christel discuss a wide variety of Diabetes subjects, including:How to confidently approach your Endocrinologist appointments.Understanding the impact of IOB (insulin on board).The importance of routine for your blood sugar.Tips for newly diagnosed Diabetics.Mistakes to avoid as a Diabetic.How we view our food living with Type 1 Diabetes.And much more.You're going to get a lot of value from Christel and this episode.As always, be sure to rate, comment, subscribe and share. Your interaction and feedback really helps the podcast. The more Diabetics that we reach, the bigger impact we can make!Questions for the Podcast:theinsuleoinpodcast@gmail.comWebsite:insuleoin.comInstagram:https://www.instagram.com/insuleoin/ Our GDPR privacy policy was updated on August 8, 2022. Visit acast.com/privacy for more information.

It's been a year since Tandem Diabetes Care released their Control IQ software, hybrid closed loop technology to help increase time in range. What have they learned about how people are using the system? Molly McElwee Malloy, Manager of Clinical Outcomes at Tandem Diabetes Care, is back on the show to answer your questions and to talk about what's next in the Tandem pipeline. Tandem Diabetes Pipeline What diabetes tech to expect in 2021 Our innovations segment: using your CGM to get more out of exercise and.. a new study for people with rare forms of diabetes.. CGM and exercise RADIANT Study  Fearless Diabetic Summit This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone      Click here for Android Episode Transcription: Stacey Simms  0:00 Diabetes Connections is brought to you by Dario health. Manage your blood glucose levels increase your possibilities by Gvoke Hypopen, the first premixed auto injector for very low blood sugar, and by Dexcom take control of your diabetes and live life to the fullest with Dexcom.   Announcer  0:22 This is Diabetes Connections with Stacey Simms.   Stacey Simms  0:27 This week, it's been a year since Tandem diabetes released their Control IQ software, hybrid closed loop technology to help increase time it range.1 since that day, as we do around here. We've all been asking for changes. Tandem says they're listening,   Molly McElwee Malloy   0:43 can it be more aggressive? Could it be less aggressive? Good, you know, do this or that I pick my targets. Could I put a timer on exercise? Could I do all that? We are looking at all of those things. I would say nothing's off the table right now.   Stacey Simms  0:56 Molly McElwee Malloy, manager of political outcomes at Tandem is back to talk about possible changes to controlling q to answer your questions, and to look ahead at other tech in the Tandem pipeline In our innovations segment using your CGM to get more out of exercise, and a new study for people with rare forms of diabetes. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Welcome back to another week of the show. I am so glad to have here. If you are just finding us if you are new to Diabetes Connections, welcome. We aim to educate and inspire about diabetes with a focus on people who use insulin, my son was diagnosed with type one right before he turned two back in 2006. My husband lives with type two diabetes, I don't have any type of diabetes, but I am the broadcaster in the family. And that is how you get the podcast. It's funny to look back on this year. Because not only did none of us have any idea what 2020 would really be like, but more to my point here, as I'm taping this on January 15. And planning to release on the 19th. This was a time when many of us in the community were just refreshing the Tandem page over and over again. Because Control IQ had been approved. And many of us had already talked to our endocrinologists about it and tried to get the prescriptions. And if you remember that time, especially on social media and some of the Tandem groups, it was a bit bananas. But we have been using Control IQ for a year. Now Benny got his set up at the very end of January, as I recall. And they are not a sponsor of the show. They do not pay me to say this. But it's been absolutely amazing for us, it has really made a big difference. And you know, I don't share numbers. I'm not all about the numbers and straight lines with him. But I do want him to be healthy. And I think we were doing great before but just back from the endo this time around about a week ago as you're listening now, his lowest A1C ever. And the time before that was his previous lowest A1C ever. And the best part is he's doing less work. And I am I swear I'm doing less nagging. If you ask him, he will tell you otherwise. But I promise you it's true. So I'm thrilled to talk about control IQ. I'm really excited that all of the pump companies are moving in this direction, it would be amazing for everyone to have access to this kind of technology. That is a discussion for another time. Probably Another little bit of personal news, Benny got his driver's license. I know I can't believe it either. Here in North Carolina, you get your permit. If you want at 15, you can actually take drivers at 14 and a half. But you get your permit at 15. And you can get your license at 16 right now, because of COVID. They are not even doing road tests. I know isn't enough bananas. But what happens is you get your basically your junior driver's license, you can't drive at night, which is what he would have been issued anyway, if he passed a road test. And they cannot move on to the next level the after nines until they get a road test. In fact, I believe what he has expired in six months without a road test. So he'll have to take one. He's a decent driver, you know how superstitious I am. So I'm not going to say more than that. But I'm confident we've got a whole system with diabetes we have we've had these discussions, and he's just so excited about it. And I'm really thrilled for him that this step has taken but as a parent, and for those of you who have known him since he was two, how did this even happen? Okay, we're gonna talk to Molly from Tandem in just a moment. But first Diabetes Connections is brought to you by Gvoke Hypopen and almost everyone who takes insulin has experienced a low blood sugar you know, that can be scary, but a very low blood sugar. It can be really scary, and that's where Gvoke Hypopen comes in Gvoke is the first auto injector to treat very low blood sugar. Gvoke is pre mixed and ready to go with no visible needle. That means it's easy to use. How easy is it, you pull off the red cap and push the yellow end onto bare skin and hold it for five seconds. That's it. Find out more go to Diabetes connections.com and click on the Gvoke logo. Gvoke shouldn't be used in patients with pheochromocytoma or insulinoma visit Gvokeglucagon.com slash risk.   My guest this week is the manager of clinical outcomes at Tandem diabetes care. And she lives with type one, Molly McElroy is I am grateful to say a frequent guest. And if you're a longtime listener, you know, her career and her life has been shaped by the technology that is now control IQ. That's not really an exaggeration. She was one of the first to test out an artificial pancreas system. And she changed her career path because of it. And my first interview with Molly was in 2016, when type zero technology announced their partnership with Tandem, and I will link up the previous episodes, we've done a bunch with her all about this software, you can find those links, as always, in the episode, show notes, wherever you're listening, the app should have show notes. If it's difficult to find, just head over to Diabetes connections.com. And every episode now has a transcript and lots of links and notes to help you out. Please stay though, to the very end beyond the interview because there are a few questions Molly had to check on. She couldn't answer at the time. And they sent me that information. And I will give that to you later on in the show. Of course, as I said, there's a transcript so you can check it out that way as well. Molly, thank you so much for coming back on to talk to me a year ago, you and I spoke about Control IQ it had basically just been approved. And you were kind enough to jump on that in late December. So thanks for coming back on.   Molly McElwee Malloy   6:26 Oh, you're welcome. I'm very excited to be back on this.   Stacey Simms  6:29 Yeah, well, lots of lots of questions, of course, from listeners and from me. But let's just start by taking a moment to kind of reflect what's the last year been like for you guys at Tandem?   Molly McElwee Malloy   6:39 You know, it's been really crazy great is the best way I could describe it. There's a lot of excitement for control IQ, and rightfully so. And there's a lot of the feedback via social media about people's experience. And it's been really, overwhelmingly positive. It's also been kind of emotional, because this has been a rough time for everybody, right? Like last eight months or so that we've been in. I've been calling it seclusion. But it's, you know, everybody working from home. And that's been a really high stress situation, particularly for people with chronic disease, and myself included. So I've really been grateful that control like has been out and approved. And a useful tool during this time. Because just you know, stress influences glucose. And so it's been a big, huge help for a lot of people, particularly during this time. So it's been crazy great. And it's been busy. But sure, I would love to experience control, like you and all the interaction with healthcare providers in person. But it's been great just talking to people on the phone or on video or teams. And it's been really good that we've been really busy. Yeah, sure. All right.   Stacey Simms  7:43 So what I'd like to do is take a look back, get some information from you about control IQ, and then kind of take a look forward because we know the product and the product line is evolving. So let's just start by asking you, what have you learned about control? IQ obviously had all the study information. But looking back at 2020? How are people using it? How is it working out? What is the data telling you,   Molly McElwee Malloy   8:07 you know that this is the funniest thing, and this is not something that you can plan or you could guess but our real world data is better than our clinical trial data. And I'll say that again, because it's just, it feels a little crazy to say that out loud, because that's usually not the case, right? clinical trials are very well managed. And you know, there's protocols and everybody's sticking to stuff. But it turns out when you put this put control, like you in the real world where people are experiencing significant hyperglycemia, or even hypoglycemia, it does even better. So I mean, the clinical trial population was pretty well controlled, right? And we were still able to improve on that. But when you put it into the real world where people are doing, you know, they're real people, they're doing all kinds of real things, and we're able to get even better outcomes. It's surprising. It's awesome. It's a really cool experience, and definitely unexpected.   Stacey Simms  8:59 Yeah. So let's dig into that. Can you tell us in terms of I guess you're measuring things like time and range? Can you give us a little bit more information about what you mean by they did better?   Molly McElwee Malloy   9:09 So for one, it's it's time and proven time and range, right. So in our pivotal trial, we had about 11% over baseline improvement on time and range from a very good well control group, which is awesome. But in real world, it seems to be closer to 13%. Sometimes a little bit better. We've got some results from D Q&A which is a third party vendor that does research and they're affiliated with Diatribe. And they did some survey results about time and range by insulin pump therapy and it's been really cool to have like a 33% getting 81 to 90% time and range 31% getting 71 to 80% of 11% getting 91 to 100% which is crazy. So you know all of that And it just is amazing because it really does. It whips up on the competition. But it also just shows that, you know, this works even better in the real world.   Stacey Simms  10:08 Any idea why? I mean, are people using sleep mode? Are people figuring out different ways to use it better? I'm just curious what you think might be happening?   Molly McElwee Malloy   10:19 Yeah, I don't think it's the using sleep, you know, 24, seven or something. I think using a sleep schedule has been very successful. But I think the reason for this is that largely, and not everybody was correcting aggressively, right. So while there are that subset on Facebook, or social media that are trying to get that, you know, super, super tight range, there are plenty of people who, between meals, we're not correcting, and now they're receiving those corrections. And there's some evidence that we were able to publish. And I think we showed an ADA, but that persons with type two diabetes are benefiting from this. And that's because they're getting the corrections between meals, which we don't typically ask people with type two diabetes to do that. So getting that tighter control is really, really helpful. And again, not everybody does that.   Stacey Simms  11:11 Yeah, I have one of those people in my house, who not everybody does that. I mean, we I tease Benny all the time, and he knows that I I talk about him on the show like this, he will happily, let me say that Control IQ has helped him significantly because he often boluses after he eats or forgets to bolus or didn't correct between lunch and let's say, bedtime, even if he gave himself insulin for dinner. And it really has made that burden lighter. And it's certainly not perfect. I have friends whose kids are much more engaged with their diabetes, I guess is a way to say it where they, they will you know, they'll bolus every two to three hours, or they're looking at their watch every 20 minutes. But he's never been like this. And it's really improved his quality of life. Because I'm not, I'm not willing to make him do that.   Molly McElwee Malloy   11:57 Well, and if you think about the long term, decrease the complications because of this going on in the background is sort of automating this. I mean, that's a huge improvement and quality of life. One of the things I'm really excited about is to watch this going forward to see how we can measure decrease long term complications from this, you know, the not just like seeming variability, but with those micro macrovascular complications. But this is long term complications from diabetes from having high blood sugars. And, you know, that's just something that we've never been able to really control for before. So this is going to be very cool to watch and see how it plays out.   Stacey Simms  12:36 No doubt. All right. We've gotten a little bit inside baseball, but I think most people listen to the podcast will understand some of the shorthand, I'll try to explain as much as I can. But if there are things that we mentioned, that you are not understanding, I'm going to link up lots of stuff in the show notes. But one of those things is sleep mode. And I just want to take a second to talk about that. Because you and I, when we talked last year, you said that there were some people using sleep mode, which will adjust basal but will not give you boluses, they were using a 24 seven in the studies, you called them sleeping beauties. And there have been many, many people in the real world settings who use that we do not we actually don't laugh at me, we stopped using sleep mode for sleep. Because as great as it was working for Benny with what you called a seclusion, we found that he was eating at interesting hours, you know, 1am 3am I mean, he went full nocturnal for about a month there way back when I want to say like June or July. And so we turned off sleep mode because we needed that bolus power at weird times. So it's been really funny how you can kind of use the system in a way that works for you. But getting back to my question, what have you learned about sleep mode? Is there anything you can share with us?   We'll get her answer to that question and what she can share in just a moment. But first Diabetes Connections is brought to you by Dario health and we first noticed Dario a couple of years ago at a conference. And then he thought being able to turn your smartphone into a meter was pretty amazing. I'm excited to tell you that Dario offers even more now, the Dario diabetes success plan gives you all the supplies and support you need to succeed. You'll get a glucometer that fits in your pocket, unlimited test strips and lancets delivered to your door and a mobile app with a complete view of your data. The plan is tailored for you with coaching when and how you need it and personalized reports. Based on your activity. Find out more, go to my daurio.com forward slash Diabetes Connections. Now back to Molly answer my question - we were talking about what Tandem has learned about the use of sleep mode?   Molly McElwee Malloy   14:44 Yeah, yeah, there's lots like I've learned I just want to share quickly that I've seen in looking at lots of reports with lots of health care providers that during what I've been calling seclusion or hibernation this this COVID time that people schedules are very, very different. They're eating at different times. And that sleep, as originally intended right is not what it looks like during this time. So there's a lot of people who have benefited from not using sleep when they're eating right through the night, or snacking, or staying up extra late or, like really altered schedules, right. So we've seen that some people have turned sleep off, and that's been successful for them. So sleep, what sleep is doing is it's based off of fasting metabolism. And it's using this 112 to 120 sort of target. And it's really, it's a really tight range. But it's doing this through modulating basal. And the reason it's only modulating basal and not giving corrections is because someone is sleeping, and they're not, we're not anticipating postprandial spikes, and we're not anticipating exercise or activity. And so it's really, really meant for when you are kind of static, and you are sleeping. Now, that said, Not everybody's sleeping normally, particularly during COVID. And so it doesn't always work that way. And then some people want to have sleep 24 seven, so that the basal is modulating, but that they're responsible for the corrections. And if you're willing to glance and see if you need a correction every two hours, that can work really well. But if you want to alleviate that burden, right, then, then sleep maybe isn't the best thing for you to use 24 seven, so it really depends on the user and the user's interaction. But the other thing I wanted to mention about sleep for users is that one of the things that we've noticed, and how people are using sleep is that if their schedule have has changed drastically with COVID, that they may need to reevaluate that sleep pattern as to what time it is. So for instance, if someone previously wasn't snacking at 10pm, and now they are starting sleep a little later may make sense because they may need an additional correction before going to that, you know, that's one circumstance I've seen a lot of. And another one is, there are some patients who can't go to bed with a positive IOB. And what I mean by that is, you know, going to bed with any insulin on board that is not related to carbohydrates, right, so for correction, and for them starting sleep sooner, and you know, obviously not eating right before bed, makes sense, because they're not getting any corrections before bed. So there's sort of really two very different types of insulin sensitivities, right, the person who's eating and then needs the additional correction, who may want to start sleep later. And then the person who isn't eating after dinner, and really doesn't want any additional corrections before they go to bed, starting it sooner. So I've also seen that very interestingly playing out in the public realm, and it's it's interesting to see how people are using it to make it work for them.   Stacey Simms  17:44 Yeah. What about exercise mode? Have you learned anything about how people use that we don't often use exercise mode.   Molly McElwee Malloy   17:50 Yeah, exercise is interesting, because it's sort of like a temporary basal rate, if you will, which you set indefinitely, right? until you start it and you stop it. And we hope in future versions, we'll be able to put a timer on this. But for right now, you start and stop it. And so you could be in sleep for 24 seven, if you wish, I have seen that be useful when people want to keep an a higher target, and want to be a bit more aggressive and preventing hypoglycemia, right. So that's an interesting thing that has and can be used selectively, whether it's for exercise, or just because you would like to keep up, you know, you need to be a little bit more conservative on the hypo end. And you really do want to have a higher target, you know, and COVID times looking at how particularly the aging population is trying to stay at home rather than go into care, using something that's going to keep them a little safer on the lower end and elevate that glucose level a bit has been useful, and just allowing people to remain, you know, in a safer range with preventing hypoglycemia.   Stacey Simms  18:51 I'm curious to see if there are any best practices, or any advice for starting the system. A lot of people who switched from Basal IQ or other pumps or no automated system, you know, just a regular Tandem x2, and I'll put myself in this camp. We were one of the first people on this in late January of 2020. We started on Control IQ before my endocrinologist or shouldn't say that way. We started on Control IQ before Benny's endo was trained. So I was in touch with him, but he was like, tell me what you find out basically, like, show me Show me Benny settings like we're gonna adjust as much as we can. But what are people saying? What are what are the you know, what are the experts saying? Trust me, my endo doesn't take advice from Facebook. But you know, it was one of those situations where we're learning together. And luckily, he trusts us to do that. But then he had, you know, we put his regular settings in, and we had massive overnight lows. And we had to adjust because of that five hour increment. We had to adjust. Basically everything works like a dream now, but it was a different transition than I had anticipated. I'm curious if you learned anything from that and what your advice might be now?   Molly McElwee Malloy   19:56 Yeah, one of the things we noticed, particularly people going from Basal IQ to To Control IQ as in basal IQ, they'd sort of artificially inflated their basal rates to sort of hug that line at 80, right or, because because it can always turn off, right? It's always preventing hypoglycemia, so why not have that basal rate a bit more. And with control IQ, it really takes that information and says, okay, that's where you are at baseline. And if that's really overly aggressive for where you are at baseline, then you're going to have hypoglycemia. So getting optimized settings is super, super important. And we do still see that people going Basal IQ to control IQ, that they've had really aggressive basal rates, and you need to back off of that, or even really aggressive meal. boluses, right. So sometimes getting that reevaluated with your healthcare provider, or diabetes educator, can be really, really helpful. But also coming from other AI D systems where you may not have as much information about, you know, what's going on with your basal rates or anything like that. But really just going when in doubt, wipe it out, you know, go back to basics with your settings, and with your provider and making sure those are dialed in. Because control IQ  is being a metabolic algorithm, it really does behave when we really did design it around sort of insulin titration as we know it. So it's not any, any crazy math, it's not an occult science, it's, you know, it's what your endocrinologist would use now, for titrating insulin and going back to those basics is is really necessary to get a good solid start.   Stacey Simms  21:23 So would you recommend maybe basal testing or just talking to your provider about what they think is best for your settings,   Molly McElwee Malloy   21:29 talk to your provider about what's best for your settings. I mean, I can't give any medical advice on on how to do that exactly. But there, there are known ways to do this, whether it's you getting your basal rate, or your carb ratio, and a correction factor all dialed in. Do that with your provider. I I personally hate basal testing, I will tell you that I don't like basal testing. The reason I don't like it is because when people are basal testing, they are altering their behavior from normal. And it is not a true test, right? They're trying to avoid hypoglycemia. They're not doing their normal schedule. Because if you get hypo right, you have to treat it's trashed, you have to do it again. And so beta testing is, in my personal opinion, a nightmare, and not a true representation of what the patient is actually needing during that time. So I would I would prefer to do is see how controller hue is changing baseline and then see what that looks like against what's programmed and kind of, you know, look at the difference between the two to get the feedback. So really think basal testing is, you know, in theory, it's a good thing, right? But nobody basal testing is doing exactly what they were doing before that because they're not eating, right, they're trying to be careful about hypoglycemia. Sometimes you're just staying home all day to try to test this out, because you have to do so many finger sticks or what have you. So I don't think it's a really good representation of what's actually going on, I think, you know, looking at your total daily dose of insulin and talking to your healthcare provider, you can get that dialed in much better, with much less frustration. What I did with Benny and   Stacey Simms  22:59 I agree with him on the basal testing, we haven't done it in years and years and years for many of those reasons. But what we did that work nicely is we made changes very slowly. And it can be very frustrating. But it really works well. For us. Again, this is not medical advice. This is me personally what we did. And it really helped, we made one change basically, like he went low at 2am. So I changed the basal rate and we waited like three days, then and even if we went low, we treated but we didn't change the basal rate, then we worked on the insulin sensitivity factor, then like it took us two to three weeks before we thought we might have it and then we adjusted again about a month later. And if you if you can be patient, which is so hard to do, you know, people especially especially, and I'll throw myself under the bus too, especially as parents, we get nervous if anything's out of whack, right? We want everything to be perfect. What happened to my straight lines, and it's really hard to dial into settings, unless you're willing to let some of that perfection slide for a few days or weeks. But I'm telling you do it slowly, it'll come out much better in the long run.   Molly McElwee Malloy   24:03 Right. And if you think about an experiment, like for instance, the one that often comes up in our household is meant to my husband likes to follow recipes. And I hate following recipes. Although I know it's absolutely necessary, right? Because if you don't get the flour and the sugar and everything else, right, it just tastes like dirt. So they when you're baking, because I have done that. But it's very important to follow those recipes because if you alter you know one thing versus another thing, you're gonna get a totally different result. So altering one thing at a time is very important in a scientific kind of experiment, which sometimes dialing and pump settings is absolutely like that. And you need to follow that recipe. You can't willy nilly. It's not an art, right. It's very much a science. There's no there's no artfulness in this.   Stacey Simms  24:51 So looking ahead, and I'm not sure how much you can tell us but I'd love to start by kind of asking you about changes planned to control like you bet He has the first question here. He wants to know when the auto correction, right that auto, I call it the auto bolus, but the auto correction, when that will be stronger, because right now it's 60%. automatically.   Molly McElwee Malloy   25:12 Yeah, 60% because we're also titrating. Basal. Right. So the combination usually gets you closer to 100%. We are currently working on what that looks like, and how we could do that safely. I don't know how quickly that comes to fruition. But I can tell you that we are working on trying to understand how you would increase aggressivity without increasing hypoglycemia   Stacey Simms  25:37 you need a teenager setting, I can tell you that   Molly McElwee Malloy   25:40 we need a teenager aggressivity setting that's, that's for darn sure. Yes, Yes, we do. Well, maybe   Molly McElwee Malloy   25:45 I should start   Stacey Simms  25:46 by really asking you what what are you looking at in terms of improving or changing control iQ?   Molly McElwee Malloy   25:52 So we've we've really listened towards to feed back, right. So one of the things we do at Tandem, which we do really, really well, is we do these surveys all the time, where I'm constantly asking you, and you probably get these, what do you think of this? What do you think of that? What do you want from this, what you want for that, and then we look at the glycemic data, and we do some comparisons, because you can't just take what somebody wants as the absolute that would be best for everybody without looking at glycemic data. So we're kind of looking at both of those things, to see how we could refine Control IQ for something in the future, that works better and something that people don't even more excited about. So we're looking at people's sort of concerns? Or how aggressive can it be? Can it be more aggressive? Could it be less aggressive? gonna, you know, do this or that, but I picked my targets? Could I put a timer on exercise? Could I do all that? We are looking at all of those things? I would say nothing's off the table right now. I don't have any promises as to what comes first. As far as the improvements go, I think, you know, the next thing that we've been working on sort of is that bolusing from your phone, and being able to bolus from the app? Because that's been a big request.   Stacey Simms  26:57 Oh, but I'm asking about that. Don't worry.   Molly McElwee Malloy   27:00 Okay, yeah, because the thing, the cool thing about working as you know, we're a software, pump company, right, software based insulin pump company, which is cool, because you can make changes to software a lot easier than you can make changes to hardware. And so since we're not reliant upon the hardware to change, to make major changes, we could kind of do this in an iterative fashion, you know, one thing and then another thing, and then you know, and build and build and build a better product as we go along. And like you said, before, doing it slowly, carefully, looking to making sure that the changes are appropriate and working for everybody. So we're gonna follow that sort of scientific process, but we're looking at a bunch of different things that we might be able to change or, or make better based on feedback that we've gotten from our users.   Stacey Simms  27:49 One of the things that the other pump companies are coming out with, or if they come out in 2021, is a lower and different range, target range, or target number, you know, Omni pod and Medtronic have said that it'll be lower than, you know, 115, or 110. It'll be down to 100. It might even be adjustable. Can you speak to what Tandem is looking on that?   Molly McElwee Malloy   28:12 I think we're looking at a lot of different things I do. And full disclosure, as everybody knows, I come out of the University of Virginia research school center for diabetes technology, and working with Dr. Boris kabocha, and working with Dr. Mark proton, and Sue brown and Stacy Anderson, and really getting familiar with what is safe, and where people can kind of push the limit and where you can't, I think that 112 point five that we've chosen as being a really safe glucose has been really safe for the majority of the population. And since we're designing for the majority of the population, it's been very successful. So I know there are people who want to choose differently and want tighter targets. Now, when you choose tighter targets, whether it's 100, you know, some people will want 80, things like that, you're going to have to trade off some hyperglycemia. And as a product that gets approved for vast majority of patients, when you increase hypoglycemia, you are inviting adverse events, right? You're inviting possible adverse outcomes. And so you have to be very, very careful and almost ginger with that, and what that's going to mean for your patients and for the whole population. So I approach that cautiously. And I think at Tandem, we're approaching that cautiously as to how do you do that without increasing hyperglycemia? I think other people choosing those targets, you're gonna see the trade off with increased hyperglycemia. At least that's what we've seen so far. And in clinical trials,   Stacey Simms  29:56 it's interesting because people listen to this podcast generally. We are found through the research that I've done, you know, are extremely well educated, you know, very much take control of their diabetes in terms of even willing to do DIY stuff, right? It's a different population. So as you're listening and you're thinking, well, I want to ride at You know, all day long Give me that flexibility. and wondering, you know, how do we balance that, as you're saying, with the 99% of people with diabetes, type one and type two, who may use this pump, who don't have access to the education or the time to look into it, or you know, many, many, many factors that increased that chance of hypoglycemia, as you said, but the other hand, it's a selling point. And other pump companies are already saying, we were going to be better, right? Or we're going to be more flexible. And I don't know if that's even a question for you, Molly in the position you're in. But it is something that I guess you really have to take into consideration.   Molly McElwee Malloy   30:38 You do. And I can speak more philosophically about this than I can. Anything else. But you know, particularly as a diabetes educator, and as someone with diabetes, hugging that line at 80, or 82, or whatever someone wants to do, you do have increased hypoglycemia. So the most relevant experience I have to pull from is pregnancy, right? during pregnancy, we asked people to stay, you know, very controlled, which you know, is a little bit like magical thinking, because it's very, very difficult. When you get all these hormones raging and everything going on and you're sick this minute, you're hungry, the next and all this stuff is going on, I spent a miserable amount of time and hypoglycemia, this was before any automated insulin system, right? So my daughter just turned four, so we can do the math. And she's my youngest. So I know nothing was on the market at that time, that would have helped me. But that was preventing that, but in letting me ride that really close line, have you know, let's hang out at 72 all day, at personally thought that was a miserable experience, whether it's the neural glycopyrronium, right, so your the lack of glucose to the brain where you're like, I can't remember what's going on or what I need to think about next, or you're constantly tweeting hyperglycemia. Like, it's not a trade off, I would take lightly. It's a risky trade off. And I would say for for people who are comfortable being in that space, that's fine. And that's a very small amount of people, right. And if you can hug 82 all day, with, you know, whether it's doing some sort of low carb diet and intense exercise or what what have you, that's awesome, you're also not the majority of the population, right? So while I can appreciate that people want that, and they want to be able to set a much lower target, you know, people with euglycemia, right, without diabetes, don't have that either. People with without diabetes do have, you know, 30 40 point range, sometimes with meals and things like that happening. So it's not, it's perfection that I don't know, is a realistic ask for someone with diabetes. Now, people who can do this and do this all the time, I guarantee you, they're spending a tremendous amount of time and thought on it. Again, if you want to do that, and you can do that. And that works for your sanity, then please, by all means, but for a lot of people, you know, like, we have other things that we are going to be focusing on, and it's not going to be diabetes 24. Seven, and the goal of an automated system is to relieve some of that burden. So, you know, it kind of depends on like, Are you okay, with the trade off being low? Are you okay, with more management with being more involved? A lot of that's just going to be decisions, personal decisions someone's going to have to make, but I wouldn't say that the lower target is necessarily advantageous for a large population.   Stacey Simms  33:24 Okay, as you listen, I know, you were screaming at me to go back to bolus by phone. Don't worry. I didn't let it slip by. Let's talk about that. Because the app came out spring-ish of last year for general users. And it's great to look at people love the information. Talk to me about if you can tell us a timeline or any information about bolus by phone?   Molly McElwee Malloy   33:46 Yeah, so one of the cool things about my job is that I get to work with the Human Factors department and we have really good human factors department at Tandem. And we   Stacey Simms  33:56 stop you there human factors, because that always confused me. That means how people actually interact like how stuff feels and looks and how you actually use it,   Molly McElwee Malloy   34:03 and how you understand it. And how logical is something to you? How intuitive is something to you, you know, something as simple as changing where and the menu structure you would put something we test to see if trained, can people find this? Is this intuitive? Does this make sense to you? If we use a new term, right, we test it to make sure that it's understandable the thing might, you know, this is a very much outside of the realm of insulin pump therapy. My favorite illustration of human factors is if you you know any hotel you've ever visited, you pick up the hairdryer that says do not use in the shower, right? Like someone did that there was someone I'm sorry, yes, somebody did that. Right. There's, you know, crazy warnings if you'd like pick up a pillow, it's like you know, do not use while smoking or do not, you know, things like that, but it did happen. So that warning has to occur. So if we change something with insulin pump therapy, or we Add a feature like bolusing. From iPhone, we have to test it very thoroughly to make sure it's safe, effective, understandable and intuitive, because not everybody is going to read the instructions. So we have just completed the mobile bolus testing. And we've done extensive work, testing it in a number of different scenarios, people with type one, type two pediatrics, where they are in charge pediatrics, where the parents in charge, you know, there's a wide range of people who are using the system. And we need to test in all of those different user groups and get feedback. And it went really, really well, which was excellent, which means that it can then get submitted to the FDA. So I suspect that that will be happening somewhat early in 2021, first half of 2021. But I don't have insight or line of sight as to when that is promised. Because the FDA is so so concerned with COVID right now as they rightfully should be, and approving vaccines and things like that. So there's a little bit of a backlog there. And I don't know how that's gonna affect our timeline. But we've been working really hard to get that out. We know people want it, we know people will need it. And it will be a really useful feature. But it's been tested really well.   Stacey Simms  36:08 So and again, I'm, I get a little fuzzy sometimes on the details here. What kind of submission is this? I have learned in the last few years that there are different ways of submitting to the FDA some take longer to approve. I mean, we never know how long it'll take to approve Having said that, but there are some things that are like building on previous submissions is bolused, by phone something so new, that they have to look at it in a new way, or is it building on something you've already asked them about?   Molly McElwee Malloy   36:32 It's a good question. And I'm not part of the regulatory team that is involved in that strategy. I believe that we are building on our previous submission, since this is an on an ace pump, an alternate controller enabled pump and the and the the way that the pump is built. And the way that that is structured for regulatory purposes, is that you build upon last submissions, but I can't speak with authority on that at this time.   Stacey Simms  37:12 The other thing that we are very interested in as a household and a community is that what has been called the T-sport, can you talk about where that is in the process, and that's the tiny tube pump, I guess I would call it, I'll link a picture, if you're not familiar with it, we will link up some more information. But it's not quite a patch pump, there is still a little tube on it. But it's much smaller than the x two and it's made to be worn kind of flush or flatter to the body.   Molly McElwee Malloy   37:28 Right. And the idea behind this is that you could have a variable to be linked right very, very short tube on your body to longer where you just put it in your pocket. So depending upon the patient needs, the reason that it is still has an infusion set is that we know right from feedback that if you have an occlusion with a patch pump, you take that patch pump off and you lose that insulin right, and you lose that whole thing. If you can replace a site, and not all of the insulin that's in you know in contained to their end, then that is an easier fix for somebody, it's also less expensive. So that's something that we've been very keen to keep. And addition, the the idea that you might need a different angle set. So not everybody can use the same sets as successfully as others. This will allow us for some variety there as well. And so we're pleased about that.   Stacey Simms  38:22 And I can just jump in and kind of translate because I know you're you have to be careful about what you can say. But as you're listening, if you're wondering what she's talking about Omnipod goes in one way, there's not an angled set, there's not a steel set, there's not a different set, there are a few more options if you're using a tube pump, if the inset on the pod pump doesn't work for you. And so there's also as you mentioned, the insulin that's in the tubing, you can do I don't know if this is Tandem approved, so maybe don't listen, Molly, but you can do separate site and tubing cartridge changes when you use a tube pump, which is what we have done for years. So when he said of insulin, the pump, we change the cartridge, when it's time to change the inset, we change the inset we don't do those together. So, you know, advantages and disadvantages for each pump. I know Omnipod people love the things that are great about their pump, but those are the differences that you're talking about. Just in case you can't get into the nitty gritty.   Molly McElwee Malloy   39:11 Right, absolutely. And you know, we're big fans of choice at Tandem. So if something works for you, great, excellent. And so one of the reasons that we're so big on choices, because not everything works for every person. So this book allows somebody some choice within that. That option.   Stacey Simms  39:27 So where are you in the in the test? I know you can, you can barely give us full details. But where are we in terms of T-sport? Is it? Is it in testing? Is it is it coming out soon?   Molly McElwee Malloy   39:37 I can't speak to the exact timeline. And part of that is because the FDA is bogged in and down in COVID right now, but we are working on it. I know we're working from a human factor perspective, we're working on what the difference is going to mean for the patient and training for something like this or from the healthcare provider and training and something like this. And that's the aspect that I'm involved in, is you know, how do you train on something that's a little But different like this, and how do you change the training to adapt to that, but everything is in development. The thing about Control IQ and and even basal IQ is right there already tested. So those can be implemented in a new form factor without any problems. So that's something that we don't have to worry about. So it's more of just form and function and things like that.   Stacey Simms  40:19 Here's a dumb question for you. I have heard that T-sport is the name that you all are kind of using internally, and it may not have that name when it's released. Any update on the name? Is there an update on the name? Oh,   Molly McElwee Malloy   40:31 I am not the person that would be able to tell you that. Oh, okay. But I appreciate the question.   Stacey Simms  40:38 I think you should have a contest and you could name it, you know, pumpy mc pump face or something. But yeah,   Molly McElwee Malloy   40:43 exactly. Yeah. Yeah,   Molly McElwee Malloy   40:45 we're shorting   Stacey Simms  40:46 Yeah, surely that's perfect. I was laughing when we talked about that this summer, because it's interesting. And it's such a wonderfully privileged place that I'm in I feel like we're we find out this information. So early in the process, that the branding isn't really even set. So it's when I heard that I thought, Wow, what a cool place to be in some very interesting stuff. Right. I have a few questions from listeners for you. I know you have some more information. We're getting kind of long here. But let me ask you, here's a quick Control IQ question. And this is more advice. I don't know if you can answer this. So this person says, sometimes I like to set a higher basal in advance of when I work out because adrenaline makes my blood sugar spike, can you change that. So we can manually adjust basal rates without having to turn off control IQ, I know my body better than the software having to manually adjust with boluses after and having to guess, since I can't do them based on blood sugar due to iob issues is tricky. And I will jump in and say Molly, Benny, and I do this too, we do some guessing with the manual boluses. So I'd love to hear what you think about this.   Molly McElwee Malloy   41:49 Sure. So there's a couple different directions we can go as one is you can turn Control IQ off and on and do temp basal rates. And there's no penalty, right for doing that. There's no learning time or restart up or, or anything like that, that impacts Control IQ if you turn it off and on for those periods of time. So that is absolutely an option. It's just it's super easy to do. Another thing that we've seen people do successfully is set up a secondary profile that is a bit more conservative or a bit more aggressive, depending upon the patient needs. And then switching into that profile for that period of time. And leaving Control IQ on so there's a lot of different ways you could do this, you could even do a secondary profile, and then put it into exercise, right? Like you could do conservative plus that temp basal, right, or you could do aggressive plus that 10 basal rate. So all of that is it's entirely possible. But knowing that you can turn it off and do the basal rate as you please and then resume it confidently, you know, that's still an option for you. I do know that people do want a bit more control over that. And so and, you know, allowing for some sort of ability to have a temporary basal rate is on the list of things that we would like to do. Great.   Stacey Simms  43:03 Another question was I am still using basal IQ. And this person is really curious about what percent of Tandem users are using control IQ. And and you've kind of touched on this. But do you have any statistics about user satisfaction rates for control? iQ?   Molly McElwee Malloy   43:18 Yeah, so D q&a, again, affiliated with diatribe, third parties who, you know, has done some user satisfaction surveys, and I will get you the exact number. But this user satisfaction with Control IQ is very high, very, very high. And I would say the majority of people have changed over to control like you. But there are still patients on base like you and I can't speak to the exact percentage, but there are reasons why somebody may want to choose based like you to just have that suspension rather than also, uh, you know, having the, the auto correction or something like that. So there's cases for both, and that's why they're both still being offered. But I can't speak to the exact number of people who have not switched over, but most people are switching over to control like you.   Stacey Simms  44:02 Are there any plans to make it more flexible in terms of switching back and forth? Because once you go from basal IQ we did this once you put the software in your pump and switch to Control IQ you can't go back to basal IQ. Are there any plans to change that?   Molly McElwee Malloy   44:16 Not at this time. The reason being is that you wouldn't need a script, write a prescription to do that. And when you upload your property went to your provider. If you went between one thing and another and another all the time, we would really have to differentiate those reports and make sure that the healthcare provider was familiar with why each was different because they would impact how you would titrate insulin so it adds a lot of complexity on the therapy end. And so we have not made a move to to make that something that you could toggle between. Got it.   Stacey Simms  44:51 And another question came in which I thought was really interesting about accessibility for people who are blind and I know in the past, there was a meter that I think talked about There was more audio is Tandem looking at more accessibility for people who don't have any vision or low vision.   Molly McElwee Malloy   45:07 Yeah, yeah. So Tandem is making technology user friendly for those with different abilities. And we're absolutely have this on our radar, persons with low vision or no vision, right, using a touchscreen could be difficult. And we're exploring ways to leverage apps and existing consumer technology that might be able to solve those unmet needs. It's definitely definitely something that we are looking at and can appreciate that that's something that we need to do.   Stacey Simms  45:32 Very cool. Another question came in, and this is based on an older press release. So I'm not sure if you can speak to it. But apparently JDRF in Tandem years ago, like eight years ago, put out a news release about a dual hormone, insulin pump. What we're seeing if you're familiar with the iLet beta bionics is because the only one at least in the US where they're trying to develop a pump with insulin and glucagon with more stable glucagon now on the market, any chance that Tandem is working on a dual chambered pump.   Molly McElwee Malloy   46:02 So the big message here is that that eight years ago, I think, for the press releases when Tandem was being used with two separate pumps in the iLet studies, right, right, they ran the Tandem pumps, and one was full of glucagon and one was full of insulin. And they were putting two pumps on one person,   Stacey Simms  46:13 I remember that picture. Wow.   Molly McElwee Malloy   46:21 So that's where that came from. So but our our micro delivery technology is really well suited for to hormone therapy, we currently are only approved for you 100, right? insulin and only indicated for insulin per FDA. But you know, it's a fundamental challenge for people developing dual chamber devices. And there's not an approved hormone available for use in pumps at this time. So it all be very investigational. But we do have, you know, this microdelivery technology, which is well suited for doing something like dual hormone, but I think there's a lot of things that need to get addressed before even that becomes something that we can put in a trial.   Stacey Simms  47:02 And then it's something that I started talking about this summer, I've mentioned this interview with I did with Steph Habif from Tandem. And I will link that up. It was kind of we call it the first look under the hood for Control IQ that we did this summer. And she's the Senior Director of Behavioral Sciences. But we brought up some of the questions about who gets into clinical trials and who actually tests these things out and the information that you get in terms of diversity. And so this question here, I'll read the whole question from a listener. I've heard some rumblings that most of the people who tested Control IQ were white, I would love to know that Tandem has plans to diversify this more. This is a huge issue in general for trials of any kind, and stuff this summer started to address that in terms of Tandem knows it. They're trying to be more diverse. Can you follow up on that? And let us know what's going on?   Molly McElwee Malloy   47:50 Yeah, and your listener question is totally right on, right. The FDA is on this as well. They recently told Moderna, you know, you have to go back with your COVID vaccine and get get more people, right, you have to get people of diverse backgrounds and and ethnicity. And so that's true in clinical trials overall, need to be all more inclusive. And it's true that most automated insulin delivery trials today have been largely white, and that includes our adult pivotal trial. One of the things we're seeing changing from both an FDA perspective, as well as research and industry is that there's active pivoting to change the approach. And there's more guidance on changing the approach. The FDA has issued guidance on diversity and inclusion in clinical trials, which I'm sure you could post in the show notes. But that's a really interesting sort of, if you will mandate from the FDA to please be more inclusive, but for those in the community who may have attended that D data event from diabetes mine, and I can send you a link to the YouTube video, Dr. brandmark, who's at Children's Hospital in Washington, DC presented on diversity inclusion, specifically in diabetes technology research, and it was very illuminating on how white those trials are right? And what we need to do to better accommodate and to be more inclusive in a lot of different communities. From a Tandem perspective, we are very committed to this, particularly in our post market studies, we encourage principal investigators to do the same who are looking at different research and the FDA is mandating it so it absolutely will be happening right? The FDA says you will be providing a trial with this type of diversity you will be doing that so I think that the that everybody is aware that this needs to happen and we're trying to figure out how best to do it and be responsible stewards and industry but for a long time you're right I mean, you know diabetes technology and automated insulin delivery trials were largely white, you know, you have to be able to take off of work right? Whether you're bringing your kids to your appointment or not. And so those are jobs with that allow some flexibility. You have to be able to afford to miss work right? You have to have paid some sort Lead, whether it's sick or personal days and, and all of that does impact the person that you recruit. Right. So being able to alleviate some of that maybe it's provide compensation, the FDA suggested providing compensation for parents that can't take off time from work or, you know, meeting people where they're out whether it's in qualified public health centers, or at schools or wherever, to make it easier for them to attend, whether it's clinical appointments or whatnot, but meet people where they're at and have people run the research that look like the people who will be in the research, right? So diversified that field as well. There's a lot that needs to be done here. And Tandem is absolutely committed to making this a priority.   Stacey Simms  50:42 That's great to hear. I'm interested in following up more about it not just with Tandem, you know, I feel like it's also a question of finding people who, you know, I have the same frustration with this podcast, how do I reach new communities? How do I find people who would maybe benefit from the information but don't know why I exist? Because I don't run in those circles, right? I mean, we tend to run in the same circles, and we need to branch out and not make people find us. But But fight. Right. So it's really, I think it's also a question of finding more. Look, I'm not an expert on this by any means. I probably shouldn't speculate. But it's also a question of, you know, finding staff that is of different races, me finding more guests that are of different races and are, are in different communities. It's for us to do the work, not to ask them to come to us. And so I'm really glad that Tandem is doing that and is on top of that. So thanks for answering that.   Molly McElwee Malloy   51:37 Yeah, there's a sea change coming in society and diversity and inclusion, and that will absolutely be translated at Tandem.   Stacey Simms  51:45 we've been talking for a long time, you've been really generous with your time. Just another quick question from a listener. And that is about the mobile app. I'll be honest with you, Benny doesn't use it a lot. He says he's waiting for bolus by phone. But someone said it wasn't that fast. In terms of uploading. Have you heard about that? Is that something that you're looking at?   Molly McElwee Malloy   52:03 Yeah, absolutely. And the reason that I think some people are experiencing that is that they haven't downloaded, they're pumping some time in, right. So whenever it last downloaded, it's going to append that data going forward. And so if you have a year's worth of data, or you have six months worth of data, that's not gotten to the cloud, that takes a while to get up there. So if you could download your pump First, if you've not downloaded in a long time to connect, or upload your pump, rather than that sort of relieves that burden to append the all the data that has never been there before. So if you could do that, and then let it sync, day after day, it will be much faster. It'll be much, much faster,   Stacey Simms  52:45 And we did that I should probably get on that. But it's Yes. Good. Hey, really, before I let you go, Molly, we haven't spent a lot of time on this interview, because you've been generous in the past to come on the show for really many years now. But I haven't spent time talking to you about your personal experiences. But as you mentioned, you know, you've been in this community not just living with diabetes, but you've been in the testing for the artificial pancreas projects for for what has become Control IQ for a very long time. Would you mind if I asked you just one more time? What is this like for you? We've had this elusive piece of software in the market with real people using it for a year. You've been testing it for I want to say almost 10 years. What's it like for you?   Molly McElwee Malloy   53:30 Yeah, yeah, it's professionally, 10 years, and personally, for 14. So it's a bit of a surreal experience. But it's also it's very cool, because I can see the improvements that need to be made. And I can see how they can be made. And it's been really, really cool to teach health care providers, and particularly, which is a big part of my job about reading the data and looking at insulin needs. And how do you make this look like you are how do you make this work with bass like you are? How do you make this work? easiest for your practice. And it's just been just to put it into practice has been really awesome. Because it's, we do get notes from users on social media and otherwise about how it's impacted their life and that they feel like a normal person now and that's all I've ever wanted, right as a person with diabetes is to like, give me back my personhood, where I'm not thinking about diabetes 24 seven, and I feel like Control IQ does that. You know, it's not Is it the be all end all? No, we will improve upon that. But you're never done right. But the fact that so many people have expressed that has been really rewarding. And I really want to see that carry forward and in all of our products that we relieve reduce burden for people with chronic disease. There's no other disease in the world where we asked somebody to do all the things we asked in diabetes. You know, if you have a heart condition, we don't ask you to beat your own heart. You know, we don't there's nothing else that we ask this much of people and then that we possibly make them feel bad or shame them for not achieving these things, which is kind of crazy. So reducing that burden and making this a more realistic disease to manage, is all I've ever wanted.   Stacey Simms  55:06 Well, I can't thank you enough for your personal participation in testing this out for years and years, as you said, 14 years and for being so accessible and coming on to answer all of these questions. So Molly, thanks so much. I look forward to talking to you more. I look forward to more improvements and exciting releases from Tandem. I know you'll keep us posted. I really appreciate your time.   Molly McElwee Malloy   55:26 Absolutely. Anytime. Thank you.   Announcer  55:34 You're listening to Diabetes Connections with Stacey Simms.   Stacey Simms  55:39 Lots more information in the show notes. I'll link up some helpful things from Tandem and more information for you. And I did have a couple of follow ups. As you heard, Molly couldn't answer every question I had. So I got a couple of notes for Tandem that I want to share with you. Now, bolus by phone was submitted in the third quarter of last year. That is called mobile bolus. I don't know if there's a branded name for it. I did ask about that. But I hadn't heard back. But that has been submitted. It's in front of the FDA right now they're hoping to hear back in the first half of 2021. You know, it's hard as Molly did save with COVID, delaying everything, it's gonna be really hard to tell, as always, when the FDA will approve these things. But I'm so excited about that. And I'm interested to see what it looks like practically, I'm going to say this with no knowledge of what was submitted, I do not have an inside track on what it would actually look like. So this is my speculation. You know, I imagine you just take out your phone and use it like your pump. Right? You can you'll have the full functionality. I don't know if that's really the case, I would imagine the FDA might be cautious. I don't know. But man, I just envisioned Benny, you know, he's got his phone in his hand half the day anyway. So beep beep, you know, let's go. Maybe that'll be their branding: beep beep Let's go. They also let me know that Tandem is still planning to submit the Tsport to the FDA in the first half of 2021. And they are hoping for a quick turnaround possibly launching by the end of this year, which would be really exciting and nice to have another option there. And a listener asked me about this. I didn't get it in time for this interview. But I did have a chance to ask Tandem about their agreement with Abbott, if you'll recall, Tandem and Abbott have an agreement to integrate with the Libre not just with the Dexcom. So there is apparently no update on that right now. But they are anticipating having one in the fourth quarter of 2021. We talk a lot about interoperability on this show. And you know, of course the dream is if a certain CGM isn't working for you, and another works better, you'll be able to slap that on and press a button on the pump. I don't think it's going to be that easy. But maybe down the road, I really do hope that we'll have more options. But if you had asked me five years ago, if the pump market would look like it's about to look right now, I think I would be pretty happy about that not just because of the great technology that's here from Tandem. And we've been talking about what's next for Medtronic and Omni pod. But because we have more pump players coming to market, I am so excited to be talking to the folks from beta bionics and from Big Foot later on this year. So we will keep you posted. Innovations coming up

No primeiro episódio do ano do Expresso Digital, programa do Opice Blum Cast sobre direito digital e proteção de dados, Marcella Costa, gestora da Startup.OBA, destaca o momento muito positivo para as startups no Brasil. No ano passado, apesar da crise causada pela pandemia, elas receberam volume de investimentos 17% maior do que em 2019. Confira também informações sobre o Sandbox Regulatório, do Banco Central do Brasil. Os interessados podem inscrever seus projetos a partir do mês que vem. Conheça a IoB ou Internet do Comportamento, uma tendência para este ano, segundo a Gartner. Trata-se da coleta e do uso de dados para conduzir ou guiar o comportamento das pessoas. Destaque, ainda, para outra tendência: aprovação da legislação federal de proteção de dados pessoais nos EUA. Editorial do jornal “The Washington Post” pressionou o Congresso nesse sentido. #pracegover: divulgação do episódio, com foto da apresentadora #dadospessoais #proteçãodedados #IoB #privacidade #DPO #startups #inovação #empresas #direitodigital

"The Privatization of American Life" Hosts: Darren Weeks, Vicky Davis Show website: https://governamerica.com Vicky's Websites: https://thetechnocratictyranny.com and http://channelingreality.com COMPLETE SHOW NOTES AND CREDITS AT: https://governamerica.com/radio/radio-archives/22391-govern-america-january-2-2021-the-privatization-of-american-life Listen live every Saturday at 11AM Eastern time or 8AM Pacific at http://live.governamerica.com or on your favorite app. Just search for "Govern America Radio". Text GOVERN to 80123 to be notified of live shows or special reports that occur outside of our regularly-scheduled Saturday broadcast. These transmissions are moved when circumstances warrant. SJWs taking over major corporations whose leadership are too cowardice and weak to fire them. Antifa needs a place to stay. Modern technology is leading to civil atomization. Was this the plan all along? War of words, missiles, and exercises with Iran. Communist Chinese not only compromise U.S. politicians, but have also neutered major media establishments by gifting private trips and dinners. What is the Kraken? Do we really want it released? The Internet of Bodies (IoB) is the next big thing. Nashville terror follow up: The "paranoid 5G" narrative and admission by authorities of foreknowledge. Eugenicist Bill Gates looms large over the World Health Organization and other key institutions, agencies, and organizations. Opposition grows to the vaccine, even among many health professionals — follow the money. Fauci admits to lying to the American people. As the alarmist media touts hospitals that are at or above "capacity", is this really as bad as it sounds? New study dubunks the notion of asymptomatic transmission of COVID-19. More outrageous deaths that are fraudulently labeled as COVID. Seasonal flu has all but disappeared; some are now calling for an independent audit / investigation of the numbers.

Nella prima puntata del 2021 e quindi della terza stagione, faremo alcune considerazioni degli eventi che più hanno caratterizzato il 2020. Dal mondo dei pagamenti, a quello del lavoro e della scuola fino al mondo della sanità. Proveremo anche a capire quali sono i trend che invece caratterizzano il 2021, un anno che è ancora completamente da scrivere viste le tante incognite e variabili che il 2020 ha portato con sé. Nella sezione delle notizie parliamo di servizio civile in ambito digitale, di un circuito in grado di produrre energia dal grafene e infine di un presunto furto di dati degli utenti, nei confronti dell’operatore Ho. mobile. --Indice-- • Il Servizio Civile diventa digitale (00:59) - DDay.it - Matteo Gallo • Gli utenti Ho. Mobile potrebbero essere a rischio (02:04) - IlPost.it - Davide Fasoli • Un circuito che produce energia dal grafene (03:15) - DDay.it - Luca Martinelli • Cosa aspettarsi dal 2021 (04:11) - NinjaMarketing.it - Davide Fasoli --Contatti-- • www.dentrolatecnologia.it • Instagram (@dentrolatecnologia) • Telegram (@dentrolatecnologia) • YouTube • redazione@dentrolatecnologia.it --Brani-- • Ecstasy by Rabbit Theft • Idyll by Peyruis

Tonight's Show: Noe Benavides. Noe is a Forex Trader and his investment group is Tradeknology. GREAT RESET 2020: "Better sit your Smart Ass down!" Transition from a Dumb Earth to a Smart World. The Smart Grid and why we need to invest in Companies that make goods and products that Drain (Suck Up) or Store Electricity. Even alternative Energy sources like Solar, Wind, Hydro, Magnetism, Algae etc. will connect to the Smart Grid. We have explained that Electricity has replaced Petroleum as Both  the Most Used Commodity by Humans and the Most Valuable Asset accepted by Humans. Have you noticed that every year a product we purchased and used our whole life is now has the word Smart infront of it (Smartphone, Smart TV, Smart Meter, etc). What makes a product Smart is it connects to the Internet. Anything connected to the Internet operates off Electricity. To manage all these Smart Products we have they created the IoT (Internet of Things). To manage the Smart Money and Contracts created and stored on the Web like Cryptocurrency, Digital Tokens & Assets we will use the Blockchain or IoV (Internet of Value). To manage all the Human Beings that use these Smart Products and Smart Money, we will have the IoB (Internet of Bodies). Yes a Internet of Bodies family, we will explain the (IoB). All of this requires 24/7/365 non stop Electricity, it can never turn off. To manage and control all these things we need to have what is known as a Smart Grid, we will explain the Smart Grid. Please listen and think of things you can Invest In based off this information about the New Electro World.

Costanza De Conno"Silent Book Contest Gianni De Conno Awards"Lunedì 7 dicembre 2020 ore 11:00“Silent Book Contest – Gianni De Conno Awards”on line suhttps://www.salonelibro.it/ita/Cerimonia di premiazione con la giuria internazionale del Premio intervengono Mussi Bollini e Costanza De Conno moderano Eros Miari e Patrizia Zerbi in collaborazione con Carthusia Edizioni, Bologna Children's Book Fair, IBBY Italia, Centro per il libro e la lettura, Comune di Mulazzo, Associazione Montereggio Paese dei Librai, IOB e BPER Bancall primo concorso internazionale dedicato ai libri senza parole arriva alla sua VII edizione. Un appuntamento per fare il punto della situazione sui silent book, conoscere il vincitore e il lavoro della Giuria. Durante la premiazione sarà annunciato anche il vincitore del Silent Book Contest 2020 Junior, il libro premiato da una giuria di oltre 120 bambini da tutta Italia.Beatrice Masini, Gianni De Conno"Il buon viaggio"Carthusia EdizioniViaggiare è soprattutto un'esperienza personale di crescita, capace di arricchire la persona che lo compie indipendentemente da come o dove esso si svolga. Qui sta il cuore di questo libro, prezioso per la poesia del suo testo e per la magia delle sue immagini.Uno ti dice Buon Viaggioquando ti vede andar viapronto per un lungo camminoper stare solo,per vedere cose e postie persone che non avevi mai visto,per scoprire tesori che ancora non sai.Carthusia Edizionihttps://www.carthusiaedizioni.it/È il 1987 quando Patrizia Zerbi, editore e direttore editoriale di Carthusia, decide di seguire il proprio sogno fondando a Milano una casa editrice per ragazzi, a misura loro e di chi come loro ama le storie belle. Siamo un mondo tutto al femminile che da oltre trent'anni si occupa di comunicazione rivolta a bambini e ragazzi, insegnanti, genitori e tutte quelle figure che lavorano con l'infanzia. Da sempre abbiamo due anime: una legata alla libreria e una ai progetti speciali. Due anime sì, ma di un solo corpo.IL POSTO DELLE PAROLEascoltare fa pensarehttps://ilpostodelleparole.it/

Patrizia Zerbi"Silent Book Contest"Vita NovaSalone del Librohttps://www.salonelibro.it/ita/Lunedì 7 dicembre 2020 ore 11:00"Silent Book Contest - Gianni De Conno Awards"on line su https://www.salonelibro.it/ita/Cerimonia di premiazione con la giuria internazionale del Premio intervengono Mussi Bollini e Costanza De Conno moderano Eros Miari e Patrizia Zerbi in collaborazione con Carthusia Edizioni, Bologna Children's Book Fair, IBBY Italia, Centro per il libro e la lettura, Comune di Mulazzo, Associazione Montereggio Paese dei Librai, IOB e BPER Bancall primo concorso internazionale dedicato ai libri senza parole arriva alla sua VII edizione. Un appuntamento per fare il punto della situazione sui silent book, conoscere il vincitore e il lavoro della Giuria. Durante la premiazione sarà annunciato anche il vincitore del Silent Book Contest 2020 Junior, il libro premiato da una giuria di oltre 120 bambini da tutta Italia.Carthusia Edizionihttps://www.carthusiaedizioni.it/È il 1987 quando Patrizia Zerbi, editore e direttore editoriale di Carthusia, decide di seguire il proprio sogno fondando a Milano una casa editrice per ragazzi, a misura loro e di chi come loro ama le storie belle. Siamo un mondo tutto al femminile che da oltre trent'anni si occupa di comunicazione rivolta a bambini e ragazzi, insegnanti, genitori e tutte quelle figure che lavorano con l'infanzia. Da sempre abbiamo due anime: una legata alla libreria e una ai progetti speciali. Due anime sì, ma di un solo corpo.IL POSTO DELLE PAROLEascoltare fa pensarehttps://ilpostodelleparole.it/

Join us as our guest Ms. Lonnette Rhone, IOB of Total Life Changes shares some exciting information on the benefits of using TLC Products. For more information and other valuable resources, make sure to subscribe, follow and visit our sites.  Website: www.thevoiceofmany.com  Instagram: https://www.instagram.com/theevoiceofmany/?hl=enTwitter: https://twitter.com/TheVoiceofMany3Facebook: https://www.facebook.com/The-Voice-of-Many 

Neuralink อุปกรณ์ IoB ที่จะเชื่อมระหว่างสมองของคุณกับคอมพิวเตอร์ มีประโยชน์อย่างไรและน่าสนใจขนาดไหน บอกเลยว่าเป็นอีกเรื่องแห่งอนาคตที่คุณต้องรู้!

Nesse episódio, nossa equipe recebe o Professor, Pesquisador e Advogado Cláudio Tessari (Currículo Lattes: http://lattes.cnpq.br/9748008854079452; website: http://tessaripohlmann.adv.br) para uma exposição sobre as questões contábeis e suas implicações tributárias nos processos de Recuperação Judicial. Referências citadas: TESSARI, Cláudio. Do compliance no planejamento tributário e contábil: o Comitê de Pronunciamentos Contábeis e o valor justo. Repertório de Jurisprudência IOB. Tributário, Constitucional e Administrativo. vol. I. n. 23, p. 908-916. São Paulo: Ed. Síntese, 1ª quinzena dezembro/2019. ISSN 2175-9987. ____________ Razões para não modular os efeitos da decisão do STF no Recurso Extraordinário n. 574.706/PR. Revista dos Tribunais on line. vol. 992. São Paulo: Ed. RT, jun. 2018. DTR/2018/15597. ISSN 0034-9275. TESSARI, Cláudio. ALLEGRETTI, Eduardo Augusto. Críticas à utilização do instituto da recuperação judicial para cobrança de créditos tributários. Revista de Direito Tributário Contemporâneo. vol. 8. ano 2. p. 165-192. São Paulo: Ed. RT, set-out. 2017, ISSN 2525-4626.

BiographyEarly in life, Lauren developed a fascination with the mechanisms that cause people to rise or fall when faced with critical challenges. As she was watching from the outside in, she couldn’t have known she would face her own test in the future. When Lauren was diagnosed with advanced cancer one week prior to her final divorce court date with 3 young children, in 2006 she had the opportunity to personally test the theories she had learned while pursuing an education in Adult Education, HRD and psychology. In the Colorado State Championship for the World Tae Kwon Do Federation, she was knocked out in the ring. She came back and won the silver medal. Several years later she was in the ring fighting for her life. She has a love for education and sees the value in it for the field she is in yet claims that the boots on the ground experience of going through two of life’s top stressors at the same time gave her the ultimate training needed to champion people into personal excellence in life. Lauren received her BS degree from CU Boulder in Journalism/Psychology; postgraduate in Education; She holds a Master of Education in Adult Education Degree and a Certification in Human Resource Development from Rutgers University; 2nddegree black belt from the World Wide Tae Kwon Do Federation; Certified Sherpa Executive Coach and ICF-PCC from the International Coach Federation; NLP/EFT Master Practitioner (two energy psychology modalities that result in profound positive behavioral transformation). Lauren is a member of the Association for Talent Development (ATD), Kappa Delta Pi, International Honors Society in Education and serves on the board of The Women of Global Change. Lauren has received National and International recognition including Ladies Home Journal; Redbook; Ladies Home Journal; Family Circle; Success Magazine; CSNBC; MSNBC; Lifetime; Discovery and the International Journal of Healing and Care. Resume Lauren E Miller, has a Masters in Adult Education with a Certification in Human Resources Development. She has personally conquered two of life's top stressors at the same time, advanced cancer and divorce. Now Google's #1 Stress Relief Expert, Award Winning Author, HRD Trainer and Certified Executive and Life Coach, Lauren facilitates process driven programs with structure, guidance, support and accountability designed to create positive change in behavior resulting in positive impact on business (IOB) and life purpose.

It's cricket most thrilling, most physically demanding and most misunderstood skill - on this week's Guerilla Cricket Podcast, host Nakul Pande constructs a three-pronged attack to unpack what fast bowling's all about: IAIN O'BRIEN: Former New Zealand fast bowler, creator of the Youtube channel 108 with IOB and friend of the show GLADSTONE SMALL: Much-loved former Warwickshire and England fast bowler and current tour host for The Black Opal Group, pod debutant IAN PONT: Pioneering fast bowling coach, author, and head coach of the Ultimate Pace Foundation and the National Fast Bowling Academy The panel talk bowling fast from every angle: physical, technical, strategic and psychological - it's your indispensable guide to what being a fast bowler is all about. Become a Patron, at any level, at patreon.com/guerillacricket and get all of our podcasts BEFORE ANYONE ELSE - help keep independent cricket commentary alive! And many thanks as ever to our producer and editor Jon Stone.

** IF YOU'VE ENJOYED THIS, PLEASE LEAVE A SHORT REVIEW. THANK YOU :-)** 1.20  - A delve into Mary’s background – 7.40 – What makes  a great people leader? – 9.30  - The power of diversity in work  – 13.00 –The key role of leaders during change  - 16.05 – Trust is key – 16.30 – Celebrate achievements (and failures!) honestly – 17.36 – People can grow through change  - 18.30 – Using a story to drive change – 24.55 – The importance of effective culture – 29.30 – How can leaders shape culture – 34.00 – Be yourself, not someone else - 39.30 – Mary’s advice for her younger self – ‘Be your authentic self’

REPORTEC - Cinque punti sulla security per il 2020 Il podcast che stai per ascoltare è realizzato in collaborazione con Reportec. Gaetano Di Blasio, ingegnere e giornalista specializzato nell’Information Technology, intervista Luca Livrieri, SE Manager di Italia e Iberia per Forcepoint. Si parla di sicurezza, evidenziando cinque ambiti strategici nei prossimi 12 mesi. E cioè: - 5G, canale sfruttato da attaccanti e utenti - La nuova frontiera del Deepfake as a Service - Cloud - Identità digitali - Migrazione tra indicatori IOC e IOB, per capire il comportamento in termini di rischio. Buon ascolto! Altri contenuti su www.radioit.it

Tandem's Control-IQ system was approved by the US FDA in mid-December. In this episode, Stacey talks to Molly McElwey Malloy, Tandem's clinical outcomes manager with behavioral sciences. Check out Stacey's new book: The World's Worst Diabetes Mom! Control-IQ technology is an advanced hybrid closed-loop system that uses an algorithm to automatically adjust insulin in response to predicted glucose levels to help increase time in the American Diabetes Association-recommended target range (70-180 mg/dL).* Check out Tandem's YouTube channel, featuring new videos about Control IQ Join the Diabetes Connections Facebook Group! This is our last episode of 2019! Stay tuned for new sponsors, new segments and new weekly mini-episodes. Sign up for our newsletter here To use Control-IQ, you must have the Tandem t:slim x2 insulin pump and you must have the Dexcom G6 CGM. The Control IQ software is as simple as a download from your computer to the pump.. it does not require a purchase of new hardware.. no new pump needed. You do need to have a prescription from you doctor. If you are an in-warranty customer the Control IQ update s free. All software updates released through 2020 are free to in-warranty t:slim X2 users. It doesn’t matter when you choose to download the update. The no-cost is determined by our release date, not your download date. ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone      Click here for Android   Episode transcription (Note: this is a rough transcription of the show. Please excuse spelling/grammar/punctuation errors) (Time codes listed refer to times within the interview, which starts 5:30 into the episode) Transcript: This episode of Diabetes Connections is brought to you by the World's Worst Diabetes Mom. Real life stories of parenting a child with Type One Diabetes, available now as eBook paperback and audio book, Learn more at diabetes dash connections.com Welcome to our last episode of 2019 and it's a big one all about Control IQ the new hybrid closed loop system from Tandem recently approved by the FDA. I'm talking with Molly McElwee Malloy from Tandem. And I'm going to try to keep this intro short. I know you all just want the information. But I do have a few housekeeping and other things to get to. You can always skip ahead if you wish, I will not be insulted. But first while my regular podcast listeners insulted first when things like this happen when there is a Big news in the community. We get a lot of new listeners. So I want to go through some basics first. Hi, I'm your host, I'm Stacey Simms. My son was diagnosed 13 years ago, right before he turned two. He is now freshman in high school. He is 15. And boy, time has really flown. My husband lives with type two diabetes, I don't have diabetes. I have a background in broadcasting, local radio and TV news. And that is how you get the podcast. We are four and a half years into this podcast. We have more than 260 episodes. So I would encourage you to head on over to diabetes dash connections. com If you're brand new, scroll through. There's a very robust search feature. So if you want to type in Tandem and see what we've done over the years leading up to this release, or any other topic pertinent to diabetes, you can go ahead and do that it's very easy to search through. It's very easy to search through, and everything you'd want to know about the podcast, including how to subscribe for free on whatever app you want to use. Joining the Facebook group all about me, it's all there on the website. Okay, let's talk about Control IQ. What is it? Control IQ technology is an advanced hybrid closed loop system. It is the software within the pump. It uses an algorithm to automatically adjust insulin in response to predicted glucose levels. So we're going to talk about that to help increase time in range. Time in range and the recommended target range is 70 to 180. And yes for the International listeners we have quite a few. This is a USA centric episode Control IQ is rolling out in the US. We will be staying up to date on when it is available in the rest of the world where Tandem is already in your marketplace. But this is a USA centric episode so when you hear us talking about numbers, that's the system that we're using. For Control IQ you must have the Tandem t slim x2 insulin pump and you must have the Dexcom G6 CGM. The Control IQ software is as simple as a download from your computer to the pump. It does not require a purchase of new hardware, no new pump is needed. You do need to have a prescription from your doctor and you will hear more about that if you are an warranty customer, the Control IQ update will be free. All software updates released through the end of 2020 are free to in warranty t slim X to users. It doesn't matter when you choose to download the update. The no cost is determined by Tandems release date, not your download date as we're right at the beginning of 2020. That probably doesn't matter to most of you listening but I think it's important to point out. Control IQ is FDA approved for those 14 and up. It is not a replacement for diabetes management. And it is not a cure. It is not a cure. There is so much information about this online already from Tandem. I will be linking up a lot of stuff on the episode web page. They have YouTube videos. There's so many features that we don't even get to in this interview. I mean, the tubing fill, you can now set that to vibrate so it doesn't beep when you fill the tubing and change the cartridge which I know Benny just so excited about but in this interview, we really just scratched the surface. So please know I will be doing follow ups and there's a lot of supplemental information on the website. Quick note about Molly McElwee Malloy, who I'm talking to from Tandem, she was diagnosed 22 years ago this week as a young adult. And as you will hear, being in an artificial pancreas trial, changed her life. It changed her career path, everything. And she is one of many, many people who has been with this project for a very long time. We do spend the first four minutes of this interview on that subject on who Molly is and getting to this point. And if you're dying to get Control IQ info, again, go ahead and skip ahead. But I think her story is an important part of all of this and I think it sets up all the information very well. One more thing. There will be a full transcription available for this interview. A lot of you have been asking for that. That's a new feature I'm making available for the podcast in 2020. So stay tuned on that for every episode, but this transcript will be right on that episode web page. The best way to read it go to diabetes dash connections. com scroll down and click on this interview to open it up. All right here is my interview with Tandems, Molly McElwee Malloy, Stacey Simms 0:01 Molly, thank you so much for joining me. I can only imagine how busy you are and how full your inbox is. Molly McElwee Malloy 0:08 It's a really exciting time. For sure. Absolutely. No doubt. Stacey Simms 0:15 Well, congratulations. We're very excited. I mean, personally and professionally. I can't wait to talk to you about this. So let's just jump right in. I do have to ask you though, for people who may not be familiar, tell me a little bit about your background because Boy, you have been with this project. Really, I want to say almost since day one, tell me about your involvement with what has led to Control IQ for Tandem. Molly McElwee Malloy 0:39 So I'm, I'm sort of what you would call like the obsessed fan who went rogue. So I, I was in an artificial pancreas prior in 2006. And full disclosure, because no surprise to anybody who knows me but I have a bit of OCD. And for me, that was manifesting is testing my blood sugar 30 times a day. Wow. And yeah, it was really out of Control. Or as most, you know, endocrinologist say, I was a perfect patient with zero Mental Health Quality, but life like it definitely was impacting my quality of life. But I participated in one of these trials. And it was, you know four IVs and somebody at your bedside for 32 hours and the whole nine yards, but for me, it was life changing that for a period of time, I could relax for the first time and just let somebody else take Control. And everything was fine. And I sort of just realized that deep breath at that time was exactly what I needed. And I and I was like, Well, I'm going to do whatever it takes to work on this project. So you know, at the time, I was a professional musician, which makes getting into science.. Stacey Simms 2:05 Be vert interesting, Molly McElwee Malloy 2:06 Just a super, super easy transition (laughs). As logical obviously, as you've spent your life, being a musician that makes sense to just go into science. So I went back to school for nursing and continued to participate in trials through nursing school. And then when I graduated they hired me on at the Center for diabetes technology at the University of Virginia, which is where all of this magic was taking place. And I have not looked back. So they hired me in 2010 have been acquainted with the algorithms since 2006 as a patient, and here we are, it's almost 2020 it's 2019. And it's finally getting to market so I've done that and I worked with a startup called Type Zero technologies, which commercialized The algorithm licensed it the Tandem diabetes care. And then I jumped over to Tandem to pursue commercializing the algorithm. So, a little bit of like a dog with a bone, go and fill it out. But it was sort of my glimpse at sanity. Like, this is what sanity, this is what my life could look like with diabetes. If something was managing it in the background, I was really only worried about the big things. And I saw that and I was like, that is exactly what I will do. That's what I'm gonna be doing. I will do this all the time until it gets there. And it is. It's been a very long journey. very rewarding journey. Very difficult journey, but to be here today, wearing the device is magical. Stacey Simms 3:54 Okay, I'm gonna stop you there. I could talk to you for a long time about the process. But as you listen, I know you want to get to Control IQ. So I will just say, I've talked to Molly a couple of times before and I will link up the other episodes because the background on this, as you mentioned, type zero, you know how Tandem came to have that software, the development of all this, it's really important. And it's really interesting to listen to. So I will link those episodes up. But let's talk about Control IQ, so many questions. What are the what are the first steps? What's going on right now. Molly McElwee Malloy 4:27 So because of this all happening right around holidays, what we're doing with him doing kind of behind the scenes and, you know, as we speak up through the beginning, or first two weeks of January is we're educating the whole you know, diabetes educator and endo workforce, getting everybody up to date, getting everybody ready, making sure we're on the same page. So that when you go to your endocrinologist and say I want this you know that customer, they are well informed of what's going on. So all of that's been going on in the scenes like, you know, just earlier today I was on the phone with 10 different doctors trying to make sure that we all understood everything. So we're, we're educating as fast and as seriously as we can. We have an excellent online training program. So you as a customer, if you are current X2 user base, like you are just x to the end user will get an email, and I believe it's the first the second week of January way of January 13. That week, you'll get an email saying, hey, go ahead and login, update your information, make sure everything correct when you get the prescription will, you know will we talk to your doctor and will help you if you're an existing customer with we have that information kind of fully loaded, ready to go. You could also log into the portal, the customer portal and you know, go ahead and start that process. I'm interested, I want this and talk to your doctor. That's all that's one place. It is super easy scripts with your doctor that gets loaded. It's an automatic process. Once we have that, if you've already got that, like a blanket prescription from your providers practice is already going with us and we're trying to initiate that next two weeks. That's already there, we will automatically check on the background and then it will, you know, provide us with going ahead and giving you the green light to issue the next email which will be your training is ready. And then you will do the online training. And it will give you the ability to learn all about Control IQ. It's very interactive, you can't hit play and walk off. I know people do this on other training like I know we have webinars and we push play and we walk off we do the dishes when we come back. You cannot do that with this. It actually won’t advance to the next part until you've done x, y, z that is asked you to do. We've designed that for a reason so that you actually come away with the knowledge you need to operate the the algorithm and integrated into your life. So then you will answer a couple of questions and take a quiz. And you will have had to pay attention to get this information correct. And if you don't, you can go back and re learn until you do answer the questions correctly. Once you do pass the quiz and the module, you will then get the download code which is specific to your serial number of your pump. So I know there's been some questions, people sharing about work arounds, can you share it? The answer is no, no. You can't share it. It is your learning and your code is specific to your serial number. So all of that lines up perfectly to allow you to download the software update. And that will be, you know, everything will walk, walk through all the steps and pretty obvious, but for those who think that this some idea that someone will get a code and then we could post it on the internet somewhere and share it like, sorry Debbie Downer you're gonna have to get this on your own. Like, we work smarter than that and the FDA is smarter than that, and they're not gonna allow one code to rule them all. Yeah, so everybody's gonna have to do this upon their own and because it requires a prescription you have to go through all this stuff. Stacey Simms 8:37 When you mentioned training healthcare providers, and this might be a really dumb question, Molly, so forgive me, but is do they go through a more in depth training? It just seems like a couple of weeks to try to get all of these endocrinologists and CDs on board is a tall task. Do they all have to be trained before they can write the prescriptions and then what is their training like Molly McElwee Malloy 8:59 this have to be trained before they can write the prescriptions we want them to be trained before, obviously, we'd like them to have knowledge before they write the prescription, but they don't, they need the training to be able to treat patients, right. And I want them to be we want them all to be informed before they write the prescription to know if this is a good choice for the patient. But you could always write the prescription and then the person doesn't do the update. Right. So there's, you know, there's, there's always a couple ways to be kept it at the end if they don't intend to write the prescription. But writing the prescription with knowledge is always excellent. And we want to be aware, it's really, you know, an hour and a half two hours of their time. It's not a whole day thing. I know with other systems, there's been some feedback about like the links of training being really long and and we took all that into consideration. You know, we got the beautiful gift of not having to go first. Right? So we got to see what happens with the market with feedback before we did it. And we implemented a training and the good news with Control IQ is, it's not difficult. You do have to understand some concepts and some differences. Right, but it's not hard. Stacey Simms 10:27 I guess my concern was that people would be calling their health care providers and saying, Are you trained? Are you trained? Did you do this yet? Because you could see that happening. Molly McElwee Malloy 10:35 Yeah, and the good news is that we're getting them trained. So and it's on there's an online module they can take to do this. Like it doesn't have to be me on the phone with somebody train them, although we are doing that for them for larger offices that need, you know, to have that interaction, but there is an online module that they can take to get trained. So we do have a provider but site that has been launched. We've been very patient centric and very patient forward and our website and our outreach, and we are adding new dimension to both Tandem and our website, and how we are looking at our business. So, you know, to be honest, when you do this business, there's, there's at least three customers you're looking at, right? There's a patient, there's the provider, and there's the payer, and all those things need to be addressed. And we've been very patient centric. And now we are and we are continuing that we're just expanding to be very have people that are actually focused on providers. And so there is a portion of our website now dedicated to health care providers, and their education and resources specific to them. So that is launched that is up and running, and it's actually a very elegant website a host of resources for healthcare provider. Stacey Simms 12:10 Alright, so let's get to the moment at hand - Control IQ. How does it work? Talk to me a little bit about you know, the pump settings or what do we have to do you? What is the? What is the basis of Control iQ? Molly McElwee Malloy 12:24 Yeah, so this is the beautiful thing and I love all things that are based in science reality and truth, right? Like, I don't like we and Tandem doesn’t like this either, but we don't like you know, don't let trick and we don't like you not be able to see what's going on. So the beautiful thing about Control like you would like about all of Tandem technology is that it stays in the science and the foundation that you know in love, which are pump settings that you already understand. So the traditional rules that healthcare providers have used and I can provide you a link to article that’s helpful on you know 15 and 1800 you know, rules that they've always used and you know, implement duration action that is built in on the foundation of many many many decades of science. So, the all of that I can provide you some links and educate people about that what does that mean but your traditional insulin to carb ratio, sensitivity factors and basal rates all still apply. We use that the Control IQ technology uses your pump foundations and your foundations order the basal rate into the carb ratio, correction factor to operate from right so those are specific to you, they always have them they always should be. And that is where we you know, we start the game of Control IQ technology. So Using those settings, Control IQ technology, what we making adjustments from your baseline parameter, so your baseline parameters are exceptionally informative of how Control it technology will work. Stacey Simms 14:12 So we've been using a pump, let's say, you know, our personal case for 12 and a half years, we're pretty good at the settings. You know, we're going to talk about insulin on board because that's an interesting change. But we have our ratios and our, you know, our sensitivity factor. People like us, you know, a lot of people who are used to changing things on their own, you're basically saying we're not gonna have to learn to use the pump that we know so well. Molly McElwee Malloy 14:38 Correct. Right. So all the settings that you know and love are great. And you will move forward with those right? Okay, people coming from other systems, like maybe different pump or multiple daily injections, things like that. You're going to want to establish some really good baseline settings and make sure that those are accurate. So you particularly, if you're coming, I could say you're coming from a competitor's product like that, that has automated insulin delivery, you want to make sure that those settings are good to go. Because the previous, you know, previous other things that you may have used, only altered on board and carb ratio, right. So if you're only pulling two levers, the other things may not be totally, you know, set in stone and based and in the reality that you need. So, moving forward, you will need to make sure that the patient has, you know, your patient which would be your son or myself, that user has the pump parameters and settings that are based in in what you would want to use. So somebody is moving from a different product. We just want to do a double check and there's going to be in the healthcare profession. We'll have a little checklist to go through and we'll ask them, you know, you're coming from a different product, please look at the baseline settings and make sure that they are perfect for the patient. In your situation, you're just going to be moving from you know, base like you to Control like you. And those settings will apply. I will say a note for your super super savvy listeners who have used Basal IQ. And something we've noticed just in real world data as we've looked at people who data people have up to their basal rate to allow for, you know, like you to go to be like suspend, resume, suspend, resume and kind of hug that line at 80. A lot of people have done that. And I want to talk to that community real quick and say, Look, I know what you did with Basal IQ with riding those basal rates high to hug that line at 80. I saw that we saw that. You did that. We know why you did that. Just look at them. One more time before Control IQ because Control IQ is going to be adding, right? It can add insulin. So just before you go on your merry way with Control IQ like you double check your baseline settings, are they where you want them to be before you go right knowing that a system can add insulin to it. Stacey Simms 17:20 Okay, so you mentioned a lot of people, a lot of my listeners like to ride that 80. Molly McElwee Malloy 17:27 Let's talk about people, man, a lot of people love that they want like, they want that super, super tight Control and I get it. I totally get it. But you got particular, you know, space of listeners needs to be open to the idea that we're now going to be adding insulin right? So if you've kind of made these aggressive pump settings with Basal IQ and now you're going to be just on your merry way. We don't want you to experience hypoglycemia, right? That, you know, we don't want to put anybody into hypoglycemia land. My personal least favorite experience of, of diabetes? Well, let's, let's not do that. Stacey Simms 18:10 Right. But the question then is, what are the targets? I thought Control IQ wasn't really going to let you ride that 80. Can you talk a little bit about I mean, obviously, nothing's perfect hypoglycemia can happen hyperglycemia can happen, but what is it aiming for? Molly McElwee Malloy 18:29 If your listeners can pull up the little chart, the patient pamphlets that I that I gave you, there's one of them that has a really good visual of what that looks like. And just so that we can go from soup to nuts, the person who has now downloaded Control IQ technology, all you have to do is turn it on. It’s either on or off. Just to preface all of this before we get into target and all of that. There's no kick out with Control IQ technology. Control IQ technology works, so long as we have CGM. And I will say that as long as we have a continuous stream of CGM, or we will continue processing that data. But if there are 20 minutes or more of missing data from that CGM and those who are very savvy with Dexcom know that you can kind of get internet readings occasionally. I'm not talking about reading, you've got a loss of CGM for more than 20 minutes, we're going to revert to your pump settings. And so we can get that until we can get that information back up and running. But if we miss a value or two when we come back, and we've got that information, we're running full steam ahead We're good to go. If we have any data point in that 20 minutes that pops up, you're still in. It are still in the game. They're still playing. But there's no kick out. Right? Stacey Simms 20:14 So as you mentioned that, just to be clear, there's no auto mode or manual mode to kick out of. So if you lose the CGM signal for that period of time, as you said, What did you say 20 minutes. Molly McElwee Malloy 20:26 It has to be greater than 20 minutes Stacey Simms 20:28 if you lose CGM signal for 20 minutes, it just goes back to regular Tandem pump, all the settings are in it. When the signal comes back, it automatically starts Control IQ, you don't have to do anything else. Molly McElwee Malloy 20:40 Correct. You could sleep through the whole process, right? You do you right. Like if we lose it, we'll we'll get it back as soon as possible. We're going to alert you that there’s no CGM available, right? Right. We're gonna alert you that this happening. But if you're sleeping or you're doing something else and you are not paying attention to it, we’re going to keep running with the ball in that process without having to like all these bells and whistles, and there's no modes, right? Control IQ is on or you can turn Control IQ off. There's no mode. Stacey Simms 21:16 Alright, so let's talk targets. Molly McElwee Malloy 21:19 Yes. So there are several targets, the one you will call the main target is the number 112.5 which in the pump, it's going to default to 110. Why because you don't have 112 point fie as an option. 112.5 for those who are interested is a weighted average between 80-120 with the least amount of hypoglycemic outcome. So if you're a statistician or mathematician and you love numbers you can a bunch of scenarios of hypoglycemia and when it will likely going to happen in all these different situations which is what did happen to come up with this number you would come up that 112.5 had the least amount of hypoglycemic outcomes in the greatest amount of time in range and you know successful euglycemia. Yeah, so 12.5 it is. And it will show up as 110 in the settings 110 will be the target. In the settings that you set up for Control IQ it is non-negotiable. We have different ranges for things that we're using throughout the way the system progresses, but as far as looks on the settings on the pump, is going to show up as 110. Now when you enter the system, as long as you're in euglycemia land, like as long as you're in range and predicting range, which would be predicting 70 to 180, we’ll use your pump, right your pump study should be adequate. But the minute your predicted to be outside of the range. And this is where this graphic is really helpful. If you’re predicted to be 70, right, less than 70, we're going to start decreasing basal insulin. It's predicted when you start going below 112.5 right. And then when you get to 70, we're going to stop basal delivery. And this is during this time, right? So the during regular Controller to you, if you are predicted to be less than 70, you start going down less than 112.5 we're going to decrease basal, and we'll eventually halt basal. Now if you're above 112 point five and you're heading up, and you're predicted to be above 160, we're going to increase that insulin delivery and increase that in the background until you hit a prediction of 180 and that's not you hitting 180. That's the prediction heading 180. If the prediction hits 180 then we can give an automatic correction bolus once an hour during waking time and I'll go over more about what that means in a minute. But predictions to be above 180 one at if there was, you know, not been another bolus in the last hour, we can give one at that point to try to keep blood sugar more in range. So the range 70-180 again, 112.5 is euglycemia. Going below that, you know, we start decreasing if you're predicting below the lower than 70 we're going to, you know, stop basal insulin delivery, you’re predicted to be above 160, we're going to be increasing basal insulin delivery of your predicted to be above 180. We're going to deliver an automatic correction bolus once an hour during the waking time. And by that I mean when you're not using exercise or sleep. There's three activities in Control IQ and they are Control IQ or what I call wake time. There's sleep and there's exercise. And those three things have three different targets. Because if you think about it, those three activities have very different applications for your blood glucose. So, waking time 70 to 180. That's sort of where we aim for all things during the day to accommodate for blood glucose fluctuations with meals and stress and schedules and everything like that. Sleep is something you program. So you can have just like you would program a basal rate. So if your basal rate normally changed from three to 4pm, every day… the sleep is, you can program that right. So mine is programmed for 10pm to 6am. So from 10pm to 6am I'm sleeping and it will automatically go into sleep, it will automatically come out of sleep. I don't have to do anything. And during sleep, we're going to target 112.5 to 120 which is a much tighter range, but we're not giving automatic correction boluses during sleep, Stacey Simms 26:02 can you tell me a little bit about the thinking there? It seems obvious. But is it just because a person is sleeping and can’t adjust the pump? I'm trying to figure out the logic? Molly McElwee Malloy 26:14 The logic of not having the autocorrection? So the logic around not having the autocorrection overnight is about being super conservative with the FDA and their comfort level . But also, the algorithm really drives a really tight range during that time because there's not a lot of interference, right? You think about sleep it's like for blood glucose is the easiest time to manage diabetes, right? because nothing's happening. Although you are asleep, so technically difficult because the operator is asleep, right but as far as what's happening with diabetes, sleep should be a pretty steady state. So if we can automate going into and out of and having a really timeframes for that period of time, then we can kind of optimize time in range by, you know, six hours a day being really tightly Controlled, or however long the sleep activity is. And we noticed in the in the clinical trial, those people who had a sleep schedule and not everybody did, and you do not have to set one. But those people who had a sleep schedule had significantly more time in range. So that's just something to notice. No, you don't have to set one right? Could you have automatic corrections going all night long and being awake, I'm sure you could do that. If that that's how your diabetes works. Great. My diabetes, your diabetes, somebody else's diabetes, they're all going to be different, right? We all have different versions of how we metabolize things and how we sleep and how we process and our activity and you know, sometimes, you know, the sky's blue and sometimes it's not and it just depends. That's life with diabetes, some things will work with some people, somethings won’t. We did have in the clinical trial have some people we refer to as Sleeping Beauties who had sleep going 24 hours a day and and that would put you at the you know, like the 112.5 to 120 all the time, no automatic corrections but you would get basal increases and basal decreases to try to keep you in that range. And for some people, that's great. You know, that's where you want to live, that's fine. You will not get the automatic correction, you will need to give that correction when you need it. It's not going to be enough to accommodate that. But hey, if you're sleeping beauty and that works for you, that's fine. Then there is exercise. Exercises is a button you press. You go into options you press exercise – start. I'm exercising now and then I will leave it on exercise and when I want to stop I will go in and I will stop exercise. And while I'm exercising will be a little Running Man on the side of the screen to show me that I am exercising. And that will tighten the reins to 140 to 160. To help prevent hypoglycemia, it also engages what we call the brakes or the prevention of hypoglycemia by 10x. So if you think of a car rolling down a hill, and if you think of getting your brakes tightened 10 X, the minute you start going downhill, you're going to stop, right? It's going to be like that, stop, it's gonna be really, really grippy. And that's the way it works doing exercise. We anticipate hypoglycemia. Now you can still get an automatic correction bolus, and you can still get an increase in basal during exercise because there are people who will go high during exercise. With the pediatric sports particularly, you notice a big difference between game day and practice day. Like game day there's a lot of adrenaline there's usually a lot higher blood sugars and practices it’s low blood sugars. So You know, this is why that's still going on in the background, starting in an hour before starting at the time of exercise, leaving it on an hour after all of that's going to vary depending upon the person and the activity and you're going to have to play with that and see what works for you. You know different strokes for different folks. And some people won’t need to put on the exercise right they'll be fine where they are. It just depends on what you're doing your body, your diabetes, what's going on. And as to when you start it and when you stop it or if you use it. Likewise, you know you could put exercise on 24 hours a day if you wanted to, if you needed to ride a little bit higher or you know were feeling very cautious about something you know, and you want it to be, driving all day or something you know, like I just want to be a little bit higher today Stacey Simms 30:53 Your kids first sleep over Molly McElwee Malloy 30:55 your kids first sleep over and you want that automatic bolus, they're going to snack. And, you know, if you think about it, like if I think about my kids there, they are active 24 hours a day until they crash, right? So if they're super, super active, and I'm getting, I'm getting frequent lows from that activity, I might put them in exercise all day, right? So depending on what's going on with that patient that time and what works for you, they'll be different. They'll be different reasons why different activities are better for some people than other people and when you want to use them, but they're all available to you to use as you want to because we all deserve choice, and we all should have Control over what happens with our diabetes. Stacey Simms 31:43 It's really interesting. Okay, I'm trying to get through the list because I have I have 14 questions for everything you answer. So I know we'll talk again, but I do want to ask you about insulin on board and I will set this up by saying in the last few months, I've been reading up a lot on this in anticipation of what we're going to talk about here, because Benny's insulin on board, which is as you listen, you may not realize there's a setting in the pump, all pumps, where you try to figure out how long the insulin that you're giving is lasting, and this is with MDI as well, but the pump does it automatically - you have to tell it and then it keeps track. So we have always said Benny's at three hours. And then when he hit puberty, we kind of tightened it up. And I've learned that it really didn't matter what we said, or what we thought that everybody's insulin on board, studies show, is about five hours. And so that's what's in Control IQ? Molly McElwee Malloy 32:40 Yeah, it's at five hours. So if you look at some data, and again, I can provide you with links to some published data on that, the data says it's between four and a half and six hours. So let's split the difference and call it five hours. So we're using five hours for several reasons. One it’s established data we can rely, on you can hang your hat on it. Also, it's a static number, right? So if you are, if you are trying to aim for targets with a multitude of patients, a multitude of patients and you're trying to automate an algorithm, you cannot then vary IOB without causing some pretty crazy ripples, right? So it's going to work for some people, some people not, we want something that works for most people, right? Like, I understand that Control IQ is an amazing solution for a lot of people. And if some people are like, I'm so much better when I do it myself. Do it yourself. That's fine, right? Like that's why we have choice. But in order to design a system for the masses, you're going to have to go with the large majority of scientific evidence, right, which again, shows insulin on board somewhere between four and a half and six hours. So going with five hours and keeping that static when you're aiming for different ranges, and you're allowing people to do different basal rates and carb ratios and sensitivity factors, you will have to lock something in and we've locked IOB. And that gives you some really good results, obviously, but and for skeptics, I will say this, you know, try it. Try it and see what you think. Because it may not be as different as you think. Stacey Simms 34:27 well, I’ve been shocked to find out that the entire looping community, and the do it yourself folks, all of those systems are based on five hours, pretty much. Molly McElwee Malloy 34:37 Right, right. And you do have to assume some, you have to make some assumptions, right when you're writing an algorithm that's going to modulate insulin for the masses. And one of the assumptions is how long does this thing last? If you change that, all the other math has to change. And that makes it a very unstable algorithm. A very unstable system. And then it’s not for the masses, right? So that is why it's locked in and there's a lot of scientific evidence. And the DIY community has embraced us too, you know, at that five hour time frame. Stacey Simms 35:13 In terms of the rollout Molly, I remember when we got Benny's pump about a year before Basal IQ was available. And as I was looking back, it was a pretty seamless process for us. In that I remember it was FDA approved. We got the email, we got the prescription from our doctor then Tandem said here's your code, and we downloaded it and the whole process took from FDA approval to on Benny’s pump, with no special treatment, was 35 days. I'm not going to hold you to that. I'm not asking you to keep to schedule, but I am going to ask and I think 35 days was pretty great. Is there anything that you all learned from the Basal IQ roll out that people who went through that can expect to experience differently this time around or did it work pretty smoothly? Molly McElwee Malloy 36:00 Yeah, so I mean, you always learn, right? You always learn, and we're always learning and Tandem is excellent at collecting data and then understanding, you know, and learning from it. So one of the things that we did, we did learn there is that we needed a more robust patient portal. And so we've done that we've built a more robust portal, and we've built a lot of automation in the background. So doing things like if you entered, you know, I'm going to update this and your physician had a blanket statement on board. And, you know, we could automatically line those two things up. It doesn't have to be a separate step it just automatically Yes. Okay, you're good. We have this checked in our records checking. We have this and this is on file, and we can do all of it. So there wasn't a lot of automation that there is now and there were maybe a couple extra steps involved in getting people either approved or making sure we had all the documents and we've streamlined all that. So it should be a very seamless process. The update itself could take eight minutes, but it shouldn't take much longer. You know, it's the eight minutes from, you know, whatever you're on now the Control IQ, and then you know, and then just reschedule it and doing the online training right before that, that's, you know, a little bit of chunk of time, but I think 35 days is pretty good. So we got approval this past Friday 13th. And we plan to roll out those emails to existing customers a week of the 13th. So it might be coming at close, but I think you can probably you could probably figure on the 35 days. Stacey Simms 37:43 (laughs) I'll give you some grace for the holidays. I mean, the last approval was August, so we only had to worry about back to school. I'm not too worried about 35 on the dot. I did want to ask you a couple of questions from the Facebook group, the diabetes connections Facebook group, you've answered a lot of them, but I had a really good question from Tim who was asking about in the clinical trial, he said, You know, people were able to familiarize themselves with the pump in the system about two to eight weeks, I guess. So he said, what took place during that period? And how much interaction with healthcare professionals was required? So I guess the question really is, how much do I need to interact with my healthcare professional? How much do I need to ramp up and learn before Control IQ will work well for me, we've mentioned you know, there are variables. Molly McElwee Malloy 38:29 So I think, and I think looking at that run-in phase, that was what it was called that two to eight weeks is that when you were taking people from multiple daily injections, introducing them to CGM technology, introducing them to pump technology and getting pump settings straight. So that was the longer run in period for people who were completely naive to both CGM and pump technology. And they could they could be allowed up to eight weeks, I don't think most of them completed their run-in phase much faster than that. And most people have people that already had pump or CGM or some knowledge of one or the other could go but at a much faster speed. So it was just getting them up and running and comfortable with the technology and the physician or whoever was overseeing at that site felt comfortable that, yes, this person is ready to proceed to the next step and go ahead and use an automated system. So that just allowed for all walks of life to come in and to do this trial. And that's really what that was about as far is, you know, how many connections how many touch points with an HCP. You know, I can't speak specifically to each situation. But typically, in a run-in phase when you're getting people up and running that have never used technology before, you might check in with them every couple of days and then do a download at the end of the week and then check those settings. So And I would suggest at a later time you having one of those sites, the principal investigators on to talk about the studies it’s fascinating. And they could really get into the weeds of these details, because I think Tim had a really good question about that. As far as the average person though, getting up and rolling, the big thing with Control IQ technology, is you have to have good pump settings. Right. So that may be a couple of touch points you maybe have to have with your HCP if you've never had a pump before, right? Or you're and you're just waiting for the first time. Or if you've had pretty poor settings, and maybe pretty poor Control along and you've never really sat and been like, Huh, I wonder if these are right, or your HCPs never sat down with you into like, let's take another look at this. That that may take you a visit or two but if your pump things are pretty good, you should be fine to go And then you can check in with your doctor. At your comfort level, right, like there's no recommendation. As long as you feel like you're doing well, then great. There is a mobile app that will roll out with this. It's embedded into the technology update for Control IQ that will give people access to this mobile app, which will be available on Android and iOS. But this will allow for automatic uploads to the cloud. So the data will be going seamlessly to the cloud. You could also then see it on your phone. You cannot yet bolus from that phone or dismiss alerts or alarms. But you can see what is happening from that phone. And it will, it's a ways to send data to the portal so that your data is always updated. And so you know, your healthcare provider can check in and say how you doing and I see this is happening or I see that's happening and you can all beon the same page without actually, we go into the office or upload your pump or any of that stuff. Yeah, I believe it that process. Stacey Simms 42:08 That was going to be my next question. But my understanding is that the phone app is going to be just for healthcare providers as it's rolled out, and then consumers can use it down the road. Is that not correct? Molly McElwee Malloy 42:19 No. So there are two parts to this. So the app will be on the patient's phone, right. That's how the data gets the cloud. So the space is going to have visibility to their data. The data going to the cloud goes to the HCP portal, right. So that's the healthcare professional portal, the portal that we offer up to professionals so they can manage all their patients in one place. Right. So they log in, they can see data as long as you have Wi Fi available Wi Fi is both publicly and people having it at home or you can choose to use cellular data. You can send your data for the cloud every five minutes. Stacey Simms 43:04 I just want to be clear. So when I get my Control IQ, let's say, let's say I get Control IQ by the end of January, when I get Control IQ on Benny's pump, he will be able to look at his cell phone, not do anything with it, but he will be able to view his pump data in real time on his cell phone. Molly McElwee Malloy Yes. Stacey Simms Yeah, that is amazing. Okay, so I know that many people who are newer might think, well, that's not so amazing. But I mean, after 13 years, you know, we had these dumb pumps and no CGM to have Benny be able to look at his phone and say oh is was my battery charged. Do I need insulin? You know, even the simplest things. And then the idea is down the line. And maybe you can give us a peek into the future. As you said, You can't bolus from it, but possibly someday, soon. Molly McElwee Malloy 43:50 Oh, we are working on integrating the ability to do a mobile bolus. Yes. Stacey Simms 43:58 All right. I'll leave that there for now because I know Talk to you another hour about it. But then my last question on the phone is, what about remote data from the pump? Can a parent caregiver, you know, friend spouse, once the Tandem information is on the user's phone, can it be shared. Molly McElwee Malloy 44:15 So we are working on a remote monitoring feature. But at this time, it will just be available on the patient's phone, and it will be a way to get the data to the cloud. Now you could log in to see connect and look and see what's going on with Benny at school. If he's if he's got Wi Fi going. It's not really meant to be a remote monitoring system is approved for that. But you know, Stacey Simms 44:44 (laughs) I’m just thinking of all the parents I know All I care about is is it charged and is there insulin in it, but I know a lot of people really want to see, you know, everything but that's really interesting. Molly McElwee Malloy 44:52 It could be that you know, and then some people know how to like do the mirroring on their phone to another device and you know, there's going to be people will figure that out. And we will eventually have a formal system for that. And again, nothing is intended to be remote monitoring or you know, per share type viewing. It’s supposed to be a, you know, a secondary viewing device of seeing the data. But you know that data is going somewhere and you can log into that place. So, you do with that with whatever you want to, but you'll be able to see that data if he's got Wi Fi going. Stacey Simms 45:32 All right. before we let you go. I have to ask you, we started this whole conversation about you talking about, you know, finally relaxing when you use an automated system in 2006. So here we are. 13 years later, Molly McElwee Malloy 45:50 I know. Stacey Simms 45:53 You've been using Control IQ I shouldn't make that assumption, but have you been using Control IQ? Molly McElwee Malloy 45:58 I do have Control IQ Okay, Stacey Simms 46:00 and I'm asking you this I know I may be limited in what you can say and I understand that. Are you as relaxed and feeling more in Control of your diabetes as you had hoped? Back in 2006? Molly McElwee Malloy 46:15 You know and.. sorry, it makes me little choked up. I am in a place I never knew existed, right? This is a place that I dreamed about. I'm not worried about what's happening with my blood sugar. I'm not worried. We had my daughter's third birthday this past weekend, and I didn't worry about, was my bolus enough for the cupcake because like it had my back, right? Like, I was like, if it's, you know, this more than this, whatever, it's got me if it’s less than this, it’s got me like, I didn't worry the whole day and I stayed in range the whole day and Got to enjoy my daughter's birthday without worrying about my diabetes. So that was pretty awesome. And that's where I want to live, right? Like I have other things to do. Everybody has other things to do than to try to be their own pancreas and their own organ. So let's relieve that burden and then you just interact with it with meals with exercise, you know, when you need to. It's much more of a relief than I imagined because in 2006, I was hooked to laptop. Stacey Simms 47:35 Oh my gosh. That’s right! Molly McElwee Malloy 47:37 Yeah, I was hooked to laptops with four IVs in my arms. And I was willing to do that. And I would have walked around like that. So this is some space age invention that never entered my mind that this could have happened but it is beautiful, very eloquently done. I have to hat tip to the engineers at Tandem, who took you know, years and years and years and years of research to work, you know, work done in neat tidy ways, right? And then put it into a system and made it this eloquent and this beautiful. Where I don't have to think about the 50 things I would have thought about before, you know, is my laptop plugged in and my plugs into the right USB port, my, you know, the things you've got to think about if you are plugged into bigger machine. Sure, like, I don't want to think about any of that. And, and during research, you know, seeing in all the different iterations. You know, we still had even we have a cell phone, we still had the fanny pack, right? Because you had to keep the receiver and the phone near each other and all this other stuff going on and the pump. And now I'm just walking around with a CGM and a pump on and it's doing it and I don't have to worry about any additional things to keep up at it's pretty great, it's pretty awesome. This is a place that I never dreamed, I never even dreamed of. And I'm just so happy to be here. Stacey Simms 49:10 Molly, thank you so much for joining me for spending so much time talking about this. It's been remarkable to just for the few years that I've followed along in your journey, it's been wonderful to watch. So thank you so much. And I cannot wait to get this for my son! Molly McElwee Malloy 49:29 that I can't wait to see what you say. Because, you know, we're like to 2.0 we’ll make 3.0 We'll see what's going on. So your feedback, everybody's feedback is so valuable. Stacey Simms 49:40 I would have liked to have ended on that emotional note that you have there. But we do have to say, for for many people who have been in this community for a long time, who are emailing you and me saying, Why can't I get the target under 100? Why cant I do this? I want this feature. I want that feature. It's not that they're that people are greedy. It's just that you know, you know we all we all want this so badly. It's a great reminder that this is the first step. This is this is the beginning of the automation. So, you know, I want it all too, but I get it. And I just think it's fantastic. So yeah, this is this is the first one with Tandem. Let's see what happens to the future. So gosh, it's so exciting. Molly McElwee Malloy 50:21 It really is. And I could say to people who want to customize everything, want to do everything good. Look, the future is coming. And it's coming faster than we then we could have dreamed up and I realized we waited a long time. Trust me, me of all people. I know how long we have waited. But this is a really solid system that we get to build upon. It’s going to be a phenomenal ride. Like I would invite them to try it. See if you can relax a little and see if it brings you any kind of peace of mind. And then we'll work on getting the targets exactly where you want them. Stacey Simms So much more information on the website please check it out. And I know many of you have unanswered questions you know you really want to do a super deep dive you want more we will dig into the research as Molly mentioned, I promise we will do mentioned I promise we will be doing follow ups on this as a tandem family. You know, we'll have Benny fool around with it. let you know what he thinks I'm hoping to get him to do a review. As soon as we get control IQ, which, you know, we're not jumping the line, we're there with all of you. So hopefully by the end of the month, beginning of February, I'm really hoping that we'll have control IQ on his pump. And, you know, that brings me to just a quick personal note on Ben, he was diagnosed 13 years ago, in December. So December of 2006, is when we heard those words, you know, your child has type one diabetes. And I remember a few bits of information from that day, we were not told, thankfully, we were never told, oh, the cure is five years away we were we were never told that and I had been a medical reporter for many years, and I'd covered type one diabetes. And I'd actually covered failed products like the gluco-watch and things like that. So I had my my knowledge around me and I knew there was going to be no cure in the next five years. So we didn't have that. But our endocrinologist did tell us that the artificial pancreas was in the works. And he said three to five years. And we would probably have that. And I have been hopeful, you know, cautiously optimistic, I didn't hang my hat on that. And I knew we'd have to learn to live well with diabetes without an artificial pancreas. But when I think now to 2006, knowing that that is when Molly, within that trial, and other people that I've been so lucky to meet and talk to, since people like Tom Brobson, so many people at JDRF, who were involved in the early early artificial pancreas project, , it kind of boggles my mind to think that I could go back to Stacey in 2006 in that hospital room and say, Look, it's not going to be here as soon as you hope. But your son's going to be fine. And you're going to get to talk to these people that right now are testing it out. I mean, to me, it's just wild. And more importantly than than me still me getting to talk to all these people much more importantly, is that the people with type one as you listen my son get to use it. I'm so excited for control IQ. I'm so excited for anything that takes any bit of burden away from people with diabetes. I'm not looking for the world's lowest A1C? I really know that I am looking for a healthy A1C  that lets my son lives a life he wants without diabetes being a pain in the ass without his mother texting him 400 times a day did you bolus Did you check? Right all that nagging stuff? I don't want him thinking about it 24 seven. When you talk to people who loop when you talk to people who've used open APS, right, these do it yourself systems. Their first response to you isn't, look at my fantastic A1C, although they're usually very good. It's, well, I get more sleep. Wow, I think about diabetes less. Wow, I worry about my kid less. And that, to me is what it's all about all of these decisions. I’m getting emotional thinking about it. All of the decisions that everybody who has diabetes, forget the parents that the people with diabetes have to make and that burden that is on you. I hope systems like this. Just relieve it a little bit. It's a good first step. It's not the end there is a long way to go. But that's what I am hopeful for. Okay. But that's what I am hopeful for. And I know that I'll hear from you. You wonderful do it yourselfers who will be figuring out ways to you know, hack the sleep mode and change the exercise mode and figure This stuff out. So we will move forward with lots more information in the weeks and months to come. You know, I don't have a way to wrap this up with a big bow. I don't have a way to end this year by, you know, saying something incredibly motivational and giving you a boost into the new year. But I do have to say that it's so exciting to end 2019 with the approval that frankly, I've been waiting for all year, and I know many of you have as well. And seeing that as another step forward. And looking forward to 2020 and what may come. Our next full episode will air on January 7, but later this week, I'm going to be releasing a new minisode I'll be doing more of these in the new year just really short episodes where I share some thoughts or some advice. love to know what you think about all that. Big thanks as always to my editor John Bukenas from audio editing solutions. Thank you so much for listening. wishing everybody a happy and healthy New Year. I'm Stacey Simms and I'll see you back here in 2020. (disclaimer) At times I mentioned tandem diabetes care. However, I am not compensated by tandem for my actions. And tandem does not support or control this content. I have created the content and it is based on my personal experiences and observations. Transcribed by https://otter.ai

The Pentagram is a powerful tool because it ustilizes the 4 magickal elements of water, fire, wind and the earth. Every problem has a facet and multiple sides to it. Let me show you how to use the IOB method of banishing and invoking.

Our second episode has so much great content we decided to release it in two parts! So if you haven't listened to Episode 2-A yet (and you like order & continuity), you probably should go back and check that out first. However, if you already did that... good news, you're in the right place! Episode 2-B includes the continuation of our conversation with special guest Tony Martino, as well as part two of our featured interview with Grant & Brett of Imperial Oak Brewing. In 'Pints Up?Pints Down?' we keep the focus on IOB as we review three of their beer offerings in addition to Pooch giving his two cents on the new album from Blue October entitled 'I Hope You're Happy.' And during '99 Bottles' the crew admits some of their guilty pleasures when it comes to food, TV, music, and more. So tune in for double the episode and double the fun! CHEERS!

Youtube: https://www.youtube.com/pielef Apple Podcast: https://apple.co/2McoMOo Spotify: https://spoti.fi/2MdHNQn Android Google Play: http://bit.ly/2MaGhhW Instagram: https://www.instagram.com/urielromano/ Twitter: https://twitter.com/urielromano/ Facebook: https://www.facebook.com/uriel.romano Website: https://urielromano.com/ Comentarios & Sugerencias: urielromano@gmail.com El goi*, el otro, el distinto. Para el mundo judío hay una fuerte diferenciación para los que son parte de la colectividad y los que no. Prejuicios, ideas malintencionadas y odio recorren los dos caminos. En este episodio Uriel y Elo hablan sobre esto. Cómo se reconstruye el vínculo entre ambos grupos, que al final del día, no son distintos uno del otro. * https://en.wikipedia.org/wiki/Goy Rabi Abahu en nombre de Rabi Yojanan dijo: Le preguntaron a Rabi Eliezer: ¿Hasta qué punto uno debe honrar al padre y a la madre? Él dijo: ¿A mí me preguntan? Vayan y pregúntenle a Daba ben Natina. Dama ben Natina era la cabeza del consejo de padres de la ciudad (Paterboli). Una vez su madre lo estaba agraviando frente a su junta. Su zapato se le cayó de la mano y él se lo entregó para que ella no se ponga mal. Rabi Jizkia dijo: “Él era un gentil de la ciudad de Ashkelon, y era la cabeza del consejo de padres de la ciudad. Sobre cualquier piedra que su padre se hubiera sentado en ella el nunca se sentaría; y cuando su padre murió él la convertiría en un ídolo.” Cierta vez se perdió la piedra de Jaspe de Biniamim [del Efod]. Y los sabios se preguntaron: “¿Quién tiene tal piedra preciosa?” Y contestaron: “Dama ben Natina la tiene”. Ellos viajaron hasta él y acordaron por 100 denarim. Él subió para traerle la piedra a ellos y encontró a su padre durmiendo. Algunos dicen: “la llave del cofre estaba descansado en los dedos de su padre” y otros dicen: “Las piernas de su padre estaban descansando sobre el cofre”. Él bajó y les dijo: “No se las puedo traer”. Ellos pensaron: “¿Quizás él quiera más dinero?”. Aumentaron la suma a 200, y volvieron a aumentar la suma hasta 1000. Cuando su padre se despertó de su siesta, él subió y se las dio. Cuando le iban a pagar la última suma acordada (1000 denarim), él no lo aceptó. Dijo: “¿Debo vender por centavos el honor de mi padre? No puedo tener un beneficio de haber honrado a mi padre.” ¿Cómo hizo el Santo, bendito sea, para recompensarlo? Rabi Iosi ben Rabi Bun dijo: “Aquella noche su vaca dio a luz a una Pará Adumá” y todo Israel tomo su oro y lo llevaron ante él y se llevaron la piedra. Rabi Shabtai dijo: “Está escrito (Iob 37:23): “…Y no pervertirá el juicio ni la abundante justicia.” El Santo, bendito sea, no retrasa su recompensa para aquellos de entre las naciones (goim) que cumplen sus mandamientos. Fuente: Talmud Jerosolimitano, Kidusin 1:7 (20a) https://www.sefaria.org/Jerusalem_Talmud_Kiddushin.20a.1?vhe=Mechon_Mamre_Talmud_Yerushalmi&lang=bi #Goy #Igualdad #Tolerancia #Diversidad #Respeto #Integración #Judaísmo

Welcome to season two of the IOB podcast. In this episode, creator Dixie shares her mission and mantra for the Global Women's Self-Care Day on July `9th, 2017

Episode 47!   We kick off with a 6-Pack Interview with Leo York from the "Inhabitants of Burque" Facebook Phenomenon!  We debut "SmartPhone Roulette", which derails the show in short order.  "Adventures in Online Dating", along with News, Entertainment Report, and much, much more.  Don't miss this episode.  It's hilarious!