Podcasts about lineberger

Dr. Shannon Westin, Dr. Stephanie Wheeler, and Dr. Caitlin Biddell discuss the paper "Economic Evaluation of a Non-Medical Financial Assistance Program on Missed Treatment Appointments Among Adults With Cancer," a simultaneous publication, podcast, and presentation at the ASCO Quality Care Symposium. TRANSCRIPT The guest on this podcast episode has no disclosures to declare. Dr. Shannon Westin: Hello, everyone, and welcome to another episode of JCO After Hours, the podcast where we get in-depth on manuscripts published in the Journal of Clinical Oncology. I'm your host, Shannon Westin, Social Media Editor of the JCO and GYN Oncologist. And I am so excited that today we have a simultaneous publication in JCO and presentation at the 2023 ASCO Quality Care Symposium here on 10/28/2023. And this is going to be the manuscript “Economic Evaluation of a Nonmedical Financial Assistance Program on Missed Treatment Appointments Among Adults With Cancer.” Very exciting work. And I'm thrilled to tell you I have two of the authors here with me today. First is Dr. Caitlin Biddell. She's a Health Services Researcher at Mathematica Policy Research.  Welcome, Caitlin.  Dr. Caitlin Biddell: Thank you. Happy to be here. Dr. Shannon Westin: And we also have Dr. Stephanie Wheeler. She is the Michael S. O'Malley Distinguished Professor in the Department of Health Policy and Management at the University of North Carolina, Chapel Hill, as well as being the Associate Director of Community Outreach and Engagement at UNC Lineberger Comprehensive Cancer Center.  Welcome. Dr. Stephanie Wheeler: Thank you. Happy to be here as well. Dr. Shannon Westin: Please note that our authors and participants have no conflicts of interest.  Let's get started. So first I would love to level set. Can you speak a little bit about what financial toxicity is and how common it is among patients with cancer?  Dr. Stephanie Wheeler: Sure, Shannon. I'm happy to take that one. This is Stephanie. So we know that financial hardship is often reported by patients and survivors who've experienced cancer. And as many as 50% of people with cancer have trouble with financial toxicity. There has been prior work that has conceptualized financial toxicity in three domains. So there's the material hardship, kind of the out-of-pocket material costs associated with cancer, which include both medical and nonmedical expenses. There is the stress and the psychosocial effects of that material hardship. And then there's coping behaviors that patients and their caregivers may employ to help deal with the high cost of cancer care. And as we've seen, cancer care increases in cost over time, and these expenditures really have very burdensome effects on patients and their families. We've been interested in looking at ways that we can try to mitigate that harm and really thinking about interventions in addition to the health policy changes that are needed to really ensure that this doesn't become a barrier to patients seeking and receiving the best quality care that they can. Dr. Shannon Westin: I think that kind of leads pretty nicely into my next question, which is really: How does this toxicity potentially impact equitable cancer care delivery?  Dr. Stephanie Wheeler: Yeah, I'm happy to talk about that a little bit as well. So we know from prior research, including some of our own, that patients of color, those from rural areas, and those who are uninsured or underinsured face the largest financial burdens associated with their cancer care. So to the extent that those financial hardships influence people's ability to seek and continue with and complete their cancer care that's been recommended, this actually is directly in the pathway and a mechanism through which patients are not able to get recommended treatment and therefore can contribute to differences in cancer outcomes. So there's direct health impacts in terms of their ability to receive and respond to cancer treatment.   In addition to that, we know that this financial hardship contributes to household-level harms both economic and psychosocial in nature. And in some other work, this financial hardship has translated to worse quality of life, worse economic outcomes, things like being able to stay employed and seeking changes in employment or remaining within a particular position because you don't want to lose your insurance—this is referred to as “job lock”—or can also contribute to higher mortality. So there's been some really important work showing that financial toxicity is directly linked with cancer mortality.  And so, as we think about ways that we need to address this, it's really key to ensuring cancer health equity that we are thoughtful about multiple solutions implemented at multiple levels that can deal with not only the contributors to high cancer costs but that can also start to affect both the nonmedical and the medical components of this cost burden. And by nonmedical, I mean things like the cost associated with transportation and seeking care, accommodations for people who need to receive radiation therapy multiple days in a row at a different healthcare facility than where they live, childcare costs. These things really start to add up in addition to the medical costs associated with cancer treatment. Dr. Shannon Westin: I really was intrigued by the intervention here that you all are studying around this Cancer Patient Assistance Fund. Can you tell me a little bit more about exactly what that was or is? Dr. Caitlin Biddell: Yeah, absolutely. So this is a program at the North Carolina Basnight Cancer Hospital, located within the Lineberger Comprehensive Cancer Center, and it started back in 2013, actually, and has really grown in size. But the main goal of this program is to ensure that patients do not face the nonmedical financial barriers to care that Dr. Wheeler was just talking about. So thinking about giving patients gas cards so that they are able to drive to and from treatment. Lineberger has a catchment area of the entire state, so many people are coming a long distance to come for cancer treatment. They also provide things like lodging and accommodations, as Stephanie mentioned, and then even paying patients' utility bills, things to keep them housed with electricity, the lights on, while they're undergoing cancer treatment. So just last year, in 2022, they distributed almost $350,000 to over 700 patients, and most of this is funded by philanthropic grants to ensure that patients can access the care they need. And it is a program that's really targeted to patients with low incomes. So they target patients with household incomes less than 250% of the federal poverty level. Dr. Shannon Westin: And how does a patient get connected to the fund? How do they find it and get hooked up?  Dr. Caitlin Biddell: Yeah, there's a couple different ways. So one path is through the outpatient social work team. So they often perform distress screening for new cancer patients. So they use the Distress Thermometer, which was developed by the National Comprehensive Cancer Network. And it measures a variety of different factors that may be contributing to distress, but that does include financial stress, job stress, and the expense of daily living stress. And so, when a patient scores a certain amount on that thermometer, a social worker will meet with them for a full assessment. And then part of the referral pathway from that assessment includes the Cancer Patient Assistance Fund. Patients who are in inpatient will often be screened with the Social Determinants of Health Module, which is housed in the electronic health record. And so that can also generate referrals for assistance. And then beyond the kind of standard pathways, there's also many other ways that a patient may express concerns to a nurse, a care coordinator, an oncologist, and then that provider can reach out directly to the Cancer Patient Assistance Fund. Dr. Shannon Westin: Your objective was to basically try to formally assess the impact of this fund on missed radiation or chemotherapy appointments. And so what was kind of your rationale for choosing this endpoint? And kind of take us through the design. Dr. Caitlin Biddell: Yeah, absolutely. So the idea for this study actually came about from the program coordinator of the Cancer Patient Assistance Fund several years back. We were just having a conversation about the program. I was commenting how important I thought it was, how interesting it was. And she was saying, “You know, I know anecdotally that this program makes a difference, but we've never really known how to quantify that.” And that's becoming increasingly important as they apply for philanthropic grants and really need to show that their program is having an impact. So that's what originally started our plan for evaluating the program.  And then, in thinking about endpoints, of course we imagined this program could have an impact on a range of different endpoints. So missed appointments is quite practicable. We also imagine it could influence patient health-related quality of life, patient symptoms associated with their cancer treatment, even potentially other long-term outcomes like mortality. But for the purposes of this evaluation, we needed to identify an endpoint that we believed could be measured, the association could be measured, in the data we had. And so we had electronic health record data. Missed appointments is something that is routinely captured in the electronic health record data because it's an endpoint that matters financially to health systems. So they are regularly tracking missed or no-show appointments. And it's also an outcome that matters financially to the health system, so they want to reduce this.  So we thought if we measure the impact of this program on missed appointments, there's potentially an opportunity to kind of align financial incentives so that if we show that the program has an impact on missed appointments, then that could be something that could get decision makers at the health system level to say, well, that's also an endpoint that we want to reduce, and so let's think about ways that we can align resources to reduce missed appointments through potentially the Cancer Patient Assistance Fund and other mechanisms. Dr. Shannon Westin: It's interesting because it definitely caught my eye because we give radiation, obviously, for gynecologic malignancies, and there's some pretty decent data that longer treatment duration for radiation has worse outcomes, with the implication that patients have missed appointments and so then, to finish their work, it takes longer, or to finish their treatment plan, it takes longer. So I definitely would be really intrigued to see the cancer-related outcomes. But I completely agree, like something practical, straightforward, and something easily obtained was the right way to start. I was just curious. So that's really interesting. So why don't you just walk us through the design of how you laid this out? Dr. Caitlin Biddell: Yeah, absolutely. So we conducted a retrospective evaluation between 2015 and 2019, and we chose that time point to end before the COVID-19 pandemic since we know that had many impacts on missed appointments. And we compared the proportion of missed appointments in the six months following treatment initiation between patients who were receiving Cancer Patient Assistance Fund assistance and then propensity-weighted comparators. And this is really just a method to make the pool of potential comparison patients look as similar to those receiving Cancer Patient Assistance Fund assistance as possible so that we can really tease apart that direct effect of the Cancer Patient Assistance Fund and separate it out from other characteristics that may be influencing missed appointments.  So we had stratified our analysis by treatment type. We looked at radiation therapy, and then we also looked at oncology infusion, so specifically immunotherapy and chemotherapy. And to evaluate these endpoints, we used a couple of different data sources that we linked together. So the first and the primary data source was the electronic health record. So at UNC, we have EHR data for research purposes stored in a data warehouse that we were able to pull from. And then we also linked in UNC Health's portion of the North Carolina Cancer Registry to get that really important information on cancer stage, cancer type, and treatment start date. And then, of course, we pulled in program records from the Cancer Patient Assistance Fund to identify which patients were receiving assistance, how much, and at what time points. And so, essentially, using that data and thinking about missed appointment outcomes in those six months following treatment initiation, we created a couple different models. So we looked at the high versus low no-show proportion using a logistic regression. And then we also looked at just the continuous no-show proportion in the sample to see if there was an effect on that as well. Dr. Shannon Westin: And what did you find? What was the impact of the fund's support on your outcomes? Dr. Caitlin Biddell: For radiation therapy, which I'll start with, the radiation therapy had a higher number of encounters, as we might expect, than immunotherapy/chemotherapy. There were a mean of 37 total radiation therapy encounters in the six-month follow-up period, and about 53% of the sample had one or more no shows. And so, then, when we looked at the impact the Cancer Patient Assistance Fund on radiation therapy missed appointments, we found that receipt of any assistance was associated with an eight-percentage-point decrease in the probability of having a no-show proportion in the highest quintile.  And then, when looking at continuous no-show proportion, we found it was associated with a 2.1-percentage-point decrease in the overall proportion of no shows, which corresponds to a 51% decrease in the overall mean no-show proportion. So a really substantial effect on radiation therapy missed appointments. And unsurprisingly, when we stratified the analysis by the amount of assistance received, we did see a greater impact of the program among patients receiving higher amounts of assistance.  Moving on to the oncology infusion cohort, this sample had a lower number of encounters in the follow-up period and less no shows, so only about 14% had one or more no shows. And so it potentially wasn't as surprising that we did not see an impact of the Cancer Patient Assistance Fund on infusion oncology missed appointments, though, of course, with the additional power and alternative analyses, it's not to say that there wasn't an effect, but in our population, we were not able to detect that. Dr. Shannon Westin: Yeah, and that makes a lot of sense. I mean, radiation is so much more time intensive and having to come back and forth. And when you were describing the fund and saying, like, housing assistance, I was like, “Oh, well, there you go.” Because that, I feel like, is one of the major issues. At MD Anderson, we also kind of take care of a very large catchment area, and it can be a huge burden for patients to have to come for that 15-minute appointment every day. So, yeah, when I saw your results, I thought that was likely what you were hypothesizing was the reason. And certainly, the impact on radiation is so impressive. It's just a hugely successful study and a hugely successful fund. So congratulations.  So, I guess, any other variables? You spoke a little bit about the amount of financial assistance received. Was there anything else that impacted the number of missed appointments in your study? Dr. Caitlin Biddell: Yeah, because of our propensity-weighting design, we really didn't focus as much on other patient-level contributors to missed appointments. So we attempted to control for all of those things through the waiting and then kind of didn't add those into the final model. So that was really the main focus, was looking at the impact of the Cancer Patient Assistance Fund and then, of course, looking by amount of assistance. That was a really important finding and also, of course, needs to be taken in the context that every patient has different needs and so the amount of assistance may differ for every patient. And so there's always a need to kind of really assess what a patient's needs are and base the amount of assistance on that. Dr. Stephanie Wheeler: It's probably worth saying again that the level at which we dichotomized these results was $180, which was sort of the median level of assistance provided. As you can imagine, there's a long tail, with some people receiving considerably more financial assistance. But I think it's really noteworthy that in the grand scheme of things, $180 per patient is a very small amount of money to provide to assist with things like housing support, transportation support, gas cards, and so forth. And the program does not have strict rules about how those funds are used. So, in our setting, where we've got a lot of rural patients potentially traveling hours across state in their own vehicles, gas cards are really important for them. But in other settings—more urban settings, for example—having flexibility in how those funds are used could be really helpful for people who need bus assistance or other public transportation beyond kind of having to drive a private vehicle to appointments.  Dr. Shannon Westin: It is a great point, and it is incredible how much you can do with a fairly little amount of money. And when we were talking about healthcare spending, obviously, that's a lot of money to an individual or a family. But in the grand scheme of what we spend on healthcare, that is a very, very small amount. So really, again, congratulations.  So I think the last question I'll ask is just kind of what are the next steps? And really should we be making sure that we have these programs everywhere? Do I need to go back and make sure that this kind of situation is set up in my institution? Dr. Stephanie Wheeler: Well, we also should share a little bit more about the economic evaluation results. Caitlin, why don't you describe that? Dr. Caitlin Biddell: Yeah, absolutely. And this speaks exactly to what you were talking about in terms of the amount of assistance that can go a really long way for a patient and is a drop in the bucket for a health system. So we did want to look at what the cost-effectiveness, or the cost consequence, of this program was from the health system perspective. And so we conducted a decision tree analysis, which is a method used in economic evaluation research, using kind of a hypothetical cohort of 350 patients, that mean number of radiation therapy encounters, 37 encounters over a six-month time horizon. And we did find that under the current funding of the model, which essentially is that philanthropy covers all of the financial assistance and then UNC Lineberger covers the cost of the staffing and the indirect cost of housing the program, we found that this program was estimated to save the health system $153 per missed appointment averted.  And then, in kind of an additional threshold analysis we conducted to see how much could the health system chip into this program in some way, whether it's through indirect cost or direct financial assistance, while still kind of breaking even from the perspective of no shows averted, and it was around $100 per patient. So, of course, that would be split across patients in different ways. Not everyone might receive that same amount. But there is opportunity here for health systems to make investments in reducing patient nonmedical barriers to care in a way that will come back in the form of saved revenue from averting missed appointments. Dr. Stephanie Wheeler: And the only thing I would add to that is this obviously was focused on those no-show appointments, but we anticipate that there's other financial benefits to the health system, like retention in care, patient satisfaction. There's a whole host of quality-of-life and clinical outcomes that are probably also benefited through use of this kind of nonmedical financial assistance program that we weren't able to measure. But I think part of our goal with this analysis is to start to make the case to hospitals and health systems that providing direct nonmedical financial assistance helps their bottom line as well. Dr. Shannon Westin: We, as clinicians and researchers, always want the benefit to the patients. But I agree, when you're dealing with administrators, we also need to show that. So I think that is super clever and a really nice part of the design.  So what's next steps for your research? Dr. Caitlin Biddell: Yeah, so I think we're currently kind of disseminating these findings within our own institution, so disseminating them back to the Cancer Patient Assistance Fund program so that they can use them in additional grant applications, but also really trying to get these findings in front of the health system administrators who might be able to make funding decisions surrounding this program. And then I think we are also thinking about ways to measure other endpoints beyond missed appointments. So we've kind of created this data set that involved some complicated linkages upfront, and now I do think there's opportunities to pull in other endpoints and even potentially some patient-reported endpoints as our electronic health records get better at collecting patient-reported data and even social determinant of health data, opportunities to really think about other impacts of this program.  And then I'll also add that there is talk among other groups at our institution about using this kind of approach to measure other similar programs. For example, we have a pretty large AYA program that does a lot of similar types of assistance and also psychosocial assistance. And so they're thinking about ways to use a similar methodology to evaluate some of their own work. So I think it's just kind of starting to open the door to thinking about how we can use the data we have within our institutions to really underscore the impacts that the programs that already exist are having on patients. Dr. Stephanie Wheeler: I would only add to Caitlin's fabulous answer that dissemination of this is really critical because we know that NCI-Designated Conference of Cancer Centers, the vast majority of them provide some kind of direct medical and nonmedical financial assistance, but many of them have restrictions on who can access those funds and eligibility criteria that preclude patients with certain cancers from accessing those funds or patients with still what we would consider to be relatively high financial vulnerability to not be able to access those funds. In addition to that, we know that community oncology practices less often have access to these kinds of financial support resources. And so what often happens—and this is an extremely fragmented space for patients and their caregivers to be navigating—is that when nonmedical financial needs present, people are left to their own devices to have to search out, seek out, and identify programs for which they're eligible in the community. And these are often funded by philanthropic organizations, really wonderful healthcare support organizations. But oftentimes these types of financial supports are not directly provided through the hospital, or if they are, they're in the form of “charity care provisions,” which are often opaque to patients and their caregivers to even find. And then the eligibility requirements for those programs, again, are often preventing access for a number of patients in need.   So what I would like to see, as a person who does a lot of research in this space around financial hardship, is for that burden to be shifting away from patients and caregivers and more towards the systems that are treating these patients and that are supporting the caregivers so that people can focus on what's important during their cancer care, which is getting treatment that's recommended, staying in treatment, and attaining the best possible health that they can. When patients and their families spend hours and hours and days and weeks trying to understand existing financial support programs in the community and then those disappear or evaporate, as they do when funding and contributions subside, that really has a very detrimental impact on the patient's entire care experience. And I think it's on us, as people who are part of the healthcare system, to ensure that that doesn't happen. And the financial case to hospitals is clear, I think, from this analysis, but the moral case to all of us, as providers, should be clear and should be compelling in itself.   Dr. Shannon Westin: On that note, I think that's a perfect way to end. Thank you so much. This was such an intriguing discussion, and I really hope people are listening that are making the decisions for their hospitals and will see how they can implement something like this in their institution.  Again, this was a discussion of “Economic Evaluation of a Nonmedical Financial Assistance Program on Missed Treatment Appointments Among Adults with Cancer,” simultaneous publication in the JCO and presentation at the 2023 ASCO Quality Care Symposium on October 28th. It was great to have you all here. This was amazing, and I hope our listeners had a good time. And please do check out our other podcast offerings wherever you get your podcasts.  The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions.   Guests on this podcast express their own opinions, experience and conclusions. Guest statements on the Podcast do not express the opinions of ASCO. The mention of any product, service, organization, patient activity or therapy should not be construed as an ASCO endorsement.      

What does it take to run an NCI-designated Comprehensive Cancer Center for 22 years? And what does it takes to recruit a successor? In this episode, Shelton “Shelley” Earp talks about his plans to step down as director of the UNC Lineberger Comprehensive Cancer Center effective in June 2024. He is joined by Norman "Ned" Sharpless, former director of UNC Lineberger as well as former NCI director and former acting FDA commissioner. Sharpless chairs the committee charged with finding Earp's successor. Earp has served as director between 1997 and 2018 and then again from 2018 on, both preceding and succeeding Sharpless in the UNC job. This is a special edition of the Cancer History Project podcast focused a little more on the present—and the future. Read more here: https://cancerletter.com/conversation-with-the-cancer-letter/20230908_1/

Ken Lineberger is the President of Waters Edge Wineries, an innovative venture that offers a one-of-a-kind franchise model, allowing individuals to fulfill their aspirations of owning and operating their own winery. Together with his wife Angela Lineberger, Ken embarked on this extraordinary journey in 2004 when they established the first urban winery franchise, originally named "The Wine Tailor," in the picturesque Rancho Cucamonga, California. Pioneering a concept that encompassed all the essential elements of a traditional winery sans the vineyards, their visionary approach transformed into what is now known as Waters Edge Wineries—a thriving entity that continues to expand across the United States. Under Ken's insightful leadership, Waters Edge Wineries has flourished into a destination where wine enthusiasts can savor an extensive selection of over 50 distinct wines.   Here's a glimpse of what you'll learn:  Ken discusses the unique franchise model for Waters Edge Wineries in the wine industry. The criteria for becoming a part of the franchise system and the suitability of this model for wine businesses The logistics of distributing juice to each Waters Edge location, including the use of the "Flash Detente" thermovinification process Ken explains the process of developing Standard Operating Procedures for Waters Edge Wineries How the franchise model allows for intentional differences while retaining efficiency, and discussions on restaurants and wine selection Ken clarifies the distinction between Waters Edge Wineries' affiliates and franchises Factors that determine franchise territories for Waters Edge Wineries, such as population and legal considerations Ken describes the ideal client or prospect for someone interested in opening a Waters Edge Winery Exploring the bottling process at Waters Edge Wineries A snapshot of general location operations, staffing, and the winery tasting experience at Waters Edge Wineries Ken shares insights and advice based on his almost 20 years of experience in the industry. And addressing common misconceptions and clarifying concerns related to franchisees The diverse sourcing and wine lineup at Waters Edge Wineries   In this episode with Ken Lineberger Ken Lineberger of Waters Edge Wineries shares his deep-rooted passion for the wine industry and how it satisfies his insatiable curiosity. He unveils the unique franchise model developed by Waters Edge Wineries, discussing the criteria for becoming a part of this innovative system and explaining why the wine industry is particularly suitable for such a model. Ken also sheds light on the logistical process of distributing the juice to each location, highlighting the fascinating techniques used. In today's episode of the Legends Behind the Craft podcast, Drew Thomas Hendricks and Bianca Harmon are joined by Ken Lineberger, the President at Waters Edge Wineries. He provides insights into the development of standard operating procedures (SOPs) and the delicate balance between maintaining distinctive franchise locations while upholding consistency and efficiency. We delve into the distinction between Waters Edge Wineries affiliates and franchises, exploring the factors that determine franchise territories and addressing legal considerations. Discover the ideal clients and prospects for opening a Waters Edge winery and gain valuable knowledge about bottling operations, staffing structures, and membership benefits. Lastly, Ken reflects on his two decades of experience and offers valuable advice to aspiring franchisees and winery entrepreneurs.   Sponsor for this episode… This episode is brought to you by Barrels Ahead. Barrels Ahead is a wine and craft marketing agency that propels organic growth by using a powerful combination of content development, Search Engine Optimization, and paid search. At Barrels Ahead, we know that your business is unique. That's why we work with you to create a one-of-a-kind marketing strategy that highlights your authenticity, tells your story, and makes your business stand out from your competitors. Our team at Barrels Ahead helps you leverage your knowledge so you can enjoy the results and revenue your business deserves. So, what are you waiting for? Unlock your results today! To learn more, visit barrelsahead.com or email us at hello@barrelsahead.com to schedule a strategy call.

Episode 21 of Drama Mamas takes you behind the scenes of one of Broadway's most beloved shows, Wicked the Musical. Our guest, Tyler Lineberger, has worked as a dresser on several Broadway productions, including the hit musical Wicked. In this episode, Tyler shares his insider perspective on what it's like to work as a Broadway dresser, from handling quick costume changes to ensuring that every actor looks their best on stage. Listen in as Tyler reveals the secrets behind the stunning costumes and wardrobe of Wicked, including some behind-the-scenes stories that have never been shared before. He also shares his tips for dressing for success in the fast-paced world of Broadway theatre, and how he keeps his cool during the most hectic moments backstage. If you're a theatre lover or just curious about what goes on behind the curtain, this episode is a must-listen. Join us as we uncover the magic of stage wardrobe and the important role of a Broadway dresser in making a show come to life. --- Send in a voice message: https://podcasters.spotify.com/pod/show/dramamamas/message

The Kevin Alan Show talks with Curtis Lineberger about UFO's and moreSupport the show

This week I had the pleasure of interviewing Faby Lineberger - an athlete signed up for the Never Summer 60k earlier this summer. Faby and I got together to discuss what it's like training for a Colorado mountain race from Virginia, doing it scared, improving nutrition, and adapting training plans to a hectic lifestyle. I bet you can relate to at least part of Faby's story. Hope you enjoy it! ----- Notes: DQs Incline training on the treadmill Improving on the incline Doing it scared Calculating nutrition Injuries Strength training in the "off" season How Faby started running Running 100k Why hire a coach? The value of consistency Letting someone else take some of the stress for you Links: Never Summer 60k Pine Creek Challenge 100k ----- Want to be able to ask your own questions for this podcast? Head to the Trail and Ultra Running Nutrition group on FB: https://www.facebook.com/groups/trailultranutrition Thank you for listening! ----- Want to chat about trail and ultra running? Go here: https://linktr.ee/will.c.frantz --- Send in a voice message: https://anchor.fm/eatsleeprun/message Support this podcast: https://anchor.fm/eatsleeprun/support

Looking for ways to differentiate yourself by adding value to customers, employees, and your bottom-line? Julie Lineberger is the President of WheelPad whose goal is to respectfully and supportively provide transitional and permanent housing for people needing accessible living accommodations in an economical, socially conscious, and environmentally friendly way.

Welcome to RevDive! For those of you who are new to the Podcast, we use this space to hear from and share with healthcare leaders inside and out of the Revenue Cycle. Our Guest today is James Lineberger, Executive Director for Anesthesia Associates of Boise. Join in as James talks about the top four pitfalls that leaders fall into when assessing data and transforming internal processes. What You'll get out of this episode: Why the rule of thumb can be guiding toward failure The importance of seeking disconfirmation Why too much confidence can be bad How are you trapping yourself into a bad situation Join the ConversationWe want to hear from our RevDivers! Tell us what topics and people you'd like us to cover in future episodes:Rev Dive on LinkedInRevDive on TwitterFollow our hosts on LinkedIn:Taya https://www.linkedin.com/in/tayamoheiser/ Kem https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/ Follow our Guest on LinkedIn:James Lineberger

Linda Minges and Jackson Dellana from the Gaston County Cooperative Extension and Frankie Lineberger from Lineberger's Farm in Dallas talk about how to introduce your kids to cooking and meal preparation and how that can start them on the path of trying new foods. 

Joining me today is  Ken LinebergerKen  is the President of Waters Edge Wineries. Waters Edge Wineries  is a micro-winery franchise. They allow you to own a winery without the risk and hassle of owning a vineyard. They outsource all of the agriculture part of the winery business and simply import the crushed grapes from vineyards worldwide allowing franchisees to become independent producers of wine. Waters Edge wineries are located in urban, populated areas in retail space - they essentially bring the winery to the people!Waters Edge Wineries was recognized as a Franchise Dictionary Magazine Top 100 Gamechanger for 2019 and is part of Franserve's Fran-Tastic 500 for the past two years. I hope you enjoy today's discussion with Ken Lineberger from Waters Edge Wineries 

Understanding debt and finance is key to investing success. At Jake & Gino, we educate our community members on all the three pillars: Buy Right, Finance Right & Manage Right ™. Let's dive into Finance Right, right now. On this episode, Jake and Gino talk with Matt Lineberger. Matt is a business development representative with Lima One Capital, LLC in Atlanta, GA. Lima One Capital is the nation's premier lender for residential real estate investors. The key takeaways from the Podcast include the following: To qualify for a Multifamily loan, you need to have a credit score of 660-680 ideally. Then an investor should have a good experience in the space. The lender would also like to see your exit strategy. Bridge financing could help you close deals in the Mom & Pop apartments space.   Listen to the podcast to learn more about multifamily financing and loans. Write to Scott, a Jake & Gino team member, if you want to reach out Matt: Scott@jakeandgino.com Do you want to learn more about Multifamily Investing? Register this complimentary training now: https://bityl.co/6v71

1v1 Lineberger vs Goode recap, and shad spawn tactics.

Your weekly dose of information that keeps you up to date on the latest developments in the field of technology designed to assist people with disabilities and special needs. Special Guests: Julie Lineberger – Founder and President and RJ Adler – Business Development Director – Wheelpad https://www.wheelpad.com Email RJ: rj@wheelpad.com Ted Talk: https://www.ted.com/talks/julie_lineberger_wheel_pad_keeping_families_together Magical I […] The post ATU514 – Wheelpad with Julie Lineberger and RJ Adler appeared first on Assistive Technology at Easter Seals Crossroads.

vcpcares.org The Valley Community Pantry was established in 1965 by Reverend Roy Schippling of the Episcopal Church of the Good Shepherd located here in Hemet. As its mission grew and the needs of the local community increased, the Valley Community Pantry became an important resource in this valley and to the County of Riverside. In 1992, the Valley Community Pantry received its certification as a non-profit 501(c)3, providing charitable tax deductions to our supporters. Some research was done by Mike Schippling, the son of Reverend Roy Shippling, and his research showed that the Valley Community Pantry may have been the first or second food pantry in Riverside and possibly Southern California.   12,025 families registered – 37,112 people almost an average of 3 people per family, averaging 131 new families per month Average annual income for our registered families is $13,718.00 Average Federal Annual Poverty Level for a family of 3 is $ 21,960 Services we provide are: Emergency Food, Utility and Rental Assistance. We also provide new and/or used refrigerators for Veterans and seniors when they are in need or homeless and put into housing. We serve 49 registered Homeless Veterans at our pantry We serve 437 registered Inactive Veterans at our pantry We serve 217 registered Disabled Veterans at our pantry We serve 2,726 registered Disabled senior families at our pantry We serve 2,989 who live on social security income only We serve 2,311 seniors 60 years and older We deliver twice a month to 19 Homebound/Disabled Seniors who have no family or a means to get to our pantry We serve 3,339 Single Mom families at our pantry Less than 1/4 of 1% of the people we serve or have served are homeless on the streets (Referred as Street Residents) The break down of age groups for our pantry: 34% of our clients are children under the age of 18 years old 39% of our clients are between the ages of 18 and 54 years old 27% of our clients are between the ages of 55 and 93 years old We average an annual income for our clients of $13,178.00 per year. The National Poverty Level annual income is $21,960.00. Our clients are 33% lower annual income than the National Poverty average.

1v1 recap from this past week Sabbagha vs Lineberger, and Chris Marshall in studio to talk jig fishing.

Shane walks through the 2021 Elite Series. Brad interrupts him, and starts talking about random things.

In this episode Scott Lineberger talks about how being consistent helps us to find contentment in our circumstance and our faith. CapeMEN Social Links: Facebook: https://www.facebook.com/capeMEN Instagram: https://www.instagram.com/capechristianmen/ We are the Men's ministry of Cape Christian Fellowship located in Cape Coral, FL. Website: https://capechristian.com/ Facebook: https://www.facebook.com/capechristian/ Instagram: https://www.instagram.com/capechristian/ Intro and Outro music by www.bensound.com (https://www.bensound.com/royalty-free-music/track/summer-chill-relaxed-tropical)

Who doesn’t love to unwind with a glass of wine at the end of a long work day? Imagine if you could take that feeling with you to work every day. Well, now you can! Today’s guest, Ken Lineberger created a wine franchise that now has 21 locations. Waters Edge has a uniquely relaxing atmosphere and makes the wine on sight. In this episode, Ken shares how he created his franchise, how he educates the owners of Waters Edge locations, and the importance of tenacity as an entrepreneur. Grab a glass of wine and join Debbie Allen in this entertaining and educational episode. Show Highlights: How Ken was inspired to turn a winery into a franchise    Ken shares how you could start a winery franchise anywhere    What the experience at Waters Edge is like    Success stories from owners of Waters Edge locations    Common mistakes business owners make when opening a franchise    Why we should educate business owners on how to measure profitability and manage money    Why having a mentor and systems put in place is important    How long does it take to set up a Waters Edge franchise     How Ken went from one location to being the leader of 21 locations     Why having passion and a mentor is necessary for business success  Ken shares the biggest lessons in disguise he discovered in this business    Connect with Ken! Ken’s Email Ken’s Facebook Ken’s LinkedIn Ken’s Phone #: 909-468-WINE (9463) Ken’s Special Offer: Take a virtual tour of one of our locations at www.watersedgewineries.com and click on the “Check Out Our Franchise Video” on the home page. Links: Podcast– Listen & Subscribe! Buy Debbie’s Book and Have a Highlighter Handy!! Please Read the Book, Rate It On Amazon, and Pass It On To A Friend! Success Is Easy: Shameless, No-Nonsense Strategies to Win in Business, by Debbie Allen https://www.successiseasybook.com/bonus/ https://www.amazon.com/Success Is Easy NEW!!!! Debbie’s Online “Highly Paid Expert Academy” https://debbieallen.com/course

Mulitple-time NCAA wrestling champion Garrett Lineberger joins John Hyon Ko of Kumite TV to discuss signing an exclusive deal with ONE Championship. ▶️Subscribe to Kumite TV https://www.youtube.com/c/KumiteTV ▶️Interviews https://www.youtube.com/playlist?list=PLpBStxIAJ_qVhp1kQ-CJzpTa2HIJ32Qmj Want to support the show? Consider donating here: https://paypal.me/jhkmma Any amount will help with the overall upgrade of Kumite TV. Without you, there is no channel. Without you, there is no Kumite TV. Follow John Hyon Ko on social media. ✅Facebook: https://www.facebook.com/JHKMMA/ ✅Instagram: https://www.instagram.com/jhkmma/ ✅Twitter: https://twitter.com/JHKMMA

Jason is the leader of an innovative and entertaining orchestra of ukulele player. --- Send in a voice message: https://anchor.fm/sandy-carlton/message

In this episode we are joined by Ervin Lineberger, owner of Kildeer Farms in Kings Mountain, North Carolina. Ervin has been farming since the 1980s in western North Carolina, between Charlotte and Asheville, where he has grown muscadines, blackberries, peaches, strawberries and vegetables. Currently Ervin grows muscadines and blackberries for wholesale markets. Ervin shares with us his experience with blackberries and muscadines, provides insight in to the future of muscadines as a commodity, and offers advice for growers who are looking to tap into the small fruit market.

In this segment of The Bass University live we sit down with Shane Lineberger. Bassmaster Elite Series pro joins our hosts Pete and Pat to talk some bassin'. Enjoy!

In today's podcast, I host Bassmaster Elite Series Pro, Shane Lineberger! Shane talks about his road to the Elite Series and his new podcast Rusty Hooks Live! Shane's Instagram: https://www.instagram.com/shanelinebergerfishing/ Shane's Facebook: https://www.facebook.com/shanelinebergerfishing/ Rusty Hook Live: https://podcasts.apple.com/us/podcast/rusty-hooks-live/id1502166402 Thanks for watching! Comment, Like, SUBSCRIBE! Follow along on Serious Angler social media: Instagram: seriousangler Facebook: Serious Angler Anchor, Spotify, Apple, & More: Serious Angler ALSO, Follow my personal Social Media: Instagram: bailey_eigbrett Facebook: Eigbrett Outdoors --- Support this podcast: https://anchor.fm/serious-angler/support

Shane talks about Lake Norman, and life on the elite series.

The early morning 911 call after Duane Bouvier Oates was shot and killed on Lineberger Street.

Abundance isn’t really synonymous to wealth, as wealth is more likely to be material. Abundance is beyond that. Julie Lineberger believes abundance is being of service which in turn produces fulfillment in your inner self. Julie is the Founder of LineSync Architecture and Wheel Pad and the past Chair of Vermont Businesses for Social Responsibility Board of Directors. She and her husband have been passionate about doing service to the people and going beyond the norm promoting what they believe is good for the world which is community and sustainability. Julie talks about how unleashing abundance and being of service makes a wonderful life. Love the show? Subscribe, rate, review, and share! Here’s How » Join the BeyondEgo community today: elizabethbarryconsulting.com BeyondEgo Instagram BeyondEgo Facebook BeyondEgo LinkedIn —

Abundance isn’t really synonymous to wealth, as wealth is more likely to be material. Abundance is beyond that. Julie Lineberger believes abundance is being of service which in turn produces

This week on What's up Greenville Podcast we speak with a very prominent Preacher here In in Greenville, Co-founder and pastor of Ignite church, Jason Lineberger. We talked about the process of starting a new church and the history of Ignite Church. Jason gives good insight on what Greenville Needs as a community and where we are flourishing. Take an hour out of your day and listen to Jason's story. Thank you for listening.Follow Ignite Church on Facebookhttps://www.facebook.com/ignitechurch252/Follow Ignite Church on Instagram:insta: @ignitechurch252Follow us on Facebook:https://www.facebook.com/whatsupgreenvillepodcast/

Follow me on IG: @Nick.Carlile Terry Lineberger and Kelly Lauterjung are financial planners and best selling authors. New book: https://www.amazon.com/Hey-Forgot-Tell-You-Parents/dp/1544511752/ref=sr_1_1?keywords=terry+lineberger&qid=1567698855&s=gateway&sr=8-1

Creating a financially secure future today is harder than ever before. Student loans and high costs of living prevent young professionals from building a nest egg, while their parents struggle to help without ... The post Hey I Forgot to Tell You: Kelly Lauterjung and Terry Lineberger appeared first on Author Hour.

How do you make every home wheelchair accessible?Today we sit down with Julie Lineberger, founder of Wheelpad, to discuss startups with a cause.https://www.wheelpad.com/ See acast.com/privacy for privacy and opt-out information.

Dr. Jared Weiss, UNC Lineberger Comprehensive Cancer Center, details the trends in lung cancer demographics and changes in histology by race and gender.

Dr. Jared Weiss, UNC Lineberger Comprehensive Cancer Center, details the trends in lung cancer demographics and changes in histology by race and gender.

Dr. Jared Weiss, UNC Lineberger Comprehensive Cancer Center, details the trends in lung cancer demographics and changes in histology by race and gender.

Dr. Jared Weiss, UNC Lineberger Comprehensive Cancer Center, discusses smoking, asbestos, radon and other risk factors for lung cancer.

Dr. Jared Weiss, UNC Lineberger Comprehensive Cancer Center, discusses smoking, asbestos, radon and other risk factors for lung cancer.

Dr. Jared Weiss, UNC Lineberger Comprehensive Cancer Center, discusses smoking, asbestos, radon and other risk factors for lung cancer.

Dr. Jared Weiss, UNC Lineberger Comprehensive Cancer Center, discusses the demographics and epidemiology of lung cancer.

Dr. Jared Weiss, UNC Lineberger Comprehensive Cancer Center, discusses the demographics and epidemiology of lung cancer.

Dr. Jared Weiss, UNC Lineberger Comprehensive Cancer Center, discusses the demographics and epidemiology of lung cancer.

Dr. Jared Weiss, UNC Lineberger Comprehensive Cancer Center, discusses the genetic risk (or lack thereof) for lung cancer.

Dr. Jared Weiss, UNC Lineberger Comprehensive Cancer Center, describes the types of situations in which local therapy is appropriate for treating limited acquired resistance.

Dr. Jared Weiss, UNC Lineberger Comprehensive Cancer Center, discusses the genetic risk (or lack thereof) for lung cancer.

Dr. Jared Weiss, UNC Lineberger Comprehensive Cancer Center, describes the types of situations in which local therapy is appropriate for treating limited acquired resistance.

Dr. Jared Weiss, UNC Lineberger Comprehensive Cancer Center, discusses the genetic risk (or lack thereof) for lung cancer.

Dr. Jared Weiss, UNC Lineberger Comprehensive Cancer Center, describes the types of situations in which local therapy is appropriate for treating limited acquired resistance.

Dr. Jared Weiss, UNC Lineberger Comprehensive Cancer Center, discusses the use of single agent vs. doublet chemotherapy in elderly patients.

Dr. Jared Weiss, UNC Lineberger Comprehensive Cancer Center, discusses the use of single agent vs. doublet chemotherapy in elderly patients.

Dr. Jared Weiss, UNC Lineberger Comprehensive Cancer Center, discusses the use of single agent vs. doublet chemotherapy in elderly patients.

Immunotherapy Forum Video #26: Drs. Jared Weiss and Matthew Hellmann answer questions from the audience following their presentations on immunotherapy for lung cancer. Moderated by Dr. Jack West.

Immunotherapy Forum Video #26: Drs. Jared Weiss and Matthew Hellmann answer questions from the audience following their presentations on immunotherapy for lung cancer. Moderated by Dr. Jack West.

Immunotherapy Forum Video #26: Drs. Jared Weiss and Matthew Hellmann answer questions from the audience following their presentations on immunotherapy for lung cancer. Moderated by Dr. Jack West.

Immunotherapy Forum Video #23: Dr. Jared Weiss highlights what doctors know about immunotherapy treatments for lung cancer. His words: "The pace of progress that I expect over the next 3 to 5 years will shock even the most optimistic..."

Immunotherapy Forum Video #23: Dr. Jared Weiss highlights what doctors know about immunotherapy treatments for lung cancer. His words: "The pace of progress that I expect over the next 3 to 5 years will shock even the most optimistic..."

Immunotherapy Forum Video #23: Dr. Jared Weiss highlights what doctors know about immunotherapy treatments for lung cancer. His words: "The pace of progress that I expect over the next 3 to 5 years will shock even the most optimistic..."

This is a report from our esteemed Field Correspondent, Jason @foolybear Lineberger.  He sent in this footage in Apr 2013.  Now publishing in Feb 2015 - no sense in putting it off any longer.

November is Lung Cancer Awareness Month. To mark it this year, GRACE is celebrating the empowered lung cancer patient. In this video, Dr. Jared Weiss, GRACE Vice President, and his patient Tomma Hargraves, discuss how they became a team.

November is Lung Cancer Awareness Month. To mark it this year, GRACE is celebrating the empowered lung cancer patient. In this video, Dr. Jared Weiss, GRACE Vice President, and his patient Tomma Hargraves, discuss how they became a team.

November is Lung Cancer Awareness Month. To mark it this year, GRACE is celebrating the empowered lung cancer patient. In this video, Dr. Jared Weiss, GRACE Vice President, and his patient Tomma Hargraves, discuss how they became a team.

Joining us today is Julie Lineberger managing partner at LineSync Architecture. They are a company that designs high profile innovative municipal, corporate and unique residential environments with a green and sustainable emphasis and she is also the board chair for Green America.     I was in awe the first time Julie and I met. We were at a sustainability conference and she was sharing how she and her team track their water and energy consumption. It was pretty cool how off the top of her head, she was quoting exact numbers of what she and her staff use. Plus, best of all they had set real life goals to reduce her consumption. I remember thinking wow, this is pretty inspiring, I need to connect with her to learn more and I’m hoping you will be as inspired as I was.

Shockingly, many people fear cancer and cancer care so much that they may not be screened or seek treatment, even when they suspect something is wrong. When they finally show up at UNC Lineberger Comp Cancer Center, the cancer may be late stage. Patient Navigators reach out into their community and help people get screening, and support them through the process to survivorship breaking down barriers to care. Jean Sellers, ONC, is focused on changing processes that prevent cancer care thru the NC Oncology Navigator Association. Lay Patient Navigators will volunteer their skills to help bring patients to a medical home. Joni live M-F at 2:00 p.m. ET on www.W4CS.com. www.JoniAldrich.com

brwp.netPaintball's most prolific writer and great friend of the show, Jason "Foolybear" Lineberger is back with Wayne and Ben for another action-packed episode of Blast Radius Woodsball Podcast.  Today the guys discuss night-vision in a paintball game, using the Eclipse Geo Soft Touch (GST) kit to fine tune the muzzle velocity of a Geo, plus using GPS in a scenario game. Foolybear Special thanks to KnightSabre for submitting his post-game report!Operation Whybrew25 Oct 2009http://www.facebook.com/group.php?gid=129742236617Special Edition download of Blast Radius BUSHBALL Podcast #001http://bit.ly/Bushball001Contact the show:Email: studio@brwp.netCall the Studio Line: 303-952-0274Skype: blastradiuswoodsballpodcastTwitter - WayneTwitter - BenFacebook - WayneFacebook - Ben Facebook - Group Youtube MyspaceComplete our listener survey!http://bit.ly/brwpsurveyMUSIC:Theme music by Greg M Johnsonhttp://myspace.com/dewydb9 Oct 2009brwp.net