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Circles Off sits down with Andrew Gombas for a deep dive into one of the most complete career paths in modern sports betting. Andrew has done nearly every job in the industry — from pick selling, to running betting groups, to working inside PPH-style operations, to becoming a full-time bettor focused heavily on MMA. In this conversation with Rob Pizzola, he breaks down what each side of the industry actually looks like from the inside and how it all connects. We also get into the evolution of sports betting groups, what most people misunderstand about pick selling ecosystems, and how the PPH world has changed over time. Andrew shares stories from inside that space, including the realities of account gathering, group dynamics, and what it takes to operate at scale. The conversation also goes into MMA betting at a high level — how his process has evolved, where his edge comes from, and what sharp fight handicapping actually looks like in practice. Later in the episode, things get even deeper with discussions around fixed fights, controversial situations in UFC betting, and the darker side of the betting ecosystem. This is part of the Circles Off interview series presented by ProphetX, focused on sharp betting minds, betting markets, and real behind-the-scenes process. If you're interested in sports betting, MMA betting, betting groups, or how the industry actually works behind the scenes, this episode delivers a rare inside perspective.
When your schedule is packed, it's easy to assume your practice is healthy—but “busy” can hide low productivity and weak profitability. In this episode, Kirk Behrendt brings in ACT Dental coach Robyn Theisen to explain why volume masks inefficiency longer than any other metric, how “busy” becomes a false proxy for performance, and what to measure instead. You'll learn how to compare number of visits with production per visit and production per hour, what inefficient schedules look like, and how to build a strategic schedule that slows down on purpose while producing more. Listen to Episode 1045 of The Best Practices Show!Main Takeaways:A full schedule can look healthy while profitability is not there because volume can hide inefficiency.“Busy” is a false proxy and has zero value unless you connect it to productivity and profitability.Compare number of visits with production per visit (PPV) and production per hour (PPH) to see whether you're churning through patients or producing efficiently.Low PPV and low PPH often show up as lots of short, low-value appointments and reactive treatment planning that keeps the day running long.Inefficient volume creates physical fatigue and mental fatigue when the activity doesn't match what ends up in the bank account.A practice that gets it right builds a strategic schedule with the right mix of procedures, not just filled spots, and matches time to clinical complexity and value.Start by planning the year (days worked, vacations, holidays, CE, meetings), set an annual production goal, and break it down into a daily target to build the schedule around.Snippets:00:00 Why a busy schedule doesn't automatically mean a profitable schedule.03:10 Why “busy” is a false proxy and what “time is the new rich” looks like.04:05 The homework metric: calculate PPV, PPH, and compare them to number of visits.06:00 What inefficient volume looks like in the schedule and treatment planning.08:05 What it looks like when a practice gets it right with a strategic schedule.11:05 The first step: plan your year, set annual goals, and convert them into a daily production target.12:00 Why write-offs matter and how inaccurate assumptions can hide the real numbers.Guest Bio/Guest Resources:Robyn Theisen brings an entire life and legacy of dental experience to the team and every team with which she works as the daughter and sister of dentists. With almost 20 years of experience in dentistry, her roles ranged from practice management to operations at Patterson Dental to coaching teams. Robyn's passion is empowering teams to realize that they can dramatically impact the lives of the people they serve by implementing skills and systems to remove barriers to life-changing dental treatment. She has done it for decades and does it every day with dental teams.Outside of coaching, she enjoys time with her husband, Rob, and two daughters, Emerson and Ruby. She loves traveling, music, fitness, and cheering on the Michigan State Spartans.Resources mentioned in the episode:Pro Coaching (ACT Dental): https://www.actdental.com/proTo The Top Study Club: https://www.actdental.com/ttt/More Helpful Links for a Better Practice & a Better Life:The Best Practices Show: https://www.actdental.com/podcast/Best Practices Association: https://www.actdental.com/bpaUpcoming Events & Workshops: https://www.actdental.com/events/Smile Source: https://www.smilesource.com/Subscribe on Apple Podcasts: https://podcasts.apple.comSubscribe on Spotify: https://open.spotify.com
Uterine compression sutures are effective, uterus-sparing techniques for managing severe postpartum hemorrhage (PPH) due to atony, avoiding hysterectomy. Keytypes include the B-Lynch suture (vertical, brace-like), Hayman suture (simplified vertical), and Pereira sutures (multiple, comprehensive sutures), and Cho Compression (quadrant square anterior to posterior closures), are applied when pharmacological methods fail. But these, while helpful with atony, do not address the LUS bleeding from previa which are below these applications. Even the O'Leary lateral sutures are often higher tha the bleeding and thin, anterior LUS affected by previa. Previa is a significant risk factor for PPH. In this episode, we will highlight 3 novel suture techniques which have been in print (TWO as recent as January 2026) which can be effective in stopping the LUS bleeding and avoiding hysterectomy. We will highlight the transverse circumferential purse string, the simple transverse Nausicaa suture, and theLUS WaveForm suture. These are easy to use and may be lifesaving. 1. Shih J, Li J, Kang J .The Nausicaä suture in the management of the placenta accreta spectrum. AJOG. Jan 2026: 233, S671-S688 S2. Transverse Purse String Suture for Placenta Previa in the Presence of Previous Cesarean Section, Experience in Northern Borders Saudi Arabia. 20223. Zhou L et alWave compression suture: A modifieduterus-preserving treatment for placenta previa by reconstruction of the lower uterine segment. Medicine (Baltimore). 2026 Jan 30;105(5):e47468.
Uterine hemorrhage remains a significant complication following abortion loss and in the postpartum period and contributes to substantial morbidity and mortality among pregnant patients. Although some FDA approved devices are on the market (Bakri balloon and Jada vacuum), they may be cost prohibited in some settings and/or some uterine cavities may be very small for either option, like after a mid-second trimester or early third trimester PPH. But every delivery unit has some form of suction tool and wall suction ability. This is where FOCUS*, STUT, and/or U-CaVIT come into play. And now there is new data on this from the AJOG (epub, April 2026). Listen in for details. (*Shout Out to Dr. Frank Jackson for his work on this as well).1. Singata-Madliki et al. Suction Tube Uterine Tamponade Versus Uterine Balloon Tamponade for Treatment of Refractory Postpartum Hemorrhage: A Randomized Clinical Feasibility Trial. International Journal of Gynaecology and Obstetrics: The Official Organ of FIGO. July 2025. (South Africa)2. Hofmeyr GJ, Singata-Madliki M. Novel Suction Tube Uterine Tamponade for Treating Intractable Postpartum Haemorrhage: Description of Technique and Report of Three Cases. BJOG : An International Journal of Obstetrics and Gynaecology. 20203. Jackson FI, Dilena NJ, Abelman SH, Blitz MJ, Gerber S. Hemorrhage management using a Foley catheter for uterine suction. Am J Obstet Gynecol. 2025 Nov;233(5):503-504. 4. ACOG Practice Bulletin No. 183: Postpartum Hemorrhage. Obstetrics and Gynecology. 2017. 5. Ranieri E, Kalimeris S, Ochsenbein N, Haslinger C, Vacuum-Induced Tamponade Using Urological Catheters for Postpartum Hemorrhage, American Journal of Obstetrics and Gynecology (2026), doi: https://doi.org/10.1016/j.ajog.2026.04.026
Episode 285-Nappen Law Firm Does Hat Trick Also Available OnSearchable Podcast Transcript Gun Lawyer — Episode Transcript Page – 1 – of 10 Gun Lawyer — Episode 285 Transcript SUMMARY KEYWORDS Appellate Division, firearm licensing, Bergen County, mental health, due process, public health, safety, welfare, falsification, character and temperament, court reversal, pro se, legal representation, gun rights, grassroots advocacy. SPEAKERS Speaker 3, Evan Nappen, Teddy Nappen Evan Nappen 00:16 I’m Evan Nappen. Teddy Nappen 00:19 And I’m Teddy Nappen. Evan Nappen 00:21 And welcome to Gun Lawyer. Well, I’m very proud to report that my firm, particularly my brother Louis, who does our appellate work, has won yet another Appellate Division appeal out of Bergen County. Now, this is the Appellate Court reviewing the trial court in Bergen County, handling firearm licensing. And this is another win that really makes some excellent legal points here that are very significant and also points out what is been going on in that county. I want to get into this case and explain the significance and how it works here in New Jersey. Evan Nappen 01:23 So, this case just came, just got posted online by the Appellate Division and is entitled “In The Matter Of The Appeal Of The Denial Of J.L.B.’s Application For A Firearms Purchaser Identification Card And Permit To Purchase A Handgun”. (https://www.njcourts.gov/system/files/court-opinions/2026/a0464-24.pdf) So, J.L.B. appealed from an Order denying his appeal from the New Milford Police Department who denied his application for an FPIC and a PPH, a Firearm Purchaser ID Card and Permit to Purchase a Handgun. Now, on this application, J.L.B. answered “no” to the question, Have you ever been attended, treated or observed by any doctor, psychiatrist in the hospital or mental institution on an inpatient or outpatient basis for any mental or physical or psychiatric condition? In denying the application, the New Milford PD cited solely a suicidal comment made by J.L.B.’s daughter several years prior, and their inability to obtain records from the Division of Child Protection Services, the DCPP. Milford PD concluded the issuance of the permits to our client would not be in the interest of “public health, safety, or welfare”, the all inclusive miscellaneous weasel clause. Evan Nappen 03:07 J.B.L., our client, filed an appeal to the law division, which is the Superior Court in Bergen. And he did this pro se. He did that by himself. The Court denied his appeal, and the court found him disqualified, Page – 2 – of 10 pursuant to (N.J.S.) 2C:58-3(c), for knowingly falsifying information on the application pursuant to 2C:58-3(c)(5). and for lacking character and temperament necessary to be entrusted with a firearm. The Appellate Court, upon careful review, reversed and remanded for a hearing before a different trial judge because they found there is no evidence in the record demonstrating that J.L.B. knowingly falsified information on his application. Further, that J.L.B. was not given notice of the 3(c)(5) disqualifier until after he had already presented his closing argument, in violation of his rights to due process. Evan Nappen 04:18 Additionally, the trial court failed to address whether the alleged falsification was made knowingly, as required by the statute. Very important, folks. Furthermore, with respect to N.J.S.A. 2C:58-3(c)(5), the Court’s reasoning provided no meaningful explanation as to why the issuance of an FPIC to J.L.B. would be contrary to public health, safety, or welfare. So, one GOFU right out of the box is don’t go Pro Se to Bergen County on an appealable license. Anytime you’re dealing with the courts, you want to have an attorney. Okay? That’s number one. Now, even though he got denied, fortunately, he hired us to do the appeal. And in doing this appeal, the Appellate Court has reversed his denial, sent it back to the court, and required that it be heard by a different judge. Evan Nappen 05:21 Let’s take a look at some of the facts here in this case. It’s very interesting, particularly how the court decided it, because it can have impact on other cases. So, the Court gathered the following facts from the trial court’s hearing. J.L.B. is a certified public accountant with no criminal history. He has primary custody of his seven children, who range from six to 16. In April of 2020, his daughter, who was nine years old, sent a text message to her teacher, saying, “I want to die” and “I spent four days with dad, and four days with my mom, and I keep switching until everything is settled. But I can’t sleep without knowing if mommy is okay and safe.” The message led to the daughter receiving several months of therapy. The DCPP was involved in the family’s life on three different occasions, each time, deeming the allegations “Not Established”. Evan Nappen 06:19 J.L.B.’s ex-wife testified on behalf of the State, describing alleged incidents of verbal and physical abuse by J.L.B. against her and her two children, as well as her struggles with alcoholism, for which she completed inpatient rehabilitation. The wife never testified or obtained a, never filed or obtained a Temporary Restraining Order against J.L.B. The court found her testimony not completely credible and characterized it as totally based on hearsay. J.L.B.’s sister testified as a character witness, describing his demeanor and relationship with his family, expressing no concerns about him owning a firearm. Dr. Richard Cyriacks, a family friend, similarly, testified that he had no concerns about J.L.B. responsibly handling a firearm. J.L.B. testified he had purchased a biometric firearm safe in which he intended to store the firearm if his permits were granted. J.L.B. testified he had seen a psychologist, a Doctor Lenzi, from 2018 to 2022 for marital issues, but he denied ever being diagnosed with a mental health condition or receiving psychiatric treatment or medication. Briefly, at around age 19, he had also seen a therapist following the death of his father. Page – 3 – of 10 Evan Nappen 07:42 Following this testimony, the State moved to compel the release of his mental health records from Dr. Lenzi, which the Court granted. So, keep in mind, folks, if you think you have medical privacy in New Jersey, you don’t! Okay? The Court ordered the records to come in. The Court admitted J.L.B.’s counseling records and a letter from Lenzi into evidence, from the doctor. In her letter, the doctor noted that she first saw him in 2017 for “marital difficulties”. “He presented as concerned about his marriage and stressed but positive and high functioning.” He reconnected for individual therapy in 2020 because of his wife taking the children to Connecticut, causing him distress. He was seen on an as-needed basis. The doctor reported his symptoms were within normal limits of chronic stressors and the family crisis he worked through during the treatment with him. She further reported that she observed no unstable mental health issues, and his treatment focused on implementing stress management strategies, communication, awareness, improvement and relationship building with the children, decreasing internal anxiety and meeting his challenges in an aware and grounded manner as to the records themselves. Lenzi wrote that he had symptoms of anxiety and depression related to marital difficulties, and in 2020 a progress noted that he presented with anxiety and depression and expressed that he was devastated by what he was going through. In 2024, the Court denied J.L.B.’s appeal, finding he was disqualified, pursuant to 2C:58-3(c)(3) for knowingly falsifying information regarding previous mental health treatment, and pursuant to 2C:58-3(c)(5) for lacking the character and temperament necessary to be entrusted with a firearm. This appeal is what followed. Evan Nappen 09:47 The court, the Appellate Court, says N.J.S.A. 2C:58-3 governs the issuance of FPICs and PPHs which it does. A person may not receive an FPIC or PPH, if they are, “known in the community in which the person lives as someone who has engaged in acts or made statements suggesting the person is likely to engage in conduct, other than justified self-defense, that would pose a danger to self or others.” Or if you’re subject to any of the other disqualifications under 58-3. Pursuant to that law, no FPIC or PPH shall be issued to any person who, and this is underlined in the opinion, knowingly falsifies any information on the application form for a handgun purchase permit or firearm purchaser ID card. Invoking FPIC/PPH disqualification when any falsification is tendered is consistent with the application’s underlying function, which is to provide information to facilitate the police chief’s background investigation. Further an FPIC application that includes, again underlined, a knowing falsehood is disqualified at the moment it is filed and cannot be rehabilitated by an admission made later. Evan Nappen 11:12 The Court then noted initially that J.B.L. did not receive notice of the 2C:58-3 issue, the falsification issue. I mean, the other issue until the State raised it at closing, which was delivered to J.B.L. after he’d already presented his closing statement. And the Court here says, “To comport with due process, a judicial hearing requires notice defining the issues and an adequate opportunity to prepare and respond.” N.J.S.A. 2C:58-3(c)(3) was not cited as a basis for disqualification in the New Milford PD’s letter denial letter. It was not cited sorry. As a basis for disqualification, nor was it discussed as a potential ground for denying his appeal until both parties had presented their evidence at the hearing. J.L.B. was therefore denied the opportunity to defend himself on this ground until the hearing was all but completed. Page – 4 – of 10 Evan Nappen 12:20 Moreover, and this is important, the trial court failed to address whether JBL knowingly falsified his response. Now we’ve experienced, folks, in our practice that there are times, many times, as a matter of fact, this trifecta of a win here that we’ve had. Where the court will make any statement that they deem to be a false statement, not even over the application, to be a basis for denial. And here the court is making it clear it takes a knowingly falsified response, and it has to be based on what’s in the application. At the close of the hearings, after both parties have presented their arguments, the court pressed, pressed J.L.B. as to his understanding of the nature of his mental health treatment, his course of therapy with his doctor, and interpretation of the question on the FPIC application regarding mental or psychiatric treatment. Evan Nappen 13:19 Footnote three, and, folks, listen to what footnote three says. This is what happened in that court. Footnote three by the Appellate Court. “We note this line of questioning by the court was improper, as were other lines of questioning throughout the hearings. When presiding over a bench trial, the court may examine witnesses ‘to clarify testimony, aid the court’s understanding, elicit material facts, and assure the efficient conduct of the trial.'” “In this case, the trial court extensively cross-examined J.L.B. on multiple occasions and, in doing so, crossed ‘that fine line that separates advocacy from impartiality’ and substantially prejudiced J.L.B.’s right to a fair hearing.” And I can tell you, folks, that there are plenty of others that have experienced that in Bergen County, the court goes on in the opinion. Teddy Nappen 14:42 If I recall, isn’t Bergen, pretty much the only county where they ever go after people for falsification? Evan Nappen 14:48 No, they’re not the only county, but they are the lion’s den of problems. And this is really great, that this case is shining the light on what went on in this case. And this is now critical, so let me just go on. J.L.B. explained that he had answered “no” because he had been treated by a psychologist who held a PhD, not a psychiatrist or physician. He further stated he never received a clinical diagnosis of any mental health condition, including depression or anxiety. He was never treated with any psychiatric medication. He noted he had not seen the progress notes until they were released during the hearing, and he had begun to address why he would not know what a doctor puts in her notes before being abruptly cut off by the court. Get a load of that, folks. The trial court did not address these contentions. Instead, it relied on the doctor’s progress notes, unknown to J.L.B. at the time he filled out his application, to erroneously conclude J.L.B. suffered from anxiety and depression and he had falsely answered the questionnaire. Whether J.L.B.’s response was false, however, is a question the record before us does not resolve for the following reasons: J.L.B. was not afforded an adequate opportunity to defend himself, given the lack of notice, the record contains no clinical diagnosis of mental health conditions, nor evidence of any mental health treatment, and the doctor did not testify at the hearings. Evan Nappen 16:35 Importantly, the court’s analysis entirely ignores the statutory requirement the falsification be made knowingly. Even if J.L.B.’s response was false, he had no reason to know the contents of the doctor’s notes when he completed the application. These records were not produced until the hearings on his Page – 5 – of 10 appeal, long after the application was submitted. A finding of knowing falsification cannot rest solely on the contents of records J.L.B. had never seen. Additionally, the court also denied the appeal pursuant to 2C:58-3(c)(5), finding that no FPIC or PPH shall be issued “to any person where the issuance would not be in the interest of public health, safety or welfare. “This is the “broadest” of disqualifications for obtaining an FPIC or PPH. “In re Application of Carlstrom”, by the way, is citing another Nappen case. The provision is intended to relate to cases of individual unfitness, even though not dealt with in specific statutory enumerations, the issuance of a permit or identification guard would nonetheless be contrary to public interest. Evan Nappen 17:58 The court’s reasoning in determining J.L.B. was disqualified pursuant to is as follows, and this is from the court hearing. This is the Appellate Court quoting this quote from the hearing in the Bergen County Court. This is the judge’s finding in that hearing. I also find that he’s disqualified pursuant to 58-3(c)(5), to any person where the issuance would not be in the interest of public health, safety, or welfare, because the person was found to be lacking the essential character of temperament necessary to be entrusted with a firearm. And that’s really due to Mr. (J.L.B.)’s testimony. Particularly his testimony before the court here today, where he minimizes his course of treatment with Dr. Lenzi, and tries to divert attention away from Dr. Lenzi’s Progress Notes, in a very long letter, which states that Mr. (J.L.B.)’s treatment, while focusing on decreasing his anxiety, and the fact that he presented with depression and anxiety, both at Intake and at various times throughout the course of his treatment. The public health, safety, and welfare doesn’t just include the public outside of (J.L.B.) household. It also includes Mr. (J.L.B.) and his children. So, that’s the court’s decision. I do find that the state has met its’ burden by preponderance of the evidence.” Evan Nappen 19:13 Then the Appellate Court says, in response to that, “This reasoning is misplaced. J.L.B.’s discussion of Dr. Lenzi’s progress notes was not an attempt to minimize his treatment or divert the court’s attention, but rather an effort to explain why those notes did not render his answer on the application knowingly false. A self-represented applicant’s attempt to contextualize his counseling records cannot support a finding of unfitness within the meaning of 2C:58-3(c)(5). Indeed, we recently rejected the notion that an applicant’s credibility or dishonesty can serve as a sole basis for disqualification pursuant to 2C:58-3(c)(5). What case are they citing? “See In the Matter of the Appeal of the Denial of Mikhail Polatov’s Application for a Firearms Purchaser ID Card.” Another Nappen win case. They’re using it to win here for our client, in which they say. Teddy Nappen 20:20 Polatov Cocktail. Evan Nappen 20:21 That’s right. That was our last show. It was on that case. Finding no correlation between the applicant’s lack of credibility and the absence of essential character or temperament that would make him more likely than not to be a danger to public health, safety, or welfare if he had a firearm. The court’s reason provides no meaningful explanation for how the record supports a finding that the issuance of a permit would be contrary to public health, safety or welfare. See Weston v. State. In the final analysis for a Page – 6 – of 10 court to sustain an administrative decision, which affects the substantial rights of a party, there must be a residuum of legal and competent evidence in the record to support it. Because the foregoing is dispositive, they declined to address the remaining arguments we made. They reverse and remand the matter for a new hearing before a different judge. This case is a great win, and we’re very proud of it. We’re very glad to have helped our client here, and it is a trifecta of three wins coming out of what goes on in Bergen County, my friends. So, beware. Learn from this and make sure you have good counsel when fighting for your gun rights. Evan Nappen 21:45 Let me tell you about our good friends at WeShoot. WeShoot is a great range in Lakewood, New Jersey. It’s the range where Teddy and I both shoot. It’s where we got our certifications and where we love to shoot. Great range, great pro shop. They’ve got fantastic firearms equipment and great training. Get your CCARE there, your certificate, so you can get your carry. Whether you’re beginner or an advanced shooter, WeShoot is a place for you. WeShoot is just wonderful. All I get is fantastic feedback from everybody that goes there. They treat everyone like family. You will love it. WeShoot is conveniently located in Lakewood, New Jersey, right off the Parkway. Easy to get to, right there in Central Jersey. It is a great resource. We need our ranges, folks. Without our ranges, you don’t have a place to shoot, and this is a great resource that you can take advantage of. Pay a visit to WeShoot. Check out their website at weshootusa.com, weshootusa.com. You will also really enjoy their website. They have the WeShoot girls. They have fantastic top of the line professional photography, and you can learn all about this wonderful experience that awaits you at our favorite range, which is WeShoot in Lakewood, New Jersey. Evan Nappen 22:31 And let me also remind you that you need to get a copy of my book, New Jersey Gun Law. It is the Bible of New Jersey gun law. It is 120 topics, all answered by question and answer in a 500 page book. That book is so big it is a weapon itself. So, get your copy today by going to EvanNappen.com, EvanNappen.com. You will help protect yourself from becoming a GOFU. You don’t want to do that. You need to know the insanity that is New Jersey gun laws. And that’s why I wrote that book, to make it as user friendly as possible for you to know. Hey, Teddy. What do you have for us today in Press Checks? Teddy Nappen 24:07 Well, as you know, Press Checks are always free, and one of the things that is always important is to keep tabs on our opponents, the gun rights suppressionists. I was perusing through EveryTown, and they put out their press release, patting themselves on the back. Everytown Gun Safety Action Fund Announces the Endorsements of Moms Demand Action volunteers for running in the offices of North Carolina and Texas. (https://www.everytown.org/press/everytown-for-gun-safety-endorses-first-round-of-moms-demand-action-volunteersrunning-for-office-in-2026/) And they were, you know, it’s various people seems that are running in these districts because they’re trying to attack there. You notice that they’re trying to hit like North Carolina and Texas, specifically in those areas, because they’re trying to counteract a lot of the fights going on in all the other states. Page – 7 – of 10 Teddy Nappen 24:56 We all know the Democrats, their polling is lower than Trump’s and the entire Republican Party. They’re at the lowest point. You can cut to Harry Enten on CNN, who is just the golden retriever of CNN, freaking out at the numbers every time. But what I love, what actually caught my eye was what was highlighted. They were talking about the Everytown Victory Fund. Back in 2021 they launched a program known as Demand a Seat, an educational program that trains, quote, unquote, grassroots volunteers and gun violence survivors to take next steps in their advocacy efforts by running them for offices and working on campaigns. They highlight 1200 volunteers across 47 states. Operating and trying to claim and move into these positions. Teddy Nappen 25:55 So, stop right there. Here are the sycophants, individuals that are politically driven in removing and taking away our rights and trying to run in small localities. This is the game they play. This is how they chip away at our rights, and this is where they’re targeting elections. And you know their endowment of money, funding by Bloomberg of his actions. Where does this pan out? To see the results, cut to Virginia. If anyone’s been paying attention on that end, the insanity of gun laws that were rolled out by, was it Shinebomb? Of all the insanity that they were trying to pump out through the legislation, that giant omnibus. Remember, they ran a moderate campaign and then what? Evan Nappen 26:47 Well, this is what they do. They make believe they’re moderates, when in fact, they’re extremists. They’re a wolf in sheep’s clothing when it comes to our rights. Teddy Nappen 26:57 Correct. And right here, they’re even bragging about it right on there. DemandASeat.org. On their whole website, 13 Moms Demand Action volunteers elected into the Virginia House. Evan Nappen 27:10 Get a load of that. They got 13 fanatical anti-gunners into the legislature. And why aren’t we running a counter program to get pro Second Amendment rights’ candidates from the grassroots to run? Where’s our candidates? Teddy Nappen 27:34 Here they’re out spending NRA’s 31,000 in the Virginia elections. So, it’s very much we need people. If anyone is out there who has time and ability to run locally, it could be anything on that in the positions. Evan Nappen 27:51 Yeah, anything. Teddy Nappen 27:52 You can be anything. Evan Nappen 27:53 Yes, I agree. Get active. Page – 8 – of 10 Teddy Nappen 27:57 Yeah, what ever it can be in the positions, because I’ll highlight, right now. Evan Nappen 28:02 Well, it’s the old, it’s the old thing. All politics are local, right? So this is critical. Teddy Nappen 28:09 I’ll highlight to you right here from the New Jersey Globe. This is back in 2023. National gun control group, Everytown for Gun Safety endorses five New Jersey municipal races and candidates from their grassroots organizations. (https://newjerseyglobe.com/gun-control/everytown-endorses-five-candidates-for-local-office-in-n-j/) Here we go again. So, they’ve been running this program since 2021. You can go on the website. They’re bragging about it right here. It’s the DemandASeat.org. And they train them up on the lingo that they’re pushing, the language that they need to put in bills. Whatever program they can and will activate in locals, they will do so. Any ordinance they can get away with, they will do so. That’s how you get the air gage knife out of California. They don’t care. It’s whatever. Evan Nappen 28:54 One thing. You’ve got to give the antis credit. Because they’re always conniving some other strategy to try to screw us out of our rights. They are good at it. I give them credit for that. Where’s our counterforce to this? Where is it? Teddy Nappen 29:09 Well, it comes down to this. To all gun owners, who it was. Well, I forget the percentage number that vote. And look, you have to understand this is how they get us. Because I see the U.K. I see California. That is their goal. We talked about in the last episode. If they ever get in power, if they ever find the means to do so, they will take away our rights. They will take away our ability to possess firearms. They will take away our rights to defend themselves. They have already done so in all these other places, and they continue to push for it. They will continue to push otherwise. So, you see, right now, people need to be active locally. This is where they get started every time. Evan Nappen 29:53 It’s critical, and it’s very important. Hey, Teddy, I want to tell you about this week’s GOFU, and it’s a really important one. It is a GOFU that became an epiphany to me. And I want to tell you about this. Because, you know, our GOFU is, of course, the Gun Owner Fuck Up, and it’s important to talk about these things. These are mistakes from actual cases that people make, and it can be very costly to them. Cost them their freedom, their fortune, their family, their careers, everything, and you, the listener, get to learn it for free. Well, I’ve got to tell you, folks. I just recently came across a case that has really shocked me about how this is a GOFU, and I want to tell you why. Because it has to do with the “Duty to Retreat”. Now in terms of self-defense, when it comes to the legal framework of self-defense, which falls under the heading of “justification for use of force”, justification. It’s an affirmative defense. And we talk about justification for the use of force. We can talk about non-deadly force. We can talk about deadly force. Then the law lays out when you can and can’t use force. Page – 9 – of 10 Evan Nappen 31:13 I’m not going to spend a whole, you know, three hours here explain to you the law of deadly force and force. But as all of you should be aware, New Jersey, like many other states, has provisions that even though they can allow and permit the justification for the use of deadly force and/or force, there is built into the law a check that has to be in place called “Duty to Retreat”. So, the Duty to Retreat is put into our self-defense law so that you might be justified in using, let’s say, deadly force. You might be justified in doing it, but the law says that if you can retreat with complete safety, then you’re required to do that. That’s called the Duty to Retreat. Evan Nappen 32:10 Now, what I’ve always thought about this, I’ve always realized that, look, what type of self-defense scenario would you be in where you know you’re in a life and death situation, or something where you feel you need to use force, deadly force, and, or, you know, even non-deadly force, but you’re in this position where you need to use force and you somehow can retreat “with complete safety”. Like, how do you have complete safety? And I always thought, you know, short of “Beam me up, Scotty”, how are you going to have complete safety in any scenario like that? I’ve never encountered a hypothetical until now, where it’s no longer a hypothetical of where Duty to Retreat might actually be applicable. Evan Nappen 33:06 And here’s the scenario, folks. Here’s where it’s a GOFU that you better be aware of when it comes to Duty to Retreat. You’re in a situation. This is based on actual case that I know of. You’re in a situation where you are encountering a threat, a threat to your life, a threat even to possibly others. And you’re, let’s say, outside of your home, encountering such a threat. And then in that encounter of the threat, you retreat into your home. Shut the door. The threat is outside. You’re inside. You arm yourself inside, perfectly lawful at that stage. What should you do? You should call the police. That’s what you do. You call the police. You’re in your home. You’ve gotten away from the threat. Evan Nappen 34:12 Where’s the GOFU? Well, in this case, leaving your home to re-engage the threat. No, no, no. You just retreated with complete safety. You now could even call the police. You now have armed yourself to protect yourself in your home. You go back out there to re-engage a threat. That’s a problem, folks. Potentially a big problem. Potentially an argument that could raise your failure to abide by Duty to Retreat. It’s a possibility, and it’s a strong possibility. So, what’s the GOFU? Once you’ve gotten away from the threat, stay away from the threat! That’s the takeaway. You got away from the threat. Stay away from the threat. Call the police. Do not take it into your own hands. Do not re-engage. You’ve escaped the threat. Leave it at that. That’s the important thing. To do otherwise may, in fact, be a giant GOFU. Evan Nappen 35:32 This is Evan Nappen and Teddy Nappen reminding you that gun laws don’t protect honest citizens from criminals. They protect criminals from honest citizens. Page – 10 – of 10 Speaker 3 35:43 Gun Lawyer is a CounterThink Media production. The music used in this broadcast was managed by Cosmo Music, New York. New York. Reach us by emailing Evan@gun.lawyer. The information and opinions in this broadcast do not constitute legal advice. Consult a licensed attorney in your state. Downloadable PDF TranscriptGun Lawyer S5 E285_Transcript About The HostEvan Nappen, Esq.Known as “America's Gun Lawyer,” Evan Nappen is above all a tireless defender of justice. Author of eight bestselling books and countless articles on firearms, knives, and weapons history and the law, a certified Firearms Instructor, and avid weapons collector and historian with a vast collection that spans almost five decades — it's no wonder he's become the trusted, go-to expert for local, industry and national media outlets. Regularly called on by radio, television and online news media for his commentary and expertise on breaking news Evan has appeared countless shows including Fox News – Judge Jeanine, CNN – Lou Dobbs, Court TV, Real Talk on WOR, It's Your Call with Lyn Doyle, Tom Gresham's Gun Talk, and Cam & Company/NRA News. As a creative arts consultant, he also lends his weapons law and historical expertise to an elite, discerning cadre of movie and television producers and directors, and novelists. He also provides expert testimony and consultations for defense attorneys across America. Email Evan Your Comments and Questions talkback@gun.lawyer Join Evan's InnerCircleHere's your chance to join an elite group of the Savviest gun and knife owners in America. Membership is totally FREE and Strictly CONFIDENTIAL. Just enter your email to start receiving insider news, tips, and other valuable membership benefits. Email (required) *First Name *Select list(s) to subscribe toInnerCircle Membership Yes, I would like to receive emails from Gun Lawyer Podcast. (You can unsubscribe anytime)Constant Contact Use. Please leave this field blank.var ajaxurl = "https://gun.lawyer/wp-admin/admin-ajax.php";
Send a textOriginally from the USA and now based in Canberra, Shelby is a rebirthing breath worker, yoga teacher, and mother of three. In this open and reflective conversation, she shares her birth imprint, her experience of neurodivergence, and how pain and trauma shaped her early births.Her first birth at the birth centre included a shoulder dystocia, 3B tear, major postpartum haemorrhage, retained placenta requiring surgery, transfusions, and a later prolapse. Her second began with prodromal labour and ended in an emergency caesarean.During her third pregnancy, Shelby realised she didn't fully trust birth — and she was no longer able to return to the birth centre due to her previous experiences. As labour began, she chose to stay home and see how things unfolded, setting up her birth pool and ultimately birthing her baby there before transferring to hospital with concerns of postpartum haemorrhage.Links:(Instagram) Shelby Trevillian | RBM Breathwork • RPYT 500 • Somatic CoachSupport the show@homebirthstoriesaustralia Support the show by buying us a coffee! Please be advised that this podcast may contain explicit language. Listener discretion is advised.The information, statistics, and research presented in this podcast are for informational purposes only and are not intended to constitute or replace medical or midwifery advice. All information discussed can be found online and is provided in the links in the show notes. It is always recommended to conduct your own research and make informed decisions. We advise you to discuss any topics or concerns with your healthcare provider. While we strive to incorporate the most up-to-date research in our episodes, we do not warrant or guarantee the accuracy of the information discussed on the show.
Hello everyone, and welcome back to Warehouse and Operations as a Career. I'm Marty and I thought we'd get to some more questions today, another Ask Me Anything episode. We had some really good ones come in, a couple of topics I've been wanting to get to myself. Let's start off with this one from Carol, a forklift operator in the distribution industry. Carol feels there's a trend developing where managers are expecting employees to do more than they were hired to. I hear this concern fairly often. When I was a counterbalance or sit-down lift operator, in a production facility, that's what I did the whole shift. Even when I was an operator at a distribution center I typically drove for, like maybe, 80% of my day. I'd have to stop and down stack a load every once and a while or maybe partially fill a pick location or make the occasional replenishment. But I drove the lift most of the time. That was a long time ago though. I think our light-industrial workplaces, warehouses, manufacturing plants, and distribution centers are different now and for a lot of reasons. Yes, people are being asked to wear more hats. There's more cross-training. More flexibility being demanded from us. More expectations to help outside of what used to be a very narrow job description. And for some folks, that creates frustration. You hear phrases like, that's not my job, that's not what I was hired to do, and that's not in my job description. But the truth is, those days are disappearing. And I want to spend a few minutes today talking about the why, and more importantly, why that's not a bad thing when we look at it the right way. Let's just be honest with ourselves. Light-industrial operations today are different than they were just 5 years ago. Volumes change daily now. Staffing levels fluctuate. Customer and client expectations are higher than ever. Same day and next day shipping isn't a luxury anymore, it's the standard. Operations can't stop just because one person is out or one department is short. We've learned that everything is connected. Inbound affects outbound. Picking affects loading. Forklift operations affect inventory accuracy. One weak link slows the entire chain down. For those reasons and a few others is where cross training comes in. Cross training isn't about making people work harder, it's about making operations more stable and consistent. It creates flexibility. It gives leaders options. And it keeps work moving when things don't go exactly as planned, which, and since we're being honest, happens a lot in our industry. Now let's talk about that phrase, That's not my job. I understand where it comes from. For a long time, jobs were very narrowly defined. You did one task, one function, and that was it. But that model doesn't work well anymore, not in our industry anyway. When everyone stays locked into a single box, operations become, what's a good word here, challenging I'll say. One call off, one delay, one surge in volume, or orders, or trucks, and suddenly the whole shift is behind. Employers today are looking for team players. People who understand their main role, certainly, but who are also willing to help the operation succeed when needed. Now, that doesn't mean job descriptions don't matter. They do. But they've shifted from rigid rulebooks into broader descriptions. And that shift is an opportunity. Here's something you know I strongly believe, learning more can never be a bad thing. When you learn another role, you gain perspective. When you gain perspective, you make better decisions. And when you make better decisions, you become more valuable. Remember how many times you've heard me say how important it is to learn the position before and after ours, where that case just came from and where it's going after we've touched it! A picker who understands receiving makes fewer mistakes. A forklift operator who understands outbound stages freight better. An associate who's helped with inventory control starts paying closer attention to accuracy. Cross training builds awareness, and awareness improves safety, quality, and productivity. That benefits the company, yes, but it also benefits us employees as well. From a career standpoint, wearing more than one hat, to use a recruiters phrase, is a plus. The more skills you have, the more valuable you become, not just to your present employer, but to the industry as a whole. When someone can share with a hiring agent or recruiter, I've worked inbound, outbound, this or that type of equipment, and inventory, that gets noticed. Those are the people who get tapped for lead roles. Those are the people who stay employable when things tighten up or change. Many supervisors, managers, and operations leaders didn't get there because they stayed in one lane forever. They got there because they were willing to learn one more process, help one more department, and take on one more responsibility. That's how careers are built in this industry. Now, let's be clear here though. This doesn't mean accepting unsafe work practices, and it doesn't mean skipping training. It doesn't mean being taken advantage of in any way. Employers have a responsibility here too. Cross training should be structured. It should be safe. Expectations should be clear. No one should be thrown into a role without proper instruction or support. When done right, cross training builds confidence instead of resentment. With that being said I'll take this opportunity to remind us all to never get on a piece of powered industrial equipment without being trained and certified to operate it. And that goes for production or manufacturing machines also. For us employees, I think mindset matters. If you see cross-training as punishment, it will feel like punishment. And if you see it as opportunity, it becomes one. Asking questions. Being curious. Showing interest in how the operation works as a whole, those things send a powerful message. They say I care about my job. I care about my team. I care about my future. I promise you that attitude gets noticed every single time. Our light-industrial world rewards adaptability. The people who keep learning stay relevant longer. The ones who refuse to grow often struggle when processes change or roles disappear. Wearing more than one hat prepares you for what's next, whether that's a lead position, a specialized role, or simply long-term job security. It builds confidence. It builds competence. And it builds careers. Next up is a question from, well, they didn't include their name, but the question was, how could I get or ask for a raise. Well, that's a fair question. And a little complicated question, especially in our light industrial, warehouse, and distribution environments. Ok, lets look at how pay works, what managers are actually looking for, and how you can put yourself in the best position when opportunities come up. First, we need to understand the business side. In most light industrial operations, wages are set by position. General labor could pay a certain range, Forklift operators will have a range, Inventory control, leads, supervisors, etc, all of our roles are budgeted for well in advance. Companies don't usually have the flexibility to give raises on the spot. Pay increases are planned during budget cycles, performance reviews, promotions, or when new responsibilities are added. Now that doesn't mean raises don't happen. It means they are earned, planned for, and justified. So instead of thinking, How do I ask for more money? I'd ask, how do I make myself worth more to the operation? How can I make my manager notice me? It’s important to know that managers notice patterns, not promises. The associates who get raises and promotions aren't usually the loudest. They're the most consistent. Here's what always got my attention. First was attendance. And we talk about this all the time. Showing up on time, every shift, matters more than almost anything else. In a productivity driven environment, reliability is everything. When a manager knows they can count on you, you're already ahead. Second is attitude. Of course this doesn't mean every day has to be perfect. But staying professional, avoiding constant negativity, and being that solution focused team member makes a difference. Positive employees strengthen teams, and managers notice that. Third, and here's that statement again, a willingness to learn and cross train. Again, Cross training is huge. Like we mentioned earlier, when you raise your hand to learn another role, another department, or another piece of equipment, you increase your value. You also make scheduling easier for your management team and that matters. And, Fourth would be ownership. Take responsibility for your work. Follow safety rules. Follow procedures. If you make a mistake, own it and fix it. That level of maturity builds trust and will get us noticed as well. Now lets talk about how to have that conversation. Walking into an office and saying, I need a raise, usually doesn't get us very far. A better approach would sound something like this. I understand pay is based on positions and budgets. I enjoy working here and I want to grow. What do you need to see from me to be considered for a raise or promotion when the opportunity comes up? That shows professional maturity, it shows respect for the business. And something like that opens a productive conversation. Now you've turned a raise request into a development and growth plan. In our industry, raises often come through movement. General labor to equipment operator. Pallet runner to selector, receiver to inventory control, fork driver to lead. Lead to supervisor. Etc. Those steps may come with structured pay increases. But you don't get there by waiting, you get there by preparing and planning. I've experience that Managers promote people who are already doing parts of the next job. Oh, and I want to mention that some positions, especially in distribution may have something like productivity pay or activity based pay, like a high productivity order selection environment, maybe even a tiered pay structure based on CPH or PPH. Where we're paid based on what we do individually. I want us to remember though that a raise isn't just about today's paycheck. It's about your future. The associates who consistently show up, stay engaged, and keep learning are the ones managers think of when new roles open up. Those opportunities usually start with something like hey, we've got something coming up, and we thought of you. That doesn't happen by accident. So if you're asking how to get a raise, here's the honest answer, I know it's not a simple answer but we need to be reliable, be positive, be willing to learn, be ready for more before you ask for more. That's how raises and careers are built in the light industrial world. Well, I got to talking too much and ran out of time! I hope you got the answers you wanted. I know all that seems simple, and did you notice how and that we, ourselves, in this industry anyway, can control more of our direction and path than what we may have thought we could. If you enjoyed todays episode please share it with a friend or coworker. I appreciate you stopping in each week, and please feel free to check in on our Facebook using @whseops and our Instagram waocpodcast. And as always keep those questions coming in. Have a great, productive, positive, and safe week out there.
The JournalFeed podcast for the week of 24-28, 2025.These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.Tuesday's Spoon Feed:Younger age and longer tenure at a site increased patients-per-hour (PPH) without increasing 72-hour returns.Wednesday's Spoon Feed:Of 138 infants evaluated with excessive crying, none had facial petechiae. Unexplained petechiae warrant further evaluation for trauma or abuse.
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Send us a textIn this episode, Katie shares the stories of her two births. After a long journey to conceive, her first pregnancy was marked by hyperemesis gravidarum. With the support of a Midwifery Group Practice, she went into spontaneous labour and gave birth in hospital. Katie reflects on the overwhelming moments immediately after birth, the early challenges of breastfeeding, and how she gradually established feeding over the following months.Just six months later, Katie conceived again and experienced hyperemesis gravidarum for a second time. Planning a homebirth, she describes how the birth unfolded, her transfer to hospital due to a postpartum haemorrhage (PPH) and large blood clots, and her recovery afterward. She also shares her baby's laryngomalacia diagnosis and how it shaped her second breastfeeding journey.Where to find Katie:Shes True Blue InstagramYeah the girls off road InstagramSupport the show@homebirthstoriesaustralia Support the show by buying us a coffee! Please be advised that this podcast may contain explicit language. Listener discretion is advised.The information, statistics, and research presented in this podcast are for informational purposes only and are not intended to constitute or replace medical or midwifery advice. All information discussed can be found online and is provided in the links in the show notes. It is always recommended to conduct your own research and make informed decisions. We advise you to discuss any topics or concerns with your healthcare provider. While we strive to incorporate the most up-to-date research in our episodes, we do not warrant or guarantee the accuracy of the information discussed on the show.
Back on August 9, 2024, we released an episode (link in the show notes) reviewing the renewed interest in transfusing whole blood for PPH rather than component therapy. Now, in O&G open, authors from my Alma Mater (UT Southwestern) have published new data bolstering the use of whole blood for PPH. Listen in for details.1. Clinical Pearls Episode 2024: https://open.spotify.com/episode/0ZhqoIE9wMcAboDlevq9OW?si=rM32uK8ER8uuWmq4mf5dzA2. Ambia, Anne M. MD; Burns, R. Nicholas MD; White, Alesha MD; Warncke, Kristen MD; Gorman, April MS; Duryea, Elaine MD; Nelson, David B. MD. Whole Blood in the Management of Postpartum Hemorrhage. O&G Open 2(5):e130, October 2025. | DOI: 10.1097/og9.00000000000001303. ACPG PB 183STRONG COFFEE PROMO: 20% Off Strong Coffee Company https://strongcoffeecompany.com/discount/CHAPANOSPINOBG
Mashirika ya afya duniani yametoa miongozo mipya yenye lengo la kuokoa maisha ya maelfu ya wanawake wanaopoteza maisha kutokana na kutokwa damu nyingi baada ya kujifungua hali inayojulikana kama postpartum haemorrhage au PPH. Tupate taarifa zaidi kutoka kwa Leah Mushi.
Hii leo jaridani tunaangazia siku ya makazi duniani, kazi za walimu katika kufanikisha malengo ya maendeleo endelevu na afya ya uzazi hasa wakati wa kujifungua na kuepusha vifo kupiti uvujaji damu.Leo ni Siku ya Makazi Duniani, na Umoja wa Mataifa unatoa wito wa kuchukua hatua za haraka kujenga miji jumuishi, imara na salama hasa kwa mamilioni ya watu waliolazimika kukimbia makazi yao. Katibu Mkuu wa Umoja wa Mataifa António Guterres na Kamishna Mkuu wa Shirika la Umoja wa Mataifa la Kuhudumia wakimbizi UNHCR Filippo Grandi wanasema miji sasa ndiyo inabeba mzigo mkubwa wa migogoro duniani lakini pia ndiyo kitovu cha suluhisho.Uongozi wa kugawana majukumu na mashauriano ya kina na walimu ni mambo muhimu katika kuboresha ustawi wa waelimishaji na matokeo ya kujifunza ya wanafunzi, amesema Carlos Vargas, Mkuu wa Kitengo na Mkuu wa Sekretarieti ya Kikosi Kazi cha Kimataifa cha Walimu kwa Elimu 2030 katika UNESCO.Mashirika ya afya duniani yametoa miongozo mipya yenye lengo la kuokoa maisha ya maelfu ya wanawake wanaopoteza maisha kutokana na kutokwa damu nyingi baada ya kujifungua hali inayojulikana kama postpartum haemorrhage au PPH.Mwenyeji wako ni Assumpta Massoi, karibu!
In the latest SBC Podcast episode, I sit down again with Dylan, co-founder of Pinnacle Odds Dropper, to take a deep dive into sharp betting, market efficiency, and the results of our detailed August 2025 review of POD.We explore how the software helps advantage bettors track steam moves, why Pinnacle remains the barometer for bookmakers, and the lessons from analysing 345,000+ logged bets. Dylan and I also share insights on CLV, market limits, niche sports, and the growing challenges facing US bettors under new tax rules.HOW POD WORKS & WHY IT MATTERSThe evolution of Pinnacle Odds Dropper as a top-down “chasing steam” alert serviceHow the in-built bet tracker has logged over 450,000 bets since launchWhy tracking results and filters is critical for advantage bettorsIndependent SBC review: 345,000-bet dataset reveals where edges really lie and on what sportsWHICH SPORTS DELIVER THE BIGGEST EDGESBasketball's “killer combo” of ROI and strike rateSoccer's vast sample size, overs vs unders trends, and higher ROI on away sidesTennis as a two-outcome sport and why sharp bettors gravitate toward itHigh ROI surprises in baseball and volleyball vs the pain of betting NFLCLOSING LINE VALUE & MARKET LIMITSWhy CLV is the best early indicator of profitabilityAnalysis: positive CLV bets returned +7.7% ROI vs –8.38% on negative CLV betsHow Pinnacle market limits act as a proxy for confidence and edge significanceShould you apply filters or follow Franco's “bet everything” approach?SHARP BOOKS & MARKET EFFICIENCYIs Pinnacle still the sharpest? Latest data says yes, within 0.24% of perfect efficiencyWhere rivals like FanDuel and Circa are catching up in niche sportsWhy bettors should map out which books are sharp for which marketsThe occasional reality of market manipulation and how to handle itPRACTICAL BETTING STRATEGIESUsing POD with soft books, exchanges, and even in-person kiosksCase study: a hedge fund manager using POD to manage exchange exposureHow successful users treat betting as volume-driven and sport-agnosticWhy bankroll growth depends on embracing variance, not avoiding itFUTURE TECH & REGULATIONThe role AI might play in pricing, advantage betting, and POD's futureWhy sharp players need to keep experimenting with new tools and marketsUS betting tax changes under Trump's “Big Beautiful Bill” and the risk of pushing players offshoreHow bettors adapt to regulatory friction, from crypto books to PPH'sDylan also shares why Pinnacle still leads the way for sharp betting, how bettors can avoid leaving money on the table, and why adaptability is the hallmark of long-term winners.You can also support the SBC Podcast by visiting our podcast sponsor, Matchbook. Get 150 days commission free via this link: https://welcome.matchbook.com/SBC150For more on Dylan & POD Website: https://pinnacleoddsdropper.comTwitter/X: https://x.com/pinnacleoddsdrop
In this episode of The Canadian Investor Podcast, Simon and Dan share the stocks and ETFs currently on their radar and dive into the surprising parallels between poker and investing with lessons from poker that apply to long-term investing. Ticker of stocks and ETFs discussed: WCN.TO, ZHU.TO, IXJ, VHT, PPH, IHI, IHF Check out our portfolio by going to Jointci.com Our Website Our New Youtube Channel! Canadian Investor Podcast Network Twitter: @cdn_investing Simon’s twitter: @Fiat_Iceberg Braden’s twitter: @BradoCapital Dan’s Twitter: @stocktrades_ca Want to learn more about Real Estate Investing? Check out the Canadian Real Estate Investor Podcast! Blossom Investor Conference Apple Podcast - The Canadian Real Estate Investor Spotify - The Canadian Real Estate Investor Web player - The Canadian Real Estate Investor Asset Allocation ETFs | BMO Global Asset Management Sign up for Fiscal.ai for free to get easy access to global stock coverage and powerful AI investing tools. Register for EQ Bank, the seamless digital banking experience with better rates and no nonsense.See omnystudio.com/listener for privacy information.
Emily enjoyed a blissful wild pregnancy, completely outside the medical paradigm, and planned to freebirth her first baby. After several days of a marathon birth experience, her baby was finally born—perfectly healthy. Emily, however, immediately recognized that she needed medical support. She transferred herself to a local hospital, where she was treated for a retained placenta and postpartum hemorrhage. Despite having received no medical care during her pregnancy and freebirthing her baby, the hospital staff were kind, respectful, and honored all her wishes. Emily feels she received the care she needed and left the experience without trauma. We wrap up our conversation with Emily's thoughts on freebirth ideology, why black-and-white thinking has no place in birth, and the importance of seeking information from across the spectrum. If you love the show, I would greatly appreciate a review on Spotify or Apple Podcasts! Follow me on Instagram @healingbirth Do you have a birth story you'd like to share on the podcast, or would like to otherwise connect? I love to hear from you! Send me a note at contactus@healingbirth.net Check out the website for lots of other birth related offerings, and personalized support: www.healingbirth.net Intro / Outro music: Dreams by Markvard Podcast cover photo by Karina Jensen @karinajensenphoto
PPH is terrible. PPH must be assessed quickly via the “4Ts” and acted upon in a timely manner. And listen to this: new data from the Journal of Maternal-Fetal & Neonatal Medicine (June 24, 2025 ahead of print) finds an association with PPH and adverse outcomes years later: the odds of cardiovascular disease (CVD) and thromboembolism disease are increased in patients with postpartum hemorrhage (PPH), to a magnitude of 1.76 fold. That's why these authors recommended "proactive postpartum care". That's what we're gonna talk about in this episode. Control of PPH includes bladder drainage, uterine massage, medications as appropriate, and mechanical methods of bleeding control. So… Vacuum uterine contraction works, and a balloon works. Even a simply 24 Fr foley has efficacy data in this setting as a uterine tamponade tool. But, in an attempt to have a LOW-COST, HIGHLY EFFECTIVE, and easy to use alternative to the Jada and Bakri- could we just use an intrauterine foley catheter and connect that to vacuum suction? JADA is effective but it limited based on uterine (EGA) size, or in cases of uterine anomaly. But most importantly…JADA and Bakri are expensive! Well, we now have data that this approach, using a low-cost, easy to use alternative, may be a consideration. It is FOCUS. This idea comes from one of our podcast family members, Dr. Frank Jackson- an MFM fellow- who has published his experience with this and already has a new publication on this technique (FOCUS), which was released as we were recording this very episode! Listen in for details.
After the safe arrival of her second baby, Poppy, Lil Bryant was anxious to return home from hospital to the peace and sanctuary of Mount Doreen Station - some 400km northwest of Alice Springs. Eagerly awaiting her return was her toddler son Dawson and hubbie Sam, along with Lil's beloved outback 'station family' of employees. But just nine days after Poppy's birth, Lil awoke in the middle of the night and immediately knew that 'something wasn't right'. Still half asleep, she turned on the bathroom nights and was greeted with a confronting sight. Lil was experiencing a significant Postpartum hemorrhage (PPH) - and everyone at the station that night would have to work together to keep the terrified young Mum alive. ***Thanks so much for listening to this episode of the Flying Doctor Podcast. It is lovely to have you along on the journey with us. There has been some wonderful feedback from listeners about our podcast and the incredible people we have interviewed. Word of mouth is always the best promotion for a podcast – so if you enjoy this podcast, or a specific story, please share with family and friends. Reviews and ratings help our podcast to be found by others, so if you can take the time to do that it would be appreciated. You can also send feedback, questions or comments through to podcast@rfds.org.au. We'd also love you to become part of the Flying Doctor Podcast Facebook group, where passionate listeners and incredible outback communities come together. Hosted on Acast. See acast.com/privacy for more information.
LA Riots; 250th Army Anniversary Parade; Ration or Ruin Cost Comparison & More w/ Ben, FD, Dave & James on the 308th episode of PPH !
Send us a textToday we interviewed Cally, who shared her experiences across two very different births. Her first pregnancy took place during COVID, where limited access to care led her to an OB by default. Red flags emerged throughout the pregnancy, but she continued with the same provider. After a long posterior labour that ended in an epidural and Syntocinon, she began to reflect more deeply on her birth choices.We also spoke about her breastfeeding journey—navigating early challenges, pumping and bottle-feeding for nearly two years—and her experience with a medically managed miscarriage, which she approached with intention and care.In her third pregnancy, Cally initially returned to her OB but switched to a private midwife at 26 weeks after feeling unsupported in her birth preferences. She went on to plan a homebirth that honoured her values and autonomy. When a postpartum hemorrhage occurred, it was swiftly and effectively managed by her midwifery team at home—including resuscitation—demonstrating the high level of skill and preparedness within well-supported homebirth care.Links:Mama Midwives Core & Floor Restore Free Antenatal ClassesThe Pink Elephant Support Network Red Nose Info on APGAR Score Ten years of publicly funded homebirth services in Victoria Mothers & Babies Report - APGAR dataNational Core Maternity Indicators - APGARWhat is Medical management of miscarriage Support the show@homebirthstoriesaustralia Support the show by buying us a coffee! Please be advised that this podcast may contain explicit language. Listener discretion is advised.The information, statistics, and research presented in this podcast are for informational purposes only and are not intended to constitute or replace medical or midwifery advice. All information discussed can be found online and is provided in the links in the show notes. It is always recommended to conduct your own research and make informed decisions. We advise you to discuss any topics or concerns with your healthcare provider. While we strive to incorporate the most up-to-date research in our episodes, we do not warrant or guarantee the accuracy of the information discussed on the show.
Send us a textEpisode 63 is shared by the amazing Alice. Alice is the creator of Halo Mumma, which is a free website resource to support those on their pregnancy after loss journey. Alice herself today shares the loss of her twins Ayla and Millie, and the trauma which this created, not just from the pregnancy, but the induction of labour, post partum, and including a delayed PPH. During the pregnancy of her rainbow baby, Vinny, she ended up switching to homebirth in order to foster a more positive experience. We talk about multiple different quite difficult topics in this ep that may be triggering for some - so please take care of yourself when listening. Ultimately, Alice's story demonstrates that you can homebirth after loss and that no one should be forced to birth in a place where they have experienced so much trauma. Resources: Halo Mumma Twins - Great Birth Rebellion Episode with Dr Stu The Fifth Vital Sign (book) Calm Birth (Education) PANDA Pregnancy After Loss Chemical Pregnancy Support the showConnect with me, Elsie, the host :) www.birthingathome.com.au @birthingathome_apodcast@homebirth.doula_birthingathome birthingathome.apodcast@gmail.com
Send us a textToday, we interviewed first-time mum Rachel about the birth of her baby. Initially planning for private OB and hospital care, Rachel explored public hospitals and homebirth midwives before choosing a homebirth after watching Birth Time. She experienced PROM and prodromal labour, and during active labour, transferred to the hospital due to her baby's elevated heart rate. Rachel reflects on the challenges that followed, particularly hospital policy placing her baby in special care. She also opens up about her breastfeeding journey, which ended around 4 months postpartum with the return of her period, and discovering her baby had CMPI.Links:Birth Time Film RANZCOG - Homebirths Transfer to hospital in planned home births: a systematic reviewTen years of a publicly funded homebirth service in Victoria: Maternal and neonatal outcomes. Support the show@homebirthstoriesaustralia Support the show by buying us a coffee! Please be advised that this podcast may contain explicit language. Listener discretion is advised.The information, statistics, and research presented in this podcast are for informational purposes only and are not intended to constitute or replace medical or midwifery advice. All information discussed can be found online and is provided in the links in the show notes. It is always recommended to conduct your own research and make informed decisions. We advise you to discuss any topics or concerns with your healthcare provider. While we strive to incorporate the most up-to-date research in our episodes, we do not warrant or guarantee the accuracy of the information discussed on the show.
In this episode, we explore where value might be hiding in today's high-valuation market. From overlooked oil and gas plays to global opportunities in Japanese railways and Chinese big tech, we break down areas of potential interest for savvy investors. We also discuss the pitfalls and potential in pharma, defense, and precious metal miners, as well as the challenges pandemic darlings face in a post-COVID world. Plus, Braden dives into the concept of quality in investing, inspired by Dev Kantesaria of Valley Forge Capital. Discover why the intersection of growth and predictability defines great companies and how this framework can help you identify enduring opportunities in any market environment. Tickers of Stocks/ETFs discussed: HAL, TVK.TO, CNQ.TO, TOU.TO, ENB.TO, TRP.TO, KMI, MPC, JNJ, PFE, MRK, LLY, NVO, KVUE,PPH, IHE, ZHU.TO, LMT, UNP, 9020, KWEB, BABA, FNV.TO, WPM.TO, ABX.TO, NGT.TO, GDX, GDXJ, ZGD.TO, DOO.TO, 7309 Check out our portfolio by going to Jointci.com Our Website Canadian Investor Podcast Network Twitter: @cdn_investing Simon’s twitter: @Fiat_Iceberg Braden’s twitter: @BradoCapital Dan’s Twitter: @stocktrades_ca Want to learn more about Real Estate Investing? Check out the Canadian Real Estate Investor Podcast! Apple Podcast - The Canadian Real Estate Investor Spotify - The Canadian Real Estate Investor Web player - The Canadian Real Estate Investor Asset Allocation ETFs | BMO Global Asset Management Sign up for Finchat.io for free to get easy access to global stock coverage and powerful AI investing tools. Register for EQ Bank, the seamless digital banking experience with better rates and no nonsense.See omnystudio.com/listener for privacy information.
Internal manual aortic compression is a procedure that may be used intraoperatively in the management of massive pelvic bleeding. But what about EXTERNAL aortic compression? In February's 2025 AJOG (Grey Journal), under their Surgeon's Corner section, there will be a very nice video recap of an easy to adopt maneuver which may “buy time” in OB hemorrhage cases as surgical intervention is being planned. This is called the EAC maneuver. First described in 1994, this technique has regained the spotlight as rates of PPH have been on the rise. How is EAC done? Does it work? If so, why is this not part of the OB Hemorrhage bundle? Listen in for details.
Send us a textIn this episode of the podcast, we begin exactly where we left off last week, with Hayley and Katja sharing the details of their healing home birth. Baby Isabelle was born safely after a previous traumatic birth, but Hayley knew instinctively that she needed some support. After a wonderful golden hour, everyone began to notice that Hayley wasn't herself, and was showing signs of deterioration. Find out what happened next, in this wonderful episode. Their story goes a long way to show that traumatic situations do not always cause birth trauma. During this experience, where Hayley felt supported, empowered, and respected, she felt in control of all decisions that were made about her care, making the birth and postpartum incredibly positive overall.You can follow them on Instagram @theschoenbergfamily and Hayley's hypnobirthing company is @thebadassbirthcompanyEpisode 63 - Unwanted Induction of Labour https://podcasts.apple.com/gb/podcast/the-ultimate-guide-to-being-a-birth-partner/id1541228817?i=1000582029431If you love the podcast and would like to support it, then please use the link to 'buy me a coffee' - https://bmc.link/sallyannberesfordIf you would like to buy a copy of either of the books that accompany this podcast please go to your online bookseller or visit Amazon:-Labour of Love - The Ultimate Guide to Being a Birth Partner - click here:-https://bit.ly/LabourofloveThe Art of Giving Birth - Five Key Physiological Principles - https://amzn.to/3EGh9dfPregnancy Journal for 'The Art of Giving Birth' - Black and White version https://amzn.to/3CvJXmOPregnancy Journal for 'The Art of Giving Birth'- Colour version https://amzn.to/3GknbPFYou can find all my classes and courses on my website - www.sallyannberesford.co.uk Follow me on Instagram @theultimatebirthpartner Book a 1-2-1 session with Sallyann - https://linktr.ee/SallyannBeresford Please remember that the information shared with you in this episode is solely based on my own personal experiences as a doula and the private opinions of my guests, based on their own experiences. Any recommendations made may not be suitable for ...
Nathan+Rachel's annual noteworthy Christmas episode is back and more festive than ever! Use promo code 10NOTEWORTHY at PPH to receive 10% off of your order. Merry Christmas from Pentecostal Publishing House! --- Support this podcast: https://podcasters.spotify.com/pod/show/noteworthypodcast/support
This is the time of year when organizations such the Pet Poison Helpline (PPH) receive the most calls. Steve talks with veterinary toxicologist Dr. Renee Scmid, director of veterinary medicine and a senior veterinary toxicologist at PPH. Lilies are fragrant for us but very toxic to cats. And chocolate is never a good idea. She […]
This is the time of year when organizations such the Pet Poison Helpline (PPH) receive the most calls. Steve talks with veterinary toxicologist Dr. Renee Scmid, director of veterinary medicine and a senior veterinary toxicologist at PPH. Lilies are fragrant for us but very toxic to cats. And chocolate is never a good idea. She […]
Surviving motherhood is a genuine concern. Maternal and newborn deaths are the 6th and 7th leading causes of life years lost in the world’s poorest nations. Sepsis, post-partum hemorrhage (PPH), eclampsia-preeclampsia, and failure to progress are the leading causes of maternal morbidity and mortality. Major interventions are to reduce family size and to provide quality obstetric care at delivery, including care for PPH and basic newborn resuscitation. Session recorded on November 7 2024 2:30 PM - 3:30 PM and November 9 2024 9:30 AM - 10:30 AM Session block #1 Speaker name(s): Nicholas Comninellis MD, MPH, DIMPH Session webpage: https://www.medicalmissions.com/events/gmhc-2024/sessions/high-risk-low-resource-maternal-care
In our last episode we tackled random questions with specific answers. After that episode went live, one of our nurses asked about the value of antibiotics with a Bakri balloon in place. This conversation happened as we were placing the balloon for PPH in a patient on Mag-Sulfate for Preeclampsia with Severe Features. That's antibiotic question is another random question that needs to be answered! So in this episode we will examine the data on prophylactic antibiotics with Bakri balloon for metritis prevention. Is there data for that? The ACOG has a statement on that very issue from back in 2018. Additional information has come to print since then, and we will review it. PLUS, as our patient was on Mag-Sulfate, we will also throw in this additional question as a FREEBEE: Is Mag-Sulfate an independent risk factor for PPH? The answer may not be what you think. Listen in for details.
Let's get informed on postpartum hemorrhage, so you can make the best decision in the third stage of your birth. Bleeding is a completely normal part of the birth process, but how much is too much?? Hospital providers are terrified of PPH and are treating every single woman preventatively, even when she just had a physiologic birth and there is no reason to assume this stage of birth needs help as well. In this episode I discuss: The current definition of PPH versus the older definition that labels a normal amount of blood loss as concerning. How PPH is assessed and what can cause a hemorrhage in postpartum. If you birth in the hospital, you will have PPH actively managed. Know the difference between active vs expectant management. All of your options and how to avoid PPH ---- Start the 5 Day Empowerment Challenge Get informed on all the stages of hospital birth (and how to support physiology instead) inside Unmedicated Academy
In this episode 478 Katie shares her pregnancy and birth experience as a plus-size woman. She was denied access to midwifery group practice because of her weight and was immediately placed in a high risk model of care. She reflects on the inherent stress of this and admits that there were frequent suggestions of induction from her second trimester onwards. After employing a doula to support her pregnancy and birth journey, she informed herself and considers her experience positive because she understood her options and advocated for her preferences. Despite pelvic girdle pain she had a normal pregnancy until 39 weeks when tests revealed very early signs of preeclampsia. She opted for an induction, used remifentanil for pain relief and birthed her baby girl after six hours of labour. __________ Today's episode of the show is proudly brought to you by Once Upon. You all know how much I love making our photo books and prints on the Once Upon app and guess what, you can create your book today and save 25%. Just use the code books25 at checkout. This offer is valid from May 26th until end of day on June 2nd 2024 Head to Once Upon.See omnystudio.com/listener for privacy information.
In this final podcast of the Ridgeview CME Podcast Series [sigh], Dr. Dennis Mohling, an obstetrician/gynecologist with Western OB/GYN, a Division of Ridgeview Clinics, along with one of his patients, Abie Rosckes discuss a special case around a improbable postpartum event and the decisions that were made. *Disclosure note: None of the speakers or planners for this education activity have relevant financial relationships to disclose with any inelgible company - who's primary business is producing marketing, selling, re-selling, or distributin healthcare products used by or on patients. Enjoy the podcast. Objectives:Upon completion of this podcast, participants should be able to: Explain the presentation of late postpartum hemorrhage (PPH). Distinguish the need for rapid evaluation and treatment of late postpartum hemorrhage (PPH). Summarize the team members and resources needed (and available) to ensure rapid delivery of treatment in a patient experiencing postpartum hemorrhage. This activity has been planned and implemented in accordance with the accreditation criteria, standards and policies of the Minnesota Medical Association (MMA). Ridgeview is accredited by the Minnesota Medical Association (MMA) to provide continuing medical education for physicians. CME credit is only offered to Ridgeview Providers & Allied Health staff for this podcast activity. After listening to the podcast, complete and submit the online evaluation form. Upon successful completion of the evaluation, you will be e-mailed a certificate of completion within approximately 2 weeks. You may contact the accredited provider with questions regarding this program at Education@ridgeviewmedical.org. Click the link below, to complete the activity's evaluation. CME Evaluation (**If you are listening to the podcasts through iTunes on your laptop or desktop, it is not possible to link directly with the CME Evaluation for unclear reasons. We are trying to remedy this. You can, however, link to the survey through the Podcasts app on your Apple and other smart devices, as well as through Spotify, Stitcher and other podcast directory apps and on your computer browser at these websites. We apologize for the inconvenience.) DISCLOSURE ANNOUNCEMENT The information provided through this and all Ridgeview podcasts as well as any and all accompanying files, images, videos and documents is/are for CME/CE and other institutional learning and communication purposes only and is/are not meant to substitute for the independent medical judgment of a physician, healthcare provider or other healthcare personnel relative to diagnostic and treatment options of a specific patient's medical condition; and are property/rights of Ridgeview. Any re-reproduction of any of the materials presented would be infringement of copyright laws. It is Ridgeview's intent that any potential conflict should be identified openly so that the listeners may form their own judgments about the presentation with the full disclosure of the facts. It is not assumed any potential conflicts will have an adverse impact on these presentations. It remains for the audience to determine whether the speaker's outside interest may reflect a possible bias, either the exposition or the conclusions presented. None of Ridgeview's CME planning committee members have relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. All of the relevant financial relationships for the individuals listed above have been mitigated. Thank-you for listening to the podcast. Thanks to Dr. Dennis Mohling and Abbie Roskes for their expert knowlege and contribution to this podcast. Also a special thanks to Jason Hicks and Fred DeMeuse for their contribution to all the Ridgeview CME Podcasts the past 6 seasons, as they made the educational podcasts fun and entertaining.
In today's episode Ashlee details her long fertility journey including her choice to have gastric sleeve surgery. She conceived baby Luca on her first IVF transfer and chose private obstetric care alongside the support of a student midwife. Placenta previa dictated a caesarean birth so Ashlee purchased The Caesarean Birth Class and listened to each episode multiple times so she understood the process and didn't feel overwhelmed about the surgery. Despite a PPH, Ashlee considers her birth a really positive experience because she was informed and supported by a wonderful team of specialists. ---------- THE CAESAREAN BIRTH CLASS, is an informative and empowering online childbirth course that offers you education and guidance for caesarean preparation, birth and recovery. You may already know what day your baby will be born but no doubt you have many questions about the operating theatre, pain relief and your recovery. This online course includes four audio modules with perinatal health specialists and three caesarean-specific breathing and relaxation practices, The Caesarean Birth Class takes you through every aspect of birth and recovery, including: Writing a caesarean birth plan and advocating for your preferences Relaxation and rest in pregnancy What happens before you go to theatre The caesarean birth process, including Maternal Assisted Caesarean (MAC) Skin-to-skin and optimal cord clamping in theatre What to expect in recovery * Pain relief options and side-effects Mobility in the first 24/48/72 hours Wound care and healing Recovery at home Enjoy life time access with the incredible course, learn more here. See omnystudio.com/listener for privacy information.
Tiffany, a former doula and fellow podcaster, shares the story of having her first baby at seventeen in a hospital, and her second birth experience, which ended in a home birth transfer. Because she remained pregnant to 42 weeks, her midwife intervened in several ways to help induce labor, and in this episode you will hear exactly how those seemingly “harmless” and common induction interventions directly compromised her safety in labor. Follow Tiffany @sacredwomb.birth Tiffany has her own birth story podcast, and if you like this show, you will love hers too! Birth and Rebirth Podcast Here is the episode where I appeared on her show. If you love the show, I would greatly appreciate a review on Spotify or Apple Podcasts! Follow me on Instagram @healingbirth Do you have a birth story you'd like to share on the podcast, or would like to otherwise connect? I love to hear from you! Send me a note at contactus@healingbirth.net Check out the website for lots of other birth related offerings, and personalized support: www.healingbirth.net Intro / outro music: Dreams by Markvard Transition music: Bubbles by PALA
While the importance of optimizing a woman's hemoglobin level during the peripartum period has been emphasized in recent guidelines by the Society for Obstetric Anesthesia and Perinatology, the ACOG, and the Enhanced Recovery After Surgery Society, postpartum anemia remains a real issue in both the developed and developing world. Postpartum anemia has been associated with depression, fatigue, impaired lactation, and impaired cognition. This may lead to impaired maternal-child bonding. Additionally, severe anemia during the antepartum interval is an important predictive factor of PPH! This relationship was shown in a published meta-analysis in 2021. Postpartum, IV Fe has been proven to be of value for asymptomatic anemia. Packed RBC transfusion may be recommended for women with postpartum hemoglobin levels
Women whose fetuses are in the occiput posterior head position at the time of delivery are known to have longer second stages of labor and more complicated deliveries, including more operative assisted births, more 3rd and 4th degree lacerations, PPH, and in some studies lower Apgar scores and lower umbilical cord arterial pH. At what point in labor should the healthcare provider attempt to rotate the fetal head: first stage or second stage of labor? Recent intrapartum studies using ultrasound to verify fetal head position has provided new insights regarding the cardinal phases of labor. In this episode, we will tackle the fetal occiput posterior position and manual rotation. Should this be a 1st or 2nd stage of labor practice?
I always recommend moms start their birth education around 20 weeks, it's a lot to learn. This is not a test that you can cram for the night before. But if your pregnancy flew by and you find yourself at 34 weeks pregnant in need of getting empowered, let's do it! In this episode, I discuss: How to know if your mindset around birth is supportive of your unmedicated birth plan. Exactly what to research and learn about for the next 6 week to get truly empowered for your birth. The things you need to start researching, plus resources to help you DIY your birth education and fast. Mentioned on the show: Start your prep routine inside the Birth Prep Class Informed Intervention Checklist in the Freebie Library Too busy to DIY it? Get access to literally everything (+ free NORA) when you join Unmedicated Academy Other episodes you'll love: 89 | 5 reasons to avoid pitocin in your birth, the risks of pitocin 87: Did you really PPH? Get informed on postpartum hemorrhage 86: Why the hospital has routinesSeason 3 of the podcast launches next week! Let me know what juicy topics you want to see on the show. Leave me a voice message.
Contributor: Kiersten Williams MD, Travis Barlock MD, Jeffrey Olson MS2 Summary: In this episode, Dr. Travis Barlock and Jeffrey Olson meet in the studio to discuss a clip from Dr. Williams' talk at the “Laboring Under Pressure, Managing Obstetric Emergencies in a Global Setting” event from May 2023. This event was hosted at the University of Denver and was organized with the help of Joe Parker as a fundraiser for the organization Health Outreach Latin America (HOLA). Dr. Kiersten Williams completed her OBGYN residency at Bay State Medical Center and practices as an Obstetric Hospitalist at Presbyterian/St. Luke's Medical Center in Denver, Colorado. During her talk, Dr. Williams walks the audience through the common causes and treatments for post-partum hemorrhage (PPH). Some important take-away points from this talk are: The most common causes of PPH can be remembered by the 4 T's. Tone (atony), Trauma, Tissue (retained placenta), and Thrombin (coagulopathies). AV malformations of the uterus are probably underdiagnosed. Quantitative blood loss is much more accurate than estimated blood loss (EBL). The ideal fibrinogen for an obstetric patient about to deliver is above 400 mg/dl - under 200 is certain to cause bleeding. Do not deliver oxytocin via IV push dose, it can cause significant hypotension. Tranexamic Acid is available in both IV and PO and can be administered in the field. The dose is 1 gram and can be run over 10 minutes if administered via IV. It is best if used within 3 hours of delivery. When performing a uterine massage, place one hand inside the vagina and one hand on the lower abdomen. Then rub the lower abdomen like mad. A new option for treating PPH is called the JADA System which is slimmer than a Bakri Balloon and uses vacuum suction to help the uterus clamp down.* Another option for a small uterus is to insert a 60 cc Foley catheter. In an operating room, a B-Lynch suture can be put in place, uterine artery ligation can be performed, and as a last resort, a hysterectomy can be done. *EMM is not sponsored by JADA system or the Bakri balloon. References Andrikopoulou M, D'Alton ME. Postpartum hemorrhage: early identification challenges. Semin Perinatol. 2019 Feb;43(1):11-17. doi: 10.1053/j.semperi.2018.11.003. Epub 2018 Nov 14. PMID: 30503400. Committee on Practice Bulletins-Obstetrics. Practice Bulletin No. 183: Postpartum Hemorrhage. Obstet Gynecol. 2017 Oct;130(4):e168-e186. doi: 10.1097/AOG.0000000000002351. PMID: 28937571. Federspiel JJ, Eke AC, Eppes CS. Postpartum hemorrhage protocols and benchmarks: improving care through standardization. Am J Obstet Gynecol MFM. 2023 Feb;5(2S):100740. doi: 10.1016/j.ajogmf.2022.100740. Epub 2022 Sep 2. PMID: 36058518; PMCID: PMC9941009. Health Outreach for Latin America Foundation - HOLA Foundation. (n.d.). http://www.hola-foundation.org/ Kumaraswami S, Butwick A. Latest advances in postpartum hemorrhage management. Best Pract Res Clin Anaesthesiol. 2022 May;36(1):123-134. doi: 10.1016/j.bpa.2022.02.004. Epub 2022 Feb 24. PMID: 35659949. Pacheco LD, Saade GR, Hankins GDV. Medical management of postpartum hemorrhage: An update. Semin Perinatol. 2019 Feb;43(1):22-26. doi: 10.1053/j.semperi.2018.11.005. Epub 2018 Nov 14. PMID: 30503399. Produced by Jeffrey Olson, MS2 | Edited by Jeffrey Olson and Jorge Chalit, OMSII
Rob Pizzola and Johnny from betstamp are joined by @GiantsBadgers to discuss becoming a bettor as a university student, the importance of networking, and how it works as a mover... ALSO... Johnny got a new hat... do you like his hat? Looking to sign up at new sportsbooks? Support Circles Off when you do! www.betstamp.app/circlesoff
In today's episode Tess shares her two very different breastfeeding experiences. She starts by detailing her traumatic birth experience which ended in a postpartum haemorrhage and left her depleted and anxious. Her baby lost 11 percent of her birthweight so triple-feeding was recommended and after a few challenging weeks, Tess made the decision to feed her baby expressed breastmilk (EBM) which she continued for a year as she navigated the grief and guilt of not being able to latch her baby. In her second pregnancy, she was proactive with her care and support from the start. She opted for private obstetric care with Dr Scott Shemer and booked in with Dr Amber Hart from Maternal and Infant Wellbeing in Melbourne who offers day stays for new mothers (the future of postpartum care is looking bright!). Tess' second postpartum has been incredibly healing and really proves the benefit of continuity of care right into postpartum, especially for lactation support.See omnystudio.com/listener for privacy information.
In today's episode, Kelsey shares her three birth stories which detail her evolution as a birthing mother. In her first birth she requested an induction which led to the cascade of intervention; an epidural, instrumental birth, PPH and retained placenta. She found her first postpartum particularly challenging and when she felt ready to conceive again, she experienced three miscarriages, including the loss of identical twins at 11 weeks. In her final two pregnancies, she embraced birth education and midwifery care to prepare for physiological births which left her feeling on top of the world. See omnystudio.com/listener for privacy information.
Our weight loss journey varies across different phases of our lives. We may be losing weight more easily when we're younger and harder when we're adults or vice versa. Accordingly, we subject ourselves to various weight loss methods that are, perhaps, unhealthy. It's time we take our health back into our hands and lose weight, no matter the age, naturally! Corinna Bellizzi is joined by Amy Wilson, PPh, BCGP, ACE, AFAA to talk about weight loss at any age through healthy food and supplements (and without being overly restrictive!). Amy is a Board Certified Geriatric Pharmacist, a certified fitness professional, and a certified nutrition coach. Using the FASTer Way to Fat Loss platform, she is disrupting the diet industry and helping her clients take their health back. She breaks down this program with us to not only shed those inches but also reverse and prevent diseases. Join Amy in this episode and learn actionable tips to lose weight and live your longest and healthiest life! Key takeaways from this episode:· FASTer Way to Fat Loss platform· Why eating less doesn't work· What you need to know about medications· Eat real food and build muscle· How to reverse some signs of aging Guest Social Links:Website: https://amykwilson.com/ LinkedIn: https://www.linkedin.com/in/amy-wilson-rph-bcgp/ Instagram: https://www.instagram.com/thenutritioncoachpharmacist/ Facebook: https://www.facebook.com/amywilsonfitness
Content Warning: postpartum hemorrhage, GBS Positive, antibiotics for GBS, On this episode of the EBB podcast, I talk with Katrina Hull, a graduate of the EBB childbirth class about her positive hospital water birth story. Katrina Hull is a former high school math and engineering teacher with over a decade of experience in the classroom. Her passion for education and entrepreneurship has led her to her current role as coordinating producer at PBS NewsHour Classroom where she develops lesson materials and resources for integrating invention education into classrooms across the country. Katrina shares her experiences taking the EBB childbirth class and discusses in depth the education and work she put into preparing for her desired hospital water birth. In addition to finding her “Golden Ticket” birth team and desired location, she shares the details of her amazing and empowering birth story, despite having a few complications, including finding out she was Group B Strep Positive and handling a postpartum hemorrhage. Resources: Learn more about Marnellie Bishop's Evidence Based Birth® Childbirth Class here Learn more about the GentleBirth Pregnancy app here Read more about Rebecca's experience with Hypnobabies in Babies are Not Pizza's Learn more about the Evidence on Hypnosis for Pain Management here Learn more about the Evidence on water immersion for Pain Management here Learn about the research evidence on combining hypnosis and water immersion for pain: Madden, K., Middleton, P., Cyna, A. M., et al. (2016). Hypnosis for pain management during labour and childbirth. Cochrane Database Syst Rev(5), CD009356. Listen to Evidence Based Birth Podcasts: EBB 131: Evidence on: Pitocin During the 3rd Stage of Labor or read the Signature Article here https://evidencebasedbirth.com/evidence-on-pitocin-during-the-third-stage-of-labor/ EBB 267: Debunking Myths about Fundal Massage with Barbie Christianson, RN Learn more about joining our Pro Membership for birth workers here, to take take our class on emergency management of PPH
On this week's Listener Series episode, Julia shares about the loss of her second baby, Rosalind, as a result of placental abruption. Julia experienced a PPH and her daughter required resuscitation. After transferring to another NICU for cooling treatment, it was determined that Rosalind did not have any brain activity. She was alive for just over 21 hours.Julia shares about the impact of Rosalind's loss, specifically on her mental health, and the challenge of navigating postpartum without her baby. Julia and her husband decided to have another child after Rosalind, and she also shares what it was like to navigate a high-risk pregnancy after loss. If you have a birth trauma story you would like to share with us, click this link and fill out the form!For more birth trauma content and a community full of love and support, head to my Instagram at @birthtrauma_mama.Learn more about the support and services I offer through The Birth Trauma Mama Therapy & Support Services.
**Tom & Dan's Special Gambling Show with Guest Jeff from "The Sharp Square" Podcast** **Today's Highlights**: - Introduction to the **Books available in Florida**: Bovada, My Bookie, Bet Online, X bet, PPH account. - **The Bitcoin Advantage**: The recommendation to utilize Bitcoin for transactions. - **Shopping for Prices**: Emphasize the importance of price shopping. - **Using Bonuses Wisely**: Exploring the strategy of not cashing out but rather using the bonuses to understand the betting system better. - **Understanding the NFL Market**: Discussing the efficiency and shaping of the NFL betting market. - **Do's and Don'ts of Betting**: Avoiding large uncorrelated parlays, the dangers of chasing bets to break even. - **The 2% Rule**: Advising to bet only 2% of your total bankroll. - **Approach to Betting**: Exploring the Top down vs. bottom up methods. - **Key Betting Numbers**: Highlighting essential numbers in betting - 3, 7, 6, 10, 14. - **Introduction to Wong Teasers**. **Podcasts to Boost Your Betting IQ**: - [The Sharp Square on BuzzSprout](https://www.buzzsprout.com/1836527) - Circles Off Podcast: Sharp insights without the picks. - [Even Money NFL Betting Podcast](https://podcasts.apple.com/us/podcast/even-money-nfl-betting-podcast/id898834847) - [RJ Bell's Dream Preview](https://podcasts.apple.com/us/podcast/rj-bells-dream-preview/id340903074) - [3 and Out with John Middlekauff](https://podcasts.apple.com/us/podcast/3-and-out-with-john-middlekauff/id1352730623) for top-tier NFL news. - [Deep Dive Gambling Podcast](https://podcasts.apple.com/us/podcast/deep-dive-gambling-podcast/id1270364139) - [The Simple Handicap - NFL & Sports Betting Podcast](https://podcasts.apple.com/us/podcast/the-simple-handicap-nfl-sports-betting-podcast/id1435717525) **Further Highlights**: - The logic behind sports betting. - The value of the closing line. - Understanding positive EV (Expected Value) and negative EV. - Fun betting formats like Survivor pools and super contests. - Final Advice: If you're just in it for fun, wait until just before the game starts and then make your pick. That's when the line will be most efficient. --- **Stay Connected with Tom & Dan**: - **Website**: [Tom & Dan](https://www.tomanddan.com/) - **App**: Available on [iTunes](https://itunes.apple.com/us/app/tom-dan/id1255375458) and [GooglePlay](https://play.google.com/store/apps/details?id=com.tomanddan.android) - **Socials**: Follow them on [Twitter](https://twitter.com/tomanddanlive), [Facebook](https://www.facebook.com/amediocre.time), and [Instagram](https://www.instagram.com/tomanddanlive) **Listen to More Episodes**: - [Apple Podcasts](https://podcasts.apple.com/us/podcast/a-mediocre-time-with-tom-and-dan/id308614478) - [Stitcher](https://www.stitcher.com/podcast/a-mediocre-time-with-tom-and-dan-podcast/a-mediocre-time-with-tom-and-dan-show) - [TuneIn](https://tunein.com/podcasts/Comedy/A-Mediocre-Time-with-Tom-and-Dan-Podcast-p393884/) **Unlock Exclusive Content**: - Become a BDM member for bonus content and special events at [BDM Registration](https://www.tomanddan.com/registration) **Get Tom & Dan Merch**: - Official merchandise is available [here](https://tomanddan.myshopify.com/) **Join Their Live Streams**: - Engage live on [Twitch](https://www.twitch.tv/tomanddanlive) and [YouTube](https://www.youtube.com/c/tomanddanlive) **Discover Hangout Spots**: - Check out [Tom & Dan Watering Holes](https://tomanddanwateringholes.com/) --- You can adjust the sequence or layout as required, but this combines the show details with the regular links and connectivity information for Tom & Dan.
Postpartum hemorrhage (PPH) is a leading cause of maternal morbidity and mortality around the world. When considering home birth, preventing and/or effectively treating PPH is an essential part of safe care. Allie Woods of Almost Holistic Allie is here today to share her three home birth stories, the first two of which resulted in significant postpartum hemorrhaging, including a hospital transfer. In the first case, she and her midwife presumed it was a fluke when she had an unknown retained placental lobe with a fully intact placenta (a very rare occurrence). Knowing that scenario was highly unlikely to recur, she planned her second home birth, and had a second PPH, this time staying home to manage it. Allie realized she may have a genetic predisposition to hemorrhaging, supported by the fact that her own sister also hemorrhaged during her births as well. When Allie decided to have a third baby, she remained fully committed to giving birth at home despite her past bleeding experiences and spent her pregnancy researching everything she could to prevent PPH. In this episode, Allie provides all the specifics on exactly how she successfully prevented postpartum hemorrhage the third time around. Almost Holistic AllieThe Power of Placenta for Hemorrhage Control**********Down to Birth is sponsored by:Needed -- Optimal nutritional products for before, during and after pregnancyModern Nursery--Your one-stop shop for eco-friendly, stylish baby gearDrinkLMNT -- Purchase LMNT today and receive a free sample kit.Love Majka Products -- Support your milk supply.Silverette Nursing Cups -- Soothe and heal sore nipples with 925 silver nursing cups.Postpartum Soothe -- Herbs and padsicles to heal and comfort.Connect with us on Patreon for our exclusive content.Email Contact@DownToBirthShow.comInstagram @downtobirthshowCall us at 802-GET-DOWNWork with Cynthia: 203-952-7299 HypnoBirthingCT.comWork with Trisha: 734-649-6294Please remember we don't provide medical advice. Speak to your licensed medical provider for all your healthcare matters.Connect with us on Patreon for our exclusive content.Email Contact@DownToBirthShow.comInstagram @downtobirthshowCall us at 802-GET-DOWN Work with Cynthia: 203-952-7299 HypnoBirthingCT.com Work with Trisha: 734-649-6294 Please remember we don't provide medical advice. Speak to your licensed medical provider for all your healthcare matters.
In this episode, Adam shares some live teaching from his local church on how to deal with conflicts and difficult people. Support the show and save $$ on your next PPH order use my code SHAW10 at checkout to save 10% - My affiliate link is HERE
In this episode, Adam chats with professor and mental health expert Dr Cindy Miller about leaders can improve their mental health and best practices for mental wellness. Support the show and save $$ on your next PPH order use my code SHAW10 at checkout to save 10% - My affiliate link is HERE Dr Miller's Self Care Assessment Click HERE Dr Miller's Podcast on Apple Click HERE Dr Miller's Podcast on Spotify Click HERE Dr Miller's Podcast on YouTube Click HERE
In this episode of 90 Degrees, Kevin Davis sits down with Frank B, an accomplished professional sports bettor and respected advisor to Mattress Mack. Together, they embark on an insightful discussion that reveals the secrets behind Frank's success and provides essential tips for aspiring bettors. Frank B's journey in the world of sports betting began with a background as a blackjack player. His expertise in analyzing odds and calculating probabilities proved invaluable as he transitioned to sports wagering. Discover how his early experiences shaped his approach and set the stage for his future accomplishments. Making the leap from advantage player to professional sports bettor is no small feat. Frank B shares his insights into the mindset, challenges, and skills required to make this transition. Learn from his experiences and gain a deeper understanding of what it takes to thrive in the world of professional sports betting. One of the key aspects discussed in this episode is the comparison between the offshore market and the legal sports betting market. Frank B provides expert analysis, highlighting the advantages and disadvantages of each market. Whether you're navigating the offshore landscape or exploring opportunities within the legal market, this discussion will provide valuable insights to inform your betting strategies. Don't miss this exciting episode of 90 Degrees as Kevin Davis and Frank B delve into the right angle in sports betting. Be sure to subscribe to our channel for more captivating episodes and expert insights that will enhance your sports betting knowledge and skills.