Podcasts about Regier

Episode 370: In this episode, we journey into the chilling case of Jesse Imeson—a man whose troubled past and violent crimes left a deep scar on Southwestern Ontario. In the summer of 2007, Imeson's name became synonymous with fear as he embarked on a deadly spree, taking three innocent lives. The victims were Carlos Rivera, 25, of Windsor and Helene Regier, 72, and her husband, Bill Regier, 73, near the community of Grand Bend. The discovery of the murders sparked a 12-day nationwide manhunt and led to the capture of the killer in Portage-du-Forte, Quebec, near the Ontario border. However, behind the headlines lies a story of trauma, addiction, and claims of childhood abuse that may have shaped the path to his horrific acts. Sources: ⁠Man who killed elderly couple and bartender has appeal rejected by Supreme Court | CBC News⁠⁠ Carlos Rivera - Search - Newspapers.com™ ⁠⁠Family of victims lash out as smirking killer gets life sentence⁠⁠ Supreme Court of Canada | 38467⁠⁠ Windsor murderer's claim of sexual abuse hits legal setback⁠⁠ 2021 ONSC 5289 (CanLII) | Imeson v. Maryvale | CanLII⁠⁠ 2018 ONCA 888 (CanLII) | Imeson v. Maryvale (Maryvale Adolescent and Family Services) | CanLII⁠⁠ 2017 ONSC 1906 (CanLII) | Imeson v. Maryvale | CanLII⁠⁠2016 ONSC 6020 (CanLII) | Imeson v Maryvale | CanLII⁠⁠ Murder suspect Jesse Imeson captured in Quebec⁠⁠Suspect in 3 Ontario slayings appears in Windsor court | CBC News⁠⁠ Ont. man pleads guilty in 3 'savage' slayings, sentenced to life | CBC News⁠⁠ LFP Archives: The hunt for, and truth about, spree killer Jesse Imeson⁠⁠ Inadmissible evidence could lead to new trial⁠⁠ Obituary of Helene Marie Regier | T. Harry Hoffman & Sons Funeral Home⁠⁠ So, why did he do it? - Grand Bend Strip community newspaper⁠⁠ America's Most Wanted joins hunt for Ontario fugitive | CBC News⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

JCO PO author Dr. Dean A. Regier at the Academy of Translational Medicine, University of British Columbia (UBC), and the School of Population and Public Health, BC Cancer Research Institute shares insights into his JCO PO article, “Clinical Effectiveness and Cost-Effectiveness of Multigene Panel Sequencing in Advanced Melanoma: A Population-Level Real-World Target Trial Emulation.” Host Dr. Rafeh Naqash and Dr. Regier discuss the real-world clinical effectiveness and cost-effectiveness of multigene panels compared with single-gene BRAF testing to guide therapeutic decisions in advanced melanoma. Transcript Dr. Rafeh Naqash:Hello and welcome to JCO Precision Oncology Conversations, where we bring you engaging conversations with authors of clinically relevant and highly significant JCO PO articles. I'm your host, Dr. Rafeh Naqash, Podcast Editor for JCO Precision Oncology and Assistant Professor at the OU Health Stephenson Cancer Center in the University of Oklahoma. Today, we are excited to be joined by Dr. Dean A. Regier, Director at the Academy of Translational Medicine, Associate Professor at the School of Population and Public Health, UBC Senior Scientist at the British Columbia Cancer Research Institute, and also the senior author of the JCO Precision Oncology article entitled "Clinical Effectiveness and Cost-Effectiveness of Multigene Panel Sequencing in Advanced Melanoma: A Population-Level Real-World Target Trial Emulation." At the time of this recording, our guest's disclosures will be linked in the transcript. Dean, welcome to our podcast and thank you for joining us today. Dr. Dean Regier:Thank you. I'm delighted to be here. Dr. Rafeh Naqash:So, obviously, you are from Canada, and medicine, or approvals of drugs to some extent, and in fact approvals of gene testing to some extent is slightly different, which we'll come to learn about more today, compared to what we do in the US—and in fact, similarly, Europe versus North America to a large extent as well. Most of the time, we end up talking about gene testing in lung cancer. There is a lot of data, a lot of papers around single-gene panel testing in non-small cell lung cancer versus multigene testing. In fact, a couple of those papers have been published in JCO PO, and it has shown significant cost-effectiveness and benefit and outcomes benefit in terms of multigene testing. So this is slightly, you know, on a similar approach, but in a different tumor type. So, could you tell us first why you wanted to investigate this question? What was the background to investigating this question? And given your expertise in health economics and policy, what are some of the aspects that one tends or should tend to understand in terms of cost-effectiveness before we go into the results for this very interesting manuscript? Dr. Dean Regier:Yeah, of course, delighted to. So, one of the reasons why we're deeply interested in looking at comparative outcomes with respect to single- versus multigene testing— whether that's in a public payer system like Canada or an insurer system, a private system in the United States— is that the question around does multigene versus single-gene testing work, has not typically tested in randomized controlled trials. You don't have people randomized to multigene versus single-gene testing. And what that does, it makes the resulting evidence base, whether it's efficacy, safety, or comparative cost-effectiveness, highly uncertain. So, the consequence of that has been uneven uptake around the world of next-generation sequencing panels. And so if we believe that next-gen sequencing panels are indeed effective for our patients, we really need to generate that comparative evidence around effectiveness and cost-effectiveness. So we can go to payers, whether it be single payer or a private insurer, to say, "Here are the comparative outcomes." And when I say that uptake has been uneven, uptake there's been actually plenty, as you know, publications around that uneven uptake, whether it be in Europe, in the United States, in Canada. And so we're really interested in trying to produce that evidence to create the type of deliberations that are needed to have these types of technologies accessible to patients. And part of those deliberations, of course, is the clinical, but also in some contexts, cost-effectiveness. And so, we really start from the perspective of, can we use our healthcare system data, our learning healthcare system, to generate that evidence in a way that emulates a randomized controlled trial? We won't be able to do these randomized controlled trials for various, like really important and and reasons that make sense, quite frankly. So how can we mimic or emulate randomized controlled trials in a way that allows us to make inference around those outcomes? And for my research lab, we usually think through how do we do causal inference to address some of those biases that are inherent in observational data. So in terms of advanced melanoma, we were really interested in this question because first of all, there have been no randomized controlled trials around next-gen sequencing versus single-gene testing. And secondly, these products, these ICIs, immune checkpoint inhibitors, and BRAF and MEK inhibitors, they are quite expensive. And so the question really becomes: are they effective? And if so, to what extent are they cost-effective? Do they provide a good reason to have information around value for money? Dr. Rafeh Naqash:So now going to the biology of melanoma, so we know that BRAF is one of the tumor-agnostic therapies, it has approvals for melanoma as well as several other tumor types. And in fact, I do trials with different RAF-RAS kinase inhibitors. Now, one of the things that I do know is, and I'm sure some of the listeners know, is the DREAMseq trial, which was a melanoma study that was an NCI Cooperative Group trial that was led by Dr. Mike Atkins from Georgetown a couple of years back, that did show survival benefit of first-line immunotherapy sequencing. It was a sequencing study of whether to do first-line BRAF in BRAF-mutant melanoma followed by checkpoint inhibitors, or vice versa. And the immune checkpoint inhibitors followed by BRAF was actually the one that showed benefit, and the trial had to stop early, was stopped early because of the significant benefit seen. So in that context, before we approach the question of single-gene versus multigene testing in melanoma, one would imagine that it's already established that upfront nivolumab plus ipilimumab, for that matter, doublet checkpoint inhibitor therapy is better for BRAF-mutant melanoma. And then there's no significant other approvals for melanoma for NRAS or KIT, you know, mucosal melanomas tend to have KIT mutations, for example, or uveal melanomas, for that matter, have GNAQ, and there's no targeted therapies. So, what is the actual need of doing a broader testing versus just testing for BRAF? So just trying to understand when you started looking into this question, I'm sure you kind of thought about some of these concepts before you delved into that. Dr. Dean Regier:I think that is an excellent question, and it is a question that we asked ourselves: did we really expect any differences in outcomes between the testing strategies? And what did the real-world implementation, physician-guided, physician-led implementation look like? And so, that was kind of one of the other reasons that we really were interested is, why would we go to expanded multigene panel sequencing at all? We didn't really expect or I didn't expect an overall survival a priori. But what we saw in our healthcare system, what happened in our healthcare system was the implementation in 2016 of this multigene panel. And this panel covered advanced melanoma, and this panel cost quite a bit more than what they were doing in terms of the single-gene BRAF testing. And so when you're a healthcare system, you have to ask yourself those questions of what is the additional value associated with that? And indeed, I think in a healthcare system, we have to be really aware that we do not actually follow to the ideal extent randomized controlled trials or trial settings. And so that's the other thing that we have to keep in mind is when these, whether it's an ICI or a BRAF MEK inhibitor, when these are implemented, they do not look like randomized controlled trials. And so, we really wanted to emulate not just a randomized controlled trial, but a pragmatic randomized controlled trial to really answer those real-world questions around implementation that are so important to decision making. Dr. Rafeh Naqash:Sure. And just to understand this a little better: for us in the United States, when we talk about multigene testing, we generally refer to, these days, whole-exome sequencing with whole-transcriptome sequencing, which is like the nuclear option of of the testings, which is not necessarily cheap. So, when you talk about multigene testing in your healthcare system, what does that look like? Is it a 16-gene panel? Is it a 52-gene panel? What is the actual makeup of that platform? Dr. Dean Regier:Excellent question. Yeah, so at the time that this study is looking at, it was 2016, when we, as BC Cancer—so British Columbia is a population right now of 5.7 million people, and we have data on all those individuals. We are one healthcare system providing health care to 5.7 million people. In 2016, we had what I call our "home-brew" multigene panel, which was a 53-gene panel that was reimbursed as standard of care across advanced cancers, one of them being advanced melanoma. We have evolved since then. I believe in 2022, we are using one of the Illumina panels, the Focus panel. And so things have changed; it's an evolving landscape. But we're specifically focused on the 53-gene panel. It was called OncoPanel. And that was produced in British Columbia through the Genome Sciences Centre, and it was validated in a single-arm trial mostly around validity, etc. Dr. Rafeh Naqash:Thank you for explaining that. So now, onto the actual meat and the science of this project. So, what are some of the metrics from a health economy standpoint that you did look at? And then, methodology-wise, I understand, in the United States, we have a fragmented healthcare system. I have data only from my institution, for that matter. So we have to reach out to outside collaborators and email them to get the data. And that is different for you where you have access to all the data under one umbrella. So could you speak to that a little bit and how that's an advantage for this kind of research especially? Dr. Dean Regier:Yeah. In health economics, we look at the comparative incremental costs against the incremental effectiveness. And when we think about incremental costs, we think not just about systemic therapy or whether you see a physician, but also about hospitalizations, about all the healthcare interactions related to oncology or not that a patient might experience during their time or interactions with the healthcare system. You can imagine with oncology, there are multiple interactions over a prolonged time period depending on survival. And so what we try to do is we try to—and the benefit of the single-payer healthcare system is what we do is we link all those resource utilization patterns that each patient encounters, and we know the price of that encounter. And we compare those incremental costs of, in this case, it's the multigene panel versus the single-gene panel. So it's not just the cost of the panel, not just the cost of systemic therapy, but hospitalizations, physician encounters, etc. And then similarly, we look at, in this case, we looked at overall survival - we can also look at progression-free survival - and ask the simple question, you know, what is the incremental cost per life-year gained? And in that way, we get a metric or an understanding of value for money. And how we evaluate that within a deliberative priority setting context is we look at safety and efficacy first. So a regulatory package that you might get from, in our case, Health Canada or the FDA, so we look at that package, and we deliberate on, okay, is it safe and is it effective? How many patients are affected, etc. And then separately, what is the cost-effectiveness? And at what price, if it's not cost-effective, at what price would it be cost-effective? Okay, so for example, we have this metric called the incremental cost-effectiveness ratio, which is incremental cost in the numerator, and in this case, life-years gained in the denominator. And if it is around $50,000 or $100,000 per life-year gained—so if it's in that range, this ratio—then we might say it's cost-effective. If it's above this range, which is common in oncology, especially when we talk about ICIs, etc., then you might want to negotiate a price. And indeed, when we negotiate that price, we use the economic evaluation, that incremental cost-effectiveness ratio, as a way to understand at what price should we negotiate to in order to get value for money for the healthcare system. Dr. Rafeh Naqash:Thank you for explaining those very interesting terminologies. Now, one question I have in the context of what you just mentioned is, you know, like the drug development space, you talked about efficacy and safety, but then on the safety side, we talk about all-grade adverse events or treatment-related adverse events—two different terminologies. From a healthcare utilization perspective, how do you untangle if a patient on a BRAF therapy got admitted for a hypoxic respiratory failure due to COPD, resulting in a hospitalization from the cost, overall cost utilization, or does it not matter? Dr. Dean Regier:We try to do as much digging into those questions as possible. And so, this is real-world data, right? Real-world data is not exactly as clean as you'd get from a well-conducted clinical trial. And so what we do is we look at potential adverse event, whether it's hospitalization, and the types of therapies around that hospitalization to try- and then engage with clinicians to try to understand or tease out the different grades of the adverse event. Whether it's successful or not, I think that is a real question that we grapple with in terms of are we accurate in delineating different levels of adverse events? But we try to take the data around the event to try to understand the context in which it happens. Dr. Rafeh Naqash:Thank you for explaining that, Dean. So, again to the results of this manuscript, could you go into the methodology briefly? Believe you had 147 patients, 147 patients in one arm, 147 in the other. How did you split that cohort, and what were some of the characteristics of this cohort? Dr. Dean Regier:So, the idea, of course, is that we have selection criteria, study inclusion criteria, which included in our case 364 patients. And these were patients who had advanced melanoma within our study time period. So that was 2016 to 2018. And we had one additional year follow. So we had three total years. And what we did is that we linked our data, our healthcare system data. During this time, because the policy change was in 2016, we had patients both go on the multigene panel and on the single-gene BRAF testing. So, the idea was to emulate a pragmatic randomized controlled trial where we looked at contemporaneous patients who had multigene panel testing versus single-gene BRAF testing. And then we did a matching procedure—we call it genetic matching. And that is a type of matching that allows us to balance covariates across the patient groups, across the multigene versus BRAF testing cohorts. The idea again is, as you get in a randomized controlled trial, you have these baseline characteristics that look the same. And then the hope is that you address any source selection or confounding biases that prohibit you to have a clean answer to the question: Is it effective or cost-effective? So you address all those biases that may prohibit you to find a signal if indeed a signal is there. And so, what we did is we created—we did this genetic matching to balance covariates across the two cohorts, and we matched them one-to-one. And so what we were able to do is we were able to find, of those 364 patients in our pool, 147 in the multigene versus 147 in the single-gene BRAF testing that were very, very similar. In fact, we created what's called a directed acyclic graph or a DAG, together with clinicians to say, “Hey, what biases would you expect to have in these two cohorts that might limit our ability to find a signal of effectiveness?” And so we worked with clinicians, with health economists, with epidemiologists to really understand those different biases at play. And the genetic matching was able to match the cohorts on the covariates of interest. Dr. Rafeh Naqash:And then could you speak on some of the highlights from the results? I know you did survival analysis, cost-effectiveness, could you explain that in terms of what you found? Dr. Dean Regier:We did two analyses. The intention-to-treat analysis is meant to emulate the pragmatic randomized controlled trial. And what that does is it answers the question, for all those eligible for multigene or single-gene testing: What is the cost-effectiveness in terms of incremental life-years gained and incremental cost per life-years gained? And the second one was around a protocol analysis, which really answered the question of: For those patients who were actually treated, what was the incremental effectiveness and cost-effectiveness? Now, they're different in two very important ways. For the intention-to-treat, it's around population questions. If we gave single-gene or multigene to the entire population of advanced melanoma patients, what is the cost-effectiveness? The per-protocol is really around that clinical question of those who actually received treatment, what was the incremental cost and effectiveness? So very different questions in terms of population versus clinical cost and effectiveness. So, for the intention-to-treat, what we found is that in terms of life-years gained is around 0.22, which is around 2.5 months of additional life that is afforded to patients who went through the multigene panel testing versus the single-gene testing. That was non-statistically significant from zero at the 5% level. But on average, you would expect this additional 2.5 months of life. The incremental costs were again non-statistically significant, but they're around $20,000. And so when we look at incremental cost-effectiveness, we can also look at the uncertainty around that question, meaning what percentage of incremental cost-effectiveness estimates are likely to be cost-effective at different willingness-to-pay thresholds? Okay? So if you are willing to pay $100,000 to get one gain of life-years, around 52.8% of our estimates, in terms of when we looked at the entire uncertainty, would be cost-effective. So actually that meets the threshold of implementation in our healthcare system. So it's quite uncertain, just over 50%. But what we see is that decision-makers actually have a high tolerance for uncertainty around cost-effectiveness. And so, while it is uncertain, we would say that, well, the cost-effectiveness is finely balanced. Now, when we looked at the population, the per-protocol population, those folks who just got treatment, we actually have a different story. We have all of a sudden around 4.5 or just under 5 months of life gained that is statistically significantly different from zero, meaning that this is a strong signal of benefit in terms of life-years gained. In terms of the changes in costs or the incremental costs, they are larger again, but statistically insignificant. So the question now is, to what extent is it cost-effective? What is the probability of it being cost-effective? And at the $100,000 per life-year gained willingness-to-pay, there was a 73% chance that multigene panel testing versus single-gene testing is cost-effective. Dr. Rafeh Naqash:So one of the questions I have here, this is a clarification both for myself and maybe the listeners also. So protocol treatment is basically if you had gene testing and you have a BRAF in the multigene panel, then the patient went on a BRAF treatment. Is that correct? Dr. Dean Regier:It's still physician choice. And I think that's important to say that. So typically what we saw in both in our pre- and post-matching data is that we saw around 50% of patients, irrespective of BRAF status, get an ICI, which is appropriate, right? And so the idea here is that you get physician-guided care, but if the patient no longer performs on the ICI, then it gives them a little bit more information on what to do next. Even during that time when we thought it wasn't going to be common to do an ICI, but it was actually quite common. Dr. Rafeh Naqash:Now, did you have any patients in this study who had the multigene testing done and had an NRAS or a KIT mutation and then went on to those therapies, which were not captured obviously in the single-gene testing, which would have just tried to look at BRAF? Dr. Dean Regier:So I did look at the data this morning because I thought that might come up in terms of my own questions that I had. I couldn't find it, but what we did see is that some patients went on to clinical trials. So, meaning that this multigene panel testing allowed, as you would hope in a learning healthcare system, patients to move on to clinical trials to have a better chance at more appropriate care if a target therapy was available. Dr. Rafeh Naqash:And the other question in that context, which is not necessarily related to the gene platform, but more on the variant allele frequency, so if you had a multigene panel that captured something that was present at a high VAF, with suspicion that this could be germline, did you have any of those patients? I'm guessing if you did, probably very low number, but I'm just thinking from a cost-effective standpoint, if you identify somebody with germline, their, you know, first-degree relative gets tested, that ends up, you know, prevention, etc. rather than somebody actually developing cancer subsequently. That's a lot of financial gains to the system if you capture something early. So did you look at that or maybe you're planning to look at that? Dr. Dean Regier:We did not look at that, but that is a really important question that typically goes unanswered in economic evaluations. And so, the short answer is yes, that result, if there was a germline finding, would be returned to the patient, and then the family would be able to be eligible for screening in the appropriate context. What we have found in economic evaluations, and we've recently published this research, is that that scope of analysis is rarely incorporated into the economic evaluation. So those downstream costs and those downstream benefits are ignored. And when you- especially also when you think about things like secondary or incidental findings, right? So it could be a germline finding for cancer, but what about all those other findings that we might have if you go with an exome or if you go with a genome, which by the way, we do have in British Columbia—we do whole-genome and transcriptome sequencing through something called the Personalized OncoGenomics program. That scope of evaluation, because it's very hard to get the right types of data, because it requires a decision model over the lifetime of both the patients and potentially their family, it becomes very complicated or complex to model over patients' and families' lifetime. That doesn't mean that we should not do it, however. Dr. Rafeh Naqash:So, in summary Dean, could you summarize some of the known and unknowns of what you learned and what you're planning in subsequent steps to this project? Dr. Dean Regier:Our North Star, if you will, is to really understand the entire system effect of next-generation sequencing panels, exome sequencing, whole genomes, or whole genomes and transcriptome analysis, which we think should be the future of precision oncology. The next steps in our research is to provide a nice base around multigene panels in terms of multigene versus single-gene testing, whether that be colorectal cancer, lung cancer, melanoma, etc., and to map out the entire system implications of implementing next-generation sequencing panels. And then we want to answer the questions around, “Well, what if we do exomes for all patients? What if we do whole genomes and transcriptomes for all patients? What are the comparative outcomes for a true tumor-agnostic precision oncology approach, accounting for, as you say, things like return of results with respect to hereditary cancers?” I think the challenge that's going to be encountered is really around the persistent high costs of something like a whole-genome and transcriptome sequencing approach. Although we do see the technology prices going down—the "$1,000 genome" or “$6,000 genome" on whatever Illumina machine you might have—that bioinformatics is continuing to be expensive. And so, there are pipelines that are automated, of course, and you can create a targeted gene report really rapidly within a reasonable turnaround time. But of course, for secondary or what I call level two analysis, that bioinformatics is going to continue to be expensive. And so, we're just continually asking that question is: In our healthcare system and in other healthcare systems, if you want to take a precision oncology approach, how do you create the pipelines? And what types of technologies really lend themselves to benefits over and above next-generation sequencing or multigene panels, allowing for access to off-label therapies? What does that look like? Does that actually improve patients? I think some of the challenges, of course, is because of heterogeneity, small benefiting populations, finding a signal if a signal is indeed there is really challenging. And so, what we are thinking through is, with respect to real-world evidence methods and emulating randomized controlled trials, what types of evidence methods actually allow us to find those signals if indeed those signals are there in the context of small benefiting populations? Dr. Rafeh Naqash:Thank you so much, Dean. Sounds like a very exciting field, especially in the current day and age where cost-effectiveness, financial toxicity is an important aspect of how we improve upon what is existing in oncology. And then lots more to be explored, as you mentioned. The last minute and a half I want to ask about you as an individual, as a researcher. There's very few people who have expertise in oncology, biomarkers, and health economics. So could you tell us for the sake of our trainees and early career physicians who might be listening, what was your trajectory briefly? How did you end up doing what you're doing? And maybe some advice for people who are interested in the cost of care, the cost of oncology drugs - what would your advice be for them very briefly? Dr. Dean Regier:Sure. So I'm an economist by training, and indeed I knew very little about the healthcare system and how it works. But I was recruited at one point to BC Cancer, to British Columbia, to really try to understand some of those questions around costs, and then I learned also around cost-effectiveness. And so, I did training in Scotland to understand patient preferences and patient values around quality of care, not just quantity of life, but also their quality of life and how that care was provided to them. And then after that, I was at Oxford University at the Nuffield Department of Population Health to understand how that can be incorporated into randomized control trials in children. And so, I did a little bit of learning about RCTs. Of course, during the way I picked up some epidemiology with deep understanding of what I call econometrics, what others might call biostatistics or just statistics. And from there, it was about working with clinicians, working with epidemiologists, working with clinical trialists, working with economists to understand the different approaches or ways of thinking of how to estimate efficacy, effectiveness, safety, and cost-effectiveness. I think this is really important to think through is that we have clinical trialists, we have people with deep understanding of biostatistics, we have genome scientists, we have clinicians, and then you add economists into the mix. What I've really benefited from is that interdisciplinary experience, meaning that when I talk to some of the world's leading genome scientists, I understand where they're coming from, what their hope and vision is. And they start to understand where I'm coming from and some of the tools that I use to understand comparative effectiveness and cost-effectiveness. And then we work together to actually change our methods in order to answer those questions that we're passionate about and curious about better for the benefit of patients. So, the short answer is it's been actually quite a trajectory between Canada, the UK. I spent some time at the University of Washington looking at the Fred Hutch Cancer Research Center, looking at precision oncology. And along the way, it's been an experience about interdisciplinary research approaches to evaluating comparative outcomes. And also really thinking through not just at one point in time on-off decisions—is this effective? Is it safe? Is it cost-effective?—not those on-off decisions, but those decisions across the lifecycle of a health product. What do those look like at each point in time? Because we gain new evidence, new information at each point in time as patients have more and more experience around it. And so what really is kind of driving our research is really thinking about interdisciplinary approaches to lifecycle evaluation of promising new drugs with the goal of having these promising technologies to patients sooner in a way that is sustainable for the healthcare system. Dr. Rafeh Naqash:Awesome. Thank you so much for those insights and also giving us a sneak peek of your very successful career. Thank you for listening to JCO Precision Oncology Conversations. Don't forget to give us a rating or review, and be sure to subscribe so you never miss an episode. You can find all ASCO shows at asco.org/podcast. Thank you. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.      

Pastor Barry shares from Acts 19:1–7, where sincere believers were missing the Holy Spirit. This week's message challenges us to ask: Is our faith complete, or are we missing something? It's not enough to be sincere—we need the full power and presence of Jesus. When we receive the Holy Spirit, everything changes.Acts 19:1–7If you're new here, we'd love to get you connected with our community! You can message us on facebook, instagram or by simply texting "hello" to 587-323-1199, and we'll respond right back.Head to calvarycommunity.ca/serve to see how you can get involved here! On the page we have different ministries you can join, engage with community, and see a little about what's going on here at calvary.

Brandon Regier is a huge fan of running. He loves it so much he's made it his career and he chases huge goals on the weekends too. He's also a proud new father and someone who values time with family. He was a pleasure to chat with and I'm so glad Chantelle made this happen! Drop by Runners Soul in Lethbridge and meet him yourself. We learned a lot about why he loves the sport, some advice he has for people thinking about it, and all kinds more! He's another legend of Lethbridge and I hope you enjoy the conversation as much as Chantelle and I did.Speaking of Chantelle and I…The Trail Running Film FestivalChantelle is my guest in Crowsnest Pass this Saturday May 3 at Frank Slide Interpretive Centre! I'm so excited for my new hometown show and to hang out with trail runners all over Alberta.Edmonton, we will see you Thursday!! Calgary, see you on Friday!! Get your tickets:* Edmonton, AB – Thursday, May 1 | Metro Cinema* Calgary, AB – Friday May 2 | Cardel Theatre* Crowsnest Pass, AB – Saturday, May 3 | Frank Slide Interpretive Centre* Jasper, AB – Saturday, May 17 | The Legion* Canmore, AB – Thursday, June 5 | artsPlace Get full access to Community Trail Running at communitytrailrunning.substack.com/subscribe

Acts 18:1-18If you're new here, we'd love to get you connected with our community! You can message us on facebook, instagram or by simply texting "hello" to 587-323-1199, and we'll respond right back.Head to calvarycommunity.ca/serve to see how you can get involved here! On the page we have different ministries you can join, engage with community, and see a little about what's going on here at calvary.

If you're new here, we'd love to get you connected with our community! You can message us on facebook, instagram or by simply texting "hello" to 587-323-1199, and we'll respond right back.Head to calvarycommunity.ca/serve to see how you can get involved here! On the page we have different ministries you can join, engage with community, and see a little about what's going on here at calvary.

ACTS 17:1-15If you're new here, we'd love to get you connected with our community! You can message us on facebook, instagram or by simply texting "hello" to 587-323-1199, and we'll respond right back.Head to calvarycommunity.ca/serve to see how you can get involved here! On the page we have different ministries you can join, engage with community, and see a little about what's going on here at calvary.

Acts 16:16-24If you're new here, we'd love to get you connected with our community! You can message us on facebook, instagram or by simply texting "hello" to 587-323-1199, and we'll respond right back.Head to calvarycommunity.ca/serve to see how you can get involved here! On the page we have different ministries you can join, engage with community, and see a little about what's going on here at calvary.

Pastor Barry's sermon on Self-Control emphasized that true freedom comes from allowing the Holy Spirit to guide our lives, leading to self-control over our emotions, desires, and choices. He highlighted that self-control is essential for spiritual growth, integrity, and healthy relationships, requiring both our willingness to submit to God and the Spirit's power to transform us.GALATIANS 5:22-23 If you're new here, we'd love to get you connected with our community! You can message us on facebook, instagram or by simply texting "hello" to 587-323-1199, and we'll respond right back.Head to calvarycommunity.ca/serve to see how you can get involved here! On the page we have different ministries you can join, engage with community, and see a little about what's going on here at calvary.

Pastor Barry's sermon explores the theme of goodness as a fruit of the Spirit, emphasizing that true goodness comes from God and transforms our hearts, actions, and relationships. He highlights how God's goodness shapes our lives, calling us to reflect His character through righteous living, selflessness, and standing for truth. GALATIANS 5:22-23 If you're new here, we'd love to get you connected with our community! You can message us on facebook, instagram or by simply texting "hello" to 587-323-1199, and we'll respond right back. Head to calvarycommunity.ca/serve to see how you can get involved here! On the page we have different ministries you can join, engage with community, and see a little about what's going on here at calvary.

GOP Senate Majority Whip Dennis Lenz, and Senate President Matt Regier join the program for their biweekly connection. Senator Lenz heads the Public Health, Welfare and Safety Committee and addresses a handful of the health and safety issues before the […] The post Capitol ReCap, w/ Sen. President Regier & Majority Whip Lenz first appeared on Voices of Montana.

Pastor Barry's message highlights the profound impact of kindness as a reflection of God's character and love. He encourages us to embody kindness in our daily lives, reminding us that our actions, especially toward those in need, are a powerful response to the grace and compassion we've received from God. GALATIANS 5:22-23 If you're new here, we'd love to get you connected with our community! You can message us on facebook, instagram or by simply texting "hello" to 587-323-1199, and we'll respond right back. Head to calvarycommunity.ca/serve to see how you can get involved here! On the page we have different ministries you can join, engage with community, and see a little about what's going on here at calvary.

This week Pastor Barry explores the contrast between living according to the "works of the flesh," which lead to imbalance and destruction, and bearing the "fruit of the Spirit," which reflects God's character and leads to a life of freedom and faithfulness. He highlights faithfulness as a divine attribute, encouraging believers to remain loyal to God and live out their faith consistently through their actions, even amidst challenges. GALATIANS 5:22-23, 25 If you're new here, we'd love to get you connected with our community! You can message us on facebook, instagram or by simply texting "hello" to 587-323-1199, and we'll respond right back. Head to calvarycommunity.ca/serve to see how you can get involved here! On the page we have different ministries you can join, engage with community, and see a little about what's going on here at calvary.

Pastor Barry explores the biblical virtue of patience as a fruit of the Spirit, emphasizing its active endurance through trials, its reflection of God's character, and its role in developing spiritual maturity and fostering peace in relationships. It challenges believers to yield to the Holy Spirit, viewing life's frustrations as opportunities to grow in patience and Christlikeness. GALATIANS 5:22-23, 25 If you're new here, we'd love to get you connected with our community! You can message us on facebook, instagram or by simply texting "hello" to 587-323-1199, and we'll respond right back. Head to calvarycommunity.ca/serve to see how you can get involved here! On the page we have different ministries you can join, engage with community, and see a little about what's going on here at calvary.

Jordan Regier emphasizes that Christian freedom, granted through Jesus Christ, calls believers not to indulge in selfish desires but to serve others in love, embodying the Fruit of the Spirit. It further defines love as a sacrificial, active, and unconditional care for others, extending beyond family to all, including enemies, guided by the example of Jesus and governed by Scripture. Galatians 5:13-15 If you're new here, we'd love to get you connected with our community! You can message us on facebook, instagram or by simply texting "hello" to 587-323-1199, and we'll respond right back. Head to calvarycommunity.ca/serve to see how you can get involved here! On the page we have different ministries you can join, engage with community, and see a little about what's going on here at calvary.

Lugi Regier shares how in the middle of recent layoffs at his job, Jesus encouraged him to not forget who is our source and identity. We look at setbacks, the frustration and confusion which they can bring, but most importantly; how Jesus meets us where we are to draw us back to Himself so that we might rest in the confidence of knowing our God and knowing that He is sovereign. Not a rest that departs when circumstances change, but an abiding assurance that we are held by our Creator and that we enjoy the privilege of His attention and care. Philippians 2:1, Proverb 3:5-6, and Psalm 37:23-25.www.instagram.com/thehishillpodcast/www.hishill.orgkelly@hishill.org

This week Pastor Barry explores the concept of freedom in Christ, emphasizing that true freedom is not about indulging our sinful nature but about living by the guidance of the Holy Spirit. Galatians 5:16-26 If you're new here, we'd love to get you connected with our community! You can message us on facebook, instagram or by simply texting "hello" to 587-323-1199, and we'll respond right back. Head to calvarycommunity.ca/serve to see how you can get involved here! On the page we have different ministries you can join, engage with community, and see a little about what's going on here at calvary.

In this episode you will:  Learn about how the Aphasia-Friendly Reading Approach was developed. Hear about the importance of actively engaging care partners in therapy through this storytelling approach. Learn the importance of celebrating stories and how to host your own version of a Waffle Night.   Katie Strong: Welcome to the Aphasia Access Aphasia Conversations Podcast. I'm Katie Strong, a  member of the Aphasia Access Podcast Working Group. I'm also a faculty member at Central Michigan University where I lead the Strong Story Lab. Aphasia Access strives to provide members with information, inspiration, and ideas that support their aphasia care through a variety of educational materials and resources. I'm today's host for an episode that will feature Harold Regier and Dr. Erin O'Bryan. We'll be talking about the Aphasia-Friendly Reading Approach that Harold developed for his wife, Rosella, who had aphasia and how Dr. O'Bryan took this approach into the lab to refine it for clinicians to use in sessions. Before we dive into the conversation, let me share a few details about our guests. First a bit about Harold. Harold R. Regier, B.S. Ed., BDiv. Theol., is a retired minister with a career path in programs addressing social justice issues. In retirement, his spouse, Rosella, had a stroke resulting in aphasia. His passion shifted to becoming an aphasia care partner focused on helping to recover language and communication skills. He is the author of “A Decade of Aphasia Therapy,” subtitled “Aphasia-Friendly Reading: A Technique for Oral Communication,” published in 2021.  Our second guest is Dr. Erin O'Bryan. Erin is an Assistant Professor in the Department of Communication Sciences and Disorders at Wichita State University, in Wichita, Kansas. Her major research, teaching, and clinical interests focus on helping people with aphasia communicate through scripts, stories, and phrases and teaching students and care partners how to support communication. Dr. O'Bryan directs the Wichita Adult Language Lab whose current projects focus on supported storytelling and Melodic Intonation Therapy. Welcome Harold and Erin. I'm looking forward to our conversation today. Erin O'Bryan: Thank you, Katie! I've been listening to Aphasia Access Podcasts for years, and so many of my heroes have been interviewed in this series. It is really an honor that you invited Harold and I to be on the podcast today! Katie Strong: I am so excited for our listeners to hear about how the Aphasia-Friendly Reading Approach was developed and expanded. This work is near and dear to my heart – particularly in this unique way of developing and telling stories. I feel compelled to disclose to our listeners that I am grateful to have been involved in this work as it was refined for clinical environments. So, I am going to come right out and say, this is my bias. Harold, I'm a big fan of yours and the Aphasia Friendly Reading Approach and of you Erin for how you brought this approach into the lab and studied it so that clinicians can use this approach. So, now let's get started! Harold, can you share a bit with us about how the Aphasia-Friendly Reading Approach came to be? Harold Reiger: Sure. Thank you so much, Dr. Strong, for the privilege of being here to share just a bit of our story. You know, Rosella and I would have celebrated our 65th wedding anniversary if she had stayed with us just a few weeks longer. We had a very long and very happy marriage. She used to kid me, “We've been together so long we know what the other person will say before he or she says it.” Well, actually, aphasia kind of shattered that theory. But maybe there was a little bit of that was true. Well, anyway, Rosella was a retired public-school teacher with part of her career also involving children's curriculum development. She led many workshops, was a storyteller, and was a frequent guest speaker. Communication and broad coalitions were a strong suit for her. So, aphasia, loss of language was a huge loss for her. Perhaps that sets the stage for working so hard to restore some major storytelling. But I'm sure this is the same kind of feeling that every person who is a care partner with the person with aphasia has. How did we discover a technique for storytelling through oral reading? Really, I think I just stumbled into it. The cues came from Rosella. She could say many words. She had a strong voice, but she did not put words together in a way that made it possible for a listener to understand what she meant to communicate. So, I was highly motivated, wishing there was a way to help her tell her stories. Looking back, I now can see three of what I call ‘indicators' that led me to the technique that I eventually called Aphasia-Friendly Reading. They were painting, reading, and church liturgy. So let me explain. Indicator number one, completely on her own, Rosella began to paint. Just shy of two years after her stroke, Rosella began to paint. She painted for four years. She painted 250 paintings. The choice of her subjects were all hers. Objects, scenery, flowers, roadside sightings, trips and vacations, past memories. And yes, stories, family stories, stories that she didn't have words to tell, but she could tell them with a brush. She gave every picture a title or caption, signed it, and dated it. And somehow she found those one, two, or three words to intelligibly, that is accurately, identify the picture that she had just painted. But after four years of painting those pictures, she put her paintbrush down, never to pick it up again. And yet I kept remembering that she was able to identify pictures accurately using those few words to explain what it was that she was telling with her pictures. But then indicator number two came, reading periodicals and books. She underlined periodicals with many circles, much underlining. For a long time, Rosella delved through as many as 40 or 50 books per month. She turned every page, but did she understand what she was reading? Frankly, I often wondered and doubted it. One day, Rosella was reading orally beside me, and I pressed my iPhone video button. Listen to just a few seconds of that reading. And while you listen, think of two questions. Could you understand what she was reading? What was the story that she was trying to tell? And secondly, do you think that Rosella was understanding what she was reading? So listen to that clip. Excerpt of Rosella reading from a book. You heard Rosella reading the story of she and her sister, Anna Grace, requesting radio station KNEX out of McPherson, Kansas to surprise their mother by playing it for her birthday. It was a song that the girls knew that their mother loved. And you heard her read those words, “I love those dear hearts and gentle people.” And then as she continued reading the lyrics of that song, she exclaimed, “Oh, Harold”, which was her way of saying how excited she was to recall that particular story. Now, that explanation, of course, was not in the book. Then there was a third indicator that I recognized, and that was liturgical reading. One day in church we were reading a call to worship displayed on the screen. We were reading responsibly with the leader reading the first line and the congregation reading the second line. I glanced to my side and was surprised to see Rosella reading with the congregation. Maybe it was only the first three or four words of the line, but she read these words accurately. A light went on in my mind. Might this be a hint of how to help Rosella participate in oral reading? Short sentences read with a co-reader who read every other line and written in an easy to follow format? And so I adapted various psalms into very short lines formatted for us to read responsively. I read the first line, she read the second. The result was amazing success. Let me just illustrate by us reading just a very short psalm for you. This is Psalm 150 that Rosella and I will read together. H: Praise the Lord! R: Praise God in his sanctuary. H: Praise God in his mighty firmament. R: Praise Him for his mighty deeds. H: Praise the Lord for his greatness. R: Praise him with the trumpet. H: Praise him with the lute and harp. R: Praise him with the dance. My thought then was, could we try to write other stories and read them in what I began to call Aphasia-Friendly Reading format and style? And so, I began in earnest to try to write other stories. Short sentences, familiar words, larger font. Each line considered a sentence, even if it was only one word. Label the first line H for Harold and the second indented line R for Rosella. As I started reading and continued to read every other line, this could set the tone, the rhythm, and the pattern for saying every word clearly. I thought it was time to try. And then I began to wonder, is there a setting that we could read stories to others? Could we create an audience in some way? When COVID hit, of course, I could not see Rosella in person anymore, for an entire year we were separated. And the only contact we had was FaceTime telephone calls. And those were really a disaster because we found it very difficult to communicate with each other when Roselle was not able to understand me and I wasn't able to understand her, except when we read Aphasia-Friendly stories. And so, I wrote many stories during that year. And we read those stories then as our connection during our FaceTime calls. And somehow we were able to survive COVID. But it was after COVID then that we were able to again get back together occasionally. And I would bring her back to my apartment. And there I would invite friends, usually a couple or two individuals to come over and I would serve waffles. I'm not a kitchen person, but I could make waffles. So, we'd have a simple meal, a simple supper that we could visit with each other and talk about anything that we would like. And Rosella almost always simply said, “I remember exactly”. Because as others told stories that she was familiar with, she could comment that way. Otherwise, her conversation skills were not there. So that was our first hour that we would spend together simply informally visiting with each other. And the second hour that we spent together, we would go to what I would call “my theater,” our living room with a 50-inch television. And there we could read Aphasia-Friendly stories. I would stream the story to the television set. I would have them formatted so that there would be an H for Harold, an R for Rosella, and we would read the story so that the folks who were listening and watching could see the story as well as hear the story. And if we made any mistakes, they could make the corrections in their own mind. There was a way that she was able to, again, participate. It's worth telling. But there was one waffle evening when she turned to me, and said, “China”. I knew she had a story in mind, but her look said, “you tell it. I can't do it.” And so, I did. It was a story about a cracked tea cup And so I decided certainly next Waffle Night we need to let her help tell that story of the cracked tea cup. Here is that story. Cracked Tea Cup. H: This is as story of a cracked tea cup. R: Harold and I were youth sponsors. H: Rose was one of the youth. R: Winifred was her mother. H: She invited me to her home. R: “Thank you,” she said. H: “Thank you for being Rose's sponsor.” R: We visited. H: Before leaving, she said R: “Let me pray for you.” H: It was a pray of blessing… R: …for our work in Mississippi. H: Then she added, R: “Wait!” H: “I have something for you.” R: She got a tea cup. H: Erland brought it to me from China. R: It's cracked. H: Put it in your china cupboard. R: You'll never use it. H: “But you'll remember be when you see it.” R: Sixty years are gone. H: This tea cup is still in my china cupboard. R: And I remember Winifred. H: It reminds me R: Of the grace, H: Of the affirmation, R: Of blessing, H: Of the seminary president's wife.   And so those Waffle Nights became the favorite parts of our week when we could spend time with friends and Rosella could be part of the conversation by reading stories together with me. Katie Strong: So beautiful! This is really just a fabulous way of having such a natural thing, a shared meal, a celebration to share stories. And it sounds like everybody enjoyed Waffle Nights. So, thank you for sharing, Harold. Erin, I was wondering if come into the conversation a bit more and tell us how you got involved with Harold and the Aphasia-Friendly Reading Approach? Erin O'Bryan: Thank you, Katie. Even though I've heard Harold's story so many times, I still get teary every time I hear him talk about their year of not being able to see each other during COVID and the Waffle Nights that were just so wonderful. So, I met Harold in 2019 when I first became an Assistant Professor after 10 years of working as an SLP in healthcare. And Wichita State already had a weekly aphasia group, and I couldn't wait to meet the members. So, I went to aphasia group and there I met all of the care partners in the observation room and Harold showed me a video of him and Rosella reading a story together. I had been watching Rosella in the aphasia group and I'd seen that most of her utterances were short one- to two-word phrases and that much of her communication was nonverbal. But then in the video, she was reading full sentences aloud, taking turns with Harold. And what really struck me was that she was so motivated and happy to read the story. I was so impressed. Harold asked me, “Do you think that other people with aphasia could benefit from doing this?” So many thoughts were running through my mind as we were having this conversation. Earlier in 2019, I had visited Audrey Holland, who was one of my mentors when I was in grad school at University of Arizona. And we'd actually set up this meeting through an online Scrabble chat. She invited me to her home. Katie Strong: How very ‘Audrey'. Erin O'Bryan: Yes, it was lovely. And I got to visit her with all her kitty cats. So, I asked her advice because I was applying for an Assistant Professor position after 10 years of working in health care. And I remember that she was so excited about her speechpathology.com video series and the related book that she was working on with Roberta Elman that she liked to call the Social Imperative of the LPAA, which I believe is the subtitle of that book. And Katie, I think you were a part of both the video series and the book. Katie Strong: I was, yes. Erin O'Bryan:  Well, Audrey just loved that. She was so excited about that, and she told me to learn everything I could about the LPAA. And she said, “I must join Aphasia Access.” She said, “that's where all the important work is happening.” So that year I listened to loads of Aphasia Access podcasts, and I got very familiar with the Chapey and Colleagues LPAA Values chapter. So then as I'm sitting there talking to Harold, I'm thinking about the LPAA value, everyone affected by aphasia is entitled to service. So, I mean, who is affected more than a spouse? So definitely I was thinking about having the care partner being involved seemed like a wonderful thing. And I was also thinking that Harold and Rosella's approach shared so many similarities with Script Training, which I have loved and have been using in healthcare care since grad school. And there also are similarities with ORLA and Multiple Oral Rereading. And all of these are evidence-based treatment approaches. So, I felt pretty confident that Aphasia-Friendly Reading could be a very valuable intervention. So, I said to Harold, “I'd like to try using your approach with other people with aphasia and their care partners in our clinic”. And Harold was happy for us to try it. Katie Strong: I love that. I love that. And just for our listeners, we'll put some links and references in the show notes for some of the approaches like ORLA and Script Training that Erin has mentioned in addition to Harold's book and some other some other resources too. Erin O'Bryan: Yes, thank you, Katie. Those are all wonderful resources for people to be looking at. So, my grad students and I started a pilot study with a woman with aphasia and her husband. And they were actually friends of Harold and Rosella's from their aphasia group. We use the pseudonyms Cora and Dave when we describe them in our papers. It became clear that we needed to make a few adaptations to Harold's approach for use in the clinic. For one thing, I wanted the person with aphasia to have the largest role in selecting the story topic and deciding what she wanted to say. For our first session, we asked Cora and Dave to bring ideas for a story that Cora wanted to tell. And we also suggested they consider bringing some related photos. In our first session, Cora, Dave, my grad student, Addison, and I all sat around the table and together we brainstormed about the story. Cora wanted it to be about a Caribbean cruise that she and Dave had gone on. She brought photos from that trip. Dave helped with supplying names and information about places that Cora wanted to talk about. Places from their shore excursions, such as having their picture taken with a donkey in St. Thomas and visiting the Bomba Shack on the island of Tortola. We got Cora's feedback on every line that was proposed, fine-tuning the story until Cora liked every line. And we also adjusted some of the lines to make them easier for her to say. So once Cora and Dave were happy with the story, we helped them practice during our sessions, one hour per week with my grad student, Addison and I at the clinic. And we gave a printout of the story and a practice log to record notes about their home practice. In this first pilot project, Cora and Dave practiced their story for eight sessions until Cora said she was ready to plan their story sharing celebration. Then they shared their story with their friends in aphasia group. And the clinicians and the other people with aphasia in the room were just amazed. And other people in the aphasia group said, “I want to do that!” So, after two people with aphasia and their care partners did Aphasia-Friendly Reading projects, I wrote a manuscript reporting the pilot results. And Katie, I had seen online that you were an editor of Perspectives at the time. So, I emailed you my manuscript and asked if it was appropriate for Perspectives. And you emailed me back and said, “let's meet online and talk about it.” I was so delighted that you were interested in my project. You suggested that I consider exploring the value of the intervention by interviewing the participants. And I didn't know anything about qualitative research. But, Katie, you helped me write great interview questions for the care partners. And you helped me learn thematic analysis so we could find the themes in the care partner's quotes. And so, after learning from you, I have come to love the thematic analysis process. I really think it leads to deep listening. What we learned from the interviews is that the care partners felt empowered by being included in the intervention and the care partners really valued the collaborative nature of the storytelling project and especially that the intervention was so different than the previous therapy experiences that they had had because it was person-centered, it was fun, and they got to share their story with other people in their lives. So, then the three of us, Harold, Katie, and I wrote our first article about Aphasia-Friendly Reading and it's published in Aphasiology and the title is, “I wasn't just sitting there”: Empowering care partners through the Aphasia-Friendly Reading Approach. And then in 2023, the three of us went to Boston and presented it at ASHA. Katie Strong: Thanks for sharing that, Erin. You know, I think the experience of the care partners saying that therapy was fun important to note. And Harold has mentioned that Rosella thought it was fun, and the other participants thought it was fun. And I guess I just want to bring home that hard work can, can still be fun or therapy can be fun. And especially when it comes from the person with aphasia and their care partners. The topics are generated by the client and care partner. They're sharing things that are really important to them that have happened in their past. I love it. Erin O'Bryan: And one of the care partners even said that they learned better when it was fun. Katie Strong: I love it. Fantastic. Erin, I was wondering if you could share some tips for clinicians who might be listening that are thinking about how they might be able to incorporate this Aphasia-Friendly Reading Approach into their practice. Erin O'Bryan: Thank you for asking, Katie. So, in the past year, you and I have been talking about how we want to make it as easy as possible for clinicians to use our storytelling approaches in regular clinical settings, outside of research. And we really want clinicians to realize that it takes almost no time to prep for a person-centered storytelling session. You just have to go into the session ready to actively listen to what the person with aphasia wants to say. I love the acronym PULSE that you and Barbara Shadden wrote about in your paper, The Power of Story and Identity Renegotiation. And then in our paper, we reviewed PULSE again. So just for our listeners, I'm going to go through it real quickly because I think these are great things for clinicians to keep in mind. The P in pulse is for partnerships, partnering with the person with aphasia. And in the case of Aphasia-Friendly Reading, the clinician partnering with the care partner also. The U in pulse is for uniqueness. So, the clinician should be prepared to help the person with aphasia tell their unique story. The L is for listening. The clinician needs to learn how to really listen. And S is for supporting the person with aphasia in telling their stories. For example, using communication ramps in Supported Conversation for Adults with Aphasia strategies to support communication. And then finally, the E impulse is for explore. So as a clinician, be ready to go off-road with your client to explore the story that they want to share. And as a clinician, know that it's okay, even it's great for you to do that. Katie Strong: I love that. I love that. Erin, I guess that leads us into sharing that we do have a paper that came out in 2024 called Person Centered Stories on the Main Stage in Intervention, which highlights examples from three different story projects, including Aphasia-Friendly Reading. So, we'll link that to the show notes as well. Erin O'Bryan: Yes, and this year at ASHA 2024, Katie, you and I are going to be also giving a talk about this work called Elevating Person-Centered Stories to the Main Stage in Aphasia Intervention. And we are looking forward to presenting this work hopefully to an audience of clinicians. Katie Strong: Yes, yes, we hope to see folks in Seattle for sure. Well, I want to bring back both Harold and Erin into this conversation. And I think one of the things that I've recognized through this collaboration that you and Harold and Rosella and later on I got to be a part of is that we really are all better together. And I was hoping each of you could take a moment to share how this work has changed your thinking or maybe some ideas about sharing with others about what you've learned from this collaboration. Harold Regier: Well, for me, one of the things that I think I really learned from this is that we care partners need the therapist and the therapist needs us care partners. And there are more ways in which we can work together than perhaps sometimes we have done it when we have just been sitting there. And so, I really, I'm so pleased to be able to feel that that we care partners are more involved or can be more involved in the whole therapy process than what so often we have been. But I think that one of the things that the therapist needs to help us understand is when is it appropriate for us to be part of the process and when it is not appropriate for us to be part of the part process. It's not a matter of us being there all the time and sometimes being in the way. So, I think that kind of very frank candid conversation with us would help us understand that. And I certainly understood better that that the role of the care partner in terms of helping the person with aphasia be able to communicate better is very different from the role of the therapist. I never tried to be the person who was the teacher, trying to let Rosella know how she should do better and how we might be able to improve our reading. We just did it and it came out the way it came out. But then when I see how Erin was working with other clients and the persons with aphasia and the family members together identified the stories that they were interested in putting together, and the therapist helped put that together into words that they then could repeat or share together and in a storyline, that that is the place where I think we can be so much more collaborative with the therapist in a process like that. So I just always was telling myself, “Don't be a therapist. Don't be a teacher. Don't try to say, well, you can do better than that. Just simply do what is natural.” And then I wish that the therapist would take the other role and really work hard to help the person with aphasia do better with their reading and their performance. We didn't do our reading for production. We did it for fun, as you were saying earlier. And then we did it because we wanted to share that fun and that experience with others. And that was so very, very satisfying for us. Those are some of the thoughts that have come to me in terms of the relationship between therapist and care partner. Katie Strong: Thanks Harold. Yeah, Erin, any thoughts? Erin O'Bryan: I've learned so much from this collaboration. From Harold, I learned what a difference it makes when a care partner puts so much time and thought into supporting their partner with aphasia's communication and her quality of life. Also I've seen how much Harold has done and I hope that me you know as a busy professor stopping and taking the time to tell him that I saw so much value in what he was doing at home with Rosella reading those videos together. I hope that this helped him realize that it was valuable to share. And I'm thrilled to say that Harold has been going around the state of Kansas giving talks about aphasia at colleges and senior living facilities. He's doing so much and I love to see that. And from collaborating with you, Katie, I've learned the importance of making the story sharing a really beautiful celebration honoring the person with aphasia and you know bringing special things like favorite food treats, beverages, flowers, and especially inviting the people that are important to the person with aphasia. We've now had five or six story sharing celebrations. It seems like everyone is more beautiful than the last. I've learned so much about that. And I've also learned that qualitative research helps me capture the meaningfulness of these projects and the meaningfulness as we're working with people with aphasia and that this research can be so fun and rewarding. Katie Strong: I love that. I love that. As I was listening to you, Erin, respond to Harold, it just sounds like together we can validate one another. The work that you're doing, you were doing with Rosella, Harold is very validating and then Erin bringing it into the lab to test it out and it's all beautiful. It's, it really is. And I guess as I reflect on this thought about what I've learned is to reiterate, Erin, something you said, that listening to family members or care partners and the ideas that they have to engage their loved ones in communication activities are so powerful and taking that time even if you are busy to listen and think and validate and see how that connects to the existing evidence-based literature. I think is really powerful. But I also think that there's this collaboration and the combination of care partners and clinicians and researchers. And of course, the person with aphasia at the center of all of that, making a powerful team to develop innovative methods of storytelling is really one of my big takeaways from all of this. Erin O'Bryan: Yes, that's wonderful. Harold Regier: I would like to give kudos to the therapists who worked with Rosella over the many, many years. Ten years of aphasia therapy, four of which were one-on-one, six of which were part of a support therapy group. Those therapists were such relational people, such encouraging people, and also knew the techniques that work in therapy. So, I wanted to say that those years were very, very meaningful, very, very helpful, and helped us with the day-to-day kind of living with hope, with the expectations that things can continue to get better. Katie Strong: Thank you, Harold. Yeah. Erin, any other thoughts as we wrap this up today? Erin O'Bryan: Well, I just wanted to say that I would never recommend that all intervention involve the care partner because I understand that it's good for the person with aphasia to get one-on-one time with the clinician. But don't forget that that care partner is often with the person with aphasia almost 24/7 and we may only see them one or two hours a week. So, it's so important that we do more to really educate the care partner about how to acknowledge the competence of the person with aphasia and really how to support their communication. So that's why I really want us to do more with in involving the care partner and in intervention. So, I'll get off my soapbox. Thank you, Katie, for letting us share about this project that I love. Katie Strong: I'm so delighted that we could have this time together today. Harold, thank you for your generosity and sharing your ideas and Rosella's stories with us and this beautiful work of Aphasia-Friendly Reading and Erin for your work in the lab and bringing it to the clinic. On behalf of Aphasia Access, thank you for listening. For references and resources mentioned in today's show, please see our show notes. They're available on our website, www.aphasiaaccess.org. There you can also become a member of our organization, browse our growing library of materials, and find out about the Aphasia Access Academy. If you have an idea for a future podcast episode, email us at info@aphasiaaccess.org. For Aphasia Access Conversations, I'm Katie Strong. Thanks again for your ongoing support of Aphasia Access. Contact information for Guests – Harold Regier hrregier@cox.net  Erin O'Bryan, PhD., CCC-SLP erin.obryan@wichita.edu  Resources Aphasia Institute's Introduction to Supported Conversation for Adults with Aphasia (SCA™) eLearning. https://www.aphasia.ca/health-care-providers/education-training/online-options/ Chapey, R., Duchan, J. F., Elman, R. J., Garcia, L. J., Kagan, A., Lyon, J. G., & Simmons-Mackie, N. (2000).Life Participation Approach to Aphasia: A statement of values for the future. The ASHA Leader, 5(3). https://doi.org/10.1044/leader.FTR.05032000.4 Cherney, L. R. (2010). Oral reading for language in aphasia: Impact of aphasia severity oncross-modal outcomes in chronic nonfluent aphasia. Seminars in Speech and Language, 31, 42–51. https://doi.org/10.1055/s-0029-1244952 Cherney, L. Babbitt, E., Oldani, J., & Semik, P. (2005). Efficacy of repeated choral reading for individuals with chronic nonfluent aphasia. [Clinical Aphasiology Paper]  http://aphasiology.pitt.edu/1548/  Kaye, R., & Cherney, L. R. (2016). Script templates: A practical approach to script training in aphasia. Topics in Language Disorders, 36(2), 136–153. https://doi.org/10.1097/2FTLD.0000000000000086 O'Bryan, E. L., Regier, H. R., & Strong, K. A. (2023). “I wasn't just sitting there”: Empowering care partners through the Aphasia-Friendly Reading approach. Aphasiology. https://doi.org/10.1080/02687038.2023.2272956 O'Bryan, E. L., & Strong, K. A. (2024). Person-centered stories on the main stage in intervention: Case examples from the My Story Project, Aphasia! This Is Our World, and Aphasia-Friendly Reading. Perspectives of the ASHA Special Interest Groups. https://pubs.asha.org/doi/10.1044/2024_PERSP-23-00272 Regier, H. (2021). A Decade of Aphasia Therapy: Aphasia-Friendly Reading: A Technique for Oral Communication. Independently published Available on Amazon Strong, K. A. & Shadden, B. B. (2020). Stories at the Heart of Life Participation: Both the Telling and Listening Matter. Chapter 5. In A. L. Holland & R. J. Elman (Eds.) Neurogenic communication disorders and the Life Participation Approach: The social imperative in supporting individuals and families (pp. 105-130) Plural Publishing. Strong, K. A & Shadden, B. B. (2020). The power of story in identity renegotiation: Clinical approaches to supporting persons living with aphasia. ASHA Perspectives, SIG 2, 5, 371-383. https://pubs.asha.org/doi/pdf/10.1044/2019_PERSP-19-00145 Youmans, G., Holland, A., Munoz, M. L., & Bourgeois, M. (2005). Script training and automaticity in two individuals with aphasia. Aphasiology, 19(3/4/5), 435–450. https://doi.org/10.1080/02687030444000877

About our Guest: Debra Regier, M.D., Ph.D.,  is the chief of Genetics and Metabolism at Children's National Hospital in Washington, DC. Before transitioning to clinical medicine, Dr. Regier was a biochemist. She came to CNH as a combined pediatric genetics resident and later completed a metabolic fellowship at NIH and served as Children's National's medical genetics program director. Dr. Regier's current work in educational outcomes research has led to federal, industry, and philanthropic funding of almost two million dollars. She has received multiple awards for her impact on rare disease education across the country and is the president-elect of the Society of Inherited Metabolic Disorders. Learning Objectives:By the end of this podcast, listeners should be able to:1. List the three main metabolic pathways and describe how they work together to make ATP2. Describe the science behind the main diagnostic tests for inborn errors of metabolism3. Explain the presenting symptoms and initial management of common, life-threatening inborn errors of metabolism. Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show. Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

About our Guest: Debra Regier, M.D., Ph.D.,  is the chief of Genetics and Metabolism at Children's National Hospital in Washington, DC. Before transitioning to clinical medicine, Dr. Regier was a biochemist. She came to CNH as a combined pediatric genetics resident and later completed a metabolic fellowship at NIH and served as Children's National's medical genetics program director. Dr. Regier's current work in educational outcomes research has led to federal, industry, and philanthropic funding of almost two million dollars. She has received multiple awards for her impact on rare disease education across the country and is the president-elect of the Society of Inherited Metabolic Disorders. Learning Objectives:By the end of this podcast, listeners should be able to:1. List the three main metabolic pathways and describe how they work together to make ATP2. Describe the science behind the main diagnostic tests for inborn errors of metabolism3. Explain the presenting symptoms and initial management of common, life-threatening inborn errors of metabolism. Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show. Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

In this conversation, I sat down Dr. Nate Regier, Founder and CEO of Next Element, and author of Compassion Accountability: How Leaders Build Connection and Get Results. We talked about so many wonderful topics focused on the importance of compassion and accountability in leadership and organizations. We explored how it can be applied to create meaningful change, as well as the challenges of navigating conflict and the need for a mindset shift in order to embrace vulnerability and authenticity. Nate shares his journey and how the power of compassion and the potential it has to transform individuals, teams, and organizations. I hope you enjoy it as much as I did! Stacie More episodes at StacieBaird.com. Links to Nathan Regier Compassion Accountability Book Next-Element.com website Nate Regier's LinkedIn Page  

Full episode here! https://www.spreaker.com/episode/bg-s2-the-pre-nicene-rabbit-hole-pt-3-with-david-regier--59408439BG Cast Podcasthttps://www.spreaker.com/show/bgcastForbidden Knowledge Network https://forbiddenknowledge.newsBecome a supporter of this podcast: https://www.spreaker.com/podcast/forbidden-knowledge-news--3589233/support.

Tonight I'll be sitting down with my guest David Regier to dive back in once again, into Pre Nicene Christianity and why this version of Christianity should be the one were following. Check out Forbidden Knowledge Network and support BOTH documentaries:www.forbiddenknowledge.newshttps://watch.amazon.com/detail?gti=amzn1.dv.gti.763483a7-ad3f-4990-b5b3-98897169249c&territory=US&ref_=share_ios_movie&r=webCheck out We Are Change Colorado!http://www.wearechangecolorado.com/http://www.youtube.com/user/WACCTVCheck out Gaia Avani Naturals!www.gaiaavaninaturals.comCheck out Root to Bloom!http://rtbwholehealth.com/Check out Milagro Mushroomswww.milagromushrooms.comWatch Jones Plantation!https://jonesplantationfilm.com/?fbclid=IwAR0zE6457BtHWhrH1iyHKUscUsnPCPZNkE7tS0wPfw8n3N1Jd6RakDNX38w Links:https://theosophy.wiki/en/Egregorehttps://theosophy.wiki/en/Thought-Formshttps://exemplore.com/new-age-metaphysics/What-is-an-egregorehttps://blog.philosophicalsociety.org/2019/01/06/egregore-and-freemasonry/https://www.newdawnmagazine.com/articles/newscience-consciousness/the-power-of-egregores-an-interview-with-mark-stavishhttps://spiritualphoenixstudios.com/blog/egregores-understanding-how-collective-thoughtforms-impact-our-liveshttps://theosophy.wiki/en/Monad Maiden Anarchy's audio book: https://l.facebook.com/l.php?u=https%3A%2F%2Fm.youtube.com%2Fwatch%3Ffbclid%3DIwAR2u-UQ0GV4ERROOa_EwwASJa-Y0k7vKmK73FqIVjYdjGE7yZ_-_ead9EKg%26v%3De8z6SXta5l4%26feature%3Dyoutu.be&h=AT0Aos6sE22YvO4aLFMrcIBzR7J6vj2PyJZ9hqO8z38yMhJBXUIQV9sZnfmOA4_LoZtL9fjcZH1wnsf73CHHKjLKGWA1pnmUzDFnetXlkUmeIeOKXNe4Y-Fwl63GJiy3Q_4wFp0tZqJovw8-hlZwAA I do not own the song

Program

“Let's do this together” with Dr. Nate Regier Power Quote: Conflict has a purpose  Description:One of the most frequent things I'm asked about is how to have difficult conversation. I have some thoughts, but I'm not an expert. That's why today's guest is here. What if we looked at conflict as an opportunity? What if accountability was something we did with people instead of to them? And what if through the process of helping people be responsible, we were also helping them be authentic human beings, increasing their agency and self-worth through the accountability process? Sound too good to be true? It's not, and Nate Regier is going to help us learn how to do it. Guest Bio:“Nate Regier, PhD, is the CEO and founding owner of Next Element Consulting, a global leadership consulting and training firm helping build cultures of compassionate accountability. Dr. Regier is a former practicing psychologist and expert in social-emotional intelligence, interpersonal communication, conflict skills, and leadership. Recognized as a Top 100 keynote speaker, he is a Process Communication Model® Certifying Master Trainer. Nate is the author of four books: Beyond Drama; Conflict without Casualties; Seeing People Through; and his newest book, Compassionate Accountability. He hosts a podcast called “On Compassion with Dr. Nate,” writes a weekly blog, contributes to multiple industry publications, and is a regular guest on podcasts.” Warmup questions:·      We always like to start with a celebration. What are you celebrating today?·      Is there a story that will help listeners understand why you are doing what you do? Welcome back! We last heard from you back in July in episode 143 Outline·      Difference between empathy and compassion·      Helping people be accountable versus holding them accountable?·      Accountability as a relationship, not an action·      New teacher struggling, but sometimes leader doesn't know how to support?·      ORPO for a struggling new teacher Closing questions:·      What part of your own leadership are you still trying to get better at?·      If listeners could take just one thing away from today's podcast, what would it be?·      Before we go, is there anything else that you'd like to share with our listeners?·      Where can people learn more about you and your work… Close·      Leadership is a journey and thank you for choosing to walk some of this magical path with me.·      You can find links to all sorts of stuff in the show notes, including my website https://www.frederickbuskey.com/·      I love hearing from you so consider email me at frederick@frederickbuskey.com or connecting with me on LinkedIn.·      Please remember to subscribe, rate, and review the podcast.·      Have a great rest of the week, be present for others and, more importantly, take time to reflect and recover so you can continue to live and lead better.·      Cheers!  Nate's links:https://www.next-element.com/ Frederick's Links:Email: frederick@frederickbuskey.comWebsite: https://www.frederickbuskey.com/LinkedIn: http://www.linkedin.com/in/strategicleadershipconsultingDaily Email subscribe: https://adept-experimenter-3588.ck.page/fdf37cbf3a

“The earth is the Lord's and all that is in it, the world, and those who live in it, for he has founded it on the seas and established it on the rivers.” Psalm 24:1-2: Mark Regier is Vice President of Stewardship Investing at Praxis Mutual Funds. WHAT IS STEWARDSHIP INVESTING AND HOW DOES IT INCORPORATE CREATION CARE?Stewardship investing is an approach rooted in biblical principles, emphasizing responsibility and management of all that God has entrusted to us. It involves recognizing God's ownership over everything and managing resources wisely and according to His wishes. This philosophy extends to caring for our neighbors, seeking justice, peace, and importantly, caring for the world God created.Stewardship investing is about managing resources as God's stewards, recognizing His ownership.The approach involves investing responsibly and ethically, integrating care for neighbors and the environment.It emphasizes investing in ways that do not harm the world but seek to improve it, aligning with biblical stewardship. HOW CAN INVESTMENT MANAGERS SUPPORT CREATION CARE?Investment managers can support creation care through various strategies, including investing in green and social bonds, engaging in shareholder advocacy, and community investing. Green and social bonds finance projects with positive environmental or social impacts. Shareholder advocacy involves using shareholder power to influence corporate behavior towards more sustainable practices. Community investing directs funds to help marginalized communities adapt to a changing climate and embrace emerging technologies.Investing in green and social bonds that finance environmentally friendly projects.Engaging in shareholder advocacy to influence corporate policies and practices.Community investing to support marginalized groups affected by environmental changes. WHAT IS GREENWASHING AND HOW CAN INVESTORS AVOID IT?Greenwashing is when companies or funds claim to be more environmentally friendly or engaged in sustainable practices than they actually are. It's important for investors to research and verify these claims. To avoid greenwashing, investors should look deeply into company or fund activities, visit their websites for environmental reports, understand the information's source, and consider the company's willingness to discuss and address environmental issues. Transparency and evidence of genuine sustainable practices are key to discerning genuine efforts from greenwashing.Greenwashing is misleading claims about environmental practices or benefits.Investors should research and verify environmental claims made by companies or funds.Looking at a company's actual environmental policies, actions, and willingness to engage in discussions about sustainability can help avoid greenwashing. ON TODAY'S PROGRAM, ROB ANSWERS LISTENER QUESTIONS:I live on a fixed income of less than $1,000 a month and want to tithe. Should I adjust my expenses to give 10% or is it more about the condition of my heart when it comes to giving?I have a CD maturing and I'm considering locking into a longer term at a higher interest rate. Is it advisable to lock in for a longer term, like 4.75% for five years? Remember, you can call in to ask your questions most days at (800) 525-7000. Faith & Finance is also available on the Moody Radio Network as well as American Family Radio. Visit our website at FaithFi.comwhere you can join the FaithFi Community, and give as we expand our outreach.   Remember, you can call in to ask your questions most days at (800) 525-7000. Faith & Finance is also available on the Moody Radio Network and American Family Radio. Visit our website at FaithFi.com where you can join the FaithFi Community and give as we expand our outreach.

On today's program: Dr. James Dobson, FRC's founder, shares how then-President Jimmy Carter's 1980 White House Conference on Families inspired the formation of FRC. Dr. Jerry Regier, FRC's first president, talks about the initial vision for FRC.

Whether it's disagreements with your partner or clashes within your team, one thing is clear – conflict is a part of life. Dr. Nate Regier understands that conflict is unavoidable, but he believes it can be turned into something positive. With his framework Compassionate Accountability, Dr. Regier has helped many groups use conflict as a catalyst for growth and positive change.Dr. Nate Regier is an author and keynote speaker. He's the founder and CEO of Next Element, a global leadership consulting and training firm. He has helped clients like Healthcare Corporation of America (HCA), Blue Cross Blue Shield, and Roche for over a decade, increasing profitability through reduced turnover while significantly enhancing teamwork and work relationships.In this episode, Dart and Nate discuss:- How to de-dramatize an organization- The definition of conflict and how to address it productively- The three roles in every drama and how to pinpoint them at work- The myths that these roles believe- Universal principles we can use when designing work- How to hold yourself accountable- Having a compassion mindset- The 3 narratives of struggle that can get management into trouble- And other topics…Dr. Nate Regier is an author, keynote speaker, and the founder and CEO of Next Element, a global leadership consulting and training firm that works to bring Compassionate Accountability to the workplace. As a former practicing psychologist and expert in social-emotional intelligence, Nate has helped clients like Healthcare Corporation of America (HCA), Ascension Health, Blue Cross Blue Shield, CarFax, and Roche save thousands in turnover and dramatically increase and improve teamwork and work relationships. Nate received his Ph.D. in psychology from the University of Kansas. He is recognized as a Top 100 keynote speaker, a Process Communication Model® Certifying Master Trainer, and the author of four books on interpersonal communications. He has served as an adjunct professor for Conflict Resolution at Pepperdine University for over a decade and is also a founding member of the Changing Work Collective. Resources mentioned:Compassionate Accountability, by Nate Regier: https://www.amazon.com/Compassionate-Accountability-Leaders-Connection-Results/dp/1523004533 Conflict Without Casualties, by Nate Regier: https://www.amazon.com/Conflict-without-Casualties-Compassionate-Accountability/dp/1523082607 Connect with Nate:www.Next-element.com

One of the most challenging aspects of our work is holding our people accountable. I've yet to meet a leader who doesn't wish that they didn't have to and that team members would do it for themselves. But we all know that's not how it works! Holding team members accountable can feel like a parent scolding or punishing the child, and no one enjoys that, mainly when dealing with a peer. Is there a way to effectively hold team members accountable without it turning into a dysfunctional parent-child scenario? The "Great Resignation," "Quiet Quitting," and “Remote Working” have all made accountability more critical than ever. How can we hold leaders accountable with compassion?  Well, the answer is something that our next guest has been dedicated to not only discovering but implementing. Our guest for the next two episodes is Dr. Nate Regier. Nate and his team at Next Element have pioneered the Compassionate Accountability framework, ushering in a new paradigm of leadership that helps organizations thrive in complex and challenging environments. Nate Regier is the CEO and founding owner of Next Element Consulting, a global leadership consulting and training firm that build cultures of compassionate accountability. Dr. Regier is a former practicing psychologist and expert in social-emotional intelligence, interpersonal communication, conflict skills, and leadership. Recognized as a Top 100 keynote speaker, Nate is a Process Communication Model® Certifying Master Trainer. He hosts a podcast called "On Compassion with Dr. Nate."   Nate is also the author of four books: Beyond Drama, Conflict without Casualties, Seeing People Through, and his newest book, Compassionate Accountability. Website https://thecompassionmindset.com https://Next-Element.com  Social Media https://twitter.com/NextNate     https://www.linkedin.com/in/nateregier Part 2: Value, Capability and Responsibility  Everyone Wants to Feel Valuable (even the destructive ones) Compassionate Accountability for Inserting Foot in Mouth Diversity and Inclusion a Compassionate Accountability Conversation Emergence Room Applications of Compassionate Accountability  Compassionate Accountability and Creating Evangelical Talent When We Need to Hold Someone More Senior Accountable Fighting For What Really Matters Climbing The Corporate Ladder When Women Become Men  Compassionate Accountability for Deepening Your Street Credibility The 4 Kinds of Struggle: Knowing Which One is Productive Bringing Justification to an End Accountability, Value, and Responsibility in Leadership Beliefs, Values, and Their Impact on Decision-Making  Empathy, Curiosity, and Connection in a Diverse World ___________________ Dov Baron's brand new course has just been released on coursifyx.com/belonging Titled: "CREATING A CULTURE OF BELONGING." The course is separated into eight sections that will take you by the hand and walk you through exactly how to create a culture of belonging. Because: CREATING A CULTURE OF BELONGING MAXIMIZES PERSONAL AND CORPORATE SUCCESS.   Get Ready to strap on the tanks and Dive Deep into, What it Takes to Create a Culture of Belonging in your organization! Curious to know more, coursifyx.com/belonging  "Those Who Control Meaning for The Tribe, Also Control The Movement of That Tribe" #videopodcast #leadership #leadershipdevelopment #emotionsourcecode #neuroscience #emotional #meaning #emotional #logic #culture #curiosity #humanbehavior #purpose Learn more about your ad choices. Visit megaphone.fm/adchoices

One of the most challenging aspects of our work is holding our people accountable. I've yet to meet a leader who doesn't wish that they didn't have to and that team members would do it for themselves. But we all know that's not how it works! Holding team members accountable can feel like a parent scolding or punishing the child, and no one enjoys that, mainly when dealing with a peer. Is there a way to effectively hold team members accountable without it turning into a dysfunctional parent-child scenario? The "Great Resignation," "Quiet Quitting," and “Remote Working” have all made accountability more critical than ever. How can we hold leaders accountable with compassion?  Well, the answer is something that our next guest has been dedicated to not only discovering but implementing. Our guest for the next two episodes is Dr. Nate Regier. Nate and his team at Next Element have pioneered the Compassionate Accountability framework, ushering in a new paradigm of leadership that helps organizations thrive in complex and challenging environments. Nate Regier is the CEO and founding owner of Next Element Consulting, a global leadership consulting and training firm that build cultures of compassionate accountability. Dr. Regier is a former practicing psychologist and expert in social-emotional intelligence, interpersonal communication, conflict skills, and leadership. Recognized as a Top 100 keynote speaker, Nate is a Process Communication Model® Certifying Master Trainer. He hosts a podcast called "On Compassion with Dr. Nate."   Nate is also the author of four books: Beyond Drama, Conflict without Casualties, Seeing People Through, and his newest book, Compassionate Accountability. Website https://thecompassionmindset.com https://Next-Element.com  Social Media https://twitter.com/NextNate     https://www.linkedin.com/in/nateregier Part 1: Compassion and Accountability - A Perfect Marriage Where "turn the other cheek" Fails  Lessons from Africa  Holding Team Members Accountable Without Toxic Dynamics  Pragmatic Compassion Using Conflict as a Catalyst for Change Are Compassion and Accountability at Odds We Forget That the Problem Is the Problem Struggle as Intimacy - Brothers and Sisters in Arms The Difference Between an Intelligent, Motivated, Capable Human. The 3 Switches That Will Power Up Your Leadership  Setting The Foundation for Being Part of a Solution Lessons in Compassionate Accountability from a Two-Year-Old  Compassionate Accountability and Resistance ___________________ Dov Baron's brand new course has just been released on coursifyx.com/belonging Titled: "CREATING A CULTURE OF BELONGING." The course is separated into eight sections that will take you by the hand and walk you through exactly how to create a culture of belonging. Because: CREATING A CULTURE OF BELONGING MAXIMIZES PERSONAL AND CORPORATE SUCCESS.   Get Ready to strap on the tanks and Dive Deep into, What it Takes to Create a Culture of Belonging in your organization! Curious to know more, coursifyx.com/belonging  "Those Who Control Meaning for The Tribe, Also Control The Movement of That Tribe" #videopodcast #leadership #leadershipdevelopment #emotionsourcecode #neuroscience #emotional #meaning #emotional #logic #culture #curiosity #humanbehavior #purpose Learn more about your ad choices. Visit megaphone.fm/adchoices

We all know it's important, but only a few of us know where to start: safeguarding and safe handling of data. Fortunately, Thomas and Kivanc are two of the aforementioned few, having built the number 1 PIC solution that now serves over 3,000 organizations worldwide. Dataguard is essentially one-stop shopping for privacy, information security and compliance matters. Thomas and Kivanc discussed current privacy regulations and mandates, how Dataguard assists companies in self-inspecting their data setup for vulnerabilities and compliance issues, as well as differences in privacy policies between the EU and US and why having a secure data setup need not come at the expense of performance.

Dr. Nate Regier reveals his process for practicing compassionate accountability that builds relationships. — YOU'LL LEARN — 1) The three switches for greater compassion every day. 2) A handy template for dealing with any conflict. 3) Why lowering standards doesn't help those struggling. Subscribe or visit AwesomeAtYourJob.com/ep888 for clickable versions of the links below. — ABOUT NATE — Nate Regier, PhD, is the CEO and founding owner of Next Element Consulting, a global leadership consulting and training firm helping build cultures of compassionate accountability. Dr. Regier is a former practicing psychologist and expert in social-emotional intelligence, interpersonal communication, conflict skills, and leadership. Recognized as a Top 100 keynote speaker, he is a Process Communication Model® Certifying Master Trainer. Nate is the author of four books: Beyond Drama; Conflict without Casualties; Seeing People Through; and his newest book, Compassionate Accountability. He hosts a podcast called “On Compassion with Dr. Nate,” writes a weekly blog, contributes to multiple industry publications, and is a regular guest on podcasts. • Book: Compassionate Accountability: How Leaders Build Connection and Get Results • LinkedIn: Nate Regier • Previous episode: 216: Transforming Conflict Into Breakthroughs with Dr. Nate Regier — RESOURCES MENTIONED IN THE SHOW — • Software: Calendly • Grill: Big Green Egg • Personality: Wayne Dyer • Book: Atlas of the Heart: Mapping Meaningful Connection and the Language of Human Experience by Brene Brown • Book: Compassionomics: The Revolutionary Scientific Evidence That Caring Makes a Difference by Stephen Trzeciak and Anthony Mazzarelli See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Compassion is trending and has gone through quite an evolution. Kevin sits down with Nate Regier to discuss that compassion and accountability can coexist and are crucial for effective leadership; they are not mutually exclusive. He shares three foundational switches of compassion: value, capability, and responsibility. Each switch represents a decision or choice made in relation to others. Listen for... 00:00 Introduction to the topic of compassion and accountability in business 01:23 The decision to write the book and the importance of compassion 02:35 Definition of compassionate accountability and its importance in leadership 08:05 The difference between accountability and responsibility 10:07 The evolution of compassion in the business world 15:39 The three switches of compassion: value, capability, and responsibility 24:45 Implementing compassionate accountability in organizational culture 29:25 Overcoming barriers to compassionate accountability 31:56 Where to learn more about the book and take the assessment 33:09 The importance of taking action and implementing the ideas discussed Meet Nate His Story: Nate Regier, Ph.D., is the author of four books: Beyond Drama; Conflict without Casualties; Seeing People Through; and his newest book, Compassionate Accountability. He is the CEO and founder of Next Element Consulting, a global leadership consulting and training firm helping build cultures of compassionate accountability. Dr. Regier is a former practicing psychologist and expert in social-emotional intelligence, interpersonal communication, conflict skills, and leadership. Nate is a sought-after keynote presenter, recognized as a Top 100 keynote speaker. Nate is the author of four books: Beyond Drama; Conflict without Casualties; Seeing People Through; and his newest book, Compassionate Accountability. He hosts a podcast called “On Compassion with Dr. Nate,” writes a weekly blog, contributes to multiple industry publications, and is a regular guest on podcasts. https://www.next-element.com/compassionateaccountabilitybook/ https://www.linkedin.com/in/nateregier/ https://www.next-element.com/ This episode is brought to you by... The Long-Distance Team. Remote leadership experts, Kevin Eikenberry and Wayne Turmel, help leaders navigate the new world of remote and hybrid teams to design the culture they desire for their teams and organizations in their new book! Book Recommendations Compassionate Accountability: How Leaders Build Connection and Get Results by Nate Regier PhD Atlas of the Heart: Mapping Meaningful Connection and the Language of Human Experience by Brené Brown The Performance Paradox: Turning the Power of Mindset into Action by Eduardo Briceño Related Episodes Leading with Compassionate Accountability with Nate Regier Creating the We Mindset with Dr. Eric George Understanding the Success Mindsets with Ryan Gottfredson

Dr. Nate Regier joins us in this interesting podcast episode to discuss why he believes that the biggest crisis facing our modern world today is the misuse of conflict. He shares interesting concepts and tools that can turn conflict into a partner for positive change within our communities.  Nate Regier is the CEO and co-founder of Next Element Consulting, a global leadership firm dedicated to bringing compassion into the workplace. Dr. Regier is a former practicing psychologist and expert in social-emotional intelligence, interpersonal communication, and leadership. Recognized as a Top 100 keynote speaker, he is a Process Communication Model® Certifying Master Trainer. To find out more about Nate's best-selling book, Conflict without Casualties: A Field Guide for Leading with Compassionate Accountability, please visit: https://www.amazon.com/Conflict-without-Casualties-Compassionate-Accountability/dp/1523082607   

According to DDI's 2023 global leadership forecast, the top skills of leaders who boost engagement, retain great employees and create cultures that thrive is interpersonal communication skills. When it comes to interpersonal communication skills, one of the most common questions we get asked is, “How do you balance kindness, care and concern with attention to outcomes?” Everyone struggles with this tension. Yet, it's the holy grail for safe, thriving cultures. Here's the conundrum. Compassion without accountability gets you nowhere. Accountability without compassion gets you alienated. You can't win if you pick sides, and trying to perform a balancing act between them is no better. The good news is that leaders no longer have to choose. Nate Regier, PhD, is the CEO and founder of Next Element Consulting, a global leadership consulting and training firm helping build cultures of compassionate accountability. Dr. Regier is a former practicing psychologist and expert in social-emotional intelligence, interpersonal communication, conflict skills, and leadership. Nate is a sought-after keynote presenter, recognized as a Top 100 keynote speaker. Nate is the author of four books: Beyond Drama; Conflict without Casualties; Seeing People Through; and his newest book, Compassionate Accountability. He hosts a podcast called “On Compassion with Dr. Nate,” writes a weekly blog, contributes to multiple industry publications, and is a regular guest on podcasts. Topics [00:04:44] "Compassionate accountability – not opposites" [00:06:57] Compassion mindset values people's capabilities, responsibilities. [00:11:28] Value switch: affirm experiences, separate person, vulnerability. [00:15:00] Leaders feel alone; Mastermind combats it. [00:17:02] Compassion and vulnerability create transformation in community. [00:21:48] Maximize capability through curiosity and investment. [00:27:13] Prescription for leaders: empathize, learn, aspire. [00:31:05] Accountability vs responsibility for leaders and teams. [00:34:22] Middle managers have limited control management advice. For the full show notes be sure to check out our website: https://leaddontboss.com/265

In this episode of The Neighboring Movement Podcast, host Adam sits down with long-time friend and colleague Dr. Nate Regier. A former psychologist - and now leadership consultant, speaker, and author - Dr. Regier presents his newest book and wisdom around the culture-changing practice of compassionate accountability.Nate Regier, PhD, is the CEO and founding owner of Next Element Consulting, a global leadership consulting and training firm helping build cultures of compassionate accountability. Dr. Regier is a former practicing psychologist and expert in social-emotional intelligence, interpersonal communication, conflict skills, and leadership. Recognized as a Top 100 keynote speaker, he is a Process Communication Model® Certifying Master Trainer. Nate is the author of four books: Beyond Drama; Conflict without Casualties; Seeing People Through; and his newest book, Compassionate Accountability. He hosts a podcast called “On Compassion with Dr. Nate,” writes a weekly blog, contributes to multiple industry publications, and is a regular guest on podcasts.To check out and purchase Dr. Regier's newest book, click here. Or, to see what all Next Element is up to, visit their website here! Finally, to get in touch with Dr. Regier and his team, email them here.

What is compassionate accountability? How can it help individuals and organizations? Join Marcus as he hosts Dr. Nate Regier, Ph.D. and the host of On Compassion with Dr. Nate as the two talk pacifism and a challenge of non-violence and what it takes to create a compassionate culture in an organization. Dr. Nate tells a grim tale of being with a trauma survivor before EMS arrived and learn how these two strangers became brothers from other mothers. Key topics:00:00 – Introductions00:30 – Marcus introduces Nate Regier, PhD.01:43 – Marcus asks about Next Element Consulting and how Nate got into the field of compassion.05:11 – Nate is asked about compassion and accountability.09:45 – The two talk about the role of judgement in compassion and self-compassion.12:31 – Marcus pivots the conversation and asks about how organizations react to this kind of consulting and integrating compassion into the workforce.14:37 – Nate shares two stories of experiencing compassion. 21:40 – Marcus steers the conversation to compassion in healthcare and Nate talks about burnout and changing outcomes. 27:30 – The two talk about Nate's paper The Compassion Crisis in Healthcare.30:00 – Marcus asks his famous rapid-fire questions. Nate wants to leave us with “Compassion is what makes us human, it's what brings us together, and it's what gets us back on track when we lose our way.”36:55 – Thank you and conclusions! Resources for you: More communication tips and resources for how to cultivate compassion: https://marcusengel.com/freeresources/Learn more about Next Element Consulting: https://www.next-element.comConnect with Marcus on LinkedIn: https://www.linkedin.com/in/marcusengel/Connect with Nate on LinkedIn: https://www.linkedin.com/in/nateregier/Follow Nate on Twitter: @nextnateLearn more about Marcus' Books: https://marcusengel.com/store/Subscribe to the podcast through Apple: https://bit.ly/MarcusEngelPodcastSubscribe to the podcast through Spotify: https://bit.ly/Spotify-MarcusEngelPodcast More About Nate Regier, PhD:Nate Regier, PhD, is the CEO and founding owner of Next Element Consulting, a global leadership consulting and training firm helping build cultures of compassionate accountability. Dr. Regier is a former practicing psychologist and expert in social-emotional intelligence, interpersonal communication, conflict skills, and leadership. Recognized as a Top 100 keynote speaker, he is a Process Communication Model® Certifying Master Trainer. Nate is the author of four books: Beyond Drama; Conflict without Casualties; Seeing People Through; and his newest book, Compassionate Accountability. He hosts a podcast called “On Compassion with Dr. Nate,” writes a weekly blog, contributes to multiple industry publications, and is a regular guest on podcasts. Date: 5/15/2023Name of show: Compassion & Courage: Conversations in HealthcareEpisode title and number: Episode 102 – Nate Regier, PhD - Compassionate Accountability

Republican lawmakers say they delivered for Montanans. Democrats say they kept a lot of bad things off the books. The Regier family reigned over much of the action. And this session marked a political turning point — but in what direction?

Republican lawmakers say they delivered for Montanans. Democrats say they kept a lot of bad things off the books. The Regier family reigned over much of the action. And this session marked a political turning point — but in what direction?

This week is the majority party hour we'll hear from Speaker of the House Matt Regier on what's left to get done in the final 12 days of the session.

Former Student and Staff Member Lugi Regier shares observations on Jesus' Triumphal Entry. (John 11 & Luke 19)

Joined by wrestling podcaster and former sportswriter Phil Strum, Mike and Dan remember two short time Islanders who became general managers as well as the most obscure player we have ever featured. Don Maloney and Darcy Regier are mostly remembered as GMs these days, but both played for the Islanders under different circumstances. Maloney signed as a free agent after many years with the hated Rangers, and after two seasons, stepped right into the front office, eventually succeeding the legendary Bill Torrey. It started well but... didn't end there. Regier came over in an important pre-Dynasty trade, but had no place to play on a stacked Islanders roster. He would work his way up the executive ladder and forge paths using some cutting edge methods until he also reached the GM chair... for a team that wasn't the Islanders. Finally, there is Garth MacGuigan, a man who played only five career NHL games, all with the Islanders. It wasn't much, but it was long enough to have a memorable interaction with a very young and budding sportswriter, Phil Strum. Check out Phil's podcast, Under the Ring: Pro Wrestling Conversations everywhere podcasts are found. Subscribe to our Patreon! Plans start as low as $2 a month and patrons get ad-free episodes of the shows, bonus podcasts, written posts, discounts and much more. Visit our friends: Vintage Ice Hockey for t-shirts, hoodies and jerseys with hundreds of classic hockey logos, and our Al Arbour and The Island merch which benefit dementia research. If you spend $50 or more, use the code FOURCUPS to get a free The Island coffee mug or pint glass or an Islanders Anxiety puck. The Pinot Project has Rosé, Pinot Grigio and a Wine Enthusiast Best Buy Pinot Noir, all under $15 a bottle. Available at local wine stores and UBS Arena. Visit Lighthousehockey.com for the most up-to-date Islanders news and discussion. Islanders Anxiety podcasts are part of the Fans First Sports Network (@FansFirstSN). Learn more about your ad choices. Visit megaphone.fm/adchoices

On the surface, the merger of Medsenic (a developer of arsenic salt formulations for therapeutic application in inflammatory conditions) and Bone Therapeutics (which develops allogeneic cell therapies for complicated bone fractures) doesn't look obviously synergistic. But  Francois Rieger,  Ph.D. says that on the scientific level, it's a perfect union, and the veteran biotech founder says the business should always follow the science. The union of the two companies formed BioSenic, which Dr. Regier now serves as CEO. On this week's episode of the Business of Biotech, Dr. Regier shows us the good, the bad, and the ugly of the merger process and shares his philosophy on letting science lead the way, regardless of the analysts' takes. Subscribe to the NEW #BusinessofBiotech newsletter at bioprocessonline.com/bob for more real, honest, transparent interactions with the leaders of emerging biotech. It's a once-per-month dose of insight and intel that you'll actually look forward to receiving! Check it out at bioprocessonline.com/bob!