Podcasts about snif

Tieghan Gerard is the self-taught cook, food stylist, and bestselling author behind Half Baked Harvest, where her comforting and creative recipes have captivated millions. Her latest cookbook, Quick & Cozy, features over 120 recipes that embrace the way she cooks now—simple ingredients, easy to get on the table, and packed with big flavor. Now, she's also bringing her love for warm, gourmand scents to fragrance with her Snif candle collaboration.In this episode, Tieghan joins Scent World host Marianne Mychaskiw to explore the deep connection between food and scent—how aromas inspire her recipes, the role fragrance plays in her creative rituals, and what it was like crafting the perfect vanilla candle.Tune in for:• Her favorite cozy meal ideas from Quick & Cozy• How food and fragrance come together• The self-care rituals that keep her feeling her best✨ Scent World is the podcast that explores the beauty and grooming rituals of today's most exciting artists and entertainers. Every other week, they reveal the scents that shaped their lives—and the ones they can't live without.

Idag gästas Lotta och podden av Charlotta Ingvoldstad Malmberg, molekylärbiolog, genetisk vägledare, docent och sammankallande för Snif (svenskt nätverk för information kring fosterdiagnostik). 

SAN ONOFRE-80´s Lawrence KS undergound Próxima liturgia onofrita: Howie Reeve + Cod O´Donnell. Lunes 10 febrero 2025. 20:00 h. Arcadia. 10 evros SAN ONOFRE agradecemos a Take the City y Beat Generation la reciente reedición de "Action/Reaction", de la legendaria agrupación de Lawrence, Kansas, Get Smart! No sólo eso, también que nos brinden la apetitosa oportunidad de entrevistar al combo. Pronto cristalizará eso en SAN ONOFRE. Mientras tanto, allanamos el camino con una breve semblanza de lo que se cocía hace unos ocho lvstros en y cerca de Lawrence, Kansas, en el fértil subsuelo musical. A alguno, Kansas le recordará a polvo en el aire; a muchos otros, el estado en el que Burroughs se fue a reunir con El Gordo. Pero ¿qué quieren que les digamos, amigos onofritas, nosotros no podemos evitar que nos recuerde a la máquina de petaco en la que aprovechábamos el tiempo en nuestra más tierna juventud. En el Bar Soria, claro. Snif, snif! Ya disponible nuestro librito jenkins Angloentrevistas Traducidas, Vol. 2 https://libritosjenkins.bigcartel.com/product/angloentrevistas-traducidas-de-san-onofre-vol-2

Steve Van Samson is the author of is the author of the novels "The Unpleasant Mister Snif", "Mark of the Witchwyrm", "The Bone Eater King" and "Marrow Dust", the collections “Black Honey and Other Unsavory Things” and "Year of the Rattlesnake". His writing tends to be on the pulpy side—intermingling genres like horror, dystopian with dark fantasy and adventure. A fierce proponent of character diversity, avoiding cliché like the plague and of planting little seeds between the lines, which the reader might only discover in subsequent readings. When not tapping the keys on his Chromebook, Steve co-hosts the Retro Ridoctopus podcast, he watches entirely too many black and white monster films. Steve lives in Lancaster, Massachusetts a houseful of girls, two cats and one smallish dragon. #SteveVanSamson #TheUnpleasantMisterSnif VOX VOMITUS: Sometimes, it's not what goes right in the writing process, it's what goes horribly wrong. Host Jennifer Anne Gordon, award-winning gothic horror novelist and Co-Host Allison Martine, award-winning contemporary romance and speculative fiction novelist have taken on the top and emerging new authors of the day, including Josh Malerman (BIRDBOX, PEARL), Paul Tremblay (THE PALLBEARERS CLUB, SURVIVOR SONG), May Cobb (MY SUMMER DARLINGS, THE HUNTING WIVES), Amanda Jayatissa (MY SWEET GIRL), Carol Goodman (THE STRANGER BEHIND YOU), Meghan Collins (THE FAMILY PLOT), and dozens more in the last year alone. Pantsers, plotters, and those in between have talked everything from the “vomit draft” to the publishing process, dream-cast movies that are already getting made, and celebrated wins as the author-guests continue to shine all over the globe. www.jenniferannegordon.com www.afictionalhubbard.com https://www.facebook.com/VoxVomituspodcast https://twitter.com/VoxVomitus #voxvomitus #voxvomituspodcast #authorswhopodcast #authors #authorlife #authorsoninstagram #authorsinterviewingauthors #livevideopodcast #livepodcast #bookstagram #liveauthorinterview #voxvomituslivevideopodcast #Jennifergordon --- Support this podcast: https://podcasters.spotify.com/pod/show/voxvomitus/support

Dans ce 11 ème épisode de podcast, ça vous dit si je vous emmène avec moi dans le Morvan? De la petite ville d'Avallon en passant par le lac des Settons et Brassy pour finir à Vézelay, ce petit road trip n'aura pas été de tout repos. Mais l'accueil fantastique des morvandais, la gastronomie morvandelle auront bien plus immortalisé ce périple que le fait d'être revenue sans ma moto mais avec deux kilos de plus. Ah oui, je vous l'avais pas dit, Constance, ma chère moto, ma Yamaha XJ6 a rendu son dernier gaz d'échappement dans le Morvan. Paix à son âme. Snif !Bref, pour les amoureux de la nature, les aficionados des belles routes virageuses, les têtes brûlées du off-road, ne cherchez pas plus loin, le Morvan est peut-être votre petit coin de paradis !Hébergé par Ausha. Visitez ausha.co/politique-de-confidentialite pour plus d'informations.

#753: Join us as we sit down for a rare interview with Kourtney Kardashian Barker & Simon Huck, the dynamic duo behind Lemme. Kourtney, a multifaceted entrepreneur, media personality, a devoted wife, mother of four, and stepmother of three, shares her insights to establishing boundaries to fully embrace her best self. Alongside her esteemed business partner and close friend, Simon, she reveals the thoughtful journey of building a thriving wellness empire. In this episode, Kourtney & Simon dive into therapy, thier boundaries, Kourtney's personal life & parenting tips, and what it takes to build the Lemme business empire.  To connect with Kourtney Kardashian Barker click HERE To connect with Simon Huck click HERE Visit lemmelive.com and use code SKINNY for 20% off all Lemme.  Visit snif.co and use code SKINNY for 20% off Snif. To connect with Lauryn Bosstick click HERE To connect with Michael Bosstick click HERE Read More on The Skinny Confidential HERE To Watch the Show click HERE For Detailed Show Notes visit TSCPODCAST.COM To Call the Him & Her Hotline call: 1-833-SKINNYS (754-6697) This episode is brought to you by The Skinny Confidential Head to the HIM & HER Show ShopMy page HERE to find all of Michael and Lauryn's favorite products mentioned on their latest episodes. This episode is sponsored by Branch Basics Save 15% on your Starter Kit or their new Hand Soap when you use code SKINNY at www.branchbasics.com. This episode is sponsored by DenTek Head to Dentek.com to find your local retailer and shop all of DenTek's products, sold at Target, Walgreens, Amazon, and Walmart. This episode is sponsored by Nutrafol For a limited time, Nutrafol is offering our listeners $10 off your first month's subscription and free shipping when you go to Nutrafol.com and enter the promo code SKINNYHAIR. This episode is sponsored by Origins Prepare your skin for the future with Youthtopia™ by Origins. Discover the transformative power of apples in skincare today. Available now at origins.com and ULTA. This episode is sponsored by Philadelphia Cream Cheese Visit creamcheese.com. This episode is sponsored by Kion Aminos Visit getkion.com/SKINNY to save 20% on Kion Aminos. Produced by Dear Media

Förlossningsläkaren Jesper Agrell berättar om olika förlossningar och hur meningsfullt det känns att kunna hjälpa kvinnor vid olika typer av komplikationer. Han deltar också aktivt i Svenskt nätverk för information kring fosterdiagnostik SNIF snif.one Programmakare Gunnel Agrell Lundgren

Snif, snif...

Der er noget i luften, jeg ved ikke hvad.. Det gjorde de heller ikke i 1800-tallets New England, da folk begyndte at hoste blod, blive ligblege og til sidst døde.. Og derfor blev den naturlig konklusion, at der sgu nok var en vampyr på spil. Derfor indledte man en intens jagt på de blodsugende svin, hvor løsningerne på at bryde vampyrens tag var mange.. Men ofte det involverede en skovl, et bål og at man som familie lige tog en ordentlig snuser til ens afdøde familiemedlems rester. Find ud af, hvordan du kommer af med den vampyr, der har luret i dit nabolag, og få også historien om de amerikanske vampyrjægere, der fik Alexander til at ligge søvnløs som 12-årig.. --------------------- REKLAME: Dagens afsnit er sponsoreret af og indeholder reklame for Zetland! De næste tre uger er vi ambassadører for netavisen Zetland! Derfor kan du få 30 dages zetland for helt ned til 1 krone. Oveni hatten får du samtidig adgang til et spritnyt og unikt afsnit af VVH. Alt, du skal gøre er at skrive dig op på: zetland.dk/VV. For hver der skriver sig op giver Zetland os 200 kr at lave podcast for! --------------------- Dagens Øl: 5 stjernet IPA, Hr. Røns Bryggeri SKIP TIL 11:10 FOR HISTORIEN. Find billetter til live-shows på: vanvittigverdenshistorie.dk/live-shows Se Vanvidsbarometeret på: barometerbjarke.dk

Als peuter - of kleutermama heb je vaak geen seconde rust. Maar nu krijg je soms te veel rust naar je zin.  De leefruimte is plots een stuk leger. We gaan niet liegen, soms is dat heel fijn, maar soms ook helemaal niet. Wat is er aan de hand? Snif! De tiener verwacht dat we hem loslaten terwijl we het liefst van al stiekem door het sleutelgat willen kijken. Uiteindelijk draait het om wederzijds vertrouwen. Maar hoe doe je dat? Anky De Frangh geeft een paar tips!Meer weten? Ontdek het boek van Evelien Kayaert en Anky De Frangh: Ouders komen van Mars

Dans la vie, il vaut mieux rester soi-même plutôt que d'essayer de ressembler à quelqu'un d'autre. Les jumeaux Snif Snif et Ouin Ouin l'ont bien compris pour leur anniversaire! 

Snif, snif.

**ADVERTENCIA Este episodio ya estaba grabado y programado para salir hoy, 17/03/23. Ayer, jueves 16 nos enteramos de la muerte de Enrique Symns. A él va dedicado este episodio y nuestro eterno agradecimiento.** ¡Snif! ¿qué qué? ¿cuando? ¿ahora? nanananana... yo yo yo, tengo la posta.. ¡snif! ¡no me miren! ¡no me miren! Pero mirenme un poquito, no me dejen, mirenme... ¡Snif! 1) Fernando Raluy presenta su libro PARA FABRICAR UN RELÁMPAGO, editado por Editorial Diotima. 2) El poeta Juan Xiet nos habla de su vínculo con Symns y varias cositas más. 3) Metemos la nariz en el plato para hablar del gran Enrique Symns. El señor de los venenos e Invitación al abismo. *Lo audios de Enrique Symns fueron extraídos del documental "Esto certifica que Enrique Symns está vivo (2016) - Fernanda Simonetti" ¡Snif! --- Send in a voice message: https://podcasters.spotify.com/pod/show/elsonidoylafuria/message

Steph first came into the limelight as Kim Kardashian's assistant and rose to become the Chief Operating Officer of Kardashian West Brands. She now serves as the Chief Impact Officer of Plus, a biodegradable body wash brand, and co-founded Future Earth, a climate education platform. In partnership with Snif, Steph has launched her own fragrance. It's genderless, housed in 100% compostable packaging, and named Suganami as an homage to her Japanese last name.In this episode, Steph sits down with Marianne Mychaskiw, who runs communications at Scentbird. She takes us back to early scent memories growing up in Ohio, why she has always been very specific about fragrance, and how she breaks norms in style and scent.Highlights:Evolving from Kim Kardashian's assistant to COO of Kardashian West BrandsMeeting Karl Lagerfeld, a “pinch-me, is this real?” momentWhat it felt like to start a new career chapterJuniper Breeze and first scent explorationsGrowing up with a “charmed childhood” in OhioReflecting on her mother's influence on self-expressionScent Spotlight: Suganami, Steph's new fragrance in partnership with SnifPaying homage to her Japanese last nameScent likes, dislikes, and the best-smelling person Steph has ever metBreaking gender norms in style and scentHow you can express yourself more authenticallyThe change Steph would like to see through Future EarthSteps anyone can take to live a more sustainable lifeScent Connection, Glam Occasions EditionAdvice for those looking to embark on a similar career pathFeatured Fragrance:Suganami by SnifSoak in all of our audio and video content at https://podcast.scentbird.com.

Orlando Actors David Almeida & Matthew Arter re-watch another episode of “The Facts Of Life” — so you don't have to! This week, we welcome back (for the last time! Snif!) TV Guidance Counselor Ken Reid!

In which the tension builds, tropes are worn, new faces revealed, and a bandana abandoned. Covering https://www.achewood.com/index.php?date=04112006 Support Brain Tape at https://galaxybrain.co/support

THIS IS THE MATCH MADE BURN BOOK! This week on the pod, Adam's company needs to... "have a talk"... We talk people who deserve punishment in the city which includes: people who steal taxi's, people who bike on the sidewalk, and MORE. We talk the theory of "growing apart," Ben Franklin, Little Bird, a new contender: Dubai mans, and MORE! And as always, give advice to some listeners. You don't want to miss it! Support the show by checking out our sponsors: > Athletic Greens is going to give you a FREE 1 year-supply of immune-supporting Vitamin D AND 5 FREE travel packs with your first purchase. All you have to do is visit athleticgreens.com/matchmade. The trio has been consistently using AG1, and we are so excited to share it with the Match Made family! > Snif is gender neutral, vegan, cruelty-free, and has a try-before-you-buy model that allows you to test scents and candles before you buy! Snif loves the Match Made fam, and now through December 15th you can receive an exclusive 25% off your order using code "MATCH25" Advice segment: If you need advice on a situation, or have a wild story to share - email matchmadepodcast@gmail.com with subject line "ADVICE SEGMENT" where we will pick stories to answer each week (anonymously - always). Write us a 3-5 sentence summary of the situation which we will read on the podcast, and include any relevant details at the bottom that you think we should know. For any updates to advice segments, email with subject "ADVICE SEGMENT UPDATE - [date of original feature]" and we will share updates to featured advice! Be sure to tag @matchmadepodcast in all of your listening stories on Instagram! Xoxo - Katy, Colbie, Adam Podcast Instagram: @matchmadepodcast Katy's Instagram: @katybellotte Colbie's Instagram: @colbie_cassidy Adam's Instagram: @aadamharrison

Basil or Basel? Bagel or Beggggel? This week on the pod, the trio is back in the saddle (Katy's floor). We talk what Art Basel is REALLY like, recent dating updates including Katy's first date gift, Adam dipping his toes in old pools, and Colbie's Miami coffee shop rendez-vous. We talk old flings, NYC subway craziness, Katy's secret talent, and dish out advice to some listeners. You do not want to miss this one! Support the show by checking out our sponsors: > Athletic Greens is going to give you a FREE 1 year-supply of immune-supporting Vitamin D AND 5 FREE travel packs with your first purchase. All you have to do is visit athleticgreens.com/matchmade. The trio has been consistently using AG1, and we are so excited to share it with the Match Made family! > Snif is gender neutral, vegan, cruelty-free, and has a try-before-you-buy model that allows you to test scents and candles before you buy! Snif loves the Match Made fam, and now through December 15th you can receive an exclusive 25% off your order using code "MATCH25" Advice segment: If you need advice on a situation, or have a wild story to share - email matchmadepodcast@gmail.com with subject line "ADVICE SEGMENT" where we will pick stories to answer each week (anonymously - always). Write us a 3-5 sentence summary of the situation which we will read on the podcast, and include any relevant details at the bottom that you think we should know. For any updates to advice segments, email with subject "ADVICE SEGMENT UPDATE - [date of original feature]" and we will share updates to featured advice! Be sure to tag @matchmadepodcast in all of your listening stories on Instagram! Xoxo - Katy, Colbie, Adam Podcast Instagram: @matchmadepodcast Katy's Instagram: @katybellotte Colbie's Instagram: @colbie_cassidy Adam's Instagram: @aadamharrison You can send all business inquiries here: matchmadepodcast@gmail.com

WE WON THE $2B LOTTERY ... jk, in our dreams. This week on the pod, the trio talks what we would do if we won the lottery, a much requested dating life update, letting go of situationships, starting over, and answer all your Q's from the dm's. We also share an advice segment update from a previous episode that you will NOT want to miss. Support the show by checking out our sponsors! This week, we are so excited to partner with Snif - your new favorite candle and fragrance one-stop shop. Snif is gender neutral, vegan, cruelty-free, and has a try-before-you-buy model that allows you to test scents and candles before you buy! Snif loves the Match Made fam, and now through December 15th you can receive an exclusive 25% off your order using code "MATCH25" If you need advice on a situation, or have a wild story to share - shoot a DM to @matchmadepodcast and we'll be picking one story every week to discuss (anonymously - always). Make sure you tag @matchmadepodcast in all your listening stories on Instagram! Xoxo - Katy, Colbie, Adam Podcast Instagram: @MatchMadePodcast Katy's Instagram: @KatyBellotte Colbie's Instagram: @Colbie_cassidy Adam's Instagram: @aadamharrison You can send all business inquiries here: matchmadepodcast@gmail.com

Bryan Edwards and Phil Riportella have been best friends since middle school. After college, the two stayed close, but their careers took them on different paths, and Bryan spent the first part of his career in management consulting. But Bryan had a feeling he would want to start his own business one day, and he knew Phil would be the ideal partner if he ever did—they just needed an idea. And then this happened.

C'est a fin de cette aventure et la fin de cette première saison de "Salut les copains!" ☀️C'était trop bien de partager ce voyage, ses galères et ses joies, avec vous. Dans cet épisode je vous résume tous les petits apprentissages que j'ai acquis pendant ces traversés de cascades, ces nuits froides et ces heures de stop. Merci à Cemil mon partenaire de voyage sans qui tout ça aurait été bien moins drôle, et merci à vous pour le soutient sur tout ce projet. C'était un immense kiff de créer tous les jours et j'ai trop hâte de recommencer ! En attendant vous pouvez toujours venir nous suivre sur Instagram @louannemanshow et @cemil_, on y fait plein d'autres galéjades. Merci à tous les supers gens qu'on a croisé sur notre route, vous êtes vraiment des p'tits cœurs et vous avez rendu ce voyage formidable. Bisous les copains Hébergé par Acast. Visitez acast.com/privacy pour plus d'informations.

On this episode of DTC Pod, Brian joins Blaine & Ramon to talk about his career in digital commerce, media, and venture capital which has spanned 4 decades. Brian is a seasoned operator and investor, having led investments in companies including Everlane, Snif, Feastables, Caraway, Afterpay, Archive, Disco, & Tydo to name a few. This episode covers topics including the overlap of web3 and commerce, what makes businesses attractive to invest in, the evolution of digital media, learnings from the best brands, what the future of commerce looks like, and how brands can think about evolving loyalty and retention frameworks, social commerce, and more.Wanna Sound Smart? Save This

¿Quién dice que el Salvador no tiene música? En los 90s, artistas rebeldes como Carlos Galicia gozaban de la escena musical surgente en los bares de San Salvador. Desde Broncco hasta Carrot y Snif, Carlos nos cuenta de la música original Salvadoreña y de la importancia de tener orgullo de nuestra propia música. Artistas Salvadoreños: Broncco  Boneyard (Jardín de Huesos) Prueba de Sonido Jhosse Lora Ovni Crisol Roberto Salamanca Alvaro Torres Rafael Alfaro Nativa Geranio Adrenalina Protocolo 2 Natalia Cantalejo Camelo Ran42k La Iguana La Pepa Adhesivo Los Tachos Nadine Masri Pamela Robin Carrot Snif Zaki Show resources: “Reactivar” album solo por Carlos Galicia “Hecho en El Salvador” Playlist on Spotify Carlos Galicia en Instagram Carlos Galicia en Facebook Music: "Al Otro Lado" by Carlos Galicia

Episodio semanal en el que conversamos sobre Blink 182 en la actualidad, la nueva temporada de Futurama. La serie de momento Euphoria ¿De verdad es tan buena? Únete a nuestro canal de Telegram: https://t.me/fanescapop Síguenos en Instagram aquí: instagram.com/fanescapop/ Curiosea y sigue nuestras cuentas personales: IG de Stefy: instagram.com/stefyriverae IG de Raffaello: instagram.com/raffaello.kr

“A really good strategy that you can do with SMS heading into Black Friday Cyber Monday is sending an email push for SMS sign ups for early access.” @jayde3sai #DTCPOD“SMS is very different than email, in the sense that SMS messages should be more skimmable than email.” @jayde3sai #DTCPODWe Speak About:[00:41] Strategies to boost SMS sales and sign ups [04:51] Optimizing the landing page and DTC examples BFCM SMS sign up strategies plus a big landing page guideIn today's episode of DTC Finds, we're looking at a great Twitter thread discussing strategies for boosting SMS sales during black friday cyber monday and elements to add to the landing page.As we dive into the landing page guide from Nik Sharma, we'll provide real DTC examples of how they improved elements of their landing pages.Stay tuned as we break down this twitter thread and learn more about how to optimize your landing page.If you'd like to learn more about Trend and our influencer marketing platform for influencers and brands visit trend.io. You can also follow us for tips on growing your following and running successful campaigns on Instagram and LinkedIn.Mentioned Links:BFCM SMS strategies: https://twitter.com/DTCNewsletter/status/1453727946342998029Landing page guide from Nik Sharma: https://nik.co/resources/landing-page-guide

In this episode, Co-Owners of Kornetti & Krafft Health Care Solutions, Dee Kornetti and Cindy Krafft, talk about all things maintenance therapy and care. Today, they talk about maintenance therapy in the home, diversifying revenue, and they bust a few maintenance therapy myths. How can maintenance patients have a goal statement if they're never going to get better? Hear about home-based therapy, teaching patients to self-manage, Medicare part B, and their book The Guide to Delivery of Home-Based Maintenance Therapy, all on today's episode of The Healthy, Wealthy & Smart Podcast.   Key Takeaways “It's never been that if you don't improve, then services aren't covered.” “Rehab potential is the responsiveness to care.” “The myth of coverage has some roots in the denial issue.” “If there's room for improvement, a restorative or improvement course of care is what your skills would be indispensable for. That's what would make your care medically necessary under the Medicare benefit.” “If someone else can do it just as well as I can then this is no longer considered skill.” “We are helping patients be accountable for their chronic disease management.” “There are times that we are indispensable to help people improve and recover function back to a prior level or maybe beyond, and then there's times we are needed to preserve and stabilise their exiting function so that their quality of life can continue on in the fashion that it currently is.” “Be a bit more open-minded with how physical therapy really works in reality. Don't assume that what your path at the moment is THE path and can't vary and can't change. There are many other ways you can utilise your skill to benefit those around you.” “Don't be afraid to ask questions, and don't think you have to know it all.” “If you've got a great idea, or you have something that is a passion, and you've got that intersection of your passion and your skill set, go for it. Start to explore that. The possibilities are endless.”   More about Dee Kornetti Dee, a physical therapist for 35 years, is a past administrator and co-owner of a Medicare-certified home health agency. Dee now provides training and education to home health industry providers as Owner/Founder of a consulting business, Kornetti & Krafft Health Care Solutions, with her business partners Cindy Krafft and Sherry Teague. Dee is nationally recognized as a speaker in the areas of home care, standardized tests and measures in the field of physical therapy, therapy training and staff development, including OASIS, coding, and documentation, in the home health arena. Dee is the current President of the American Physical Therapy Association's Home Health Section and serves on the APTA's national Post-Acute Work Group. She serves as the President of the Association of Homecare Coding and Compliance, and a member of the Association of Home Care Coders Advisory Board and Panel of Experts.  She has served as a content expert for standard setting for Decision Health's Board of Medical Specialty Coding (BSMC) home care coding (HCS-D) and OASIS (HCS-O) credentialed exams. She holds current credentials in Home Health Coding (HCS-D) and Compliance (HCS-C) from this trade association.  Dee is also on Medbridge's Advisory Board for development of educational content on its  home health platform, and has authored several courses related to OASIS, Conditions of Participation (CoPs) and therapy. Dee is a published researcher. on the Berg Balance Scale, and has co-authored APTA's Home Health Section resources related to OASIS, goal writing and defensible documentation for the practicing therapist. Dee has contributed chapter updates to the Handbook of Home Health Care Administration 6th edition, and co-authored a book, The Post-Acute Care Guide to Maintenance Therapy published in 2015, along with an update in 2020 titled, The Guide to Delivery of Home-Based Maintenance Therapy that includes a companion electronic workbook. Dee received her B.S. in Physical Therapy from Boston University's Sargent College of Allied Health Professions, and her M.A. from Rider University in Lawrenceville, NJ. Her clinical focus has been in the area of gerontology and neurological disease rehabilitation.   More about Cindy Krafft Cindy Krafft PT, MS, HCS-O is an owner of Kornetti & Krafft Health Care Solutions based in Florida. She brings more than 25 years of home health expertise that ranges from direct patient care to operational / management issues as well as a passion for understanding regulations. For the past 15 years, Cindy has been a nationally recognized educator in the areas of documentation, regulation, therapy utilization and OASIS. She has and currently serves on multiple Technical Expert Panels with CMS Contractors working on clinical and payment reforms and bundled payment care initiatives. Cindy is an active member of the National Association of Home Care and Hospice (NAHC) and currently serves on multiple committees. She has written 3 books – The How-to Guide to Therapy Documentation, An Interdisciplinary Approach to Home Care and the Handbook to Home Health Therapy Documentation – and co-authored her fourth, The Post-Acute Care Guide to Maintenance Therapy with her business partner Diana Kornetti PT, MA, HCS-D.   Suggested Keywords Maintenance, Therapy, PT, Physiotherapy, Improvement, Assessment, Goals, Home Care, Rehabilitation, Accountability, Medicare, Myths, Health, Healthcare, Sustainability,   Book Discount Code (10% OFF): KK2021 The Guide to Delivery of Home-Based Maintenance Therapy   To learn more, follow Dee and Cindy at: Email:              kornetti@valuebeyondthevisit.com Website:          https://www.valuebeyondthevisit.com Facebook:       Kornetti Krafft HealthCare Solutions Twitter:            @Dkornetti                         @KornettiKrafft LinkedIn:         Kornetti Krafft HealthCare Solutions   Subscribe to Healthy, Wealthy & Smart: Website:                      https://podcast.healthywealthysmart.com Apple Podcasts:          https://podcasts.apple.com/us/podcast/healthy-wealthy-smart/id532717264 Spotify:                        https://open.spotify.com/show/6ELmKwE4mSZXBB8TiQvp73 SoundCloud:               https://soundcloud.com/healthywealthysmart Stitcher:                       https://www.stitcher.com/show/healthy-wealthy-smart iHeart Radio:               https://www.iheart.com/podcast/263-healthy-wealthy-smart-27628927   Read the Full Transcript Here:  Speaker 1 (00:01): Hi, D N Cindy. Welcome to the podcast. I'm happy to have you guys on. Welcome. Welcome. Thanks for having us happy to be here. Glad to be here. Excellent. So today we are going to be talking about maintenance therapy. So when a lot of physical therapists think about maintenance therapy, they often think that, well, this is something that's not reimbursed. This is something that maybe the patient doesn't quote unquote need. So today we're going to talk about what it is, some of the myths and a lot of other stuff surrounding maintenance care. So my first question is, can you define what maintenance care is or maintenance therapy? Speaker 2 (00:47): Okay. Karen, this is Cindy. I'll take that one. I think, you know, just as you were saying, the word maintenance, I'm sure at least one listener twitched, a little, the eye Twitch, the uncomfortable many times when you say the word maintenance, it looks like, you know, people react like you swore in church to like, oh, I don't do that. Or I, you know, somebody does that and get in trouble. And, and I think even the word has become a barrier. So Dee and I have tried to reframe the conversation by getting to the heart of what it is by referring to it as stabilization of function. So putting aside that baggage and the history of the word, the approach to care is saying I'm utilizing all the wonderful things I know as a therapist, my ability to assess and all of those great things and develop a care plan. But the end result that I'm going for is a stabilization or preservation of their functional level or slowing of decline. I think maintain can get people tied up in knots and miss the point or think that we have to do all kinds of different things, which we'll talk about in a moment with the myths. But I really think it helps to, to approach it as we're talking about stabilizing someone's function. Speaker 1 (01:58): That makes a lot more sense. And I really like that word. And you're right. I feel like maintenance care does kind of give people that, oh, I don't know if that's quite my lane, but when you say stabilization of function, preservation, decreased speed of decline. I think physical therapists are like, yeah, of course that's what we do. We'll think about it. We, we, we treat patients that have these chronic diseases right there. We don't share them. They go to doctors, numerous doctors, you know, cardiologists primary care, right. With their, with our heart conditions, they see nursing, right. They see all kinds of disciplines and all kinds of professionals. But they're never getting cured. They're it's management of their symptoms, right? So, so it's to like Cindy said, we are, we're going to preserve function. We're going to, you know, optimize their ability. Speaker 1 (02:50): We're gonna re hopefully use our skills, knowledge, and ability to reduce their demand or their requirement, higher cost centers of care. What happens when you have poorly managed symptoms of chronic disease, like COPD or CHF or diabetes, these people use urgent, emergent care. These people go in the hospital. This is extremely costly to our, to our medical system. And it's, it's not sustainable as an aging pie, you know, as we age as the population. And so this idea that there's things we can do to have people function optimally, no matter what phase or stage of this chronic condition they're in too, so that they're not as dependent or on higher cost centers of care, or they don't realize the kind of sequella, you know, think about a diabetic with poorly managed blood sugar, you know, that starts to develop retinopathy Neff, prophecy, peripheral neuropathy, right? All these other problems that happen. You know, that's all very manageable. If we can get an early and often and preserve an optimized, I even say optimize function. So we're not improving people necessarily because sometimes they haven't already experienced a decline. A lot of times we're just going in there to share what we know so that they can be accountable and manage these chronic diseases themselves. Yeah. That makes so much Speaker 2 (04:16): Karen. I would add to that, you know, for your listeners, cause some folks, you know, D and I have been talking about this for years. Some folks have a difficult time with this conversation, not just the word, but the concept. It sounds good. It sounds valuable. But I think we have to take a moment and acknowledge how deeply as therapists. We have defined ourselves by that word improvement. You can see it in our documentation. If you're going to get physical therapy, you're going to walk five feet more or 10 feet more, every time I get near you because that's, that's what I have to do. And that if I'm not improving you, we've all been told that if, you know, after a certain number of visits or certain number of treatments, if you don't see improvement, you're obligated to discharge people. When you start finding out that, that isn't really true and it hasn't really ever been true. Speaker 2 (05:06): I think we've got to give ourselves a little bit of grace here and realize that this can be quite the seismic shift internally about how we value ourselves as therapist, how we define ourselves and how we're defining ourselves to our patient populations. I think to the patients, to the potential patients, to our other members of the interdisciplinary team, we've done such a bang up job, talking about improvement, that when they don't feel that they're going to improve as, as the beneficiary or other members of the team say, well, that's patient, isn't going to get better. They don't even refer them to us. They don't even come to us because we've created this wall of you have to be able to get better, or you can't come to physical therapy. Speaker 1 (05:47): Yeah. Oh, I'm sorry. I was going to say, Cindy, what's your favorite line? When you talk about how we are addicted, like we, we are ingrained with improvement. What is your favorite line to say? Speaker 2 (05:57): Oh, well, I created a little, self-assessment like you answer these questions to get these points about how addicted are you. Because it, I feel very comfortable using that word because this challenge is a lot of those core beliefs. And we have identified ourselves by this. So tightly that it's like, okay, we, we have to step outside of our comfort zone a bit. And then as we see therapists start to do that, then we get the questions. Then we get the, okay. I kind of understand it, but what about this? And what about that? And what about this other thing? And that's when the myths all start to bubble up to the surface with where did that even come from? Speaker 1 (06:40): Yeah. So let's talk about some of those myths and see if we can bust them. So I will, I'll take, I'll throw it over to you guys. Either one of you can start, but let's talk about a couple of myths of maintenance therapy for me. One big one is, well, it's not covered. Speaker 3 (06:58): It's not covered by insurance. Speaker 1 (07:00): I'll take that one. This is thing. Yeah. Well you know, maintenance has been part of the Medicare benefit under any Medicare beneficiary part a or part B, since you can find it in the Medicare benefit policy manual, as far back as the, as the 1980s. So it's been around forever. This is not new, that Jimmo V Sebelius case that was brought forward. Just kinda shine the light on it, but it's never been that if you don't improve and services aren't covered or you don't have no, this idea that rehab potential is the ability to improve no rehab potential that we all typically document at some point is the responsiveness to care, right? That's what rehab potential is. Whether the care is going to allow you to improve from where you are at the baseline of assessment or to maintain or stabilize your function from where you are now without any unforeseen event in the next three, six, nine, 12 months, two years, are you going to be able to manage this condition and not decline, right? Speaker 1 (08:13): Or if you're in a progressive type of disease process, are you functioning optimally? And are we slowing that deterioration or decline? That is a normal part of the condition. So Cindy, I can pop a punch it over to you. And since we talk about it being paid, I think we busted that Karen. Right? We busted that pretty good. Okay. So, so other payers, I don't know, but anybody that is a Medicare provider, so under part a or part B, it, it is part of the benefit. Okay. So Cindy, talk to me about what are the type of conditions that are covered by maintenance as if the diagnosis determines it? What do we know about that? Speaker 2 (09:00): Well, very often what we hear is, okay, I understand maintenance therapy. I know what it's for. It's for people who have progressive neurological conditions. So it would make sense for Parkinson's. It makes sense for Ms. It makes sense for ALS. So it must be those three patient populations that are maintenance. Okay. We got to step back for a minute. There are patients with those three conditions that benefit and have the ability to improve with therapy. So it's not Parkinson's is synonymous with maintenance. And there's nothing in the coverage criteria that is diagnosis specific. Diagnosis is only one piece of the conversation. It is where are they functionally? What are the, what is the impact of this diagnosis and their resorted comorbidities on their functional ability? And what does a therapist know? What does that skill that you bring to the table that is unique to that discipline that is indispensable to this patient? Speaker 2 (09:56): But I think the myth of coverage has some roots in the denial issue. We, we can't go past this point without acknowledging that therapists have seen denials for providing maintenance therapy, that you did not show improvement in wham. They took away payment for part of this care, which is what drove the Jim versus civilians conversation that led to the court settlement with CMS to basically say, you know, Hey, we've looked at this benefit. It doesn't say you have to improve to get services. And, and we're, we're good friends with Judah Stein who was the lead attorney in that case, and still has the ability to call CMS back on the carpet and the legal sense about how that settlement has played out since, because CMS basically approached it with a oops, you're right. It doesn't say that shame on us, but it's like, wait a second. Speaker 2 (10:48): You've been denying coverage of services for a long time. And so it's very hard to say, yes, it's in there. And we understand it's in there. And D and I've explained the fundamental pieces of that, but there's still that I got denied, or I know somebody who got denied this can't possibly be true and it's unfortunate. And my personal opinion is I have a really hard time with CMS, just kind of Oop, seeing it versus, you know, ownership. And we saw a subsequent event to the initial Jimmo case that compelled CMS to put on their resources, particularly on their website, where they had to quote disavowal the improvement standard. So not just say oopsies, but say you have to flat out say that does not exist. And if beneficiaries qualify for these services, they absolutely should get them. Speaker 1 (11:36): Yeah. The, the, the woopsies sees that my bad defense never, ever seems to go over well, does it? No, no, no. Okay. So we talked about, is it covered? We talked about diagnoses covered. What other big myths are there surrounding maintenance therapy? All right. I Speaker 2 (11:59): Got one for you. D I got, you know, where I'm going. We very often hear they say, okay, so if it's not about their diagnosis, I need to assess the patient. Right. Figure this out. So now looking at what I typically do in an assessment, oh, test and measures. Well, those must not apply. Then I wouldn't be using tests and measures on a maintenance patient. And we would say, well, why not? Well, why would I measure something if I measure it again later? And it's the same, then why did I measure it to begin with? So any thoughts on those tests and measures in the maintenance patient D Speaker 1 (12:32): Yeah. Well, and, and I'm going to tie it to goal statements too, from there, right? So, so this idea, why do we take objective measurements of patients to establish a baseline, right? And we need to do that regard, you know, based on the presentation of the patient, regardless of their diagnoses and comorbidities, because we want to see if they're functioning at, or near where we would expect them think of a class three heart failure patient, are they functioning where you would expect, you know, a class three heart failure patient to function, or are they functioning like end stage, right. Class four, are they functioning below where you would expect them to function? And so obviously if there's room for improvement, a restorative or an improvement course of care is what your skills would be indispensable for. That's what would make your care medically necessary under the Medicare benefit part a part B that's what it would do so that the tests and measures, establish that baseline. Speaker 1 (13:30): And you compare, this is how the patient's functioning. This is how we'd expect them to function. Now, when you get a patient who is functioning at, or near where you would expect them to function with, with their PR their presentation, the question you have to ask yourself, as you don't just jump right to maintenance, right? You can't just say, okay, this a maintenance patient. They need me. Yeah. Basket. What do they need me for? You know, is there something I can teach them, train them, provide them so that they continue to stay, be stabilized, maintain, be accountable for their care over longer period of time. Right? And if the answer is yes, then you absolutely should pick them up on, on, on a maintenance course of care, because there's some sort of skills, your knowledge, your expertise, that which makes you, you, what I like to call the magic, that is me as a PT, right. Speaker 1 (14:21): And we've all had those magic. That is me moments. When you ever, whenever you walk or, or you, you readjust a, an assisted device to properly fit a patient and people look at you like, oh my gosh, why didn't we think of that? And it's just like, because you're not the magic. That is me. I mean, I, and we take it for granted. So the idea is that tests and measures absolutely help you establish a baseline and determine if there's room for improvement or they're functioning at, or near where you would expect them to function based on the severity, the course, the interplay of these disease processes. And then that helps you pick which course of care restorative or improvement, stabilization, or maintenance. And then you have to say, this is what my skills are going to be medically necessary for. So, so I'm going to tie that now to the next thing that comes, because if we get people this far down the myth-busting trail, Karen, the next thing they say is, well, how am I going to write a goal for that? I mean, if I'm not going to write something to improve, I mean, our, our documentation is called progress notes. I mean, you want to see how addicted we are. That's Cindy's line, right? We write on progress notes you know, Cindy, talk to us about goal statements. How can, how can maintenance patients actually have a goal statement if they're never going to get better? Speaker 2 (15:43): Well, I think, you know, we talked, we talked about coverage criteria, and then the documentation piece goes with that because I can't, and I'm going to kind of work backwards because what we'll see at times is therapists kind of go, okay, I understand it. And then you go to the goal statements and every one of them says, maintain this to maintain that I'm maintaining strength to maintain ADL's. And it's kind of like, okay, let's, let's take maintenance out of it for a minute. That that doesn't measure anything. What ADL's are you talking about? You didn't give any sort of quantifiable way to say what you're trying to maintain. So the goal solution is not to stick the word maintain in there as many times as humanly possible. It's still looking at it as we should be looking at it is what is that quantifiable element? Speaker 2 (16:29): How am I measuring something so that I can demonstrate whether or not we've improved it or stabilized it or slow the decline. And then the end piece is how was this functionally relevant to the patient? So I think what happens at times when D and I work with agencies about writing goal statements for maintenance, the by-product is actually their goal writing overall gets better. Because I think we've lost focus. We think, oh my gosh, I have to have an HCP goal, right? Because that's another addiction, you know, patient will have, you know, visual be independent with Hep. Well, it doesn't say what it's for. Why do you tend for them to do it forever? We don't know, but you have to have that goal. Then you have to have a strength goal. So, oh gosh, this has maintenance. I'm going to put, you know, increase a quarter grade. And yes, Karen, I have seen that documentation, the plan to increase one quarter grade, it's like, can you just go to maintenance and stop trying to improve in minuscule, teeny tiny amounts? Speaker 1 (17:27): How, how is that measured? I Speaker 2 (17:30): Have no idea. I thought half a grade was bad, but then we get into quarter grades. We see assessments that contain the terminology of severely poor. I thought poor was like the basement. I didn't know there was a tunnel under the basement. So this goal writing is really a good place to say, am I focusing in on, what am I quantifying? Why is this functionally relevant to this individual? Then we're setting the stage as to why therapy is in fact necessary for this person. I think the, I will maintain this to maintain that. Doesn't really speak to that. And then we'll go see, I got a denial. That means this whole thing is, is self fulfilling prophecy. They don't pay for maintenance. I will never do this again. And it's like, yeah, but did you really cover what you needed to cover and speak to why the therapy was important and why they needed to have it now? Yeah. Oh God, Speaker 1 (18:24): No. I was going to say, that's great. Thank you for that. Speaker 2 (18:29): But I think the extension of that, and I guess my way to push the ball back to D here as it were, is okay. So I've assessed them. I did my test and measures that wrote some goals. Now the issue becomes, I got to establish a care plan. So how often am I going to see them? And this is where at times, you know, when we had the ability to see folks in person, I swear people's heads are going to start spinning around in confusion because we start talking about things like you don't necessarily see these folks every week. You may see them once a month. And then D what about PRN visits? Can, can therapy use visit frequency? I mean, don't, we have to go or see them or interact with them at least once a week or else this won't be paid for. Speaker 1 (19:14): So talking about service utilization, you know, it's my answer is it depends. What does the, what does the beneficiary, what does the patient need, right? And so do I have to go three times a week for them to stabilize function? Do I have to go once every three weeks? What does it take? What is it that I'm doing that is indispensable for them that only can be provided by a therapist? You know, they can't go to the local you know, green, orange theory and have somebody work out with them in the gym and get the same benefit. What, why, why do you know, why does it have to be me? And so we, so we have to have an understanding of what's it going to take? How often do I have to go? And so when Cindy's talking about PRN visits, that's like a big no-no in home care for therapists, right? Speaker 1 (20:04): Under the Medicare part, a benefit in reality, it's not nurses do it all the time. You know, when they have to adjust Coumadin levels, right? For, or blood thinners, when they have to, if people still even on Coumadin, when they have to do sliding scale insulin adjustments, when they have to run labs, when they update or they're changing wound care orders, they write PRN visits all the time, but supposedly therapists can't do that. Well, that's not true because think about it. I think in, when I'm making this care plan, I'm not writing everybody for three weeks for I'm writing this person in five times a week, because they just got out of the hospital for an elective surgery. And I'm going to go every day, because if they went to an ER for SNIF, rather than home, they'd probably get daily therapy. Right. Okay. And this person was referred from maybe from their physician. Speaker 1 (20:54): And, and we're in the second episode of care, if you will, the second certification period. And there were still as ensuring that they are being, that they're stabilizing function. They're still teaching training oversight, checking, following up on 30 day reassessments to confirm that our interventions are actually working well, if I'm waiting on a piece of equipment, maybe that I decided, okay, we're going to get them a splint or something to meet, or we're going to get them this, this device. And we have to go through all the machinations with DME. I could write that I'm going to go out one time a week for four weeks. But what if that device doesn't come in for two weeks, what am I going to do? Just go, yada, yada yada. And the second week of that 30 day period, or do I just write like a PRN visit that says, you know, when the device comes, if it's not a, you know, when I would normally go out, if it's not going to be there, when I'm planning to go out, I'm not going to let it sit in my office or the back of my, you know, the boot of my car for another week. Speaker 1 (21:52): Or I'm not going to write an add on order. I'm going to have this PRN, but well, it's come in. I wasn't planning on seeing you for a week. I'll bring it out there, fit, adjust it, set it up, teach you how to put it on Don and doff it, you know, check your skin, how to wear it, everything you need to do. It's the same thing. Think about when you think about Karen, when you tell your patients, oh, Hey, if you have a problem with this exercise program, give me a call. How many calls do you get? I don't get that many calls. And then I go back out there and they're doing like rhythmic gymnastics with the Sarah band. And I'm like, that's not what we taught you. Right. That's not the correct exercise. So, so this is a way this, this kind of go out as often as you need to, and not one visit more is appropriate, not just for maintenance, right? Speaker 1 (22:37): So, so writing, writing utilization is really hard for people to understand, because they're used to seeing their patients every week and that doesn't sometimes have to happen. How long do you have to wait to see if the exercise program was efficacious two weeks, three weeks, four weeks, how long, you know, you've got to base it on what, you know, what the evidence shows us? What, what, what our, you know, our, our scientific literature says that's important. So, so I have one more myth to kind of finally push the ball back to Cindy since utilization depends. So now we've got people test to measure some kind of goals that aren't just written, maintain. We have utilization. That seems to be very beneficiary specific, Cindy now, cause they're on maintenance. I got to see them for the rest of their life, right? Speaker 2 (23:29): Yeah. That that's, that's very common and, and it kind of splits into different ways. Karen, sometimes it's the, I made a lifelong commitment because they could decline at any point in time. So by that standard, this is forever or there's the gleeful hot maintenance, a great way to go for patients that don't want to be discharged. So as opposed to them crying, when I talk about discharge or the daughter runs back to the doctor and keeps getting orders, I'll just put them on maintenance and then everybody's happy. Okay. You can't do either one of those things you still are accountable to skilled, reasonable, unnecessary. So the benefit is clear. You can't just keep going or having them come to see you at the clinic, just because you're nice. This does need to require the skills of a therapist. We're still accountable to all of those criteria. Speaker 2 (24:19): And as di said earlier, if there's nothing left to teach, train, or do I can't just do it because you either don't want to, unless I stand here or the caregiver doesn't want to have someone else can do it just as well as I can, that this is no longer considered skilled. And that's what drives the decision to discharge as well is when I have taught you what I, everything that I can the program I've given you is effective. It is in fact stabilizing function. There are no more adjustments to make. There are no things that need to be changed, then you really don't need me anymore. And that's where I think that it comes back to again, how are we finding our value that I think we've gotten very used to. They come to see us X number of times per week for this number of weeks in a row. Speaker 2 (25:07): Then we say, okay, you're done. The order is done. If anything goes wrong, then come back again. Where maintenance really makes us think about a term we use very often is how are we dosing ourselves? So thinking about ourselves, like a medication, when do they actually need that encounter with a therapist? And when we've reached a point where you don't need it, there's nothing I'm doing that is uniquely therapy, then we need to stop. But I think the hard part in that, Karen is some of our skill and touched on one, oh, I had just a piece of equipment in the family looks amazed because that is a skill. You, you know how to do that because of your training. I think sometimes the decision to discharge, we jumped the gun too fast, whether it's a maintenance approach to care or restorative by this. Oh yeah. Speaker 2 (25:53): They got it. They understand it. I don't really, you know, they're just doing the same thing, but are you still contributing something? Are you still making any sort of adjustments? Are you convinced? Because on the restorative side, I've never understood these, you know, lofty strength and improvement goals for a two week care plan that suddenly, you know, the, the they've gained a whole muscle grade in two weeks. I don't know what literature I missed, but this, this, this will be great because I'm going to go join a gym for two weeks when it's safe for me to do so. And then I will be fixed in two weeks. It's all done. So I think it, again, challenges us to think about, have we done everything that we can, are we confident as do? You've said more than once. I mean, we've taken care of mitigating concerns. Speaker 2 (26:37): I mean, if they may have a completely unexpected stroke next week, I'm not expected to be telepathic, but I have looked at your condition, given you the tools and resources. And in fact, whether there is nothing left for me to adjust to do, I am going to discharge. So there is active discharge, planning and maintenance care. We are, we are not saying because of this decline risk, then I'm here forever. And we also have to be careful because a lot of beneficiary advocacy groups have done a great job, educating our patients about this, who will then come at us with the resource. You can't discharge grandma because I've got this GMO thing. And it says, you have to, that's where I think some therapists have gotten caught and been like, oh, okay. That looks like an official document. I'm going to keep having you come to the clinic. I'm going to keep seeing you in the home. And it's like, wait a minute. That's why you have to know what the rules really are because yes, beneficiaries should be educated, but they don't necessarily understand the coverage criteria very well, just because they want this to continue. Doesn't mean it's automatic because of that, Jim. Okay. Speaker 1 (27:43): Yeah. And I think that that is where your judgment as a physical therapist and as the authority figure in that situation, you really have to come down from on that and, and be able to explain exactly why you're making that decision instead of just being like, oh, okay. I guess I'll just keep seeing the men, even though it's at this point, not medically necessary. So what, what advice do you have for the physical therapist who might be in that situation? How do they then speak to the caregiver, the patient, et cetera. So that's, that's happened to me cause I've been providing maintenance therapy. When I had my Medicare certified agency in central Florida, way back 2008, 2009, been doing it a long time because we get tired of people. We get them better and then they'd go off and then they decline and then they come back on. Speaker 1 (28:41): I'm like, we're missing something. We have to be able to monitor these people. I watched nurses do it all the time with the monthly catheter changes, right? Because most people are not good at self cathing and preventing infection and doing it accurately. So they'd end up in the hospital, you know, with some sort of puncture or something or an infection. So, you know, monthly catheter changes can happen for years and years with nurses. So what were we missing here? Here is the bottom line for clinicians. I, when I have taught and trained everything and my skills are no longer necessary. You ask yourself, is there somebody that could oversee that could carry this out with you? Because it really just requires sometimes the assistance of another person or a cheerleader or somebody to motivate you or supervise you. What we have a lot of patients that might have cognitive and limitations. Speaker 1 (29:31): And even if that person isn't available, just imagine, just ask yourself the question. If that person holographically appeared in the room, right, and said, teach me train. And they were capable. Would you give it to them? And if the answer is yes, then you should no longer be going anymore. So what I tell patients is I will say to them, I understand that you want me to come, but as a licensed physical therapist, I have a fiduciary responsibility to the payer and the payer has requirements. And one of them is medical necessity. And at this point you need to do this, but you don't need me as a physical therapist to do this. So I can teach and train you, your spouse, your family member, a paid caregiver, or you can pay me to come, right. But I cannot bill your insurance for this because I would be in essence, fraudulently saying, it's still required. Speaker 1 (30:27): My skills, knowledge and ability when I'm telling you it doesn't, it just requires another pair of hands or somebody that could be shown a lay person, how to do this. And so they're like, oh, well you calm. And then I'll tell them, this is what it costs to privately to pay for a physical therapist. And some people take me up on it. And some people say, oh no, I'll get my grandson to come over. Can you show him how to do it? And I'm like, that's great. So, so I think we have to, like Cindy was saying, we have to understand the regs. We have to understand this. Doesn't go on forever. We have to understand that when we are going to sign our name with our credentials, so hard earned right through through education and practice that we are basically signing an affidavit. If you will. Speaker 1 (31:13): That says, I attest that this meets the requirement of this third-party payer. If Benny therapists stopped, many clinicians heck stopped and thought about that. They might not provide some of the services that they're told they have to provide or do the things they have to do, but it's really comes down to our license. So when I sign that and say, this is medically necessary, I I'm going to make sure that I show that my skills and my contribution to that visit is a billable visit. If I no longer have needed for that, then I can teach and train someone else, or I can discharge them from the third-party payer and they can pay me privately. They could, it can be a cash based service. And that has happened. Speaker 3 (31:56): Yeah. Yeah. That Speaker 1 (31:57): Makes so much sense, guys. This was so good. I just know that therapists are going to have a much better idea of what stabilization care is versus maintenance care. We won't use that term anymore. Maybe we can, we can change that preservation of function, care stabilization of function, carrot just, it sounds it's. I think it sounds better for the therapist and quite honestly, like more humane, more human for the person that we're caring for. Instead of just maintaining someone, you know, we're preserving their function, we're their ability to do the things that they want to do. Just sounds so much more, I don't know, human than maintenance care. It sounds so cold and sterile. I don't know. Maybe it's just me. No, I think, you know, for me, when you say that, it makes me think that we are helping patients be accountable for their chronic disease management. Speaker 1 (33:01): Right. We are teaching them what we know and how important it is for people with aerobic impairments that they have to maintain that lung capacity you know, within the confines or the constraints of that disease process so that they can continue to do their self care, which is metabolically demanding. Right. So, so it, it really, it really shifts responsibility. I think maintenance is a very passive sort of thing that, you know, we're, we're maintaining range. You know, I, I think you know, people that were doing stuff to versus where we're in we're we're arming people with the ability to manage and be accountable for their chronic disease and to, and to function optimally within the constraints of those, that disease or those diseases through a stabilization or preservation of function. Yeah. Speaker 2 (33:55): And I think it's important to, to just kind of circle back a minute that we don't want the visual now to always be maintenance patients or stabilization patients are very debilitated, have to have a caregiver, very ill individuals. These, we can teach these types of programs to the patients themselves, for them to self manage. I think sometimes, you know, okay, I'll give it up. It's not Parkinson's ALS and Ms. I got that point, but these must be like really sick, bad off people. They might be, but they might not be, they might be the heart failure patient that's functioning pretty well right now, but has a history of pushing themselves too hard. So the now kicks in the fluid overload. It ends up back in the hospital because they're overdoing. How do you better task plan? How do you help someone understand when their disease process gives them good days and bad days? Speaker 2 (34:45): What, what do we want them to do on a good day? What do we want them to do on a bad day? Because we know many of our folks that are receiving therapy. Cause they basically think that we're gym instructors, we're gonna, you know, show up for the treatment, wearing spandex and tell them to drop and give us 20 anyway. So we're trying to get past that, but on a bad day, too many of our patients, regardless of diagnosis, sit and wait until they feel better, maybe, you know, with a recent orthopedic surgery, a little bit arrest, okay. We encourage some rest. That's not a problem. And some of these chronic diseases, you're one day turns to two days, turns to a week, you haven't done much of anything and now you've compounded the problem. So I think you're right. It does feel like we're utilizing our skills in a more person focused way meeting them where they are. Speaker 2 (35:34): But I think, you know, very often just briefly we'll get the, well, what are the treatment interventions for maintenance you didn't in this whole conversation, give us any treatment strategies because it's not about the treatment. It's not about the assessment. We do what we do. We have the tools in the toolbox, but what, what are we trying to get to? What is the end vision for this individual? And then I'm going to utilize what I know how to do best in that context. I just think for a lot of us, we felt that door was never open. That you were not supposed to do that. That if you could not show significant improvement that you had to discharge and Dee and I have seen therapists, when you see the wheels turning, I've said a couple of times we need to develop like a stages of grief equivalent for the discussion of maintenance, because we'll have people get mad. Speaker 2 (36:21): Like I can't believe nobody told me this. And then you'll see guilt, you know, oh my gosh, I've had patients and I discharged them. I thought I was doing the right thing. I'm a horrible therapist. What am I going to do now? And it's like, okay, let's just start looking at the information and change what we do going forward and not go backward and be all upset and think we're horrible or mad about who lied to me. It didn't tell me about this before, but we do need to start making a difference. Cause D and I heard far too often, you know what? That was interesting ladies, but we don't do that here in this clinic. We're not going to do maintenance therapy. And it's like, wow, you just get to unilaterally, decide you're out. If you want to be out, that's fine. But then you want to direct them to a clinic that does do it because if they need it and they qualify for it, then find them a provider who will, but this kind of, oh, I never heard of it. I'm not participating thing is, is very frustrating in the current environment. Speaker 1 (37:14): It's, it's not correct. I mean, we have to understand beneficiaries have paid into this benefit. They are entitled to it. And if their presentation is such, that stabilization of function is the appropriate course of care. They are entitled to it. It is part of their benefit package. You don't have a right to say, oh, we'll take you on care. But you know, you're not going to get that. That that's that's you, you can't do that. I mean, you either provide the care that is within the insurance. Right? I mean, think about it. If you went to Jiffy lube for your 32 point checkup and they charged you 90, 95 and, and you only got 10 of them because that, oh, we don't do those other 22. Would you be paying for, I wouldn't as like, listen, I'm entitled to this. This is what I'm appropriate for. Speaker 1 (38:07): It's part of my benefit. Maybe you don't do it, but you can't determine that I don't get it if it's part of my benefit package. So it really comes back to the beneficiary. If they're entitled to it, we, as professionals are not ones to say, we can recommend and say, I don't think that's the appropriate course of care. But to literally say, we're, you're not getting that component of your benefit. I don't think that would go over very well. Do you care? Do you not? No, not at all. Not at all. Especially with, you know, like you said, people have been paying into this, their whole working lives. If it is part of the benefit you should offer it. For sure. And if you're a physical therapist who says, I don't know how to do that, well, you better get educated and learn how to do it. Speaker 1 (38:56): Exactly. The things that I am not the most gifted at as a therapist. So I'm not just going to start dabbling in dry needling. Okay. That's that's not my area. Oh yeah. Just give me some, you know, go into the pin cushion and let me start working on you. It's a skill set and it's something that you have to understand the rules and regs. You have to understand what the payer source requirement is, but we as clinicians don't need any other evaluation skills. We don't need any other tests and measures. We don't need special interventions. What we need to understand is that there are times that we are indispensable to help people improve and recover function back to a prior level or maybe beyond. And then there's times we are, we are needed. We are indispensable to preserve and stabilize their existing function so that their quality of life can continue on in the fashion that it currently is perfect. I was going to say, do you want to button it up? But I feel like that did it, but now listen, before we wrap things up, let's talk about the book, the guide to the two delivery of home-based maintenance therapy. So talk about the book, where can people find it? And what will they get out of the book? If people go and purchase this book, what are they getting? Speaker 1 (40:16): Well, they're going to get DNA, Cindy. That's what I'm going to start with. They're going to get us, they're going to get us. They're going to get an updated version. I think it's the only book. And actually it's our second edition and really focused on community-based care part a and part B for Medicare, right? Whether it's part B in a clinic or part B in the patient's home. And we really focus on the rules and the regs. And we and, and literally walk you through common case scenarios. We try to myth bust, and we try to give you a how to like how to start to think about this, because I think theoretically or conceptually when, Cindy and I talk about this and we've been talking about this for eight or nine years now. And teaching on this, people don't disagree with this. They fundamentally understand, they just don't know how to operationalize it. They don't know how to, if they see it. Okay. Well, I understand what you're saying. I understand. I, I agree with you. That would be, I could see where that would happen, but then how do I do these things we've talked about? So Cindy, what does this second edition really afford them? This time around that, you know, it was kind of like a value. Speaker 2 (41:30): Well, I think part of it came from, we were folks, as you just said, understand the concept, but then struggling to say, I got chew on this for awhile. This is really going to change my core, that I am not just defining myself by improvement. I got to work through some stuff and figure out how to do that. And so our first edition started out. We have a consistent scenario throughout to really talk about assessment and goal writing and detail and all of those pieces. But then as we looked at the second edition, we said that that's a good place to go. You got a nice, consistent scenario. It builds throughout the entire book. So you have opportunity to do that. But then this time around you know, I think you got the sense. I tend to be more in the regulatory nitpicky, wheelhouse, and D tends to go toward the operationalization side. Speaker 2 (42:18): And so she brought up, why don't we put a workbook with it? Why don't we add to that idea of a consistent scenario and say, what are some additional knowledge application activities? How do you comment that same thing about assessment or goal writing a little bit differently than one scenario to really get the juices flowing about how to do this. Now, the challenge is, is there a right answer? Like, do I just go to the answer key? And there was only one way that could have been done while listening to this conversation. There was quite a few, it depends. How often would I go? What would I focus on? So the answers give you some context, some suggestions, some validation, but it was not meant to be, there's only one way to do this. And in a scenario, you know, five sentences long, you better figure out exactly what you would do all the way through this only one path, but it's really to help kind of put those guard rails on and say, well, did you think about this? Speaker 2 (43:14): Or what about that element to, to be able to say, okay, I am understanding this. So I could use that as an individual to go through that process, or I could use it in an organization and do it as a group activity, but to really help people continue to process what sounds like. Yeah, I got it. But now I have a patient in front of me and, and I'm still stuck. Old habits die hard. I still struggle with the goal. I still think I can fix this. I, I still feel that voice in my head. That's telling me if they're not getting better, you're not supposed to be here. So people need that opportunity. So we wanted to provide that in a tangible way that, you know, doesn't really lend itself to an educational event unless the thing was days and days long, and people camped out with us, which nobody wants to do. But gives them that opportunity to come to step away, think about and come back to it at their own pace. Speaker 1 (44:07): Awesome. And just so everyone, all the listeners out there the book, the guide to delivery of home-based maintenance therapy, it's on the Kornetti and craft website, but we will have a link that takes you directly to the book and, and listeners. If you use the coupon code KK 2021, you'll save percent on your purchase. We will have all of that at the show notes at podcasts on healthy, wealthy, smart.com under this episodes, you don't have to remember it. You don't have to send everybody DMS and things like that. Just go to podcast at healthy, wealthy, smart.com click on this episode, it'll be under the resource section in the show notes. So we will make it very, very easy. That's all you got to do is one click, and it'll take you right there. So now before we wrap things up, the question I ask everyone on the podcast is knowing where you are now in your life and in your career. What advice would you give to your younger self? Speaker 2 (45:19): Come on Cindy? I would say, well, I, I would say to my younger self to be a bit more open-minded with how physical therapy really works in reality. I think career-wise would come out. I came out very, this is what I'm going to do. And, and briefly my goal is I'm going to work in a traumatic brain injury unit. I loved working with that population as a student, I'm going to be a famous therapist in a big old rehab facility. And now I'm going on nearly 30 years in home health and have never actually worked in a, in a fancy schmancy rehab clinic. I started this kind of on the side, fell in love with it and never went back. I tell, I tell students all the time, don't assume that what your path is at the moment is the path and can't vary and can't change whether you go into teaching, whether you go into other avenues there's a lot more possibilities and it took me a little while to process that piece to say there, there are many other ways you can utilize your skill to benefit those around you. Speaker 1 (46:28): Excellent. D I would say to my younger self I may not come across that way now 30 going into my 36 years a PT, but I would say don't be afraid to ask questions and don't think you have to know it. All right. So I, I think that I kind of stayed in my box a little bit more and got really, really good at what I did. Some of that time, Cindy was in a traumatic brain injury a locked unit and I got very good at what I did, but I had a lot of questions about, but what if, but why not? Right. And I think sometimes I kind of just that maybe I shouldn't ask that question. I was a little bit too con you know, self-conscious about it. And so I, I think the idea is ask those questions, be fearless. Speaker 1 (47:18): And, and instead of asking, why would I do that? You know, look around. Why not? You know, I'm a big, why not, if you've got a great idea, you have something that is like a passion, and you've got that intersection of your passion and your skillset go for it. Right. A good friend of Cindy and mine Dr. Tanya Miller started event camp for kids. Like when she was like a new grad PT. It's like in it's what, 27th year. And she's written grants for it. And, you know, they take these kids on ventilators out in kayak. I mean, you can do it, you can do it. So be fearless and don't be afraid to ask questions. Don't don't, don't think, oh, well, I don't know as much as Karen Litzy or I don't know as much as Cindy craft, you know, start to explore that the possibilities are endless. That's what I would have told myself when I was younger, fabulous advice from both of you. And I couldn't agree more. Thank you so much for coming on for sharing all of this great information and your book, and it's just sounds great. So thank you so much, Dee, and thank you so much, Cindy, for coming in. Thanks for having us, Karen. It's always nice talking to you. Pleasure. We had a great time. Excellent. All right. And everyone who's listening. Have a great couple of days and stay healthy, wealthy and smart.  

Dagens tre gäster i MHV-podden är Karen Flö, mamma till Liv, 3 år, med Downs syndrom. Mickan Lüning, sakkunnig fosterdiagnostik på Svenska Downföreningen och föreningens representant i Snif (Svenskt nätverk för information kring fosterdiagnostik). Charlotta Ingvoldstad Malmgren, genetisk vägledare på centrum för fostermedicin vid Karolinska Universitetssjukhuset samt sammankallande för Snif. Intervjuar gör samordningsbarnmorska Emma Lilliehöök.

Dagens tre gäster i MHV-podden är Karen Flö, mamma till Liv, 3 år, med Downs syndrom. Mickan Lüning, sakkunnig fosterdiagnostik på Svenska Downföreningen och föreningens representant i Snif (Svenskt nätverk för information kring fosterdiagnostik). Charlotta Ingvoldstad Malmgren, genetisk vägledare på centrum för fostermedicin vid Karolinska Universitetssjukhuset samt sammankallade för Snif. Intervjuar gör samordningsbarnmorska Emma Lilliehöök.

Dagens tre gäster i MHV-podden är Karen Flö, mamma till Liv, 3år, med Downs syndrom. Mickan Lüning, sakkunnig fosterdiagnostik på Svenska Downföreningen och föreningens representant i Snif (Svenskt nätverk för information kring fosterdiagnostik). Charlotta Ingvoldstad Malmgren, genetisk vägledare på centrum för fostermedicin vid Karolinska Universitetssjukhuset samt sammankallande för Snif. Intervjuar gör samordningsbarnmorska Emma Lilliehöök.

La Tienda De Biblioteca Del Metal: Encontraras, Ropa, Accesorios,Decoracion, Ect... Todo Relacionado Al Podcats Biblioteca Del Metal Y Al Mundo Del Heavy Metal. Descubrela!!!!!! Ideal Para Llevarte O Regalar Productos Del Podcats De Ivoox. (Por Tiempo Limitado) https://teespring.com/es/stores/biblioteca-del-metal-1 La historia de la banda comienza en Madrid cuando el grupo Tickets cambia su nombre por el de Asfalto en 1972. La formación original estaba compuesta por José Luis Jiménez (bajo y voz), Mario del Olmo (guitarra y voz) y Pancho Company (batería y voz). Publican un par de singles para el sello discográfico Acción con escasa repercusión. En 1974, Julio Castejón (guitarra y voz), Enrique Cajide (batería) y Lele Laina (guitarra y voz) se unen a José Luis Jiménez en lo que se puede considerar la primera formación oficial de Asfalto. En 1976 realizan un homenaje a The Beatles, grabando diferentes canciones del combo inglés y que se editan en formato casete.Ya en 1977, el grupo ficha por Chapa Discos, una nueva marca de la compañía discográfica Zafiro que es dirigida por Vicente Romero "Mariscal". Con el nacimiento de 1978, ve la luz su primer álbum bajo el título de Asfalto, un trabajo que, por motivos de producción y discrepancias musicales, deja insatisfechos a todos sus componentes. Aun así, el disco está cargado de clásicos como Capitán Trueno.Días de escuela, Ser urbano o Rocinante. Jiménez y Laina deciden abandonar el proyecto para fundar Topo, sin embargo, Castejón y Cajide continúan en la aventura e invitan a Jorge García Banegas (teclados) y José Ramón Pérez "Guny" (bajo) a embarcarse con ellos. Esto trae consigo un periodo de estabilidad y creatividad, que a la postre situará a Asfalto en lo más alto de la escena roquera española durante los años venideros. En diciembre de ese mismo año 1978 se publica Al otro lado, grabado en los Estudios DJM de Londres (Inglaterra). Aprovechando su paso por la capital inglesa, se presentan en directo en el mítico Marquee Club, convirtiéndose así en la primera banda española en actuar en dicha sala. Este disco contiene temas como El viejo, Nadie ha gritado o Mujer de plástico. En 1979 graban su tercer disco, ¡¡Ahora!!,que incluye cortes como Nada, La otra María o En nombre de la moral. Los conciertos se suceden y Asfalto se encuentra en el punto más álgido de su carrera. Tanto es así, que su compañía, ante la creciente popularidad de la banda, decide editar en 1980 un recopilatorio titulado Lo mejor, a modo de grandes éxitos. Se incluye el tema Canción para un niño, solamente publicado anteriormente como sencillo. Asfalto decide afrontar un nuevo reto y en 1981 graban Déjalo así,el primer disco doble de estudio editado por un grupo español. Aunque pueda parecerlo, no se trata de una obra conceptual y entre las muchas canciones incluidas podemos encontrarnos con Demasiado aprisa, La generación perdida, Díselo, Lucy escóndete, El maniquí, Nada que decir o Déjalo así. Chapa Discos no se entusiasma ante un trabajo que es, por su formato, complicado de promocionar y vender. Déjalo así obtiene una escasa repercusión en los medios de comunicación y la banda rescinde su contrato para crear su propio sello discográfico bajo el nombre de Snif. En 1983 se lanza Más que una intención, un disco que les devuelve al primer plano de la actualidad y presenta como novedad la entrada de Miguel Oñate como cantante. Destacan temas como el propio Más que una intención, La paz es verde o El hijo de Lindbergh. Además, Más que una intención se convierte en el primer video-LP que se comercializa en España. Cronophobia aparece en 1984 y al año siguiente, 1985, Miguel Oñate abandona Asfalto. Su sustituto será Ricardo Benítez "Richie", con el que graban Corredor de fondo en los Estudios Trak de Madrid en 1986. Termina la gira y "Richie" deja el grupo por motivos personales. La banda, entonces, decide realizar una parada temporal que también implicará la salida de Banegas y Pérez de la misma. Pocos meses después y contando con la participación de todos los músicos que alguna vez pasaron por Asfalto (a excepción de Oñate), se regraban algunos de sus éxitos para un disco que se titulará 1972 - 1987... 15 años de música y que incluirá, El teatro de la vida, un tema inédito de la primera época. Estamos en 1988. Durante el periodo de inactividad sobre los escenarios, ve la luz una nueva compilación titulada Los singles, 1981 - 1988 que incluía los sencillos editados durante esos años, algunas caras B y una versión de Halley en inglés. Julio Castejón decide, una vez más, rearmar el grupo y cuenta de nuevo con José Luis Jiménez y Lele Laina, además de Terry Barrios (batería). El resultado de esta unión es Solo por dinero (1990), y será la última grabación de Barrios, que fallecería dos años más tarde. En 1993, Cajide vuelve a hacerse con el puesto de batería. En 1994 publican El planeta de los locos con la misma formación que debutaron en 1978. Molinos de viento, Carpanta, Quijote eléctrico o Espera en el cielo son canciones que muestran el gran momento compositivo del que gozan, pero poco a poco la experiencia se va diluyendo en una gira nacional que no logra captar la atención del público, al margen de los incondicionales de siempre. Sus últimos conciertos se celebran en 1995. Después de un prolongado parón, donde Castejón lanza su carrera como solista, publicando un par de discos (¿Hay alguien ahí? y El corazón de la manzana), Jiménez y Laina continúan con Topo, Oñate publica Muy personal, Banegas y "Guny" siguen como músicos de sesión y Cajide decide dejar definitivamente la música, Asfalto vuelve a la carretera, en 2008, de la mano de su alma máter, Julio Castejón, y una remozada formación con Carlos Parra (teclados y voz), Raúl Santana (guitarra y voz), Viti Ilarraza (batería y voz) y Juanvi García (bajo). Con ellos se gestará en febrero, Utopía, su undécimo disco de estudio. Meses después, Alejandro Ollero "Pollo" sustituye a Juanvi en plena gira de promoción. El 3 de julio de 2009, en el Teatro Pilar Bardem de Rivas Vaciamadrid (Madrid), Asfalto graban su primer disco en directo, saldando así la deuda histórica contraída con sus seguidores. Con el título de ¡Al fin vivos! el disco se publica el 30 de octubre del mismo año en formato de doble CD y doble DVD.En junio de 2012, Parra y Santana acaban su ciclo en Asfalto. Jorge García Banegas regresa después de veinticinco años de ausencia.El color de lo invisible es editado en 2014. Banegas solo participa en las canciones Secuencia para un gran momento y Es hora de vivir, abandonando la grabación y la formación que, actualmente, completan junto a Julio Castejón: Arturo García, Pablo Ruiz, Paul Castejón y Nacho de Lucas. Asfalto en 2015 se encuentra inmerso en conciertos y en la realización de Más que una intención, un documental donde Julio Castejón cuenta su particular visión sobre la revolución musical en España y la trascendencia de la misma en la historia de dicho país.

Hvad foregår der, og hvor kommer alle de z'er fra?! Podcasten når Kronborgkritiske niveauer. Matilde er zur, mens Pernille finzer sig gennem det hele. Bonusmedaljen er ved at forsvinde i elendigheden. Snif med!

Phil Riportella (a.k.a Pip the Rip/Simon's fiancé) joins this week's episode of "Emergency Contact."  Melissa finds out how Simon and Phil actually met, when they knew it was getting serious, and we get the inside scoop on their engagement/wedding plans. Also, Simon's shares more about how JUDY came to be and Phil talks about his new fragrance company, Snif.Executive Producers: Simon Huck, Melissa Gray Washington, and Allison Bresnick Produced by Wishbone ProductionProduction Assistant: Connor HallThis show is powered by Simplecast.This episode is sponsored by MVMT, Function of Beauty, and JUDY.

Hashtag not-so-humblebrag alert! This week, I talk about the child-like excitement of winning a contest that FragranceNet hosted, scoring YSL Libre and Maison Margiela's Jazz Club for a steal, and the perfume that knocked Victoria's Secret Rapture out of its spot as the only fragrance I will ever say is objectively bad (spoiler alert: it's in the title). I also review Tenue de Soirée by Annick Goutal, a new startup that aims to take the pretentiousness out of buying fragrance, and a charming op-ed about Flower by Kenzo.  Mentioned in this Episode: Tenue de Soirée (Goutal Paris): https://www.goutalparis.com/collections/tenue-de-soiree/products/tenue-de-soiree-eau-de-parfum?variant=32590048886830 Fragrance startup Snif won’t tell you what their perfumes smell like. You have to sniff them for yourself: https://www.fastcompany.com/90562875/fragrance-startup-snif-wont-tell-you-what-their-perfumes-smell-like-you-have-to-sniff-them-for-yourself Snif (official website): https://snif.co/ The First Time I Saw Myself in a Perfume: https://www.thecut.com/2020/10/review-2020-flower-by-kenzo-perfume.html Connect: Instagram: @pinotandperfume Email: sarahchacon784@gmail.com

Snif, artista urbano, grafitero y activista hip hop, snif dice: "Si queremos vivir de la música tenemos que comportarnos serios", ya mas de 6 años dentro de la cultura hip hop local y gracias a eso a logrado cruzar fronteras hasta España y Colombia dando a conocer mas del arte hip hop, su mas reciente disco freddy krudo, donde el quiso a dar demostrar muchas cosas, comenzando desde sus nombres y las actividades que pasan después de un buen evento, hasta la realidad que estamos pasando con el control que tiene los medios sobre la sociedad, entérate de el en este podcast. soy javywar y este es mi podcast. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/javywarsay/support

En este episodio muy especial de Songmess nos sentamos con uno de los referentes principales del rap Salvadoreño, SNIF! Nuestra conversación aborda sus inicios en batallas de freestyle, su trabajo con jóvenes MCs en los barrios de San Salvador y el por qué es importante para un artista independiente estar presente y activo en el marketing y preparación de su proyecto. Esta imperdible plática es larga y profunda, sin pelos en la lengua, y también incursionamos en el clasismo, la importancia del rap para la juventud nacional y la violencia que ha impactado la psicología nacional. Playlist: SNIF, Oneime, Kover, Jack Russell, Queen MC y Locoplaya. SNIF Bandcamp: https://snif.bandcamp.com/releases SNIF Spotify: https://open.spotify.com/artist/27u7gwUTB5ZRJ0YW13gXMf?si=XehPiIGaTim2SKVwY2P1Dg SNIF Deezer: https://www.deezer.com/en/artist/2677271 SNIF Facebook: https://www.facebook.com/snifartista/ SNIF Instagram: https://www.instagram.com/snif_rap/?hl=en Richard Villegas Instagram: www.instagram.com/rixinyc/?hl=en Songmess Instagram: www.instagram.com/songmess/?hl=es-la Songmess Facebook: www.facebook.com/songmess/?ref=settings Songmess Twitter: twitter.com/songmessmusic Songmess Merch: https://songmess.threadless.com/ #BOPS Playlist: https://open.spotify.com/playlist/2sdavi01h3AA5531D4fhGB?si=Wzq3KqmOSWGM8HOw7BLRuA Subscribe to Songmess on Spotify, Apple Podcasts, Stitcher, Google Play or SoundCloud, find us on Facebook, Twitter and Instagram, and contact us at songmessmusic@gmail.com.

Today we talk about dogs being trained to Snif out coronavirus --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/psychics-anonymous/message Support this podcast: https://anchor.fm/psychics-anonymous/support

In deze lockdown aflevering staat veiligheid boven alles: we laten geen anderhalve meter, maar 78 kilometer tussen ons. Plus, omdat je nooit zeker kan zijn met Maxim, hou ik de hele tijd mijn DOOM-mondmasker op. Nah. PS: deze podcast werd opgenomen vlak voor Sony het uitstel van The Last of Us 2 bekendmaakte. Snif.

L’actu des smartphones, vous aimez ça ? Nous aussi ! Vous trouvez ça moins stressant que les actualités sur le coronavirus ? Tu m’étonnes ! Nous avons pensé à vous : nous avons quelques actes remarquables sur l’actualité de nos précieux ! Mais bien entendu, nous ne pouvons pas éclipser totalement les événements historiques qui se passent actuellement et mesurer leurs impacts sur l’acte tech... Réagissez à l’émission en commentaires sur techcafe.frSoutenez Tech Café sur PatreonDiscutez avec nous et entre vous sur le groupe Telegram Followup D’où viennent les masques qu’Apple a donnés ?Google rejoint l’effort de guerre… Simple comme un coup de fil #incroyable #scoop : le téléphone de Pablo Escobar était une arnaque ! Chinese Pai : Royole annonce son FlexPai 2.Shhhhhhh…. Qualcomm promet l’annulation de bruit pour tousHuawei (aka number 4) passe à Qwant, à de bonnes idées et vous présente Celia.Sens des priorités : les américains cherchent toujours à enquiquiner Huawei. Covido ergo sum COVID-19 depuis SeattleLa grogne chez Amazon aux US.Snapchat gamifie le confinement, Infowars viré du Play Store, Snopes en surchauffe.Le trafic d’Azure explose, celui de Facebook aussi, mais pas le bon.Taper le virus avec des big data : Covidnet et Orange qui confirme l’exode parisien.Poucave : Zoom caftait à Facebook, il cafte toujours à votre patron…Monnaie, accès Internet la question du service public revient. Elle était partie ?The fifth riskDyson, Ford et GM vont fabriquer des respirateurs.Pandémie spatiale : OneWeb en banqueroute, télescopes et Satellites à l'arrêt.Les gens écoutent moins de podcasts… Snif… (et écoutent moins Spotify qui annonçait déjà une chute de 23% des écoutes début mars)Merci pour la transition : l’OMS recommande de jouer aux jeux vidéo Jeux Vidéo Epic Win pour Remedy, Playdead et Gen Design.Nintendo Direct : pleins de jeux 2K pour la Switch, en … semi physique.Good job sur Switch En vrac Nouvelle offre Office Microsoft 365Mise à jour cool de Telegram Bonus Lethargic Panda : Kill Chain, the cyber war on America's elections documentaire HBO sur les vulnérabilités du système électoral américain et l’industrie des machines à voterGPP : Les “Features Discovery” de Flight Simulator.Guillaume :  Participants :  @lethargicpanda - Hashtags - Le CKB ShowGuillaume PoggiaspallaPrésenté par Guillaume Vendé

Mi versión de Harry Potter y el misterio del príncipe. De J. K. Rowlling. Para Alma Dia. 2. no cole. día 1. Aislamiento social. Snif

"Maman... C'EST FINIIIIIII!!!" Oui, la saison 2019 de Formule 1 est officiellement terminée. Snif, snif! Elle est couronnée par une victoire de Lewis Hamilton, lors du Grand Prix d'Abu Dhabi. Cette semaine, Abdou Sall revient sur cette course marquée par un ennui généralisé de DRS, les pépins de Max Verstappen, le sauf-conduit de Charles Leclerc et le dernier tour de piste (?) de Nico Hulkenberg et de Robert Kubica. Aussi au programme: le segment "En route vers la F1", avec un retour sur le dernier meeting de Formule 2. Visitez bulletinf1.com pour lire les chroniques, les avant-courses et les bulletins de notes après chaque Grand Prix. Musique: Kasger – Highland Musique provenant de NoCopyrightSounds Téléchargement gratuit: http://ncs.io/highland

Pour notre 21e épisode, on fête la Saint-Valentin ET Noël avec Micheal Bolton’s Big Sexy Valentine’s Day Special. Comme cadeaux, Sophie nous fait l’historique des cartes de Noël, Simon résume un épisode de Noël de Coup de Foudre et Étienne lit des extraits de l’autobiographie de Normand L’amour. C’est aussi le dernier show de Sophie. Snif snif. Diffusion originale : 1er mars 2019 Site web : MysterieuxEtonnants.com © Les Mystérieux Étonnants. Tous droits réservés.

Le final de la saison 8 ! Snif. Alors, bon ou mauvais final ?

Snif, snif, buáaa, tchibum! Último e derradeiro episódio do Carreteiro de Copa™ porquê sim, tudo tem um limite. Neste programa final, Fane Webber e Gabriel Pinto falam dos últimos dois países que participaram da Copa: Suécia e Japão. Na pauta a Ikea e o fundador sueco, além  dos personagens que marcaram época nos seriados e desenhos […]

El tercer programa de A Ritmo de Gol estuvo lleno de dinamismo y entusiasmo por parte de nuestros amigos Fidel Mondragón y Snif. La motivación y la lírica fueron los ingredientes para conocer facetas que poco a poco van mostrando nuestros invitados. Continúa acompañando a Rómulo Guzmán y Moisés Magaña en este camino donde están descubriendo la magia de la música y el fútbol, sumada a la complicidad de la pelota y el micrófono.

Le Népal de Camille [caption id="attachment_69962" align="aligncenter" width="1024"] Le temple en bois de Sing Gompa et ses drapeaux de prières bouddhistes - Crédits photo : Camille Bonazzi[/caption]   En février dernier, Camille s'est rendue au Népal pour célébrer le mariage de son amie népalaise Unnati. A l'issue des festivités, elle en a profité pour voyager à travers le pays. Après un trek de 4 jours dans le Langtang entre Dunshe et le lac de Gosaikunda, elle a sillonné la vallée de Kathmandou (Kirtipur, Dakshintkali, Patan, Bhaktapur) avant de regagner le parc national de Bardia, où, à son grand regret, elle n'a pas vu de tigre. Snif ! Elle a terminé son voyage par Lumbini, la ville de naissance de Bouddha. [caption id="attachment_69965" align="aligncenter" width="1024"] Camille et Inès au restaurant Nirvana Dream[/caption]   De retour à Paris, je retrouve Camille dans le restaurant de spécialités népalaises Nirvana Dream. Ensemble, on goûte aux deux grands plats nationaux : le dhal bhat, un thali végétarien d'influence indienne, et les mö-mö, des raviolis d'influence tibétaine. Camille me fait aussi goûter la bière Nepal Ice. Ce n'est pas l'Evrest, la bière qu'elle a bu au Népal, mais ça lui rappelle quand même de bons souvenirs de voyage. [caption id="attachment_69964" align="aligncenter" width="1024"] Le lac sacré de Gosaikunda - Crédits photo : Camille Bonazzi[/caption] Après la fin de la guerre civile en 2006 et malgré le séisme de 2015, le pays se reconstruit petit à petit et le tourisme se développe doucement. Outre les amateurs de trekking, Camille a d'ailleurs croisé de nombreux "baba cool en dreadlocks", sans doute en voyage spirituel. Enfin, Camille s'est régalée car au Népal, on trouve une grande variété d'artisanat, l'occasion de ramener plein de petits cadeaux : des écharpes, des drapeaux de prières bouddhistes, des bols de prière, des marionnettes, des masques, des bijoux etc. Carte postale sonore : En fin d'émission, on part au Laos avec la carte postale sonore d'Antoine et Florian de Douze regards du monde. Plongés dans le noir, nos deux globe-trotters préférés nous font un coucou depuis Konglor cave, dans la province de Khammouane. [caption id="attachment_69966" align="aligncenter" width="1024"] Antoine et Florian au Laos[/caption]   Programmation musicale :  -Om Mani Padme (chant bouddhiste) -Syndicate de Bipul Chetli   Réalisation et diffusion :  Ecriture, montage, voix : Inès Edel-Garcia Durée : 15 min environ Emission diffusée le 30 avril 2018  

Snif! Déjà le dernier épisode de notre première saison. On termine en force en recevant la populaire youtubeuse ET entrepreneure en série Emma Verde! Marie-Claude Duquette, Étienne Crevier et Carlo Coccaro abordent ensuite le délicat sujet de la santé mentale en entrepreneuriat lors du débat « Les PDG se cachent pour pleurer », animé par Matthieu Charest de Les Affaires.

- Bonjour à toutes et tous. Voici le Podcast numéro #068 de Geek0Rama ! Astalavista baby ! Dans cet épisode, Ikson a joué à un petit RPG qui a tout d'un grand ! Du tour par tour, un graphisme accrocheur, et des personnages peu communs. Octokom a contrôlé des armées de mycoses pour dominer ... La forêt ! Ouaip ! Un jeu de stratégie en temps réel passionnant ! Un instant culture animé par notre Miss Culture, où Addycyclette, nous parle de la prochaine fermeture du Miiverse ! Snif ! Bonne écoute !

En este episodio encontrarás las claves para establecer una conexión con otro ser humano, una que te ayude a conocerte mejor a ti misma/o y te haga sentir parte de la especie humana. Deja tus comentarios aquí o escríbeme en mi blog nadirchacin.com.[El audio tiene algunos defectos (saltos o aceleración) porque se ha dañado justo hoy la consola de grabación. Snif. Pido disculpas por eso. He decidido publicarlo porque me ha gustado como quedó.]

En este episodio encontrarás las claves para establecer una conexión con otro ser humano, una que te ayude a conocerte mejor a ti misma/o y te haga sentir parte de la especie humana. Deja tus comentarios aquí o escríbeme en mi blog nadirchacin.com. [El audio tiene algunos defectos (saltos o aceleración) porque se ha dañado justo hoy la consola de grabación. Snif. Pido disculpas por eso. He decidido publicarlo porque me ha gustado como quedó.]

CDNews Qwant investit dans des calculateurs NVIDIA pour le machine learning. Volta : le GPUzilla de NVIDIA. Soleil de ma nuit : des panneaux solaires… pour l’intérieur…! Riding the Wave : communiquer par radio, mais sans radio. Qualcomm Tricorder Prize : 34 maladies diagnosticables par un seul appareil. Encore une nouvelle technologie de batterie. Qui explose pas. AI got the power : ARM prépare une offre focalisée sur le deep learning. Sony lance un nouveau senseur photo idéal pour les voitures… Après 4 ans et demi et …. rien, Imagination revends MIPS. AMD: VR sans fil. Avec des ondes. De très haute fréquence. Focalisées. Dans ta tête.. Intel Page qui se tourne : L’IDF, c’est fini. Snif. Itanium aussi. Re-snif. Re-snif ? Non ? Ou bien ...? Page qui se tourne doucement : Intel Optane, la moins révolutionnaire des révolutions. Page qui se tourne pas : Intel présente d’excellents résultats et… plonge en bourse. Page qui se tourne peut-être (pas ?) : Intel Bientôt doublé par Samsung ? Ou TSMC ? Computex 2017 Ryzen Threadripper : 16 coeurs à partir de 850$, mais la concurrence se réveille... Intel lance ses Core i9 jusqu’à 18 coeurs, pour 2000$. Le Computex 2017, c’est aussi le moment de choisir ses cadeaux de noel. Je veux ça. e-Sim, Gigabit LTE, NVIDIA Max Q, les PC fous fous fous…! [su_spoiler title="Transcript (généré automatiquement)" style="simple"] Transcript [0:00] Music. [0:29] Salut à tous et bienvenue dans la chronique des composant la 30, 4e édition de la chronique des composants je suis Guillot Vendée nous enregistrons le jeudi 15 juin 2017 et comme pour tout bonne chronique des composants qui se respecte je suis bien entendu accompagné de l' incontournable Guillaume, objet spalla Salut Guillaume comment vas-tu très très bien si jamais vous entendez des petits blancs dans c'est parce qu'on a des, les petites coupures probablement de mon fait ou plus probablement de du fait de ma connexion donc ne nous en voulez pas tu sais que j'ai reçu des sollicitations régulière pour me dire alors la chronique des composants il y en a plus, et bien si il y en a toujours mais j'avoue que j'ai énormément de mal à dimensionner Du, étant déjà porté café dans dans ma petite vie en ce moment mais bien entendu il est absolument pas question que ça s'arrête et Guillaume était toujours présent, pour avoir tout a suivi la même des des projets secrets et on vous en reparlera en temps et en heure autour de la chronique des composants, pour l'heure il est temps de faire la CB News la la rubrique des actualités de la chronique des composants qu'est-ce qui s'est passé dans le monde merveilleux des composants ces dernières semaines, ben ouais c'est plutôt ces dernières semaines un petit mot déjà d'un acteur donc on entend pas forcément parler dans l'univers des de la chronique des composants justement et de la microélectronique c c quoi on t'a l'heure pourquoi on va parler de compte ce soir Guillaume, oui c'est vrai que les news certaines yeux sur un petit peu moins news a du fait c'est vrai qu'elle a un petit peu de mal à dégager du temps des fois. [2:05] La dernière antenne externe donc on va dire que on voit la vie de parler de compte parce que quand vous l'utilisez peut-être pas d'envoyer l'essayer c'est un acteur petit un petit moteur de recherche envisage de concurrencer les grands, et qui m'envoie pas mauvais du tout je sais pas si tu l'as essayé moi je l'ai essayé je suis souvent déçu et en tout cas je perds mes marques, par rapport aux résultats que je peux avoir chercher google mais il faut reconnaître que pour quelqu'un qui est pas forcément je sais pas si ça existe d'ailleurs les power-user de la recherche au contraire lennon pouvoir de la recherche que ça peut convenir à une immense majorité des besoins de, beaucoup de monde sur le moteur de recherche éclair oui oui effectivement, mais bon comme tout petit Espira devenir grand il faut faire un petit peu comme les grands et du coup,

¡Hola! Dans ce 14ème épisode, nous allons apprendre comment deux connards aigris ont réagi devant ce que toute l'industrie annonce comme le film de l'année et la comédie musicale du siècle: La La Land. C'est un petit peu notre épisode spécial Saint-Valentin. En tous cas, prenez-le comme tel car il n'y a aucune chance que nous fassions une véritable spéciale Saint-Valentin! Non mais oh. On est des hommes. On regarde du foot et les films de Vin Diesel. On n'est pas du genre à pleurer devant Toy Story 3. Quand les jouets se tiennent la main et acceptent leurs morts certaines, nous n'étions pas terrifiés. Pas du tout! Quand Woody regarde Andy partir au loin avec un regard triste mais plein de reconnaissance, nous n'avons pas versé nos larmes. Non non non. Snif... Non! Pas du tout! Arrêtez de me parler et écoutez ce foutu épisode! Retrouvez les extraits et bande-annonces sur notre site!

Episodio 28. Como no fue poca cosa la muerte de Megaupload (y Megaporn) y todo el despapaye que se hizo con la SOPA, nos dedicamosen esta ocasión  a despotricar y a maldecir contra los pinches gringos. Recomendamos en esta ocasión un jueguito independiente, bastante bueno, si les late la estrategia: Orcs Must Die! Y en la música tendremos pura música de calidad papá: Pantera con una sorpresita musical, Children of Bodom (una complacencia), rock progresivo con Transatlantic (onde toca también Portnoy) y la magnánima presencia de los únicos y auténticos herederos del Thrash Old School de nuestro Tuchtlán: los inigualables Comisarios, ídolos de chicos y grandes. Sólo por acá mero con click derecho si lo quieren guardar, o púchale al bonito reproductor hecho especialmente para vos.

Com certeza, o Claquete de hoje foi um programa sensacional! Quem perdeu o programa ao vivo, pode conferir agora o que o pessoal falou das estreias como Os agentes do destino, Caminho da liberdade e Padre. Foram renovadas algumas séries de TV como Fringe, House, Simpsons e outras que foram canceladas, como é o caso de Human Target e Lie To Me. Teve também os comentários sobre Jean Claude Van Damme que será o vilão de Os Mercenários 2. Na sessão fofoca, Arnold Schwarzenegger e Maria Shriver se divorciaram. Que pena, né! Snif!! Rolou promoção para os ouvintes e as recomendações de filmes, como Alien - O Oitavo Passageiro, Blade Runner - O Caçador de Andróides e Jornada nas Estrelas 2: A Ira de Khan. Ouça, baixe e divirta-se! E não perca! O Claquete vai ao ar, ao vivo, todas as quintas, a partir das 20H (horário de Brasilia) aqui na BestRadio Brasil!

Boohoo, Linda and Markus too are very sad. Snif, it is finished and we will have to wait another year to live something as good again. These winter festivals are so cool, can't wait. Maybe next summer, maybe next spring. That'll make time go faster.

Boohoo, Linda and Markus too are very sad. Snif, it is finished and we will have to wait another year to live something as good again. These winter festivals are so cool, can't wait. Maybe next summer, maybe next spring. That'll make time go faster.

Boohoo, Linda and Markus too are very sad. Snif, it is finished and we will have to wait another year to live something as good again. These winter festivals are so cool, can't wait. Maybe next summer, maybe next spring. That'll make time go faster.

Boohoo, Linda and Markus too are very sad. Snif, it is finished and we will have to wait another year to live something as good again. These winter festivals are so cool, can't wait. Maybe next summer, maybe next spring. That'll make time go faster.