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As the COVID vaccine roll out continues in the United States, many people with type 1 diabetes feel like they’re in danger of being left behind. Why is this happening and what can we do about it? Hear from long-time advocate Paul Madden. He's lived with type 1 for almost 60 years and he's been fighting for the rights of people with diabetes almost as long. Stacey & Paul talk about what the science says about COVID and all types of diabetes, why the priorities are different state to state and what we can all do to be better advocates. JDRF COVID Vaccine statement/info  ADA COVID Vaccine statement/info  In our Innovations segment this week, preventing type 1 in the tiniest possible patients.. a new European study on babies and a new study about closed loop and kids. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.   Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone      Click here for Android Episode Transcription:   Stacey Simms  0:00 Diabetes Connections is brought to you by Dario Health, manage your blood glucose levels, increase your possibilities by Gvoke HypoPen the first premixed auto injector for very low blood sugar, and by Dexcom, take control of your diabetes and live life to the fullest with Dexcom.   Announcer  0:21 This is Diabetes Connections with Stacey Simms.   Stacey Simms  0:27 This week, as the COVID vaccine rollout continues here in the United States, many people with type 1 diabetes feel like they're in danger of being left behind. Why is this happening? And what can we do about   Paul Madden  0:40 The science is very clear that type one is comparable to the risk of type two diabetes, if you should happen to get COVID. And I would say make sure your governor's office knows that make sure the Department of Health knows that because we've got to change this and the science is clearly there.   Stacey Simms  1:01 That's longtime advocate Paul Madden, one of many leading the charge to get people with all types of diabetes higher up in the vaccine priority lists in every state. We'll talk about what's going on here. And action we can all take in our innovation segment this week, preventing type one and the tiniest patients, a new European studies looking at babies, and another new study this one about closed loops and kids. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.   Welcome to another week of the show, I am always so glad to have you here. We aim to educate and inspire about diabetes by sharing stories of connection with a focus on people who use insulin, my son was diagnosed with type one more than 14 years ago, he just turned 16. Recently, my husband lives with type two diabetes, I don't have diabetes of any kind. But I have a background in broadcasting. And that is how you get the podcast. And longtime listeners who have heard me say that over and over again, know that over the years, this podcast has evolved, you know, where I used to focus only on type one. And then I got a lot better educated, frankly, about the strength of the diabetes community overall, and learned that a lot of people with gestational or type two or other types of diabetes, listen to the show because of the focus on insulin use and the technology and a lot of the research. And it's topics like this one that I'm focusing on this week that really drive home, how much we have in common and how we need all hands on deck the entire diabetes community when we're talking about something like the COVID vaccine, and getting priorities in order. So I'm thrilled that our focus has kind of widened out over the years. And it's thanks to a lot of better education by listeners, you know, like you talking to me about the needs of the community. And I think people like Paul Madden, and you'll hear more about him and his advocacy coming up, really drive home how much we all need to stick together. I also want to point out if you don't already know in our Facebook group, Diabetes Connections, the group, we have an ongoing discussion and some posts about what is happening state to state I've asked people to share from their state health department what is happening where they live, so that if you want to check in, and you're not exactly sure where to find your prioritization in whatever state you live in, you can pop into Diabetes Connections, the group on Facebook and find that information out pretty quickly. And if you know the right website and your state, please come in and add it. I have to tell you about something that happened in North Carolina recently, and this became a mainstream news item where I live in North Carolina. And this was a billboard that went up I will share this in the Facebook group. And it was a billboard that went up I believe in late January. And it said Governor Roy Cooper, our governor here does not consider type 1 diabetes an underlying health issue. Think about that. That's what it says on the Billboard in late January when I believe this billboard went up. Type 1 diabetes was not considered a priority for vaccination in North Carolina. That has since changed, but a lot of people garnered a lot of attention. This billboard went up in Johnston County, which is in the eastern part of the state. It's kind of Southeast Raleigh. I don't know if it's deep enough east to be called down east, as we say here. It's not quite toward the beach or that area. I believe there is an Ava Gardner Museum though, in Johnston County. That's kind of its claim to fame. As far as I know. Please don't correct me on that. You can you can correct me if you want on that. Send me your Johnston county emails, but really interesting stuff that somebody paid for it. The billboard company was contacted by the media outlet that did the story here was a Raleigh TV station and they said this isn't an anonymous person who bought the ad space. All I know, they said is what's in the message. But since that billboard went up, and I think it's still up, things have changed. People with type one and type two are now in what they're calling group four here adults at increased risk of severe illness. As of this taping, I'm taping this on February 19. We are on group three frontline essential workers so Hopefully we will get to people with diabetes and others with severe illness who are under the age of 65. And don't fit the other groups pretty soon. I don't know, maybe by mid to late March, but it is really a moving target. And I think that's important to keep in mind as you listen to this interview. And you think about this discussion. I talked to Paul this week. And as I am taping on the 19th, everything he said, is still in effect, but it could change by the time this episode is released, which is February 23. So if you're listening to this live on that date, I will post on social media if things change and of course, come visit the Facebook group to find out more of what's happening in your state. I'm optimistic that type one is going to move up as people get better educated and advocacy steps up across the country. But you know, it is a moving target like much of the vaccinations across this country. Alright, Paul Madden, and what you can do coming up in just a moment, but first Diabetes Connections is brought to you by Dario. Health. You know, one of the things that makes diabetes management difficult for us. I mean, that really annoys me and Benny, it's not really the big picture stuff. It's the little thing that's all the little tasks adding up. Are you sick of running strips, do you need some direction or encouragement going forward with your diabetes management with visibility into your trends help you on your wellness journey? The Dario diabetes success plan offers all of that and more. No more waiting in line at the pharmacy no more searching online for answers. No more wondering about how you're doing with your blood sugar levels, find out more go to my dario.com forward slash Diabetes Connections.   My guest this week is probably one of the busiest people in the diabetes landscape that you will ever meet. He really has. I don't think he's done at all. But oh my gosh, Paul Madden has been on the frontline of advocacy for a very long time. He worked for 30 years at the Joslin Diabetes Center in Boston. He also worked at Johnson and Johnson with Animas, he has been part leadership roles at children with diabetes. He's been a part of the diabetes education and camping Association, the Association of diabetes educators had a large leadership role advocating specifically for people with type one at the American Diabetes Association. And he spoke last year, you might have seen him he was at the White House announcement on insulin pricing. Paul was diagnosed with type one when he was nine years old. And that was almost 60 years ago. And he talks a little bit about that in my interview with him. But I have seen Paul on social media advocating for the COVID vaccine prioritization for people with type one. So I reached out and I was really happy that he agreed and had time to join me. This is also a video interview, it's over on the YouTube channel. And I'll link that up in the show notes. If you would prefer to watch that the video is a little bit different. It is a little bit longer. And you will see exactly what we're referring to here right at the beginning. But you can certainly listen to it just as easily. You're not going to miss anything. If you just listen to my interview with Paul Madden. Paul, thank you so much for joining me.   Paul Madden  8:01 Stacey . I've watched your podcasts and I know that you're getting right information out to us all and our diabetes world all 34 plus million of us here in the US. Yeah,   Stacey Simms  8:11 well, I appreciate that. I'm grateful that it's generally an audio podcast with these video segments put in because as you can see, my production is sometimes a little wonky. We hit this at the exact right time for the sun to be setting on my window. So we've got some interesting stripes on me with the light. But we'll work around that. Yes. You're here because you have so much great information about type one advocacy, specifically right now around the COVID vaccine and prioritization. Let's just take a step back. Can you talk a little bit about the situation? We are in the middle to late February at the moment where things stand? I mean, the US has a bunch of different policies where things stand for people with type one right   Paul Madden  8:49 now. Yeah, I'll give you a couple of scenarios of where it stands right now, Stacey . And regrettably, we can't define it well for every state without going into this state COVID Medical policy, but generally the CDC put out their announcements, and they said something to the effect. I won't quote them, but I'll paraphrase. But they did recognize that type two diabetes was a higher risk and a priority for earlier vaccinations. And that is very correct. Unfortunately, their wording for type one was far more nebulous, far less clear. And they said that for type one insulin dependent diabetes, we suspect it could be a higher risk. Now the challenge is, as you know, Stacey , we have approximately 1.6 million people in the US with active type 1 diabetes of all ages, you older guys and gals and folks like me, and very young little babies, little kids and all the way in between the type two population. It's over 32 million and so very quickly within the first few months of COVID, after February, March, they saw the data from the hospitals from the treatment centers, the ICU that said, Wow, type two diabetes is about a 3.3 times greater risk of serious complications than the citizen without diabetes. So they correctly log that in there, unfortunately, and we're saddened by the fact and I and others, it's it's never alone. It's always a group of us. But I reached out to the ADA, the JDRF, the the diabetes patient advocacy coalition, the leadership and diabetes group, and I children with diabetes, a group that you and I know, well. And 18 groups finally signed on when we sent a letter to Dr. Redfield, who was in charge of CDC. And we said, Please, sir, there's some new data, some new science that started to come out beautiful science in November, December, and a new article just came out in January to say, type one? Absolutely. If you give COVID Is it the same high risk level and one study imply there could be a little bit higher risk than type two? So six states have made the change? And have said, Absolutely, let's do it. Some states haven't defined type one and type two in their state policy, because remember, the CDC allowed the states to determine who gets the vaccinations on their state schedules, I got involved very much in Massachusetts, because unfortunately, they did distinguish, and they still have not changed the Priority Ranking for type one. And we're very discouraged by that. very discouraged. So the type one population, our kids get no priority. If you're over 65, we can now start to get it just because of our age tomorrow. But that's not enough. We've got to get all people with type 1 diabetes at the same Priority Ranking for vaccinations. So that's what we dug in, we're trying to get, we have a sense that we're going to get a meeting with the COVID Committee, the medical leaders here in Massachusetts, I know others are doing the same. So we only again, know of six states that have put type one in with type two. But as I'm talking to more and more advocates throughout our country, I'm learning that some again, like I said earlier don't distinguish. And they allow type one and type two to be together both as a high priority ranking. But we don't think that's more than about 20 to 25% of our states. And we don't have a definite number on that. So we got to keep pushing.   Stacey Simms  12:38 I'm in North Carolina, as you know, and they did not first but they did slide type one up. And you know, a question that came up early on. And again, we want it to all be the same we want, again, we want that type one higher, but who would check and what a burden to kind of put on these health care workers who are giving vaccinations? I mean, I get it, if you're going up to kids, if you're a 12 year old, they're gonna say type two. But if you're 40, is someone going to be standing there saying, Well, what type do you have? What's your a one? See, show me your insulin pump? You know, it just seemed to put a burden on folks.   Paul Madden  13:12 Yeah, we certainly did with this. You know, we haven't done this, as you know, since the Spanish Flu 1918. But none of us were around, you know, maybe 30 people around, but they can't really relay the story very well. They were three years old.   Stacey Simms  13:27 And I hate to use a little dark humor. But people with type 1 diabetes were not included. They hadn't even figured out insulin at the last time   Paul Madden  13:34 we checked I was pretty insulin era. Exactly, exactly. Right. So we've got to keep pushing and you know it Stacey  advocacy. And for everyone who's participating in this advocacy is about getting the science clear. Having good backing, making sure you have some spokespersons from healthcare who are specialists in diabetes. I am a psychologist. I'm a diabetes educator. I know my diabetes, my personal diabetes of 59 plus years, and I've been an educator in it for 47 years, so I know it well. But I also realized that I often need to make sure I've got several physicians and other healthcare providers lined up and that we have done. Several people that have said, Yes, the Joslin clinic came roaring through and said, What do you need from us? We've got it. And they just sent me another article today that I can submit to the governor's office and the COVID Committee. And that's the type of things that we have to do. There's not enough people that get paid to be advocates. And I want to stress that and I wish that there were and I know the diabetes organizations wish they they had so much money that they could easily hire more people to do these things. So it really relies on us. The volunteers also offered to put the pieces together again working though, and supporting those diabetes health care providers.   Stacey Simms  15:00 So if someone isn't an individual, they're not affiliated with a formal advocacy group, and they're in a state like Massachusetts or another state where they haven't put the type one priority higher. What do you do? What do you call?   Stacey Simms  15:18 Right back to Paul answering that question. But first Diabetes Connections is brought to you by Gvoke Hypopen. And you know, almost everybody who takes insulin has experienced a low blood sugar and that can be scary. A very low blood sugar is really scary. And that's what Gvoke Hypopen comes in. It's the first auto injector to treat very low blood sugar Gvoke Hypopen is pre mixed and ready to go. With no visible needle. That means it's easy to use in usability studies, 99% of people were able to give Gvoke  correctly, I'm so glad to have something new, find out more go to Diabetes connections.com and click on the Gvoke logo. Gvoke shouldn't be used in patients with pheochromocytoma or insulinoma. Visit gvokeglucagon.com slash risk. Now back to Paul Madden answering my question of what are we supposed to do? Who do you call?   Paul Madden  16:08 Yeah, I think most people bombard their diabetes specialist team phone number and email which was by the young people especially. And typically, the diabetes professionals in our states know who the advocates are. And if they don't, and they're seeing this, I want to encourage you to find out who your your statewide volunteer advocates are, and know the people from JDRF, from ADA, from the diabetes, DPAC group, patient advocacy coalition. They're quite a remarkable group. This is to pay staff and a bunch of wonderful volunteers, some very top senior business leaders who have been in diabetes for a long time, including the nonprofit world in diabetes, and they volunteered their time for this. So your medical professional should know. And then we the people living with diabetes should get to know these advocates also, because there will be other issues. This is a big one right now. But there's other big issues, the whole reimbursement, the medical switching, all of these things that make no sense whatsoever.   Stacey Simms  17:14 Yeah. so in this situation, though, you would think it's better to call the people that are already working on it, rather than your congressman or your health department, or things like that?   Paul Madden  17:24 Well, no, I think rather to coordinate with the people that are already working on it. But no, Stacey , you bring up a great point here, you and I and all of us have to be wonderful employers. And by that I mean, our state representatives, our federal senators and representatives, they work for us whether or not you voted for them, they are in office and taxpayer dollars, pay their salaries and benefits packages. And again, we've got to be a cooperative employee, employer, but we they do work for us. And we have to make sure they understand that this is a priority for 1.6 million people in the United States that live with diabetes. Absolutely. Yeah.   Stacey Simms  18:08 I don't know if you can answer this. But I'm curious. Do you think that when the CDC put out those guidelines, and when states like Massachusetts aren't listening to advocates like yourself? I think not taking type 1 seriously? Do they maybe not understand it? They don't they think it's just kids? What do you think's going on?   Paul Madden  18:26 Yeah, so maybe it's not a full understanding, but that the medical experts on the COVID committees, typically, and I'll speak for Mass. These are good doctors. Yeah, they know medicine, but they also are not diabetes specialist. And the thing again, I'll go back to the does hinder us some, when you're trying to collect quick data on a crisis like this a COVID crisis, it takes five to six months to get enough, a big enough and a big enough group of people with type 1 diabetes that have had COVID. I respect that they went after this from the very beginning with What does healthcare show us? What does the what's the medical condition? Because we got to rank order this I appreciate that I even though I'm a psychologist, I always go after what's the medicine say first before I start to speak, and I surround myself with bright people who are endocrinologist who are brilliant research scientists, and they share things with me so I can understand it. And I can pass it along. But we've got to get the message. I tell you what I think is happening. This is a frightening crisis financially, for every state for an awful lot of good families. Some adults are out of jobs for the first time in their lives. And maybe they have a child and maybe even two children that happened to have diabetes or some other added concern that costs a lot of money. Sometimes, you know, some people have gone into more of a survival and I respect that and we are in a survival state of mind. It's hard to process more information coming in. And I'm aware that there are many groups right now approaching and I'll speak specifically for mass COVID. Committee, but it's all of the committee's in every state of saying, How come my condition is not a priority? How come this is not a priority. And I just would say to all of us that our diabetes will stick with the science, get medical people aligned with you. I remain very discouraged right now. But I remain very positive in the way I state things, because we must change this. And that has to change soon. I think the committee's are sometimes so overwhelmed with so many emails, and so many calls. And that's why I go to groups like Joslin, like Harvard for their backing. And I've pulled called in a colleague who was a good friend of a friend who knows the governor. So we're doing those types of things that we all of us will know someone who knows someone. And boy, you got to do that you have to win advocacy work? Yeah.   Stacey Simms  21:08 It's difficult to say the least I'm glad. I mean, I know how I would want to prioritize it. But I'm glad I'm not the person who has to prioritize it.   Paul Madden  21:17 Very challenging, difficult. And that's why they can put a little bit of a protection in front of themselves by saying, we understand the science clearly says this now. So now we must change this. And if you stay on the science, and that's it, the science will guide you with the wisest of decisions. Yeah.   Stacey Simms  21:37 I'm curious, Paul. And we will probably talk more about vaccinations as we go forward here. But how have you been this last year? You know,what have you been up to? I see all of your conference tags behind you. Obviously, we haven't been going to those conferences. How are you all doing?   Paul Madden  21:53 Yeah, I you know, it's challenging for me. And let me personalize it. It's challenging, challenging for me, for my sister's family, my brother's family, for cousins, all of us. We've actually done some zoom calls with cousins. Who ever would have thought I would have done that I would have just driven you know, 50 miles away to see my cousin. Right. early on. I you know, I had launched my business in after going into semi retirement and we had some family, a family challenge with a health issue with a wonderful loving family member. So I decided, oh, she's 68 years old, you can step back a little bit and focus more on family right now. And I appreciate that I had that that luxury, truly do. But then I realized and he's doing great. cancer free for the first time in over a year after seven years of dealing with a challenging cancer. So we are so blessed. And I realized, oh boy, you better get going. So I launched my business in January of last year. 2020. Wow. Robust February, and then the day flew home from the diabetes technology meetings in Madrid. I saw in a CNN screen in English, the first case of Corona Coronavirus, identified in Madrid, I had no idea what that meant. The last Sunday in February. Wow. What did I know that four to five weeks later, because I've had diabetes for so many years. Because I am over 65. I said, I just took a breath and said, You know what? You need to shut down. I certainly kept doing some present zoom presentations, some FDA work and all of that. But I really basically shut down what I was doing. You know,   Stacey Simms  23:34 from your perspective, you're much more dialed into this. Is this a question of sit tight, it's coming, push where you can? Or is there a voice in your head saying this is gonna take forever? We're not gonna get people with diabetes vaccinated until summer, or later, or? I'm not sure what I'm asking Paul. But I'm just sometimes I could lay awake at night and worry.   Paul Madden  23:51 Yeah. And so they're opening it up for me at over 65 tomorrow in Massachusetts. So I'll get it the first one within the next three to four or five weeks. Okay, at least I have an identified timeline now. But I do worry about the rest of my younger friends. I do. And I would say again, you are and this is on a state level. Now, your state senators and state representatives work for you. The science is very clear. That type one is comparable to the risk of type two diabetes, if you should happen to get COVID. And I would say make sure your governor's office knows that. Make sure the Department of Health knows that and absolutely call and ask your state senator and state representatives to work on your behalf or your loved ones behalf because we've got to change this. And the science is clearly there. It's on the ADA web page. It's on the JDRF web page. And clearly you can get a hold of the science and you look up COVID and diabetes right now. Did this morning, and some of the more prominent good studies are listed, including now to type 1 diabetes to   Stacey Simms  25:07 show wonder, I don't know if I agree with this, but I've heard a few people say that one of the issues was almost self created by at the very beginning of the pandemic, people feeling that there. And maybe it's because there wasn't enough information, but that people with type one who got COVID did not have as serious cases as people with type two, and somehow separating that out and saying, It's okay, we're gonna be okay. We don't have to worry as much because I remember seeing those posts back then. But as you're saying, the science doesn't bear that   Paul Madden  25:35 out. If you get it, you know, if you have type one or type two diabetes, there's no you have no greater chance of getting coke. Right, you know, thank goodness, so, so mass, washing hands, social distancing, all those things are crucial. And I just say to everyone hang in, the light is at the end of the tunnel in the months ahead, and I want to shorten it to a few months, not several more months. And that's why I'm saying for people with diabetes, and for our loved ones, you know, and maybe it's your neighbor, it's three houses down, who signed, married, the governor's daughter, I don't care what the connection is. It's been important our health, it really is. And that's networking at the fullest. And it's amazing to me, some of that my grandmother, one of my grandma's was an incredible network. And I think I probably got it from her and then passed along by my mother. You know, that's what you've got to do right now.   Stacey Simms  26:30 I'm curious to you know, do you think going forward, there are any lessons in this for the diabetes, the whole diabetes community, not just type one and lessons and all this?   Paul Madden  26:40 Yeah. So I think there are a couple of lessons and thanks for asking. I think the lessons are that, based on the science, standing together, we can change wrong agendas throughout our country relative to diabetes care. In this case, I mean, care for COVID prevention, vaccination, but for everything, and I need it for every new technology and drug that gets out there. If we stand together, just because you get the CGM. And if your other friend who's a senior or 12 years old, doesn't have the CGM help push for them. We are one family of 34 plus million people with type one or type two diabetes. I know the rest have distinct differences. But there's a lot of commonalities. And together that's an awful lot of votes for anyone who is serious about continuing in the political world. And I think we have to approach it like that. And it is a question of the blunt statement, the quality and quantity of one because Paul Madden has had access I had like like you and your family does with your son. I have been blessed. My mother and father knew nothing. When I was diagnosed. 59 years ago, there were under 3 million people in this country with diabetes. Wow. And it was it was closer to two is what I'm told, right? 34 plus million now. It's unbelievable. So diabetes really wasn't discussed. In fact, it was all the poor kid. He's got it. Yeah. Because people didn't survive. And my mother and father with my medical team at you have and I will say and we had a family practitioner, he diagnosed it. I was nine years old. I was peeing the bed like Niagara Falls.   I didn't know what was going on. And my sheets actually were sticky. So yes, folks, there is sugar in the urine. And I was heartbroken and I dropped 10 pounds. It was a healthy little boy. I would drop 10 pounds in five or six days. And the family doc said to my parents I was in the room and he said Mr. Mrs. Madden, Paul, I don't do diabetes and children, but the Joslin clinic is 15 miles away, and I'm gonna make a referral over there. And hallelujah for the next 30 years Dr. Leo Kroll and his team at Joslin imprinted on me beautifully on my parents, you know, my father walked me out into the courts when I was I guess it was 10 at that point, my first full summer with diabetes and walked me on the court to  meet Bill Talbert, the first professional and the first athlete ever that was named number one or two in the world that happened to have insulin dependent diabetes, Bill & I became good friends for the next almost 50 years before bill passed in his late 80s. But that was the exposure my parents made sure I got and that's that's what all of you have to do to to the best of your ability. You know, one reason I have stepped down after two terms in six years on the children with diabetes board, I just tell everyone and as you know, Stacey , it's it's we call it children with diabetes, but approximately half of the people come now are adults with type 1 diabetes. And I forget the numbers, Jeff Hitchcock sentences that over 5000 people did the Virtual Education because we couldn't meet in person. Oh, it was amazing. It was amazing. And you will find that yes, absolutely. But the camaraderie you get from that, and we bring in some of the finest speakers in the world who say yes. And typically they do it for free. That's unbelievable. They fly from all over. And not just sometimes the US from other countries even, you know, so it's that type of cost and peer support, because let's face it, kids with diabetes don't live there. They don't probably don't have six other neighbors in their neighborhood that are also kids with diabetes. No, no, do us adults who have type one diabetes, I don't know anyone who lives within three miles of me, that's not fair. I do know one gentleman who's had type 1 diabetes for 65 years. And we've known each other for 50 plus years. But other than that, I don't know who else has type 1 diabetes in the neighborhood. So Martin, and I go off a walk sometimes. And it's an absolute pleasure. And we do support each other. And it's the power of support when you're dealing with something you wish the heck you didn't have. And you know, you got to move through it. So you have the fullest, most robust and the happiest of lives, that peer support can be rather powerful. That's why I think a well run diabetes camp, I think, the support education groups at some of the organizations. That's why I think the podcasts are so crucial. I think things like this station that you and others are doing consistently, a very powerful to convey information. And again, you and I know as long as people remember that Paul said, what he does with his diabetes, gives me great results. Yeah, but remember, folks, I do it with my medical team who's coached me and always coach me. And if I ever had a problem, I can't figure out the answer to what I do. I'm a diabetes educator. But but when it's a personal thing, you don't stay as objective and you don't sometimes pull out all the science, right? When you're talking about yourself or thinking about yourself, I pick up the phone, and the young people probably send the email more frequently than I do. That's okay. Whatever your line of communication is, that's the important thing to promote the most robust health so that diabetes is an element of your life, but never hinders your life. That's the goal. That's the goal.   Stacey Simms  32:30 Paul, thank you so much. I could talk to you all day. You're inspiring on an I don't know, I'm gonna probably regret saying this. But you are inspiring on kind of like an everyday getting it done. level. You know, you and I are not people that are going to go up Mount Everest, I don't think you've been at Mount Everest.   Paul Madden  32:47 You know, I have a few merits. I know, I'm not gonna do Everest. I'll leave that to the world crushes.   Stacey Simms  32:56 But I just love it. And I'm so glad to hear your family members doing better than doing well. So stay well. Keep us posted. Thank you for your incredible advocacy. And let's follow up as more information comes in and you go give them Helen, Massachusetts, Paul.   Paul Madden  33:11 Absolutely. Listening, call your state reps and Saturdays, please. Thanks.   Unknown Speaker  33:23 You're listening to Diabetes Connections with Stacey Simms.   Stacey Simms  33:29 More information about Paul and about the COVID vaccine and what we can do, and more advocacy from the groups that he mentioned. I'll put that all in the show notes at Diabetes, Connections comm you can always find the episode homepage there. I always say this, but it's a little difficult sometimes in the podcast apps to find the links. So if you have any trouble, just head on back to the homepage, and it is always there for you. I want to make this as easy as possible. So if there's a better way to do it, or you need more info, always contact me Stacey  at Diabetes connections.com. We're going to talk about a new study looking at prevention of type one by focusing on babies. And a new study that I gotta tell you is a no duh. I mean, who was surprised by this kind of study, but that's coming up in just a moment. First, Diabetes Connections is brought to you by Dexcom. And do you know about Dexcom clarity, this is their diabetes management software. And for a long time, I just thought it was something our endo used, you can use it on both the desktop or as an app on your phone. It's an easy way to keep track of the big picture. I check it about once a week. And it really helps me and Benny just dial back and see longer term trends helps us not overreact to what happened for just one day, or even just one hour. The overlay reports help put context to Benny's glucose levels and patterns. You can even share the reports with your care team, which makes appointments a lot more productive. managing diabetes is not easy, but I feel like we have one of the very best CGM systems working for us. Find out more at Diabetes connections.com and click on the Dexcom logo.   Our innovations segment this week features a couple of studies that focus on kids. And this very first one is really for the tiniest in the diabetes community. It's a study that just started and it's looking at the correlation of the antibodies that appear in people with type 1 diabetes, as well as intestinal flora in early childhood. So basically, what the heck is going on in the gut in people who go on to develop type 1 diabetes, the study, and I'm not sure I'm pronouncing it correctly, I'll link it up with a study is center one, a si en T one, a. And it's going to start in the spring this year, in a few European countries, as part of an international initiative to prevent type 1 diabetes, it follows another study that they're all doing called point, which is administering insulin orally in the hopes that it would somehow it says your train and sensitize the immune system at an early stage so that auto immunity against insulin does not occur. So if the results were both studies show what they're hoping they're going to combine them for what they hope will be a type one prevention strategy, really interesting stuff. And I will link up this study. Again, it's not open here in the States. This is happening in Europe, but really interesting study. And I will link up more information. Again, it's happening in Europe. So it's not open for people in the United States to take part in. But hey, I'll keep you posted. The other study I want to talk about this week, and I mentioned this earlier in the show as like a real Hey, no duh type moment. But hey, these things have to be studied. I will read from the endocrinology network where I saw this written up, and they say, a closed loop control insulin delivery system could be safe and effective for use in adolescents and young adults with type one diabetes, according to the results of the International diabetes closed loop trial. Shockingly, I added that results of the study indicated use of a closed loop control for six months resulted in improved time and range and reduced incidence of hyperglycemia. In younger patients with type one diabetes, I shouldn't get around because they do need to prove these things. We do need to you know, make sure that there is clinical evidence before we move forward. But you as you listen, know, many of you have been doing DIY for many years, and you know this to be the case, I will make it up. Interestingly, as in most of these studies, the biggest improvement was in overnights, right, a lot less overnight, low blood sugar hypoglycemia, which is amazing. And I can tell you just from experience with Benny on what I call a hybrid closed loop, but Tandem is control IQ is one of those used in this study. So they're calling a closed loop. But I mean, he wakes up almost every morning, not only in range, but he wakes up almost every morning between 90 and 115. I mean, you know, for a 16 year old, it's pretty amazing. And I think that overnight sleep for everybody, it gets so much better. And that in and of itself is such a great health benefit. So I'll leave that study up as well. Next week, we're gonna be circling back to tell me something good. So I need your good stuff for the show. You can hit me up Stacey  at Diabetes connections.com. I will post to the Facebook group and I'd love to hear what's going on that you want to celebrate. Okay, before I let you go, I need to let you know that this was really weird. I had a crazy low blood sugar in the middle of this episode. Right after the dex comment that you heard. I pressed pause and I was feeling shaky and sweaty and I really was having trouble getting through it. I went downstairs and I checked my blood sugar with one of Benny's meters. And it was 46.  So I scurried around and got some peanut butter crackers, I probably should have had a juice box, I wasn't really thinking clearly shockingly. And I sat down and ate the crackers and waited for my blood sugar to come up. And boy, I gotta tell you, it's no shock to most of you. I was so hungry after that. And we're about half an hour away from dinner and slaves making a great dinner and I was so hungry, but I waited. And now I'm upstairs again, where my office is recording the podcast. It's not the first time that I've had a low blood sugar like that, that I've measured it that low. And I've talked to my doctor about it, I actually had a low blood sugar, the first time that I remember really measuring it several years ago at friends for life. And I checked it in the middle of the vendor Hall and it was it was in the 40s. And of course you know, you've got what a great place to have a low if Rudy was bringing me gummies and tabs and taking care of me. But you know, again, I don't have diabetes. And I don't have I don't think this is the right name for it. But I don't have like chronic hypoglycemia or anything dangerous. My doctor just has told me that I'm the kind of person that needs to eat every couple of hours and I need to be careful that I don't just eat empty carbs during the day that lunch and breakfast, have protein and all that good stuff. So today for the first time in a long time. I had a lunch that was not smart and it was delicious, but it was very carb heavy and I've been eating really lower carb for the last couple of months. So I just didn't have a lot of stuff in the house. Slade was at the grocery store. I had cheese blintzes for lunch. They were delicious. I'm not sure if they were working 46 blood sugar a couple of hours later, but there you go. So True Confessions all man, low blood sugars, they just suck. They feel like garbage. And I'm really happy that I'm feeling better. But I was sweating and low and shaky. And I think that feeling of wanting to eat everything after it's so difficult, I will follow up if I need to. I take very good care of my health and I take these things seriously. But I wanted to let you know that that happened while I was taping the show. How weird All right, a classic episode coming up in just a couple of days. We're gonna be taking a look back at Jerry the bear. And this is not during the bear as you know him today. This is a much earlier incarnation of Jerry and the great people who created him. It was so much fun to talk to them five years ago now man, I love these classic episodes. I hope you're enjoying them.   Stacey Simms  40:48 Thank you so much to my editor John Bukenas from audio editing solutions. Thank you so much for listening. I'm Stacey Simms. I'll see you back here in a couple of days. Until then, be kind to yourself.   Benny  41:03 Diabetes Connections is a production of Stacey Simms Media. All rights reserved. All wrongs avenged

Sickness among God’s People in the New Testament Although there is a close connection between faith and healing in the New Testament, we cannot automatically conclude that if a Christian is not healed it is because there is sin in their life or because they do not have enough faith. It is by no means as simple as that. Furthermore, that kind of teaching can lead to dangerous extremes like refusal to see a doctor when we are seriously ill. For example, any doctrine that teaches that God has guaranteed healing to us as Christians if only we will claim it by faith implies that it is unnecessary (and perhaps wrong) for Christians to resort to medical assistance when sick[1]. However, this is not a position adopted by the writers of the New Testament which, despite the many miraculous healings that are recorded, also makes reference to Christians who were sick and who did not find immediate supernatural healing.   These include: Paul Trophimus Epaphroditus Timothy. We will consider each of these in turn, before turning to the case of some of the Corinthians, who were sick because of their sin. The Weakness and Thorn in Paul's Flesh In Galatians 4:13 Paul says, As you know, it was because of an illness that I first preached the gospel to you. The Greek words translated as illness here literally mean a weakness in the flesh. This is similar to, though not the same as, the phrase a thorn in my flesh which he uses in 2 Corinthians 12:7. Although at first sight it is tempting to assume that these two expressions refer to the same thing, we certainly can not be sure, so we will deal with each separately. Paul’s illness (Galatians 4:13) Most commentators agree that Paul's ‘weakness’ was a sickness although there is little agreement as to what that sickness was[2].   Others, however, understand Paul's weakness to have resulted from the persecutions described in Acts 14:19ff[3].   But even if Paul's persecutions are seen as the cause of his weakness, that does not preclude the possibility that the weakness was a sickness.   Severe persecution such as Paul encountered could certainly lead to sickness. This possibility is acknowledged by Longenecker who suggests that: Perhaps that illness was a result of one or more of the afflictions mentioned in 2 Corinthians 11:23-25; frequent imprisonments, severe floggings...[4]. But whatever the cause of Paul's weakness might have been, its effects were undeniably physical as the use of the word flesh in this context clearly indicates[5].   Clearly either interpretation would fit the context and it would be unwise to be dogmatic as to the precise nature of that weakness or sickness.   In short, we cannot be sure that it was a sickness rather than a weakness (or vice versa). But does this matter?  It does for those who teach that Jesus died for our sicknesses as well as our sins and claim by faith such ‘promises’ as Matthew 8:17 and 1 Peter 2:24[6].   I say this because the Greek word astheneia (weakness or illness) is used in both Matthew 8:17 and Galatians 4:13, so to claim that in Galatians  astheneia refers to a weakness and not a sickness fails to resolve the difficulty, because in Matthew 8:17 Christ is said to have borne our astheneias!   So if this verse is to be claimed as the advocates of the doctrine say that it should be claimed[7] we may well ask why Paul did not claim deliverance from his astheneia.   We can only assume that he was ignorant of the doctrine!   Paul’s thorn in the flesh (2 Corinthians 12:7) This verse is set in the context of Paul's defence of his apostleship against the claims of those he calls false apostles (11:13). He refers to his abundant labours and frequent persecutions (11:23-33) as evidence.   In the opening verses of Chapter 12 Paul reluctantly (v.5) speaks of the visions and revelations (v.1) he has received and informs his readers that it is because of these that he has been given a thorn in the flesh, a messenger of Satan, to keep him from being excessively exalted (v.7).   But how is this thorn to be understood? Was it, or was it not, a sickness?   Paul’s Thorn - Not a sickness The view that Paul’s thorn was not a sickness is backed up by four facts: The phrase messenger of Satan could well refer to a person since, as Martin has pointed out[8], it appears that Paul does not use the Greek word aggelos (messenger) except to refer to a person. The thorn may well be rightly understood to be personal on the grounds that Chapters 10-13 describe Paul's fight against his adversaries. The use of the Greek word kolaphizein (torment) may be taken to refer to beating about the head. In the Septuagint the Greek word skolops (thorn) is associated with opponents of Israel (Numbers 33:55, Ezekiel 23:24).   Paul’s Thorn - Possibly a sickness Despite this evidence, however, the view that Paul's thorn was a sickness should not be entirely discounted, for the following reasons: Satan is associated with illness in biblical tradition (Job 2:5, Luke13:16) and it does not seem inappropriate for a sickness to be described as a messenger of Satan. Not all the difficulties Paul faces in chapters 10-13 need to have been inflicted by personal agency[9], and therefore the thorn need not be understood to be a person. Indeed, it is questionable whether Paul would have asked the Lord to take it away (12:8) if the thorn referred to human opposition[10]. But all this is extremely inconclusive and as Martin comments, “The exact meaning of the thorn remains elusive.   No one has ever yet given an interpretation that is generally accepted”[11]. Yet this uncertainty does not mean that nothing may be learned from the passage. It could be that our uncertainty about the thorn is providential as it leaves open a wider field of application to our personal needs[12].   Paul's thorn clearly represents suffering in some shape or form and, whatever its precise nature, there are lessons to be learned that may well be of value to Christians in circumstances far different from Paul's and yet undergoing a form of suffering for which the lessons of Paul's thorn may seem entirely appropriate.   Thus even if Paul's thorn was not a sickness – and in my view, on balance, it probably was not – the principles taught in the passage may certainly be applied in cases where a Christian’s sickness has not been healed in response to persistent and believing prayer. But such a position is unthinkable for those who hold that healing from sickness may always be immediately claimed because it is in the atonement.   Here, as with the passage in Galatians 4:13, it is vital for those who hold that view that Paul be shown not to have been sick.   Yet once again[13] the problem lies in Paul’s use of astheneia, for if Christ has really carried our astheneias (Matthew 8:17) how can Paul say that he glories in them (2 Corinthians 12:9)? Trophimus, Epaphroditus, and Timothy The evidence for the sickness of Trophimus, Epaphroditus and Timothy is very easily provided. 2 Timothy 4:20 tells us that Paul left Trophimus ill at Miletus. Philippians 2:27 reveals that Epaphroditus had been extremely ill, indeed he had nearly died, but the Lord had mercy on him. 1 Timothy 5:23 refers to Timothy's frequent illnesses and recommends the taking of a little wine as a remedy. Epaphroditus The passage in Philippians 2:25-30 shows us, first of all, that Epaphroditus was a highly respected servant of the Lord. There is certainly no suggestion that there was sin in his life or that he was lacking in faith! Paul describes him as my brother, fellow worker and fellow soldier, who is also your messenger (v.25). He tells the Philippians to welcome him in the Lord with great joy and honour men like him (v.29). This was because he had risked his life for the work of Christ and had almost died (v. 30). Yet the passage makes it abundantly clear that this outstanding servant of the Lord became very sick – even to the point of death (Philippians 2:27).   Of course, Epaphroditus was healed.   But the words But God had mercy on him (v.27) are very significant.   Far from implying that Epaphroditus claimed his healing, these words clearly indicate that the source of his healing was God’s gracious mercy. Nothing else is said about what caused the healing.   There is no suggestion that Paul, whose miracle-working power is well known both from the Book of Acts and from passages like Romans 15:18-20, could command his friend’s recovery.   There is no mention of faith, or prayer, or the laying on of hands, or the anointing with oil.  Rather, Paul views Epaphroditus’s recovery as the direct merciful intervention of God. Furthermore, it is significant that Epaphroditus was not healed immediately. Yet, if getting healed were as simple as claiming it by faith, why didn’t Paul command his healing straightaway, or why didn’t Epaphroditus himself rise up in faith the moment he first got sick? Of course there is no easy answer to such questions, but what is clear from the case of Epaphroditus is that good Christians can get seriously ill and that they are not always healed immediately.   Trophimus 2 Timothy 4:20 simply states that Paul left Trophimus at Miletus sick.   But if healing is readily available and may be claimed by faith in the ‘promise’ that Christ has already carried our sicknesses, then why didn’t Trophimus claim it?   Surely if Paul had believed such a doctrine, Timothy, as one of his companions, would have known about it too? Yet it appears that he did not, for Paul left him at Miletus sick. Some have suggested that perhaps Trophimus himself was to blame for his illness or simply lacked faith for healing[14].   But this is an entirely unwarranted assumption!   As Donald Gee pointed out: Those who want, somehow or other, to fit in this verse about the illness of Trophimus with their own doctrines of divine healing are tempted to assert that he MUST have failed somewhere.   But that is the worst possible way of interpreting the Scriptures.  There is nothing whatever, in the statement, or in its context, to suggest anything spiritually or morally wrong about Trophimus[15].   And the alternative explanation, that Trophimus may have been healed later (with the corollary that not all healings are instantaneous)[16] really fares no better.   First, there is no statement that Trophimus was healed later, and secondly, the defence that not all healings are instantaneous really will not do. If sickness has really already been carried by Christ and healing may, therefore, be claimed by faith immediately[17], there should be no need for any delayed healings! Thus the simple brief statement that Paul left Trophimus sick at Miletus implies that neither Trophimus nor Paul could demand his healing. Indeed, according to Paul, healing like other spiritual gifts is as the Spirit himself determines (1 Cor.12:8-11).   Timothy Paul's inability to use his healing gifts whenever he chose is also made clear in his recommendation that Timothy take a little wine for the sake of his stomach and his frequent illnesses (1 Timothy 5:23).   As with Trophimus, if the illness were Timothy’s fault we might have expected Paul to say so and to encourage him to rectify the matter accordingly.   Instead he offers a medicinal solution.  If Paul had believed that healing could always be claimed by faith, why did he not encourage Timothy to do so? But it is perfectly clear that Paul neither believed nor taught any such doctrine! In considering the cases of Paul, Trophimus, Epaphroditus, and Timothy, therefore, we have shown that: Highly respected servants of God may become sick – sometimes seriously Sickness is not always caused by lack of faith or sin Healing is not always immediate Although we firmly believe in God’s power and willingness to heal, it is not always possible to claim healing[18].   [1]See Thesis pp.14-18, 21, 24.   Cf. pp.38-44, 81-84. [2] Suggestions include malaria, epilepsy, and poor eyesight. See Note 10 on p 271 of Thesis. [3] E.g. Ridderbos, H.N., ‘The Epistle of Paul to the Churches of Galatia’, Grand Rapids, Eerdmans, 1976, pp. 166-167 [4]Longenecker, R.N., 'Galatians', Dallas, Word, 1990, pp. 190-191 [5]The context does not allow for flesh to be understood in its ethical sense here. [6]See, for example, my comments with regard to Carrie Judd Montgomery and A.B.Simpson on pp. 18-24 of Thesis, esp. p.19.   See also pp.34-37. [7]E.g. Osborn, T.L., Healing the Sick, Tulsa, TLO Evangelistic Association, 1961, p.48. Cf. Montgomery, C.J., The Prayer of Faith, London, Victory, 1930, pp. 41 and 47.   See my discussion of Matthew 8:17 and the reasons for rejecting this claim in Chapter 4 of Thesis, esp. pp. 116ff. [8]Martin, R.P., 2 Corinthians, Waco Word, 1986, pp.413-414. [9]See, for example, 2 Corinthians 11-23 (esp.v.27) [10]So Martin, op. cit. p.415. [11]See Note 29 of Thesis (pp.273-4 ) [12]So, Hughes, op. cit., p.442.   See also Barnett,  ‘The Message of  2 Corinthians’, Leicester, IVP, 1988, p.177 [13]Cf. my comments on p. 254 of Thesis. [14]Simpson and Jeter both suggest this. See: Simpson, A.B., ‘The Gospel of Healing’, London, Morgan & Scott, 1995, pp.63-64. Jeter, H., ‘By His stripes’, Springfield, GPH, 1977, pp. 105-106. [15]Gee, D., 'Trophimus I left Sick', London, Elim, 1952, p.12. [16]Again Simpson and Jeter both suggest this.   See note 1 on p 178. [17]See, for example, my quotation from Copeland on pp. 1-2 of Thesis. [18] As I have already suggested, we need, like Jesus, to know what the Father is doing. It is only when we are submitted to his authority and hearing from him, that we can speak with his authority and in his name claim or command healing.

Copywriting with Martin Booth Copywriting is second nature to Martin Booth. He learnt his trade as a journalist. Now he runs Leboo Media in Kingston, south west London. A Career in Sports Journalism Martin's background is in journalism. Particularly, sports journalism. He spent more than 20 years on the staff of various national newspaper titles on the sports pages. He worked for the Daily Express, Sunday Mirror and News of the World (when it closed down in 2011). After that, Martin moved into the betting industry both in business and consumer markets. After his contract with that industry expired he just knew he should be doing words. The Go-to Copywriter When someone around him in his various job postings wanted something doing with copywriting or words (LinkedIn profile, a strategy for horse-racing, etc) Martin was the person they turned to. He realised this was his sweet-spot. 18 months ago, he started networking around his home in Kingston, SW London, and picked up several contracts. He went from there. What sort of material does he write? You name it, Martin will write it. "I keep hearing I'm supposed to find a niche and specialise." He writes: webpages blogs case studies emails articles white papers annual reports brochures leaflets big documents audio scripts video scripts plus a lot of proof reading! Who are his copywriting clients? Nor does he work for any particular sector of clients. Recently, he has written for: charities carpet cleaners bike makers garden suppliers solicitors planners data security specialists someone who makes mayonnaise property experts mortgage providers At this stage in his businesses development, he is happy to say, "come one, come all". His niche is words. What has mayonnaise got in common with journalism? http://thenext100days.org/wp-content/uploads/2018/11/Mayonnaise.mp4   LISTEN - your initial briefing Who is your audience? Who are you trying to get this over to? Shorthand Martin One icebreaker Martin deploys is shorthand... Listen to the story and re-produce it faithfully (hence shorthand) for the client in a commercial context. from wsj.com LeBoo Media - it's French isn't it? http://thenext100days.org/wp-content/uploads/2018/11/LeBoo-french.mp4   When a client says their audience is 'anyone really', who must delve deeper to help them. is it people in a particular area? age group? demographic? Then you can write for the audience. So the message is phrased and targeted to the right people. It is always better to absorb feedback from customers' clients. Speak to happy customers and adopt that as part of the copy. This message: I needed this The company provided that Therefore I'd recommend them The Manchester United Transfer Story - promote the headline grabbing story that will attract readers. Martin wrote a book last week 10,000 words, loads of illustration, for the centenary of a design company. He loved it. The research. Listening to people who have worked there. He enjoys getting the tone of voice. So Martin is a ghostwriter in waiting. The designer in question designed Welwyn Garden City? [a cemetery with light?] Copywriting versus Journalism So much comes down to clients. It's about establishing trust. Client: leverage their satisfaction. What fails has Martin observed? how often do you go on a website and YOU HAVE NO IDEA WHAT THEY DO and the benefit they bring to you. absolutely critical we are, we do - rare do they use YOU heres how we are positioned to solve your problem Martin would love it if everybody used the word YOU. LeBoo - Getting the Message Across The first word on his website is You've... Focus on benefits All his networking group sell 'peace of mind'. Mortgage, IT support, copywriting = peace of mind. Ease that burden.

Overview:  As the tax against self service endpoints evolve to be more complex, and many financial institutions struggle to keep up, there's a growing demand for security management services in the industry. In this podcast, you will hear about this trend and what it means for financial institutions.  Resources:  Blog: A look at how ATM security has changed … and how it hasn’t ATM Security Management: Know Your Options COMMERCE NOW (Diebold Nixdorf Podcast)   Diebold Nixdorf Website Transcription: Amy Lombardo:                00:00                     Hello again, and thank you for joining us on this episode of Commerce Now. As the tax against self service endpoints evolve to be more complex, and many financial institutions struggle to keep up, there's a growing demand for security management services in the industry. Today I have the pleasure of being joined by Julie Osborne, our Global Vice President of Diebold Nixdorf's Service Portfolio, and Martin Nearhos, Principal Security Architect for the Global Services Portfolio Division as well. We're going to hear about this trend and what it means for financial institutions. So, hello Julie and Martin. Thanks for being with me here today. Julie Osborne:                   00:38                     Thanks Amy, it's a pleasure. Thanks for having me. Martin Nearhos:               00:41                     Yeah, thanks Amy. Happy to be here. Amy Lombardo:                00:44                     Okay. I'm really excited here, because I'm based here in the US, but I'm talking to two subject matter experts who are in our Singapore office. It's great to just have this global view on this security topic. So, let's dive in here. Let's start with just a high level question on why do you think financial institutions are having difficulty managing their self service security? Martin Nearhos:               01:10                     That's a good question. Maintaining the security of the customers' assets and information has always been a high priority for the industry, but threats against the self service banking channel have evolved. It's now much harder to keep up. A tax against ATMs have traditionally been isolated to geographic regions, and slow moving out of those regions, but this is no longer the case. We're now seeing increasingly complex attacks, such as various forms of jackpotting, taking place across the globe, and at the same time the threat of traditional physical attacks hasn't really gone away. It's a lot to combat. Julie Osborne:                   01:47                     If I might just add to what Martin said, financial institutions usually don't have the time or in-house expertise to keep security measures up to date. As retail banking paradigms shift, banks and credit unions are under a lot of pressure to do more with less, and even if financial institutions wanted to hire in-house security specialists, as businesses and governments fight cyber security threats, these resources tend to be really expensive and in high demand. Also, as we all know, this constant pressure to stay compliant with security regulations and industry standards, ATM security service providers can help relieve the burden of staying on top of changes and staying protected against attacks. Amy Lombardo:                02:28                     Okay. Got it. Martin, if I can ask this to you before we jump into this whole idea of doing more with less, since you're located in the Asia Pacific region, are there certain types of attacks that you're seeing on the rise today? We talked a lot about jackpotting in the Americas, but could you give us an idea of maybe what you're seeing over in your region? Martin Nearhos:               02:51                     The Asia Pacific region is quite diverse. You've got many different markets at many levels of maturity, so it varies. Locally you won't get, say Singapore, there's a certain limit to attacks, whereas in other countries very close by, you've got a much broader range of attacks. It's complex and it doesn't move. Amy Lombardo:                03:15                     Got it. Yeah. It sounds like no matter where you are, just keeping on top of that security is always going to be top of mind here. Martin Nearhos:               03:22                     Yep. Amy Lombardo:                03:23                     Okay. Let's talk about this idea of doing a little more with less. When we're looking at it from a financial institution standpoint, can we talk a little bit about why they should be looking into outsourcing their ATM service and management? Julie Osborne:                   03:37                     Oh, absolutely Amy. I might take that one. It's becoming increasingly popular for FIs to work with organizations that have intimate knowledge of the ATM channel, and offer specialized security services as part of ATM fleet management arrangements. They will want someone who can offer 24/7 secure operation centers for monitoring, and who can also take care of all necessary maintenance, hardware and software upgrades, and updates for them. Some FIs don't have the capability in house to reliably maintain secure ATM environments, and others would just simply rather have someone else handle it because it is a specialist capability, as I said. So, if FIs are looking to take the burden off themselves and effectively manage the security services of the ATM  fleet, with an ATM security service provider such as Diebold Nixdorf, they should look for a provider who can deliver the following three things.                                                                                 First, you'd want optimized security through 24/7 monitoring, proactive threat elimination, and an in depth understanding of emerging threats, to try and protect against attackers. Second, you'd want increased efficiency, freeing the FI from day to day ATM security management responsibilities, or streamlining processes. Third, you want a service that will effectively manage operational risk, to provide real time threat insights, and offer remote troubleshooting, and has a deep understanding of the industry requirements. Ultimately, I think the best approach is a multilayered security protection approach that offers real time information to ensure ATM networks are protected and available, whilst also providing the information FIs need for a [inaudible 00:05:17] ATM security audits. Amy Lombardo:                05:19                     Okay, got it. Those three points were really helpful here, especially in looking to determine your outsourcing, your Managed Security Services, but what does an engagement actually look like for an financial institution? What are some of the specific options, and what would it take to get a program like this up and running? Martin Nearhos:               05:41                     I can take that. If you're an existing customer, and you're already ready using sort of self service fleet management, which is just a suite of services designed to run multi-vendor self service devices cost effectively, the customer can sort of decide what level of protection makes sense for their organization, based on their risk profile and their operational risk. If you're a new customer, we'd look at all the fleet details that required. The ATM make, the model, physical location, that would all be analyzed. Then the customer would select the appropriate security service, and again, it's based on their business and operational risk. We suggest that whatever FIs choose is a core security service. The services offered should, at the very least, provide everything needed to comply with industry standards and requirements such as those developed by the Payment Card Industry Security Standards Council.                                                                                 It should also include the hardening of various aspects of the ATM with remote monitoring and software patch deployment. It would also include things like device monitoring, secure connectivity, managed firewall, peripheral device control, anti malware, antivirus, and of course intrusion detection and prevention. Then the FI can have the option to build upon that basic level of services for such things as protection against complex logical system attacks. Although I would recommend this sort of protection to everyone, we know that financial institutions want to prioritize their investments in advanced security, and they just can't do it all at once. With these types of services, FIs can then rely on the security service provider to proactively monitor the ATM for suspicious activity, protecting terminals more effectively in real time, responding quickly when attacks are detected, and engage with customers to resolve the incident, and take the burden of managing the self service fleet off the FI, who, as we've already said, may be stretched pretty thin on resources. Amy Lombardo:                07:42                     So Martin, if I can ask you a question here just based off of the compliance portion, the regulation portion of what you mentioned, I would think that's pretty important, almost as a value added services as well, that your security partner could provide you almost with the consultation, the education, on what all these requirements might mean for your institution. Am I thinking about that the right way? Martin Nearhos:               08:11                     You are. There's some industry standards that, across everywhere, but what happens is you get into regional areas. Some have slightly different requirements, so as a global offering, it's quite difficult, but we have specialists in all the major regions that could offer that service. Amy Lombardo:                08:29                     Okay. Thank you. Okay, so to close out this topic, have you heard how customers are responding to these types of Managed Security Services in the industry today? Are they able to focus more on their customers without the burden of managing their own ATM security services then internally? Julie, how about you take that one? Julie Osborne:                   08:51                     Thanks Amy. Actually we have. We've seen some very positive results from the financial industry. Threats against the self service channel aren't going away anytime soon, but with Managed Security Services, financial institutions can spend less time trying to prevent attacks, and spend more time with their customers growing their businesses, and ultimately that's where we want them to be. Martin Nearhos:               09:11                     And, just as the FI is focusing on on their customer, the security service provider, but it's got to focus on continuing to evolve and develop, because the expectations will continue to rise, and FIs will expect to be offered more value in the future as well. Amy Lombardo:                09:29                     Well great. This sounds like a no-brainer to me. I would want to stay protected and just not have that burden internally. Thanks Julia and Martin for being with me here today, and to our listeners for tuning into this episode of Commerce Now to learn more about Managed Security Services, and how FIs can better protect themselves. Log Onto DieboldNixdorf.com. Until next time, keep checking back on iTunes or your favorite podcast listening channel for new topics on Commerce Now.    

Another episode of tales at sea. Following on from the mysterious tales of the Dark Gentleman, we find another curious passenger on board…although will they turn out to be any less disturbing to the crew? Music: Creepy — Bensound.com.   Andrew: Here are some Totally Made Up Tales, brought to you by the magic of the internet. This week: The Stowaway. James: Martin, the First Mate, thought he knew everything about this ship, as First Mates really ought to. Andrew: It was not the largest ship the world had ever seen, but nevertheless it contained many nooks and crannies and corners that men who had served on it across journeys of several months had still not managed to explore. James: Martin, however, knew them all. But something was not quite right. Andrew: There was a strange energy on board the ship, that was quite different to the masculine peace that settled aboard the boat once the shore was safely left behind. James: It reminded him of the one or two times when they'd transported families from Southampton across to the New World looking for a new life. Andrew: It was not as strange as the time when the famous occultist traveled with them and disappeared halfway across the ocean, but it was still something not quite right. James: Martin didn't like it when things weren't quite right, it upset the smooth running of the ship and it made the men grumble, and that was one of the worst things to contend with. Andrew: He decided that he would determine for himself whether there was anything untoward going on, on the ship, but he would do it in a subtle and determined manner. James: He drew up a schedule where he could regularly walk every turn and every corner of every deck, both above and below. Andrew: He began his exploration and very soon began to have an even more acute sense that there was something either just ahead of him or just behind him, but it was as if, whenever he turned his head, the thing it was that was following him or that he was following — and he could not be sure which it was — had disappeared, and he was left once more alone. James: He had first had the sense a day or two out of port, and it continued for a full week, gradually making him more and more frustrated, until one day, Timothy, the old cook, came to him. Andrew: Timothy was a grumpy man, perpetually red in the face with irritation, and missing his right leg. He had adapted his kitchen galley successfully so that he could navigate his way around, but in all other areas of the deck he moved on traditional sailor's wooden crutches. James: He came to Martin with a complaint about theft. Andrew: An entire barrel of biscuits, which he had been intending to use later that week, had disappeared from the kitchen, lock, stock, and barrel. James: Martin knew that none of the men would have tried to secrete an entire barrel anywhere else about the ship, it was a ridiculous and foolhardy notion that you could even get away with it, and so he continued his pacing about the decks until he discovered the barrel, now empty, in one of the smaller holds. Andrew: Scattered on the floor around the barrel here and there were biscuity crumbs. James: Martin spent some time checking the rest of the hold, looking behind the crates and boxes, and underneath the tarpaulins, but he could not find any indication, other than the barrel and the crumbs, that anything was amiss. Andrew: Later that day, in the evening, he sat down with the Captain for dinner, and the Captain turned to him with his customary question and said, "Well then, First Mate, what are the news?" James: He recounted how Timothy had come to him and his investigation and what he'd discovered, and the Captain looked at him with suspicion crossing his face, "Have you felt a presence onboard ship?" he asked. Andrew: "Well sir, as it happens," Martin replied, "I have felt a rather different atmosphere on the ship than usual… it has seemed that there has been something here." "What do you make of… this?" said the Captain. He opened the draw of his work desk and took out a piece of paper covered in a strange childish scrawl, and laid it out in front of the First Mate. James: "Was that? It looks like it was drawn by a child, sir." Andrew: "Yes, it could be a child or possibly a madman, or I'm not entirely sure. I dismissed it entirely of course, read it through for me." James: "I can't make it out at all, sir. It doesn't seem to be written in English, or indeed any other language as I recognise." Andrew: "Yes, I thought that," said the Captain. "But here, look, when you hold it up to a mirror, now try." James: "Oh my word," said Martin. "You're right. It's a diary." Andrew: "Yes, that's right. A page from a diary. A diary that's been kept while on this ship. I found it fluttering along the passage outside the door to the hold." James: "Do you really think so sir? We have a stowaway?" Andrew: "I think we should consider the possibility. Nothing has been quite right on this ship since the time that mysterious man disappeared after saving us from pirates, and I wonder if the forces of the occult have returned to haunt us." James: "I shall organise the men to do a thorough inspection, sir. I'm sure we will catch them." And indeed Martin was sure that he would catch the stowaway. Andrew: Duly assembled, the men set out in groups of two around the various passages of the ship in search of the mysterious diary writer. James: Creeping down the passageways, hunting through the holds, peering into the dark corners, the men gradually covered every inch of the ship. Andrew: Each pair in their turn, returned from their searching to the main deck to report to the First Mate, and came back empty handed. Not a sign, not a scrap, not the slightest clue as to the writer of the diary had been found. James: Two by two, Martin ticked them off in his head until there were five pairs still out, then four, then three, then two. The last pair that had gone down into the holds below reported that they could see nothing out of the ordinary, and he was just wondering how the other pair was getting along when the sound of a struggle came from the cabins that they had been searching. Andrew: The cries and thuds muffled by the several layers of decking nevertheless could be heard and stirred an immediate call to action in the First Mate. He grabbed two of the pairs nearest him, his trustiest men, and set off down the hatches to go and investigate for himself. James: He burst in, the men hard behind him, on an amazing scene. Andrew: Inside the passengers' cabin, standing quietly and unassumingly in the centre of the passenger cabin was a small elfin faced girl with close cropped hair, beaming at them with her hands on her hips. Lying on the ground of the cabin in front of her were the two burly sailors, out for the count. James: A thought flashed through Martin's mind, wondering how on each how such a small child had managed to overcome such large men, but he was too well trained to voice this concern. "Seize her!" he cried. Andrew: The men who had come down with him and to whom his order was addressed looked at the girl, looked at their fallen comrades, looked nervously at each other, and hesitated upon the threshold. "Didn't you hear me, men?" said the First Mate, "in and seize her!" James: Greg looked at Harry, and Harry looked at Greg, and neither of them wanted to be the one to make the first move. So Martin reached forward and grabbed the girl by the scruff of the neck. Andrew: At once, she burst into tears, and paying no heed to her bawling, Martin dragged her through the passageway, dragged her up onto the deck, into the Captain's cabin, where he threw her roughly to her knees in front of the ship's commander. James: "Good work, Martin," said the Captain. "And what are you, eh?" Andrew: The little girl looked at him, sobbing, wide eyed, and said, "oh please sir, please, have mercy on me." James: Martin nudged her with his foot. "Captain asked you a question," he said. Andrew: "Oh, oh, I am ..." The girl took a deep breath in and looked directly at the Captain imploringly and said, "I am but a poor child, sir. My father was a sailor of many years standing and spent his life at sea and one day in a tragic accident was killed when his ship caught fire. My mother was unable to support herself, me and my brother, and my brother signed up to sail to the New World in the Navy and I decided that the only way forward for me was to follow him and so I ended up here on the first ship I was told was sailing to the New World and I hid in the hold." James: The Captain looked at her sternly. "I cannot just let stowaways use my ship as free transport between the continents." He said. "We cannot throw you overboard, we're in the middle of the sea, but if you are to remain here, you must work to earn your keep." Andrew: "We have no use for you on deck, this is man's work requiring a man's strength, but the kitchen is short of a boy, you shall serve there for the remainder of the voyage. Go, at once. You will be directed by Timothy the cook." James: And so Martin took her down to the galley, and introduced her to Timothy, and Timothy immediately put her to work scrubbing the Brodie stove to keep it clean or at least as clean as Timothy deemed necessary for basic sanitary food production purposes. Andrew: With a dedication and an application and a thoroughness that seemed uncharacteristic for someone that looked outwardly so delicate, the little girl scrubbed at the stove, scrubbed and polished and shined. Bucket after bucket of dirty water was emptied over the rail into the sea, until the Brodie stove was as good as new. She turned to the cook and said, "sir, I have scrubbed the stove. What would you have me do next?" Tim looked at her and said, "sir? I'll have no sir in my kitchen! I'm Tim the cook, and what's your name?" James: In a small voice, Elsie introduced herself and told her story of how she had come to be on the boat. In return, Timothy gave her a history of the vessel, including some of the rare goods that they had transported and the confusing and perplexing tale of the Master of the Dark Arts, who had recently bought passage with them to the New World. Andrew: Over the days that followed, Tim and Elsie built up an extraordinary rapport. The cook, who was usually one of the grumpiest and least sociable fellows aboard the ship, had taken a shine to this little girl, and she to him. The atmosphere in the kitchen changed from one of shouting and swearing to one of laughter and camaraderie, and the quality of the food rose remarkably as a result, raising the morale of the rest of the crew. James: Over dinner one night at the Captain's table, the Second Mate, Will, turned to the First Mate, Martin, and mentioned sotte voce that perhaps they should have a stowaway on every voyage. Andrew: They laughed, looking at their empty plates wiped clean by freshly baked bread, when suddenly they were interrupted by a cry from the lookout tower. "Ship ahoy!" James: Coming onto the deck, the Captain looked at the lookout, who was pointing hard astern. Behind, somewhere in the darkness, there was a light. Andrew: A half a mile off or so it seemed, there was a ship shaped object bobbing backwards and forwards with the motion of the waves with an eerie glow that seemed almost otherworldly. James: Slowly, the shadowy shape was gaining on them. Andrew: The Captain summoned the crew to their action stations, called for the sails to be hoisted full up, and observed the mysterious shape still gaining on them. James: The faster they went, the faster it pursued. As the spectre came closer, the lanterns from their own ship, and the light inside it, gradually made the shape clearer. Andrew: The First Mate turned to the Second Mate and, furrowing his brow, said, "this is going to sound like a very strange thing to say, but does that look to you like a ship made out of smoke?" James: "Not any ship," said the Captain. "That is the ship that we saw burn to the waterline." And it was true, the superstructure looked identical, the rigging, the position of the masts and sails. It was the pirate ship that had chased them so recently. Andrew: And as it came closer, the mysterious glow that had revealed it when it was at a distance to the lookout resolved into the flickering embers of the final burning pieces of wood floating on the water underneath the smoky shape. James: "Can we even fight that, sir?" asked the Second Mate. Andrew: "Do we need to fight it, sir?" said the First Mate. "What's its intention? It's just smoke." James: "It's evil," said the Captain. "Prepare the cannon." Andrew: "How do you know it's evil, sir?" said Will. James: "I just have a feeling," said the Captain. "The feeling that evil has been dogging us ever since that ship burned." Andrew: The cannon trundled forward on its heavy wheels to the ship's rail and was being loaded by the men responsible for it. They turned to the Captain and said, "Ready to fire, sir", and the Captain said, "Very well, fire at —" But before he could finish the command, a small tug on his elbow revealed that Elsie had come up to the deck and was looking at him with a serious face. "Please sir," she said, "don't fire on the vessel, it's me that it's come for. Please let me go and speak to it." James: Agog, the Captain let her pass. Elsie walked right up to the rail and held her hand out towards the ship that was now only a few dozen feet away. Andrew: Out of the swirling mass of smoke that made up the shape of the ship, with its amorphous and shifting edge, there seemed to solidify an additional shape of a man standing opposite Elsie, face to face, where the rail of that ship would be if it had a rail, and it seemed to that an arm came out from his smoky body and extended across the water and gently, gently, gently made its dark tendrily way to her hand until it touched it. James: As soon as it did, the smoky ship started to dissolve and waft away on the fresh breeze coming in from the ocean behind it. "Daddy," she called out gently. And in response, a deep thrumming sound seemed to make the word "Elsie" from across the water. Andrew: With the contact between the two having been made, the form of the smoke ship dissolved and it became once more the mists that roll over the seas at night and ceased to have any shape or solidity. James: And as it dissolved, so too did Elsie's form gradually fade away until the Captain, the First and Second Mate and the crew members could see plain through her. Andrew: As she was on the verge of disappearing before their very eyes, she turned looking at the crew in turn and taking them all in with her penetrating gaze, finally her eyes rested on the Captain and she said, "thank you" — and vanished. There came from the hatch leading down to the galley a sobbing which caused the First Mate to turn and there to his surprise he saw Tim with his face buried in his cook's apron, uncharacteristically emotional. James: The crew were quiet for the rest of the journey, less banter and less grumbling than usual. In the Captain's cabin, a number of hushed conversations over dinner attempted to discern just what Elsie had been and where she had gone — but without coming to any conclusions. Andrew: The only thing that everybody could agree on was that the quality of the food had improved, and from that day forward it remained the best on the high seas.

I normally edit each interview to fit into one podcast, but Martin has too many great stories, including one interesting encounter he had with Luigi Nono, which he wrote about in the New York Times, and many others about studying with Ligeti. So Martin gets two episodes. In part one we talk about different political climates and the music being made in them. In part two we focus on his music and aesthetics. You can listen to more on his website www.martinbresnick.com.Martin is a composer from New York who teaches at Yale University. He has written music for films, orchestras, and chamber ensembles, and has won numerous prizes including three N.E.A. Composer Grants, a residency at the American Academy In Rome, the ASCAP Foundation’s Aaron Copland Prize for teaching, a Guggenheim Fellowship, and an elected membership to the American Academy of Arts and Letters.

I normally edit each interview to fit into one podcast, but Martin has too many great stories, including one interesting encounter he had with Luigi Nono, which he wrote about in the New York Times, and many others about studying with Ligeti. So Martin gets two episodes. In part one we talk about different political climates and the music being made in them. In part two, which will be released next week, we focus on his music and aesthetics. You can listen to more on his website www.martinbresnick.com.Martin is a composer from New York who teaches at Yale University. He has written music for films, orchestras, and chamber ensembles, and has won numerous prizes including three N.E.A. Composer Grants, a residency at the American Academy In Rome, the ASCAP Foundation’s Aaron Copland Prize for teaching, a Guggenheim Fellowship, and an elected membership to the American Academy of Arts and Letters.