“I think that there are certain agents that are so foundational in some diseases that they will remain. Whether they remain first-line, maybe not; maybe they'll go to second line as we see things evolve with new agents. Some of these drugs have been very effective in the diseases in which they are used to treat patients. There's a long term place in therapy for these, and I think that will still be using these,” Rowena Schwartz, PharmD, BCOP, FHOPA, known to many as “Moe,” professor of pharmacy practice at James L. Winkle College of Pharmacy at the University of Cincinnati in Ohio, told Lenise Taylor, oncology clinical specialist at ONS, during a discussion about what oncology nurses need to know about antimetabolites. This episode is part of a series about drug classes, which we'll include a link to in the episode notes. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.5 contact hours of nursing continuing professional development (NCPD), which may be applied to the oncology nursing practice and treatment ILNA categories, by listening to the full recording and completing an evaluation at myoutcomes.ons.org by December 1, 2025. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to antimetabolites. Episode Notes Complete this evaluation for free NCPD. Oncology Nursing Podcast: Pharmacology 101 series ONS Voice oncology drug reference sheets ONS books: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition) Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice ONS courses: ONS/ONCC Chemotherapy Immunotherapy Certificate Course ONS Fundamentals of Chemotherapy Immunotherapy Administration Clinical Journal of Oncology Nursing article: Chemoprevention: An Overview of Pharmacologic Agents and Nursing Considerations ONS Huddle Cards: Antimetabolites Alkylating Agents Miscellaneous Agents Patient education guides created as a collaboration between ONS, HOPA, NCODA, and the Association of Community Cancer Centers: Oral Chemotherapy Education Sheets Intravenous Cancer Treatment Education Sheets To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode “Antimetabolites are relatively old agents. They are some of the oldest anti-cancer drugs that we have. They were developed to be similar to naturally occurring compounds that are important in cellular production. They are similar but not the same. So, they sometimes will bind to an enzyme important for cell proliferation. And because it binds to an enzyme, does it mean that it helps the enzyme? It may block it and that may cause cell death. And so, they've been used for a long time in oncology.” TS 1:44 “There's different classes of antimetabolites in oncology. If you think of the structure of DNA, there is purines, that's adenine and guanine, there are pyrimidines, which are things like cytosine and limonene, and then in RNA there's uracil. So, some of the antimetabolites are either purine analogues or pyrimidine analogues, meaning they look very much like the natural parts of DNA, and by being incorporated into the DNA they cause cell death. There's also a class of antimetabolites that interfere with how we use folate in the body, such as methotrexate is an obvious one, and these are called folate antagonists.” TS 2:43 “The purine analogs—and those are things like fludarabine or clofarabine—those drugs are very toxic to lymphocytes. And because they're very toxic to lymphocytes, these are drugs that we use in lymphocytic diseases. But that also means that these are drugs that we get immunosuppression because of the toxicity to lymphocytes. So, these patients have risk of infections because of their decreased lymphocyte activity after receiving these drugs.” TS 6:37 “Methotrexate works by blocking an enzyme that decreases the ability to make the folate that we need in our body to make cells. So, one of the things that we do when we use really high doses of methotrexate is we let it work for 24 hours and then we come in and we give leucovorin, which is the thing that we blocked. So, you're coming into rescue cells. And you're rescuing cells because the cancers we use high-dose methotrexate, we know that 24-hour exposure is going to be a really good effect on those cancer cells. So that's why we use leucovorin after methotrexate. We use it to minimize the toxicities that you would see with methotrexate. You decrease GI mucositis; you decrease the bone marrow suppression when you come in and adequately rescue with leucovorin.” TS 12:22 “I think [that's] one of the biggest challenges. I just had a situation that was an antimetabolites drug I'd never used before. I couldn't find in the literature and through resources I normally use, how to manage, so I actually reached out to colleagues to find out, who have used the medications to say, ‘What's your experience? What's worked for you?' It's one of the reasons I really love ONS, because I think it gives a forum for people to ask those questions together.” TS 15:23 “I think developing good patient education tools that people can take home that highlight the most important things about the regimen, including the antimetabolite aspects, making sure patients know what to monitor for so that they can contact their team if they need them. Diarrhea is something I always talk about with patients getting 5-fluorouracil. I do it because otherwise people self-manage and don't actually know what to do, and we really want to make sure that they contact us if they're having problems with diarrhea.” TS 17:14 “I think one of the best things that people can do is work together in the development of the order sets, whether they be electronic or not. And, so, that within the order sets there is clear indications of those things that highlight to patients the strategies to take, to manage. I think that's really helpful, and I think it's best done by a team. And to modify those order sets as things are learned that are helpful so that, you know, the strategy is dose reduction that's clear that that's going to be the strategy. So, I think that in this day and age it's really important that there is collaboration in developing whatever resources that we have.” TS 18:55 “Because gemcitabine is such a good radio sensitizer, when we use it with radiation, we use a very small dose. Very small. We're not talking anything near what we use when we use it in combination chemotherapy. So, when you have a patient getting gemcitabine, if somebody decides that they're going to do radiation, you have to make sure everybody knows they're on gemcitabine because you may hold the drug while they're getting radiation because you don't want to increase in toxicity.” TS 22:31 “I think that there are so many new, exciting agents and there are so many older agents that are still used in practice, that it's becoming very difficult for people to understand the mechanisms of the drugs that we're using and the agent-specific toxicities. So, I think that the education that's needed is the foundation and fundamentals of chemotherapy, because they still are used so much in practice. And I would hate to lose the knowledge that practitioners have because we're excited about the new, exciting therapies that are new and exciting.” TS 25:09
“你再怎么写，也写不到美国的主流社会里。” 二十多年前，赴美攻读免疫学博士的李翊云放弃科研，转而投身英文写作的时候，一位老同学曾出于好意这样告诫她。 二十年后的今天，坐在普林斯顿的校园里，面对着已经出版过五部英文长篇小说，三部短篇集，一部散文集，获得过美国“麦克阿瑟天才奖”等多个重要奖项，正在向英语母语者教授创意写作的李翊云，这句预言很难不听上去像个笑话。 不过，李翊云的写作史远非一目了然的成功学剧本，正如她笔下的人物，总爱挑战和改写陈词滥调：市面上流行讨喜的女性角色，她偏偏最看不上；主流期待会“折腾”，有主动性（agency）的人物，她却为被动辩护，认为“犹豫是一种被低估的美德”；她书写被科技巨头占据之前的加州，并以外乡人独有的清明指出，纽约就是个大农村，所谓的“都市”值得商榷，尽管她的中国同行会说：“国内已经没人这么写了，乡土文学已经过时了。” 今年八月，李翊云首部中文小说译作《我该走了吗》筹备期间，我们带着好奇和敬慕对她进行了一次专访。同为在异乡创作的写作者，钟娜向这位前辈问起她驯服一种全球化语言的经验：怎样把英语变成“自己的”？什么样的语言可以“陈年”，经历时间的考验？她们也谈到李翊云写作中一以贯之的主题：自我、情感、亲密关系，以及人如何面对过去。 李翊云说，当一只蝴蝶飞过的时候，有一类作家会把蝴蝶抓住，钉在板子上，把翅膀展开，让色泽一览无余；而另一类作家，会在扭头的瞬间，捕捉蝴蝶的影子。如同柳宗元的那句“潭中鱼有百许头，皆若空游无所依”，理想的写作，需要捕捉影子。 【本期嘉宾】 李翊云，美籍华裔作家，现任普林斯顿大学刘易斯艺术中心创意写作教授。已出版五部长篇小说、三部短篇小说集、一部回忆录。 【本期主播】 钟娜，中英双语写作者，译者。译有《聊天记录》《正常人》。（豆瓣ID：阿枣） 【时间轴】 02:41 用英语写作会遇到哪些困难？如何把英语变成自己的语言？ 10:27 为什么会选择《我该走了吗》作为第一本面向中文读者的作品？ 14:40 研究俗语和陈词滥调，可以成为一种语言的考古学 23:57 最反感“女性角色一定要讨喜”，所以写了一个带刺的女人 26:38 我感兴趣的是“缝隙”里的美国，比如被科技巨头占领之前的加州 32:50 《我该走了吗》中的亲子关系：每一个母亲都是失败的 37:11 “藏也没有用”：自我和写作有什么关系？作家一定是自恋的吗？ 45:01 不写那样“主动把控命运”的人物，是我对美国当代的反抗 60:04 中文的最高境界，应该是“皆若空游无所依” 【节目中提到的人名和作品】 人名 弗拉基米尔·纳博科夫（1899-1977）：俄裔美国小说家、诗人、翻译家和鳞翅目昆虫学家。代表作有《洛丽塔》《微暗的火》等。 伊丽莎白·鲍温（1899-1973）：爱尔兰作家，曾被批评家誉为“当代奥斯汀”。代表作有《心之死》《炎炎日当午》等。 玛丽安·摩尔（1887-1972）：20世纪美国著名诗人、评论家和翻译家。代表作《观察》等。 凯瑟琳·曼斯菲尔德（1888-1923）：新西兰出生的英国作家，文化女性主义者，新西兰文学的奠基人。代表作有《花园酒会》《幸福》《在海湾》等。 菲利普·拉金（1922-1985）：继T·S·艾略特之后最有影响力的英国诗人。代表作有《高窗》《爵士笔记》等。 托马斯·哈代（1840-1928）：英国著名诗人、小说家。代表作有《德伯家的苔丝》《无名的裘德》等。 书籍 A Thousand Years of Good Prayers Where Reasons End：A Novel Must I Go Kinder Than Solitude Dear Friend, From My Life I Write to You in Your Life The Book of Goose 《与托尔斯泰为伴》[美]李翊云 《小团圆》张爱玲 文章 To Speak Is To Blunder，But I Venture[美]李翊云 【出品人】蔡欣 【制作人】何润哲 广岛乱 【文案编辑】阁楼客 【运营编辑】黄鱼 不理 【后期剪辑】KIMIU 【音乐】钱子恒 【视觉顾问】孙晓曦 【视觉指导】汐和 【平面设计】心心
La artista plástica, Sasha Diana quien es parte de la exposición De Tierra Adjuntas : Colectiva de Artistas Adjunteños en la Galería de Arte Joaquín Parrilla de Casa Pueblo: Colectiva de Artistas Adjunteños en la Galería de Arte Joaquín Parrilla de Casa Pueblo que consiste en 16 piezas creadas por los artistas Adams Ortiz, Verónica Aponte, Naúd Avilés, Joe Martínez, Serafín Rosado y por la invitada de hoy Sasha Diana. De pajaritos y arte en Casa Pueblo a los 16 días de activismo por la violencia contra la mujer Rachel Smith Sepúlveda y Susanne López con José Raúl Cepeda … Segmento 1 Sacha Luna habla de la exposición de arte colectiva q se presenta en Casa Pueblo hasta el 16 de diciembre. Segmento 2 Sacha habla de su arte, sus “soportes encontrados” y los medios variados q usa. Comentamos sobre la importancia de los espacios para exposiciones alrededor del País. Segmento 3 Susanne presenta a la Dra. Mabel Lopez Ortíz, expresidenta del Colegio de TS de PR. Hablan de los 16 días de activismo sobre la Violencia Contra la Mujer. Los “16 días“ culminarán con un evento en la Plaza de Río Piedras el 8/diciembre con la participación de Amnistía Internacional PR q celebrará su 40 aniversario. Segmento 4 La Dra López comentó sobre los feminicidios y los feminicidios íntimos en Puerto Rico y de la importancia de la participación no solo del gobierno, también de la empresa privada en esta campaña. https://cptspr.org/16-dias/ La Dra. Mabel Lopez Ortiz, presidenta del Colegio de Trabajadores Sociales: Hoy estamos en el día 6 y durante el día ha habido alrededor de esa misma cantidad de actividades con la temática del rechazo a la violencia por razones de género y expresar su solidaridad y compromiso para denunciarla. Campaña de los 16 Días de Activismo contra la Violencia de Genero…
Today's conversation revolves around the importance and challenges of goal setting within organizations. It highlights how identifying and articulating real problems can be transformative, turning abstract desires for growth into concrete plans for improvement. Host Victoria Guido and special guest Evan Hammer discuss the nuances of leadership and organizational self-awareness, emphasizing the need for honesty and a growth mindset when addressing weaknesses. They touch on Evan's role as an OKR Coach in fostering alignment, focus, and excitement around goals, particularly in small to mid-sized companies. Evan shares his enthusiasm for goal setting and believes his passion can inspire others. He points out the positive outcomes when employees engage with goals that address problems they care about. Victoria and Evan agree that success is not solely measured by hitting OKRs but also by engagement and alignment within the team. They discuss the ideal organizations for Evan's work, which include small to medium-sized companies seeking to improve focus and alignment, as well as start-up teams needing more straightforward goal statements and go-to-market strategies. Evan also recounts his experience as a Techstars mentor, noting that a common issue across companies is the lack of clear goals, and he emphasizes the power of focus as a lever for growth. Follow Evan Hammer on LinkedIn (https://www.linkedin.com/in/evanhammer/) or X (https://twitter.com/evanhammer). Visit his website at evanhammer.com (https://evanhammer.com/). Follow thoughtbot on X (https://twitter.com/thoughtbot) or LinkedIn (https://www.linkedin.com/company/150727/). Become a Sponsor (https://thoughtbot.com/sponsorship) of Giant Robots! Transcript: VICTORIA: This is the Giant Robots Smashing Into Other Giant Robots podcast, where we explore the design, development, and business of great products. I'm your host, Victoria Guido. And with me today is Evan Hammer, OKR and personal goals coach. Evan, thank you for joining us. EVAN: Thank you for having me. I'm excited to be here. VICTORIA: Wonderful. Me too. And I wanted to ask you first, before we dive into business, tell me a personal goal that you've achieved recently that you're most proud of. EVAN: I guess a couple of months ago, I did a 100-mile loop of Mount Rainier. So, it was a 10-day backpacking trip. My younger brother, I went with him, and it's the kind of thing he does more regularly. Yeah, it was something I was kind of excited to do but really unsure of, and worked super hard between the gear and the training and just, like, the mindset. But it was also just awesome being out in the woods for ten days. VICTORIA: I also love being out in the woods for long periods of time. I guess, like, how long did your brother plan this trip for? And how long were you involved before you decided to go? EVAN: You know, it was something he was planning to do since the spring. He won a lottery to be able to do it. And I was going back and forth for a few months. And I think it was just maybe in the end of June where I was like, okay, I'm doing this. I need to put together a gear list, figure out a training plan. I live in Fort Greene in Brooklyn. And it was a lot of, like, waking up early and going up and down the steps in Fort Greene Park, which is, like, you know, 6, 10 flights of steps, something like that outdoors -- VICTORIA: [laughs] EVAN: With a heavy backpack on for two to three hours, like on weekends. VICTORIA: Oooh. Wow. EVAN: Yeah, it was one of those things I was like, you know, you don't know when you do something like this how it's going to go until you're there doing it or how your body is going to respond. So, it was a little bit of, like, trying to train as much as possible but also being aware that I just have to deal with whatever will happen on the trip. VICTORIA: I love that, at first, it sounds sort of, like, fun. Like, "Oh, do you want to go on this trip with me?" And you're like, "Yeah, okay." And then you look at the training plan, and it's like, "We'll wake up at 6:00 a.m. every day and walk up and down ten flights of stairs [laughs] with a heavy backpack on," you know, like, "Oh okay, [laughs] a lot of prep work to have this trip." [laughs] EVAN: It's fun in that you're doing something amazing, and it's beautiful. And it was just one of the more beautiful places I've ever been. It was really interesting and meaningful to me to kind of be detached from everything that I normally do and just focus on being in the woods and hiking these mountains. But yeah, you don't know how it's going to go. So, it's like you're putting yourself in an extreme physical situation. I think that's anxiety-inducing, and it feels good and is healthy and protective to train for it. VICTORIA: I agree. Yeah, I mean, I totally relate to that. I'm a rock climber and hiker myself. And sometimes I spend all this time, you know, on gym memberships, climbing in the gym, running up and down hills. And then, I get all the way out to rock, and I'm about to start my climb, and I'm like, why am I doing this? [laughs] This is a lot of work to get to this point. But then it is all fun, and it's super worth it. And I always feel restored whenever I come back from being a long time in nature. It's really great. I think maybe to get towards, like, a metrics conversation that we talk about a lot in climbing is the type of fun something is. So, there's three types of fun levels. Have you heard this framework before, Evan? EVAN: I have not. VICTORIA: Okay, so there's three levels of fun. Level one fun is, like, you're having fun while you're doing it. We're, like, laughing and enjoying recording a podcast together. Like, oh my God, it's so much fun, super easy, not stressful. Maybe it was a little stressful for you, I don't know. [chuckles] It's a little stressful for me. Level two fun is it's a little difficult while you're doing it, but you're still looking back on it and having fun, but you're never really in any kind of intense danger, right? Like, you're going on a backpacking trip. It's relatively within your health expectations, and the trail is walkable. You're not, like, going to fumble and fall down a cliff. It's level-two fun. So, you're mostly enjoying it. Like, it's kind of difficult, and there's some effort involved, but it's still fun. Level three fun is when it's very dangerous, and you're really scared the whole time [laughs], and, like, you maybe, like, could have died. But looking back on it, it's fun. So, how would you rate your Mount Rainier trip? EVAN: It's funny because we actually...we didn't come up with the levels, but we spoke about how when you're hiking, often, in your head, you're just trying to figure out how much longer you have to hike as if the whole point was not to be hiking. And then you finish hiking for the day, and you're like, "Oh, that was so great. I'm so looking forward to waking up tomorrow and hiking some more." VICTORIA: Yeah [chuckles], exactly. EVAN: That fits the level two fun pretty explicitly. VICTORIA: That's great. Yeah, it's a very, you know, I've found it to be pretty useful. And, you know, as I get older, I tend to try to avoid level three fun more often [laughs]. Like, I don't really need to be frightened [laughs]. I have enough stress in my life. I don't need to also endanger myself too aggressively. But, you know, everyone has their own risk level as well, right? Like, someone else might think the type of climbing and hiking that I'm doing is level three fun, but, for me, it's more...and, like, there's other things like skateboarding and riding a bike where, for me, is level three. I'm scared and [laughs] -- EVAN: Right. And I think you also frame level three as, like, sort of physical safety. But, you know, people have different risk tolerances and classifications across the board. So, like, for me, I try to stay away from things that I would consider physically dangerous. But I'm very comfortable, like, taking financial or social risk, where I know other people have an inverted kind of spectrum where, like, social risk is, like [laughs], you know, is a terror to them when physical risk doesn't seem that scary to them, you know, so... VICTORIA: That's so interesting. And especially for me, I do a lot of networking. And I'm, of course, been really active in San Diego Startup Week this week. We're recording this in October. So, for some people, going to an event where there's going to be hundreds of people, you maybe have met some of them before, but you really don't have a buddy that you are coming to this event with. You're on your own. You're going to have to walk up to people, start conversations, figure out who is who, and, like, find your people. That's terrifying for a lot of people. And they're like, "Absolutely not." [laughs] EVAN: Well, it's interesting how, like, level one and level three can be inverted. I went to a conference last fall by myself, and I actually had some voice issues. So, I couldn't talk for a little bit before this, so it was like...or even that well, during, you know, it was kind of an environment that I think a lot of people might be feeling like, oh, that's level three social experience. And I just remember how much fun I had there. Like, for me, it was totally a level one thing. But, you know, there's definitely moments on this hike where I was like, oh, this is level three. This feels physically scary, even though most of the time it wasn't. VICTORIA: Yeah, no, I think it's helpful. So, maybe that helps us segue a little bit into telling me more about what you do and how you came to do what you do. What's your background? EVAN: What do I do? I'll give you, like, a list of the things that I do. I will say I help people focus and maybe communicate better. You know, the list is, like, I am an OKR coach, right? That's objectives and key results, coaching business leaders on how to set goals and get everybody aligned towards the same goals. I do personal goals coaching, and that's, like, helping individual people set goals that are meaningful to them and live more intentionally. I'm a Techstars mentor, where I mentor companies. And I also do, like, a fractional head of product role. And it's a little all over the place. I mean, it's something that, obviously, a lot of that is, like, business coaching but really focused around focus and how you can use goal setting to accelerate growth for a business or an organization or for yourself personally. VICTORIA: How did it get started? What led you to be the coach that you are today? EVAN: Yeah, you know, I get asked this question. And I feel like there's a story about how I kind of tested goal setting. I was a founder. I went to Techstars in, like, 2013. And I was running the company. So, I had to, like, mess around with goal setting and then ended up being at Codecademy and Vimeo. They were doing OKRs. And there were certain things I liked and certain things I didn't. And there was, like, this progression. But I think the truth is that I just really like systems and organizing things, and I think I've always been like that. And OKRs are a way of taking something that's really messy, which is, like, a group of people running together in some direction and saying, "Oh, well, what if we come up with, like, some agreed plan here, and some rules, and some guidance? And we can split this out between what, like, the company and the organization is doing versus what individual people are doing or what the department's doing." I think I just find that process comforting. It's just, like, gleeful for me to be working with people on how they're going to focus and organize themselves, and then also how they're going to communicate that focus to each other, which I think is, like, a key part of people staying on the same page. VICTORIA: I love that. And I really want to dig into some examples of OKRs and maybe even get some free OKR coaching for myself on this episode. But, you know, but with your background, I wanted to start with looking at the founder experience versus being someone in a larger organization. How do you bring in that context of where you are in your journey into how you think about setting goals for an individual? EVAN: I think it's a hard question for me because my viewpoint on how goal setting and strategy and achievement in organizations has changed over this whole time, right? So, I was a founder, then at these larger organizations. I think I've tried to synthesize some, like, through line rather than difference between them. So, let me start there. I think when you look at a founder, or a founding team, or a larger organization, the key thing to figure out is where you're going and coming up with really clear goals. And then, depending on the size of the organization, there's different tactics you can use, right? So, if you're a founder, it might be just sitting down with your co-founders once a week, having a clear Northstar metric, and having a clear goal, and then everybody's running, and that works. Zoom to a 100-person company, which is, like, I probably focus on, like, 20 to 100-person companies. And now you have a lot of confusion between departments because you have people who are working on very different parts of the business. So, I think OKRs, at that point, are really great because it is this, like...and we will talk more about OKRs. But it's this cascading goal-setting technique where you have company goals that everybody understands and agrees to, and then each department is carving out how they're going to support that, which is, like, less necessary for a small company. But I still think the key thing is to know what you want, what your biggest problem is in getting there, and what your approach is going to be in overcoming that problem, which is, you know, is, like, I guess, strategy 101. VICTORIA: I like that. And it's funny; it makes me think of a tarot card layout. That's a situation I'll come and approach. Anyways, I wanted to get, like, down to the basics. I think we said OKRs earlier, but what is an OKR, if you can define that? EVAN: Yeah, so objectives and key results. An objective is any goal you have, so that can be launch a feature, revamp your sales process, or achieve some sort of milestone or some capability, right? So, often, that's, like, build a new department, or come up not just with a specific feature but a new offering, like launch a whole product line. Anything that's important to you can be a goal. It should be clear and inspiring. And that's the objective piece. Key results answer the question: how will you know if you're successful in reaching that goal? That might be if you're building a new department, a certain number of hires. If you're launching a feature or want to have a new offering, that might be some KPI for the product team, like, you know, onboarding rates or retention rates. VICTORIA: Yeah, and let's maybe even go into a real example: myself, I'm a managing director here at thoughtbot. People who aren't familiar with thoughtbot...I'm sure everyone listening has [laughs] familiarity with what we do as a product and business consultancy. And our team at Mission Control, the goal was to innovate on our approach to how we were deploying and managing software. So, over 20 years, the trends and modernization of infrastructure was something we wanted to be a part of, and we wanted to enable and accelerate not just our own development teams but our clients' teams in deploying software securely and efficiently and meeting everything that we need to do. Like, it's an incredibly complex environment. And there's lots of choices to make. So, that's, like, the big vision of what we're trying to do at thoughtbot. It's a new service. It's touching not only our internal processes but also, like, the growth of our business overall. So, what I've done as a managing director I talk with my team. I work with the CTO of thoughtbot, Joe Ferris. He's my acting director [chuckles] on identifying what is our overall approach? What's our strategy? So, one of the things we do at thoughtbot, one of our strategies, is to put content out there. So, we want to build stuff that works for us, and we want to share and talk about it. And we believe that by putting good stuff out there, good stuff will come back to us [laughs]. So, really just increasing the amount of blog posts, increasing the amount of open-source contributions and [inaudible 13:03] people we talk to and hear about what their problems are. We think that that will be an indicator for us of whether or not we're being successful in growing this business. So, that's just, like, one small strategy, but I've got five other ones if you want to talk about them. EVAN: Yeah, I mean, you highlighted a large goal that you have, and then some of the, like, sub-objectives in reaching that goal. And you could imagine key results being metrics along number of blog posts, audience size, number of readers, engagement. I mean, all those have different values, depending on what your goals are. VICTORIA: Exactly right. Like, there's the overall leading indicators we have of, like, whether or not we're successful as a business [laughs], which is, like, revenue, and, like, margins of profit, which really aren't going to change. And as a company, we don't change our policies or things that often to where those costs are ultimately going to change. It's all about, like, are we bringing in new business? Are we retaining the clients we have? And are we able to sustain, you know, work that centers around this problem area? So, that kind of, like, makes our goal tracking, like, the numbers month to month somewhat easy. Although those individual strategies and how they all line up to meet, that is something I think I'm curious to hear about how you facilitate those discussions with teams. How would you, like, begin an engagement with a team where you have a company like thoughtbot [laughs]? How are you going to coach us to get better at our goals? EVAN: Well, one thing I do is I pull apart KPIs, Key Performance Indicators, from OKRs, which you actually implied. KPIs are metrics you use to judge the health of your business, when OKRs are the goals that are going to transform your business. They fit well together. But, you know, for a founding team, they're still trying to figure out, well, how do we actually measure if this is going well? What does that mean? And I have a whole technique for that. But for a larger company, something like thoughtbot, you probably have pretty clear KPIs for the business and for each department. And you can look each month to make sure that those are in a healthy band or each week. And then, when you go to set goals, one of the things you can say is, "Hey, what's not working well? Why are the KPIs not where they should be?" And there's other ways of coming up with good goals, but I do think that's one of the starting points for goal setting. Another one, and I'm curious if you all have this here, is, like, a sense of what's holding back your growth. So, if you have a clear goal of growing your business year over year; usually, people in different departments have a sense of what challenges they're facing in executing towards those growth goals. And, fundamentally, there's usually some sort of competitive or market conditions or customer conditions that are concerning to you as a business in terms of where you're currently at. So, do you all have that type of, I guess, angle on thoughtbot's growth at all? VICTORIA: You know, for me, it's my first year as managing director. And experiencing how thoughtbot does planning, I appreciated our approach this year was to ask each managing director more like a retro style, like, "What should we do more of? What do we like doing? What didn't really work, and what should we do less of? And what other things do we want to start doing?" So, it's kind of similar to start, stop, continue but, you know, just really reflecting on, like, what's working? What should we do more of? What doesn't work, and we should just stop [laughs], or change, or figure out how to improve? And then, what should we start doing? And what kind of new behaviors do we need to practice and learn to build a better system? Which I think when you talk about what's holding people back, I think it's difficult to understand in a complex organization of 100 people how all these departments work together and how they contribute and support teams. So, I'm curious, from your experience, and you like to come in and organize and get focused, so if you have that level of complexity in an organization, how do you start to get people organized and understanding how they all work together and what's working and what's not? EVAN: Yeah, that's a good question. I might punt that to the second half of my answer here and answer an earlier question [inaudible 17:08] how we get started. Because I think that actually comes up as, like, the second piece. I think the first piece is, like, when I start with an organization, I usually sit down with the CEO. Maybe there's a founding team. Maybe it's a leadership team. And I try to understand their vision for where the company's going and, one, how clear and actionable it is. So, does it feel like, oh, I get exactly how they're going from point A to point B to point C, or is it a little bit murkier? And trying to nail that down. And sometimes I do, like, a strategy workshop around that. But the next piece is understanding if they have a clear plan for the next quarter, next year. When I come into companies, I'm doing OKRs quarterly. So, even if they don't have a clear strategy, we still need to set goals for the next quarter. I then have them just kind of draft goals with not that much guidance here. I might do some sort of training so everybody, like, understands what OKRs are. And then, you know, I do...and this is a common thing, I think, like, my background is in product, is trying to understand the root cause of things. So, usually, there's some goal that I can ask. And, usually, there's a goal that's, like, something that seems very strategic, like a new offering, or changing how the business is organized, or it's very growth revenue-oriented. Those are, like, the two types of goals that people usually come up with. So, there's a lot of just, like, asking why this is valuable, and kind of going up the ladder, down the ladder asking why it's valuable, and understanding what their root motivation is for doing this. And then going the other direction and saying, "Oh, if we did this, then what would happen?" And trying to just understand how they're thinking of this goal and how it fits in a longer chain of events. And, usually, through that process, we shift the focus point. So, it's rare that somebody comes up with, like, exactly the right goal. I think when they start understanding what would the effect be of that goal, sometimes one of those things is the actual goal. Or if there's a root cause, it doesn't always mean that we go to the root cause, right? If somebody wants to, like, fix their onboarding, and that's really, like, their whole focus point, you know, when you say, "Why?" and they talk about helping a certain customer get more focused. And then you may say, "Well, why?" And they say, "Oh, well, you know, we have this revenue model that involves helping them, and we make money." And "Why?" "So we can grow our business at a certain clip." And that's the arc that we build. That doesn't mean we go to, oh, well, you're trying to make more money faster. That might not be really what the focus should be for the quarter. So, we have to always start just trying to, like, dial in with what the right angle is. That's both...I think you want to choose the thing that's the most fundamental to the business that still feels attainable and focusable, if that's a word, in the short term, right? That's like, oh, this is a good target for a quarter or a year, if you're doing it on an annual basis. So, that's, like, how I usually get started with folks, which, you know, depending on how much thought there is around strategy, like, it goes in different ways. Sometimes, the company has a very, like, clear strategy, and then everything I said works pretty smoothly. And you get to a goal very quickly that you kind of orient the company around. If the strategy is either not explicit or maybe the CEO has a different vision for it than, you know, CTO or the head of sales, then there's more negotiating between folks and getting on the same page. And I think that's a whole, like, can of worms that we can dive into, but that's, like, a different type of exploration. VICTORIA: Yes, I love all that. I have so many follow-up things I want to ask. Just to play it back a little bit, too, I really resonated with some of what you're saying around it's kind of better to draft it; just write it. Like, the act of planning is more valuable than the plan itself. Like, get as close as you can as fast as you can [laughs]. That makes sense. Like, something that feels, like, good enough and, like, kind of go with it and, like, see how it goes. You know, like, I think that's a mindset that can be difficult to implement in an organization, especially if there's been, like, past trauma with, like, not meeting your goals. And how does that flow down to the organization? EVAN: That's a hard thing. VICTORIA: And it makes me think of, like, what you started with, like, talking about getting to the root of what's happening. Like, what are the motivations of individual people? Like, what's happened in the past? Like, trying to take an approach that's...I prefer blame-aware to blameless. You can't get away from the tendency to blame people. So, you just have to accept that that happens and kind of move on and, like, quickly go past it [laughs] and just, like, really get to, like, what are the facts? What does the data say about this organization? So, anyways, I think that that was where I went to. I think -- EVAN: One thing I did...I started with a new company; I guess, two or three quarters ago around the OKR coaching. And, you know, I think there was this expectation. We've been doing OKRs. There's issues we need you to come in and solve and fix everything. And the tone I tried to set was, hey, I'm not here to set great goals for you. You're going to set the best goals you can. And I'm here to help support that process and teach you a lot about goal setting. And we're going to do this every quarter. And after two or three quarters, things are going to start becoming a lot easier. People are going to communicate better. Everybody's going to be on the same page. And it's going to feel like, oh, we're getting really good at goal setting. And then, like, I try to set that tone when I start working with the CEO of, like, the point here is to make your whole leadership team good at goal setting so that you have this skill as an organization, rather than set just the right goals with the right language in the right way right now, right? We want to timebox everything. So, we're moving forward using this tool to make progress throughout the quarter, and then each quarter, revisiting it and getting better. MID-ROLL AD: Are you an entrepreneur or start-up founder looking to gain confidence in the way forward for your idea? At thoughtbot, we know you're tight on time and investment, which is why we've created targeted 1-hour remote workshops to help you develop a concrete plan for your product's next steps. Over four interactive sessions, we work with you on research, product design sprint, critical path, and presentation prep so that you and your team are better equipped with the skills and knowledge for success. Find out how we can help you move the needle at tbot.io/entrepreneurs. VICTORIA: And I'm curious if there's anything else when you're evaluating whether or not someone might be a good fit for the work that you want to do with them. Are there, like, some red flag, green flag energy that you check for with executives when you're deciding whether or not to work with them? EVAN: Yeah, there are two flags that come up; one is, are they clear with what they're saying? I think a lot of leaders want to sound good. So, that doesn't mean that they need to be clear right off the bat. But in a conversation where someone says, "This is our vision," and you say, "Hey, I don't understand X, Y, and Z," or "This part didn't make sense to me. Can we dive into it?" And yeah, if someone through a conversation can be really clear about what's important to the company and where they're going, I think that's, like, key. Because if someone's talking around issues all the time and when you kind of bring up things they don't really address it, it's very hard to make any progress. It's like, you know, the lack of specificity ends up being a defense towards maybe dealing with some of the difficult conversations. But, like, at the end of the day, like, one of the major things that happens with goal setting that makes it, I think, feel exciting to people when it does—it always feels exciting to me [laughs]—when it feels exciting to other people is that they say, for the first time, "Oh, this is actually the thing holding us back. This is the problem. Yeah, we want to grow our business." But when you say, "Well, what are all the things you do to grow your business?" All of a sudden, you start talking through things, and someone says, "Hey, this is the real problem. This is why we're struggling to grow our business." And, you know, that transforms the conversation. People who are avoiding being specific, that can be really hard. That's one thing. And the other thing is around responding to feedback. And, you know, you can just...and this is a common interview question, right? You can ask somebody, "What do you think the weaknesses of your organization are?" And if somebody doesn't know, but they're, like, open to it, that's, I think, totally fine. But if it seems like they're constantly kind of, like, filibustering the answer there, it's like, hey, the main thing you're bringing me on to do is to make sure that you communicate the weaknesses of your organization to everybody else because that's what goals are about. They're about overcoming the weaknesses of your organization. So, those are two areas. And they also speak to, like, I think, rapport with the people that I'll be working with. VICTORIA: I agree. And I like that, you know, you're asking really for people, are you going to be honest about what's happening in your organization? Are you honest with yourself about where you're not doing well? And I think I also pay attention to the language people use to describe those problems. And are they really speaking with a growth mindset or a fixed mindset? Because that's a really hard thing to change [laughs]. Naturally, I think people who are good leaders and run successful companies have a growth mindset. So, I think that's usually there. But that would be some yellow-flag stuff for me. EVAN: You know, when people are looking to hire an OKR coach, they usually already are looking for improvement. And it's not like they're hiring a product manager, right? You have to be saying to yourself, hey, I believe that if we did better around goals, our company would grow better. We'd have better focus. We'd have better alignment. Like, there's already a belief that people have that is usually pretty self-aware of the limits of both the people there and the organization where it's at today, and they're looking for help. So, I think I come across what you brought up more in individual people on a leadership team that, like, feel more coachable or less coachable depending on how interested they are around expanding how they think about things and growing. And, you know, obviously, [inaudible 27:01] lots of opinions that are wrong, and I love the disagreement that comes up there. But you want to, you know, you want to be speaking to people that are generally open to learning through a conversational process. VICTORIA: Right. Yeah, I think it's like a confirming thing. Like, if they're reaching out to a goals coach, they probably do have a growth mindset. And if the top leadership does, then that means that there's an opportunity for other people to come along as well. So, I like opening it up that way and getting people to get specific about their goals as well. I think that's a real challenge. Like, it's either too vague or too specific, not inspiring enough. Some people still bring up SMART goals with me. I like to prefer HARD goals, but you probably need those. And I'm curious if you're familiar with those acronyms. I can spell them out. And I'm sure you've heard of both of these [laughs]. A lot of people are familiar with the SMART goals and the specific, measurable, actionable. I forget what the Rs and Ts are. But then HARD goals are heartfelt and more around, like, the big vision. And it's something that you want to get people excited about, which is something that you said earlier. Like, how do you get people excited? And some people would think of a corporate goal-setting event as a level three fun [laughter]. So, how do you make it more like a two or a one? EVAN: I don't know, a lot of what I hope I offer to folks...and I've gotten good feedback here is that I enjoy goal setting a lot. So, talking through all these problems, talking through challenges, doing workshops, having these conversations. Like, whenever I'm doing that, it's my favorite thing to be doing. So, I think, hopefully, some of my joy just rubs off on the people around me. Because I do think talking to somebody who's excited about what you're talking about is helpful. The other thing is, usually, at a decently small company, under 100 people, I'm working with the CEO and the leadership team; you know, people are there because they care about the company. They care about the mission of the company. They care about the people in the company, and they care about the growth of the company. So, I get why goal setting has, I think, can have a bad rap. But if you're fundamentally solving problems that people care about, there should be some, like, glee that comes in when people say, like, "Oh, yeah, I thought this was going to be about, like, how do we grow more? And that felt very generic to me." And it turns out when we actually think about how we grow more, and we talk through what's holding back our growth and what we can do to overcome that, and we have the top few ideas that we've all come up with, usually, those feel really relieving to people. And there's a company I'm working with now that I think is struggling to shift their target market a bit because...and there's awareness that the target market needs to shift, but there isn't so much knowledge around the new target market. There's a lot more knowledge around the old target market. And so, we're doing a bunch of research and talking to folks. And I know once we're able to say, "For this target market, we need to do X," there is going to be, like, a huge amount of excitement and relief at the organization because people will feel like, oh, we've crossed that bridge, that bridge that we were kind of in the middle of crossing and didn't really know where the other side was. We now can see that other side, and we're going there. So yeah, I think there can be a lot of excitement around this stuff when it's real, and it's important work that you're doing. VICTORIA: Right. Like, maybe there's a good factor of, like, how do you measure if what you've done with a company is successful? Is there a glee scale that you [laughs] use to evaluate? EVAN: You know, for me, it's still probably more subjective than I want it to be. You know, I'd love it to be like, what percentage of people's OKRs did I [laughs] hit each quarter? And when I work with them, it gets better. But I think that's, like, a pretty short-sighted view in terms of my role. So, you know, I'm looking for people who were maybe disengaged to be more engaged, people who didn't see the value of OKRs to see and be able to articulate how their daily work is different because of the OKRs we set. Yeah, and obviously, there's excitement when we're solving real problems. And we're changing the problems each quarter, and people are seeing growth increase. You know, like, all that stuff, I guess there's, like, a tangible excitement with. But I hope folks can, like, just connect the dots between the work, which can be tedious work around goal setting and negotiating with people. And often, it pulls you out of other day-to-day work that you're doing, especially for a small company, with the excitement towards the end of the quarter of reaching these goals and moving on to the next challenge. VICTORIA: I think that's great. I think that was a perfect answer. It's kind of not always easy to know what [laughs]...like, sometimes there's a sense of it, like, you have a feeling, and sometimes you can get data to back that up. And other times, you know you're doing the right thing by the people's faces around you at the end of the workshop [laughs]. So, I think that's great. And so, maybe my final question would be is, like, what would be the ideal organization that you would want to work with? Like, who's your ideal customer right now? EVAN: Yeah, I guess I have two ideal customers based on these, like, two things that I'm doing. In terms of the OKR coaching, I usually look for CEO or founding team of a company that's now, like, 20-plus people who's saying, "Oh, we have these departments," or "We have this leadership team. And we need to really get all on the same page at the beginning of the quarter because then everybody's going to consistently be talking to each other but has other people that they need to organize." That's definitely for the OKR coaching where, like, 20 to 30 people is where that starts. That probably goes up to 100 in terms of where I focus. For the other work I do as a Techstars mentor and the coaching I do through that, that's really for founding teams. And that's more focused on how do you take your vision and make that a clear goal statement, which is around, like, behavior change, usually, in a certain population you're targeting? How do you turn that into a go-to-market plan? How do you turn that into a product roadmap? So, for that, that's just much smaller teams. I actually think that work often needs to be done at larger organizations, too. That's, like, a common thing that comes up. And that can bleed into strategy at large organizations. But yeah, I know that's probably a pretty broad bucket, but groups of people that believe that focus is a key lever towards faster growth. VICTORIA: Thank you for that. And I guess I said that was my final question, but I'll add two more questions. Can you share an anecdote from being a mentor at Techstars that you think will be interesting for our audience? EVAN: I think I was struck the first time I did the mentoring. They do, like, a Mentor Madness. So, it's like, you know, six companies in a row, and every company they all have different challenges. But a lot of them, it's, like, helping them articulate what they're doing a little bit more clearly. And often, there's a question around sales and growth and maybe fundraising. So, there's just, like, a focus in that direction. And I found that every company, even though they had kind of different questions, I was giving the same answer to, which was, I don't think your goal is clear to you or to me. And so, there's this framework that I would use with each company that there was, like, this aha moment. And I picked this up from a person named Matt Wallaert. It was a book, "Start at the End." It's called a behavioral statement. And it's when population wants to motivation, and they have limitations, they do behavior as measured by data. And the kind of conceptual version is, oh, you're trying to get some group of people to change their behavior. And that's only going to happen if you can tap into a motivation that happens to them as frequently as the behavior you want to change. So, it's like a formalization of that. And each group, I'd like bring up the statement; we work on filling it quickly. And there was just, like, a clarity that would develop around what they were doing and how to orient themselves both on the growth and marketing side and on the product development side. I guess it just struck me how much that little framing was transformative to [laughs] accelerating both focus and alignment but, more importantly, like, getting somewhere that they wanted to get to. VICTORIA: It sounds almost like building a mental model of what you're trying to do [laughs], right? Like, it was a mental model that you referenced in your mind that helps you make decisions every single day. So, I really appreciate that. And we are about out of time. So, let me ask you, is there anything else that you would like to promote today? EVAN: Sure. Looking for a couple more OKR coaching clients for the new year, and just happy to chat with anybody who has questions around OKRs or goal setting for their organization. I also do personal goals coaching, which is a little different from the OKR coaching that I help individual people with their goals. But it's also similar. It's a lot of like...it's a lot more, like, reflection, and getting to know oneself, and coming up with goals that are really meaningful. And then the other half of, like, I think you alluded to this earlier around systems. Like, how do you take a goal that's important to you and actually act every day in ways that move you towards that goal? So yeah, interested in talking to people about both of those. I do some workshops as well, so people can reach out to me at firstname.lastname@example.org. I can also put anybody on my mailing list. I do some workshops around both those things. VICTORIA: Wonderful. Thank you so much, Evan, for joining us today. You can subscribe to the show and find notes along with a complete transcript for this episode at giantrobots.fm. If you have questions or comments, email us at email@example.com. And you can find me on Twitter @victori_ousg. This podcast is brought to you by thoughtbot and produced and edited by Mandy Moore. Thank you for listening. See you next time. AD: Did you know thoughtbot has a referral program? If you introduce us to someone looking for a design or development partner, we will compensate you if they decide to work with us. More info on our website at tbot.io/referral. Or you can email us at firstname.lastname@example.org with any questions. Special Guest: Evan Hammer.
“I think the key in effective communication is building trust, because without trust, patients are not likely to engage in their care as effectively, which can influence patient well-being and their overall health outcomes. Building trust is, I think, crucial,” Deb Christensen, MSN, APRN, AGCNS-BC, AOCNS, founder and chief patient officer at the Cancer Help Desk, a nonprofit that provides personalized cancer treatment resources, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a discussion about strategies oncology nurses can use when approaching difficult conversations with patients across all populations. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.75 contact hours of nursing continuing professional development (NCPD), which may be applied to the oncology nursing practice ILNA category, by listening to the full recording and completing an evaluation at myoutcomes.ons.org by November 24, 2025. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to difficult conversations in cancer care. Episode Notes Complete this evaluation for free NCPD. Deb Christensen's ONS Voice articles about communication Oncology Nursing Podcast: Episode 14: Having Difficult Conversations in Oncology Practice Episode 208: How to Have Fertility Preservation Conversations With Your Patients Episode 235: Self-Advocacy Skills for Patients Episode 253: The Ethics of Caring for People You Know Personally Clinical Journal of Oncology Nursing articles: Tools for Communication: Novel Infrastructure to Address Patient-Perceived Gaps in Oncology Care Breaking Bad News: An Evidence-Based Review of Communication Models for Oncology Nurses ONS Resources: Palliative Care Communication Strategies Shared Decision Making in Prostate Cancer Journal of Oncology Practice article: Role of Kindness in Cancer Care SPIKES: A Framework for Breaking Bad News to Patients With Cancer Ask-Tell-Ask method City of Hope: The Interprofessional Communication Curriculum Center to Advance Palliative Care Agency for Healthcare Research and Quality's Health Literacy Universal Precautions To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode “Patients tend to be less anxious when they have a trusting relationship with their providers, with their oncology team on a whole, and they tend to follow through better on their treatment plan because they trust what you're saying. It's not easy to establish a trusting relationship when you first meet someone. But what I found in my practice is that anticipating their needs and really listening to their story has made a world of difference in establishing that trusting relationship—and admitting if I don't know the answer to something or if perhaps I've gotten something wrong.” TS 2:32 “Intellectual empathy asks you to imagine yourself in that person's place. And we've all had challenging experiences; we just don't get through life without them. And as a result, we can generally think of a time when we might have been in a similar situation, maybe not exactly the same, but a similar situation, and garner that empathy for the patient and, importantly, for the caregiver, too. Because we genuinely, genuinely want to understand somebody. Intellectual empathy really comes from listening carefully to what's being said and what's not being said, analyzing different people's perspective, knowing your own bias, and asking open-ended questions.” TS 4:41 “I think that the first thing that an oncology nurse needs to do is recognize that patients have their own autonomy to make their own decisions and not go into a conversation expecting a specific outcome. So going in with the intention to do your best, but also be open to what the patient wants to do.” TS 8:30 “Our biggest foe in all of this communication, these communication strategies, really is time. We just do not have the amount of time. I mean, we love the luxury of time to be able to sit and really get into these kind of deeper conversations with people, but we may only have 30 minutes. We may only have 15. So, how do we do that? That is still a question that's out there that there's a lot of investigating. Are there techniques that can help? And there are.” TS 13:47 “All of these points in the continuum have one thing in common, and that's uncertainty. That's really a whirlpool—uncertainty—for people. One of the communication strategies that I've used with people is letting them know that this is a very common emotion to experience—a sense of loss of control, uncertainty—and that in my experience, that people generally, once they have a plan, the anxiety settles. So, giving them kind of a guidepost, hope in the future, that the anxiety will settle. Because I would say 98% of the time it does, once people gain a sense of control, because they have a plan of action to move forward.” TS 16:10 “The setting is really, really important, especially when you're having these challenging conversations. Always checking for understanding: What is that perception? What is the patient perceiving? What is the caregiver family perceiving? Are they understanding you correctly? And being respectful of what people want to know, because sometimes they don't want to know specific things.” TS 21:57 “Oncology nurses need to be aware of their own biases and their own emotional state when they're going into these emotional conversations, these difficult conversations they really need to be in. You might not always be the right one for the conversation. I think that's an important thing to note too, and be able to admit that you may have had a personal life experience that just is not going to allow you to get around a bias or an emotional reaction to the conversation, and so you might not be the right one.” TS 23:11 “I've always felt like if you can help someone find joy and peace in the moment, then that moment was made better. Life is a series of moments. That's kind of how I get through that piece of it.” TS 26:20
This week I break down my favorite mallet putters right now. I dig into why I love the PXG Battle Ready II Bat Attack, LAB Mezz.1 Max, Odyssey AI-One Milled 8 TS, and the TaylorMade Spider Tour X Proto putters. Each one had a bunch that I love, but also maybe something I don't. What are your favorite mallets?
JP gets Reprimanded Wes Buck breaks the Biggest news of all time for TS and TD Vince Musolino talks his 2023 TD NHRA World Championship Rex and JP talk Vegas F1 and running the Baja 1000 on a dirtbike its a great show
Welcome to the second episode of our very special mini-series, The Glow Up with Paula Joye. Today, we're talking G.O.A.TS, the OG's the real game changer skincare ingredients that we cannot live without. And, the ones that are a complete waste of your money. You can find Paula's book The Glow Up, here. SPECIAL THANKS TO OUR GUEST: Paula Joye LINKS TO EVERYTHING MENTIONED: NOBLE PANACEA The Exceptional Chronobiology Sleep Mask $537 COSRX Advanced Snail 96 Mucin Power Essence $38 Paula's Choice Skin Perfecting 2% BHA Liquid Salicylic Acid Exfoliant $16 Advanced Night Repair Synchronized Multi-Recovery Complex $70 Clarins Double Serum $170 Clinique Take The Day Off Cleansing Balm $86 Alpha-H Melting Moment Cleansing Balm with Wild Orange $70 CeraVe Hydrating Foaming Oil Cleanser $24 Avène XeraCalm A.D. Cleansing Oil $38 Bioderma Sensibio Micellar Cleansing Oil $34 The Secret Acne Spot Treatment $150 Cinch Sleep + Glow 5 in 1 Overnight Skin $40 Clarins Radiance-Plus Golden Glow Booster for Face $43 Tan Luxe The Face Illuminating Self-Tan Drops $85 SUBSCRIBE: Subscribe to Mamamia GET IN TOUCH:Got a beauty question you want answered? Email us at email@example.com or call the podphone on 02 8999 9386. Join our You Beauty Facebook Group here. Want this and other podcasts delivered straight to your inbox? Subscribe to our podcast newsletter. You Beauty is a podcast by Mamamia. Listen to more Mamamia podcasts here. CREDITS: Host: Mia Freedman Producer: Cassie Merritt Executive Producer: Talissa Bazaz Audio Producer: Leah Porges Mamamia acknowledges the Traditional Owners of the Land we have recorded this podcast on, the Gadigal people of the Eora Nation. We pay our respects to their Elders past and present, and extend that respect to all Aboriginal and Torres Strait Islander cultures.Become a Mamamia subscriber: https://www.mamamia.com.au/subscribeSee omnystudio.com/listener for privacy information.
- Các đại biểu Quốc hội thống nhất cao việc thông qua Nghị quyết về áp dụng thuế thu nhập doanh nghiệp bổ sung, theo quy định chống xói mòn cơ sở thuế toàn cầu tại Kỳ họp này.- Giá khám bệnh bảo hiểm y tế tăng khoảng 10% so với mức cũ sau Thông tư 22.- 14 ngư dân của tàu cá BĐ 98268 TS bị nạn trên biển đã được tàu quốc tế cứu nạn thành công.- Nhân kỉ niệm ngày nhà giáo Việt Nam 20/11, trong chương trình mời quý vị cùng đến với lớp học đặc biệt của những trẻ khuyết tật vận động, khuyết tật trí tuệ, khuyết tật ngôn ngữ của cô giáo Hoàng Thị Vỵ ở tỉnh Yên Bái.- Ứng cử viên theo đường lối cực hữu Giavie Miley giành chiến thắng trong cuộc bầu cử Tổng thống tại Argentina.- Chính phủ Ấn Độ dự kiến sẽ duy trì lệnh cấm xuất khẩu gạo đến năm 2024. Điều này có thể đẩy giá gạo toàn cầu tiếp tục lên cao. Chủ đề : Giá khám bệnh, bảo hiểm y tế, tăng khoảng 10%, Thông tư 22 --- Support this podcast: https://podcasters.spotify.com/pod/show/vov1thoisu0/support
Hàng loạt IT mất việc, tỷ lệ sinh viên công nghệ thất nghiệp tăng, song TS. Lê Duy Tân cho rằng, nhu cầu nhân sự khi thị trường khi phục hồi sẽ gấp đôi số hiện có, bài toán của "fresher" là tự nâng kỹ năng để chạm được yêu cầu.
Welcome to The Challenges of Faith Radio Program. Today's topic Are you affected by the Word? Part 3 of 3 I ask that you listen, ponder, apply, and pray.....Also ask God for guidance, on how your gift(s) should be used in the public square for Him, and others..that are hurting, helpless, homeless, and feeling hopeless. As you continue your sojourn thru 2023, Remember, Life is like a coin, You can spend it any way you want to. But, you can only spend it once. So, spend it wisely! COFRP airs on Amazon Music, AntennaPod, Apple, Audacy, Audible, BTR, Castbox, Edifi, Fathom Fm, Fyyd Radio (DE) , Google Podcast, Himalaya Learning, JAM, Padverb, Pandora, Player Fm, Podbay Fm, Podbean, Podtail, Podyssey, Radio Podcast Addict, SoundCloud, Spotify, TS, Wave, Wisdom, YouTube, and more.
“When I meet with patients, I try and remind them, ‘Yes, you do have these side effects that can happen' and make sure that they're informed, but also try and reassure them that not everyone gets it as severe as maybe the movies and TV shows portray,” Dane Fritzsche, PharmD, BCOP, informatics pharmacist from the Fred Hutchinson Cancer Center at the University of Washington Medicine in Seattle, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a discussion about what oncology nurses need to know about alkylating agents for patients with cancer. This episode is the first in a series about drug classes, which we'll include a link to in the episode notes. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.75 contact hours of nursing continuing professional development (NCPD), which may be applied to the oncology nursing practice and treatment ILNA categories, by listening to the full recording and completing an evaluation at myoutcomes.ons.org by November 17, 2025. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to alkylating agents. Episode Notes Complete this evaluation for free NCPD. Oncology Nursing Podcast Episode 242: Oncology Pharmacology 2023: Today's Treatments and Tomorrow's Breakthroughs ONS Voice oncology drug reference sheets Clinical Journal of Oncology Nursing article: Chemoprevention: An Overview of Pharmacologic Agents and Nursing Considerations ONS book: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition) ONS Huddle Card: Alkylating Agents The Emperor of All Maladies: A Biography of Cancer by Siddhartha Mukherjee ChemoCare drug information Hematology/Oncology Pharmacy Association (HOPA) National Cancer Institute's A to Z List of Cancer Drugs Patient education guides created as a collaboration between ONS, HOPA, NCODA, and the Association of Community Cancer Centers: Oral Chemotherapy Education Sheets IV Cancer Treatment Education Sheets To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode “Alkylating agents are a very interesting class of chemotherapy agents, both mechanistically as well as historically. I remember back in pharmacy school learning this was actually the first class of medicines used to treat cancer, and it actually starts way back in World War I with the use of sulfur mustard gas, in kind of a military fashion, and then noticing some of the responses that soldiers as well as civilians who were actually exposed to that. They would develop things like bone marrow suppression, as well as other antitumor effects. Sadly, it's rough to see mustard gas as being the first agent to lead to something so remarkable, because it was a weapon of devastation, but it did lead to some breakthroughs.” TS 1:43 “The first thing that jumps to my mind when thinking about alkylating agents is their toxicities and then their supportive care agents that we use to make sure that we're treating our patients well and making their care optimum. So, when I, as an oncology pharmacist, would look at these orders, I immediately am jumping to, are we giving them appropriate antiemetics? Because a lot of these agents are highly emetogenic or moderately emetogenic by NCCN. A lot of them have other organ toxicities, like are really harsh on the kidneys. Are they getting their pre- and post-hydration? And then also many of these agents are very bone marrow suppressing, meaning they're targeting the red blood cells, they're hitting platelets, they're reducing our ANCs and making patients at higher risk for infection, you know, so do we need growth factor support here? Are the patients—their current labs—are they able to take another dose at this time or do we need to dose reduce or delay therapy because their platelets are just too low now?” TS 09:54 “Honestly, it's probably one of the most important things is collaborating together to help provide optimal patient care. And to me, kind of the biggest thing that jumps out is just good communication between the various team members. I can't tell you how many times I would learn crucial information either from an infusion nurse chatting with the patient or walking down the hall or giving a call to one of our lovely clinical nurse coordinators here at Fred Hutch. You know, I always wanted to make sure that I go in and have the full picture of where the patient's at, what, if any, challenges there have been with this patient's particular case, just to make sure that I'm up to date about them and able to provide as good of care as I can.” TS 14:55 “Unfortunately, this class of drugs does come with kind of those generic chemotherapy side effects that we think of: hair loss, nausea and vomiting, and bone marrow suppression. That just comes as a function of how these work. These agents are not selective for just cancer. They're more selective for rapidly dividing cells. So, that leaves our normal cells that rapidly divide like our hair, our GI tract, our bone marrow, you know, to get hit by these.” TS 17:50 “The next thing I always drill my residents on, when I'm teaching them how to provide actionable and helpful information about their regimens that they're getting, is kind of like you're saying, outlining those expectations. How do you prevent these side effects? When do these side effects even start to show up? Like, am I going to immediately be nauseous right when the cisplatin gets turned on? Well, maybe, not super common, but it's more common that we'll see it in, you know, at the end, in the next couple of days and within the next 72 hours or going into the nuances between acute versus chronic nausea and things like that. So, it's really trying to empower the patients with information. How do they prevent this? What are we doing to help prevent it? And then when should they call us? When is the stuff that we're preventing didn't help? When should they call us to get more help?” TS 24:04 “I think that's a misconception that we as healthcare professionals can really help alleviate with our patients, reminding them that, yes, they do carry risks, but we also have a lot of supportive care agents to kind of help minimize that toxicity. And then we have this whole team of professionals behind you to help carry you through the treatment.” TS 29:34
Agradece a este podcast tantas horas de entretenimiento y disfruta de episodios exclusivos como éste. ¡Apóyale en iVoox! símbolo de la opulencia y el arte del siglo XVIII en Rusia. El Salón Ámbar es una famosa sala de ámbar ubicada en el Palacio de Catalina, en Tsárskoye Seló (también conocido como Pushkin), cerca de San Petersburgo, Rusia. Es conocido por ser una obra maestra del arte decorativo en ámbar y una de las principales atracciones turísticas de la región. El Salón Ámbar fue construido en el siglo XVIII durante el reinado de Isabel I de Rusia. Se cree que fue diseñado por el escultor alemán Andreas Schlüter y posteriormente mejorado por el maestro artesano danés Gottfried Wolfram. La sala está decorada con paneles de ámbar, espejos y láminas de pan de oro, creando un ambiente deslumbrante y lujoso. A lo largo de los años, el Salón Ámbar ha sufrido diferentes destinos. Durante la Segunda Guerra Mundial, fue saqueado por las fuerzas alemanas y su paradero se volvió desconocido. Después de décadas de búsqueda, fue restaurado y devuelto a su lugar en el Palacio de Catalina en la década de 2000. La restauración fue un proyecto monumental que involucró a expertos en ámbar de Rusia y Alemania. Hoy en día, los visitantes pueden admirar la belleza del Salón Ámbar mientras recorren el Palacio de Catalina. Es una muestra impresionante de la artesanía y el diseño del siglo XVIII, y su historia agrega un elemento de intriga a su atractivo. Escucha el episodio completo en la app de iVoox, o descubre todo el catálogo de iVoox Originals
Tottiler Messiler yeni bölümüyle tam kadro yayında! Fritz Fassbender, Hüseyin Kıyıcı ve Koray Gök milli ara öncesi TSL'nin son haftasını değerlendirdi, menümüz için buyrunuz: (1.00) KRAL TV Müzik Ödülleri 1997 En İyi Beste Ödülü (7.00) ADS-FB, Kluivert'ın planı, FB'nin bol pozisyonlu oyunu, Kartal'ın değişiklikleri (24.00) BJK-BŞK, hoş geldin Rıza Hoca, Burak Yılmaz'ın açıklamaları, Ante Rebic, Çağdaş Atan'ın takımı (51.00) Hatay-GS, oyunda mı sorun var, takım mı yorgun? Okan Hoca'nın kadro seçimi, Kerem Aktürkoğlu'nun rolü (1.11.00) TS-Konya, TS'nin topla sınavı, Onuachu abim saygılar (1.26.00) Anadolu'dan notlar, Shelvey, Güven Yalçın, Emre B. vs Nuri Şahin, Paşa-Kayseri, Erencan Yardımcı (1.32.00) Soru-cevap-kapanış. İlginize teşekkürler, iyi dinlemeler!
To Seek and To Save | Join us today in our study of Luke 3:23-38, learning how being rooted in history makes us ready for tomorrow. The post TS&TS | Rooted and Ready appeared first on Lake Superior Christian Church | Marquette, MI.
Welcome to The Challenges of Faith Radio Program. Today's topic Are you affected by the Word? Part 2 of 3 I ask that you listen, ponder, apply, and pray.....Also ask God for guidance, on how your gift(s) should be used in the public square for Him, and others..that are hurting, helpless, homeless, and feeling hopeless. As you continue your sojourn thru 2023, Remember, Life is like a coin, You can spend it any way you want to. But, you can only spend it once. So, spend it wisely! COFRP airs on Amazon Music, AntennaPod, Apple, Audacy, Audible, BTR, Castbox, Edifi, Fathom Fm, Fyyd Radio (DE) , Google Podcast, Himalaya Learning, JAM, Padverb, Player Fm, Podbay Fm, Podbean, Podtail, Podyssey, Radio Podcast Addict, SoundCloud, Spotify, TS, Wave, Wisdom, YouTube, and more.
- Quý vị có biết! Tiểu đường là căn bệnh mà có lẽ chỉ người trong cuộc mới hiểu hết được những mệt mỏi, khó khăn trong quá trình điều trị, nhất là khi phải chung sống với nó suốt đời. Mỗi ngày, một bệnh nhân tiểu đường có thể phải uống, tiêm nhiều loại thuốc, ước chừng hơn 10 viên thuốc các loại như: mỡ máu, huyết áp, dạ dày, men gan…. Nhưng, bên cạnh tác dụng điều trị bệnh, thuốc điều trị tiểu đường có thể gây ra những tác dụng phụ không mong muốn như nhờn thuốc hay hạ đường huyết quá mức...Chẳng thế mà nhiều người bệnh vẫn than phiền, lo ngại bởi điều trị một bệnh nhưng phải dùng nhiều loại thuốc. Làm sao để sử dụng thuốc điều trị tiểu đường hợp lý nhưng vẫn có cách hỗ trợ giảm tác dụng phụ của thuốc hay không? Tư vấn của PGS.TS.BS Hồ Bá Do- Phó Chủ tịch Hội Y học cổ truyền Việt Nam, Giảng viên cao cấp Học viện Quân y. Tác giả : Phương Anh Chủ đề : Chuyen gia cua ban, ĐTHT, AĐTP, --- Support this podcast: https://podcasters.spotify.com/pod/show/vov1sukien/support
“I think oftentimes people think this is just a radiology procedure that is rather benign. That's really the role of the oncology nurse, just to be [an educator], support, emotional support, and a coach,” Lisa Parks, MS, APRN-CNP, ANP-BC, nurse practitioner in hepatobiliary surgery at The James Cancer Hospital and Solove Research Institute at The Ohio State University Comprehensive Cancer Center in Columbus, Ohio, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a discussion about what oncology nurses should know about transarterial chemoembolization administration and their role surrounding that procedure. This episode is part of a series about non-IV chemotherapy administration; the others are linked below. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.75 contact hours of nursing continuing professional development (NCPD), which may be applied to the oncology nursing practice or treatment ILNA categories, by listening to the full recording and completing an evaluation at myoutcomes.ons.org by November 10, 2025. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to transarterial chemoembolization. Episode Notes Complete this evaluation for free NCPDComplete this evaluation for free NCPD. Oncology Nursing Podcast episodes about non-IV chemotherapy administration: Episode 271: Intraventricular and Intrathecal Administration: The Oncology Nurse's Role Episode 265: Intravesical Administration: The Oncology Nurse's Role Episode 252: Intraperitoneal Administration: The Oncology Nurse's Role Oncology Nursing Forum articles: Symptom Distress in Patients With Hepatocellular Carcinoma Toward the End of Life Living With Hepatocellular Carcinoma Near the End of Life: Family Caregivers' Perspectives ONS Chapters To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode “So, TACE was commonly used to treat liver metastatic cancers, primarily metastatic colon cancer, until research showed that some of these cancers were not responding to TACE. Therefore, it is no longer really used in metastatic colon cancer. TACE is used in hepatocellular cancer. It also was used more than 10 years ago to treat metastatic neuroendocrine cancers. But recent research has showed that neuroendocrine cancers respond to this embolization without the use of chemotherapy. By eliminating chemotherapy, we also eliminate the potential for side effects.” TS 3:29 “TACE, or TAE, is usually completed more than once in the course of a patient's treatment. Depending on the tumor burden of the liver, the procedure can be segmentally completed on a liver lobe, or you can do the procedure on the right lobe and then follow-up treatment in about six weeks in the left lobe.” TS 5:45 “This is something that isn't even really taught in medical school. So it's really important to understand that even though this is a postprocedural side effect, there are certain things that you have to be aware of. So, the most common side effect that you will see is right upper-quadrant pain, and this is very common. And if the left side of the liver has received the therapy, this pain can radiate to the epigastric area and the patient will describe it as chest pain. And when you have the patient point to that area where he's having pain, it's often epigastric and it's just a referred pain, it's not cardiac pain, typically. You can get a EKG and troponin, but those are almost always negative and it's just really part of this embolization syndrome.” TS 14:30 “As far as what the oncology nurse needs to really be aware of pre-TACE or pre-TAE, I just want to emphasize the importance of patient education. The patient and their family need to understand again, it's not a surgery, it's a radiology procedure, and that the patient is going to have abdominal pain and nausea and vomiting that will last for several weeks and that is why they are not kept in the hospital for three weeks until these symptoms dissipate. Oftentimes these symptoms will be present until they get reimaged at the medical oncologist and then it's time for them to come back and maybe get another phase of their procedure that they are supposed to have as part of their treatment plan.” TS 17:44 “I do want to let you know, though, that patients that have a significant spike of their transaminases over 1,000, those patients are of great concern of going into liver failure. So, the nurses need to let the patient know that they will be monitored and kept in the hospital until we start to see a downtrend in those transaminases before they will be discharged.” TS 19:48 “As an oncology nurse and medical oncology, [it's] education, education, education. Also being able to triage these patients on the phone, talking them through how to keep themselves hydrated. . . . So I just think it's really a coaching job of the oncology nurse. A lot of reassurance, a lot of suggestions on how to get through this very uncomfortable difficult procedure.” TS 21:16 “I want it to be clear that if you're doing local regional therapy, TACE or TAE, this is considered a palliative procedure. You are not going to get a cure with this treatment. In this situation, neuroendocrine carcinoma, it's already metastatic if you're treating the liver. And with hepatocellular, again, it's still palliative because you're not doing a surgical resection on this patient. And every TACE experience for every patient, I've had patients that've and I've had six of these procedures, every experience they get is different.” TS 28:11 “When the patient comes back to our floor after having the treatment, it's just very important for those nurses to know the ‘abnormal normal,' to know that some of the things that they're seeing, the hypertension, the severe pain, the severe nausea, is actually normal and the provider will work with them to try to come up with a regimen that will make the patient as comfortable as possible.” TS 33:22
(Víspera del Día de la Tradición en Argentina — Natalicio de José Hernández) En el prólogo a la segunda parte de su obra maestra titulada La vuelta de Martín Fierro, el poeta argentino José Hernández declara: «No tengo noticia de que exista ni que haya existido una raza de hombre aproximados a la naturaleza, cuya sabiduría proverbial llene todas las condiciones rítmicas de nuestros proverbios gauchos.»1 Más vale, entonces, que aprovechemos y pongamos en práctica los siguientes consejos del gaucho Martín Fierro a sus hijos con los que Hernández alude a enseñanzas, consejos y mandamientos bíblicos y le pone punto final a su épico poema: Un padre que da consejos, más que padre es un amigo;2 ansí como tal les digo que vivan con precaución. Naide sabe en qué rincón se oculta el que es su enemigo. . . . . . . . . . . Hay hombres que de su cencia tienen la cabeza llena; hay sabios de todas menas, mas digo sin ser muy ducho: es mejor que aprender mucho el aprender cosas buenas. . . . . . . . . . . Su esperanza no la cifren nunca en corazón alguno. En el mayor infortunio pongan su confianza en Dios;3 de los hombres, sólo en uno; con gran precaución, en dos. Las faltas no tienen límites como tienen los terrenos; se encuentran en los más buenos, y es justo que les prevenga: aquel que defectos tenga, disimule los ajenos.4 . . . . . . . . . . Ni el miedo ni la codicia es bueno que a uno lo asalten.5 Ansi no se sobresalten por los bienes que perezcan.6 Al rico nunca le ofrezcan y al pobre jamás le falten.7 Bien lo pasa entre pampas el que respeta a la gente. El hombre ha de ser prudente para librarse de enojos,8 cauteloso entre los flojos, moderado entre valientes. . . . . . . . . . . Debe trabajar el hombre para ganarse su pan; pues la miseria, en su afán de perseguir de mil modos, llama en la puerta de todos y entra en la del haragán.9 . . . . . . . . . . Muchas cosas pierde el hombre que a veces las vuelve a hallar... Pero les debo enseñar, y es bueno que lo recuerden: si la vergüenza se pierde, jamás se vuelve a encontrar. . . . . . . . . . Respeten a los ancianos; el burlarlos no es hazaña.10 Si andan entre gente estraña deben ser muy precavidos, pues por igual es tenido quien con malos se acompaña.11 La cigüeña, cuando es vieja, pierde la vista, y procuran cuidarla en su edá madura todas sus hijas pequeñas. Apriendan de las cigüeñas este ejemplo de ternura.12 . . . . . . . . . . Procuren de no perder ni el tiempo ni la vergüenza. Como todo hombre que piensa, procedan siempre con juicio, y sepan que ningún vicio acaba donde comienza.13 Ave de pico encorvado le tiene al robo afición, pero el hombre de razón no roba jamás un cobre, pues no es vergüenza ser pobre y es vergüenza ser ladrón.14 . . . . . . . . . . Es siempre, en toda ocasión, el trago el pior enemigo. Con cariño se los digo, recuerdenló con cuidado: aquel que ofiende embriagado merece doble castigo.15 . . . . . . . . . . Mas naide se crea ofendido, pues a ninguno incomodo; y si canto de este modo por encontrarlo oportuno, no es para mal de ninguno sino para bien de todos.16 Carlos ReyUn Mensaje a la Concienciawww.conciencia.net 1 José Hernández, La vuelta de Martín Fierro, Prólogo, en Poesía gauchesca (Caracas: Fundación Biblioteca Ayacucho, 1977), p. 258 En línea 20 julio 2023. 2 Pr 1:8–7:27 3 Éx 20:2-3; Sal 37:3-118:8; Pr 3:5 Is 26:4; 4 Mt 7:1; Lc 6:37; 41, 42; Ef 4:32 5 Éx 20:17; 1 Ti 6:10 6 Sal 62:10; Mt 6:19, 20; Lc 12:20, 21; Jn 6:27 7 Dt 5:7; Sal 41:1; Pr 19:17; Mt 19:21; Gá 2:10 8 Sal 37:8; Pr 14:17; 15:1; Ec 7:9; Mt 5:22; Col 3:8; Stg 1:19 9 Gn 3:19; Ef 4:28; 1 Ts 4:11; 2 Ts 3:12 10 Lev 19:32; Pr 23:22; 1 Ti 5:1; 1 P 5:5 11 Sal 26:3-8; 1Co 15:33 12 Éx 20:12 13 Lc 21:34; Ro 6:12; 1 Co 10:13; Gá 5:19-21; 1 P 5:8; 14 Éx 20:15 15 Pr 20:1; 23:20, 21; 29-35; Is 5:11; Lc 21:34; Ro 13:13; 1 Co 6:10; Ef 5:18 16 Hernández, XXXII, pp. 371-78.
Seg 1: The ban on importing U.S. bee packages dates to the 1980s. The primary concern was that U.S. bee packages could introduce pests and diseases into Canadian bee populations. Guest: Ian Grant, President of the Ontario Beekeepers' Association Seg 2: View From Victoria: The Green Party was left ousting their deputy leader after tweets surfaced related to attacks on Dr. Bonnie Henry. We get a local look at the top political stories with the help of Vancouver Sun columnist Vaughn Palmer. Seg 3: Have you ever heard of space mining? It's something straight out of a science fiction movie, but we're getting one step closer to this industry becoming a reality Guest: Michelle Hanlon, Executive Director of the Center for Air and Space Law at the University of Mississippi School of Law Seg 4: The cost of a university education in Canada is expected to rise by 39% over the next 18 years, with Nova Scotia and Ontario being the most expensive provinces. Guest: Andrew Lo, President and CEO of Embark Seg 5: A group of information commissioners in Canada has issued a joint resolution that calls for a comprehensive overhaul of access laws and a significant enhancement of the public's right to access information held by public institutions. Guest: Michael McEvoy, Information and Privacy Commissioner for British Columbia Seg 6: First Nations leaders and the parents of two missing members of the Saik'uz First Nation are urging that more resources and government action be implemented to solve cases. Guest: Morgan Asoyuf, Ts'msyen Eagle Clan Artist from Ksyeen River Seg 7: In Canada, students are increasingly relying on university admissions consultants. This trend has arisen due to the escalating competitiveness of university admissions, leading to heightened pressure and anxiety among applicants. Guest: Michelle Cyca, Award-Winning Journalist and Contributing Editor for Maclean's Learn more about your ad choices. Visit megaphone.fm/adchoices
First Nations leaders and the parents of two missing members of the Saik'uz First Nation are urging that more resources and government action be implemented to solve cases. Guest: Morgan Asoyuf, Ts'msyen Eagle Clan Artist from Ksyeen River Learn more about your ad choices. Visit megaphone.fm/adchoices
Tottiler Messiler yeni bölümüyle yayında! Bu bölümde Fritz Fassbender, Hüseyin Kıyıcı ve Koray Gök, TSL'de 11. haftanın nabzını tuttu, menümüz ise şöyle: (5.00) ANT-BJK, Burak Yılmaz vakası, Bailly-Tayfur, BJK'nin yeni hocası kim olur? (35.00) FB-TS, Avcı Kartal'ı mat etti, TS'nin savunma ve hücum planı, Kartal'ın reaksiyonu (47.00) GS-Paşa, Wilfried Zaha şov, GS'nin ideal forvet arkası üçlüsü, Bayern maçına bakış, (1.08.00) Anadolu'dan notlar, Welinton şov, BŞK-ANK, Sivas'ın formu, Rize'nin enteresan penaltısı (1.14.00) Fikstüre bakış (1.19.00) Soru, cevap, kapanış. İlginize teşekkürler, iyi dinlemeler!
In this edition of Madison Book Beat, host Andrew Thomas speaks with Tacey M. Atsitty about her poetry collection (At) Wrist, (2023, The University of Wisconsin Press Press).In a fever dream of metaphor and image, Atsitty explores themes of loss, romantic love, and faith. Drawing on the familiar poetic form of the sonnet, Atsitty demonstrates how vulnerability, nakedness, and risk are an essential part of the connections we build with others across time. Delicate and visceral, (At) Wrist is a collection which "amplifies silence, so you can hear/ every crunch or offering of self."Tacey M. Atsitty is of the Diné tribe and her clans are as follows: she is Tsénahabiłnii (Sleep Rock People) and born for Ta'neeszahnii (Tangle People). Her maternal grandfather is Tábąąhí (Water Edge People) and her paternal grandfather is Hashk'áánhadzóhí (Yucca Fruit Strung-Out-In-A-Line People) from Cove, AZ.She is the winner of the Wisconsin Brittingham Prize for Poetry and is a recipient of the Louis Owens Award, Truman Capote Creative Writing Fellowship, the Corson-Browning Poetry Prize, Morning Star Creative Writing Award, and the Philip Freund Prize. She holds bachelor's degrees from Brigham Young University and the Institute of American Indian Arts, and an MFA in Creative Writing from Cornell University. Her work has appeared or is forthcoming in EPOCH, POETRY Magazine, Kenyon Review Online, Prairie Schooner, swamp pink, Literary Hub, New Poets of Native Nations, Leavings, and other publications. Her first book is Rain Scald (University of New Mexico Press, 2018). Her second book (At) Wrist is forthcoming (University of Wisconsin Press, 2023).She is the director of the Navajo Film Festival, a member of the Board of Directors for Lightscatter Press, a member of the Advisory Council for Brigham Young University's Charles Redd Center for Western Studies, and the founding member of the Advisory Board for the Intermountain All-Women Hoop Dance Competition.She is a PhD candidate in the Creative Writing Program at Florida State University, where she lives with her husband.Photo courtesy of University of Wisconsin Press
Mensagem proferida na Igreja Presbiteriana de Anápolis no culto matutino do dia 05.11.2023 pelo Rev. Lucas Quintino em 1 Ts 1.1-10 - A força da Igreja no Evangelho.
Welcome to The Challenges of Faith Radio Program. Today's topic Are you affected by the Word? Part 1 of 3 I ask that you listen, ponder, apply, and pray.....Also ask God for guidance, on how your gift(s) should be used in the public square for Him, and others..that are hurting, helpless, homeless, and feeling hopeless. As you continue your sojourn thru 2023, Remember, Life is like a coin, You can spend it any way you want to. But, you can only spend it once. So, spend it wisely! COFRP airs on Amazon Music, AntennaPod, Apple, Audacy, Audible, BTR, Castbox, Edifi, Fathom Fm, Fyyd Radio (DE) , Google Podcast, Himalaya Learning, JAM, Padverb, Player Fm, Podbay Fm, Podbean, Podtail, Podyssey, Radio Podcast Addict, SoundCloud, Spotify, TS, Wave, Wisdom, YouTube, and more.
(re-edited on 11/3/2023) This week Eric has a real-life situation so it's a pieced-together show in which: Matt goes rogue and visits IndieLand, and Eric tells a second story, ponders Portal, dreams of BlizzCon, and tries to take us back to The Dark Ages (which earns TS its first-ever Explicit tag). Releases: RoboCop: Rogue City & Star Ocean The Second Story R
“We incorporate nurses and clinicians and users for any tool from the very beginning. They say, ‘You know, we need help with this.' And then we start ideation: We start understanding the problem, we meet with them, we try to see what is it that they're trying to do, is it feasible given the data we have? We go back, we do some research, feasibility study. We say we think this is something we can predict with decent performance. Now let's do it,” Nasim Eftekhari, MS, executive director of applied artificial intelligence (AI) and data science at the City of Hope National Medical Center in Duarte, CA, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a discussion about how the use of AI in cancer care affects an oncology nurse's daily work. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The advertising messages in this episode are brought to you by LUNGevity. Episode Notes Oncology Nursing Podcast: Episode 281: Nursing's Role in AI in Health Care Episode 131: NLM Is Changing Health Care Through the Power of Data ONS Voice articles: New Technology Tools Help Oncology APRNs Improve Patient Outcomes AI Ultrasound Is Nearly 100% Accurate in Detecting Thyroid Cancers Nursing Informaticists Are the Backbone of Technology-Driven Care What ChatGPT Says About Belonging and Oncology Nursing Clinical Journal of Oncology Nursing article: Technology and Humanity Oncology Nursing Forum article: Artificial Intelligence for Oncology Nursing Authors: Potential Utility and Concerns About Large Language Model Chatbots Primers for AI concepts and terminology: Introduction to Artificial Intelligence for Beginners 12 Important Model Evaluation Metrics for Machine Learning Everyone Should Know To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode “So, there is a lot of applications of AI in cancer care, so I can't possibly give you an exhaustive list. But the ones that come to my mind, at least the ones that we are actively working on are early detection and diagnosis, treatment planning, predictive modeling for predicting unwanted outcomes, remote monitoring, radiology applications, pathology applications, improving operations and helping the resource allocation, precision medicine, and research. And we also started a year or so incorporating AI and helping with drug discovery.” TS 2:13 “We've been using AI for a very, very long time. Recently, we just hear more about AI, but AI is in our lives, in health care or not, all day, every day. Google Maps, Google search, all of this is enabled by AI, but we may not realize even that we're using it.” TS 8:27 “So, for technical challenges, you have to always consider: Is this model performing in a decent manner for this application? And depending on the use case, that's different. If you're providing a decision support to someone that is impacting patient care, then you have to be very careful about model performance. So, model performance is one technical consideration, then how do you really technically integrate with the EMR system? It's not easy, EMR systems are not usually very open, and that's a whole challenge in itself to be able to read from any EMR system in real time and feed data back into it in real time.” TS 10:16 “For nurses to successfully approach and adopt this work, I think the most important thing is to keep an open mind to really realize that these technologies can, at best, take the mundane part of their work away so they can operate at the top of their license, but what AI does best is to do things that are repetitive and doesn't require a ton of human intelligence. I think that would be very helpful. Just that mindset could make things more collaborative and cooperative, and that's the only way that we can make these successful.” TS 12:37 “What could help is for nurses to learn the basic concepts that are involved in the development and deployment and testing of these models, so that they can really understand the limitations and capabilities and they can take an active part in the development as well. So, it's not like we build something for you and then we're trying to convince you this is good for you. We try to build together. As an AI and computer scientist, I'm always learning the medical language. I try to educate myself about the clinicians' workflows and language, and I think the same needs to happen on the clinician side for us to be able to build tools that really work in their workflows for their everyday life.” TS 13:58 “We incorporate nurses and clinicians and users for any tool that will be developed from the very beginning. So, usually, the need for something, like a predictive model, comes from nurses and doctors. They say, ‘You know, we need help with this.' And then we start ideation: We start understanding the problem, we meet with them, we try to see what is it that they're trying to do, and is it feasible given the data we have? We go back, we do some research, feasibility study. We come back and say we think this is something we can predict, you know, with decent performance. Now let's do it.” TS 14:30 “All of our models, even the ones that have been in production for the longest, we're still getting feedback, we're still improving, and we're still retraining models, not only with new data that becomes available but also with the feedback that we get from our users.” TS 17:43 “For example, after going live, we've had less ICU admissions because of sepsis or septic shock, or after going live had less sepsis mortality, which is very reassuring. So that seems like we're doing the right thing, and our model is working, but if you want to put your scientist hat on, you cannot say 100% this is the impact of the model because there is a lot of different workstreams that are trying to improve those same metrics. And unless you do a clinical trial or what we call in industry A/B testing, where you control for everything else and it's only the model intervention that is the variable, you cannot say for 100% that this is the impact of the model. That's why we combine our qualitative metrics that seem to be right in the right direction with the quantitative metrics.” TS 22:17 “I think for the first time, something has come up that can really make a big change in health care. I could not say this before generative AI. AI has always been helpful, but now I think it's the time to see real change. We're still experimenting. It's really new technology. We are experimenting with in-house development as well as third-party tools that we are testing and evaluating. Again, there's a huge potential in reducing manual labor and documentation, note taking, there are implications in billing and finance, data abstraction for research or whatever other purposes that we need them, tumor boards, predictive modeling, clinical trial matching is one big use case in oncology, and finding similar patients—something that we've been aspiring to for a really long time—seems to be very possible now with these technologies.” TS 25:30 “The users also weigh in. So, if you're considering it to improve clinical operations, the people who will be using the tool will have a say in, ‘Yes, we think this tool will be helpful.' So, it's not just looking at the technical and cybersecurity and ethical and legal aspects, but also is this something that our users will use because that's the ultimate goal. If they don't use it, it doesn't matter how good the tool is. It won't work.” TS 31:13 “Making it successful is not about the technology, but mostly about people and processes and operational support.” TS 33:33 “Helping people, helping clinicians, nurses to be more free of mundane tasks and be able to interact with patients, do patient care, which is what they should be doing, rather than the things that I know a lot of nurses hate. I think we have a very exciting time ahead of us.” TS 38:47
In today's episode - I talk about some of the most important aspects of thought work and the biggest errors I see my clients making when learning to manage their minds.Listen to find out the key DO's and DON'Ts - and how to take your self-coaching to the next level.Mentioned in this episode:MYRMD group programme info and waitlist.Processing emotions meditation.
EPISODE 126 | Guest: Debbie DeWitt, marketing communications manager for Visix Most organizations have communications for both internal and external audiences. If you're sending mixed messages, or if those messages don't reflect common branding and values, you can lose both employee trust and customer revenues In this episode, we talk about the importance of aligning your internal and external communications, what the benefits are when you do, and some of the real bottom-line repercussions if you don't. - Learn where internal and external communications should overlap - Understand the benefits of communications alignment - Hear why brand standards are just as crucial as consistent messaging - Discover the three Ts (transparency, trust and training) and channel maps - Get best practices you can start using today See the full transcript HERE Get more communications advice in our free guide Digital Signage Communications Planning
Tottiler Messiler yeni bölümüyle tam kadro yayında! Fritz Fassbender, Hüseyin Kıyıcı ve Koray Gök yeni bölümde STSL'nin son haftasını değerlendirdi. Menümüz için buyrunuz: (0.00) Cumhuriyet Bayramı'mız kutlu olsun! (4.00) Hoş geldin SportsBase! (7.00) BJK-Antep, İdeal BJK 11'i, Ghezzal, Demir Ege, Rashica (24.00) Pendik-FB, Dzeko şov, sakatlıklar, fikstüre bakış, (36.00) Rize-GS & GS-Bayern, ideal orta saha üçlüsü, yeni transferlerin performansına bakış, Okan Buruk'un performansı (53.00) Anadolu'dan Notlar, Karagümrük-TS, Aytaç Kara, Hakan Keleş, Ömer Erdoğan (1.06.00) Makas gerçekten bu kadar açıldı mı? (1.13.00) Fikstüre bakış, (1.30.00) Soru-cevap-kapanış. İlginize teşekkürler, iyi dinlemeler!
“Having a nurse-driven protocol, at my facility we call them clinical practice guidelines, allows for that immediate action and swift intervention for the patient,” Maura Price, MSN, RN, AOCNS®, oncology clinical nurse specialist at the Lehigh Valley Topper Cancer Institute in Bethlehem, PA, told Jaime Weimer, manager of oncology nursing practice at ONS, during a discussion about what oncology nurses should know about desensitization strategies. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.75 contact hours of nursing continuing professional development (NCPD), which may be applied to the nursing practice, oncologic emergencies, oncology nursing practice, symptom management, palliative care, supportive care, and treatment ILNA categories, listening to the full recording and completing an evaluation at myoutcomes.ons.org by October 27, 2025. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to desensitization strategies after an infusion-related reaction. Episode Notes Complete this evaluation for free NCPD. ONS Voice articles: Nurses Have Immediate Access to Necessary Medications and Supplies With Hypersensitivity Reaction Kits For Oxaliplatin Hypersensitivity Reactions, Prevention Is the Best Strategy, but Here's How to Manage Them Nurse Innovators Develop Processes to Combat Common Oncologic Emergencies Clinical Journal of Oncology Nursing articles: Nursing Care of Patients Undergoing Chemotherapy Desensitization: Part I Nursing Care of Patients Undergoing Chemotherapy Desensitization: Part II ONS courses: Fundamentals of Chemotherapy Immunotherapy Administration Oncologic Emergencies ONS Chemotherapy Huddle Card Reaction grading systems: Brown https://www.brighamandwomens.org/Common Terminology Criteria for Adverse Events (CTCAE) CTCAE Grading for Immune System Disorders Immune Hypersensitivity Reaction Types I–IV (as described by Gell and Coombs) Brigham and Women's Drug Hypersensitivity and Desensitization Center Dr. Castell's Drug Desensitization Video To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode “An allergic reaction is kind of a more general term that's used when someone has an allergy, whether that be to a medication, an environmental allergy. But an allergic reaction can really range in symptoms, anywhere from mild to severe. So, if a patient tells me ‘I'm allergic to amoxicillin' or ‘I had an allergic reaction, when I take this drug,' definitely ask them to elaborate.” TS 4:40 “Your assessment in grading is really going to be based on the symptoms that the patient is experiencing during the reaction. So, just personally knowing the CTCAE grading so well, this really helps us to identify those next steps for the patient. So, if the reaction was mild and more of a grade one or two, then we can consider rechallenging the patient after additional meds we're always giving and intervening at that point. So, the patient may already have taken premeds prior to starting the infusion. And then we're giving rescue meds to help them through this reaction. So we could potentially rechallenge at that point and either continue them but at the same rate that we were using it at or, per the prescribing information, maybe slow the rate down.” TS 13:58 “I always like to use the example of a GYN-onc patient that's receiving either typically taxol carbo for either their diagnosis of ovarian cancer or endometrial cancer. So that taxane-platinum doublet is really the gold standard for these patients. We know that that is standard of care for them to receive that doublet chemotherapy. So, if the patient has a reaction to the carboplatin but is willing to continue receiving the drug if they pursue that desensitization, they're still getting that gold-standard treatment. So alternatively, completely fine for the patient if they would not like to pursue that and they tell you ‘I'm scared' or for whatever reason they don't, that's why it's just very important to have these conversations up front and educate the patients on the risk versus benefits of all of their treatment options.” TS 16:13 “A great example that I typically use is that patient again with ovarian cancer that had six cycles of taxol carbo. Maybe they then went on to maintenance PARP inhibitor and then several months or years later, they unfortunately have recurrence. That, like you said, it kind of looking back at their treatment history to say, ‘Oh my goodness, this patient already had six doses of the taxol carbo.' So even though it looks like it's fresh taxol carbo—maybe in the treatment plan—they've already been sensitized to that, so as you said, making sure that you're looking back and you know their treatment history.” TS 24:54 “Just remembering that with a desens, this is never a permanent tolerance; it's only temporary. So, making sure that we are closely observing the patient, getting their vital signs, educating them, making sure that they know, ‘Hey, you've reacted to this drug previously. We of course want to keep you on this drug. That's why we're going this route with desensitization. So, if you are feeling anything out of the ordinary, you want to let us know right away.” Making sure that we have our emergency equipment and medications available and right at the bedside or chair side, making sure that there's no contraindications for the desensitization.” TS 27:35 “I think explaining the rationale behind the desensitization and why we're doing it is really key, explaining to them we want to keep you on this drug that you're currently getting, explaining that whole process. None of us like to go into anything without knowing a plan, so it's even just as simple as giving the patient the plan and explaining the process.” TS 30:59 “I'd say the most common misconception that I hear, or get the question about, is this is once and done. So, definitely not the case, it's not once and done. When we do desensitize, just keeping in mind that is a temporary tolerance to the drug. So every time that the patient is going to receive this drug in the future, that is going to require the desensitization. So definitely get that question from nurses that are unfamiliar with it and then also patients thinking like, ‘Oh, I'll be good after I get this one time over a long day, then I'll be okay,' but just reiterating, this is for every single subsequent administration with this medication.” TS 33:55 “It's very scary for patients, and as we said earlier, if they have a friend or a family member with them, it's really a scary time for them. So, reassuring all of them, everyone that's there that day, definitely encouraging them. Another thing that I think gets forgotten is just the financial implications of it. So, if we have a younger patient or even a middle-aged patient that's still working full-time, this is not a short infusion that they were used to prior before they had the reaction. This is a long day. So if they are working full-time, making sure that they understand, ‘You are going to need to miss a day of work each time that you get this going forward.' So, I would say some of those psychosocial things are things that are not often discussed, but definitely important to have that conversation with your patient.” TS 34:40
Tá an tAontas Eorpach ag iarraidh ar Iosrael agus Hamas go gcuirfí an troid ar athló chun cúnamh daonnúil a scaoileadh isteach do phobal Gaza agus imní léirithe acu faoin ngéarchéim sa réigiún. Tá dhá eitleán troda Mheiriceá tar éis ionsaí a dhéanamh ar áiseanna armlóin sa tSíría, tír a fhaigheanns tacaíocht ón Iaráin.
The Black Male Podcast guys are back with a new EP and we doing what we do.. Topics: ***Sports Convo*** [x] NBA is back so let's talk about it. - [x] TS might be wrong about Wemby - [x] Coach Ham wants AD to shoot 6 threes per game this season. WTF? Is he a top 10 player right now when healthy - [x] NBA GMs vote for best player at each position ***Regular Topics*** - [x] Women always ask us what we do for a living? Should we be asking them as well? - [x] Lets talk bout the women that ordered 48 Oysters - [x] As a father is it difficult to tell your child NO? As a husband? ————————————————————— TALLSHON - [ ] Instagram: https://www.instagram.com/tsiswhoiam/ Tre-Dot - [ ] Instagram: https://www.instagram.com/bosstredot/ - [ ] Twitter: https://twitter.com/BOSSTREDOT Got What U Need Network - [ ] Instagram: https://www.instagram.com/gwun.network/ - [ ] Facebook: https://www.facebook.com/GWUNNetwork - [ ] Website: https://gwunnetwork.com/ - [ ] YouTube: https://www.youtube.com/channel/UCeA-JJasR0-64nBb1efDJ1Q/featured
This week, in preparation for the release of 1989 (Taylor's Version), Kate deep dives the making of 1989. Since Kate wasn't podcasting in 2014, she never got to do a proper review of one of her favorite TS albums, so she's taking this opportunity to talk through the timeline of how/when it was written, her favorite songs/lyrics, and revisiting some of the voice notes and live performances. Unsurprisingly, she ends up mostly talking too much about Out of the Woods and New Romantics, but hopefully, when she goes crashing down, she comes back every time. Review of the vault tracks will be on patreon.com/bethereinfive once they come out. Enjoy!Intro music by tim_music on YouTube: https://www.youtube.com/watch?v=lt1NBVJKmjISUPPORT OUR SPONSORSPre order my book, One in a Millennial here!Listen to the podcast on Amazon Music!Get your first book for $5 with code BETHEREINFIVE at bookofthemonth.com.Right now, we have a special discount just for our listeners. Get 10% off your first order sitewide with code BTIF at OSEAMalibu.com. Head to OSEAmalibu.com and use code BTIF for 10% off.Hungryroot is offering my listeners 30% off your first delivery and free veggies for life. Just go to Hungryroot.com/BETHEREINFIVE, to get 30% off your first delivery and get your free veggies.
Get ready for a thrilling session of SwifTea as we unravel the hottest topics in the Swiftiverse.First up, we break down the meteoric rise of "Cruel Summer" to the summit of the Hot 100 charts. Finally! Cruel Summer gets its moment to shine in the spotlight!Then, we delve into the enigmatic message from Taylor Swift and Jack Antonoff. Is their message just for celebration, or is there more to it? AND THAT WINK?! Are we officially in the Glitch?And that's not all… Speculation is running rampant about TS 11. We explore the rumors, hints, and fan theories swirling around the highly anticipated eleventh studio album.Plus, the cutest picture of Taylor Swift and Travis Kelce has surfaced after another weekend together!So, grab your favorite Taylor Swift merch and popcorn bucket, because this episode of "13" is one you won't want to miss.What did we miss? What would you like to hear from us? There are lots of ways to reach us!CONTACT THE PODCAST!Email – firstname.lastname@example.orgIG: https://www.instagram.com/the13podcastTikTok: https://www.tiktok.com/@the13podcastFOLLOW US!Ana - https://www.instagram.com/anaszabo13Lacey – https://www.instagram.com/laceygee13Amy – https://www.instagram.com/amysnicholsNick – https://www.instagram.com/nickadamsonairCHECK OUT OUR OTHER PODCASTS!Lacey & Amy – "Loose Lips & Child-Bearing Hips"Ana - "On Cloud Wine"Nick – "Shut Up!" & "The Chatty Daddies"This podcast is in no way related to or endorsed by Taylor Swift, her companies, or record labels. All opinions are our own.
Bobby and Mike talk through the highlights of both championship series', discuss black out swing, a proposed new rule for travel ball, and why Travis Kelce plays better with T***** S**** in attendance. 6:22 - ALCS 25:15 - NLCS 30:46 - Blackout swings 38:51 - New rule for travel ball 43:44 - Kelce/Swift talk Hosts: Bobby Tewksbary, Mike Olt Producer: Patrick McDonnell Send us your topics! Email email@example.com Or tag @PeloteroPickle on twitter
“We really need to do our best to reach people who don't have access to palliative care in their communities, and this is an innovative way for us to do that,” Carey Ramirez, ANP-C, ACHPN, nurse practitioner and manager of advanced practice and supportive care medicine at the City of Hope National Medical Center in Duarte, CA, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a discussion about how telehealth is overcoming barriers and disparities that previously limited patients' access to timely oncology palliative care. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.5 NCPD contact hours of nursing continuing professional development (NCPD), which may be applied to the care continuum, coordination of care, nursing practice, oncology nursing practice, psychosocial dimensions of care, quality of life, symptom management, palliative care, supportive care, treatment https://www.oncc.org/ilnaILNA categories, by listening to the full recording and completing an evaluation at myoutcomes.ons.org by October 20, 2025. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to telehealth-based oncology palliative care. Episode Notes Complete this evaluation for free NCPD. Oncology Nursing Podcast: Episode 251: Palliative Care Programs for Patients With Cancer Episode 135: ELNEC Has Trained More Than One Million Nurses in End-of-Life Care Episode 41: Advocating for Palliative Care and Hospice Education ONS Voice articles: Bipartisan PCHETA Legislation Reintroduced in U.S. Senate U.S. Senators Introduce Legislation for Earlier Palliative Care Help Your Patients Prepare for the End From the Beginning APRNs Can Lead by Example When Integrating Palliative Care in Practice Clinical Journal of Oncology Nursing articles: Palliative Care: Oncology Nurses' Confidence in Provision to Patients With Cancer Telehealth in Palliative Care: Communication Strategies From the COVID-19 Pandemic Clinical Oncology Nurse Best Practices: Palliative Care and End-of-Life Conversations Integrating Palliative Care in Hematopoietic Stem Cell Transplantation: A Qualitative Study Exploring Patient, Caregiver, and Clinician Perspectives ONS Palliative Care Huddle Card ONS clinical practice resource: Palliative Care Communication Strategies ONS book: Integration of Palliative Care in Chronic Conditions: An Interdisciplinary Approach Center to Advance Palliative Care (CAPC) Hospice and Palliative Nurses Association (HPNA) National Hospice and Palliative Care Organization (NHPCO) To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode “If a person is uncertain of their prognosis or if a provider is uncertain of the goals that the patient has for themselves, that might be an appropriate time to consider palliative consultation. These are all important considerations for triggers that might make palliative a possibility for patients in those scenarios. The take-home message, though, is that the sooner that palliative care is involved, the more likely the patient and family are to benefit.” TS 2:51 “From a patient and family perspective, we frequently find that there are misperceptions regarding palliative care. Oftentimes, they'll conflate the word palliative with either hospice or end-of-life care. They unfortunately sometimes believe that they're one and the same. They demonstrate a lack of knowledge regarding the benefits, including the fact that palliative care can and should be provided alongside life-prolonging care.” TS 3:53 “Palliative providers do their best to help patients maintain hope throughout their disease trajectory, regardless of how well or how poorly things are going. I tend to view things in terms of climbing a sand dune: Living with cancer can sometimes feel like you're walking up a sand dune, either at the beach or at the desert, and there will be days where you take two steps forward and you might slide only one step back. There may also be days where you take two steps forward and slide three steps back. And you find, for example, that if you keep trudging toward the top, that because the winds are constantly blowing those dunes, the top you eventually reach might be different than the one you initially set out to reach. And I think that speaks to the changing nature of hope.” TS 6:08 “It's important to ensure that providers are aware of the local services available to them in their respective communities. [And] we often find that from an organizational or a structural barrier perspective, there are lack of access to palliative care in the community. We often find that outpatient programs may not be as robust, or you may find that there is great variation between outpatient programs with regard to quality.” TS 10:10 “We have multiple patient populations who unfortunately do not have equal access to palliative care. They include rural populations, those who come from low socioeconomic backgrounds. We find that male patients and/or patients who are older adults have lower access to palliative care. We find that those who might be either single or live alone, those who might have an immigrant status, those who don't speak English, those who might have certain cancer diagnoses. It may surprise some of you to know that those with hematologic malignancies actually have much lower rates of palliative referral than those with solid tumors.” TS 11:23 “There's a maldistribution of palliative care resources nationwide. We tend to see that many of the resources are in urban areas, and as a result, we find that a great many rural areas are left untouched. I think it's important for us to recognize that these social determinants of health exist. It's important for us to look intentionally at them and whether they affect some of our patient populations and to work together to overcome them.” TS 14:03 “Anecdotally, I've been doing telehealth for about five years and it's been quite well received. It decreases my no-show rates. It improves my ability to monitor patients over time, and it can be carried out safely.” TS 16:12 “It's important to recognize that telehealth can be utilized not only for a planned appointment that might be scheduled to surveil someone every two weeks or every month from a pain and symptom management perspective, it can also be utilized as a same-day possibility. So if, for example, we have a patient who's due to have an MRI tomorrow and their last MRI was stopped in part because they couldn't tolerate it due to pain or symptoms, we might have a primary team reach out to us and ask whether we can see that patient the day prior to their MRI and devise a plan with that patient so that they can tolerate the MRI more easily the next day.” TS 22:26 “Many of our patients no longer have the ability to get to and from their place of worship, and we can sometimes bring their clergy people to them via telehealth video. We also offer psychology services, psychiatry services, child life services, all via telehealth. And I think it's important to recognize that palliative care is actually made up of an interdisciplinary team, including all of the aforementioned specialists who can basically work together to improve the experience of the patient who is living with cancer and being treated for it.” TS 26:41 “Accept the inevitability of ups and downs. Learn from the downs and persevere. The outcomes are definitely worth it.” TS 28:11
Briefly recapping our eventful weekends (SPOILER: it involves Halloween activities & a Lion's game TV appearance) & revealing newfound knowledge about TS on the TV during football games. Then, diving into our tarot readings & what the cards have in store for us as the reading gets so deep it's actually spooky. & Ending the episode with a spooky story from our special guest that WILL give you the chills. This week's episode is sponsored by Green Chef. Go to GreenChef.com/60shady & use code 60shady to get 60% off plus FREE shipping! Follow Brandi on social media @ charmed.mi or book a session with her here: www.charmedintuitive.com Shop the NEW fall edit featuring halloween home decor & spooky season sweaters here: https://justalittleshadypodcast.com/collections/fall-2023 Submit your SPOOKY story to be featured in a future episode anonymously here: https://forms.gle/VyXLKoDfE8udBBim7 Join our Patreon for this week's BONUS content with my fiance, Evan as a special guest: https://www.patreon.com/justalittleshadypodcast Subscribe to our youtube channel: https://www.youtube.com/c/justalittleshadypodcast Follow us on instagram: https://www.instagram.com/justalittleshadypodcast/ Watch us on Tiktok: https://www.tiktok.com/t/ZTR6yk19Q/ Learn more about your ad choices. Visit megaphone.fm/adchoices
This week, Kate welcomes back Sami Sage (co-founder of Betches) to the podcast to discuss a real grab bag of topics related to current and past pop culture events. They discuss lessons learned from a rewatch of early Southern Charm seasons, the shift in cultural conversation about age gaps, millennials dating to marry versus dating to date, Taylor Swift's recent pap walks, RHONY's new cast, the Tiktok phenomenon of “Tube girl” and the trend about the “female Roman Empire,” among other topics. Spoiler alert: they spend the last half hour or so discussing the Roy Man Empire (if you will) since Kate just watched Succession during mat leave and needs Sami's thoughts about the show and the Roy family, and eventually, they close with a few thoughts about TS's newly released vault track titles. Enjoy!Pre order my book, One in a Millennial here!Listen to the podcast on Amazon Music!Sign up today at butcherbox.com/bethereinfive and use code BETHEREINFIVE to get $20 off your first order. That's butcherbox.com/bethereinfive and use code bethereinfive to claim this deal.Grab your Liquid I.V. in bulk nationwide at Costco or you can get 20% off when you go to LIQUID-IV.COM and use code BETHEREINFIVE at checkout. That's 20% of ANYTHING when you shop better hydration today using promo code BETHEREINFIVE at LIQUID-IV.COM.Prep your skin for fall with clean, vegan skincare from OSEA. And right now we have a special discount just for our listeners. Get 10% off your first order sitewide with code BTIF at OSEAMalibu.com.Promote skin support from within without compromising clean science. HyaCera from Ritual is a skin supplement you can actually trust. Ritual is offering my listeners 30% off during your first month. Visit ritual.com/BETHEREINFIVE to start Ritual or add HyaCera to your line up today.