Pastor Bryan Wolfmueller of St. Paul Lutheran, Austin, TX Martin Luther's Sermon for Trinity 19 Pr. Wolfmueller's YouTube Channel And Take They Our Life: Martin Luther's Theology of Martyrdom World-Wide Bible Class And Take They Our Life: Martin Luther's Theology of Martyrdom A Martyr's Faith in a Faithless World
"Have to stack firewood before I can go see my friends? You got it." by u/Quitthesht: https://www.reddit.com/r/MaliciousCompliance/comments/q1fizl/have_to_stack_firewood_before_i_can_go_see_my/ "Dont want me to wear the company's provided vest? Okay bet" by u/treeblindeddragon: https://www.reddit.com/r/MaliciousCompliance/comments/q15vjv/dont_want_me_to_wear_the_companys_provided_vest/ "You want me to 'stay in my lane?' OK!" by u/WhoSc3w3dDaP00ch: https://www.reddit.com/r/MaliciousCompliance/comments/q19b5g/you_want_me_to_stay_in_my_lane_ok/ "Quit Overstepping? If you insist..." by u/smohk1: https://www.reddit.com/r/MaliciousCompliance/comments/q1ggsu/quit_overstepping_if_you_insist/ "Dress professionally? Okay, I will" by u/Satanicbuttmechanic: https://www.reddit.com/r/MaliciousCompliance/comments/q17meo/dress_professionally_okay_i_will/ "You must wear a Class III vest with sleeves. Understood." by u/Brittanicus1: https://www.reddit.com/r/MaliciousCompliance/comments/q1ipcm/you_must_wear_a_class_iii_vest_with_sleeves/ "You know how much work I have and dont think I need more manpower, we will do what I can." by u/hellcat47: https://www.reddit.com/r/MaliciousCompliance/comments/q1cpi7/you_know_how_much_work_i_have_and_dont_think_i/ "Sure, I'll dress professionally" by u/DumpsterPhoenix93: https://www.reddit.com/r/MaliciousCompliance/comments/q19jm5/sure_ill_dress_professionally/ "A friend gave me my malicious compliance" by u/wildassedguess: https://www.reddit.com/r/MaliciousCompliance/comments/q130u9/a_friend_gave_me_my_malicious_compliance/ "Here are all your monthly status letters." by u/wolfbayte: https://www.reddit.com/r/MaliciousCompliance/comments/pzzehh/here_are_all_your_monthly_status_letters/ "Just Following Orders Petty Officer" by u/RevisedGibbon: https://www.reddit.com/r/MaliciousCompliance/comments/pzzd46/just_following_orders_petty_officer/ --- Send in a voice message: https://anchor.fm/reddit-guy/message Support this podcast: https://anchor.fm/reddit-guy/support
Communication is key! Dr. Trever Dietrich and I talk about Habit 5 from The Seven Habits of Highly Effective People. Learn more about my course Conversations That Empower if you are ready to break unhealthy cycles of non-communication in your family. When you commit to growing you will be the positive change in your family for generations to come. https://www.thefocusedmindset.com/products/ You Tube: Cher The Focused Mindset Instagram: Cher The Focused Mindset Facebook: Cher The Focused Mindset Facebook Group: Solution Focused Families Linkedin: Cher Kretz Cher”s Blog: www.thefocusedmindset.com/blog-by-cher Head over to www.thefocusedmindset.com/contact to ask Cher Kretz a parenting question. Your question may land on the show! Want products for your children that will help them be strong and confident? Check out The Big Life Journal. Please use my link here or on my website to shop and you will be supporting this podcast. https://biglifejournal.com/?aff=1186 Like what you hear? Share this episode on your favorite platform or email it to a friend. They will be glad you did. And on Apple Podcasts you can leave me a review by looking for the star review area so Apple will push this podcast to many others who may need encouragement. Thank you! You are never alone with The Focused Mindset. Join my Facebook group Solution Focused Families and join my exclusive family at www.thefocusedmindset.com Conversations That Empower is a life changing mini-course that is fun to go through and with easy to practice skills for the entire family. Upgrade your communication skills with Conversations That Empower found at https://www.thefocusedmindset.com/products/p/conversations-that-empower. You Tube: Cher The Focused Mindset Instagram: Cher The Focused Mindset Facebook: Cher The Focused Mindset Facebook Group: Solution Focused Families Linkedin: Cher Kretz Cher”s Blog: www.thefocusedmindset.com/blog-by-cher bit.ly/cherkretzinfo
The term “neurodiversity” seems to be everywhere right now. But what exactly does it mean? Hosts Amanda Morin and Gretchen Vierstra talk with Emily Kircher-Morris to find out. Emily is a neurodivergent parent to twice-exceptional kids. And she's the host of The Neurodiversity Podcast. Listen in to hear Emily's unique perspective on neurodiversity. Understood is a nonprofit and social impact organization dedicated to shaping a world where the 1 in 5 people who learn and think differently can thrive. Learn more about In It and all our podcasts at u.org/podcasts. Copyright © 2021 Understood for All, Inc. All rights reserved.
The Apostle John goes on from his introduction of Revelation to cite multiple Old Testament passages and applies them directly to Jesus Christ. The first identifies Him doing something God does. The second clarifies Him as the one predicted in Zechariah and Daniel. And the third calls Him the Greek equivalent of God's title, The First and the Last. In a book titled The Revelation of Jesus Christ, he isn't leaving that task up to guesswork. 1. John refers to Jesus as coming with the clouds because the Old Testament refers to God riding the clouds. 2. John quotes Zechariah's prophecy of the Messiah to draw to mind how Israel will react to how they treated their God. 3. John calls Jesus the Alpha and Omega in order to draw the nearest Greek equivalent to God's title in Isaiah.
Connie’s quote today is by ~ Dr. Seuss “Oh the places you'll go! You have brains in your head. You have feet in your shoes. You can steer yourself in any direction you choose.” Check Out These Highlights: As a kid, I remember going to Barnes and Noble to buy our summer reading books for […] The post 210. Help Children to be SEEN, HEARD and UNDERSTOOD appeared first on WebTalkRadio.net.
Connie's quote today is by ~ Dr. Seuss, “Oh the places you'll go! You have brains in your head. You have feet in your shoes. You can steer yourself in any direction you choose.” YouTube: https://youtu.be/Tda02-bWMz8 Check Out These Highlights: As a kid, I remember going to Barnes and Noble to buy our summer reading books for the next academic year. As I reflect on those fond memories, I can feel the excitement. For me that feeling of walking into the huge bookstore, the smell the of the paper the books were printed on, and the exploration of which books to choose to help start my summer adventure. There was always a selection of about a dozen books, and we had to choose 5 or 6 to read. I'd love for you to take just a moment and reflect on your summer reading, the feeling it evokes, and the memories, whether good or bad. For me that reflection feels so nice and allows me to pause and be a kid for just a few minutes and it feels so good! About JoAnn Nocera: JoAnn Nocera. JoAnn is an Educational Leader, Creativity Enthusiast, and Author with over two decades of experience helping children reach their highest learning potential and teaching parent's strategies to greater assist in the process. In short, Jo helps children to be SEEN, HEARD and UNDERSTOOD. Nocera has worked to change the culture of schools and provide families tools for their home life to help children succeed academically and emotionally. She has spent years researching and developing techniques in the areas of reading, math, science, differentiated instruction, time management, social emotional learning, and has proven successful in helping students in all facets of education. Her forthcoming children's book series, Katherine Grace, is due out in Fall 2021, and her book Give Me Back My Crayons with companion planner Give Me Back My Creativity are available wherever books are sold. How to Get in Touch With JoAnn Nocera: Email: firstname.lastname@example.org Website: https://www.joannnocera.com/ Book link on Amazon for Katherine Grace Unlocks the Keys Stalk me online! Enlightenment of Change Facebook group: tinyurl.com/EOCFacebookGroup Website: https://whitmanassoc.com/ Connie's #1 International Bestseller Book - ESP (Easy Sales Process): 7-Step to Sales Success: https://whitmanassoc.com/resources/ Download Free Communication Style Assessment: www.whitmanassoc.com/csa Subscribe and listen to Enlightenment of Change podcast on your favorite podcast streaming service or on YouTube. New episodes post every week - listen to Connie dive into new sales and business topics or problems you may have in your business.
Pastor Bryan Wolfmueller of St. Paul Lutheran, Austin, TX Martin Luther's Sermon for Trinity 19 Pr. Wolfmueller's YouTube Channel And Take They Our Life: Martin Luther's Theology of Martyrdom World-Wide Bible Class And Take They Our Life: Martin Luther's Theology of Martyrdom A Martyr's Faith in a Faithless World
"Wrong polo shirt" by u/Plain_Jaine: https://www.reddit.com/r/IDontWorkHereLady/comments/pj1d3g/wrong_polo_shirt/ "Wrong Library" by u/Agent___23: https://www.reddit.com/r/IDontWorkHereLady/comments/piu67p/wrong_library/ "Understood mistake to angy customer" by u/Sokiawolf: https://www.reddit.com/r/IDontWorkHereLady/comments/pikyya/understood_mistake_to_angy_customer/ "I've got to remember to take off my hard hat and vest" by u/Cordero_Biggs: https://www.reddit.com/r/IDontWorkHereLady/comments/picljy/ive_got_to_remember_to_take_off_my_hard_hat_and/ --- Send in a voice message: https://anchor.fm/reddit-guy/message Support this podcast: https://anchor.fm/reddit-guy/support
"We all know that an amazing teacher can have a huge impact on our kids. But is that impact even greater when the teacher learns and thinks differently, too? In this episode, hosts Amanda Morin and Gretchen Vierstra talk with Kara Ball, a teacher who's “in it.” Kara shares what school was like for her as a student with dyslexia and dyscalculia, and how those experiences shape how — and why — she teaches.Understood is a nonprofit and social impact organization dedicated to shaping a world where the 1 in 5 people who learn and think differently can thrive. Learn more about In It and all our podcasts at u.org/podcasts. Copyright © 2021 Understood for All, Inc. All rights reserved. "
Signs of ADHD can pop up for kids — and adults — in unexpected, emotional, and even funny ways. But sometimes there's a single moment when someone realizes that they or someone they know has ADHD. In this bonus episode, host Amanda Morin talks with Laura Key, host of ADHD Aha!, a new podcast from the Understood Podcast Network. Listen in to get a sneak peek of the show before it launches on September 28 — and be sure to subscribe to ADHD Aha! to hear the full story of Laura's “aha” moment. Understood is a nonprofit and social impact organization dedicated to shaping a world where the 1 in 5 people who learn and think differently can thrive. Learn more about In It and all our podcasts at u.org/podcasts. Copyright © 2021 Understood for All, Inc. All rights reserved.
What's understood don't need to be explained. It's Wednesday and we came to groove! Happy Wednesday Groove groovy ones. It's your boy C.Will.Holla aka The Pod Father and it's your girl Mika Joi The Voice Behind The Truth back in the building. Pushing you over your hump day with positive conversations and good vibrations. On this week's episode we're celebrating a real one's birthday. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/truthmoment/message
Amanda Morin and Maria Moser share the impact the pandemic had on children going back to school. Understood created Take N.O.T.E, an initiative developed and launched in partnership with the American Academy of Pediatrics, to provide families with the tools to identify early signs f learning disabilities and ADHD.Alex Seidel, Chef and James Beard Foundation Best Chef Award Recipient talks all about the great dishes you can make with beef and the role it plays in sustainable eating.Christopher Gilbert is the author of Noble Edge. He is a senior international ethics consultant and popular keynote speaker. nobleconsulting.comRoxè released his first video for breakout song "Jesus: Kingdom of Love" and talks all about the no hate no violence campaign.
Discover In It, a podcast that explores the joys and frustrations of supporting kids who learn and think differently. Join hosts Amanda Morin and Gretchen Vierstra as they talk with parents, caregivers, teachers, and sometimes kids. They offer perspective, advice, and stories for and from people who have challenges with reading, math, focus, and other learning differences. Understood is a nonprofit and social impact organization dedicated to shaping a world where the 1 in 5 people who learn and think differently can thrive. Learn more about In It and all our podcasts at u.org/podcasts. Copyright © 2021 Understood for All, Inc. All rights reserved.
Pastor Bryan Wolfmueller of St. Paul Lutheran, Austin, TX Martin Luther's Sermon for Trinity 19 Pr. Wolfmueller's YouTube Channel And Take They Our Life: Martin Luther's Theology of Martyrdom World-Wide Bible Class And Take They Our Life: Martin Luther's Theology of Martyrdom A Martyr's Faith in a Faithless World
There is suffering and then there is suffering understood. There is a beauty and a ministry God gives to us when we go through seemingly unbearable trials and tribulation. If you are suffering, this will most definitely encourage you.
Parables are often challenging to interpret and today we look at Matthew 13 which contains the densest chapter on parables in the Bible. We'll talk about how to interpret parable and also see what our Lord tells us about the nature and message of the Kingdom. Join Us! Like us on Facebook! https://www.facebook.com/keychapters Grateful to be included in the "Top 40 Bible Podcasts to Follow" from Feedspot.com https://blog.feedspot.com/bible_podcasts/ and for frequently being chosen as "Podcast of the Day" by PlayerFM https://player.fm/
Today, we're talking about a killer that was clearly not okay mentally. He doesn't have electricity at every floor. Maybe because of that, he killed his pregnant girlfriend and led police on a high speed chase while dangling the baby he removed (cut) from her, out of his car window. In his own words, you'll hear why he did it, and why he said, “she understood she had to die”. Subscribe and share 10 Minute Murder with your true crime loving friends. Connect on social media to know when new episodes are released and to see visuals that go along with the episodes. Facebook: https://facebook.com/10MMpodcast Instagram: https://www.instagram.com/10minutemurder/ Tiktok: https://vm.tiktok.com/ZMRBEFtUg/ Youtube: https://youtube.com/channel/UCkJLUCEZlkn9In3AA46RVxw Twitter: https://twitter.com/10minutemurder Submit future episode story ideas: email@example.com
In this podcast, Shadi Hamid shares his views on the recent exit of the American troops from Afghanistan and the chaos that has ensued since then. He explains how in his view the Americans never understood Afghanistan like the Taliban did and that resulted in a series of policy disasters from one administration to the other. Follow Shadi: Twitter: @shadihamid OpEd on the subject: https://www.theatlantic.com/ideas/archive/2021/08/what-taliban-understood-about-afghanistan/619864/ Buy Shadi's books here: https://www.amazon.in/Shadi-Hamid/e/B00GOPZTG0/ref=as_li_ss_tl?ie=UTF8&linkCode=sl2&tag=shtwitter-20&linkId=e9e5ed0e8a56bf590bf606fd064df952&language=en_US Check Wisdom of Crowds here: https://wisdomofcrowds.live/ #Taliban #Afghonistan ------------------------------------------------------------ Listen to the podcasts on: SoundCloud: https://soundcloud.com/kushal-mehra-99891819 Spotify: https://open.spotify.com/show/1rVcDV3upgVurMVW1wwoBp Apple Podcasts: https://podcasts.apple.com/us/podcast/the-c%C4%81rv%C4%81ka-podcast/id1445348369 Stitcher: https://www.stitcher.com/show/the-carvaka-podcast ------------------------------------------------------------ Support The Cārvāka Podcast: Become a Member on YouTube: https://www.youtube.com/channel/UCKPxuul6zSLAfKSsm123Vww/join Become a Member on Patreon: https://www.patreon.com/carvaka UPI: kushalmehra@icici To buy The Carvaka Podcast Exclusive Merch please visit: http://kushalmehra.com/shop ------------------------------------------------------------ Follow Kushal: Twitter: https://twitter.com/kushal_mehra?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor Facebook: https://www.facebook.com/KushalMehraOfficial/? Instagram: https://www.instagram.com/thecarvakapodcast/?hl=en Koo: https://www.kooapp.com/profile/kushal_mehra Inquiries: https://kushalmehra.com/ Feedback: firstname.lastname@example.org
Hi y'all! In this episode Tori and I talk about how God delights in you but we have to be careful to not belittle that and diminish His love for us. We do diminish it in the way we talk to ourselves Link to Sweet Subscriber who sent us the worship song!https://www.instagram.com/janelanett/Patreon: https://www.patreon.com/themastersfamOur Instagrams: Tori's- https://www.instagram.com/torimasters/Chad's- https://www.instagram.com/chadmasters/Podcast- https://www.instagram.com/themessymasterpiecepodcas
This information will turn your perception of the world upside down. What people found out at the conference "Global Crisis. This Already Affects Everyone" gives a complete understanding of the seriousness of what is happening on the planet. Climatic and environmental crises are expanding on a critical scale. If we do not change anything, we will face a disaster. We can overcome the upcoming cataclysms only if we unite, while this is possible only in a creative format of society. Each of us bears the responsibility of changing society's development vector from consumerist to creative. "Global Crisis. This Already Affects Everyone" is the large-scale online conference that took place on the platform of ALLATRA IPM on July 24, 2021. It was broadcast on thousands of online channels and simultaneously interpreted by volunteers into 72 languages including sign language. People from more than 180 countries participated in arranging the conference in order to convey the truth to every person on Earth regarding what is actually happening to the world nowadays and what challenges and shocks await us in the near future. This global online event has united people from totally different spheres and professions: scientists, physicians, politicians, representatives of culture and arts, independent researchers, eyewitnesses of climate disasters, entrepreneurs, and opinion leaders from various fields. All these people expressed their concern about the current situation in the world, shared facts, observations, personal discoveries, as well as the main understanding that there is only one way out for our civilization today — Creative Society, and we can build it only all together. People's responses to the conference "Global Crisis. This Already Affects Everyone" are coming from all over the world. You can send your video feedback to email@example.com Conference "Global Crisis. This Already Affects Everyone" with a selection of languages on the official website of the Creative Society project: https://allatraunites.com YouTube broadcast of the conference in English: https://youtu.be/OdBqRbohhKc Broadcast in Russian: https://youtu.be/ZTsNJuJ_z0M Broadcast in Spanish: https://www.youtube.com/watch?v=o88YB... "The Future? This Affects Everyone" | NEW VIDEO with Igor Mikhailovich Danilov: https://youtu.be/pUegF_knWoc ALLATRA TV website: https://allatra.tv/en E-mail: firstname.lastname@example.org #GlobalCrisis #CreativeSociety #Allatra
Aunty Vesna, host of Sydney live music platform Queer As Fvck and front person of queer-electro rock outfit Gaia Rising take you on a fascinating journey through the creative process of some the best up and coming queer/gender diverse artists, characters and issues in Sydney and beyond.This month the Ask Aunty team sat down with the divine Ms Cassy Judy, all powerful Goddess Sellma Soul, ever fabulous Miss Understood and Antonio Mantonio pops in with another episode of Queer History.Please don't forget to click subscribe, rate and review the show on the podcast page and also, Ask Aunty now has a Patreon account, so if you are enjoying the podcast and you feel strongly about supporting queer artists then please follow the links to the Patreon page via our Facebook.Cassy Judycassyjudy.comSellma Soulsellmasoul.com.auMiss Understoodhttp://www.youtube.com/user/MissUnderstoodDrag?feature=mhw5#p/aAntonio Mantoniohttps://www.facebook.com/antoniomantoniodragkingQueer As Fvckhttps://www.facebook.com/QueerAsFvckAsk Auntyhttps://www.facebook.com/AskAuntyMusic by Vesna Grace, Britania FlowerQueer History music by AShamaluevMusic
In this week's episode, Alyssa sits down with suicide and abuse survivor, Johnny Crowder, to talk about the seemingly "small things” that are hugely important to have in trauma recovery. Johnny opens up about his own journey from abuse survivor to now hosting his own podcast and being the CEO and founder of an app designed to help mitigate trauma symptoms. Johnny is an amazing warrior with so much love to give! Support the Podcast Learn More About Johnny Crowder Transcript: Alyssa Scolari [00:23]: Hello, hello Friends. How are we doing today? I am trying to get back into the podcast swing of things. I have had a couple of weeks break from recording. We went on vacation. We bought a house. We have been packing and getting ready to move and all those good things and it's been really busy but all good stuff. Really, really excited. Of course, the moving process is like triggering trauma symptoms out of the wazoo but that's a conversation for another podcast because today, we have very special guest. I am looking forward to this episode. We have with us Johnny Crowder. Now, Johnny is amazing. He is a 28 year old suicide and abuse survivor. He is a TEDx speaker, a touring musician, mental health and sobriety advocate and the founder and CEO of Cope Notes. Cope Notes is a text based mental health platform that provides daily support to users in nearly 100 countries around the world, which is awesome. I love that. I can't wait to talk more about that. Armed with 10 years of clinical treatment, a psychology degree from the University of Central Florida and a decade of peer support and public advocacy through the National Alliance of Mental Illness, Johnny's youthful vigor for mental health has impacted millions of lives across the globe. Since his first keynote in 2011, Johnny's refreshingly candid perspective has attracted praise from hundreds of outlets, including Upworthy, CNN, and Forbes. Even when commanding a virtual stage or touring with his metal band, Prison, his infectious positivity and firsthand experience with multiple mental illnesses, ranging from bipolar disorder and OCD to schizophrenia, uniquely equipped him to provide realistic yet hopeful insight into the pains of hardship with authenticity, levity, and unconventional wit. So that was quite a bio. So hello, Johnny, welcome. Johnny Crowder [02:48]: Howdy. Alyssa Scolari [02:50]: You're a rock star. I mean, holy smokes, everything that you've been through ... I've really been looking forward to this conversation, even though it's taken us a little while to schedule and to get here, just because of the things that you're doing and the resiliency that you have. So can you take us back, how did you get to be the person that you are today? Johnny Crowder [03:17]: Lots of- Alyssa Scolari [03:19]: That's a loaded question, I know. Johnny Crowder [03:20]: Yeah. I'm trying to think lots of music. Lots of exercise, I'm looking back and I just think like, we all like to ... we all wish life was simple enough and binary enough to point to one thing and be like, "Oh, that was the thing that defined me," but I'm a pretty outspoken proponent of the fact that all of the little things make a big difference too, so it's interesting when I do interviews, and people want to talk about like the few big things, like tell us about your suicide attempts or tell us about being raped. I'm like, there were thousands of little moments in between, that shaped me, that I don't always get to talk about. So whenever someone is like, "How did you become who you are?" My brain runs like an infinite inventory of all of these tiny little decisions that I've made, but ultimately, an easy way to describe it is every time I experienced some kind of pain, I stubbornly decided there had to be a way to justify it. I had to use the pain or else the pain would have been for nothing, so that's why I think my life has progressed in the way that it has, is every time I hurt myself like I stubbed my toe and I think, man, I'm going to start a committee that's going to look at every corner in my house so that people don't stub their toes anymore. I just think that way. Alyssa Scolari [04:42]: Yeah. So basically, what you do is you have chosen to find meaning from the pain, take it and do something with it. Johnny Crowder [04:56]: Yeah, and there's a blurry line there too. When I was growing up, if someone would have said like, "Search for purpose and your pain," I'd be like, "Shove off. I don't want to talk about that," because I was caught up on the fact that it wasn't fair that I was experiencing pain, but once you can get past that hurdle, which is much easier said than done, you've kind of realize you do have a choice. Either I experienced that pain for no reason, and it will benefit no one and I learned nothing or I can leverage that so that there's some type of fruits, so that when I look back on my life, I don't wish I was hurt more so that I could have learned more, produce more good things. It's a way of like retroactively justifying the pain that you've experienced. I think anybody can do it, it just takes some pretty heavy mental lifting. Alyssa Scolari [05:44]: Absolutely and I think there's a lot in what you said, I think you're right. It's one of those things where would we prefer to live without our abuse? Johnny Crowder [05:55]: Yeah. Alyssa Scolari [05:56]: Yeah, that would be pretty fucking awesome. Please, I'll take that. I think so many people struggle, myself included at times with the mentality of it's not fair. It's not fair. This isn't fair. How did you ... and this is also a loaded question, so I understand that it's more complex than just a simple question, but how did you get into that mindset, because I think so many of us stay stuck in, "Well, this isn't fair." Especially living in a world where there's no justice. Johnny Crowder [06:39]: Yeah. I'm trying to think it wasn't like .... I think the way people envision people who are resilient is like, they wake up every day and they're like, "Oh, I'm just going to climb this mountain every day." I was talking to a buddy of mine, who I really admire, her name is Kristen. She's been doing this like advocacy for a lot longer than I have, so I asked her a lot of questions and she mentioned something like ... something along the lines of you can't be courageous, if you don't experience fear. Courage is overcoming fear. So if you're not afraid, then there's like a synapse, not firing in your brain. You should experience fear at some point, some things are scary and I kind of view my story so far that way like, it wasn't about training myself to think it is fair and I do deserve this. That would have been really unhealthy, right? Much like not experiencing fear is really unhealthy. So, the first thing you have to do is kind of either speak with someone who has been through something that you have, like talk to a peer about it and kind of validate that it's not your fault, and you didn't attract ... you didn't like law of attraction your way into being abused or something like that. There's a lot of that nonsense going around. So once you get past that piece, where you can just look straight at it, and you say, "That's not fair," then it's almost like that issue is put to rest. You're not wrestling with whether or not you deserved it anymore. Once you can lay that down, you can use all of that energy you were using on that problem for something more productive. Alyssa Scolari [08:30]: Right, it's about overcoming like it's not fair, but all the energy that you're taking, sitting in this almost ... I almost see it as a sense of denial, right? Because the more we sit in that spot of, "This is unfair, how could this have happened? I didn't deserve this." It's like, yes, yes, yes to all of it but we get stuck there, and when we get stuck there, then we're not using the energy that we have to push forward and create light for ourselves. Johnny Crowder [09:05]: We're also ... In talking about it, we're like skipping the step that is most crucial, which is like understanding that ... some people might not agree, but for me, it was understanding that I was right about not deserving the abuse. Alyssa Scolari [09:23]: Absolutely. Johnny Crowder [09:23]: Think about it ... most people never actually hear that they're right in feeling that they were hurt. A lot of it is like, "Well, what exactly happened and what did you do and what were you wearing and how long did you know that person," and if you let them in, maybe they didn't mean it like that. There's lots of like, it's whatever the opposite of victim blaming is. It's like, aggressor excusing. So, people experience a lot of that where they say, "Well think about it from his perspective," and even, these friends are trying to help too, so don't get it twisted, like they're trying to comfort you and help it not sting as much. Without someone who's experienced trauma, just hearing, "You know what, you're right." No, it's not fair at all and nobody deserves that. Without actually hearing that, it's so tough to get to the point where you can do something with it because you're too busy wrestling with the idea that it could have been your fault or maybe it was fair and maybe that pain was justified. You can only lay that down once you realize like, "Wow, I am right," and you feel validated in that frustration. Alyssa Scolari [10:38]: Yeah, you're 1,000% correct and I think back to the one time in my life that I reported one of my abusers, there was a full investigation, multiple victims and at the end, of course, there was not enough to try this man and the police officer said to me ... and I laugh about it, because that's just what I do, that's how I cope, but the police officer said to me, "Well, you kind of have to see it from his perspective." If you ... would you want your entire career ruined by people accusing you of this when there's no evidence? I mean, you're right, if it's not blaming you directly, right, then we're saying, "Well, you have to look at things from his perspective and not necessarily always a he," right? I want to be clear, there are women and non-binary folks who also can be abusers. We spend a lot of time doing that and we also spend a lot of time where I get a lot of ... and I don't know if you've had an experience with us, like, well, you have to just move on with your life. Johnny Crowder [12:03]: Yeah. Alyssa Scolari [12:04]: That comes before the, "You're justified in feeling what you feel," right? We don't get that. Johnny Crowder [12:04]: Yeah. Alyssa Scolari [12:09]: People skip right to like, "Well, you got to move on with your life." Johnny Crowder [12:12]: Dude, I love you describing it that way because I'm ... Do you remember PEMDAS from school? Alyssa Scolari [12:19]: Yeah, Please Excuse My Dear Aunt Sally. Johnny Crowder [12:21]: Parentheses, exponents, multiply, divide, addition, subtraction. Alyssa Scolari [12:21]: Subtraction. Johnny Crowder [12:29]: I didn't use the correct form of each of those words, but yeah, PEMDAS. So if you wind up doing the addition part of the equation first, it screws up the whole answer, you get the wrong answer every time unless you go in the order of operations and I'm viewing this like healing and coping process as exactly that. If you jump straight to, "Hey, buddy, you got a job to do. You got a life to live. Get back out there and experience it without the validation part," or without even feeling like you were justified in bringing it up to somebody. That's another step that I think a lot of people skip, is they don't ... like friends and family who try to help, someone who has been through something traumatic. We don't often like applaud people for saying something about it in the first place and that's almost always like, in the top three hardest parts of experiencing something traumatic is like mentioning it to someone and we forget to congratulate that person, which sounds like a weird word but to commend them for the strength that took to bring it up because we're too busy trying to help them get out of the mud, I do this all the time too, even with little innocuous stuff, like my buddy is like, "Dude, my boss is such a jerk," and I'm like, "Well, the job market is really fluid right now and you might be able to find something great." I'm like, "What did I say that? Why did I skip straight past my friend's pain point into a potential solution that they didn't ask for?" I do that all the time and I think it's ... in a weird way, it's how we care for each other. I don't want to hear that you're hurting, I want to fast forward to when you're not hurting anymore because I love you, and we forget that a lot of steps are being neglected when we do that. Alyssa Scolari [14:14]: Yeah. Yes. I feel like that is part of what makes trauma, right, because not everybody who experience this abuse can develop PTSD and not everybody becomes traumatized, but sometimes I feel when the support system doesn't kind of slow down and be with people in that pain and rushes people to recover or, what's the word that I'm looking for? Negates its significance and negates the importance of even speaking about it, which really has been my entire life growing up, right? I would say ... I remember the first time I told somebody in my family I had an eating disorder and the response was like, "No you don't." Johnny Crowder [14:59]: Yeah. Alyssa Scolari [14:59]: I was like, "Okay, all right. Here we go." So I think that that just continues to traumatize people. That's how people end up even more traumatized. Johnny Crowder [15:12]: Dude and think about it too, you just made me realize something, the opposite of validating someone and being like, "Wow, that is ... you are experiencing disordered eating." I'm like, "Man, what's been going on and tell me about it, and I want to understand it." The opposite of validating it is like gaslighting you into saying that it's not happening, and I picture like all of this ... I mean, I don't know your story, but I picture all of the courage and effort and mentally weighing the pros and cons of bringing it up in the first place and what does this mean and do I have to ... Am I going to have to go to treatment or are people going to look at me differently? Then is my behavior even going to change or is my disordered ... is my eating even that disordered, other people have much more disordered eating than me? So all these thoughts raced through your head for ... and Lord knows how long you struggle with this and then you finally bring it up, and it's kind of like a fireworks finale or whatever, where it just like ... and then like, doesn't even shoot, like the mortar doesn't even shoot off the ground. You're like, "What the heck?" Alyssa Scolari [16:21]: Those just happens. Johnny Crowder [16:23]: I think people forget the lead up to saying something like that, like it's not just someone casually mentioning it like at least in my personal experience, before I mentioned stuff like this to people. There's like a whole ... I mean, I'm writing like a mental dissertation about ... it's like a term paper in my mind, where I'm like, weighing out all of the potential ... and I'm so anxious about the outcome I'm bringing up, that it's exacerbating what I'm experiencing in the first place. So to mention it and have someone go, "Well, I mean, other people will have a lot more disordered eating than you." You just are like, "Oh, did I just waste five semesters on a paper that no one is going to read?" Alyssa Scolari [17:12]: I may just go burn this paper. Johnny Crowder [17:14]: Yeah. That's tough. Alyssa Scolari [17:16]: Right, figuratively speaking. So, for you, did you have that support from your family? I know that you had mentioned that you're a sexual abuse survivor and a suicide attempt survivor. So did you have that support growing up with your family, friends? Johnny Crowder [17:41]: So all my family is still alive, so I do my very best to speak kindly of everybody. Alyssa Scolari [17:48]: Understood. Johnny Crowder [17:49]: I grew up in a family that was not necessarily conducive to healthy mental and emotional patterns. Alyssa Scolari [17:59]: Understood. Johnny Crowder [17:59]: When I was ... I'll just say this, but you can kind of extrapolate out the type of family that I grew up in, when I was younger. So I had really debilitating OCD and it was getting to the point where I couldn't function normally. I couldn't get dressed, I couldn't make food, I couldn't leave my house sometimes. I couldn't touch doorknobs or people or step on cracks. There were like, hundreds of things that I couldn't do. It was really interfering with my daily life to the point where I couldn't function. My brothers, while, we didn't really talk about this, they knew that something was up with me and they knew what bothered me. So there was this one time we went to subway and they took my sandwich and licked it. The entire sandwich, like a foot long sandwich, they licked it because they knew that I couldn't eat it. To them, it was hilarious. They're like, "Oh, look, he just got this sandwich and now, he can't have it," and there were kids in school who would lick their hands and put it on me or spin on me and because they knew it would bother me so much to the point where I would have a behavioral outburst and be sent to the principal's office and I would get in trouble every time, because I was the one who had a behavioral outburst. So, it was tough with my family because I think there was a level of denial from my parents where they were like no son of mine, whatever. My mom just told me recently that my dad didn't believe that I had asthma. When I was a kid I had to use like the nebulizer like the huge thing. I use preventative medicine. I had to use like a Diskus every day and take medication and albuterol like it was really, really debilitating asthma. My dad was like, "No, he doesn't." So the family that I grew up in was kind of like a rub some dirt in it kind of family and my mom ... What's really cool is my mom in recent years, so she does, like stenography for students like for live events and stuff. So like if a student, a deaf student is attending classes at a college, my mom will attend the class and type on a stenograph everything that's being spoken. So it's like closed captioning for students. Alyssa Scolari [20:19]: Right. Johnny Crowder [20:19]: We wound up having to take psychology courses, because students were taking those courses. So now she's learning about like social work and about abnormal psychology. In this point in my life, I think she's like, "Oh, crap, we got to do something about this." So my mom has been kind of like the success story of beginning to ... especially in my teens and 20s, wrapping her head around, or at least making a conscious effort to ditch that denial pattern and try to understand what I was going through. Alyssa Scolari [20:53]: Yeah, which is awesome. Johnny Crowder [20:53]: Yeah. Alyssa Scolari [20:54]: I mean, right. It can't change the past, but that certainly is like, awesome, moving forward for you. Johnny Crowder [21:02]: Yeah. In my opinion, she's like the Most Improved Player, like how you get that trophy or whatever. Alyssa Scolari [21:09]: Yes. Johnny Crowder [21:11]: She'll come to my band's shows now and she tells her friends like, "Oh, my son runs a mental health technology company." So it's cool to see like the growth and change. She literally texted me today, and growing up, I never thought that I would really talk to my family, like moving forward after I moved out and it's cool to like ... I literally saw her this weekend and it's cool that we can maintain contact now in a way that we couldn't before. Alyssa Scolari [21:38]: Yeah, huge improvements. Johnny Crowder [21:41]: Yeah. Alyssa Scolari [21:42]: Does that also help you through the recovery process? Johnny Crowder [21:47]: I think yes, because I know a lot of people in my life, very close friends and family members who have kind of kept me at arm's length, because especially when you're younger, everything is viewed as like, you're a freak- Alyssa Scolari [22:05]: 1000% Johnny Crowder [22:06]: If you're experiencing these mental health issues, and people don't really dig any deeper, they don't take seriously what you are saying to them. I had lost hope in a lot of interpersonal relationships. I figured, I'm a lot healthier now than I was 10, 15 years ago but there are people who will never talk to me again, maybe because of my behavior when I was really sick and for the rest of my life, I will feel somewhat penalized for behavior that I was not ... I wasn't even sentient through some of that. I was in like, full blown psychosis and it's a challenge to know that I've lost some very close friends because of behavior patterns that I had no control over. Seeing my relationship with my mom slowly repair itself over the course of several years, it gives me hope that maybe some of the people who I lost through my psychosis I might wind up reconnecting with in the future, because now I'm capable of maintaining relationship in a way that I wasn't when I was younger. Alyssa Scolari [23:17]: Yeah, yeah. The things that you're saying are really speaking to me. I think part of the place where I'm at in my recovery is, I think acknowledging that I will forever feel penalized for things that I did 10 years ago and I was very, very sick. There are people and family members who still like exactly like you said, keep me at arm's length, right? I'm the freak of the family. I don't get invited to things. People don't ask me anything about the work that I do. People don't really know. Johnny Crowder [23:59]: Yeah, really, I don't want to open up a can of worms. Alyssa Scolari [24:01]: Yeah. You don't want to know. Johnny Crowder [24:03]: Don't even ask for how she is. I don't want to ... Alyssa Scolari [24:05]: No, I don't even want to know, right? Johnny Crowder [24:06]: Yeah. Alyssa Scolari [24:07]: They don't ask they don't call and for me, it's been one of those like coming to terms of like this also, the way other people choose to react and I think that a lot of trauma survivors need to hear this, is also not our fault and it's not fair. That too is not fair. It's not fair that we were traumatized but it's also not fair, the way other people reacted, Johnny Crowder [24:33]: Dude, this is real. It's tough like I- Alyssa Scolari [24:37]: This is the hard stuff. Johnny Crowder [24:38]: I look back and I know I had some very close friends that when I was hallucinating very severely, I was essentially living in just a completely different reality than my friends were. Those friends that I was very close with, especially in high school, I've tried reaching out to, talking to mutual friends to see if I could like try to see them again. They're just not willing to see me because in their mind, they have a very distinct vision of how I behave and I remember not too long ago, this is several years ago, but still pretty recent, I met up with a friend from high school who had that opinion of me still. It was just by chance, we both wound up being at our mutual friend's house at the same time. Alyssa Scolari [25:26]: So this was not planned. Johnny Crowder [25:27]: Yeah, and we spoke, and at the end, she was saying goodbye to everybody and stuff. She gave me a hug and she was like crying a little bit and I was like, "What's going on?" She was like, "I know, people who didn't come, because you're here, because they thought that you are today, like you were in high school and they didn't get to see the version of you that exists today. They have to live with that old version, and that's sad, to me." That's what she said and when she left, I was like, not only was it incredibly kind of her to acknowledge the work that I've done, and that I am different now, but for her to view it like that, not like, "Oh, you need to get out there and prove to them that you're different, like giving me a task." She said, "It's sad for them, that they don't get to see the progress you've made," and there was something so sweet and genuine about that, that I try to cling to whenever I feel left out or excluded. I think, I'm sad that those people don't get to know the version of me that exists today. The true version of me. Alyssa Scolari [26:50]: There absolutely, I think is a level of grief there. Also, even just hearing, right, I don't know this person who said that to you. I will probably never know this person, but even just knowing too, that there are people out there that will say things like that is hugely comforting. Johnny Crowder [27:10]: Yeah, we were never close too, me and this person, we just always ran in similar circles and had mutual friends, but we never were like close enough for her to be that heartfelt with me. I think it made it mean so much more because she wasn't doing it to be nice or to blow smoke or because she was my friend. It was like her genuine- Alyssa Scolari [27:30]: It was her genuine reaction. So, today, right, because I want to go back to something that we were talking about earlier, just so we can clarify, right, because we were talking about getting to a certain point in our recovery, where we can say like, this wasn't my fault and I didn't deserve it and I'm justified in feeling the way that I feel. I am justified in all of these emotions. Once you get to that point like today, where you're at today, right, hugely successful human being doing incredible things affecting millions of people for the better, changing lives. Do you still have moments where you struggle with that or is that like something you've completely like, come to terms with and are at peace with? Johnny Crowder [28:25]: Dude, I am ... Maybe it's because I'm cynical or skeptical or whatever word you want to use, but every time I hear someone say that they're fully past everything, it's not that I doubt the human minds ability to overcome, right? I doubt a perfect record. I doubt anyone having 100%. If you're at 99, you're a superhero but 100, you're a robot. So at least for me, personally, I shouldn't be speaking about other people's records. I'll say for me, it is not 100%. It is not a 90%. It's a pretty common ... I mean, it brings me back to what my buddy Kristen said about fear. It's like to be courageous, you face fear on a daily basis and I do that regularly and there's ... I mean, even people who have experienced trauma, like when you go out, you meet someone with your abuser's name or something. Keep in mind, what are they supposed to do about it, right? It's not their responsibility to address that. There's so many little individual things that you have to carry on a personal level, like you hear a song come on the radio and you're like, "That song was playing when we were driving to ..." It throws you back into something and you just build the rock climbing muscles you need over time to like climb out of that hole and I heard this really cool phrase, I'm going to butcher it but it's something along the lines of building the ability to bridge the gap between being thrown into that head space and recovering. So, let's say you hear a song and it triggers you and then, you spend 18 hours in this place where you're just overwhelmed by emotion. Then, after a couple of years of hearing that song every once in a while and being triggered another ways, then that gap goes from 18 hours to 45 minutes. Then, a couple of years later, you experience some other stuff and then, maybe that goes to three hours and seven minutes. It's not going to be linear but over time, there will be a general trend, if you consciously work at it where you can bridge that gap so I'm constantly experiencing stimulus that is extremely mentally and emotionally taxing and I don't task myself with avoiding that stimulus or with immediately overcoming every time that pops up. I do task myself with improving my recovery time. Alyssa Scolari [31:13]: Yeah. Yeah. I love that. I love the way you put it and importantly, very importantly it's not linear, right? Sometimes it is going to be that you're lost for 18 hours after you get triggered. Sometimes, it's going to be 45 minutes. It really is sometimes about muscle, building up ... like you would be building up a muscle, like your training muscles at the gym but also life is hard and even after we are abused, there are still things that can leave us triggered and traumatized, right? Just because we've experienced childhood abuse does not exempt us from the other painful things that life brings. Johnny Crowder [31:54]: Yeah, dude, I picture it a lot like a sunburn. If you've ever had a real bad sunburn and then someone comes and gives you a hug and pats you on the back and you're like ... I think there's a misconception around trauma where it's like, well, only things related to your trauma are really going to be harder for you, everything else is going to be normal. That's like saying, well, only the sun can hurt your sunburn. No, lots of different stuff. I mean, my shirt rubbing against my back hurts my sunburn. Alyssa Scolari [32:26]: Everything. Right, when you have sunburn, everything hurts it. Johnny Crowder [32:29]: Yeah. So it's difficult to describe to someone who hasn't experienced that, it's not just things in that specific category, that might exacerbate what I'm feeling. Basically, anything that touches that thing, I'm just already sore. I'm pre-sore. So if you go out into the world, and you wear a shirt or you lean against a chair or something, and it doesn't hurt your back, probably because you don't have a sunburn. I have a sunburn, so you might not be able to see it because it's covered by my shirt, but I might not be able to wear a backpack, even though you can and I will be able to later, because I won't be as sunburned and it won't hurt as bad, but right now, it's tough to explain to someone that something as seemingly innocuous and not related to your pain as a backpack could exacerbate the pain that they can't even see. Alyssa Scolari [33:28]: Yeah. Yeah, I think that's a beautiful way of putting it. A really, really beautiful way of putting it and it really drives home exactly what it feels like. It's brilliant. I'm going to have to marinate on that, actually because I think it's ... Johnny Crowder [33:44]: Me too. I just said it right now and I'm like, "Dang, that kind of works." So, I immediately thought it too. Alyssa Scolari [33:48]: You just came up with that. Johnny Crowder [33:49]: Yeah. Alyssa Scolari [33:51]: I have been here to witness this brilliance, because it is an incredible way of putting it. It really truly is and even for non-trauma survivors, I think it's a wonderful way to help people to understand what it can be like, so thank you for that. So, I want to ask you about what you're doing now, tell me what you're doing? So I read about it in your bio. Tell me more about Cope Notes because I love this idea. Johnny Crowder [34:18]: I appreciate the kind words. They are not lost on me and I don't want to fast forward into this part without saying thank you for being so supportive. Cope Notes is, in just a sentence or two, we use daily text messages to improve mental and emotional health. Then every text that we send is written by a peer with lived experience. It's reviewed by mental health professionals and then, delivered at random times to train your brain to think in healthier patterns. So, you're going through your day and you're sitting at a stoplight or your boss is yelling at you or whatever, and your phone buzzes and it's an interruption to a negative thought pattern, so an exercise or adrenaline pump or a psychology fact and it breaks that pattern of negative thought, negative emotion. Provides a catalyst for positive thoughts so that as the weeks and months and years pass, with that consistent positive stimulus, your brain starts to prioritize new neural pathways associated with those coping strategies. So that might have sounded a little tech and psychology heavy but really, we just use text messages to help you cope with anxiety, loneliness, stress, fear, depression, you name it. Alyssa Scolari [35:32]: Right, you're rewiring the brain, which all the listeners out there ... you all know this is my candy. I love talking about this stuff. Johnny Crowder [35:43]: Yeah. Alyssa Scolari [35:45]: Because right, what you're doing is A, you're providing support in the moment for people who often feel very, very alone but I think on a long term goal, what you're doing is you're rewiring that brain, you're forming new neural pathways, which helps hugely in trauma recovery, because as we know, trauma literally changes the brain. Johnny Crowder [36:09]: Yup. That's the coolest part that I don't think a lot of people know. You've done your readings. So you know this stuff, but I bet maybe half the listeners have, and they already know this and half of this is going to be new information. We don't say change your brain as in this like ephemeral metaphorical thing. It's like literally, physical parts of your brain are moving and rearranging themselves physically, like you can observe it and that's what's always fascinates ... so, I went to school for psych. It's always fascinated me that the brain doesn't metaphorically change or figuratively change, like literally the folds and the synapses and stuff, it's like this living breathing organism and that's me. Alyssa Scolari [36:55]: Yeah. I think that's one of the first things that I teach my clients who step into my office for help with trauma is like, "Okay, well, first, let's validate this and let's talk about what's happening in your brain," because this isn't like ... right, because then it becomes, if not, people then go into like, "Well, what's wrong with me? Why am I acting like this?" It's like, "Well, this is what's happening in your brain right now." Johnny Crowder [37:17]: Yup. Alyssa Scolari [37:17]: It gets a real thing. Your brain has literally changed itself. Johnny Crowder [37:22]: That's so awesome. Alyssa Scolari [37:23]: Yes. I love all brain stuff. So then, Cope Notes is also a podcast, right? Johnny Crowder [37:31]: Yeah, so there's the Cope Notes podcast and we are between seasons at this current moment at the time of recording, but there's like 40 episodes that are already up, that listeners can go check out and basically, we created the podcast to give people who don't commonly have a voice in the mental health conversation and opportunity to speak. So if like every ... and trust me, I work with a lot of clinicians, I love clinicians. Clinicians have changed my life but pretty much every podcast, mental health podcast I listened to is like doctor this and doctor that and researcher this and researcher that. I'm like, let's hear from the tattoo artists and the barbers, and the janitors- Alyssa Scolari [38:12]: The people who have been in it. Yes. Johnny Crowder [38:13]: Yeah, what are their experiences with mental health, because the longer we relegate mental health to be this, like clinical phenomenon and not like very much a lifestyle conversation, the longer stigma will prevail? Alyssa Scolari [38:28]: Absolutely, because it's not ... mental health doesn't just stop at Dr. John Smith, right, who has this PhD. Again, not that that's not a wonderful thing, right? I'm a therapist. Great, we like clinicians, but we normalize mental health and when we start hearing from people who are typically ... sent messages that they're not allowed to talk about this stuff, so when we start asking them to use their voice, that's affecting real change and real fight against stigma. Johnny Crowder [39:03]: Dude, and think about this too, how many people have experienced something related to mental health, which is literally everybody who then feel like, "Well, my opinion isn't really valid, like, I'm only a nanny or I'm only a graphic designer," and that's what we're trying to really attack is you don't need a doctorate to share your opinions and thoughts and experiences and your coping strategies with people. Your voice is valid in the mental health conversation, regardless of whether or not you think it's valid. Alyssa Scolari [39:37]: Yes, and nobody ... right, regardless of who is speaking and whatever degree they may have, nobody can tell you how to navigate your journey better than you. Johnny Crowder [39:52]: That's honestly ... to speak candidly, that is such annoying advice. I'm picturing myself when I was younger. So, I saw a number of different care providers and I was seeing therapists and psychiatrists and stuff, that was like a common theme where it was like, I had to take responsibility and I was like, "No, no, make it someone else's job." I so didn't want to hear it, but it's kind of like what we were talking about earlier, there is this very bizarre sense of freedom in that too, where if you can shift it from ... there's lots of this like, obligation talk like, "Well, no one else is going to do it for you, you got to do it," and it feels very drill-sergeanty. That doesn't really resonate with me. I know, it works for some people, but the way that ... the framing that helps me is I don't have an obligation to help myself, I have an opportunity to help myself and that feels to me so much more hopeful and positive and less like incriminating. It's not making it my fault. It's like, "Hey, dude, you don't have to wait for somebody else to do this. You can start doing stuff today." I'm like, "Oh, for real?" There's like an empowering sentiment to it, that it took me maybe a decade to wrap my head around. Alyssa Scolari [41:13]: Yeah, I think that it's much more empowering to phrase it like that and I think, I like changing the wording of that kind of stuff. I'm a big fan of that, but also in like, every day, right? The people who will like come into my office and be like, "I have to go to work." It's like, you don't have to do anything. You actually don't, right? I work with teenagers, right? Johnny Crowder [41:37]: That's awesome. Alyssa Scolari [41:38]: I work with teenagers, and they come in and they're like, "I have to empty your fucking dishwasher tonight." I'm like, "You actually don't. You don't have to. Just because somebody told you to, doesn't mean you have to. You get to, you choose to," right? That doesn't mean that we're exempt from consequences but you don't have to do anything because none of us like being told what to do. So the second we switch that from, "This is your responsibility. This is your obligation," right? To like, "No, this is what you can do. You can get up and go to work today or you can call out, right? You can do whatever you want to do." Johnny Crowder [42:16]: Dude, that line is so hard to find. I'm looking back on my early days in OCD treatment. There's a difference ... a lot of people say, "You can do it, you can do it," because I would say like, "Oh, I can't step on cracks." If someone says, you can step on cracks, it's negating what I say but if you say it exactly like you said it, you said, "You can step on cracks. You don't have to, you can choose not to step on cracks," but don't say that you can't because you and I both know that if you had to, you could step on a crack. So you ... like once you remind somebody that they're making the choice, because like, "Oh, well, my OCD says I can't step on the cracks," and my doctor is like, "Well, that's not you. That's your OCD." Alyssa Scolari [43:02]: That's not you, yeah. Johnny Crowder [43:04]: So you can choose to say, "Yes, OCD, I will avoid cracks," or you can say, "You know what, today I'm going to step on a crack because I choose what I do, not you." It's a crazy, empowering feeling. Alyssa Scolari [43:18]: It is. It's the best. No, I think that shift, right, it's subtle but it packs a punch in terms of treatment and recovery and all that good stuff. So I know I have ... I've kept you on here for a while. Thank you. There's so many good things for us to talk about. I feel like we have only barely scratched the surface. So, if people want to find you, they can ... because you have the Cope Notes app, right? It's an app that you offer. Johnny Crowder [43:49]: No, it's actually not an app. Alyssa Scolari [43:50]: It's not an app, what is- Johnny Crowder [43:52]: It's just, you go to copenotes.com and you type in your phone number. So nothing to download, no appointments or anything like that. No software updates. You just go to the website, copenotes.com and you type in your number and voila. Alyssa Scolari [44:05]: Beautiful and then, people also ... your podcast, people can find you basically wherever. Johnny Crowder [44:12]: Yeah, the Cope Notes podcast is wherever you listen to podcasts and then also a couple shameless plugs, I did get a head talk about Cope Notes and about some of the neuroscience stuff that we talked about today. So if there are any nerds listening like us right now, definitely go on YouTube and just search Johnny Crowder TED talk and you'll find. Then also, I do a fair amount of music still. Music has been a part of my life. It's like my primary coping mechanism. So if anyone enjoys rock or metal, or even if you don't, please go look up the band, Prison. We have a record called still alive. We talk a lot about suicide prevention. We have literally have a song called mental illness. Definitely go check out the band, because we talk about a lot of the stuff that we've discussed here, but maybe in a little more aggressive package, but it's still pretty cool. Alyssa Scolari [45:13]: I love it. Now, if I ... so the link where I read your bio, can I just ... if I link that in the show notes, people will be able to find all that, right, because I'm checking it out now and it has a link for Prison. It has the Cope Notes. It has your TED Talk all that good stuff. Johnny Crowder [45:31]: Yeah, you share whatever you think makes the most sense. Alyssa Scolari [45:35]: Perfect. So for the listeners out there, there will be a link in the show notes, so go check that out and then you will have access all in one page to everything that Johnny is talking about today. Johnny, thank you so much for being on the show. I appreciate it. This is my first episode back after taking a couple weeks off. So it was a good one. Thank you so much for your vulnerability. Johnny Crowder [46:03]: Absolutely and thanks for having me, but also for people listening. I just don't want any listener to overlook the fact that they just spent 45 minutes listening to a conversation like this that speaks about your character, just like my friend who mentioned that thing to me in confidence, that made me feel like, "Wow, I didn't even know she thought on that level." The fact that you've spent 45 minutes listening to this and engaging with this conversation speaks volumes about the type of person you are and the work that you're doing in your life. So don't just turn this off or listen to another podcast straight away, like stew in this for a minute or two after this finishes playing and realize like you're doing really important work and making a huge difference by spending your time this way and we both applaud you. Alyssa Scolari [46:53]: 1,000%. I agree with that you, as the listeners are phenomenal human beings fighting every day to make life a little bit lighter, and that is what this podcast is all about. So thank you, we appreciate all of you and take good care. I will be holding everybody in the light, and until next week. Thank you, Johnny. Thanks for listening everyone. For more information please head over to lightaftertrauma.com or you can also follow us on social media, on Instagram, we are @lightaftertrauma and on Twitter it is @lightafterpod. Lastly, please head over to patreon.com/lightaftertrauma to support our show. We are asking for $5 a month, which is the equivalent to a cup of coffee at Starbucks. So please head on over again, that's patreon.com/lightaftertrauma. Thank you and we appreciate your support.
Listen on Spotify Listen on iTunes Listen on Blubrry Have you ever had the experience of feeling like someone really ‘gets you'? This can take various forms - like being able to share what's on our mind and... READ MORE The post Season 2 Episode 10 – The Science of Feeling Understood appeared first on Stefanie Faye.
As we celebrate 16 years and 3,000 episodes of Feast of Fun, we've asked one of our all time favorite drag queen guests, Miss Understood, to join us to look back at the early years of drag on TV and film.In the 90s, Miss Understood was a regular on the daytime TV talk show circuit. When Sally Jesse Rafael or Geraldo Rivera wanted to showcase eccentric kooks from the New York City nightlife scene, Miss Understood was there in her psychedelic pink and green looks to wow the audience.Miss Understood was cast as one of the contestants in the pageant scene in the first major Hollywood film to focus on drag queens “To Wong Foo Thanks for Everything, Love Julie Newmar.”This bright colored wigged gal has been in a lot: Miss Understood was featured in the documentary Wigstock and the premier episode of Sex and the City. She was also the first drag queen we had on this podcast to talk about drag queen make up long before all the makeup tutorials made it onto the internet.MISS UNDERSTOOD: http://www.screamingqueens.comMAGICTEEZ: https://magicteez.comToday Miss Understood joins us to look back on her life as a drag queen and manager of Screaming Queens Entertainment and her new fashion line Magic Teez.HELP FEAST OF FUN REACH 3000 SHOWS: https://gofundme.com/feastoffun3000Episode #2978
Apparently, then, our lifelong nostalgia, our longing to be reunited with something in the universe from which we now feel cut off, to be on the inside of some door which we have always seen from the outside, is no mere neurotic fancy, but the truest index of our real situation. And to be at last summoned inside would be both glory and honour beyond all our merits and also the healing of that old ache. - C.S. Lewis That old ache within us is a longing to be whole. Complete. Fulfilled. Something is missing and we must find it. Nature, along with the soul, abhors a vacuum. And so we refuse to stay still. We move toward anything and everything that bears any semblance of fulfillment. The shallow things of this world like fame, fortune, power, and pleasure capture our initial attention, but over time we realize that they fail to bring us into the quality of being that we long to experience. We then find ourselves inexplicably drawn to what is deeper than things the ego is capable of grasping. The soul begins to guide us us. And lead us. Toward truth, meaning, purpose, and worth. We long to be known. Understood. Valued. Loved. To find such things, we search for sacred spaces - places where the soul can attune itself to these things and the ego's incessant voice fades into silence. Such spaces are hard to find, and so we make travel plans to reach them. In the Old Testament Scriptures, the Jewish temple in Jerusalem became the most sacred space of all - the place where God himself dwelled - primarily in the Holiest of Holy Places, between the angels atop the mercy seat that covered the Ark of the Covenant. But over time things went wrong. The Ark disappeared. The temple became a legalistic sacrificing machine in the inner courts and a greedy and smelly marketplace designed to take advantage of visitors in the outer. What a disappointment! Where, then, is our sacred space? Our axis mundi? The place where we can find what is right and escape what is wrong? Where we can find comfort and welcome from God and others? There is a sacred space, and there is a doorway you can walk through to get there. Let's open it right now. Source Scripture Spacing Out: Matthew 12:15-21; Mark 3:7-12 Connect Twitter: @AwestruckPod Email: email@example.com Extras The Awestruck Podcast musical playlist (Apple I Spotify)
Approximately thirty percent of the Bible is prophecy. Have you ever wondered why? And can those prophecies be understood? We will discuss provide an overview of Bible prophecy and analyze a few of the the major prophecies you must understand in the end time on this edition of End of the Age.
What makes your favourite nonfiction books so compelling, understandable, or enjoyable to read? Those works connect with you, as a reader. When you recognize what's happening, you can apply those same methods to your own writing. Whether you're an expert trying to communicate with a mainstream audience or a nonfiction writer hoping to reach more people, our guest offers us the insight we need to reach more people with your words. It's a pleasure to welcome the author of "Writing to Be Understood: What Works and Why", Anne Janzer More about Anne: https://annejanzer.com
Harry's guest this week is Jeff Elton, CEO of a Boston-based startup called Concert AI that's working to bring more "real-world data" and "real-world evidence" into the process of drug development. What's real-world data? It's everything about patients' health that's not included in the narrow outcomes measured by randomized, controlled clinical trials. By collecting, organizing, and analyzing it, Elton argues, pharmaceutical makers can it design better clinical trials, get drugs approved faster, and—after approval—learn who's really benefiting from a new medicine, and how. Concert AI, which has offices in Boston, Philadelphia, Memphis, New York, and Bangalore, specializes in providing “research-grade real-world data” and AI-based analytical services to companies developing cancer drugs. Before joining Concert AI, Elton was managing director of strategy and global lead of predictive health intelligence at Accenture, and before that he was a senior vice president of strategy and global chief operating officer at the Novartis Institutes of BioMedical Research. He's the co-author with Anne O'Riordan of a 2016 book from Wiley called Healthcare Disrupted: Next Generation Business Models and Strategies.Please rate and review MoneyBall Medicine on Apple Podcasts! Here's how to do that from an iPhone, iPad, or iPod touch:• Launch the “Podcasts” app on your device. If you can't find this app, swipe all the way to the left on your home screen until you're on the Search page. Tap the search field at the top and type in “Podcasts.” Apple's Podcasts app should show up in the search results.• Tap the Podcasts app icon, and after it opens, tap the Search field at the top, or the little magnifying glass icon in the lower right corner.• Type MoneyBall Medicine into the search field and press the Search button.• In the search results, click on the MoneyBall Medicine logo.• On the next page, scroll down until you see the Ratings & Reviews section. Below that, you'll see five purple stars.• Tap the stars to rate the show.• Scroll down a little farther. You'll see a purple link saying “Write a Review.”• On the next screen, you'll see the stars again. You can tap them to leave a rating if you haven't already.• In the Title field, type a summary for your review.• In the Review field, type your review.• When you're finished, click Send.• That's it, you're done. Thanks!Full TranscriptHarry Glorikian: I'm Harry Glorikian, and this is MoneyBall Medicine, the interview podcast where we meet researchers, entrepreneurs, and physicians who are using the power of data to improve patient health and make healthcare delivery more efficient. You can think of each episode as a new chapter in the never-ending audio version of my 2017 book, “MoneyBall Medicine: Thriving in the New Data-Driven Healthcare Market.” If you like the show, please do us a favor and leave a rating and review at Apple Podcasts.Harry Glorikian: In the world of drug development, there's a tendency to think that the only data that matter are the data that get collected from patients during randomized controlled clinical trials. That's the type of study that drug companies use as the gold standard to test the safety and effectiveness of new drugs and that the FDA uses to make drug approval decisions. But it's just not true. Way before clinical trials begin, there's a ton of genomic or proteomic or chemical data that can go into identifying new drug candidates, as we've learned from many of our previous guests on the show. And today my old friend Jeff Elton is here to tell us about another important kind of data that get collected before, during, and even after clinical trials that can have a huge impact on how drugs are used.It's called real-world data, and it basically means everything about a patient's health that isn't included in the narrow parameters and outcomes measured by clinical trials.Jeff is the CEO of a startup here in Boston called Concert AI that specializes in organizing and analyzing this real-world data. And his argument is that when you pay attention to real-world data, it can help you to design better clinical studies. It can help support the core clinical data that drug companies submit to the FDA when they're applying for approval. And after approval, it can help show who's really benefiting from a new medicine, and how. Jeff has been thinking about the importance of real-world data for a long time, at least since 2016, when he leading predictive health intelligence at Accenture and he published a book called Healthcare Disrupted. The book argued that real-world data from wearable devices, the Internet of Things, electronic medical record systems, and other sources could be combined with advanced analytics to change how and where healthcare is delivered. In our interview, I asked Jeff to explain how Concert AI is helping patients and how the predictions he made in the book are playing out today.Harry Glorikian: Hey, Jeff, welcome to the show. Jeff Elton: Thank you Harry. Pleasure to be here. Harry Glorikian: Yeah, it's been a long time since we've actually seen each other. I mean I feel like it was just yesterday. We were you know, interacting. Arshad was there and we were talking about all sorts of stuff. It's actually been quite a few years and, and, and you have now transitioned to a few different places and, and right now you're running something called Concert AI. And so, I mean, let's just start with what is Concert AI, for everybody who's listening. Jeff Elton: Yeah. So Concert AI is a real-world evidence company. We'll spend a little bit of time breaking that down. We are very focused on oncology, hematology, urological cancers. So we kind of tend to stay very much in that space.And within the real-world evidence area, we really focus on bringing together high credibility research grade data. This usually means clinical data. Genomic data can include medical images combined with technologies that aid gaining insights out of those particular data and that kind of align with our own various use cases.A use case could be designing a clinical study, it could be supporting a regulatory submission. It could be gaining insight, post-approval, about who's benefiting, who's not benefiting. And you know, our whole mission in life is accelerating needed new medicines and actually improving the effectiveness of current medicines out there.Harry Glorikian: So who's like, I don't know, the user, the beneficiary, in a sense, of this.Jeff Elton: So, you know, we like to think we have a very heavily clinical workforce. You know, we always put the patient first. So I'm actually gonna say that a lot of the reason why we're doing things is that we have the benefit to be stewards, combined with provider entities, of focusing on questions that matter for patient outcomes.So the first beneficiary is patients. I think the second beneficiary are biomedical innovators. We're trying to kind of support those innovations. We're trying to understand how to go into the clinic. We're trying to understand how to design those clinical trials to have them be more effective. We're trying to understand how to show that relative to the current standard of care, they offer a range of incremental therapeutic benefit. A lot of medicines become improved once they're actually already approved. And so we actually spend time doing a lot of post-approval research that actually begins to improve the outcomes by beginning to kind of refine the treatment approaches.And then the clinical communities we work very closely [with]. We're a very close working partner with American Society of Clinical Oncology and their canceling program. We're in a 10-year relationship with them that allows us to do work in truly high need areas. We did a COVID-19 registry jointly with ASCO that worked off of some of the data we brought together because it you know, COVID-19 uniquely hit cancer and particularly hematological malignancy patients.We do work with them in health disparities, making sure that racial, ethnic, and economic groups can be the beneficiaries of new medicines and are appropriately part of doing clinical trials, clinical studies. And then we work directly with provider communities who oftentimes are seeing the value of the work we're doing and making sure that for research purposes, we have appropriate access to data, information to conduct that research.Harry Glorikian: Yeah. I want to get into, you know, I think we're going to, I'm going to hit on some of that later, but I just want to make sure everybody's sort of on a level playing field with some of these wonky terms we use. How do you define real-world data and real-world evidence. I mean, I know what the FDA defines it as. I'm just curious. Jeff Elton: Yeah. So yeah. And FDA does have some, they have some publications really there that came out at the end of 2018 that actually began to lay out a framework around that, which I would encourage folks to reference. It's actually a very well-written document.So real-world data is sort of what it sounds like. It's the data. Right. And You know, if you were a clinician, if you were sitting in a clinical care environment, you probably wouldn't be using the word real-world data because those are the data generated through your treatment of the patient. So clinicians sometimes actually kind of pause for a moment to say, what's real-world? It's the things I'm doing. And in fact, you know, real-world data would be structured data in a structured field. It's a lab value that may have come in from the laboratory information system or a drop down menu. Did they smoke or not? Which can be a fixed field in an EMR. All the way over to physician notes, to appended molecular diagnostic reports, to imaging interpretation reports.So all those are forms of data. Now, evidence is a little bit about also what it would sound like. Data are not evidence. You have to actually, and in fact, to generate evidence, I want to have to trust the data. I have to believe those data are an accurate reflection of the source systems they came from. I have to believe they're representative or appropriate for the question that I'm actually trying to address. And then I have to make sure that the methodologies I'm using to analyze something, either comparing the effectiveness of two drugs relative to each other, actually then when I look at that analysis, I'm willing to either make a regulatory decision or a guideline modification.And the intent of evidence is either to support a regulatory decision or something that can inform practice of medicine or nature of treatment. So there's a bar, right, that one has to achieve to actually become evidence. But I think evidence is the right goal by what we're trying to do.Harry Glorikian: So you know, in the past, I mean, because I've, worked with companies like Evidation Health and so forth right there, some of this data was in paper form, right. Not in electronic form. So, what holes in the current system of, say, drug development would better real-world data or real world evidence help fill or, or drive forward.Jeff Elton: Yeah, that's a super good question. And, you know, Harry, you were kind of going back to your, I mean, you were one of the primary, leading individuals around that when the days of personalized and individualized and precision medicine, and even some of molecular medicine kind of came around. In fact, that's probably where you are my first point of interaction.And I come back to that concept because when you, when you're looking at data—and again, not all data are kind of created equal here—when I think about setting up and designing a clinical study, so now I'm with an experimental therapeutic or I'm thinking about moving it in. If it worked in one solid tumor and I suspect that same molecular pathway or kind of disease mechanism may be at work in another one. And so I want to kind of think about doing a pan tumor strategy or something of that nature. When I actually, when I, if I can bring together molecular diagnostic information, aspects of the individual patients, but do it at scale and understand the homogeneity, the heterogeneity and the different characteristics in there, I can design my trials differently and I can make my trials more precise. And the more precise the trials are, the higher the likelihood that I'm going to get meaningful outcomes. The outcomes here that are meaningful is what actually helps medicines progress. It's actually getting those questions to be as narrow and as precise and as declarative in their outcomes as possible.And so a lot of these data can actually be used to help guide that study design. Now, if I also have very rare cancers or very rare diseases—so this would apply even outside of oncology, although most of our work is oncology related—even if I'm outside of that, if I'm in very rare, oftentimes finding, you know, putting a patient on a standard of care therapy as a control oftentimes may not be in the patient's best interests. And so this notion of either a single arm or having an external control or having a real-world evidence support package, as part of that, may be part of what can occur between the sponsor and actually the FDA, et cetera, for kind of moving that through.But, you know, this has to be done individually around the individual program and the program and the characteristics have to kind of merit that, but these are big deals. So we feel that these are forms of data that can complement what would have been traditional legacy approaches to give more confidence in the decisions being made in the evaluation, the ones actually coming, too.Harry Glorikian: Yeah, I can hardly wait. I mean, maybe it's a dream, but I can hardly wait until we get rid of first-line and second-line and we just say, okay, look, here's a battery of assays or whatever. This is what you should be taking. No more first line or second line. I mean, these are sort of in my mind, I mean, almost arcane concepts from, because we didn't have the tools in the past and now we're starting to move in that direction.Jeff Elton: Yeah. So, Harry, just to, maybe to build on that a little bit. So if you look at some of our publications and things that we presented at this last ASCO, there's work one can do when you look at different features of patient response, et cetera. We're a company, but we also have a very strong data science backbone to what we do. And AI and ML applications. There are features that sometimes you can predict metastatic status. You can predict rate of response. You can predict progression. Now the very fact that I can make that statement kind of indicates that as you started thinking about the paradigm in the future, particularly when I start doing it liquid tumor, biopsies and surveillance mechanisms where I can see response much more rapidly in less invasive ways, you are going to start even over the course of this next five years, I think some of these will start to start influencing practice patterns in some very positive ways for patients, Harry.Harry Glorikian: From your lips to his or her ears. It needs to move faster. But, but it's interesting, right? I feel like you've been on this path for quite some time, like, I want to say since you're at least since your book in 2016, if not before. Jeff Elton: Yeah. So, you know yeah, you and I, in fact, you and I interacted first, I think we were kind of in the hallways, first interaction of what had been the Necco candy factory on Massachusetts Avenue in the Novartis building, where I was working in the Novartis Institute for Biomedical Research at the time.And Even prior to that, I think I did my first work back in the days of Millennium Pharmaceutical when it was still a standalone company, doing work in precision medicine and personalized medicine all the way through. And obviously Novartis's strategy was looking at pathway biology and actually using that as the basis of actually understanding where in a pathway system one could actually target and actually understanding that it is a system, it's got redundancy both in a bad, in a positive way. How do we use it to progress new medicines? So there's been an aspect of this that's always been kind of a little bit hard. I think I kind of made a decision to kind of pivot much more to a large scale data-centric, insight-technology-centric approach, and actually at scale, bring some of that back to the biomedical innovators. But yeah, it's been a progression over time and some of this it's a field that I feel, you know, strong passion around and will stay committed to for the duration of whatever my professional career looks like.Harry Glorikian: So can you give us maybe an example? I mean, I know some of it may be confidential. How does the data that you're providing, say, improve maybe drug safety or effectiveness? Jeff Elton: So you know, we're doing a project right now that that's safety related and I'll kind of try to keep it such that it I'm not betraying anybody's confidence. Eventually this will be in a publication, but it's not at the point yet. We're looking at a subpopulation that had severe adverse events, cardiac adverse events in the population. And originally the hypothesis was, it was a relatively homogeneous group. And we brought together some of our deepest clinical data, which means we have many different features of intermediate measures of disease, recurrence, progression, response, adverse events, severe adverse events. And we also brought some of our data science and AI solutions to it. And one of the major insights that came out of that is actually it wasn't a single homogeneous group. One group was characterized by having a series of co-morbidities that then linked to this significant adverse event and the other were purely immunological based.And so therefore actually in both cases, they're screenable, they're predictable. They're surveillable. And monitorable. And so therefore, but the actions would be very different if you didn't know what the two groups are. So in this particular case, we could discriminate that now. Well, we'll take that into more classical biostatistical analysis and do some confirmatory work on that, but that has significant implications on how you're going to kind of screen a patient survey of patients, look for whether or not they exhibit that area, and how you would kind of handle it, manage that. That would improve the outcome significantly of that subpopulation.So that's one example. In other areas, some of our data was actually being used as part of a regulatory submission. It was a very, very rare population in lung cancer. And it was unclear exactly how nonresponsive they were to the full range of current standard of care. And we were actually illustrating that there was almost a complete non-response to all current medicines that were actually used against this particular molecular target because of a sub mutation. And that actually was part of the regulatory submission. And that program both actually got breakthrough designation status, and that actually supported that and actually got an approval ahead of the PDUFA date. So when you start pulling some of these pieces together, they work to again, provide more confidence and interpretation and more confidence in decision-making. And in this particular case, certainly accelerated medicines being available to patients. Harry Glorikian: Oh yeah. Yeah. Drive value for patients and drive value for the people that are using the, the capability to get the product through. So, you know, we're talking about data, data, data. At some point, you've got to turn this into a product or a service of some sort or, or some, or maybe a SaaS as, as, as you guys might look at it, but you've got something called, you know, Eureka Health, right, in your product lineup. Can you give us an idea of what that is? I think it's a cloud-based SaaS product. You call it research-ready real-world data. So I'm just curious how that works. Jeff Elton: Yeah. So we do think.. So if you think about what we're trying to do, we're trying to allow a level of scale and a level of precision and depth on demand in the hands of individual researchers, from translational scientists, folks in clinical development, post-approval medical value and access. Kind of in that domain. And so each of those have different use cases. Each of those have different kind of demands that they'll place on data and technology for kind of doing that.We're trying to move away from the world of bespokeness, because by nature of bespokeness, the question has its own orientation. The data is just unique to the question and that utility later is very low and, you know, in a way, what we'd rather do, what have we learned about what actually kind of create utility out of data, and let's make sure that we're covering the use cases of interest, but let's do it at very large scale. And that scale itself and the data we even represent at that very large scale is in itself representative and actually has significance whether it's on a prevalence basis of sub cohorts of disease or not. Now, the reason why I'm spending so much time developing that is when you put that in the hands of the right people, you're avoiding bias, but you're also giving utility at the same time and so you're actually improving their ability to conduct rapid question interrogation, but also structure really good research questions and have the discipline if I have a good research methods right around that. So we do structure those as products.And so, so actually one of the things we think of is, the work that we do in non-small cell lung cancer is an extremely large data set. It also has high depth on the molecular basis of non-small cell lung cancer. And it's created in a way that actually allows you to make those questions from translational through post-approval medical and doing that.Eureka is the technical environment. It is a cloud environment we are working in, and it actually allows you to do on-the-fly actually insights. So, outcome curves, which are called Kaplan-Meier and a few other measures. I can compare groups. I can compare cohorts. I can ask questions. It's actually exceptionally fast.And so this ability to navigate through a series of questions, its ability to make comparisons of alternative groups of patients on different classes of questions and finally get down to the patient cohort of interest that you may want to move into in the next phase, your research is done a lot faster. Now we took that, and now we're integrating more AI and ML into that. So we now have created probably what's one of the leading solutions for doing clinical study design. So we can optimize different features of that study design. We can actually release lab values. We can change parameters. There's a level of kind of fitness, ECOG scoring. We can actually modify that and show what the changes would be in the addressable patient population, and actually optimize that study design all the way down to the base activity level. And we're basically creating a digital object that's rooted on huge amounts of data. Underneath the 4.5 million records runs inside that particular area.There is no other solution in oncology, hematology that gets anywhere to that depth of information that can reflect, with different optimization, to the endpoint and even reflect statistical power. Now we're integrating in work around health disparities. How do you assure that if it's a disease like multiple myeloma, which may disproportionately affect black Americans, that I'm actually getting adequate representation of the groups that in fact, actually may be afflicted by the disease and actually assure the design of the study itself assures their representativeness actually in that work?Harry Glorikian: This dataset, what are some of the features of it? What is it? What sort of information does it have in it that you would be pulling from? Because my brain is like going on all sorts of levels that you would pull from, and some of it is incredibly messy.Jeff Elton: Yeah. So you are absolutely right. And so there have been expressions in the field of people who do work in real-world data that the real world's messy you know, fields may be empty. Do you know, as an empty field, because nothing got put there where's the empty field, because in that electronic medical record environment empty means it was not true of the state of the patient. That may sound like a nuanced thing, but sometimes empty actually is a value and sometimes empty is empty. And so you start getting into some things like that, which you start thinking about, like, those are pretty nuanced questions, but they all have to do with, if you don't know which it is, you don't know how to treat and move the data through.So back to your question here a little bit. What we actually, the sources of where we bring data from are portions of a clinical record. So, you know, we work under businesses, the work we do is either research- or quality-of-care-focused. And so, you know, we work actually, whether it's with the American Society of Clinical Oncology and et cetera, appropriately under all HIPAA guidelines and rules for how you interact with data around doing that. So I'll put that as a caveat because methods and how you do that security and everything else is super, super important. We have a clinical workforce. These are all credentialed people. Most of them have active clinical credentials. Most of them were in the clinic 10 to 15 years and even still interact on it. So a lot of my people feel they're still in clinical care. It's just happens to be a digital representation pf the individuals that are in there. And we're seeing, whether it's features of notes, depth of the molecular diagnostic information, radiologically acquired images that may show how the tumor progressed, regressed, et cetera, that's in there, any other, the medications, prior treatment history, comorbidities that may confound, actually, response. So all those different features are brought together, but if you don't bring it together consistently, we have tens of thousands of lines of business rules, concepts, and models that we try to publish around about how you bring a concept forward.So if you want to bring a concept forward, want to do it consistently, we come out of 10 different electronic medical record environments, and we're, we're actually interacting with the work of 1,100 medical oncologists and hematologists, et cetera. You have a lot of heterogeneity. Handle that heterogeneity with a clinical informatics team into a set of rules as it's coming forward so that everything comes to the point that you can have confidence in that, you know, in that particular analysis and that presentation.So there's something called abstraction, which is a term applied to unstructured data—and unstructured just means a machine can't read it on the fly. And so we're actually interacting with that, which could have a PDF document or something else. And from that, we use the business rules to then develop something that now is machine-readable, but actually has a definition behind it that one can trust, that one can, that kind of comes from some published basis about why did you create that variable? So I could measure outcomes of interest progression-free survival, adverse events, severe, whatever the feature of interests can. Help me answer the question we try to kind of bring through. So we're usually creating about 120 unique variables that never would have been machine-readable, in addition to the hundred, that probably were machine-readable when we bring that together. Harry Glorikian: So you're using a rule-based AI system, maybe not just a straight natural language processing system, to parse the words.Jeff Elton: Yeah. So natural language processing gets a little tricky. We do. We have, actually, excellent natural language processing. We'll sometimes use that for pre-processing, but you have to be careful with natural language processing. If it has context sensitivity, and if you're parsing for sets of reliable terms, it can actually be relatively accurate. If I'm doing something like a laboratory report that's so discreet, so finite, and it's so finite with how many alternatives you have with the same concept, it works really well. When you start getting into things that are much more nuanced, you actually start to have a combination of technology with the expert humans to actually have confidence in the ultimate outcome.Now we do have some very sophisticated AI models. Like I'll give you an example. When you're looking at a medical record, usually metastatic status has just done a point of first but diagnosis in cancer care. So if the patient actually progressed and they made through there that they don't update the electronic medical record because they want to maintain what the starting point was when therapy was administered.But a biomedical researcher wants to know it at a point in time. So we have models that can literally read the record and bring back that status at any point in the time of disease progression. Now, would that work up to the grade of, say, for regulatory submission? No, but for a rapid analysis to pull back your question of interest and have it done in minutes, as opposed to weeks or months it works exceptionally well.Harry Glorikian: Understood. Understood. So now you and I both know that clinical trials, you know, are available only to a certain portion of the population really participate for a whole bunch of reasons. And then if you go down to sort of, you know, equality or, or across, you know, the socioeconomic scale, it, it gets even, it gets pretty thin, right? You guys, I, I think you've been pushing around inequality and cancer care and you have this program called ERACE which I think stands for Engaging Research to Achieve Clinical Care Equality. So help me out here. What is that? Jeff Elton: So we are, as an organization we're super privileged to have a very, very diverse workforce. And you know, men, women all forms of background races, ethnicities, and we really value that. And we've tried very hard to build that in our scientific committee. And I think when the public discourse around kind of equity, diversity, inclusiveness came forward, and you know, as you know, Harry, this has been a unprecedented period of time for just about anything, any of us. I mean, COVID-19 and social issues. You know, things of that nature. It's, it's really been a very, very unprecedented time in terms of how we work and how we interact and the questions.Our organization and our scientists actually came forward to me and said, you know Jeff, we have a tremendous amount of data. We have partners like American Society of Clinical Oncology and some of the leading biopharmaceutical researchers in the world. And we've got technology, et cetera. We want relevance. We really want what to make contributions back and we believe that actually, we can do some research that no one else can do. And we can actually begin to deliver insights that no one has the capability to do. Would you kind of support us in doing that? And so we put together the ERACE program and it actually was named by a couple of our internal scientists.And the program actually now is being collaboratively done. We've done a couple of webinars, with you know, some of our partners and that's included, you know, folks from, whether it's AstraZeneca, Janssen, and BMS, et cetera. It's become something around, how can we rethink how research takes place and actually assure its representativeness for all groups, but particularly in specific diseases. It impacts different groups differently. And so can we make sure it reflects that? Would we be generating the evidence so that they can in fact be appropriate beneficiaries earlier? And a lot of this came from when we looked at aspects of diagnostic activity we could say that, you know, black American women have a higher incidence of triple negative breast cancer and a few other diseases. When we look at patterns of diagnosis and activity, unfortunately, the evidence that we even have is not substantially in the practice of what we're actually seeing sometimes when we begin reviewing our data. And so we began confederating through our own work. We now have actually set up research funding. So we actually now will fund researchers who come in the academic community. If they come up with research proposals that have to do with, you know, health related disparities, whether it's economically based, or if it's racial, ethnically based. Those questions. We've got an external review board on those proposals. We'll provide them data technology and financial support to get that research done. We're doing it with our own group and we're doing it collaboratively with our own kind of biopharma sponsor partners kind of as well. So for us right now, it's about confederating an ecosystem, it's about building it into the fabric about how research questions are framed, research is conducted, clinical trials are conducted, and then actually those insights put into clinical practice for the benefit of all those groups. And so, you know, it's even changing where we get our data from now. So it's, it's like an integral part of how of everything we do. Harry Glorikian: So you saw, I don't want to say an immediate benefit, fooking at it this way or bringing this on, but I mean, you must have seen within a short period of time, the benefit of, of, I don't want to say broadening the lens, but I can't think of a better way to frame it. Jeff Elton: We were surprised how quickly, whether it was academic groups or others, rallied around some of the concepts and the notions. And we were surprised how quickly we were able to make progress in some of our own research questions. And we were pleased and astonished, only in the best ways, that we saw industry and biomedical research, the whole biomedical community, attempting to integrate into their research and the questions that they asked actually different ways of approaching that.And in fact, it's probably one of the most heartening areas. You couldn't have legislated this as quickly as I believe leading industry biomedical innovators decided it was time to kind of change portions of the research model. And you made a, Harry, you made a statement earlier on that. It's not just about kind of us analyzing data. Sometimes bow you find that to broaden actual, say, clinical trial participation, I actually have to go to sites that historically didn't conduct clinical trials. I may need to have investigators that are trusted, because some of the populations we may want to interact with don't trust clinical research and have a long history about why they didn't trust clinical research.So you're changing a social paradigm. You're changing research locations and capacity and capability for that research. So we're now moving research capacity out into community settings in specific communities with this idea that we actually, we actually need to bring the infrastructure to the people and not assume again, that people want to kind of go to where the research historically was conducted because that wasn't working before, you know? Harry Glorikian: At some point, you turn the crank enough, you start to influence, you should be able to influence, you know, standard of care and all that stuff, because if you're missing data in different places, you've got to make sure that we fill these holes. Otherwise we're never going to be able to diagnose and then treat appropriately.Jeff Elton: Generate the evidence that supports actually doing that and do it on an accelerated basis, but also that it gets confidence for those decisions. Absolutely. That's part of our goal. Harry Glorikian: Yeah. So I want to jump back in time here and sort of go back to your your Healthcare Disrupted book. You know, I feel like, you know, we're on the same page because I think the message was, you know, pharma, devices, diagnostics, healthcare, they need to rethink their business model to respond to this digital transformation, you know, which is obviously something in my own heart. I've been sort of banging that drum for quite some time.In particular, you argued in the book that real-world data from EMRs, wearables, the Internet of Things could be combined to change how and where healthcare is delivered. Is there a way in which like Concert AI's mission reflects the message of your book? Can I make that leap?Jeff Elton: I appreciate the way you asked the question and I think if you said our principles and perspectives about that, we need to kind of focus on value and outcomes, and then we're going to be bringing insights, digital cloud, and a variety of other tools to underpin how we work and operate. Absolutely.And in fact, I think, you know, positively. I had a lot of engagement and did a lot of interviews, even as we were putting the book together, which took place over a couple of months ago, it was probably, you've done your own books. Whatever you think it's going to be, it's a lot longer. So I'll leave it at that. I have recovered from the process now, but I think we had a lot of engagement, whether it was with medical community, biopharma, leadership, community, et cetera. And I think that alignment is some of the alignment we have with our partners today. It's actually around some of the same principles.What I couldn't have predicted, in fact, I was a couple of years ago and this probably would have been towards the tail end of 2019, I was already starting to think about, okay, I've recovered from the first writing. How did I do? And what would I say now? And at the time I was beginning to say certain things seem to be taking shape slightly more slowly than I originally forecast, but then COVID-19 happened. And all of a sudden certain things that we kind of had thought about and kind of had put there actually accelerated. And in fact, I think, you know, out of adversity, you'd like to say we bring sources of strength we didn't know we would kind of be beneficiaries of. But out of that, you could argue this concept of say a decentralized trial activity.So we have, let me pick up, you know, I'm one company, but let me pick a parallel company that I have respect for, say, Medable as an example, and Michelle [Longmire] leads that company, it does a very nice job, but that's the idea. Everything could be done remotely. I can actually do a device cloud around the individual. I can do a data collection and run RCT-grade trial activity. Now that doesn't work super well in oncology, hematology, et cetera, where I'm, you know, I'm doing chemo infusion and I have to do very close surveillance, but that concept is an accelerated version and got broader adoption and actually was part of some of the COVID-19 kind of clinical studies and capability. And it's not going to revert back. So actually what happens is you find it has a level of efficiency, a level of effectiveness and a level of inclusiveness that wasn't available before, when it had to do facilities-based only. Now we ourselves now we're asked to accelerate, we bring technologies and integrate them into provider settings for doing retrospective analysis. But actually during that period, not only did we bring our clinical study design tools and use AI and ML for doing that, which led to, we've supported the restart of many oncology studies now, and actually the redesign of studies to be able to move into different settings that they never were in before.And actually now we're beginning to use some of our same approaches for running prospective studies, but from clinically only derived data sources. It's a very different paradigm about how you conduct clinical research. So when you think about this, there are unpredictable shocks, you know, which, you know, some of may have called Black Swan events or whatever you may ascribe to it, that actually are now consistent with everything we did. But actually accelerating it and in a weird way back on trajectory, if you will. But I think, yes, everything we're doing was informed by a lot of that seminal work and research and foundation about what worked in health system and didn't how are people being beneficiaries or not? How do we need to change how we do discovery translational clinical development? And we're very committed to doing that. Harry Glorikian: Yeah. I mean, it's interesting cause you almost answer my next two questions. I'm really hoping it doesn't slide backwards. That's one of my biggest fears is, you know, people like to revert back to what they were used to.Jeff Elton: But you know, maybe to encourage you and me. So one of the things, if you take a, let's take a look at a teleconsult. So during COVID-19, HHS opened up and allowed as a coded event, doing a digital teleconsult for kind of digital medicine, telemedicine, and that was put into place on an emergency basis by HHS. And then before the outgoing HHS had that, it's now made permanent. And it's now part of the code that actually will continue to actually be a reimbursable event for clinicians. That was actually super important during COVID-19. What's not that well known is, not only did that allow people to be seen, but hospital systems were really financially distressed because most of their work was informed by kind of, you know, elective procedures and things of that nature. And that couldn't take place. But the teleconsult became a very important part of their even having economic viability, which you can't underestimate the importance of that during a pandemic. Right. So now that's part of how we're going to work. My personal view is, now that people are using digitally screening tools, they have decentralized trials, some of the solutions that we're putting into place, AI-based, bringing RWE as part of a regulatory submission, I don't see anything going back. And the work we're doing is if we can start putting 30 to 50% time and cost improvements and add more evidence around a decision, more robustly than we did before, that's not going backwards at all.Harry Glorikian: Good. That's that makes me. I'm hoping that we're all right, because we've been saying this and beating this drum for quite some time.It's interesting, right? Because I don't think I've gotten over the whole writing thing because I've got a new book coming out in the fall. So you know, I, I couldn't help myself. I hope, you know, we. We're able to give the listeners sort of a view of where this whole world is changing, how data's changing it.I mean, I've had the pleasure of talking to people about digital twins and that sort of data. And I believe that this, we're gonna be able to make predictions, as you say off this data almost proactively. It's interesting because I do talk to some people who are in the field that look at me strange when I say that, but after working with different forms of data in different places for so long, I can see how you can look at things predictively and sort of, you know, decide what's, you know, see what's going to happen almost before it happens for the most part, if you have a big enough data set. Jeff Elton: So we do a lot of prediction thing in the AI and ML world. And we predict, you can actually be relatively accurate on who's going to adhere and not adhere. You can begin to look at the biological response to being placed on a new therapy and understand whether that response is kind of in a direction that, that patient's going to remain on that therapy, or you need to discontinue to be placed on a new therapy.And you're right. And in fact, some of these features…well, the question, we use it from generating insights to design and hopefully improve outcomes, et cetera. That's a rapid process. I mean, I've seen things in the last three years in setting up Concert AI that would have taken me a decade to have seen in previous methods. But we're still not as fast and as effective as we can be.And the very fact that I can in my digital laboratory, if you will, create AI/ML to predict whether that patient is going to be discontinued or continue on to that course of therapy. Some of that needs to be brought into confidence tools that can start to inform parts of practice as well. They're not ready for that. They have to ascend to that. But when you look at these, some of these, whether it's coming in as software, as a medical device, sets and solutions to augment, are going to add a huge, huge amount of utility. And you're finding a lot of interest, even biomedical innovators are looking for predictive tools, too, complement their medicines.And you know, we're doing a couple of things that would be definitely considered in a more confidential area around doing that right now. And I have to tell you I've been so pleased and it's just for me, it's so, so catalyzing of our energy to be brought into this, to see people willing to reshape the paradigm about how they do things that actually will reshape how medicine's delivered and care provided too. Harry Glorikian: Oh yeah. I mean, look, ideally, right, I think every physician wants to give the patient the optimal therapy. Not pick the wrong one and have to redo it again. But, but I think a lot of these tools are also gonna lend themselves to adjudication.Jeff Elton: Absolutely. Harry Glorikian: Right? And that is a huge paradigm shift for everybody to wrap their head around. And I think we're going to get pushback from some people, but I can't see how you don't end up there at some point. You can see where it's going. You know, what's going to work, here's the drug. And if it doesn't work, here's the data to show [why] it didn't work.Jeff Elton: Well, and actually and Harry, to your point, right now you're thinking about how payers authorized the treatment that's proposed by our clinician for super expensive medicines. Right? But if I'm an oncology, I can tell you right now that claims data as a single data source can't tell you much about whether that patient responds, whether they're being treated according to NCCN ASCO guidelines or not. So you're wondering what's the basis of that. Whereas I can actually look at the data and I can understand how that patient presents and I can see what's actually the intended treatment. And you can immediately say that perfectly makes sense, given how everything's matched up and I can continue to kind of say what that response is it consistent with what I would have hoped for placed in that patient on that specific treatment. So to your point, this is going to change all sorts of things.Harry Glorikian: I love it when it changes on that level, it just makes me all happy inside. So, Jeff, it was great catching up with you. I hope when this pandemic is open, we can get together in person and you know, have a beer. Maybe we'll even bring Arshad because I think he's been working in this whole data area with a number of companies for a while now. Jeff Elton: Yeah. Would love it.Harry Glorikian: Excellent. Jeff Elton: All right. Harry Glorikian: Thank you.Jeff Elton: Thank you too.Harry Glorikian: That's it for this week's show. You can find past episodes of MoneyBall Medicine at my website, glorikian.com, under the tab “Podcast.” And you can follow me on Twitter at hglorikian. Thanks for listening, and we'll be back soon with our next interview.
In this episode we are covering Principle 48 from Jack Canfield's book The Success Principles. We are in Section 4 of the book, where Canfield talks about building successful relationships. Check out my favorite books here: https://kit.co/FlourishAcademy Please visit the link below to change your life: http://flourish.academy/time Major Points from this Episode: Seek first to understand, rather than to be understood. Rather than just hearing what others are saying, practice active listening. Actionable Strategies: Ask yourself: Am I talking more than I'm listening? Where am I taking things personally and what do I need to adjust? How to Support the Podcast: Subscribe to the podcast on iTunes, Stitcher, Google Play or wherever you listen to podcasts. Please like, share, and leave a review. If you like the content, please share with your friends by posting on social media so that we can reach and impact more people. If you want to purchase any of the books that we discuss, please use the link in the notes to shop on Amazon. In fact, if you shop on Amazon at all, then use our link to help support the podcast. https://www.amazon.com/?tag=weddbyheat-20 Connect: Heather Lahtinen: Website, Facebook, Instagram
How is college different from high school for neurodivergent students? There's almost no comparison, and that makes the transition difficult for many. Elizabeth Hamblet is a specialist who helps neurodivergent people make decisions and successfully enter the higher education world. Emily talks with Elizabeth about the big move on episode 90. ABOUT THE GUEST - Elizabeth C. Hamblet is the author of From High School to College: Steps to Success for Students with Disabilities, published by the Council for Exceptional Children, and a laminated guide on college transition, available from National Professional Resources. Elizabeth has worked both ends of the college transition, beginning her career as a high school special education teacher and then moving to the college level in the late 1990s. She is now at her third university, where she helps students with time management, organization, reading, and study skills. In 2008, Elizabeth began offering programs to families and professionals on transition to college for students with disabilities, speaking locally and at national conferences. She's also a contributing writer for Disability Compliance for Higher Education, a journal for higher education disability professionals, and her work has also appeared in the Journal of College Admission, Teaching Exceptional Children, ADDitude Magazine, Attention, Raising Teens, and Career Development for Exceptional Individuals, and on platforms like Understood.org and ADDitudemag.com. You can support the podcast and receive subscriber-only benefits at www.patreon.com/neurodiversity. The Neurodiversity Podcast is available on Facebook and Instagram, and on Twitter @NeurodiversePod. For more information go to www.NeurodiversityPodcast.com
Good morning Kings and Queens, Often times we get an assignment and it becomes overwhelming. Although, we understand what needs to be done we tend to stress over even the minute details. Just remember that You understand the assignment, but the assignment was not meant to understand you! Have a blessed day
Our guest today on the Brett Allan show is the amazingly hilarious Mark Normand. Mark talks to Brett about his process, getting started, things he might to differently, Brett's loft and former tough shed, being funny, why he chose comedy, what annoys him as a comedian, being "famous", podcast's and much more. Give us kind rating and review!https://ratethispodcast.com/brettallanshowEmail firstname.lastname@example.orgBe sure to follow us on social media for all the latest podcast updates!Twittertwitter.com/@brettallanshowIGinstagram.com/brettallanshowFacebookFacebook.com/brettallanshowwww.brettallanshow.com
Every day we download apps, purchase products, sign up for services and legally bind ourselves at the click of a button or flick of an e-signature.A staggering 91 percent of mature adults surveyed admit they sign contracts without even reading them. 97 percent of younger adults in the same survey say they don't read before they "accept." And, as is the case with many contracts today...even if you read them, chances are you won't understand them without a lawyer - Is That EVEN Legal? Harvard law trained lawyer and technologist Jonny Allred joins Bob to talk about what can be done to make contracts more understandable. Jonny is joined by law student Trevor Cook - the first-ever recipient of the Is That Even Legal Scholarship for suggesting a great episode and guest.What you might be signing away when you click yes:Right to a jury trialRight to have a dispute resolved in your own stateYour first born child (WHAT? listen to the episode to hear about that!)
Buster opens the show recounting the scene at Yankee Stadium yesterday as the game against the Red Sox was canceled due to a COVID-19 concerns among the Yankees. Then, Hembo discusses coronavirus concerns after players gathered in Denver, the pressure Brian Cashman is under as the trade deadline approaches, Atlanta trading for Joc Pederson and second half over/unders. Later, Doug Glanville stops by to talk about Shohei Ohtani and the culture of nonverbal communication in baseball, the first domino of a Cubs selloff falling and if the Cubs could've done more to sustain success after winning a World Series.
Alise and Amanda are back to break down why Texas Democrats have left their state for the next 27 days to prevent a vote on sweeping voting rights restrictions. They explain how the lawmakers can be arrested if they return and how they plan to troll Congress while in exile. They break down a story of a Texas man arrested for accidentally voting three months before his parole ends, and how it highlights a key provision of HR1 allowing formerly incarcerated people to vote more freely.