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The Armed Career Criminal Act provides that felons who possess a firearm are normally subject to a maximum 10-year sentence. But if the felon already has at least three "serious drug offense" convictions, then the minimum sentence is fifteen years. Courts decide whether a prior state conviction counts as a serious drug offense using the categorical approach. That requires determining whether the elements of a state drug offense are the same as, or narrower than those of its federal counterpart. If so, the state conviction qualifies as an ACCA predicate. But federal drug law often changes-as here, where Congress decriminalized hemp, narrowing the federal definition of marijuana. If state law doesn't follow suit, sentencing courts face a categorical conundrum. Under an earlier version of federal law, the state and federal offenses match-and the state offense is an ACCA predicate. Under the amended version, the offenses do not match-and the state offense is not an ACCA predicate. So the version of federal law that the court chooses to consult dictates the difference between serving a 10-year maximum or a 15-year minimum. The question presented is: Which version of federal law should a sentencing court consult under ACCA's categorical approach? The Armed Career Criminal Act mandates fifteen years in prison for federal firearm offenses where the defendant has three prior "violent felonies" or "serious drug offenses." The ACCA defines a "serious drug offense" as "an offense under State law, involving manufacturing, distributing, or possessing with intent to manufacture or distribute, a controlled substance (as defined in section 102 of the Controlled Substances Act (21 U.S.C. 802)), for which a maximum term of imprisonment often years or more is prescribed by law." 18 U.S.C. § 924(e)(2)(A)(ii) (emphasis added). Four circuits have unanimously held that § 924(e)(2)(A)(ii) incorporates the federal drug schedules in effect at the time of the federal firearm offense to which the ACCA applies. In the decision below, however, the Eleventh Circuit accepted the government's express invitation to reject those circuit decisions. In doing so, the Eleventh Circuit held that § 924(e)(2)(A)(ii) instead incorporates the federal drug schedules that were in effect at the time of the defendant's prior state drug offense. The question presented is: Whether the "serious drug offense" definition in the Armed Career Criminal Act, 18 U.S.C. § 924(e)(2)(A)(ii), incorporates the federal drug schedules that were in effect at the time of the federal firearm offense (as the Third, Fourth, Eighth, and Tenth Circuits have held), or the federal drug schedules that were in effect at the time of the prior state drug offense (as the Eleventh Circuit held below).1 1 A related question is presented in Altman, et al. v. United States (No. 22-5877) (response requested Nov. 16, 2022) and Brown v. United States (No. 22-6389) (docketed Dec. 23, 2022).

Another unnecessary crisis averted. In this episode, Jen examines the debt ceiling crisis events of the past to show that the Fiscal Responsibility Act of 2023 - which raised the debt ceiling - is not likely to reduce our government's debt but will likely ensure that our environment will be trashed for profit. She also examines the best path forward to ensure that the debt ceiling is never used for political leverage again. Please Support Congressional Dish – Quick Links Contribute monthly or a lump sum via PayPal Support Congressional Dish via Patreon (donations per episode) Send Zelle payments to: Donation@congressionaldish.com Send Venmo payments to: @Jennifer-Briney Send Cash App payments to: $CongressionalDish or Donation@congressionaldish.com Use your bank's online bill pay function to mail contributions to: 5753 Hwy 85 North, Number 4576, Crestview, FL 32536. Please make checks payable to Congressional Dish Thank you for supporting truly independent media! View the show notes on our website at https://congressionaldish.com/cd275-debt-ceiling-2023-crisis-normalized Background Sources Congressional Dish Episodes CD261: Inflation Reduction Act CD257: PACT Act – Health Care for Poisoned Veterans CD151: AHCA – The House Version (American Health Care Act) CD049: Crisis… Postponed CD048: The Affordable Care Act (Obamacare) Debt Ceiling Overview “US debt ceiling - what it is and why there is one.” Natalie Sherman. Jun 2, 2023. BBC. “What Happens When the U.S. Hits Its Debt Ceiling?” Noah Berman. Last Updated May 25, 2023. Council on Foreign Relations. “A brief history of debt ceiling crises and the political chaos they've unleashed.” Raymond Scheppach. May 12, 2023. The Conversation. “Congress has revised the debt ceiling 78 times since 1960. An expert explains why.” Scott Simon and Lennon Sherburne. April 29, 2023. NPR. New Development Bank Ben Norton on Twitter New Development Bank on Twitter New Development Bank Website “BRICS New Development Bank de-dollarizing, adding Argentina, Saudi Arabia, Zimbabwe as members.” Ben Norton. Jun 8, 2023. Monthly Review Online. “NDB Board of Directors held its 40th meeting.” Jun 5, 2023. New Development Bank. Debt Limit History “The Debt Limit Through the Years.” Bipartisan Policy Center. “US government shutdown to end after Congress passes debt ceiling deal.” Paul Lewis and Dan Roberts. Oct 15, 2013. The Guardian. “S.& P. Downgrades Debt Rating of U.S. for the First Time.” Binyamin Appelbaum and Eric Dash. Aug 5, 2011. The New York Times. “Gingrich Vows No Retreat on Debt Ceiling Increase.” Clay Chandler. Sept 22, 1995. The Washington Post. 2023 Crisis “House Democrats Move to Force a Debt-Limit Increase as Default Date Looms.” Carl Hulse. May 2, 2023. The New York Times. “Can Congress Make an End-Run Around a Debt Limit Impasse? It's Tricky.” Carl Hulse and Jeanna Smialek. Apr 7, 2023. The New York Times. The Debt “2023 VAT Rates in Europe.” Cristina Enache. Jan 31, 2023. Tax Foundation. “National Debt: Definition, Impact, and Key Drivers.” Updated May 25, 2023. Investopedia. “Briefing Book: What is the Child Tax Credit?” Updated May 2021. Tax Policy Center. The Law H.R.3746: Fiscal Responsibility Act of 2023 Jen's Highlighted PDF CBO Estimate of Budgetary Effects Law Outline Division A: Limit Federal Spending Title I: Discretionary Spending Limits for Discretionary Category Sec. 101: Discretionary Spending Limits Sets spending caps for fiscal years 2024 and 2025 2024: Over $886 billion for defense Over $703 billion for non-defense Sec 102: Special Adjustments for Fiscal Years 2024 and 2025 If there is a continuing resolution in effect on or after January 1, 2024 for fiscal year 2024, or a continuing resolution for 2025 on or affect January 1, 2025, defense and non-defense spending will be sequestered, meaning a 1% across the board cut Title II: Budget Enforcement in the House of Representatives Explains how the House of Representatives must implement this law Title III: Budget Enforcement in the Senate Explains how the Senate must implement this law Division B: Save Taxpayer Dollars Title I: Rescission of Unobligated Funds Takes money back from accounts where it wasn't all spent including from: The Public Health and Social Services Emergency Fund The Centers for Disease Control and Prevention Specifically their COVID vaccine activities and vaccine supply chains All the money except $7 billion for COVID testing and mitigation All of the SARS-CO-V2 genomic sequencing money except for $714 million All of the money for COVID global health programs International Disaster Assistance funds for the State Department National Institutes of Health - National Institute of Allergy and Infectious Diseases Centers for Medicare and Medicaid Services Community health centers National Health Service Corps Nurse Corps Graduate level teaching health centers Mental health and substance use disorder training for health care professionals and public safety officers Grants for mental health for medical providers Funding for pediatric mental health care access Grants for survivors of sexual assault Child abuse prevention and treatment Medical visits at home for families State and local fiscal recovery funds Rural health care grants Restaurant revitalization fund Elementary and secondary school emergency relief funds Housing for people with disabilities Housing for the elderly Grants to Amtrak and airports Air carrier worker support and air transportation payroll support Title II: Family and Small Business Taxpayer Protection Sec. 251: Rescission of Certain Balances Made Available to the Internal Revenue Service Defunds the IRS by approximately $1.4 billion Title III: Statutory Administrative Pay-As-You-Go Requires agencies to submit plan to reduce spending in an equal or greater amount to every action they take that increases spending. This is easily waived and expires at the end of 2024.. Title IV: Termination of Suspension of Payments on Federal Student Loans: Resumption of Accrual of Interest and Collections Sec. 271: Termination of Suspension of Payments on Federal Student Loans; Resumption of Accrual of Interest and Collections At the end of September, people with Federal student loans will have to begin repayment of their loans, and the Secretary of Education is not allowed to implement an extension of the payment pause. Division C: Grow the Economy Title I: Temporary Assistance to Needy Families Orders reports about work requirements for welfare payments Title II: SNAP Exemptions Sec. 311: Modification of Work Requirement Exemptions In order to receive food benefits for more than 3 months in a 3 year period, "able bodied" people have to work at least 20 hours per week or participate in a work program for 20 hours per week unless that person is under 18 or over 50 years old, medically unable to work, is a parent with dependent children, or is pregnant. This provision increases the work requirement age over the next few years so it becomes 55 years old. This provision adds homeless individuals, veterans or foster kids until they are 24 to the list of people exempt from the work requirements This provision expires and the qualifications revert back to what they used to be on October 1, 2030 Title III: Permitting Reform Sec. 321: Builder Act Changes the requirements for NEPA environmental studies to include "any negative environmental impacts of not implementing the proposed agency action in the case of a no action alternative..." and requires only "irreversible and irretrievable commitments of FEDERAL resources which would be involved in the proposed agency action should it be implemented" Adds circumstances when agencies will not have to produce environmental impact documents Requires environmental impact statements when the action has a "reasonably foreseeable significant effect on the quality of the HUMAN environment." Allows agencies to use "any reliable data source" and says the agency is "not required to undertake new scientific or technical research unless the new scientific or technical research is essential to a reasoned choice among alternatives and the overall costs and time frame of obtaining it are not unreasonable." Assigns roles for "lead agencies" and "cooperating agencies" and says that the agencies will produce a single environmental document Sets a 150 page limit on environmental impact statements and 300 pages for a proposed agency action with "extraordinary complexity" Sets a 75 page limit on environmental assessments Requires lead agencies to allow a "project sponsor" to prepare environmental assessments and environmental impact statements under the supervision of the agency. The lead agency will "evaluate" the documents and "shall take responsibility for the contents." Environmental impact statements must be complete in under 2 years after the EIS is ordered by the agency Environmental assessments must be completed in 1 year The agency may extend the deadlines Project sponsors are given the right to take government agencies to court for failure to meet a deadline Sec. 324: Expediting Completion of the Mountain Valley Pipeline "Congress hereby ratifies and approves all authorizations, permits, verifications, extensions, biological opinions, incidental take statements, and any other approvals or orders issued pursuant to Federal law necessary for the construction and initial operation at full capacity of the Mountain Valley Pipeline." Gives the Secretary of the Army 21 days after enactment of this law to issue "all permits or verifications necessary to complete the construction of the Mountain Valley Pipeline across the waters of the United States" "No court shall have jurisdiction..." to review "...any approval necessary for the construction and initial operation at full capacity of the Mountain Valley Pipeline... including any lawsuit pending in a court as of the date of enactment of this section." Division D: Increase the Debt Limit Sec. 401: Temporary Extension of Public Debt Limit Suspends the debt limit until January 1, 2025 On January 2, 2025, the debt limit will automatically increase to whatever amount the debt level is at the end of the suspension Audio Sources Senate Session June 1, 2023 Highlighted Transcript Senate Session Parts 1 & 2 May 31, 2023 Highlighted Transcript Meeting: H.R. 3746 - Fiscal Responsibility Act of 2023 May 30, 2023 House Committee on Rules Watch it on YouTube Clips 22:50 Rep. Jason Smith (R-MO): I should note for my colleagues that Democrats could have raised the debt limit last year when they controlled the House of Representatives. 35:30 Rep. Ron Estes (R-KS): The Fiscal Responsibility Act finally ends the federal student loan moratorium and the so-called interest pause, effective August 31, 2023. For every month borrowers were allowed to skip payments, $4.3 billion were added to the American taxpayers debt. 41 months later, the moratorium has cost American taxpayers approximately $176 billion. 1:01:15 Rep. Joe Neguse (D-CO): The President put forward a budget months ago. Chairman Smith, do you know when the President submitted his budget to the United States Congress? Rep. Jason Smith (R-MO): I don't remember but it was -- Rep. Joe Neguse (D-CO): It was March 9th. Rep. Jason Smith (R-MO): It was late. It was due February 1st. Rep. Joe Neguse (D-CO): Oh, I'm glad you noted that. Chairman Smith, when did the Republicans submit their budget? Rep. Jason Smith (R-MO): You would need to ask the budget committee. Rep. Joe Neguse (D-CO): I would need to ask the budget committee. Mr. Estes. When did the Republicans submit their budget? [Pause] Only in the Rules Committee, by the way, could a witness lay blame at the president for being a few weeks late in submitting his budget when his party hasn't submitted a budget, period. 1:06:45 Rep. Brendan Boyle (D-PA): We also run the risk that we will one day not be the reserve currency of the world. The reason why our interest rates are so low comparatively, is because we are a safe haven for investment for the rest of the world. These sort of antics increasingly bring that into doubt whether or not folks will get their money, the folks who are lending to us. 1:24:15 Rep. Teresa Leger Fernandez (D-NM): Now, Standard and Poor's, they downgraded our credit rating. Have they increased that credit rating? Rep. Brendan Boyle (D-PA): No. There are three credit agencies Standard and Poor's, which was the one that downgraded us in 2011, never reversed their downgrade. And frankly my concern and the worry right now is that the other two credit agencies will now follow suit, given the events of the last couple of months, which obviously look very much like 2011 all over again. 1:50:55 Rep. Jim McGovern (D-MA): I continue to be stunned by the fact that when I look at this deal, which focuses on discretionary funding, that the people who seem to be asked to do the most or to absorb the hits the most are the people that least can afford it. The military budget is part of this discretionary budget, it's over 50% of the discretionary budget. The United States spends more on national defense than China, Russia, India, Saudi Arabia, United Kingdom, Germany, France, South Korea, Japan and Ukraine combined. And yet, if this moves forward, we see an increase in defense spending. I mentioned in my opening remarks, I don't know how many of you saw the 60 minutes piece the other day, I mean, we all know, of the cost overruns in the Department of Defense. I mean, the idea that we're spending $10,000 for a $300 oil switch. I mean, it's been there for a long time, and yet, we seem unable to want to grapple with that waste and those cost overruns. I don't know if it's the defense lobbyists or the campaign contributions or whatever it is, but somehow, when it comes to the military budget, you know, not only are we not holding them accountable, but you know, we say we're going to increase it even more, even more, we'll give you more. 2:57:40 Rep. Chip Roy (R-TX): Look, I'm for NEPA reforms 100%. We need them for road projects, transportation, particularly for our energy industry. But my concern here that we've got language that none of us have fully reviewed, going through the committees of jurisdiction that has been adopted, that I've got colleagues texting me and saying they're not 100% sure if that language is good or bad for the purpose intended. I've got colleagues on both sides of the aisle that have raised those questions. And so the purpose intended, of course, is to streamline projects, whatever those projects may be. But I've got a text right here from GOP colleagues saying, Well, I'm not so sure that these will actually do what we think they will do, to streamline said projects. And in fact, a former high up in the administration, in the Energy Department under the Trump administration, just validated that concern by one of my colleagues. Yet we are putting forward this measures saying some grand improvement with respect to NEPA, that that's somehow something we should be applauding when it's not the full package of H.R. 1, which had gone through committee. And importantly, the one thing that I think is 100% clear, is that this bill fails to include even the most basic reform to President Biden's unreliable energy subsidies that were put forward in the so called inflation Reduction Act for the wealthy, elites, corporations, and the Chinese Communist Party just to be blunt. And frankly, it ensures that permitting reform will likely benefit renewables the most. Basically, if you're a government that is subsidizing the crap out of something, in this case, unreliable energy, giving massive subsidies to billion dollar corporations, giving significant subsidies to families that make over 100,000, 300,000 for EVs, because you're chasing your your dreams of, you know, a fossil fuel-less world. You're going to absolutely decimate our grid because you're not going to have the projects being developed for the gas and the coal nuclear that are actually required to keep your grid functioning. But yeah, that's what we're doing and I just for the life of me can't understand why we're applauding that. 3:15:50 Rep. Jason Smith (R-MO): So we've been asking for the IRS to give us a plan of how they wanted to spend the additional $80 billion that they had. They finally gave that to Congress about six weeks, eight weeks ago. They broke down how they're spending the $80 billion: $1.4 billion of it was for hiring more agents and what the bill before you does, it eliminates that $1.4 billion for this year. House Session May 25, 2023 Highlighted Transcript House Session, Morning Hour, Parts 1 & 2 May 24, 2023 Highlighted PDF How the Pentagon falls victim to price gouging by military contractors May 21, 2023 60 Minutes The Rich Get Richer, Deficits Get Bigger: How Tax Cuts for the Wealthy and Corporations Drive the National Debt May 17, 2023  Senate Budget Committee Witnesses: Bobby Kogan, Senior Director, Federal Budget Policy, Center for American Progress Bruce Bartlett, Former Deputy Assistant Secretary for Economic Policy, United States Department of Treasury Samantha Jacoby, Senior Tax Legal Analyst, Center on Budget and Policy Priorities Dr. Adam Michel, Director of Tax Policy Studies, Cato Institute Scott Hodge, President Emeritus & Senior Policy Advisor, Tax Foundation Clips 32:25 Bobby Kogan: Today I intend to make two points. First, without the Bush tax cuts, their bipartisan extensions, and the Trump tax cuts, the ratio of debt to GDP would be declining indefinitely. And second, our rising debt ratio is due entirely to these tax cuts and not to spending increases. Throughout this testimony, When I say spending, I mean primary spending, that is spending excluding interest on the federal debt, and every mention of revenues, spending deficits, and debt means those amounts as a percent of GDP. Okay, according to CBO primary deficits are on track to stabilize at roughly 4% over 30 years, high enough to cause the debt to rise indefinitely. The common refrain that you will hear, that I heard when I staffed this committee, and that unfortunately, I expect to hear today, is that rising debt is due to rising spending. Revenues have been roughly flat since the 1960s and while spending was also roughly flat until recently, demographic changes and rising healthcare costs are now pushing the costs up. These facts are true. Our intuitions might reasonably tell us that if revenues are flat, and spending is rising, then the one changing must be to blame. But our intuitions are wrong. In CBO's periodic long term projections earlier this century, spending was projected to continue rising, but despite this CBO routinely projected long term debt stability, It projected revenues to keep up with this rising spending, not due to tax increases, but due to our tax code bringing in more as our country and the people in it prospered. That prosperity results in both higher revenue collection and higher real after tax income for the people whose incomes are growing, it is a win win. In other words, we used to have a tax system that would fully keep pace with rising spending. And then the Bush tax cuts were enacted and expanded, and then on a bipartisan basis eventually made largely permanent in 2013. Under the law dictating CBO and OMB's baseline construction, temporary changes in tax law are assumed to end as scheduled. In practice this meant that CBO is projection showed the Bush tax cuts ending on schedule with the tax code then reverting to prior law. 2012 was therefore the last year in which CBO is projections reflected the Bush tax cuts expiring. Yes, CBO's 2012 long term projections showed rising spending, but it also showed revenues exceeding spending for all 65 years of its extended baseline with indefinite surpluses, CBO showed debt declining indefinitely. But ever since the Bush tax cuts were made permanent CBO has showed revenues lower than spending and has projected debt to rise indefinitely. And since then, the Trump tax cuts further reduced revenues. Without the Bush tax cuts, their bipartisan extensions, and the Trump tax cuts, debt would be declining indefinitely, regardless of your assumptions about the alternative minimum tax. Two points explain this. The first employs a concept called the fiscal gap, which measures how much primary deficit reduction is required to stabilize the debt. The 30 year fiscal gap is currently 2.4% of GDP, which means that on average primary deficits over 30 years would need to be 2.4% of GDP lower for the debt in 2053 to be equal to what it is now. The size of the Bush tax cuts their extensions and the Trump tax cuts under current law over the next 30 years is 3.8% of GDP. Therefore, mathematically and unequivocally without these tax cuts, debt would be declining as a percent of GDP, not rising. 41:45 Bruce Bartlett: The reason I changed my mind about taxes and decided that we needed tax increases happened on a specific day that I'm sure Senator Grassley remembers, if nobody else. And that was the day in November of 2003, when the Medicare Part D legislation passed, and I was just, you know, at the time, I thought the reason Republicans, and I was a Republican in those days, were put on this earth was to control entitlement programs. And I was appalled that an entirely new entitlement program was created that was completely unfunded. It raised the deficit forever by about 1% of GDP. And I thought a dedicated tax should have been enacted, along with that program, which I didn't oppose and don't oppose. In fact, I benefit from it at my age. But I just think that we need proper funding. And that was when I first started saying we needed to raise taxes, because we just can't cut discretionary spending enough to fix the problem. And I think this is the error of the House budget, which cuts almost entirely domestic discretionary spending, doesn't even touch defense, and I just think that's extraordinarily unrealistic and an unserious approach to our deficit problem. We simply have to do something about entitlements. If you're going to control spending, control the budget on the spending side, I don't think we're going to do that. I think we need a new tax. I have advocated a value added tax for many years, as a supplement to our existing tax system. It creates, you can raise a lot of revenue from it every virtually every industrialized country has one. The money could be used to fix things in the tax code, as a tax reform measure. Once upon a time in the 70s, and even the 80s, it was considered the sine qua non of Republican tax policy, because it's a consumption based tax system, a flat tax, and now many Republicans are in favor of something called the Fair Tax which is very similar except that it won't work. Administratively it's poorly designed. The Value Added Tax will work and that's why it should be a better approach to these problems. 49:15 Samantha Jacoby: Wealthy people who get their income from investments accumulate large gains as those assets go up in value over time, but they won't owe income tax unless they sell their assets. And if they never sell, no one will ever pay income tax on those gains. That's arguably the biggest flaw in the tax code. Policymakers should consider a tax like President Biden's budget proposal to enact a minimum tax on very wealthy households. This would treat unrealized capital gains, which is the primary source of income for many wealthy households, as taxable income instead of letting income accrue tax free across generations. 54:15 Dr. Adam Michel: Keeping government small is the best way to ensure that the American people can continue to prosper. 58:45 Scott Hodge: There are many elements of the tax code that benefit the wealthy and big corporations, I absolutely agree, and the inflation Reduction Act is the most recent example of corporate welfare in the tax code. 1:01:00 Samantha Jacoby: So the the 2017 law, it dramatically changed the way that foreign profits are taxed of multinationals. And so what happens now is large corporations who have big, big foreign profit centers, lots of foreign profits overseas, they pay a lower tax rate on those foreign profits than they do on their domestic profits or purely domestic businesses pay. 1:02:55 Bruce Bartlett: And one of the things I tried to do in my prepared testimony is look at what has actually happened in the seven years since then. And very few studies, I know, some of the tests, the footnotes and my colleagues testimony or to our projections based on studies were done in 2017, 2018. I tried to find things that were written more recently, perhaps, or preferably, I should say, in the academic literature, which I think is more substantive and more dependable. And I looked at peer reviewed journals, and the data that I could find showed no macroeconomic impact whatsoever. It didn't raise growth, it didn't lower growth. And I think I concluded in that -- Sen. Sheldon Whitehouse (D-RI): It did shift wealth, correct? Bruce Bartlett: Excuse me? Sen. Sheldon Whitehouse (D-RI): It did shift wealth. Bruce Bartlett: Oh, absolutely. No question about that. But I'm more interested in the macroeconomic effect on investment and growth and employment. And I would just close by saying that if a tax cut had no positive impact, then it can't have any negative impact if you get rid of it. Now, you may not want to for other reasons.... 1:05:25 Bobby Kogan: Right. So our demographic changes and rising healthcare costs are the reason that spending is increasing. If you break spending into two categories, Medicare, Medicaid, Social Security, everything else, including the everything else entitlements, the everything else is shrinking as a percent of GDP and it's the Medicare, Medicaid and Social Security that are growing. And they are growing not because they are getting more, they're doing more, it's not because we're giving more and more to seniors, and to extremely poor people, but because it costs more to do the same. And that is the rising that is the demographics is changing the ratio of non workers to workers and there's also the rising health care costs. And so what this means is that if you want to spend less, you are necessarily saying that future seniors should be getting less of a benefit than they're currently getting. That's the only way to do it. Since that's the portion of the budget that's growing, if you want to cut that, you have to say that the current amount that we're doing for Social Security recipients, the current amount that we're doing for seniors, the current amount that we're doing for people on Medicaid is too much, and future people should be having less. That's the only way to do it. And, you know, the very nice thing that I had though, ii my testimony, we used to have a tax system that despite that rising, we keep up with that, and now we don't. 1:15:50 Bruce Bartlett: Well, first of all, I think in terms of tax shelters and tax evasion and extreme levels of tax avoidance, the problem isn't so much with the law as with the enforcement. And as you know, it's been the policy of Republicans to slash the budget of the IRS in real terms, for many years, which is a way of giving, privatizing tax avoidance to rich people and the rich individuals have the greatest power and ability to evade taxation. And I think it was really wonderful that the Congress increased the IRS budget, and I think it's just the height of absurdity that one of the major elements of the House Republican proposal is to slash the IRS budget again, even though the CBO has said this is a revenue losing proposition. 2:06:40 Bruce Bartlett: I think there's absolutely no question that the debt limit is unconstitutional, and not just under the 14th Amendment, section four, but under the general powers of the President. I mean, one of the things that I will point out is that the debt limit is a very serious national security issue. A huge percentage of the national debt that is owned by foreigners is owned by foreign central banks. They are not going to be happy if their assets are suddenly worth a great deal less than they thought they were. I think the President has full power within his inherent authority to simply declare the debt limit null and void. And I would point out that it's not a simple question of whether you just break the debt limit. I think a lot of people, even on this committee, forget the impoundment part of the Budget Act of 1974, which says the President must spend the money that is appropriated by law, he doesn't have the choice not to, which is what some Republicans seem to think that he can do. And he lacks that power. So I would agree that the President has that power. I wish he would use it. I wish it as sincerely as anything I believe in life. Thank you. Senate Session May 16, 2023 Highlighted PDF House Session May 16, 2023 Highlighted PDF Senate Session May 15, 2023 Highlighted PDF House Session May 10, 2023 Highlighted PDF Senate Session, Parts 1 & 2 May 19, 2023 Highlighted PDF Senate Session May 9, 2023 Highlighted PDF Senate Session May 4, 2023 Highlighted PDF Senate Session, Parts 1 & 2 May 2, 2023 Highlighted PDF Music Tired of Being Lied To by David Ippolito (found on Music Alley by mevio) Editing Pro Podcast Solutions Production Assistance Clare Kuntz Balcer

Chris, Melanie, and Zack try to understand the U.S. government's approach to global trade. Two successive presidential administrations have turned their backs on trade liberalization, and there is little enthusiasm in Congress for free trade – and a fair amount of outright hostility. For all the talk of “friendshoring” and building resilient supply chains, Washington's allies and partners seem mostly concerned about rising protectionism in the United States. If Washington is no longer leading the world on trade, who is? Or who will? Or is the United States trying to lead toward a particular type of trade, one that doesn't benefit revisionist autocrats? And will that fly? Grievances for Joe Biden's granddaughter, for getting married at the White House when the APEC summit was going on, to Ukraine and its supporters for falsely claiming an errant missile that landed in Poland was a deliberate Russian attack, and to incoming House Republicans planning a series of hearings designed to score political points. Attapeople for recent authors Will Inboden for his new book on Ronald Reagan, and Arthur Ross award winners Carter Malkasian and Mary Elise Sarotte, and an Atta Vice President to Kamala Harris for her planned trip to the Philippines. Episode Reading: warontherocks.com/2022/11/why-the-united-states-no-longer-leads-on-free-trade

In this episode of Bona Fide Needs, Arnold & Porter Partner Mike McGill and PubKGroup Managing Editor Bill Olver cover a broad range of recent legal developments affecting government contractors. Our feature this month is Mike's in-depth discussion with Arnold & Porter partner Chuck Blanchard, who previously served as general counsel of the Air Force and earlier the Army. Mike and Chuck discuss a range of topics, including the Defense Production Act, Other Transaction Authority, and Foreign Military Sales. The episode starts with Mike highlighting several key regulatory and policy developments that you may have missed over the summer, including the Department of Labor's proposed rule on non-displacement of service employees, the Office of Personnel Management's proposal to update “ban the box” rules for federal employees and the implications for the upcoming rules applicable to federal contractors, the Department of Defense's guidance to contracting officers related to assessing and enforcing contractor cybersecurity compliance, and the Department of Defense's guidance on economic price adjustments to combat inflation. Next, Bill flags several notable PubK headlines, most involving recent significant developments involving the False Claims Act. Bill provides an overview of the Supreme Court's consideration of cases involving the Rule 9(b) particularity standard and DOJ's authority to dismiss qui tam complaints, as well as other cases involving causation and the Anti-Kickback Statute. This month's headlines also touch on GAO case decisions and two court decisions that impacted regulatory issues, including the Chevron deference.   Show notes 0:25 - Introduction and Overview 01:45 - Mike McGill's summary of regulatory and policy developments 19:00 - Bill Olver's summary of headline developments 33:30 - Mike's discussion with Chuck Blanchard on DPA, OTA, and FMS 1:18:00 - Credits and copyright Music credit: Scratch the Itch by Marc Walloch (Shutterstock) Links Department of Labor Proposal Rule Implementing EO 14055, Nondisplacement of Qualified Workers Under Service Contracts. Office of Personnel Management Proposed Rule Implementing Fair Chance to Compete for Jobs Act of 2019. Department of Defense Memorandum "Contractual Remedies to Ensure Contractor Compliance with Defense Federal Acquisition Regulation Supplement Clause 252.204-7012, for contracts and orders not subject to Clause 252.204-7020; and Additional Considerations Regarding National Institute of Standards and Technology Special Publication 800-171 Department of Defense Assessments." Department of Defense Memorandum “Guidance on Inflation and Economic Price Adjustments.” Arnold & Porter Alert “Expanded Use of the Defense Product Act and Focus on Building the Domestic Supply Chain: What Companies Need to Know.” Arnold & Porter Webinar “Understanding and Leveraging the Defense Production Act.” Arnold & Porter Alert “DoD Ushers in CMMC and NIST SP 800-171 Assessment Methodology With Interim Rule.” Justice Department Sues to Block Booz Allen Hamilton's Proposed Acquisition of EverWatch Booz Allen says Acquisition Aimed at Lockheed, Raytheon, ‘Billions' in Contracts GAO Rejects Agency's Tortured Explanation as to How a Key Person Who Resigned Was Still Technically Available. If a Key Person Leaves After Proposal Submission, When Do They Become “Unavailable”? United States Court of Appeals for the DC Circuit No. 20-5291; the Humane Society of the United States v. United States Department of Agriculture Supreme Court of the United States No. 20-1530; West Virginia, et al., v. Environmental Protection Agency, et al.; Supreme Court restricts the EPA's authority to mandate carbon emissions reductions District Court Adopts Swift Standard of Unfettered Right of DOJ to Dismiss Qui Tam Actions Nothing to See Here: Solicitor General Recommends That SCOTUS Deny Cert. in Eleventh Circuit Case on Rule 9(b) Fraudulent Activity, Without the Submission of False Claims, Insufficient to Support Qui Tam Case Seventh Circuit Reverses Ruling on Knowledge Element, Finding Defendant Had to Know High-Cost Services Were Material to High Capitation Rate Dissent: Materiality Not Shown Where Defendant Failed to Provide One Service Out of Many Possible Services CBO Issues Long-Awaited Analysis of Proposed FCA Amendments Court Split: Sixth Circuit Says FCA Anti-Retaliation Provision Also Applies to Former Employees Eighth Circuit: But-For Causation Required to Show FCA Liability Arising from AKS Violations Eighth Circuit Puts the Teeth Back in the AKS's Causation Requirement, Creating Yet Another FCA Circuit Split Second Circuit: Anti-Kickback Statute Liability Doesn't Require Corrupt Intent  

This episode is also available as a blog post: https://youarewithinthenorms.com/2022/07/19/the-supreme-court-voids-the-grand-opioid-deception-of-the-doj-dea-9-0-unanimous-ruan-khan-v-united-states-no-20-1410-so-say-we-all/ --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/norman-j-clement/support

This episode is also available as a blog post: https://youarewithinthenorms.com/2022/07/19/the-supreme-court-9-0-unanimous-on-medical-opioid-prescribing-ruan-khan-v-the-united-states-no-20-1410-so-say-we-all/ --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/norman-j-clement/support

Do Christians have the biblical warrant to pronounce curses upon the President of the United States- No. Nor do Christians have the right to pronounce curses upon anyone. It must stop. It is sin. Period.

This episode is also available as a blog post: https://youarewithinthenorms.com/2022/01/04/the-medical-school-to-prison-pipeline-physician-against-abuse-paa-a-florida-corporation-files-amicus-brief-in-supreme-court-supporting-xiulu-ruan-md-vs-united-states-no-20-1410/ --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/norman-j-clement/support

QUESTION PRESENTED:Whether, when deciding if it should “impose a reduced sentence” on an individual under Section 404(b) of the First Step Act of 2018, a district court must or may consider intervening legal and factual developments.Date                     Proceedings and Orders (key to color coding)May 24 2021 | Petition for a writ of certiorari filed. (Response due June 25, 2021)Jun 21 2021 | Motion to extend the time to file a response from June 25, 2021 to July 26, 2021, submitted to The Clerk.Jun 22 2021 | Motion to extend the time to file a response is granted and the time is extended to and including July 26, 2021.Jul 19 2021 | Motion to extend the time to file a response from July 26, 2021 to August 25, 2021, submitted to The Clerk.Jul 20 2021 | Motion to extend the time to file a response is granted and the time is further extended to and including August 25, 2021.Aug 25 2021 | Brief of respondent United States of America in opposition filed.Sep 08 2021 | DISTRIBUTED for Conference of 9/27/2021.Sep 09 2021 | Reply of petitioner Carlos Concepcion filed. (Distributed)Sep 30 2021 | Petition GRANTED.Oct 22 2021 | Motion to dispense with printing the joint appendix filed by petitioner Carlos Concepcion.Nov 01 2021 | Motion to dispense with printing the joint appendix filed by petitioner GRANTED.Nov 15 2021 | Brief of petitioner Carlos Concepcion filed.Nov 17 2021 | ARGUMENT SET FOR Wednesday, January 19, 2022.Nov 17 2021 | Record requested from the U.S.C.A. 1st Circuit.Nov 22 2021 | Brief amici curiae of Drug Policy Alliance and The Law Enforcement Action Partnership filed.Nov 22 2021 | Brief amici curiae of FAMM, The National Association of Criminal Defense Lawyers, and the National Association of Federal Defenders filed.Nov 22 2021 | Brief amicus curiae of Americans for Prosperity Foundation filed.Nov 22 2021 | Brief amicus curiae of Constitutional Accountability Center filed.Nov 22 2021 | Brief amici curiae of The Howard University School of Law Civil Rights Clinic; A New Way of Life Reentry Project filed.Nov 22 2021 | Brief amici curiae of Dr. Karen Swanson, Dr. Byron R. Johnson, and Dr. Sung Joon Jang filed.Nov 22 2021 | Brief amici curiae of Due Process Institute, American Civil Liberties Union, ACLU of Massachusetts, and Southern Poverty Law Center filed.Nov 22 2021 | Brief amicus curiae of American Conservative Union Foundation filed.Nov 22 2021 | Brief amici curiae of The District of Columbia, et al., filed.Nov 22 2021 | Brief amici curiae of Criminal Law Scholars filed.Dec 06 2021 | The record from the U.S.C.A. 1st Circuit is electronic and located on Pacer.Dec 06 2021 | The record from the U.S.D.C. Dist. of Massachusetts is electronic and located on Pacer, the Sealed Appendix is filed electronically.Dec 14 2021 | CIRCULATEDDec 15 2021 | Brief of respondent United States filed. (Distributed)Jan 07 2022 | Reply of petitioner Carlos Concepcion filed. (Distributed)Jan 19 2022 | Argued. For petitioner: Charles L. McCloud, Washington, D. C. For respondent: Matthew Guarnieri, Assistant to the Solicitor General, Department of Justice, Washington, D. C.★ Support this podcast on Patreon ★

Who is the most popular skin care influencer in the United States? No, it’s not a dermatologist, plastic surgeon, or aesthetician. It’s a 24 year old skin care enthusiast named Hyram. After bursting onto the scene less than a year ago, Hyram has amassed a loyal following of millions of Gen Z and millennials who hang on his every word and trust his recommendations to improve their skin. And unlike many other skin care influencers, his tips and reviews are based on real science. So who is Hyram, and how did he become such a giant in the world of skin care? On this episode, we get answers. He shares with us his story, why he’s on a mission to help young people with their skin, and what skin care routine he regards as the perfect one. Please join me and skin care specialist Hyram as we reveal The Perfect Skin Care Routine for Young People.   Link: https://www.youtube.com/c/Hyram/featured

Tonight, you will be listening to Overcast’s Terms of Use and Privacy Policy. Narrated by Scott Elchison. Overcast Terms of Use and Privacy Policy Highlights * Word count: 3836 * Arbitration Agreement: No * Overcast Premium subscriptions automatically renew unless it is canceled at least 24 hours before the end of the current period * Users are solely responsible for maintaining the confidentiality of there Overcast account passwords * New Overcast accounts are created anonymously, without email addresses or passwords. * Users in the EU consent to have their data stored in the United States * No personal data is used to target Overcast’s ads except the categories of podcasts that you’re subscribed to, such as “Technology” or “Business” Support this podcast at — https://redcircle.com/ts-and-zzz/donations Advertising Inquiries: https://redcircle.com/brands

What you’ll learn in this episode: How Robert Lee Morris started as a self-taught jewelry designer and forged a path to the pinnacle of the fashion jewelry world. How galleries like Sculpture to Wear and Artwear helped promote studio jewelry. What it was like to be part of the 70s and 80s fashion scene. How Robert Lee Morris became a household name. Why the excess of the 80s led to the minimalism of the 90s.   How taste in jewelry has changed over the years.   About Robert Lee Morris: Robert Lee Morris is a fashion jewelry designer and sculptor, who attributes much of his inspiration to organic forms he admires in nature and to designing for an imaginary futuristic society. His designs have been made in gold, silver and bronze. He is known for his 24 carat matte gold plating and rich deep red copper and green patina. Robert has collaborated with many leading fashion designers, including Geoffrey Beene, Karl Lagerfeld, Kansai Yamamoto, Calvin Klein, Anne Klein, and Donna Karan. He was awarded the Coty Award in 1981 and the Geoffrey Beene Lifetime Achievement Award by the CFDA Awards in 2007. Robert was first discovered in 1971 by New York gallery owner Joan Sonnabend and first exhibited his work at her art jewelry outpost in the Plaza Hotel called Sculpture to Wear. Shortly after the closing of Sculpture to Wear in 1977, he opened the first iteration of Artwear Gallery. After relocating to SoHo in 1978, he gained new celebrity clientele, including Issey Miyake, Madonna, Cher, Bianca Jagger, Janet Jackson, Oprah Winfrey, among others.   About Lisa M. Berman*: Lisa M. Berman, is known as the Visionary Proprietor of the iconic gallery Sculpture to Wear, which was instrumental in launching the studio jewelry movement in the United States. Berman curates exhibitions and places collections into museums, as well as offering an eclectic array of art, jewelry and unique objects via her gallery to discerning collectors, media and art institutions, which have been featured in multiple films, television and publications. She is also the founder of Berman Arts Agency, Director of the Oropeza Sculpture Garden, the Official West Coast Representative of Robert Lee Morris’s Archives and the first Ambassador for ARTISTAR Jewels in the United States *No relation to host Sharon Berman Additional Resources: Facebook Instagram Robert Lee Morris: NYC Jewelry Week at Pratt institute Watch a video of Lisa M. Berman showcase her work with Robert Lee a Morris as she reviews some of his unforgettable pieces. Watch a video of this podcast on youtube Transcript COLLAR 1980, brass with verdigris patina. Sample for a KANSAI YAMAMOTO EVENT, one-of-a-kind. ROLLING MACHINE Collar, Sterling silver & brass,1974. One-of-a-kind. From RLM: “Yes! This is my favorite! Has incredible Providence...was one of my two signature pieces in the “SCULPTURES AS JEWELRY AS SCULPTURE” exhibition at the Boston ICA in 1974. LONG CUFF #6 1989, Cutout photo etched sheet metal created for DONNA KARAN. Resort collection,18k gold plate. One-of-a-kind. Lisa M. Berman, owner of Sculpture to Wear Gallery and West Coast dealer for the Robert Lee Morris archives.

What I learned from reading The Difference Between God and Larry Ellison: God Doesn't Think He's Larry Ellison by Mike Wilson.If you want to listen to the full episode you’ll need to upgrade to the Misfit feed. You will get access to every full episode. These episodes are available nowhere else. Upgrade now.Notes and quotes from Founders #127:You want to know what I think about Larry Ellison? Well, I suppose he had some private sort of greatness but he kept it to himself. He never gave himself away. He never gave anything away. He just left you a tip. He had a generous mind. I don’t suppose anybody ever had so many opinions, but he never believed in anything except Larry Ellison.  That was the way Ellison’s mind worked. He was like a search engine gone haywire. I asked Ellison how he had seen his adult life when he was a kid. What he thought was going to happen to him. “You mean did I anticipate becoming the fifth wealthiest person in the United States? No. This is all kind of surreal. I don’t even believe it. When I look around I say this must be something out of a dream.”  Ellison is the Charles Foster Kane of the technological age. He is bright, brash, optimistic, and immensely appealing, yet somehow incomplete.  He worked in the computer industry for several years but never had a job that suited what he saw as his superior intellectual gifts.  The stockholder who benefited the most from Oracle’s performance was Larry Ellison, exactly what he intended. Ellison started the company because he wanted to be his own boss. And he stayed in control throughout his tenure at Oracle always holding onto enough stock that his power and authority could never be seriously challenged.  To him there was no power greater than the human mind.  What Larry reminds me of is a truth that Benjamin Franklin hit on 250 years ago. He says his mind was much improved by all the reading he did. There were very tangible results in Benjamin Franklin’s life when people found his conversations more enjoyable because he was a more interesting person to talk to—that led him being able to raise money for his business. It helped him close sales. Larry Ellison is very much the same way. When hiring, Ellison valued intelligence more than experience. He often looked for unruly geniuses instead of solid, steady workers.  If he hadn’t made me rich, I’d probably hate him because he is obnoxious. He is not nice to people.  He was capable of chilling selfishness and inspiring generosity. He could dazzle people with his insights and madden them with his lies. He was a fundamentally shy man who could delight audiences with his colorful speeches. He was known for his healthy ego and often seemed deeply insecure. Many people learned to accept Ellison’s contradictory nature.  In 1970 sales of packaged computer programs amounted to only $70 million for the entire year.  There is a book called The HP Way. I did a podcast on it (Founders #29)  The Oracle Way was simply to win. How that goal was achieved was secondary.  Ellison’s [early] life left a lot to be desired. He was never very happy with the humdrum facts of his life so he changed them. Beginning when he was a child, and continuing into his days in the Forbes 400, Ellison lived partly in a world of his own invention.  He wasn’t going to be smothered by the dreary circumstances of his life. He was going to leap over them. Larry reads a lot of biographies. One person he admired the most was Winston Churchill. He had a lot in common with Churchill. Both were mediocre students. Both desperately sought the approval of their fathers to no avail. And both were witty, insatiably curious, and charming when it suited them. Reading about Churchill reassured him that even ‘gods have moments of insecurity.’  A description of Larry in his mid twenties: Ellison was extremely hard on himself. He had a mental image of where he should be and what he should be and he was not able to attain it.  He has incredible intelligence and he applies it with incredible intensity.  The subject he liked best was himself. He was forever telling people how wonderful he was, how smart he was, and how rich he was going to be.  For Ellison, Oracle was a holy mission.  There was a problem. A sheet rock wall stood between the offices and the computer room. Scott said, “Larry, we need to hook up these terminals. How are we going to hook them up?” “I'll show you how.” Ellison replied. He grabbed a hammer and smashed a hole through the wall. Bruce Scott came to believe that Ellison's entire business philosophy could be summed up in that single act. Find a way or make one. Just do it. Ellison could not have dreamed up a more amiable and helpful competitor than IBM. Think of the marketing of relational technology as a race, with Ellison and IBM as two of the main entrants. IBM taught Ellison to walk, bought him a pair of track shoes, trained him as a sprinter, and then gave him a big head start. How could he lose?  He was practicing. He was working. He knew there was a problem and he fixed it. The idea that somebody else might take away Oracle's business was poison to Ellison. He understood the importance of locking up a large share of the market early. “How much does it cost Pepsi to get one half of a percent of the market from Coke once the market has been established?” he once asked rhetorically. “It's very expensive. This market is being established. If we don't run as hard as we can, as fast as we can, and then do it again twice as fast, it’ll be cost prohibitive for us to increase market share.”  Larry put marketing first and everything else second. Average technology and good marketing beat good technology and average marketing every day.  My view is that there are only a handful of things that are really important and you should devote all of your time to those things and forget everything else.  I was not terribly forgiving of mediocrity. I was completely intolerant of a lack of effort. And I was fairly brutal in the way I expressed myself.  Kobe Bryant: I had issues or problems with the people who don’t demand excellence from themselves. I won’t tolerate that.  The guy that was in charge of Oracle’s advertising in the early days of the company: My ads attack like a pack of speed crazed wolverines and have the same general effect on your competition that a full moon does on a werewolf.  Larry fundamentally believed that his company was going to be more important than IBM. You can’t imagine how far fetched those ideas sounded. He would say he was here to become the largest software company in the world. People were taken aback.  Larry goes against consensus. Every single one of his advisors told him sell equity, sell equity, sell equity. And Larry just had a fundamental belief that that would be a mistake because the equity is going to be worth a lot more in the future.  There are only two kinds of people in the world to Larry. Those who are on his team and those who are his enemies. There is no middle ground.  Even when he was feeling his worst Ellison remained an optimist. A man who couldn’t help looking forward. He lived in the future.  He was terrified he would fail, confirming his father’s dark predictions about him. There was a note in his voice that you didn’t usually hear with him—just scared, worried.  I am very competitive, and sometimes, when somebody does something really great, I get upset because I just feel like that isn’t me. And my reaction to Steve [Jobs] wasn’t competitive at all. I felt what he had done was so wonderful, and I was so proud of him, and I love him so much, it was almost as if I had done it. I didn’t feel the least bit competitive. The wonderful thing about loving somebody else is that it can expand your ego in the best sense. If they do something great, you feel terrific about it.  The only things that are important in our lives are love and work. Not necessarily in that order. We work because work is an act of creation. We identify with it. Both love and work conspire to deliver some kind of happiness. If we can get reasonably good at both of them, we are in really great shape.  He’s got the same problem the rest of us have. He has to engage in an enlightened pursuit of happiness. To figure out what makes him happy. Human beings are builders. He is going to have to find something he really wants to build. He is going to have to have some idea and create something out of that idea. If you want to listen to the full episode you’ll need to upgrade to the Misfit feed. You will get access to every full episode. These episodes are available nowhere else. Upgrade now.

LIVE on the Sport Physiotherapy Canada Facebook Page, I welcome Dr. Christian Barton on the show to preview his lecture for the Third World Congress of Sports Physical Therapy in Vancouver, Canada.  Dr Christian Barton is a physiotherapist who graduated with first class Honours from Charles Sturt University in 2005, and completed his PhD focusing on Patellofemoral Pain, Biomechanics and Foot Orthoses in 2010. Dr Barton’s broad research disciplines are biomechanics, running-related injury, knee pathology, tendinopathy, and rehabilitation, with a particular focus on research translation.  Dr Barton has published over 40 papers in Sports Medicine, Rehabilitation and Biomechanics journals, and he is an Associate Editor for the British Journal of Sports Medicine. In this episode, we discuss: -The inspiration behind TREK Education -Different mediums that facilitate knowledge translation from researchers to clinicians and patients -Common misconceptions around running and injury prevention -The good and bad surrounding social media and knowledge translation -And so much more!   Resources: Third World Congress of Sports Physical Therapy Christian Barton Twitter La Trobe University Sport and Exercise Medicine Research Blog Switch TREK Facebook Group Made to Stick TREK Education Website   For more information on Christian: Dr. Christian Barton, APAM, is both a researcher and clinician treating sports and musculoskeletal patients in Melbourne. He is a postdoctoral research fellow and the Communications Manager at the La Trobe Sport and Exercise Medicine Research Centre. Christian’s research is focussed on the knee, running injuries and knowledge translation including the use of digital technologies. He has written and contributed to a multitude of peer-reviewed publications and is a regular invited speaker both in Australia and internationally. He also runs courses on patellofermoral pain and running injury management in Australia, the United Kingdom and Scandinavia. He is on the board of the Victorian branch of the Musculoskeletal Physiotherapy Association, and a guest lecturer at La Trobe University and the University of Melbourne. Christian is currently studying a Master of Communication, focussing on journalism innovation. He is an Associate Editor and Deputy Social Media Editor at the British Journal of Sports Medicine, as well as Associate Editor at Physical Therapy in Sport.   Read the full transcript below: Karen Litzy:                   00:00                Hey everybody, welcome to our live broadcast. I'm just going to take a look quickly on my phone to make sure that we are in fact live, which I think we are. Yes. Great. All right, so we're live, which is awesome. All right, so thanks to people who are already on and thank you to my guest, Christian Barton, coming all the way in from Australia. So it is my times as you're watching this. It's 9:30 New York time. So Christian, what time is it in Australia right now? Christian Barton:           00:37                11:30 in the morning. That's quite a nice time to do this. Karen Litzy:                   00:43                Yeah. So we're doing this over two different days, so Tuesday for me and Wednesday for you. So crazy. But anyway, thanks for taking the time out to come on to chat with us. So for all the people who are on right now and for as we go through, if you have questions, you can type them in the comments, we can see them and we'll be able to address them as we go along. But before we get started, Christian, what I would love for you to do is just to tell the viewers and the listeners a little bit more about you and how you got to where you are now. Christian Barton:           01:18                Yeah, sure. So I'm a physiotherapist by background have been for nearly 15 years now. So it's getting on. I've always had an interest in research and clinical practice and continuing to try and juggle the two. And that probably started from the very beginning. I finished my undergrad course and well tried to find a position to do some research assistant work on clinical trials and things like that. And quickly my mentors taught me to do your PhD and actually started that about a year and a half out. And so I did that quite early in my career and probably since then I've been probably a mix of half, half clinic and research. So along the way, probably as I've gone through more recently doing more and more research because it gets harder to keep the research, you can do bigger picture things, which is something I've become really passionate about and I'll talk more about later. Christian Barton:           02:05                And so currently I work three main roles. One is my own clinic in Melbourne, which is a sports and an injury clinic. And we work one day a week there and then also work at the Trobe university three days a week. And my main research focus areas around there it's translation and implementation. And then the past couple of years have been doing one day a week with a surgical group. So the Department of Surgery, it's in Newton's hospital in Melbourne and there big project or area of research is around preventing inappropriate surgery. So that aligns very well with what I do of trying to optimize what we do as therapists to prevent unnecessary or inappropriate surgery as we go along. Karen Litzy:                   02:44                Yes. Fantastic. Busy weeks. You have busy weeks. Christian Barton:           02:48                Yeah, I work alongside the three kids at home and yet it's not, not the easiest to juggle at times, but it's certainly all things that I enjoy. Karen Litzy:                   02:55                Yeah, that's amazing. And every time all the interviews ever had with all of the speakers who are coming to Vancouver in October, all do so much. But we didn't do one time is just have an interview on how you manage your time. But that's for another interview. But I think people would really enjoy that. So now let's talk a little bit more about physiotherapy. So why this field? Christian Barton:           03:23                Yeah, I think as a kid I was always active, playing a lot of sports and had a few injuries myself. And I think I always valued the physios guidance about getting back from some of those injuries. So that got me interested in the field and then you go to university, you actually realize physio has a lot more than just train sports injuries. And you need to have to think about pulmonary rehab and cardiac rehab and you're electrical physio. There's a whole range in spectrum that we through. But I think pretty quickly when I come out I would want it to go back to musculoskeletal and sports. And so we went back down that path. And I think what I enjoy about being a physio therapist is just keeping people active. That's your more sedentary person, where you're trying to motivate them through lifestyle changes to get active and manage their persistent knee pain or back pain or whether it's a really elite sports person. I really enjoy trying to get people to achieve their physical activity goals essentially is what I'm enjoying. Karen Litzy:                   04:18                Awesome. And now I can see more and more people joining you. Again, if you're joining, please write like where you’re watching from and if you have any questions, put them in the comments because we'll be talked with, you know, so now let's, you had mentioned this earlier, talking about kind of what you do, part of what you do and you're involved in several knowledge translation initiatives. One of them being the trek group, which I remember I guess it was last year after sports congress and we all changed our social media to the trek elephants logo, which was really great. So this is a nonprofit initiative created to enhance knowledge translation to healthcare professionals, but also to patients and general public. So can you tell us a little bit more about trek and how it all started? Christian Barton:           05:13                Yeah, sure. Also I think my research journeys being quite interesting. When I first started off doing research, I was in a gait clinic doing biomechanics research and I've always found that side of our practice really interesting. And you do this real integral research and you spend a long time for assessing data and finally end up with maybe a couple of things that you can share in the community and they share them. And then I started doing more clinical based research and trials. Firstly looking at biomechanics and then did you that exercise interventions. Very early on I actually worked on a lot of systematic reviews and my passion for doing that was, well we have all this great body of research, we need to bring it together so we can disseminate a little bit better. And then I actually did a project in London where it was actually looking at clinical reasoning of physical therapists and how they integrate evidence into their practice. Christian Barton:           05:59                And what I discovered really quickly is not only were people not using evidence based practice all that often when I actually talked to them about patellofemoral pain, which I'd spent the best part of seven or eight years researching, they've never read any of my papers, never read any of my research. And so it sort of made me reflect a little bit and go, well, why am I doing all this research? And it's not actually being translated into practice. And so I started to have a bit of a flipping all I did and instead of spending time in the lab alongside doing clinical trials, I started to focus a bit more time on actually getting information out there. And so have a good friend of mine, Michael Ratliffe who's based in Denmark and we often catch up and catch up at conferences. Christian Barton:           06:40                And actually one of the first times we spent a lot of time together was when I went to a Danish conference a number of years ago. It was actually after that conference, I was sitting down both quite frustrated, having a couple of Belgium beers talking about this problem and the acronym trek come up with just on a random occurrence sitting his kitchen table. I still remember it. It was like, how do we do this? We'd probably need to brand it with already and get people behind a movement and something happening. So trek stands for translating research evidence and knowledge. So it fits really nicely with that. It actually has more meetings in that. And if you look at English language for trek, it means a long and arduous journey, which I think an old translation very much use when you try and actually make change. And then it also fits with Christian Barton:           07:22                probably one of my favorite books I've ever read, which is called switch, which is how to make change when change is hard. I highly recommend people read this book. It changed my life. And it's a really simple analogy. You have a rider sitting on an elephant and you need to get to a destination. So there's three main parts to that. The rider needs to know where to go. The elephant needs to be motivated because it doesn't matter if the writer tells them how often to go. It's not going to go anywhere to be big beast. Right? Christian Barton:           07:48                We also need an appropriate pathway to get there. So if you picture yourself as an elephant rider on an elephant and an elephant in the middle of the jungle, we want to get to the beach. There's no path to get to the beach and it doesn't matter, you're not going to get there. So the concept of trek is that we have clinicians, we have patients searching for health information who are all motivated to learn more and to do better. They don't really know where to find that information and they certainly don’t know appropriate path to get there. So the idea of trek is to try and improve that. So that sort of started as an idea about how we do this. And then we've, I guess talking and trying to work with lots of people. It's been set up as a not for profit. Christian Barton:           08:25                So it's not meant to be owned by anyone. No one's meant to profit from it. It's trying to bring everyone together and break down the silos of competition between universities because universities don't like to talk to each other and help each other because they're in competition for the same grants and that they might be buried. The knowledge translation. So it's been really important to me from the beginning that yes, we'll try here where I work supports it. But it's not meant to be owned by the tribe. It's not meant to be by myself. It's meant to be everyone seeing. And it comes from a socialist I guess, concept called connective action where we actually, it's basically a meeting which we connect people with the same ideas. And then I did a communications degree and was focusing on journalism and multimedia and social media and writing a whole bunch of stuff around that. Christian Barton:           09:10                And I thought, well, this is a nice platform to use. I think about not just mainstream media, but also social media or whatever people turn. And then our favorite thing, doctor Google, where most people turn to health information. And when you start looking at doctor Google, it's a pretty broken system with a lot of misinformation. And so the concept and my hope is that in time, this trek movement or trek concept could maybe be something that we can't take over with Dr Google, but we can certainly contribute to the information that people find on doctor Google. And so it's getting people around the world to contribute information but create it in an engaging format that will actually get people to rate it and use it. We know there's lots of barriers to reading research for clinicians, understanding your research their reading, but also it's time. Christian Barton:           09:53                And if you can consume the same information sitting on a train, listening to a podcast or looking at a brief video or infographic that maybe gives you the key information from some research and you can trust that source, that it's not biased, it doesn't have an agenda, then that means you can be confident that you can bring that into clinical practice. And for a consumer or a patient that gets that information, they can maybe make health decisions based on that as well. So that was kind of the origins of the project and it's still growing and developing. A lot of people were helped along the way and hopefully we'll get more as well. Karen Litzy:                   10:24                And what has been, so this sort of launched last year, right? Like officially launched. So what metrics have you found from launching last year to where you are now? Christian Barton:           10:39                Yeah, so what I did is actually was lucky enough to get a small grant from the Australian physio association to build a platform to improve physiotherapists knowledge of exercise prescription. And so we did a study last year where we basically built a website, which is exercise.trekeducation.org and before we gave access to everybody, we made them do a test, which is about 20 minutes. And so I have this great data for grants. It's linked with your physios. You've still need to sit down and write up and we see big variations  of knowledge of exercise prescription. And we kind of expected, our hope was that we could then test the evaluate, right? This website helped to improve people's knowledge. Now out of 1,600, I think about a hundred filled in that follow up survey or questionnaire rate. But it was at least as the grant gave us the funding to build a platform. Christian Barton:           11:26                And it's a multisite platform. So since this time we've built a website now for many patellofemoral pain, which is a big area of mine for clinicians. We've actually just finishing up a low back pain site and a knee osteoarthritis sites. So by the time the conference is around, we will have launched them and be available and working with some other researchers to make a shoulder side. So think of all the big musculoskeletal conditions with variables. And we've also been developing platforms, consumer patients as well. And so we have one which a PhD student in new idea, Olivia or Silva has been working with me for the last two years and we did a super little trial looking to see how beneficial that might be by itself. And then in conjunction with physiotherapy intervention. And certainly the website by itself is incredibly helpful for improving patient's knowledge and self management strategies, their confidence in doing things. Christian Barton:           12:17                And it seems to lead to reasonable clinical outcomes as well by itself, but probably better outcomes if we combine it with physio. And we haven't done what to evaluation yet, but we're hoping that we can start to do that more and more as we go along. And most importantly, just have some quality resources that are free. You don't have to pay for it, just there, you can use them. And it's been nice to see the exercise site. And certainly the one with the value at the moment. There's plans to do this as well, but they've been embedded into teaching curriculum as well, which has been really good. So University here at La Trobe is using them, but other universities around the world have also used bits and pieces of content and that's the idea of it is to write and use it all way pointless multiple people around the world creating the same content when we could work, maybe be better together. Karen Litzy:                   13:06                No, that makes a lot of sense. And now you're sort of like you said in the beginning, sort of doing a little bit of both your research and clinician. So why are we, in your opinion, why is it so important to bridge that gap between research and clinical practice? Christian Barton:           13:23                Yeah, I think from, if I put not my research hat that my clinician hat on and I think about our physiotherapy profession, I think we have some amazing physios around. We do really, really good job. We have others who are very good physios that are working really hard to continue to improve knowledge. We have a lot of practice that I would also consider as pretty low value care and sometimes iatrogenic care where actually maybe delivering health education and information is actually detrimental to the patient. And so I think collectively we need to work really hard to establish our brand better and better because we can do better. And a big part of that is actually making sure that what we do know to be beneficial for patients all around the world is actually disseminated into the hands of people who can use it. And that's a big part of that is physios and other health professionals. So that's the big passion for trying to change it. And I see in my clinic second and third opinions and sometimes it's just the patient hasn't been motivated, haven't done the things that I need to do that have actually been given really good guidance. But equally we see cases where they've seen multiple health professionals and just the treatments and information being given is just not aligned with what we know of contemporary knowledge around evidence about what should help that person Karen Litzy:                   14:36                As physio therapists, what do you think we're doing really well and were doing right and what do you think we need a little bit of hopefully they’re not doing wrong. But what they just need a little boost. Christian Barton:           14:57                Yeah, it's a good good question. I think in the most part physio practice and physical therapy practice is moving towards more active management and there's lots of debates on Twitter and social media and people argue about the value or lack of value, whichever side to sit on about manual therapy and things like that. But I think overall we are moving to more active management approaches. We are moving more towards managing the pain science side of things and educating patients better about that. And I think that's probably what we're not doing very well is building that brand of what we deliver. And as a couple of hours to that one is I guess getting collective way across the board that we're all on the same page and delivering similar high value interventions. And what that means is some patients will go to see for therapists or physiotherapists, then they maybe get delivered a lot of electrotherapy or something else and they don't get better in a long time. And then they go back to their doctor or their surgeon and say, oh, I did PT, I did physio. It didn't help. Karen Litzy:                   15:54                Yeah, yeah. Failed PT. Christian Barton:           15:57                It failed. And I think that's something that drives me a little crazy is you don’t fail that profession, you fail an intervention. It's a lot of inappropriate surgeries and other treatments. I think collectively we need to be more on the same page, but that's something the knowledge translation probably helps with a lot. The other part that I think we do very, very poorly and actually worked with Rob Brightly, he's going to be presenting the conference and that is collecting outcome measures. So we don't actually measure what we do very well. We occasionally measured them and this is the same around the world for compensable patients because we're forced to. But if you were to audit most people's clinical practice and say, can you show me that what you do is truly valuable, it's worth something. Christian Barton:           16:48                Most physio practices won't be able to. And I reflect on myself and I can't do this very well. So we need to get better at measuring the value of what we do. So we can take that information to funders and say, hey, we are actually worth something in what we do is worth something. And so I think that's a cultural thing and it's a systems thing and I think it's something we collectively maybe need to work pretty hard to, to try and change. And certainly locally I'm trying to work with the Australian physio association here and it started to come up with some processes that you can, we might do that and knowledge translation. One of the projects I've enjoyed the most here in Australia is a program called GLA:D. I'm going to talk to Ewa recently and that will be certainly discussed at the conference in the biggest strengths of GLA:D isn't it aligns with clinical practice guidelines. Christian Barton:           17:34                That's education and exercise. So I'll bring that standard up across the board. So first to trust that when they send someone to the program they will get exercise with education and it also raises the outcomes related to that as well. So it can turn around and we have some great data in Australia which were yet to publish, but it certainly shows from now data that not only does pain improve, which is something that may or may not be the most often, but also changes things like medication and also changes things like surgical intention. So people may believe I need surgery or going down the line to surgery. Am I saying certainly in Australia that less people are desiring that. But we look at that in GLA:D that's great here. But the rest of  physio practice so you have nothing to contemplate. Suddenly we need to work. You don't run out. Karen Litzy:                   18:19                Yeah. And I know the APTA here in the United States does have an outcomes registry that they started I think maybe a couple of years ago, maybe two years ago is starting to collect that data so that we can take it at least here in the US to insurance companies to show that what we do is valuable and that what we do should be reimbursed. Christian Barton:           18:42                Do people contribute to it, do the people actually give data? Karen Litzy:                   18:51                I don't know the answer to that question cause it is voluntary. So I don't know the answer to that question at the moment. But I would assume some people do, but do the 300,000 physical therapists that work in the United States? No, but hopefully it's something that will grow over maybe the next, I mean it's slow. Right? So it may take like a decade plus to kind of, if we're being realistic. Right? If someone were to audit my books so to speak, I dunno. I can certainly show that. I don't know. I don't know. That's something I need to get better at, so I'm calling myself out, I guess. And it's something that I certainly need to do better at myself. Karen Litzy:                   19:52                So let's talk about your experience as a researcher. So we'll move from kind of the clinical dissemination to do you have any tips for, let's say, new and upcoming researchers or even physio therapy students who maybe want to go into the research track to kind of help maximize their potential for reach and for knowledge dissemination? So, you are the researcher, you're doing great work and then what? It doesn't get to where it needs to go. So what tips would you give to people to help with that dissemination? Christian Barton:           20:37                Yeah, sure. So we put together a paper, which was just recently published in BJSM, trying to remember the exact title, but it's time. I think it's something along the lines of it's time for a place, publish or perish. We've got vanished. Yeah. So we have this in research that if you don't publish your work, then obviously there's no record of you doing it. But also you can't give credibility to your work in peer review processes. Very important to doing that. When we go for job promotions and we got the scholarship, for example, to do a PhD or whatever it might be, they're a competitive process and people look at metrics and one of the key metrics is really simple is how many papers have you published? What journals are they publishing? So it's really hard to get away from that. But ultimately, as we've discussed, that doesn't put the knowledge into the end users hands. Christian Barton:           21:23                And what happens is we end up with commercial companies selling pharmaceuticals and nutraceuticals and surgical interventions. That can be, I guess maximize money. And even pay teams event and for that matter. And so therefore the researchers, good knowledge doesn't get there. And maybe in health information that if news information gets cut through to clinicians and to patients, so you simply have to allocate some time to do it and you have to be quite aware and understanding that that might mean that you take a little bit of a heat on your academic gap or from a publication perspective because when they have so much time in the day. So that's a thing. It's just having that expectation that you can't do it all. That's really important. Spending some time on it. But in saying that it's not a ton of extra time to, after you publish a great RCT that was part of a PhD or whatever it might be, to spend some time with your media team at the university, put out a press release about that RCT and what the implications might be, which there may be ways from a radio interview or getting picked up in papers. Christian Barton:           22:27                And so that's not a lot of extra work on top of maybe two or three years of the study even. Right. I think linking in with me, your teams at different universities is a really good starting point if you can. Then we have the social media world, and the social media world as a challenging one because there's a lot of strong and loud voices on there. Some of them are good, strong amount, Sometimes there's misinformation from those strong loud voices. And so you're going into competition for the microphone essentially on social media to do that. And you can get on and you can have debates and arguments and discussions and conversations about your research that you've done. But ultimately the people who disseminating, interpret that are the ones with the loudest voice and that's kind of, you can lose your information, which is a bit of a frustrating thing. Christian Barton:           23:12                So yeah, so people get very frustrated about that when they've spent two or three years doing some research and then it gets misinterpreted by someone on social media who's got the microphone. So there's a few options around that. I think one of them is either creating a skill yourself or working with someone who has the skills to create knowledge translation resources. So we know from research that we've done and certainly evaluation of this is that the general consumer and that consumer can be the coalition or it can be the patient won't engage with your article, but they are likely to engage with your article but they are likely to engage with an infographic or an animation video. And so spending some time and effort on creating those types of resources to summarize your research findings is probably time and money well spent. So I'd strongly encourage people to price some emphasis on that. Christian Barton:           24:04                And then you've got an asset on social media, and if you already have a big following on social media, you have to be the one that shares that asset because you've created the asset. So you've controlled the narrative of what goes into that asset and the key messages. You can then leverage the people. We do have a market friend and hopefully they can then share for you, et Cetera. We help with so you can spend your time arguing with the people, misinterpreting your work on Twitter or you can spend your time maybe creating some of resources. And I guess the concept of trek is to try and create resources with those types of things can be embedded into a web page. So if you've done research on my back pain and it's game changing research, then those knowledge translation resources can be put onto a platform on trek. Karen Litzy:                   24:50                Yeah. Great Advice. Anything else? So we've got getting to know the media team at your university to release a press release, which is huge because that can lead to other opportunities. And knowing how to either get your original research onto an infographic or an info video or a podcast, and then use that as your vehicle via social media, attaching that to some social media influencers, if you will in order to kind of get that out there. But I definitely think that's much better advice than banging your head against the wall and arguing with loud voices. Christian Barton:           25:34                Yeah, exactly. Probably the other advice, if you go back a step in terms of designing search, it's probably really important and this hasn't been done well, but you engage the end user from the beginning. So going back a step and when you're designing your clinical trial, no good designing an intervention that no patient is going to engage or to use. So you might design an exercise program that you think is amazing and it's fantastic, but actually when the patients in the trial do it because they in a clinical trial, but then you go into the real world, It's too challenging for them to do. It's just too difficult. And therefore you're going to get criticized for your intervention that isn't clinically applicable. You want to cop that criticism in that design phase and people say, this is not clinically applicable. This won't work. Because then you've got time to redevelop on it and evaluating it and then realizing it won't cut through. So that's, yeah, I will probably important thing to think about. So when we talk about engaging the end user, particularly patients as the end user, but also clinicians as well, and getting their input because they're all going to be the ones delivering yet. And just to some extent, funders, they're a little harder to talk to. Karen Litzy:                   26:45                Yeah. Yeah. A little bit easier to get in with the patients or your fellow colleagues, hopefully. And now earlier you had mentioned that you have done research into topics such as patellofemoral pain. We also know that you do research in running injuries, obviously knowledge translation. So let's talk about kind of some common misconceptions around, we'll take running injury prevention and management, right. Cause these misconceptions come about because of poor dissemination of information I think is one aspect of it. So what would you say are some common misconceptions around running and injury prevention? Christian Barton:           27:32                Yeah. So we can go into lots of areas here. Karen Litzy:                   27:35                No, it’s a lot of branches. Christian Barton:           27:37                Yeah. So let's stick to running because it's a popular thing again. Everyone likes to manage runners and treat runners and not a lot of people like to run themselves. We actually put an infographic series out on our trek website. So James Alexander who is a master student environment moment putting together a series and we have the graphics and there's a few key ones for running injury prevention. One being stretching helps. And so that's something that has long been ingrained in people's beliefs that why you’re getting injured is that you haven’t stretched enough then stretching doesn't actually help us prevent injury. So it's not that it's a bad thing necessarily, although there is some evidence that stretching might impair muscle function, might actually reduce your ability to have muscle function but certainly it doesn't prevent injury. Christian Barton:           28:31                So focusing on that as the problem is probably not the answer. Footwear often gets blamed for injuries, prevention and also as though the key focus. Now typically most of the times if you changed before where yes, it could definitely cause the injury drastic change, but a lot of times it's not the fault of a footwear. Someone buys a new pair of shoes, but they also decide they want to get fit and lose weight at the same time. And they go out and they overload and they train too much. Karen Litzy:                   29:01                Yeah. So those things kind of do overlap cause you get motivated, you go out and buy the new shoes and then you blame the shoes and not so much the amount of load that you just put through your body that you haven't put through your body in months or years. Christian Barton:           29:14                Exactly. This is not the shoes that are important because they will moderate where the loads go can to some extent. But I think we get very obsessed and part of that comes back to who controls information that gets out there. And it's shoe  companies, right? They sell shoes. There's all these motion control technology that shock absorption technologies. And so that's a big marketing campaign and that changes what people buy. And what I will say, it's a big problem. People have that answer. And then we have big pushes about minimalist shoes and they're the answer to everything. And in reality it's probably going to be very variable across different people in it. People with running shoes, all their life will be taken into women's shoe. That's a big change. So that will probably injure them. So yeah, might help. They need, they might get some acuities buying. Christian Barton:           29:59                It might help their heel pain or forefoot stress fracture. So again, just that big emphasis on footwear and often because it's a commercial and marketable thing is offering the way what happens? I always love the example of Australia by a guy called cliff young. So some people are watching may know him, but those who don't, he actually run the first ever Sydney to Melbourne ultra marathon. So that's 800 kilometers or so. And one of our quite a few hours now, cause John did most of his training in numbers. He used to run two or three hours on his farm every day chasing sheep in Gum boots. So Wellington boots, clearly he didn't have any significant injuries. Right. And I have some great footage that I take when I teach my running course. That's some great footage of me doing that. And that's not to say everyone should go out and run in gumboots. Christian Barton:           30:46                But certainly for him he was doing it his whole life. So he's adapted to doing that. And if you're adapted to doing something, don’t change it, right? Maybe maybe you might modify footwear to reduce the weight because that we know that helps with performance, but beyond that we don't really have a lot of good evidence that changes footwear will help with injury or performance or anything like that. So my philosophy mostly before where it ain't broke, don't fix it. But there are some nuances around some biomechanical considerations depending on what you want to try and change. But that's probably a couple of the key points of stretching and in footwear and the importance we place on them. I think it's probably more important to get our training loads right. And probably also thinking about, and these are my biases and there's not strong science on this, but doing a resistance training program might be more beneficial for preventing injury. We could do more loading with our muscles and tissues without that impact. And so that's possibly beneficial. And we do see some evidence that may be doing a resistance training program helps with performance as well. And most people get down because they're trying to run personal best times or beat their friends or whatever it might be. So rather than smashing yourself more and more on the training track, maybe get in the gym and do some resistance training would be my advice. Karen Litzy:                   31:57                Great. All right. Now, we're gonna shift gears just a little bit here. So the next question is what is or are the most common question or questions, I'll put an s on there that you get asked. And this could be by researchers, clinicians, patients, maybe you've got one for each. I don't know. What are the most common questions you get asked? Christian Barton:           32:28                Yeah, so I'll start with researchers. So academics, you sort of touched on this a little bit before, but it's often around how to dedicate time and make knowledge translation, but not just that. So creating the resources we've talked about before, but how to navigate media or platforms like Twitter, like you get on Twitter and someone's attacking your research and let me see, interpret it. Or you get on Twitter and you put something out there and someone gets offended and that's a problem as well. And so it's actually, it's very difficult on social media because when you're typing things and writing things in, emotion gets taken out of things and people interpret emotions. So you might write something that has really no emotion attached to it, just a simple statement, right? But someone who thinks that you might be attacking them, we'll take that as an attack and then that creates a problem. Christian Barton:           33:19                All the time. And I know that I offend people at times because they tell me that I've offended them and that's what I really appreciate it at least it gives me a chance to reassure and go look. It's not meant to be offensive when used social media is a positive way of translating knowledge and then other people probably get offended and just don't talk to me anymore. Yeah, I think I've been blocked a couple of times. Christian Barton:           33:51                So my advice usually to people about Twitter is I think it's immediate that you can get a really good understanding about how part of the world is thinking. It's only a small part of the world. And then I think it's important to understand that that's the case. You're only getting a snapshot of some people and often it's people who have louder voices and want to go on talking, but it does give you some insight into that. And I think for me that frame some of my research questions and maybe modify as and move it and helps me narrow it down. It gives me a media where I can use assets that we've created to put them in hands of people who will disseminate them. So I think that's really, so sharing a good infographic or podcasts or video on that platform is one of the influential people there who hopefully then share your message. So I think it's important to have some presence there for that reason, but don't get emotional about it. If you feel like you're engaging in a circular conversation, you probably are engaging in circular conversation. You just stop, don’t keep going. Karen Litzy:                   34:48                Pull yourself out of it. Like I think often times what I see in those circular conversations is like somebody, it just seems like one of the parties within that conversation wants to win more than the other one. Or are they both really, really want to win. And so it's just like, I'm going to get the last word. No, you're going to know I am. No, I am. It goes back and forth and you just like, Christian Barton:           35:14                My advice in those situations, for someone who feels like they're in a circle of conversation, they're beating your head against the brick wall. Just step back for a little bit and just think why is this happening? Why is what I believe or what I think not being interpreted the same way. Right. And it might be that actually you discover your own biases and it might be that. And that's a good reflective thing. It's ok to change you mind and beliefs. That's a good thing. That's a positive thing. Or it might be that actually you don't have as much supporting evidence for what you believe in. And maybe that's because you need to do some better quality research to test your biases and maybe you discovered that actually you were wrong, or maybe you test your biases properly and you discover I was on the right track, so that's good. Yeah. You usually have to prove myself wrong more than I proved myself. Right. That's a good thing. Yeah. Or actually worse what's happening, it comes back to that communications is you're not disseminating your messages very well. So you're actually not providing an adequate messenger. You can sit back and think about that and don’t keep argue with that person. You think about some strategies to disseminate and put together a podcast or a video, or write a blog about the topic that has really good details where you've got more than a couple of hundred characters. Karen Litzy:                   36:30                Yeah, that is really useful. So, and sometimes in these kind of conversations, if you will, sometimes you can also just take the person and send them a direct message where you can write a novel if you want to do as a direct message. And I find that when you do that and you kind of can explain yourself a little bit better, it helps to kind of foster better communication and a better conversation. And oftentimes when it's in private, people are different. Christian Barton:           37:07                Yeah, that's great. And, taking the conversation off the social media platform is often a really good strategy too. Navigate and get over those miscommunications that can happen. Yeah. Karen Litzy:                   37:17                Yeah, I've done that before. Christian Barton:           37:20                That's really spread enemies. Right. And then probably the other advice I'll give to people when I've actually put a tweet about this I think earlier this year or late last year. It's just, I'll refer to them as trolls and I'll call them trolls in until they show their face. People who are on there who don't have a public face. So it's social media. So for me you should have the transparent profile and the reasons for that is you want to know where people come from and where their beliefs come from so you can understand their point of view. And if you can understand that point of view, it makes it a little bit easier to have discussions with. But there's probably people on Twitter who just set up their identify profiles just to kind of attack and stir the pot and it's just not worth engaging with those people's I used to try and have their fun with them and make a few jokes and I've done that a few times. If you'd be probably saying that like, so that's also a time wasting. So it's kind of entertaining, but it's also time wasting as well. So I think when you identify, communicates, asking you persistent questions and almost feels like you're having circular conversations just block that person. There's no, you don't know what their alterior motive is. You don't know what their conflicts of interest are. You don't know where they're coming from. Karen Litzy:                   38:28                Well, you don't even know who they are. Christian Barton:           38:31                Exactly. And so I don't think we should engage with those people. That's my first way. Most people won't like hearing that and they just keep creating new profiles. Right. Well that's okay. I never used to block anyone until six months ago, are quite a few people in racing time for that very reason. In short, if you get it, get into social media and you kind of, so you can learn from it and focus more on giving some quality content and having meaningful discussions rather than arguing. Yeah. Karen Litzy:                   39:01                Yeah. That's sort the idea of social media, especially when you're a professional, you want to be a professional because you're a professional and so, and the point of social media is to be social. Christian Barton:           39:20                Yep. I like that. Karen Litzy:                   39:21                You know, it's not to go on there and be antisocial and argumentative. You're there to be socially it's fine to debate. It's fine to disagree. But some of the things that people hear this all the time that you see on social media, you would never see that kind of an argument with people face to face. It just wouldn't happen. You know? So you have to remember to keep this social in the social media and not be like a maniac. Christian Barton:           39:52                I like that phrase. Keep the social in social media. Karen Litzy:                   39:54                Yeah. So if you could recommend one must read book or article, what would it be? Christian Barton:           40:02                Yeah, so I mentioned earlier about with the trek origins and the concept around that. So switch is probably my book. I think it's influenced my life the most from many respects. I think I gave a really brief, probably poor synopsis of it. It is the elephant, the rider and getting to the destination. But it just changes the way you think. And when you're trying to make a change, it gives you nice, simple way for you where your barriers are. So is it people don't know what they need to do? Is it about the emotion and motivation? There's lots of great analogies that examples within that that I think will kind of really inspire you to think about the rest of your work. Not just research it, it's not just clinical practice but how to change relationships with different people and things like that. So I think it's a really good book to read. I'll give you a second one as well. John Rockwood. Yeah, no, he's translation and dissemination is a book called made to stick and that's basically made to stick. So it's around how to make your messages stick. So that's a really nice book as well. So if you're trying to communicate more clearly, that will hopefully give you plenty of ideas and concepts to look out for. That'd be my to go or recommendations. Karen Litzy:                   41:12                Perfect. All right, now let's get to the conference. It is October 4th and fifth in Vancouver of this year, October 4th and fifth of this year. And can you give us a little bit of a sneak peek about what you'll be speaking about at the Third World Congress? Christian Barton:           41:32                Yeah, sure. So we've got a couple of presentations. One is actually in the session review, which I'm really looking forward to discussing with yourself and all around knowledge translation. And one of the things I want to talk about in that is how healthcare disinformation develops and spreads? Cause I think it's important we understand the mechanisms of that. And that also allows us an opportunity to understand how we can spread good information because we understand how, how can this disinformation grows and spreads. And hopefully that gives us some insight into how we can grow and spread the good quality information. And so we'll go through some of that and break down some of the things we've talked about around using I guess digital assets for knowledge translation in. One of the things I've actually really looking forward to talking a little bit more about is some of the outcomes from the research we've been doing, particularly around patients and finding them and what we can achieve through a good quality website. Christian Barton:           42:23                So we have a review at the moment, which is under peer review looking at patellofemoral literature and it doesn't just do a systematic review of patient education. It also looks at online information sources. Basically when we look at all of those is the vast majority of conflicts of interest, often financial conflicts of interest. There's a lot of missing information on there. And so for the person navigating that, that's really challenging for them. And we've done a lot of qualitative work with people with the patellofemoral pain. And then part of the new ways work I talked about before, we actually did reasonably if we needed to clinical trial where for a period of that trial all they had was a website that we developed for them. And we put multimedia and engaging resources with quality information and accurate information, simple exercise program that they could do. Christian Barton:           43:12                And so we're still pouring through the results and we'll have it done before the conference and I can see from the preliminary stuff was actually do really well by themselves with quality information. And certainly that then makes your life easier as a physio cause you don't have to fill in as many gaps. I can focus on adequate exercise prescription or clarifying some information and things like that. So it makes us more efficient. So yeah, really looking forward to talking about that in our session. And then the second session I'll be talking on is around exercise prescription and I think the title is beyond three sets of 10. And so I mentioned at the beginning my research started in the biomechanics lab and I used to think biomechanics, were the be all end all and I've probably changed my opinion on that over the years and very subtly, very slowly and I still think biomechanics matter, and exercise prescription around that can be important, but equally education alongside your exercise prescription to address things like Kinesiophobia and pain related fear or something that we find is a really important factor in managing people’s pain. Christian Barton:           44:19                So yeah, a huge barrier to actually getting engagement, but even getting, they might do exercise but they won't get as much out of it if you haven't tackled those fears and beliefs. We'll talk some of the research we've done in that space recently around how that can guide exercise prescription and some processes around that. And then I've had some fun almost on the other end of the spectrum where we've actually just got people in the gym and focus more on physiological responses and we just smashed it in with strength and power. And one in physical therapy in sport, which is just a feasibility study. Probably 10 people, people who we just put through a resistance training program of strength and power and the reason we did this study is when you look at all the patellofemoral literature, no one has done a program of adequate intensity of progression and duration. Christian Barton:           45:10                You would actually see any meaningful changes in strength and power despite the fact that a lot of them say that they do strength from your title when you actually look at their protocols are not true strength protocols. So we decided to just put great people through this program and just smashed them in to do. And they did better than I thought they would do. I was actually surprised. And so we'll talk about some of the findings and implications of that and how to put that into your clinical practice. And I think the whole idea for me is we have these programs that physios focus on around motor control and they often low dose exercise. Don't know what the education part alongside that done very well around pain, weighted fear and even exercises to tackle that. And simple great exposure. But equally we don't get the end stage stuff done very well. Actual really good progressive resistance training. Yeah. I think we get the middle part done well, but we kind of miss those two elements that's trying to bring all that together. So I'm looking forward to that where it’s not just three sets of 10 of hip abduction and knee extensions. Karen Litzy:                   46:11                Yeah, no, that sounds great. And, and I know that anyway, they'll probably be a lively discussion around that topic. I know here in the US, if people are using their insurance, they're often cut off before we would ever even remotely get that. Let's get you in the gym and really do it, you know, let's really kind of work and like you said, like smash it out, get them stronger, get them confidence and, and it's unfortunate, but that's the system that we have to play in and yeah. Christian Barton:           46:44                Well, we can put a link up to the paper on the Facebook group. It’s actually open access at the moment? It's appendix of all the exercises. I think they're really simple exercises which was kind of cool about. So we just, we really just pushed it straight away and we only went for 12 weeks. And that was purely from a feasibility perspective of yeah, it just costs money to do these projects over a long period of time. Yeah. But my bargain is that if we kept going and with the clinical hat on, they continue to improve, at least in terms of function. A whole different kettle of fish, but they can do more exercises, more progressive. We make it, the more they can do and wherever their pain usually reduces. But wherever it gets to the point where they're happy or not, at the conference we'll talk about that. Karen Litzy:                   47:29                Yeah. Sounds great. I look forward to it. And are there any presentations at the conference that you're particularly looking forward to? Christian Barton:           47:38                Yeah. So I think, and not just because I'm talking to you now, but looking forward to our presentation, not just from me talking but also hearing from yourself and rod and I, I think one of the things I've appreciated about knowledge translation and using social media experts, there's no person in the world that knows everything you guys had it through. Then over the years I've actually learned quite a bit from yourself with the podcasts and stuff you do and really enjoy some of yours. And I think I like the process and approach you've taken and I think you've been quite inspirational about how you can actually find a model where you can spend time doing it, which is really cool. I'm so looking forward to hearing more about that and maybe you have some good tips for me, but also Rob Whitely presenting in the same session. Christian Barton:           48:22                I really like the way rob thinks, he thinks very differently to most people. He's got my favorite Twitter profile picture that I've seen so enough. Those are not from Australia where I quite understand it, but there's a picture of a kid with his head down looking asleep. We've got ex Prime Minister Tony Abbott talking at the same time. So it's quite a funny picture. But he's, yeah, he's a bit eccentric, but also very clever for instance. The whole conference is really good with lots of, I think clinically focused presentations because everyone presenting going through it has a really strong clinical focus here in what they do. I think that's a real strength of it. The Saturday morning there'll be a couple of really good workshops I was looking at it yesterday and trying to work out knowing that you would ask this question where I want to go. Christian Barton:           49:13                And you've got that and it's allowing presentation with Ewa Roos, Christine, both of which have a huge respect for and I’ve learned a ton about exercise. And so I'm looking to that and saying what other things I could learn from my clinical practice. But at the same time, talk to you about upper limb, the same stuff. Now I see a few cases in shoulders. I don't see as many as Rollin, so it'd be great to learn some things from them, but also I liked to take knowledge from other areas and see how I can apply that to lower limb in my research and yeah. One interesting to do that, but I reckon I'm going to have an apology to those guys for saying that I won’t be able to make both. I'll have to make sure I send someone along. Karen Litzy:                   49:55                It’s going to be hard to choose, but you know, you'd take someone over, you have to divide and conquer. Exactly. You know, can you send someone with that? Yep. Need a team. Yeah, yeah, yeah. Over a beer or wine Karen Litzy:                   50:32                No, for me, like a small little glass of beer. That's right. Yeah. Thanks. Yeah, that's true. That's true. And you know, look at sports congress. This past year I did not have the flu. So drinking those like small little ones kept me awake. Christian Barton:           50:49                Good, good, good. Karen Litzy:                   50:51                I found like this sweet spot. Well Christian, thanks so much for coming on and giving your time. Thanks everyone for coming on and listening. And Christian, where can people get in touch with you? Where can they find you? They have questions or they want to give you some unsolicited feedback or arguing. Christian Barton:           51:26                Very happy, very happy with any feedback or questions. Probably easiest way to engage is probably on Twitter. So do you use Twitter a little bit for that? We also have a Facebook group for the trek exercise group. So if you look that up, I might put a link to that as well. So it's trek exercise group. And so that's not a bad medium to kind of start to engage with the trek initiative. And we'll actually use that to launch the back pain and also arthritis websites and I can put some links on there to the top from a website which we set up. And actually the other thing on that note, and I might put this on the Facebook page here as we have a course for anyone who's interested, it's a free online course learning how to critique randomized controlled trials. Christian Barton:           52:14                So basically it takes you through some modules about how you go back to taking them. Before that we kind of get your knowledge and confidence on your capacity to do that. Do the course and then you could take a few articles and then at the end of it there's a followup test to see how you go. There are actually some prizes as well. So at this point in time we've had I think over a hundred people sign up to this. But only around about 20 finished. Yeah, there are two $500 prize as far as with Australian dollar prize. So at the moment those 20 people will have finished it or, and we've a one in 10 chance we'd pop your dollars. Say I would suggest that you jump on board and have it for learning, but chances to win a prize Karen Litzy:                   52:51                This is 500 Australian dollars or US dollars. Christian Barton:           52:56                It’s about $350 US. So it's not as lucrative. It's not a small amount. So this is actually part of the, the trek project in collaboration at the University of Melbourne who established this. And so that's the sort of stuff that we're trying to do with trek is to put these types of resources out there and Yep. So hopefully we can get a few people on board back. Karen Litzy:                   53:21                Yeah. So you will try and put all the links. I'll find the links to books and everything that you had mentioned. Switch and make a stick and trek and we'll put them all in the comments here under this video. So that way people can click to them, and join the trek group and figure out how to get in touch with if you have any questions. So everyone, thanks for listening, Christian. Thank you so much. This was great, and I look forward to seeing you in Vancouver.   Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter, instagram  and facebook to stay updated on all of the latest!  Show your support for the show by leaving a rating and review on iTunes!

Can you imagine someone having to pretend to be the President of the United States? No, seriously, we’ll wait for you to stop laughing. We mean REAL ACTORS. After all, our presidents are among some of the most recognizable figures in American history. Whether they are heroes or scoundrels, they cast a large shadow. Put it this way: everyone can do a bad JFK impression, but how many people can do it well enough to be credible in a movie or TV show? (Answer: Not Greg Kinnear in “The Kennedys”)  This week we look at the people who got it right, whether their performance was carefully crafted homage or scathing satire. SHOW NOTES Daniel Day-Lewis as Abraham Lincoln in “Lincoln” (Joint Choice) Anthony Atamanuik as Donald Trump in “The President Show (Michael’s Choice) Edward Herrmann as FDR in “Annie” (Richard’s Choice) Robin Williams as Teddy Roosevelt in “Night at the Museum (Michael’s Choice) Phil Hartman as Bill Clinton on “Saturday Night Live” (Richard’s Choice) Paul Giamatti as John Adams in “John Adams” (Michael’s Choice) Harry Shearer as George H. W. Bush on “The Simpsons” (Richard’s Choice)

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