Podcasts about VVA

De afgelopen jaren zijn er grote veranderingen geweest in het huurrecht. In deze aflevering van onze VVA podcast nemen Maarten Blok en Tjeerd van Veen je mee in de belangrijkste ontwikkelingen rondom huurrecht voor woonruimte. Zij bespreken: De terugkeer van vaste huurcontracten als norm De regulering van huurprijzen in de middensector Mogelijkheden voor tijdelijke verhuur – wat mag nog wel? De rechten en plichten van huurders en verhuurders Wat te doen bij een verhuurder die zich niet aan de regels houdt?

ASX 200 slipped 11 points to 8201 (0.1%) in quiet trade. Eyes on the Middle East. Hong Kong markets rallied sharply after the holiday. China still closed. Banks steady again, CBA up 0.6% with MQG off 1.0% and the Big Bank Basket up to $232.39 (0.3%). Insurers slightly better as REITS slid, SCG down 1.9% and SGP off 0.8%. Healthcare gave back some recent gains, CSL down 0.4% and RMD falling 1.7%. Industrials weaker, WES off 2.3% and WOW and COL in a hole too. Tech wrecked with WTC off 1.7% and XRO down 2.5%. Travel companies in trouble, FLT down 2.4% and QAN dropping 2.7% on Virgin news. LNW still under pressure. Retail also easier. LOV off 1.1%. Resources once again the place to be, BHP up 0.9% and the Three Amigos all doing well. Lithium stocks finding friends too, PLS up 0.6% and LTR up 2.6%. Gold miners in demand, EVN up 0.2% and NST up 0.7%. Uranium stocks also in demand as were oil and gas stocks. WDS up 3.1% and KAR up 7.5%. In corporate news, NAM looks to be done and dusted as LDC gained over 50% control. ANZ lost its court case. VVA posted a positive outlook statement. Nothing on the economic front. Asian markets mixed, HK back and flying. Property index up 15% and Japan down 1.9%. 10-year yields steady at 3.96%.Why not sign up for a free trial? Get access to expert market insights and manage your investments with confidence. Ready to invest in yourself? Join the Marcus Today community. 

10.02.2024 - Die Vriende van Afrikaans (VVA) is 30 jaar oud. Luister gerus op 10 Februarie, wanneer Chareldine van der Merwe, projekbestuurder van die VVA, op Kopskuif gesels oor die VVA se drie dekades van stories. Geluk aan die VVA met hierdie mylpaal – die verskil wat daagliks landwyd gemaak word in die lewens van kinders wat die wonderwêreld van lees ontdek, is enorm.

Join us for our monthly benefits program. Our guests include: Veterans Radio's Carol Ann Fausone, Nurse and Retired Air Force Brig.General from Legal Help for Veterans and Sandie Wilson, Retired Army Nurse from the Vietnam Veterans of America. Sandie has recently returned from the VVA National Convention where she received the VVA Commendation Medal, The VVA's highest award for outstanding, exemplary service to Veterans and the community. She was also reelected as a National Director At-Large. And she is the Chair of the Agent Orange and Toxic Exposures Committee.

On this episode we spoke to Margarida Couto, executive director of VVA foundation and president of the board at Grace about Corporate social responsibility. Grab a coffee and be part of this conversation :)

This week, Bronson Pate is on with Charli to have a chat about his story. Bronson is the Global Fugitive Emissions Director, MagDrive Technologies, he has experience in the environmental field focused on air quality compliance inthe refining, petrochemical, and natural gas processing industries in the United States, China, Malaysia and Saudi Arabia. He has experience in fugitive emission source Leak Detection and Repair (LDAR) monitoring, tagging, and database management, including Process and Instrumentation Diagram (P&ID) review. Bronson is familiar with VV, VVa, GGG, GGGa, KKK, QQQ, MON, HON and worked with multiple facilities to develop LDAR programs including those subject to LDAR consent decree requirements. Bronson has is also one of Sage's LDAR Consent Decree (CD) and Comprehensive Environmental Assesment (CEA) Auditors. Bronson has also preformed Highly Reactive Volialte Organic Compound (HRVOC) audits for various facilities. Bronson is also familiar with certain provisions of the Benzene Waste Operations NESHAP (BWON) standard including required sampling, training and lab auditing. Bronson has also helped with Environmental Impact Statements (EIS) for oil and gas production companies. Bronson has also worked with the refining industry in Texas that have received a section 114 letter. Bronson has also worked with the refining industry in producing Spill Prevention, Control and Countermeasure Plan (SPCC). Bronson is also familiar with air permitting including MACT and Title V. Bronson also is one of HSE-U trainers for LDAR Essentials, Advanced LDAR and LDAR for Experts.Connect with Bronson on LinkedIn Read up at EmpweringPumps.com and stay tuned for more news about EPIC in Atlanta this November!Find us @EmpoweringPumps on Facebook, LinkedIn,  Instagram and Twitter and using the hashtag #EmpoweringIndustryPodcast or via email podcast@empoweringpumps.com 

The National Institutes of Health spends about $42 billion on medical research each year, but less than one-eighth of that money is spent specifically on women's health. That may come as a bit of a shock, given that women make up a majority – about 51% – of the population. This underserved market is a huge economic opportunity for med tech companies.That's what Holly Rockweiler discovered as a Fellow at the Stanford Byers Center for Bio Design. So she put her background in biomedical engineering to work and started Madorra Medical, developing solutions to improve the vaginal atrophy and dryness that women experience after menopause or breast cancer. Madorra's flagship product is a handheld home-use device that uses ultrasound to rekindle the body's natural moisture-producing capability. The FDA has granted it breakthrough device designation The first randomized trial has been published, and a second one is on the way, and the company is now working toward the next set of data. Here in Episode #24, Madorra CEO Holly Rockweiler and Andy Rodgers talk about how that data is helping to blaze new trails in women's health. Need to know: There was a commercial about menopause in this year's Super Bowl (Astellas Pharma). That simple fact signals a new era in women's health.  Fundraising can be the most difficult part of bringing a new product to market, and it never goes away. Investors want to know what data has been collected, what payer requirements are, and to see a clear path to market. Piggyback on existing data when you can. For Madorra, there was substantial literature and technology using ultrasound in other therapies, data on vaginal blood flow from sexual arousal studies, and existing ultrasound devices that could be modified to show proof of concept. The nitty-gritty:Vaginal dryness resulting from vulvovaginal atrophy (VVA) affects over half of post-menopausal women and is also common among breast cancer survivors due to treatments that cause estrogen levels to drop. Symptoms include soreness, irritation, pain, increased urinary tract and yeast infection rates, and pain with sexual intercourse. Today, the standard treatment for menopausal symptoms is estrogen therapy. But that comes with risks: breast cancer, heart attack, and stroke. The quandary for doctors and patients alike is whether the benefits of pharmaceutical treatment outweigh the risks. For some patients, the risks are too significant and estrogen therapy is not recommended.   By putting data to work, Madorra created an ultrasound solution that stimulates natural moisture production and eliminates these risks. Madorra's hand-held external device, used on regular basis for 8 minutes, has been producing significant results in 1 to 3 weeks.  The device is shaped to be intuitive as possible to fit naturally and is used with disposable proprietary hydrogel. Safety is always a key issue, and the wide variety of literature on ultrasound therapies – including the fact that it's used on pregnant women – has instilled confidence in patients and clinicians alike. Data that made the difference:Market data from the Stanford BioDesign program helped Rockweiler learn to do an analysis of unmet needs, stakeholders, and market dynamics before taking the big leap.An Institutional Review Board (IRB) feasibility study helped in initial development.Pre-existing data on ultrasound showed that ultrasound therapy in other uses improved blood flow to treated areas. This key finding indicated that it might work on thin friable vaginal tissue as well.Patient data revealed how the condition feels to patients and what they wanted in a product.Bench studies and computer simulations proved invaluable in prototyping.This story is not only compelling because of the ingenious device itself, but it also reveals a broader story about opportunities in the underserved market of women's health.Interesting links:https://www.madorra.com/https://www.ispot.tv/ad/1VAi/astellas-pharma-super-bowl-2023-whats-vms

Philip Pepe from Shaw and Partners and Mathan Somasundaram from Deep Data Analytics go in-depth and stock specific. Stocks covered: PMV, TLG, DUR, RFG, IHWL, ANN, ASX, TVL, VVA, ELD. Stock of the day is New Hope. Hosted on Acast. See acast.com/privacy for more information.

Asunnottomuutta käsittelevän podcast-sarjan viimeisessä osassa kuulla kokemusasiantuntijan tarina. Nimestä huolimatta tämän kertainen jakso ei sinänsä kerro asunnottomuudesta. Se pikemminkin alleviivaa punaista lankaa joka kahdessa aikaisemmassa jaksossa rakennettiin. Asunnottomuus ei ole vain ilmiö, jossa yksilöltä puuttuu katto pään päältä. Vaikka ympäristöministeriö vastaa rakennetusta ympäristöstä, asunnottomuuden ehkäisyyn vaaditaan kriittistä sosiaali- ja terveyspalveluiden tarkastelua ja pitkäjänteisempää tukitoimintaa, jotta ihminen sopeutuu uuteen elinympäristöön. Jakso on toteutettu yhteistyössä VVA ry:n kanssa.

Luke Winchester from Merewether Capital and Claude Walker from A Rich Life go in-depth and stock specific. Stocks covered: CMP, ALU, HZN, SEQ, CDM, XF1, CLZ, VVA, TLG, WLE. Our stock of the day is Genex Power (GNX). Hosted on Acast. See acast.com/privacy for more information.

Adam Dawes from Shaw & Partners and Karen Towle from Tribeca Investment Partners go in-depth and stock specific. Stocks covered: ABP, TAH, NAB, WDS, CSL, YAL, VVA, SCG, WPR, AIA. Our stock of the day is Magellan Financial Group (MFG). Hosted on Acast. See acast.com/privacy for more information.

Asunnottomuus vol. 2 jatkaa siitä mihin ykkösosassa jäätiin. Studioon saapui vieraaksi yli 30 vuotta asunnottomuuden parissa työskennellyt Jussi Lehtonen. Jussin taival alkoi 90-luvun Suomessa, jolloin asunnottomuus oli selkeästi karummalla tolalla. Vuosikymmenien saatossa Jussi on omakohtaisesti päässyt todistamaan kiistattomia kehitysaskeleita, joita ilmiön ehkäisyssä ollaan saavutettu. Samaan aikaan Jussi on kuitenkin myös päässyt todistamaan asunnottomuuden sukupuolittuneisuutta. Vuonna 2021 kaikista Suomen asunnottomista 77 % oli miehiä. Jussi painottaakin vuosikymmenien asiantuntijakokemuksellaan miesten syrjäytymisriskin tilaa suomalaisessa yhteiskunnassa. Jussin kanssa puhuimme asunnottomuudesta tasa-arvokysymyksenä: Mistä johtuu, että miehet ovat asunnottomien joukossa yliedustettuja? Miten asunnottomuus linkittyy syvemmin yhteiskunnan sukupuolikeskusteluun? Mitkä syrjäytymisen taustalla vaikuttavat rakenteet näkyvät myös asunnottomuusilmiössä? Jakso on toteutettu yhteistyössä VVA ry:n kanssa.

Mathan Somasundaram from Deep Data Analytics and Joshua Barker from Maqro Capital go in-depth and stock specific. Stocks covered: SCG, ANZ, EVN, KGN, STA, TPW, EV1, VVA, PDN and TCL. Our sector of the day is oil. Hosted on Acast. See acast.com/privacy for more information.

Carl Capolingua from ThinkMarkets and Mark Gardner from Maqro Capital go in-depth and stock specific. Stocks covered: LTR, STX, AX1, CHC, HLS, VVA, M7T, IPL, DGL, VUK. Our stock of the day is Macquarie (MQG). See acast.com/privacy for privacy and opt-out information.

In this episode of Real Talk, KJK Student Defense Attorneys Susan Stone and Kristina Supler are joined by Dr. Lauren Streicher, a Clinical Professor of Obstetrics and Gynecology at Northwestern University's medical school, and the founder and medical director of the Northwestern Medicine Center for Menopause and the Northwestern Medicine Center for  Sexual Health.  They discuss sexual and reproductive health in college kids. The conversation includes prevention, infection and maintenance of Sexually Transmitted Infections (STI's), the myths behind contraceptives and how they actually benefit women, and how to empower women with education about sex, reproductive and gynecological health, and sexual pleasure. Links: Dr Lauren Streicher's Website (Click here) Inside Information: the Menopause Podcast (Click here) Show Notes: (00:38) How we crossed paths with Dr. Streicher and her amazing accomplishments to date (02:01) The irony between hot flashes and college (02:46) The surge of sexually transmitted diseases and infections…a.k.a. College (03:31) What measure should every mom and their child take to prevent contraction of STI's known to cause certain types of cancer? (06:11) A scary new trend of how college students have fallen victim to STI's (07:19) How this makeshift form of protection that is often ridiculed can allow women to safely enjoy oral sex…well for 15 seconds (08:10) Unraveling the mysteries of a female condom– yes, you read that correctly. (09:10) Saran wrap belongs in the kitchen, not on your lady parts  (09:52) The real solution to safe oral sex for women (that's FDA-approved) (11:50) How $6 can save you from a potentially life-long sexually transmitted infection  (12:34) Why not all sexually transmitted infections can be treated with just creams or at all (13:28) The best safety measure you can take to prevent a permanent battle with HPV (13:40) Unfortunately, there is no catch-all screening test for sexually transmitted diseases (15:37) Common misconceptions about emergency contraception (17:31) The scientific explanation of pregnancy and fertilization (18:40) A non-pill form of emergency contraception (19:10) The ancient alternative to Plan B pills (19:50) An over-the-counter, essential component of your child's college first-aid kit (21:14) News flash: You can still get pregnant after taking Plan B (21:42) Alternative forms of contraception with higher efficacies (22:36) The dwindling existence of access to safe abortions for unplanned pregnancies; 50% from failed contraception (23:52) A lesser known benefit of IUDs (24:20) Busting the myth that contraceptives like birth control pills  lead to infertility in women; they actually protect it (25:44) The effect of marijuana on reproductive health in both men and women  (26:52) Why in the end, money matters more than health; the explanation behind the lack of scientific studies on the effects of marijuana to a female's reproductive health (27:53) What is the most prevalent gynecological health issue facing women in their early twenties today? (28:20) An online resource young women can utilize for sex education and pleasure; basically everything our mothers didn't talk to us about (29:08) Female sexual pleasure and why it should not be overlooked (31:30)  Sex should never hurt period. (34:56) The sex talk that every mother should have with their daughter before sending them off to college Kristina Supler: Today we are so pleased to be joined by Dr. Lauren Streicher. Who's a clinical professor of obstetrics and gynecology at Northwestern University's Medical School. Dr. Streicher's also the medical director of the Northwestern Medicine Center for Menopause and the Northwestern Medicine Center for Sexual Medicine. Susan Stone: I just have to say, we are really excited. We worked with Dr. Streicher on a case where she gave us some gynecological expertise. There was an issue and we got to know her and it's an amazing colleague to have. She just released a book. Her recent books are Slip, Sliding Away, Turning Back the Clock on Your Vagina and Hot Flash Hell, a Gynecological Guide to Turning Down the Heat. Susan Stone: And as a woman in her fifties, I can tell you that's important. But she's also an expert on issues that would pertain to women in college, which is why we actually met her.  Kristina Supler: Yeah. It's been such a pleasure to Work with Dr. Streicher and review all of her books and her social media content. I should mention she's also the host of a podcast called Dr. Streicher's Inside Information, the Menopause Podcast. So for all of our listeners out there, parents who are listening to learn about what to talk to their college kids about. Check out Dr. Streicher's podcast as well.  Susan Stone: we get a double bang for our buck because typically our podcast is for our listeners of kids in college. Susan Stone: So if you think about it, Dr. Streicher, we're here to talk about health of college kids, but our listeners are their mothers who should turn onto your podcast. So welcome a board to Real Talk.  Dr. Lauren Streicher: Well, thank you. And, and of course your listeners are my listeners because isn't it just kind of strange how, when women have their first hot flash is also the time they're waving goodbye to their kid and redecorating their bedroom. Dr. Lauren Streicher: So true. because women, as you know, tend to put off having kids, and it is not unusual for a woman to have a family starting in her mid, late thirties, which means hot flashes in college. It's all goes together. That is  Susan Stone: the great tie in. Why don't we lead off with our first question that would really impact women going off to college. Susan Stone: What's new in the world of preventing diseases, anything new in that area?  Dr. Lauren Streicher: It's funny, you should ask, sexually transmitted infections is of course a big topic, which that issue starts long before someone goes off to college, you know, certainly in high school we addressing those issues, but there's no question that the numbers of sexually transmitted infections do go up in the twenties during the college years, because that's the time when young men and young women are exploring sexuality. Dr. Lauren Streicher: Very often having multiple partners and quite frankly, very often having too much to drink too often, which can sometimes lead to sexual activities that even people who have the best of intentions find that maybe they don't use the condom. They don't use the protection, they don't need. Do what they need to do. Dr. Lauren Streicher: So it is a time that stories going a day out well,  Susan Stone: and that's why we have a business. Right?  Dr. Lauren Streicher: So let me start why it talks about what's new in terms of sexually transmitted infection prevention. This isn't exactly new, but it bears repeating for parents that before you pack your kid off for college, make sure they have their HPV vaccine. Dr. Lauren Streicher: And we are talking both boys and girls, you know, a lot of people, they put it. For a variety of reasons when their kids are 11 or 12, it's kind of on the back burner. Maybe the pediatrician doesn't bring it up. Maybe they don't see a pediatrician anymore. And this is critically important because what we know is that if a woman gets the HPV vaccine, that she's going to be protected against 90% of strains of human papillomavirus. Dr. Lauren Streicher: Which of course are not only responsible for cervical cancer, but also vaginal cancers V our cancers, some head and neck cancers and the thing is, and also, yeah, and, and we have data coming out now because it's been around long enough that we're starting to see the fruit of that vaccine because it used to just be okay. Dr. Lauren Streicher: We have less girls with abnormal. Pap tests, but now we are seeing people, we're now 15 years later seeing less cervical cancers, less other cancers. And this is just as important for the boys as the girls. You know, a lot of times I'll get a parent who says, well, you know, that encourages sexual activity. Dr. Lauren Streicher: We know that it does not encourage sexual activity. And for the parents who say, my kid is not gonna be sexually active, you can think that, and, and maybe your kid won't be, but as you know, better than anybody, the rates of non-consensual sex are very high in, at college. And just like you wouldn't set your kid off to drive without putting on their seatbelt. Dr. Lauren Streicher: You shouldn't send them off without their HPV vaccine. So. For starters, even if you don't wanna have the conversation with your kid about it they need that HPV vaccine. It is critically important and it is FDA approved, of course, for both boys and girls, up to the age of 45, by the way, moms, for those of you who are single out there, and as you send your kid off, you're saying, okay, now it's my time. Dr. Lauren Streicher: Keep in mind that as you get out there, you wanna protect yourself as well. While it is not FDA approved for women over the age of 45. I give an HPV vaccine to any woman who asks I don't care how old she is because older guys have HPV too thought. I would just throw that in, even though it's a little bit, Hey, off  Susan Stone: topic, protect those moms out there. Susan Stone: Protect single mom.  Dr. Lauren Streicher: Well, truly when we think about this being a time of sexuality for your young adult, for a lot of people, especially single moms, this is the time that you say, okay, my turn, or even the people who are married or in long-term relationships, suddenly you're not worrying about the, the teenager lurking outside the door and sure. Dr. Lauren Streicher: They actually have a little bit more activity. But the thing that's new, that's really interesting. While anyone, any college student you talk to is certainly aware that condoms, um, will protect against sexually transmitted infections during intercourse. We know that there are a lot of sexual activities that have nothing to do with the penis going and the vagina. Dr. Lauren Streicher: And in fact, there are a lot of people that will avoid. Penile vaginal penetration specifically because they are worried about pregnancy or they are worried about an STI. So they'll do other things. And a lot of times what other things might involve is oral sex. So the problem of course, has always been, if you have a woman who is on the receiving end, Of getting oral sex from a male or female partner. Dr. Lauren Streicher: There's always the concern about the trans the genital oral transmission of sexually transmitted infections. And we're talking things like human papilloma, virus, herpes Even gonorrhea, even syphilis, you can transmit a lot through genital oral contact and you don't want to end up with an infection like that. Dr. Lauren Streicher: So what options does a young woman have to protect herself and to protect her partner? In the past, a woman was always told to use a dental dam. Now, now you have you ever. Seen a dental dam outside of your dental office. I  Kristina Supler: never one had to try and mention it.  Dr. Lauren Streicher: No, it's like, no, of course not. They're not gonna buy it. Dr. Lauren Streicher: They're not going use it. They, everyone hears about it and jokes about it's not gonna happen. So what's the alternative to the dental dam. Well, for the Martha Stewarts out there what you can do is you can take an UN lubricated condom. You can cut off the tip, you can cut open the condom, and now you've got a square of latex, which is gonna be impermeable. Dr. Lauren Streicher: So theoretically. For the highly motivated, you can then teach which work and spread it over the vulva. And it's never gonna happen. That's gonna last for about maybe 15 seconds before it falls off or gets pushed aside or whatever. So that's really not a solution. And then we have the female condom, which a lot of people haven't heard of. Dr. Lauren Streicher: And the female condom is basically an over the counter product, just like a male condom. Only this one goes inside the woman's vagina. And then there's a sheath, basically a tube with the ring at the end that goes outside on the VVA. And I know you're making a face. People can't see that, but I will tell everybody you're making a face and that's exactly. Susan Stone: I am you making a face going, does that cause up an infection?  Dr. Lauren Streicher: Well, I affection, but the face you're making is the same face young women make when I tell them about it, because they say, are you kidding? First of all, I'm not gonna, you know, find buy one of these things. I'm not gonna put it inside me. I'm not gonna hang it out, have it hanging out on my vagina, just to have the guys say, what's that. Dr. Lauren Streicher: So that's not gonna happen. And before we get onto what the real solution is, I also wanna mention that saran wrap is also not. An option. A lot of people, I know this is what's good. I mean, this is what's going on out. There is people are saying, okay, I don't wear nowhere to get a dental dam. They don't know about the condom thing and they saran wrap. Dr. Lauren Streicher: I've got it in my kitchen. It's easy. I'll grab it. So they take saran wrap, they spread it over their Volvo, but here's the problem. Wrap is made to go in microwaves. And what that means is it's porous. Hello? Hey, there's a little ports of entry for all those bugs. You're trying to keep out. So aside from the fact that it's very amusing, when you go to the store and you see a woman buying jumbo cran wrap, and you think, gee, I wonder what that's for. Dr. Lauren Streicher: It is not to prevent sexually transmitted infections. I have good news. What's the solution. The solution is there is a new product, actually, not a new product, but what's new is that the FDA has just sanctioned. It is actually protecting against sexually transmitted infections. And this product is a panty. Dr. Lauren Streicher: It is called Loral L O R a L. I do not work for these people. And basically what Loral is, is it was invented for the purpose of preventing sexually transmitted infections when a woman is receiving oral sex so that she doesn't give it to the giver who you're always grateful to the giver. You don't wanna give them something, right. Dr. Lauren Streicher: And you're not gonna get anything from the giver. So the way that this works is that these panties are made out of the same material as condoms. It's a latex panty, and they're kind of cute. They come in, very stretchy bikini style. It's, you know, you won't feel stupid wearing it cuz they actually are cute panties. Dr. Lauren Streicher: And the idea is that the. where is this panty? And it's very, very thin so that if someone is giving her oral sex, she still gets all the sensation. She can feel everything he or she who's giving can feel everything. But if there's anything lurking on her genitals or on the giver's tongue, it's not gonna get transmitted. Dr. Lauren Streicher: The panties are not looking. Not that  Susan Stone: we're Googling it everybody. And we see that it's, we're not getting paid either. I just learned about this.  Kristina Supler: Wow. Oh, look at this. We think it's about damn time undies were designed for pleasure of the, the pleasure of their wearer  Susan Stone: and it's $25 and vanilla scented and it's seamless. Susan Stone: So it's not gonna super stretch.  Dr. Lauren Streicher: So I, when I was talking to the company and, you know, I always get on my high horse about, you're not supposed to cover up normal genital odors because women are not supposed to smell like English gardens. And this whole idea is offensive to say that you have to put something on that has a different taster or smell, but in this case it's actually valid because they're what they're the purpose of the vanilla scent is to get rid of the latex taste and smell mm-hmm , you know, mm-hmm so it's not to cover. Dr. Lauren Streicher: The woman it's to cover up whatever, might be going on with the latex. So the, people block at the price, it's $6, a panty, but truth be told. There is you can't put a dollar value on not getting a sexually transmitted infection like HPV that you will be dealing with potentially for the rest of your life. Dr. Lauren Streicher: And when you think about the cost of what you might spend on the lipstick to go out on the date, Or the drink you have on the date spring for the $6 panties. I'm just  Susan Stone: saying, yeah, I'd like to add, it says $25, but you get four, four individually packed undies. Yeah.  Dr. Lauren Streicher: So $6 did.  Kristina Supler: So let me ask you this STS are most, I think there's a, a perception. Kristina Supler: Most STIs are treatable with an antibiotic and then the person's fine, true or not true.  Dr. Lauren Streicher: Well, it depends on the STI Uhhuh . So if you look at something like gonorrhea or syphilis, that would be true. If you look at herpes, herpes is, you know, obviously very, very common. And while we can control herpes using various antiviral. Dr. Lauren Streicher: Medications you don't get rid of it. We hope that the herpes virus is just going to quietly live somewhere and not rear its ugly head too often, but it doesn't ever go away. So it is something that while it is certainly not a, yeah, I mean, I don't wanna. Make it sound like if you get herpes, it's horrible. Dr. Lauren Streicher: It's not a lot of people get herpes and they deal with it and they're still good people and they're clean people and people love them and they have sex and all of that, but it is something you do need to manage for the rest of your life. And the same is true of HPV human papilloma virus, which is the most common, sexually transmitted infection right now. Dr. Lauren Streicher: We do not have anything to eradicate it the best, but of course is to make sure that you're vaccinated. But if you are vaccinated, that is not going, that's 90% basically, which is pretty good, but it's not a hundred percent. And that is also something that you may be dealing with going forward. Dr. Lauren Streicher: And when we talk about sexually transmitted infections and, and one of the things that you hear so often, which is so not true is when a woman says, well, my partner was tested for everything. There is no everything. There are something like 30 to 40 sexually transmitted infections. And when a woman comes to my office and says, I would like to be tested for everything. Dr. Lauren Streicher: My response to her is I can't test you for everything, but let me tell you what I would recommend as a general screening as a general battery, what I would include, but then most important I say, but are you concerned about any specific exposures or have you had any specific symptoms that may then lead me to say, oh, I also wanna test for X, Y, Z. Dr. Lauren Streicher: So there is. Everything. There's just good to know. Yeah.  Susan Stone: That's really good. Know we're gonna switch gears onto the next topic. We think impacts college women, and that is pregnancy prevention. Yeah. And Christina, wouldn't you say that every case that's coming in the door what's with the plan B everyone's talking plan B. Kristina Supler: Well, it's really interesting, particularly in cases where we're seeing our clients. Who had a hookup whatever the circumstances are. And basically what I'm getting at is the sexual partners don't know each other that well. Yeah. And if there's a pregnancy issue, talk of plan B, it just really it adds a lot of stress and creates a really difficult dynamic that very few students are really. Kristina Supler: Emotionally equipped to navigate. And so I can't tell you how many of our title IX matters across the country at schools of all different calibers and tiers. There's a title I case with a plan B issue at the heart of it. In terms of, issues of consent and coercion and so on and so forth. Susan Stone: Well, we wanna go back to basics for our listeners. Yeah. Can you just explain what is plan B, how it works? What are the side effects? Just educate our parents about it because I didn't grow up with it.  Dr. Lauren Streicher: Well, no, we did not. And so plan B, we, we refer to it as emergency contraception. We do not refer to it as the morning after pill. Dr. Lauren Streicher: And the reason why is because you don't have to do it the morning after. I mean, when I would, you know, I used to get these phone calls, emergency phone calls at 2:00 AM, where I could still hear the heavy breathing. Saying, you know, I need the morning after. The condom broke. I need the morning after pill right now, you have more time than you think. Dr. Lauren Streicher: And in fact with taking plan B, these are pills and I'll get into the specifics, but you have up until five days now, the sooner, the better, you know, we would like you to take plan B or another form of emergency contraception within. Ideally 24 hours, 48 hours, 72 hours. Because when you look at failure rates, the failure rates are much, much lower early on, but the most important thing to know about plan B is first of all, it is not an abort patient. Dr. Lauren Streicher: And I cannot say that enough. It is not. We've had many  Kristina Supler: students come to us, really confused about that.  Dr. Lauren Streicher: Very issue. And the reason why it's so confusing. Um, and we won't get into politics here and, and MIS, you know, messaging and all that. But they actually came out about the same time when you look at R 46, which is an AOR patient. Dr. Lauren Streicher: And then you look at plan B, which is not, which is emergency contraception, meaning it prevents. Conception from occurring as opposed to disrupting an established pregnancy. So just to be clear, emergency contraception prevents a pregnancy and abort patient disrupts or aborts and already established pregnancy. Dr. Lauren Streicher: So  Susan Stone: someone said to us though, and I just wanna have you clarify that there. EC does one, it prevents pregnancy one of two ways. One, it prevents the actual fertilization of the egg. Yeah. And two, it prevents implantation and some people argue that. It should be considered abort of if there's a fertilization, I don't wanna get into politics, but can you explain how it prevents pregnancy? Dr. Lauren Streicher: So, so this is the thing when we look in terms of timing we know that the best time to take emergency contraception is, as I said, early on. When you look at, when does fertilization actually occur after a sex act, it's not immediately, it occurs in the fallopian tube when the sperm makes that journey up the cervix up the uterus out through the tube where it potentially will. Dr. Lauren Streicher: Meet up with an egg. Well, this journey is not instantaneous. This journey can take 4, 5, 6 days. So what that means is that if you take emergency contraception within those first 24, 48 hours, conception has not occurred yet. When you're looking at emergency contraception, that's taken as an outlier. Dr. Lauren Streicher: At five, six days when you, you really don't want to. Cause first of all, it's not gonna work as well, but is there the potential that the egg has already been fertilized, but just hasn't traveled down yet to the uterus? Yeah. And strictly speaking, if you think of that as being. An early termination of a pregnancy, but I don't look to me. Dr. Lauren Streicher: A pregnancy is when you have a fertilized egg, which is implanted in the uterus, that's, you know, we have ectopic pregnancies, we have all kinds of things that happen in the tube that are not actually what I consider to be viable pregnancies. You can say the same thing for IUDs intrauterine device, which actually. Dr. Lauren Streicher: A copper, I U D can be used as a form of emergency contraception. A lot of people don't know that they think it's just the pills, but you can also use a copper I U D, which is very similar in terms of it setting up an environment in the uterus where fertilized egg is just simply not gonna implant. Dr. Lauren Streicher: But when you look at plan B, so it's actually, when you go back historically, when plan B first came out, Long before they came out with the actual plan B manufactured as such what we used to do as kind of our own concoction. If you will, is if a woman came in and said that she had unprotected sex, we would give her four birth control pills two in the morning, two at night, it was basically it's a high dose pill and that would work very well. Dr. Lauren Streicher: I'm sorry, what would those women get sick and really nauseous from that?  Dr. Lauren Streicher: They would get sick. Yes, but they would get sicker if they got pregnant. So it seemed like a good, there you go. There you go. But, so that's what we used to do. And then of course, manufacturers came out with plan B, which is not the only emergency contraception. Dr. Lauren Streicher: There's some others also, but the, the beauty of this is not in every state, but in most states you do not need a prescription. This is something that you can get directly from the pharmacist. It is state by state. But quite frankly, I think when we talk about, as a parent sending your kid off to school and there, you know, you pick the first you, you put your first aid kit together and I, and I know you had Dr. Grimes on as a guest and talked about her book. And in her book, she talks about all the things you wanna have in that health kit to send off. I don't think she has plan B, but that's what I would add. Oh no. Oh, I would add, I gotta talk to her about that cuz she's my friend. I would add the panties and plan B to that little kit that you send with your daughter. Dr. Lauren Streicher: Or son off to school because we want the guys to be responsible and be able to share that. And if a guy's condom breaks, it's nice. If he's be able to give to the woman who's involved, here's plan B, you don't need to go and spend the money and go to the pharmacy and all that. This stuff doesn't expire. Dr. Lauren Streicher: You it'll hang out for the year. So every year you can give them a new prescription, but instead of the prescription, just give them the actual pills because you're not giving your daughter permission to have sex. Trust me, they're gonna, if they're do it, they're gonna do it. You just wanna keep 'em safe. Kristina Supler: You talked about like ideally taking it 24 to 48 hours up to five days and the longer you wait, I think it, it impacts efficacy, but let's say you take it early on. Can a woman still get pregnant after taking a plan B.  Dr. Lauren Streicher: Yes. It's not a hundred percent. And, and I think that that's important to know that if you, if you take it and and then you end up missing your period you still need to do the pregnancy test. Dr. Lauren Streicher: You still need to deal with potential consequences, but the numbers are much lower. Ideally you don't wanna just rely on a condom because condoms do break condoms do get left off the absolute best form of contraception. For a young woman, hands down is what we call non-user dependent. Dr. Lauren Streicher: Meaning you don't have to take the pill. I mean, pills are good, but better you get busy. You know, you've got a crazy schedule. You're not gonna take that pill at the same time every day. And that's why we love IUDs. We love the implant Nexplanon because it's said it and forget it. And we know. That the efficacy rates are up there in the 98,99%. Dr. Lauren Streicher: And it doesn't get any better than that. So my feeling is, is before you go off to school or the second you get there, get an I U D get your next plan. It'll hold you for the whole four years. So it's a one time thing for most people. And then yes, you still need to protect against sexually transmitted infections, but at least if something happens, you're not worried about both. Dr. Lauren Streicher: You don't have to worry about pregnancy and again, not to get too political, which is hard for me. We have states now and more soon to come and it may be across our country that the. The whole notion of having access to a safe and reliable abortion is simply not going to exist. Dr. Lauren Streicher: And we need to deal with the reality of that. And we know that right now in this country, 50% of unplanned pregnancies are not no contraception, it's failed contraception. And that's a very important fact for people to know, because fascinating statistics. Yeah. You can get all these facts on the group mocker site but the thing that's so critically important is there are people out there that say, well, if someone gets pregnant, it's their own damn fault, cuz they weren't being careful or they weren't being responsible. Dr. Lauren Streicher: And aside from the fact that we have non-consensual sex on campus, even responsible. Couples very often will have contraception that fails, whether it's the pill that's taken too late. I mean, this is an absolute fact that 50% of unplanned pregnancies occur in a cycle in contraception was used, but it failed. Dr. Lauren Streicher: So quick  Susan Stone: question, just a transition just as a mother with, daughters. Is there any concern that the plan B or the implant would impact future fertility?  Dr. Lauren Streicher: Quite the opposite. We know that an I U D does actually, we don't advertise this, but can actually decrease the transmission of sexually transmitted infections. Dr. Lauren Streicher: And the reason why is that one of the effects of the I U D that prevents pregnancies, it makes the cervical mucus very, very thick, very, very tenacious. So it keeps those creepy crawlers from going up into the uterus and the tubes. So it's actually protective, but again, we don't advertise that cause we want people to do STI protection anyway. Dr. Lauren Streicher: And certainly birth control pills in no way are going to impact. Someone's ability to get pregnant down the road. And what's so interesting is when we think in just in terms of hormonal contraception in general, we know it actually protects fertility because when you look at the reasons why people can't get fertil, can't get pregnant. Dr. Lauren Streicher: The number one reason is that they're too old. And so when someone's been on the pill for 20 years and they go off the pill and can't get pregnant, it's not cuz they run the pill for 20 years. It's cuz now they're 40. But if you look at young, Who go off the pill. What that means is if that young woman had a problem such as endometriosis, that has been controlled during that entire time and actually protects her fertility. Dr. Lauren Streicher: So  Kristina Supler: while we're on this topic of fertility and just thinking long term, let me ask you, this is I'm sure you're likely aware most college students these days, and of course I'm generalizing, but they don't view marijuana as a drug whatsoever. It's like taking a cough drop. So right. Looking down the road, does smoking marijuana regularly, or maybe infrequently have any impact on reproductive  Susan Stone: health? Susan Stone: And I just wanna say Christina. We take turns, working on the questions we have. And I said to Christina, Where are you getting that question? I mean, who would ever even think, like does marijuana or any drug use impact fertility? I'm like, I, I naturally assumed it wouldn't but then I thought  Dr. Lauren Streicher: that's a brilliant question. Dr. Lauren Streicher: It is a brilliant question because the kids aren't thinking about it, but the potential grandmas to be are and thinking, you know, if my kid goes off to school and does four years of pot, am I a ever gonna have a grandchild? Or if I do is my grandchild gonna have two heads? And so it, it's a totally, totally appropriate question. Susan Stone: So that's why I'm in business with you. There you go. There you go days. So this  Dr. Lauren Streicher: This is what we know. We, and we don't know a lot because of course it has not been studied nearly enough. We know that in men. That smoking pot can cause fertility problems and can alter sperm, but men make sperm as they go, if you will. Dr. Lauren Streicher: So this pat, a guy smokes in college, as best as we know is not going to affect his sperm. 20 years later, women are born with all of their eggs and those eggs are just like sitting there ready to be released and we don't have any data. That says that that cannabis will alter fertility down the road, but we also don't have any data that says it does not. Dr. Lauren Streicher: We don't, that's a big, we don't know  Susan Stone: why I just have to ask why aren't we studying that?  Dr. Lauren Streicher: Who's gonna do that study and who's gonna pay for it. Okay. Wow. Which is true of any pretty much all studies with cannabis. This is the thing that people forget when they say how come there aren't. the reason why pharmaceuticals will spend millions and millions and billions of dollars on a product is cuz that's the only way they can bring it to market. Dr. Lauren Streicher: If they don't do every single test to see, does this make your nose turn green? Is it gonna make your hair fall out? Is it gonna cause problems? The FDA will never approve it, but cannabis is in a different category because cannabis. Available and doesn't need those tests to come to market. So what cannabis company in their right mind is gonna spend millions of dollars to prove that cannabis does something bad, not gonna happen. Dr. Lauren Streicher: Right. That  Kristina Supler: makes sense. That's very practical. Yeah. So tell us this, based on your experience and that of your colleagues, what is the most prevalent gynecological health issue facing women in their early twenties today? Or  Dr. Lauren Streicher: where's there a knowledge gap? Yeah, the big knowledge back. Well, it, it depends it really depends. Dr. Lauren Streicher: I mean, some young women are incredibly savvy, cuz if they have moms like you, they give them a ton of information and send them off, armed with information. They know quite a bit. And then there, of course there are the young women that come from families and schools where they don't get appropriate sex education, their mothers aren't telling them. Dr. Lauren Streicher: And some of them figure it out on their own and, and some of them don't. And there's a couple of good websites. Sex education for young women. One of them, I think it's called Scarla. Teen is quite good, which is directed for young people to give you accurate information. But the thing that's so interesting to me is we can talk about non-sexual issues, you know, that young women need to know about, but when it comes to sexual issues, it's not difficult to, for someone who's motivated and wants to know about it, to learn about safe sex and and contraception. Dr. Lauren Streicher: But when no one talks about his sexual pleasure and it's a thing, nobody,  Susan Stone: my mother did not talk to me about that.  Dr. Lauren Streicher: No. And even moms that, that are responsible moms that talk to their daughters about, you know, okay, ha you're going off to college and I want you to be. Safe emotionally and physically and STIs and all that stuff. Dr. Lauren Streicher: But have you ever say, and I want you to have great orgasms, no women generally don't have that conversation. And that's where these young women are. Mm-hmm because societally, cause then they start asking about your orgasms. That's why, but the, but the problem is societally boys have an expectation that they are entitled to sexual. Dr. Lauren Streicher: They just do, it's everywhere women. Have this idea that they are put on earth to give men's sexual pleasure, as opposed to that they should be enjoying sex on their own. And even if you look at enlightened sexual education, it's very, very rare that anyone talks about pleasure. So what's so interesting is my daughter's a sex therapist and we give a lot of talks together. Dr. Lauren Streicher: She's quite amazing. She's I'm not a therapist. She's amazing when it comes to this stuff. We give a lecture together. We give a lot of, we give a lecture every year to graduate students at Kellogg, which is the school of business here at Northwestern. And we give one talk to the men and one talk to the women and it's their idea to do it separately. Dr. Lauren Streicher: Not ours. I  Kristina Supler: am I gonna like fifth grade sex ed was because it  Dr. Lauren Streicher: allows them to more freely ask questions. And we've been doing this probably for about four or five years now, and it is a hundred percent predictable. What questions they are asking. And for the women, it comes down to pleasure. How come I don't have an orgasm? Dr. Lauren Streicher: Is sex supposed to hurt? Those are the questions.  Susan Stone: Oh, well you are segueing into a question that we have. Yeah. Who actually have a lot of cases where females complain on about painful intercourse. And they're saying that the male caused it. Yeah, by being too  Kristina Supler: rough or, or perhaps because consent wasn't  Dr. Lauren Streicher: if they  Kristina Supler: weren't around and right. Kristina Supler: Or, or they felt pressured to consent or something like that, there's a direct cause and effect to the painful incourse and seems like sometimes that may be true, but then sometimes there's yeah, very real medical reasons. What can you tell us about that? Susan Stone: If we go into that, because that's how we met. Is there was the claim that a woman said, you can only don't go too deep. And there was complete confusion between the students about what is going too deep. And was that related?  Dr. Lauren Streicher: Yeah. Well, the first message and, it's so important for all young people to know this and quite frankly, adults too. Dr. Lauren Streicher: Um, which is how I spend my day in the menopause center in the sexual medicine clinic is sex should never hurt period. Sex should never hurt. It is never okay to have pain during sexual activity. And a lot of people don't know that especially young women who maybe have never had a pain free or a pleasurable, we've gone from, okay, you should have pleasure to you shouldn't have pain. Dr. Lauren Streicher: These are obviously two different things, but it's shocking how many women think that it is normal to have pain. It is not normal to have pain. So then that brings us more to your question. Why would someone. Pain. And of course the list is very long of reasons why a young woman might have pain. Um, sometimes it's a condition such as endometriosis. Dr. Lauren Streicher: Sometimes women will have actually vaginal dryness because of a birth control, which is little. Understood, but it's a definite problem. Sometimes they might have other issues such as something called Vestia that all of those things have nothing to do with the partner. Okay. These are conditions that they may not know about until they have partnered sex, but. Dr. Lauren Streicher: Those are not caused by the partner. If you look at conditions that are specifically caused by a partner that otherwise wouldn't be there with, let's say a different partner or something, then what you're looking at is a woman aroused. We know that sometimes, certainly when you look at nonconsensual sex obviously women are not aroused during non-consensual sex. Dr. Lauren Streicher: They are expressly saying they do not want it and they will not stay  Susan Stone: out, stay out of my vagina. That's what they're saying.  Dr. Lauren Streicher: The vagina says stay out too. And the way the vagina says stay out is by not lubricating by the muscles tightening. And basically the vagina goes into keep out mode, which is in pain mode if someone attempts. Dr. Lauren Streicher: So, no question that. Certainly that would be a partner related situation. And, and certainly in my practice, we have seen women that have had nothing but painful sex. And then with something as simple, as a different partner who they love and who is patient and they are aroused with things are okay. Dr. Lauren Streicher: But I will say that for the most part. Women that have pain with sex it's because there is something going on with them that we can fix, you know, you're not broken. It just means that it's  Kristina Supler: an important message for women to understand what of all ages that right. You don't have to live with this forever  Susan Stone: and that it could be sign of something else that needs to be treated. Dr. Lauren Streicher: Right. And that's why I've said, I think 10 times right now, pain is never, okay. Pain is never normal. But then the follow up to that is, and it is always treatable. It is always treatable. We have solutions for pain. It's funny cuz with these clinics that I run and obviously we see women that have a lot of different problems, whether it's libido issues or orgasm issues and the ones that we actually kind of like the best, if you will, are the women who come with pain because that we can fix. Dr. Lauren Streicher: Yeah, we can always find out why is someone having pain and how do we eliminate the cause of the pain. But it is very common that women too common that women have pain and people, when they hear we have a sexual medicine clinic, a lot of times they assume that this is for women older, you know, over the age of 45, 50, 55. Dr. Lauren Streicher: No, they don't come to our sexual medicine clinic. They go to our menopause clinic cuz we do. Sex and pain in the menopause clinic, but that's the menopause clinic. The sexual medicine clinic is only women in their twenties and thirties and forties. She's never, that's a wonderful resource.  Dr. Lauren Streicher: Yeah. So do you think the message should be for those moms who have daughters going to college? Dr. Lauren Streicher: Because I don't think mothers gonna really, most mothers are gonna really wanna have a conversation about orgasm, but would it be more appropriate to say, look, I just want you to know. Sex should not hurt. And if you find yourself in pain, you need to call me and we'll figure it out or call the doctor.  Dr. Lauren Streicher: Oh doctor. Dr. Lauren Streicher: So this is the other thing too. And this is, I know Dr. Grims has made this point and I dunno if she made it with you is as you send your young adult off, part of sending off your young adult is to send them off armed with the phone numbers of doctors, their insurance card because you can't expect a young woman to call her mom and say, I had sex with a guy last night and his penis was enormous and I'm now I'm in pain. Dr. Lauren Streicher: What should I do? She's not gonna call her mother and say that, but very few girls are gonna do that. So, so to your point, the message is when you have the sex talk, the going off to college sex talk, the talk is I want you to be. Both physically and emotionally. And I want to make sure that if you choose to become sexual, that you prevent sexually transmitted infections and pregnancy, but I also wanna make sure that you know, that sex is not to please men. Dr. Lauren Streicher: It is to please yourself and you should never have pain. And that's it. Oh my gosh. That's it. Yeah, that's alone. That's the message. Kristina Supler: That was really profound and in, in some ways obvious, but yet I think it's so important that women of all ages hear that and really think about that. And  Susan Stone: if they do, I think that Kristina will see a lot of, a lot less sexual assault cases because women will know how to advocate for themselves and really communicate to the males. Stop. I, you need to get away from me. I don't like this. Hopefully,  Dr. Lauren Streicher: hopefully, well that it's not all about you. It's about me, you know? Yes. It's really where comes down to, because, from the beginning of time there's been this idea that if I don't have sex with him, he won't like me. Dr. Lauren Streicher: And then that will end the relationship. And I will tell you that. I'm not saying that it might not cause be problematic in a, particularly a longer term relationship if you're not have sex, but it's, you know, this is actually one of the problems that my, my daughter, the sex therapist deals with a lot because she does support groups for young women who, who, who have painful sex. Dr. Lauren Streicher: And a lot of what they're navigating is okay, I'm in this relationship. I really like this guy. I want to be able to have sex with him, but I can't because it hurts. How do I deal with that from a relationship point of view? And I can't answer those questions cause I'm not a therapist but I can tell you that there are plenty of guys out there who you know, you can have great sex without having intercourse starting with that, but they are. Dr. Lauren Streicher: If, if they really care about you, they care about the fact that sex hurts and there will be workarounds. Wow. While you get it while you get it treated until you.  Susan Stone: Until we grow. And by the way, I think this applies to couples of all types, right?  Dr. Lauren Streicher: Yeah, absolutely. Well, that's why I've been careful not to say, you know, necessarily a man. Dr. Lauren Streicher: I use the word partner for that reason. Um, that's right. Because I treat people with vaginas cuz I'm a gynecologist, but beyond that, I don't really it, it doesn't impact on me. How they identify whether they identify as male or non-binary or female. And I don't care for what someone has sex with. I just want it to be consensual and pleasurable and safe, that's it. Dr. Lauren Streicher: And consensual.  Susan Stone: Yep.  Kristina Supler: Great words to end on Dr. Streicher. Thank you so much for joining us today. It's been a pleasure and again, to our listeners, check out Dr. Streicher's books that are available for sale basically everywhere, go to Amazon or anywhere else. And then Dr. Streicher's podcast, Dr. Streicher's Inside Information, the Menopause Podcast,  Susan Stone: we really enjoyed having you and could talk to you for hours more. Susan Stone: So we're gonna have to have you back.  Dr. Lauren Streicher: I would love that. It's been my pleasure.

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It's time to talk about our happy places - our vaginas! On this episode of The Hormone Prescription Podcast, host Dr. Kyrin Dunston is joined by special guest Dr. Betsy Greenleaf, an OBGYN and pelvic floor physical therapist, premier womens health expert, a best-selling author, entrepreneur, inventor, and business leader specializing in female pelvic medicine and reconstructive surgery for over 20 years, to talk all things vagina. Dr. Greenleaf, is a trailblazer as the first female in the United States to become board certified in Urogynecology, CEO of The Pelvic Floor Store, a blog at drbetsygreenleaf.com, and she is the host of Some Of Your Parts Podcast, and host of the happy vagina rally summit.   She dedicated to women's wellness and the notion that you are greater than the sum of your parts. and BODY MIND SPIRIT podcast that focuses on the trinity of total health. She is the best-selling co-author of You Were Made To Be Unstoppable.    In this episode you will learn: -How your vagina changes throughout your life -Pelvic floor physical therapy and how it can help with things like incontinence, pain during intercourse, and more -The importance of self-care for your vagina -And much more!   So whether you're dealing with the changes that come with menopause, are concerned about your pelvic health, or just want to learn more about taking care of your vagina, this episode is for you! Tune in now and let's get started on having a happy vagina for a happy life.   [01:15] Hey everybody. Welcome back to another episode of the hormone prescription with Dr. Kirin. Thank you so much for joining me today. Today. We are gonna talk about vaginas. Yes, I know this is probably something that you don't hear talked about that much, but the truth is you have one, you take it with you everywhere, and it's a big part of what makes you a healthy woman. And my expert today knows this better than anyone. She is an expert in vagina house. She has a great event coming up. We're gonna tell you about, and she has a voice and she's not gonna be silent. And you shouldn't be silent either about what's going on for you. I'm gonna tell you a little bit about her and then we will get started. Premier women's health expert, a bestselling author, entrepreneur inventor, and business leader, specializing in female, pelvic medicine and reconstructive surgery for over 20 years.   [02:14] Dr. Betsy Greenleaf is a trailblazer as the first female in the us to become a board certified Euro gynecologist. Yay, Betsy. She is the CEO of the pelvic floor store. She has a blog at Dr. Betsy greenleaf.com. She's the host of some of your parts podcast, and also she hosts the happy vagina rally summit. We're gonna tell you about she's dedicated to women's wellness and the notion that you are greater than the sum of your parts and body mind spirit podcast that focuses on the Trinity of total health. She's the best selling co-author of you are made to be unstoppable. Welcome Dr. Betsy Greenley.    [02:55] You so much, Dr. Kirin for having me here. I'm so excited. I love talking to you. So this is gonna be great.   [03:00] yes. Betsy is so much fun. Not only is she brilliant, uh, when it comes to women's health and special, especially vaginal ecology and pelvic floor things, but just such a free thinker and out very outspoken. She shared the quote from Alan Albright with me before this episode, and I said this so speaks to who she is in the world. And I think who I am too, right. It took me quite a long time to develop a voice. And now that I have it, I am not going to be silent. So did you used to, to not have a voice on important matters?   [03:37] You know, I, unfortunately I think I've always just kind of not had a filter, just spoke my mind, but I did find very quickly that especially in traditional medicine, especially in, in, unfortunately the time that I did my training being in a male dominant field, that people did not wanna hear me. And it did get me in trouble, especially my first, my actually very first job. I came out in the early two thousands thinking, come on, it's two thousands. Like, you know, this is crazy. Like how bad can, you know, medicine be? And I'm going into a hospital where it was like stuck in the 1950s. And so they were not used to having somebody that spoke up.   [04:42] Later on, I spoke to some of my family colleagues and they're like, you, what is the doctor's lounge? And I was like, uh, last time I looked, I do have a degree. They're like, oh, we don't go in there. Only the men go in there. So yeah. So unfortunately I kind of learned the hard way that people don't always wanna hear what you have to say. So I do have a tendency to rock the boat, but I just, you know, as much as they've tried to squelch me over the years, I still haven't learned to shut up and I'm just gonna keep talking.    [05:12] oh my gosh. You just brought back so many memories from when I first came out of residency and went to work in this hospital and the doctor's lounge. Oh my gosh. Yes. You were like an anomaly. You were like a rare bird walking into the Seren Getty and they would look at you like they were like lions you're doing here. And do you know what? I even remember that in the, so in the surgical suite, they didn't even have a female doctor's locker room. Yes. The only doctor's locker room, they said, this is the doctor's locker room was for males and females. So they would tell us, you have to go in there and change. I'm just remembering this. And of course, none of us wanted to, so we didn't.    [06:05] I think it's still like that in some of the hospitals I go to, it says like doctors' locker room and then there's the nurses' locker room. And I'm like, but there's a lot of male nurses. And obviously there's a lot of female doctors. So, but you know, the, the men go into the doctors when the female go into the nurses.   [06:21] and God forbid, you would, you would raise your hand or say something at the, you know, the OB GYN staff meeting. They really would look at you like with these daggers, like, are you real? Like, it's enough that we gave you a seat at the table, but you're gonna open your mouth and say something really   [06:38] It's actually, you know, it's funny too. Cause I actually even started out in general surgery before I switched to OB G a N. And I remember walking into the operating rooms and like the doctors would look up and they'd be like, uh, you, what am I gonna talk to you about? And I would go home and study the sports page. Everybody else was study like surgery, textbooks. I was studying the sports page. So I had something I could walk in and talk to them about.    [07:04] Maybe I should have done that. I didn't think of that. And I think it's important thatm in listening know kind of what the environment was like for us and still is in the hospital environment, because it will help you to understand a lot of why you're not getting what you need from medicine. Because if this is the oppressive environment that the doctors are living in, when it, it comes to women, this is what is being translated to you, without words in the care that you're receiving or not receiving, and the attention to your vagina and lady parts that you're probably not getting to the level that you need it. So that's why I think it's important to know. So let's dive into talking about, well, first you're the first certified urogynecologist female in the us. That's amazing. Yeah. What prompted you to want to go into urogynecology?   [08:06] You know, what's interesting. So I told you I started out in general surgery and I was the person who I wanted more of a relationship with my patients and listen, general surgeons are amazing people, but I found for me, they were too much like body mechanics, you know, get in, get the job done, get out, but I, and not have a relationship with the patients. And so I wanted a relationship with, with the patients I was going around on general surgery and I was the one who was rounding and being.    [08:56] I didn't necessarily wanna deliver the babies partially. Cause I like to sleep at night babies come at all hours of the day. And so they told me that doesn't exist. It doesn't exist. And it wasn't until my very last rotation as a OB GYN resident that I did Euro guide. And I'm like, this is amazing. I mean, this is what I've been telling people. I wanna do, you know, I was being told before, like, that's blasphemous, you can't just do the surgical aspect. And so, yeah. So I found that and uh, I got really lucky because I was a month from graduation and most fellowships have already accepted their fellows into the program.    [09:59] Yeah. Amazing. And so you've had this really deep dive into pelvic floor disorder. I know you're very passionate about the VA biome and you're holding this event, uh, the puppy vagina rally, that's coming up soon. We will have a link in the show notes for you guys to sign up. And what are some of the most interesting things that you learned doing the interviews for this event about the vagina that you would like to share with.   [10:32] Everyone? You know, it's been so much fun cuz every time I interview people, I think like all of us as we talk to people, it's not just the conversation, but then it's an exchange and we're learning so much from each other. I think, you know, part of it was being traditionally trained. We didn't get a lot of training in sexuality. In fact, actually they took it out of the curriculum when I was in medical school. And I think even when it was in the curriculum, it was only like a week long. So we have a couple speakers that talk about sexuality that like from Susan Bratton to, I have a woman who is the erotic massage coach.   [11:31] And I'm like bringing in this woman, who's the tic massage coach, like talking to her, first of all, she is just so much fun. I'm like, wow, I never even thought about that as like an option. And when you first hear about it, she does these classes on like how to like kind of, you know, get your partner aroused. But I was like, well, that doesn't sound fun for, for me or the woman, but it is super empowering.    [12:27] So it has been really enlightening along the way. And of course we have you talking about menopause on the summit too. So a lot of fun little tidbits from Dr. Karen. So it is just, it was a lot of fun making it. And I mean, I can't, I could go off on hours for all the different speakers that we had. We actually had to kind of hold it down to 30 speakers. Cause that was the other thing at first, it was turning into this week long summit. And my, I really wanted to address busy women because I don't know about you, but I don't really have a lot of time to sit there and watch a lot of videos. So I wanted, we decided to par it down, make it 30, 30 different speakers over a four day period. So in like short half hour session. So you could just kind of get in, get the information and get back on, you know, with your life.   [13:18] Yeah, I am super excited to hear it. Definitely wanna hear about that massage therapist you talked about. So why is the vagina so important? I know some women here get it. Any woman who's had recurrent Vitis. Oh my gosh. That's probably one of the most frustrating things for women. And if you've had that, you probably know what a big deal the vagina is. But I think that most people don't get the importance of the vagina. Just like they don't get the importance of their mouth. People are like, yeah, my mouth, what do you, what about it? I chew food. I swallow it. I go to the dentist, I brush my teeth big deal. And I'm like, no, your mouth is everything. So why is the vagina so important when it comes to women's health?    [14:05] And it it's been fascinating over the years to find the connections between the gut, the brain and the vagina. And even if you're talking about the mouth, when we talk about microbiome, so microbiome are the small microorganisms that live in different areas of our body. So our microbiome of our mouth is different than that of our gut is different than the vagina, but they all interact. So, you know, starting with the mouth, we're 75% of us are chronically dehydrated. So if you're dehydrated, you're gonna actually throw off the healthy bacteria in the mouth and that's where your digestion begins. And if your digestion isn't good or the bacteria in your mouth, isn't good.   [14:56] That's gonna throw off your gut health and your stomach health. And we know that the gut health, 95% of our happy hormones are made in our gut. And 80% of our immune system is made in our gut. So if our gut is off, that can lead to inflammatory conditions, autoimmune conditions, probably 90% of the medical conditions out there today are either caused by or aggravated by things in the gut. And then things like anxiety and depression are aggravated by our gut. And then if the gut is off, that throws off the microbiome of the vagina, and then we're more susceptible to recurrent geese and recurrent vaginal infections.   [15:57] And so it will dampen sex drive and fertility. And because the brain doesn't know the difference between wanting to have a baby wanting to have fun. So now a lot of times we, you know, women, especially postmenopausal women would come in that like I have no sex drive, gimme hormones and hormones are a great tool and they are amazing and they work, but in some women, it doesn't completely fix the problem. And then we gotta go look at the, the microbiome because if the microbiome of the vagina is off, the brain is going okay, it shouldn't be reproducing right now. Let's dampen everything.    [16:46] I think that's so important. So thank you for highlighting that is that, you know, with the modern age birth control, we have uncoupled sex from reproduction and we just wanna have it because we enjoy it. It improves intimacy or for whatever reason your body doesn't see it that way, it still sees it. As you get, you're rewarded with a sex drive when you are optimally healthy, cuz then it thinks you'll make a healthy baby and you'll be around to take care of it for 18 years. But how interesting that there's data that if you, your vaginal environment is off, that it's gonna feed back into your brain to be a kill switch on your sex drive.    [17:50] Yeah. And then it feeds into, you know, hormones do play a part because if we're not getting estrogen well and there's other receptors in the vagina, if we're not getting hormones to the vagina, the vaginal tissue thins out and our healthy bacteria, the lactobacillus lives in like the symbiotic relationship with us. Like it lives off our, off of our dead tissues, which sounds kind of gross, but it eats something called glycogen and it survives on that. And in return, the healthy bacteria produces hydro peroxide, which keeps the vagina very acidic, which fights all the yeast and the bacteria.    [18:40] Everything connects to everything else, thing else everything's related. Um, and I love how I love when women see that light bulb go off and no longer is it like, oh, I just have a recurrent vaginitis problem. And they get it that, oh my gut micro flora is off. Oh my mouth, my hormones. Right? All these things. And so we're gonna have a link to the happy vagina rally. I'm wondering, they're gonna get lots of great information there. There's so many women I find in their forties and fifties who start having problems with their pelvic floor. And I find I'm amazed by this. You're probably used to this. They don't even wanna talk about it, but to their providers, cuz they're so embarrassed, I've had women, uh, and I'll ask them, are you having a problem with, you know, something protruding from your vagina you're notch for what it is and they'll go yes. And I say, well, why don't you say something?    [19:59] Sure. You know, this is, I can't tell you. I mean, being a gynecologist is what I did every single day of my life. And yet every single day I would have a woman in the office that goes, oh, I'm the only one this has ever happened to. Right. and I'm like, no, in fact, actually 50% of women will have a pelvic floor support problem. And so the way we're built, unfortunately gravity takes over everything. I mean, you know, everything starts heading south, you know, from our boobs to like ear lobes to our vaginas and some women who've had babies are a little higher risk of things, drooping and dropping though.    [20:52] I mean, we're just, everything's going to gravity. And so inside our pelvis, you have your bladder, you have the vagina, you have the rectum and these things can start drooping and dropping and falling out. And part of it's from ligament damage, not, you know, you know, whether it's having a baby or being constipated and straining too much or maybe coughing or lifting something too heavy. And then the problem is we start losing muscle mass. We lose about 8% muscle mass for every decade that we live.    [21:42] But what lot of times they'll say like, well, sometimes people come in, they think they have a tumor. Cause all of a sudden something's hanging between their legs. Mm-hmm and usually it's the vagina that's bulging. You're seeing the mucosa, like the skin of the vagina that's protruding. And well, sometimes we refer like the bladders falling out, the vagina is falling out. The uterus is falling out the rectum falling out. Like nothing's gonna be falling and dropping on the floor.    [22:27] Or the rectum's gonna start leaning on the vagina and push it out. And basically everything's just kind of flopping and collapsing and stage four prolapse is actually where the vagina can fall down and turn inside out and hang between the legs. So that is possible. So if you're experiencing anything that's dripping or dropping, you know, get it checked out. Uh, at the same time, I know it's kind of shocking. If so that happens, cuz it can be a gradual process or somebody could lift something heavy. And if they're not lifting properly, you gotta blow out as you're lifting. But if you hold your breath and all of a sudden pop there goes something and you're finding it between your legs, it is not a surgical emergency.    [23:31] Yeah, it is shocking cuz nobody talks about it, but we're talking about it and I'm glad you're here. So now if it happens to you or your BFF send texts, you what is this photo? And you can be like, no problem. It's PE it's pop pelvic organ prolapse. Yes I got you. Right. And so like, say that did happen. I know I've heard, I knew this doctor, she trained up in the Appalachia and she's like, they would put potatoes, put a potato up there to hold it up.   [24:02] You know, what's so funny in ancient Egypt, they used to use like rocks or pomegranates. And then Roman times they'd use rocks or potatoes, which I don't recommend any of those things. They do make medical devices called pessaries, which are usually made out of silicone. And they're coming all kinds of crazy shapes and sizes. Some like look like very small Frisbees all the way to, they look like donuts or cubes.    [24:48] Some people have heard about vaginal mesh and I see the 1-800-BAD-DRUG commercials. And I have to say vaginal mesh is not a hundred percent as bad as it was made out to be, but that's a whole nother topic. But when I first came out, I was doing surgery on everybody cuz that's what you were treating to do. And then one day I realized, wait a minute, why am I doing surgery? If it's not bothering the person or if it's not causing health conditions. And so you don't necessarily need to have surgery there's non-surgical options. Or if it's not causing recurrent urinary tract infections or it's not affecting your kidneys, it can actually just be followed and you can kind of leave it alone and manage it that way. But you do have to get it checked out to make sure it's not affecting your kidneys or your urinary tract.    [25:33] Yeah. So what is a treatment? So pessaries are one option. The mesh was big fiasco and our doctors even using mesh at this point, say there's somebody listening. Who's like knows that she's got stress, urine incontinence. She's got a cystic seal, right? The bladder's falling. Maybe she has a recusal and or an entere. So the backside's coming down too. What should she look for in trying to find someone to complete a surgical repair for her? What, what things are available?   [26:03] You know, there's are some regular gynecologists are very well trained in this, but I, of course I'm a little partial to Euro gynecologists or someone who's gone through female pelvic reconstructive training the problem with any of the surgeries. And this is something that as a profession we've learned over time is none of them are a hundred percent permanent. It's not like you get your appendix out and like you no longer have your appendix like the process that caused you to have that in the first PA place. And the fact that we know that some people are just genetically have weaker tissue, even when you put it back surgically, it can recur.    [26:50] So there are a number of surgeries. There's ones that go can go through the vagina and it's not like people always ask, well, why don't you just find the ligaments that are torn and just rehook up into those? Well, a lot of times those ligaments are so thin and non-existent, there's not anything really to rehook up into, but there are still vaginal procedures though. The vaginal mesh only refers to the mesh that's placed through the vagina and mesh has been used for surgery for hernia surgery since the eighties. So mesh is actually still used, but it's actually placed in through the abdomen and that's not considered vaginal mesh.    [27:41] And people always ask like, is a robot doing my surgery? And I'm like, no, no, no, it's the doctor's running the robot. The robot has the ability to do finer movements. So mm-hmm and then basically they're reconstructing and wrapping this material. And it's usually like a thin mesh around the vagina and kind of attaching it to the tailbone to reconstruct that, that ligament. And then I have to say over the years, I've gotten a lot of, uh, questions about mesh. Like some people picture it in their mind as being like a window screen. It's not that rough.    [28:29] When you were talking about like, why can't you just reattach the tendon? So I was thinking it's not like a cut shoelace. It's more like panty hose. That's been so stretched.   [28:39] Exactly. Exactly. Yeah. If you could like run in your that's a great I and where were you when I BA Brazilians of years ago? And I could have used that. Yeah. Like if you get a run in your, your stockings, you're not gonna sit there and try to try to sew it back up cuz you're just gonna make more runs and it's just gonna keep going. And there's really not much to pull together.    [29:00] And the mesh. Yeah. It's like TWI or it is like panty hose kind of like a really fine fishnet panty hose, but alright, so some great solutions there. Well tell them about what they're going. Who else is gonna be, uh, the happy vagina rally summit. I'm there? You talked about Susan. She's amazing. Any other people and we will have the link in the show notes and it airs on what days?   [29:28] June 9th through 12th.   [29:30] Ninth through 12. Yeah. So anything else you wanna share about what? Good goodness they will get there.   [29:35] Yeah. Even though we call it the happy vagina rally, it's not everything about vaginas is we're talking everything from perimenopause to menopause and vaginal health. So we're kind of covering it all. So we have Kevin Ellis, the bone coach talking about osteoporosis when, uh, which was actually interesting. When I interviewed with him on his podcast, we actually found studies that connected bone health with vaginal health, which I was fascinated by. I was like, what? We have people like Susan Bretton. We have we Jagger. Who's the, the erotic therapist. We have JJ Virgin talking about sugar and your diet. We have Deborah Atkinson talking about exercise and how, why we can't lose weight. As we get older. I have Dr. Aika Becca talking about hysterectomies and menopause. I have some your other urogynecologist talking about prolapse, talking about incontinence, different vulva dermatology, a vulva dermatologist on Dr. Lynette Maren.    [31:21] Vagina smoothies. There's a pelvic meditation. This was actually fun. I, I, I actually created this pelvic meditation. I started looking into things beyond traditional medicine and looking into some of these alternative therapies and sound therapy and certain wavelengths that are supposed to stimulate your pelvic chakra, which is opens up creativity. And we created a pelvic meditation at a certain frequency as with something called Bial beats where it's like slightly different tones in each ear and actually has a relaxing property to the brain, which was actually fascinating to look into and create. So we have a little bit of everything going on. It it's all gonna be a lot of fun.   [32:33] Can, and it's funny, you mention, it's funny, you mentioned the vagina spa because that's in the works. That's in the works.   [32:40] Ah . Yeah. And you know, I was gonna ask you along those lines, I have to we'll end with this. So I go to this, don't tell anyone, but like one of my favorite places in Atlanta, when I go there is Jeju sauna. Do you know Jaju?   [32:55] No.   [32:56] So JJO is this, I don't know. It's like 20,000 square feet, Korean bathhouse up in Gwinnett county. Oh. And they have first off every kind of sauna you could wanna go to. Right? They've got the Jade sauna and this salt rock sauna and the gold sauna. And like all these saunas, they've got steam rooms, they've got the best foot reflexology I've ever had. Every time I go there, I get the foot reflexology. They have this Korean scrub where the women, you lay naked on this table. It's like this big room of all these, they look like surgical tables T VH, and they scrub you down. You're like totally naked. They have a towel over your head. If you didn't know what was happening, you'd think it was really weird. And they scrub down to your body with this scrub and it is, it is just, it's wonderful.    [34:08] You know, it's funny you bring that up cuz I know that was made super popular, especially with Gwyneth PTRO. I know she's been kind of touted as making that super trendy and there is a lot of belief that vaginal steaming can help with fertility or the biome or menopause. I think when you come, I I'm really into body mind spirit. So I think if you believe it's gonna help, it's going to help. And I think it's maybe very relaxing, but honestly it doesn't work anywhere close to what people think it believes does. They think they're gonna sit on this pot of herbs and that this steam is gonna go up in the vagina and clean it out. But Reno is gynecologists.    [35:05] So the steam is really not gonna get up there. Plus you have the lips of the VVA that are kind of protective and for most, and there's so much, I always say, vulvas are like snowflakes. There's not like there's not, they all they're all look different. But for the most part, the lips of the VVA are kind of keeping that area closed. So it would be really difficult for that team to get up in there and steam things out the way people are picturing it. But if you think it's relaxing to do so, I'm like, okay, you know, go ahead and do it though.   [36:05] Yeah. So if you've had one, check me out on Instagram or Betsy and let's hear your experience, I'd love to know I did it one time cuz I wanted to see and the herbs are great. You get to breathe them in. So I'm wondering if actually it has more respiratory benefit than anything else I else have   [36:26] I'm with you. Like the vaginas collapsed down. It's not a stove pipe and so I don't really know how much benefit there is to it. But I do think that if you have a belief around it and it could be working at an energetic level on the energy body and on that SAC chakra, that is all about creativity. So I we'd love to hear your thoughts and opinions on that. So check out Betsy on her Instagram, what's your Instagram, Betsy   [36:52] At Dr. Dr. And then Betsy Greenleaf underscore you gotta put the underscore. This is my second account. I kind of okay. off the Instagram. Talk about not keeping my mouth shut. I off the Instagram. God's the first, the first account. So   [37:06] yeah. Well, let's end with this other quote you had from Anne Rand, which I love it. The question isn't who's going to let me it's who is going to stop me? Well, Instagram may try, but the vagina lives on with the happy vagina rally. Thank you so much for joining me, Dr. Betsy Greenleaf, we will see you at the happy vagina rally.   [37:33] And thank you for joining us for another episode up the hormone prescription with Dr. Kirin. It's been my pleasure to have you here today. I want you to take in mind some of the things that we've shared. If you learned something that could benefit another woman, please do consider sharing it. And I want you to think about developing your voice and not being silent. What is it that you need to speak up about and be truthful about?   [38:00] Thank you so much for listening. I know that incredible vitality occurs for women over 40. When we learn to speak hormone and balance these vital regulators to create the health and the life that we deserve. If you're enjoying this podcast, I'd love it. If you give me a review and subscribe, it really does help this podcast out so much. You can visit the hormone prescription.com, where we have some free gifts for you, and you can sign up to have a hormone evaluation with me on the podcast to gain clarity into your personal situation until next time, remember, take small steps each day to balance your hormones and watch the wonderful changes in your health that begin to unfold for you.    Get Dr. Betsy Greenleaf's FREE Yoni Meditation: Unlock your creativity, release emotions that don't service you and trigger pelvic emotional healing. CLICK HERE: https://info55d483.clickfunnels.com/pelvic-meditationto56zken   Happy Vagina Rally, hosted by Dr. Betsy Greenleaf: 30+ Women's Health Experts Reveal Proven Solutions to Have A Healthy Vagina Free Of Infections or Discomfort, Boost Your Confidence And Experience Mind-Blowing Sex Without Pain! The FREE Virtual Summit Starts June 9th, 2022 CLICK HERE to register: https://GreenleafInstitute.ontralink.com/t?orid=40&opid=1   Join The Hormone Bliss Challenge  FEEL ENERGIZED, SEXY & CONFIDENT IN YOUR BODY AGAIN... IN JUST 5 DAYS. Discover How To Balance Your Hormones & Jumpstart Your Metabolism So That You Can Lose Weight & Regain Energy! CLICK HERE: https://bit.ly/hormonebalancebliss  

Episode 2302 of the Vietnam Veteran News Podcast will feature a story about Vietnam Vet Larry Cavanaugh and the new path he discovered in the VVA. The featured story appeared on Spectrum News 1 of Green Bay, Wisconsin and was … Continue reading → The post Episode 2302 – Vietnam Vet Larry Cavanaugh found a better path appeared first on .

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Have you ever wondered why you are prone to hormone problems?   In this episode of the Hormone Prescription Podcast, we talk with Dr. Aviva Romm about why women are more likely to experience hormone imbalances and what we can do to prevent them.   Dr. Aviva Romm is a leading authority on natural health and holistic medicine, and her insights will help you understand your own body better. She is a midwife, Yale-trained MD and Board Certified Family Physician who specializes in Integrative Gynecology, Obstetrics, and Pediatrics, with a focus on women's endocrinology. She's also a world-renown herbalist, and author of the textbook, Botanical Medicines for Women's Health, as well as 7 other books, including The Adrenal Thyroid Revolution and her new book, Hormone Intelligence, an instant New York Time Bestseller, which explores the impact of the world we live in on women's hormones and health, and brings us a new medicine for women that is holistic and natural, while being grounded in the best science and medicine, have to offer. A practitioner, teacher, activist, and advocate of both environmental health and women's reproductive rights and health, she has been bridging traditional medicine, total health ecology, and good science for over three decades.   In this episode, we discuss the importance of listening to your "hormone intelligence" and how it can guide you to making better choices for your health.   You will learn: -Why women are more prone to hormone problems -What you can do to prevent hormone imbalances -How to listen to your "hormone intelligence" -The importance of making choices for your health And much more!   [01:01] Welcome back to another episode of the hormone prescription podcast with Dr. Kirin. Thank you so much for joining me today. We are going to jump into some hormone deliciousness today with Dr. Aviva Ram. Some of you probably already know her because she is one of the queen bees of hormones. She's a medical doctor. She's also a nurse midwife. Her background is in nurse midwifery. We actually found out that we went to the same high school in New York City, Bronx science.   [01:56] So maybe you will learn some tips on how to tune back into what she's telling you and transform your hormones and your health. I think that that quote really exemplifies what Dr. Aviva Ram is all about. She shared this quote with me before we met for her interview. And it's really what she wants for you. It's what I want you. I think that you will get lots of information that can help you to thrive and not just survive in this life. Cause if you're just surviving, you're not doing it right.   [02:55] So Dr. Aviva Ram is a medical doctor and a midwife. She's Yale trained for her medical degree and she's a board certified family physician who specializes in integrative gynecology, obstetrics and pediatrics with a focus on women's endocrinology. She's also a world renowned herbalist and author of the textbook botanical medicines for women's health as well as seven other books, including the adrenal thyroid revolution and her new book, hormone intelligence and instant, New York times bestseller, which explores the impact of the world. We live in on women's hormones and health and bring us a new medicine for women that is holistic and natural while being grounded in the best science and medicine have to offer a practitioner, teacher, activist and advocate of both environmental health and women's reproductive rights and health.   [04:16] I am super excited to talk to you about hormones in, oh my gosh. I freaking love your book and agree with really everything that you say. And I love how honest you are and you're honest. I mean, it's unfortunate, but we've gotta face some hard truths right now about the care that we are giving women or should I say not giving women. And I love that you are honest and that you really stop the medical gas lighting that's going on. And you say women, you are right. You are not being taken care of. You're not being nurtured. So talk about how you became so passionate about women's health.   [04:56] Well, it started out really early for me. I, as we were chatting about before, um, Karen and I, you all, we, we both went to the same geeky science high school in New York. We both went to Bronx high school of science and I knew I wanted to be a physician even as early as ninth grade, but I wanted to get out of New York and I was living in a housing project.    [05:53] And we're talking back to 1981. So this was a long time ago. And when I started to look at the history of women's health, the fact that at that time in 81, the C-section rate was already becoming a concerning issue, how high it was getting. And at that point, it hadn't even hit 19% yet. Now we're at like 34% nationally in 1981, it was still legal for black and brown women to be sterilized at childbirth without their consent in California, for example.    [06:57] So it kind of goes pretty far back deep in my roots of the things that I was just very blessed and ballsy enough to like that combination of like stepping out there to dare, to take some chances. And then those people were in my path to help me understand. So that really kind of just pushed me to a whole new commit, to deeply understanding healthcare. And I became a home birth midwife.   [07:49] And at that time too, you know, we're talking like 81 all the way into the mid two thousands. Believe it or not things like herbal medicine, nutrition, midwifery, these were really fringe. I mean, really, really fringe. The medical model was not giving any of these things, even lip service at that time. It was like you were either in the system or you were out of the system.    [08:52] So I also wanted to be a voice and an advocate for people needing it, but like increasingly my mission is now to also just be a voice and an advocate for changing healthcare because healthcare providers are getting burned out on how healthcare is too. So that's kind of, you know, in a nutshell, the journey and where I've come through and come to. And then, you know, I was part of that. I went to medical school. I mean, I went to Yale, I got my MD and did my internship in internal medicine, women's health. And I did my residency in family medicine, cuz I wanted to add in the OB and the pediatrics, which most internal medicine docs don't do. I couldn't do the OB. I started the interview, no like I to interview in OB programs. And I actually withdraw my applications because I was like, I am gonna be so unhappy as a midwife doing OB in that system. So I really give you credit for doing that. For me, family medicine was a softer way to be able to stay aligned with what I, who I was and where I was going.   [09:56] You know, it's interesting that, you know, you point out that a lot of herbal medicine was on the fringe home. Midwifery was fringe. When I came out of residency in 96, a couple years later, I actually started being the backup for the midwives locally. And they had applied for privileges at the hospital to do liver decades before and been blocked repetitively.   [10:37] And that's for the nurse midwives. Right. So that was for CMS. It wasn't even like the traditional direct entry midwives. And they had the CMS had an obstacle and they're trained in the medical model.   [10:50] Right. And even after the commission and the suit, they say the hospital has to entertain their application. When they reapply, they would always lose their application and bottom line, they weren't gonna let them in. And then I came and the tides had turned politically and it was then in Vogue to have birthing suites yeah. And allow the family in and have midwives.    [11:22] Yeah. That's amazing. You know, in Georgia, there are over 90 countries that have no OBGYN at all, no hospital access at all. So we were really trying to advocate. In fact, I just spoke this past year to the, um, Georgia state legislature. And we did a lunchtime hour for them still trying to get a home birth midwives licensed. It's very difficult for nurse midwives to attend home births because they're under the auspices of the OB GYN. So if the OB GYN don't approve it, they can't do it or they'll lose their licenses and privileges. So they can't do it.    [12:18] It is insanity. And I may be a little liberal on this, but I really think that it doesn't take all the training that we OB GYNs have to deliver a baby. And this medicalization of the process, really, I think the majority of births would be handled by midwives.   [12:35] That's my, yeah. I mean, we've seen that in every, I mean, we're not talking, you know, in the middle of the Outback somewhere and you know, Australia, we're talking about the middle of like the Congo. We're talking about Western nations that have demonstrated that year after year after decade, after decade, Canada, Germany, UK, Sweden, et cetera, et cetera, that home birth is optimal for otherwise healthy women.    [13:31] And I think like, you know, along with the medicalization that you mentioned an overmedicalization, we see this incredible and infantilization as if adult women should have to be told what we're allowed to as opposed to like, may I, or is it okay if I do this procedure or check you? And it's not just in birth, it's pelvic exams, breast exams, how we're talked to in the doctor's office.    [14:24] It is, you are so right. It is so true. And I really think it's time for a complete revamping of women's healthcare, really a revolution. And I think your book is a great place to start because you cover a lot of these kinds of sociopolitical issues in there. So can you tell everyone what hormonal intelligence means?   [14:46] Yeah. So to me it means a couple of things. So one this idea that we have actually an innate biological blueprint that really hasn't changed over eons of time when women menstruate, the same way we get pregnant, the same way we give birth the same way internationally. We go into menopause basically at the same age that may have changed a little bit historically over time, the age that we did, what these processes repeat over and over and over same hormones, the hormones haven't changed, you know, since we first started walking on two feet and actually even before.    [15:39] We can't just say, oh, well, that's because you're a woman or that's because you have estrogens because you have a uterus. We haven't always had all of these problems. And certainly not at the scope and magnitude and amount of women that and people with a womb that experience them now. So hormone intelligence on the one hand is understanding that we have this innate biological blueprint, hormone intelligence is also having the intelligence or wisdom to understand that blueprint.   [17:05] It's so true. In my medical training, I really was taught and got the impression that we were little men and, and that we had this little extra accessory pack, like a little black bag you might wear to a black tie event. That was our female hormone pack that conferred oh, interesting. The ability to reproduce. And that was like a separate department and it really didn't affect who we are foundationally. And you know, in my journey I've learned that nothing could be further from the truth we are.    [17:46] Totally. And I think sometimes too, because as women, you know, we all know the statements. What are you on your period? I mean, we had a president that said to a reporter, is that you're, you know, is that blood coming out of your hoots or whatever right now, you know, it's like the, to admit that our hormones have an impact on our life and our actions and thoughts and behaviors.   [18:32] Yeah. And you know, I love how you talk about just the words that we use to describe our anatomy. Can you talk a little bit about that and kind of moving towards a less violent nomenclature that is more nurturing and supportive of us.   [18:49] Yeah. We tend to have a very male centered and militaristic approach to health in general. I mean, we all hear, you know, in this moment of the pandemic, right? Like your immune system fighting and battling, and we're very keyed into this war mentality and with, with women's bodies, I mean, all the parts are named after men, even pelvic floor exercises were for women were originally named after Dr. Keel. You know, we have our Bartels glands, we have all these pouches of Douglas.    [19:45] So I really like to reclaim body parts whenever we can use an Ana correct name. That's great. But I do think we need to rethink some of those names and maybe rename things. But you know, when we can just call things what they are pelvic floor instead, you know, pelvic floor exercises, instead of Kas, you can say birth canal, if you want to, instead of vagina and not everyone who has one wants to get birth. So how do we rethink it? It's so funny, but because my oldest daughter is here visiting me right now and she's 33 and she was saying how funny it was.    [20:30] And my daughter was like, it's so funny, mom. Whenever I hear it, she's like I cringe cuz it was so embarrassing when I was a kid. But she's like, it's so popular now. And it's not necessarily the perfect word, but it is at least a respectful term for women's really means the VVA. That's another thing too.    [21:25] It's so true. Ava and I used to, when I practiced basic OB GYN, which I don't do anymore, I used to keep a mirror in my exam rooms and I would show everyone when we would have the speculum exam, this is what your cervix is and show them their anatomy. And I was surprised how many women had never looked yes. At their anatomy.   [21:47] And when do they're like, oh, that's amazing. Or that's really cool or wow, that's not what I thought. Yeah.   [21:54] I am for anatomy and biology education, age appropriate all the way through our training. Just so I think we'd have a lot fewer health problems. I love how you explain cuz this is so I harp on and I love how you describe this. Hormones are messengers, symptoms are messages. So I don't think a lot of people understand what is the role of hormones? What are they doing? Can you talk a little bit about that as messengers and then symptoms?    [22:38] Yeah. For sure. Well, as you and I both know, I mean even in basic medical school, basic endocrinology, we learn that hormones are chemical messengers and that's what they literally are. They are produced in one part of the body, in a gland. So that could be your hypothalamus, your pituitary, your thyroid, your adrenals, your ovaries, and then those chemicals are released. And usually like when we're talking about female hormones, we're talking about estrogen or progesterone testosterone, but many others play an important role like cortisol on thyroid, hormone and insulin. And so they're released from wherever their origin place is.   [23:38] And then they rip in one and they cause it to mature and it releases and then that place that's left over produces hormones. So they're just these beautiful signaling molecules. And really, they shouldn't make too much noise. I mean, we shouldn't really be that aware of their presence in any significantly UN uncomfortable way. They should just do their job. But some of the jobs that they do, for example, estrogen does make our breasts get fuller each month.    [24:35] But the kind of crossing over into the line of where a, now it becomes a symptom is when it's causing you discomfort in your life. So your breasts are killing you. Like you can't even put your bra on premenstrually. That may be a symptom of too much estrogen. And for some women that can be a risk factor for fibro cystic, uh, for cystic breast disease, but also for breast cancer, having too much estrogen that causes you to have a lot of really heavy periods of really a lot of pelvic discomfort may be also a risk factor for uterine fibroids because of that too much estrogen we've been taught as women that all of these signs that we get each month, you know, restfulness PMs, heavy periods, late periods, cravings, incredible mood swings are just kind of par for the course of being women.    [25:41] They actually tell us when things aren't going quite according to that hormone, an intelligent blueprint. So if we ignore or suppress those little symptoms and signs, even if they're just causing us, you know, minor discomfort, but definitely discomfort, we're potentially suppressing opportunities, stall other problems later on. So that's why it's so important to listen to these little symptoms and these little messages and take them seriously often when we don't listen to them. When they're small, they start getting louder and louder and louder until they're in full, full blown condition. So that's why I say that symptoms are important messages from our hormones.   [26:24] Yes, absolutely. And you know, I love how you say don't care. Know the messenger.   [26:31] Because the symptom is there to tell you something, you know, I always, I call our body, she and she's telling you.   [26:44] Right. And Tylenol may be great for the moment, right. But if we're doing that day in and day out, we are missing an opportunity. And a lot of the gynecologic conditions that are very common, whether it be PMs or whether it be menstrual cramps or polycystic ovary syndrome, or a lot of breast tension, you know, cyclically, skipped, irregular, all those things are harbingers of later conditions in the sense that many of them are triggered by excessive inflammation or insulin resistance or blood, blood sugar. I balance.    [27:47] Great. Well, and I know everyone should get the book, but can you give them a little kind of overview of wherever they are at whatever stage of life, whatever they're dealing with, maybe heavy irregular, painful periods, P C O S whatever it is, what kind of would be a general overview of the path that they should take to start addressing these problems?   [28:11] Yeah. So I think the first thing is really just to acknowledge that you're having them and then be forgiving of yourself. I know we both love quotes. And one of my favorite quotes is Maya Angelus. Like the font of she's the quote goddess. So she really is my source of often my favorite quotes, but she says, I'm gonna paraphrase. But you know, we do what we can with the information we have when we have it. And when we know better, we do better. So the first thing is just to be really honest with yourself about the symptoms you're having, cuz as women, we are taught to ignore them, suppress them, pretend they're not happening to gloss right over them.    [28:56] So if you don't know your body parts, if you don't know what your uterus is, your bladder is your intestines. The difference between your vagina and your VVA, where your ovaries are. Look at a good image, go to my book, go online and start to identify, you know, what are those symptoms? What are they associated with? And if you can find a wonderful provider, that's always a great step to have someone you can really partner with in exploring what's going on.    [29:48] And then, so with my book, for example, and in my medical practice, I help women identify not just what the medical symptoms are and the medical condition is. But what are the things that we know that may be contributing to those that we can do something about? So for example, we know that women who have really painful periods often have more inflammation and we know that movement, some dietary changes like reducing red meat, reducing dairy, increasing fruits and vegetables, not even rocket rocket science can really make, really make a difference.    [30:55] So for example, one study that I thought was really interesting, looked at a group of teenage girls who were using body products that were very high in S which is a form of plasticizer. It makes plastics soft and they were also drinking out of plastic, water bottles and plastic cups. So the researchers measured their blood level of thas had them go. I think it was one week only of no body products that had added those in it. So like clean body products or no body products and just no more drinking out of plastic. And within that week period of time, their th levels plummeted. Well, we also know those fallates and many environmental chemicals act as what are called endocrine disruptors.   [32:03] But I love and often repeat to my patients. And in, when I teach is your body has the capacity to heal beyond anything you've ever been led to believe. And I don't mean that just, you know, if you just change your thoughts, your fibroids are gonna go away or you're not gonna get breast cancer. Health is much more complicated than that. And disease is much more complicated than that. But in conventional medicine, we're taught that our medical conditions are basically genetically programmed and they're fixed and they're inevitable.    [32:59] But then of course, you know, sometimes it does need a little bit more. So that's where partnering with a good integrative practitioner, your conventional practitioner who knows integrative therapies may help you. And of course that's where my book and articles that I have. I'm sure you have articles too. Can really come in handy to learn from people that you trust. What supplements, what specific foods, what specific, you know, we know that there are a few specific yoga postures that really have been found in research to help with menstrual cramps as an example. And this is so with my book, but also, you know, when we think about women's reproductive health, my book covers the first time you have a period all the way till through Perry menopause.   [33:57] It is. Thank you for outlining. All of that. I know when I was reading the book and you told you have a section called women, women unseen and unheard, and you quoted if just one doctor had listened to me, I wouldn't have lost years of my life to this end quote. And I talk to women every day. I know you do too, who they're just so there's so much frustration. They're not being heard. They read your book, they hear us talking online and they know that a higher standard of care is available for them, but they're really having trouble accessing it.   [35:05] Yes. And you have to, I mean, it's so hard because we're so taught to be polite and not question authority, but it's your body, you know, your body best. If you're really, if you're experiencing something, don't let someone else Gaslight you and tell you you're not, or dismiss it as just stress. I mean, stress may play a part in what's going on, but if you're experiencing anxiety, depression, period problems, fertility challenges, heavy periods, menopausal symptoms. Don't just let somebody tell you, that's just normal.   [36:02] Like being more bold or being more sexualized or like a, you know, in an empowered way. And so I always, I say to women, I even have an article about this on my website, learn to channel your Sasha fierce, like whatever that is for you, it can be any name. You, it can be a wonder woman. It can be Sasha fierce, whoever you, it is for you, but channel her when you go into a physician's office and hold your power. And there's so many things you can do to make notes about what your questions are.    [36:46] I mean, you are sometimes vulnerable when you go into a system and your doctor has seven or 10 minutes to see you amongst the 50 patients. He or she may be seeing that day and is trained in a system to dismiss women and absolutely not trained at all to recognize that there's more to healing and health and wellness than just, you know, here's a pill. Here's that pill here is a surgery or whatever, whatever.    [37:25] Yeah. I love that. Channel. Your inner Sasha fierce, put your big girl panties on and yep. And just do it. One of the things that I really work with, all the women I work with on with their health is their energy body, I and their story and their hi her story. And I love how Carolyn me says that your biography becomes your biology. And so it's really an integral part of the work I do with women. I love this quote you shared from Clarissa Pinola, Estees the doors to the world of the wild self.   [38:30] Couldn't agree more about our stories and how we think of our stories and how we tell our stories. And in fact, in hormone intelligence, in my medical practice, the book and, and what I do with my patients, one on one, one of the things that I do share is a practice on writing your story, reading your story, and rewriting your story so that you are the heroine of your, so many of us have stories that include mistreatment or trauma or being in the dark about something that was going on in our bodies.    [39:25] And nobody said, uh, you could have endometriosis, no matter what, that's not normal. You shouldn't suffer like that. So astonishing. So really writing your story, whether that is your life story and how you are, where you are right now, or just your gynecologic and reproductive health story. And the other thing, and the reason I ask women to read that and rewrite our story is that very few of us are ever taught that we can be the author of our story.   [40:14] You know, if you had a gynecologic variant that was victimizing, for example, 7% of women now report birth trauma. There's a percentage of women in the United States now having such significant birth trauma, that it is diagnosed as PTs D women who struggle horribly with endometriosis or P C O S who become so identified with the trauma are so identified with the diagnosis that they feel victimized by their own bodies or by the health system.    [41:29] And rather than seeing them as a deficit, how can we see them as our superpower? And it's a little bit like that Japanese artist, I think it's called Kenui where you take the wounds of a broken piece of pottery and you paint them with gold so that they're like they're actually sealed back together with gold so that the broken vessel becomes even more of you beautiful and more of an art piece than maybe even the original one as it was sort of created to be.   [42:28] And so for me, I'm very, very alert to my environment. I'm also incredibly about what's going on in my environment. I had to learn to read faces and expressions easily as a child for my own physical and emotional safety. But I'm also deeply aware of the facial expressions and sense of safety of my patients and others, and able to just read subtle nuance. So how can you reframe so that those parts of you are now a gift that you can bring forward to the world and also recognize when you're activated. So those parts are driving you in a not healthful way.    [43:33] I love that. Thank you so much for sharing it. You're welcome. And I could just go on talking, talking, talking to you, but I do wanna be respectful of our listeners' time and attention. Thank you so much for joining us today, Dr. Aviva Romm, do you have any, where can people find you? Where can they find out more? I know they can get the book, hormone intelligence, wherever books are sold, but tell the 'em all the places that they can find   [43:57] You. Okay. So I love hanging out on my Instagram. I am one of those weird people. I don't love social media in general and all the bad things about it, but I do love connecting with my community. So if you go to Dr. Aviva RO on Instagram, you will find me. And that's really me and the comments and DMS. So, you know, it's just quick, like little tips and, and things I'm thinking about and a little glimpse into my life. That's a great place. And then if you want tons of articles, podcasts, videos, eBooks information, my website is the place to go. It's just Aviva rom.com and it's very easy to navigate.   [44:38] Awesome. Thank you so much for those great resources. Thank you for the work you do. Thanks for helping with the revolution when it comes to women's health. I have to ask you this one last question. Yeah. What is it gonna take for us to really overhaul the way women's health is handled, uh, in the mainstream,   [44:56] You know, it's already happening, you know, when you talked about mid, you talked about midwives, right. And midwives create a presence. I mean, it was really women in a sea change kind of way speaking up for and demanding what they want. And sadly, the medical system is also a, it is an industry and it's driven by consumer demand. So the more we all actually channel our Sasha fierce, the more we actually do say to our providers.   [45:40] We, we, we actually can change it with where we are, where we put our money in healthcare. You know, the more we're going to get other forms, the nutritionist that we're seeing, the health coaches that we're seeing that creates that sea change also.   [45:53] Right. Great. Thank you so much for that. Thank you for joining us today, Dr. Aviva Romm,   [45:57] You are so welcome. Thank you for having me.   Get a FREE copy of Dr. Aviva Romm's book: Hormone intelligence - The Woman MDs Guide to Healing Your Periods, Reversing PCOS, Easing Endometriosis, Increasing Fertility, Rekindling Your Sex Drive, Cooling Hot Flashes, and Feeling Really Good in Your Body Again CLICK HERE: https://avivaromm.com/book/   Q & A Episode each month Submit your questions here (leave me a voicemail): https://bit.ly/AskDrKyrin    Join The Hormone Bliss Challenge  FEEL ENERGIZED, SEXY & CONFIDENT IN YOUR BODY AGAIN... IN JUST 5 DAYS. Discover How To Balance Your Hormones & Jumpstart Your Metabolism So That You Can Lose Weight & Regain Energy!   CLICK HERE: https://bit.ly/hormonebalancebliss  

WISCONSIN MUSIC PODCAST Episode 067 Thoughts For Food https://www.thoughtsforfood.org/ In the late fall of 1992, Mark Paffrath (then Executive Director of Racine County Project Emergency), Steve Klinkhammer, Bill May, and Ron Schultz (Vets 21 of Racine), and Dave Popoff (George's Tavern) developed Thoughts For Food™ as a benefit to support Project Emergency.  Racine County Project Emergency, now the Racine County Food Bank, is a non-profit, United Way supported organization that supplies food to residents in need in Racine County.  Vets 21 of Racine had previously sponsored several food and fund raising benefits for the Racine County Food Bank and wanted to continue its efforts while allowing for greater input and support from the community.  What developed was the concept of local musicians donating their "thoughts for food."  This would give Racine area musicians an opportunity to showcase their talents and the community a chance to respond with food and cash donations for the Food Bank. Thoughts For Food™ 1, held on February 27, 1993, featured twelve acts on one stage.  The event was held at George's and the tavern was filled beyond capacity before the first act had finished.  Admission to Thoughts For Food™ 1 was $3 and a non-perishable food item.  The event raised $1,200 and 435 pounds of food. Since then, the annual event has grown in size as has the amount of food and funds contributed. This year's event will feature venues in the "River North" and Downtown areas of Racine.  ​   The success of Thoughts For Food™ has always depended on the support of its volunteers. Over the past 24 years, hundreds of dedicated people and families from VVA 767, the Racine County Food Bank, and the general Racine community helped by staffing the event, distributing and collecting food contribution boxes during the month of February, photographing the event and doing the myriad other tasks that make the event successful. In addition, several hundred band members, sound and lighting techs, and other contributors to the event gave unselfishly of their time and talent.  ​ Over its 29 years, Thoughts For Food™ has raised over $525,000 and more than 120,000 pounds of food for the Racine County Food Bank! It is truly a peaceful demonstration of caring and concern by Racine area residents!   ​ Mission Thoughts For Food™ benefits . . . THE RACINE COUNTY FOOD BANK ​ THE PURPOSE OF THIS ORGANIZATION To efficiently and effectively obtain resources and facilitate the distribution of food, and other necessities through a network of direct service providers to individuals and families of Racine County who are in need.  In doing so, we will equalize the distribution of resources throughout the community and advocate on behalf of the community to reduce hunger. ​ OVERVIEW For over 35 years the Racine County Food Bank has operated an efficient and successful food program. Funding and support of it's operation has come from all areas of the community as well as from the FEMA, which is managed by RCFB.  Because of community involvement and a great staff, Racine County Food Bank is able to help supply the emergency food network in Racine County. ​ FURTHER INFORMATION      For further information on Racine County Food Bank visit the web site at: ​ www.racinecountyfoodbank.org or contact: Racine County Food Bank 2000 DeKoven Avenue, Racine, WI 53403-2481 (262) 632-2307 fax (262) 632-2643 2021 Thoughts for Food TM

The Smart 7 is a daily podcast that gives you everything you need to know in 7 minutes, at 7 am, 7 days a week...With over 9 million downloads and consistently charting, including as No. 1 News Podcast on Spotify, we're a trusted source for people every day.If you're enjoying it, please follow, share, or even post a review, it all helps...Today's episode includes the following:https://twitter.com/SkyNews/status/1496171101541605383?s=20&t=8AzPgCCan5CNpFfO-u_7HA https://twitter.com/BBCWorld/status/1496207005832339457?s=20&t=mgyaRGFcE3i3qjsBKL8MiQ https://twitter.com/LBC/status/1496102783484891138?s=20&t=oq939cDD_ouXz0-zty-vvA https://twitter.com/SkyNews/status/1496109292436471809?s=20&t=8AzPgCCan5CNpFfO-u_7HA https://twitter.com/SkyNews/status/1496025716567195648?s=20&t=smV5BTIZQyWqNk-btRjScg https://twitter.com/Haggis_UK/status/1496071834541961217?s=20&t=Kbz_mMMxZiGiHdDakcHUXg https://twitter.com/nowthisnews/status/1496164541616607243?s=20&t=G-jn1hOveAoSMTjE3tUJ0Q https://twitter.com/btsportfootball/status/1496249819551223810?s=20&t=LV6YH8ZY64DDyy7YD4d0Gghttps://www.youtube.com/watch?v=QtBS8COhhhM&t=797s&ab_channel=BBCNews https://twitter.com/APEntertainment/status/1495540518947753985?s=20&t=Sw31YD62MFKgu1oMufZnmg In Ireland? Why not try our Ireland Edition?Contact us over at Twitter or visit www.thesmart7.comPresented by Jamie East, written by Liam Thompson, researched by Olivia Davies and produced by Daft Doris. See acast.com/privacy for privacy and opt-out information.

Mark Gardner from Maqro Capital and Luke Winchester from Merewether Capital go in-depth and stock specific. Stocks covered: STG, LRK, COE, MCA, MPL, CRW, MND, VVA, PBH, ARB. Our stock of the day is BHP (BHP). See acast.com/privacy for privacy and opt-out information.

Join Chris and Peach as they discuss Chris' recent trip to visit missionaries in Rwanda, Africa. Topics Covered: Travel Woes Unexpected Surprises Big Takeaways Here is a link to the VVA website if you want to learn more or how you can support their work: https://virungavalleyacademy.org/ Stay connected with us! Instagram - @biblebuffoons Twitter - @biblebuffoons Email - thebiblebuffoons@gmail.com

Jeff King is the Operations and Certification Manager for NVBDC.   The National Veteran Business Development Council (NVBDC) was established in 2013 to address the growing need to identify and certify both service disabled and veteran owned businesses (SD/VOBs) in the government and commercial (corporate) marketplace. The NVBDC administers a rigorous certification process designed to withstand the scrutiny of governmental and corporate entities seeking to utilize certified SD/VOBs.  Jeff talks about the new programs at NVBDC, its working with other certifying organizations for Women, Hispanics, Minorities, etc.  He talks with host Jim Fausone about growing up with a father active in the VVA and his own US Army service as a Bradley Gunner.   

Jason McIntosh from Motion Trader and Carl Capolingua from ThinkMarkets go in-depth and stock specific. Stocks covered: GWR, BXB, PDN, QHL, VVA, NMT, IOU, CIM, AVG, ALU. Our stock of the day is Telstra (TLS). See acast.com/privacy for privacy and opt-out information.

Gary Glover from Novus Capital and Howard Coleman from Teaminvest go in-depth and stock specific. Stocks covered: DUB, WOW, DTL, PAN, VVA, ALD, COH, NOV, QAN, AVN. Our stock of the day is Western Areas (WSA). See acast.com/privacy for privacy and opt-out information.

We didn't know what to expect when we sat down with Greg Beaumont, Senior Business Intelligence Specialist at Microsoft specializing in serving Microsoft's Healthcare space customers' technical Power BI issues.  What we got was an insightful, delightful, and impactful conversation with a really cool and smart human! References in this Episode: The Game Azure Health Bot The Future Will Be Decentralized-Charles Hoskinson Spider Goats Episode Timeline: 3:10 - The magic of discovery with the Power Platform, It's all about the customers(and Greg has a LOT of customers!), and Greg's Data Origin Story 21:10 - The IT/Business Gap, Getting good BI and keeping data security is a tricky thing, The COVID Challenge hits Healthcare 43:00 - Power BI-Not just a data visualization tool, a very cool discussion on Genomics and using data to save lives, the importance of Data Modelling 59:10 - The Bitcoin Analogy, The VertiPaq Engine and when is Direct Query the answer 1:08:30 - We get a little personal with Greg, Azure/Power BI integration and Machine Learning, Cognitive Services and Sentiment Analysis Episode Transcript: Rob Collie (00:00:00): Hello, friends. Today's guest is Greg Beaumont from Microsoft. Like one of our previous guests, hopefully, Greg has one of those interface jobs. The place where the broader Microsoft Corporation meets its customers at a very detailed and on the ground level. On one hand, it's one of those impossible jobs. More than 100 customers in the healthcare space look to Greg as their primary point of contact for all things technical, around Power BI. That's a tall order, folks. And at the same time, it's one of those awesome jobs. It's not that dissimilar, really, from our job here at P3. Rob Collie (00:00:45): In a role that, first of all, you get broad exposure to a tremendous number of organizations and their problems, you learn a lot super, super quickly. When you're doing it right, your work day is just nonstop magic. The power platform is magic and not really because of the technology, but instead because of its impact on the people who use it, who interact with it, who benefit from it, whose lives are changed by it. And again, I can't stress this enough, software usually doesn't do this. And as we talked with him, Krissy and I just couldn't stop nodding, because we could hear it, he lives it, just like we do. And I hope that just leaps out of the audio for you like it did for us. Rob Collie (00:01:32): No surprises here, Greg didn't start his life as a data professional. He's our second guest on this show, whose original training was in biology. And so, some familiar themes come back again, that good data professionals come from a wide variety of backgrounds, that the hybrid tweeners between IT and business are really where the value is at today. And I love this about Greg, that we made a point of talking about how much easier it is today to break into the data profession than it's ever been and what an amazing thing that is to celebrate. Rob Collie (00:02:06): We talked about COVID and specifically its impacts on the industry. How that has served as a catalyst for many organizations to rethink their analytic strategy, the implications of remote work, data privacy and security. And of course, it wouldn't be an episode of Raw Data, if we didn't nerd out about at least one thing. So, we get a little bit into genomics and the idea of DNA and RNA as forms of biological computer code. And as you'd expect, and want, Greg is far from a one dimensional data professional, just such an interesting person, authentically human, a real pleasure to speak with, so let's get into it. Announcer (00:02:47): Ladies and gentlemen, could I have your attention, please. Rob Collie (00:02:51): This is the Raw Data by P3 adaptive podcast with your host, Rob Collie. Find out what the experts at P3 Adaptive can do for your business. Just go to p3adaptive.com. Raw Data by P3 Adaptive is data with the human element. Rob Collie (00:03:13): Welcome to the show, Greg Beaumont. How are you? Greg Beaumont (00:03:17): I'm doing well. How are you all? Rob Collie (00:03:19): I think we're doing pretty well. Greg Beaumont (00:03:19): Awesome. Rob Collie (00:03:20): Business is booming. Data has turned out to be relatively hot field, but I think it's probably got some legs to it. And the Microsoft platform also, well, it's just kind of kicking ass, isn't it? So, business wise, we couldn't be better. I think personally, we're doing well, too. We won't go into all that. What are you up to these days? What's your job title and what's an average day look for you? Greg Beaumont (00:03:39): So, I'm working in Microsoft and my title is Technical Specialist. And I'm a Business Intelligence Technical Specialist, so I focus almost exclusively on Power BI and where it integrates with other products within the Microsoft stack. Now, I'm in the Microsoft field, which is different from a number of guests you've had, who work at corporate and we're working on the product groups, which is that I'm there to help the customers. Greg Beaumont (00:04:01): And you hear a lot of different acronyms with these titles. So, my role is often called the TS. In the past, it was called a TSP. It's just a change in the title. Sometimes you might hear the title, CSA, Cloud Solution Architect. It's very similar to what I do, but a little bit different. But effectively from an overarching standpoint, our goal in the field as Technical Specialists is to engage with customers, so that they understand how and where to use our products, and to ensure that they have a good experience when they succeed. Rob Collie (00:04:29): Your job is literally where the Microsoft organism meets the customers. Greg Beaumont (00:04:34): Yep. Rob Collie (00:04:35): That's not the role I had. I was definitely on the corporate side, back in my days at Microsoft. I think the interaction between the field and corporate has gotten a lot stronger over the years. I think it's a bit more organic, that interplay, that it used to feel like crossing a chasm sort of thing. And I don't think that's really true anymore. Greg Beaumont (00:04:54): At a green, I think that's by design, too. So, with the more frequent release schedules and also kind of how things have changed under Satya, customer feedback drives the roadmap. So when these monthly updates come out, a lot of it is based off of customer demand and what customers are encountering and what they need. So, we're able to pivot and meet the needs of those customers much more quickly. Rob Collie (00:05:15): Yeah, you mentioned the changing acronyms, right? I mean like yes. My gosh, a thousand times yes. It's almost like a deliberate obfuscation strategy. It's like who's what? Why did we need to take the P off of TSP? I mean, I'm sure it was really important in some meeting somewhere, but it's just like, "Oh, yeah, it's really hard to keep track of." It's just a perpetually moving target. But at the same time, so many fundamentals don't change, right? The things that customers need and the things that Microsoft needs to provide. The fundamentals, of course, evolving, but they don't move nearly as fast as the acronym game. Greg Beaumont (00:05:52): Right. I think that acronym game is part of what makes it difficult your first year here, because people have a conversation and you don't know what they're talking about. Right? Rob Collie (00:06:00): Yeah, yeah, yeah. Greg Beaumont (00:06:00): And if they just spelled it out, it would make a lot more sense. Rob Collie (00:06:03): Krissy was talking to me today about, "Am I understanding what Foo means?" There's an internal Microsoft dialect, right? Krissy was like, "Is Foo like X? Is it like a placeholder for variable?" I'm like, "Yes, yes." She's like, "Okay. That's what I thought, but I just want to make sure." Krissy Dyess (00:06:18): That's why there's context clues in grade school really come into play when you're working with Microsoft organization, because you really got to take in all the information and kind of decipher it a bit. And those context clues help out. Greg, how long have you been in that particular role? Has it been your whole time at Microsoft or are have you been in different roles? Greg Beaumont (00:06:36): So, I should add, too, that I'm specifically in the healthcare org, and even within healthcare, we've now subspecialized into sub-verticals within healthcare. So, I work exclusively with healthcare providers, so people who are providing care to patients in a patient care setting. I do help out on a few other accounts, too, but that's my primary area of responsibility. Greg Beaumont (00:06:55): So, I started with Microsoft in 2016. I was actually hired into a regional office as what's called the traditional TSP role and it was data platform TSP. So, it was what used to be the SQL Server TS role. A few months later, the annual realign happened, I got moved over to Modern Workplace because they wanted to have an increased focus on Power BI, and I had some experience in that area. Plus, I was the new guy, so they put me into the experimental role. A year later, that's when they added the industry verticals and that's when I moved into what is kind of the final iteration of my current role. And the titles have changed a few times, but I've effectively been in this role working with healthcare customers for over four years now. Rob Collie (00:07:35): And so, like a double vertical specialization? Greg Beaumont (00:07:37): Yeah. Rob Collie (00:07:37): Healthcare providers, where there's a hierarchy here? Greg Beaumont (00:07:40): Yeah, yeah. Rob Collie (00:07:41): Those are the jaw dropping things for me is sometimes people in roles like yours, even after all that specialization, you end up with a jillion customers that you're theoretically responsible for. Double digits, triple digits, single digits in terms of how many customers you have to cover? Greg Beaumont (00:07:58): I'm triple digits. And that is one of the key differences from that CSA role that you'll see on the Azure team is they tend to be more focused on just a couple of customers and they get more engaged in kind of projects. And I will do that with customers, but it's just, it's a lot more to manage. Rob Collie (00:08:14): Yeah. What a challenging job. If you think about it, the minimum triple digit number is 100, right? So, let's just say, it's 100 for a moment. Well, you've got 52 weeks a year plus PTO, right? So, you're just like, "Okay." It is very, very difficult to juggle. That's a professional skill that is uncommon. I would say that's probably harder than the acronym game. Greg Beaumont (00:08:37): Yeah, there's been times I was on a vacation day and I got a call. I didn't recognize the number. I'm like, "Okay, I'm going to have to route this to somebody because I'm off today." And they're like, "Well, I'm the VP of so and so and we need to do this." And I'm like, "Okay, I got to go back inside and work now, because this is an important call." So, you have to be flexible and you're correct, that it makes it a challenge to have that work-life balance also, but the work is very rewarding, so it's worth it. Rob Collie (00:09:01): Yeah. It's something that vaguely I have a sense of this. I mean, transitioning from corporate Microsoft to, I mean, you can think of my role now as field. I'm much, much closer to the customers than I ever was at corporate. And yes, Brian Jones and I talked about it a little bit. And this is a bit of an artifact of the old release model that it was like every few years, you'd release a product, which isn't the case anymore. But that satisfying feeling of helping people, like even if you build something amazing back at Microsoft in the days that I was there, you were never really around for that victory lap. You would never get that feedback. It even never make it to you. Rob Collie (00:09:37): It was years later muted whereas one of the beautiful things about working closely with customers and our clients with Power BI, and actually the Microsoft platform as a whole, is just how quickly you can deliver these amazingly transformational like light up moments that go beyond just the professional. You can get this emotional, really strong validating emotional feeling of having helped. And that is difficult to get, I think even today, probably, even with their monthly release cycles, et cetera. By definition, you're just further removed from the "Wow" that happens out where the people are. Greg Beaumont (00:10:15): Yep. And I'm sure you all see that, too, with your business is that a lot of work often goes into figuring out what needs to be in these solutions and reports, but when you actually put it in the hands of leaders, and they realize the power of what it can provide for their business, in my case for their patients, for their doctors, for their nurses, it becomes real. They see it's actually possible and it's not just a PowerPoint deck. Rob Collie (00:10:38): And that sense of possibility, that sense of almost child-like wonder that comes back at those moments, you just wouldn't expect from the outside. I had a family member one time say, "Oh, Rob, I could never do what you do." Basically, it was just saying "How boring it must be, right?" It's so boring working with software, working with..." I'm like, "Are you kidding me? This is one of the places in life where you get to create and just an amazingly magical." It's really the only word that comes close to capturing it. You just wouldn't expect that, right? Again, from the outside like, "Oh, you work in data all day. Boring." Greg Beaumont (00:11:17): I'd add to that, that I'd compare it to maybe the satisfaction people get out of when they beat a game or a video game. That when you figure out how to do a solution and it works and you put in that time and that effort and that thought, there's that emotional reward, you get that I built something that that actually did what they wanted it to do. Rob Collie (00:11:35): Yeah. And after you beat the video game, not only did that happen, but other people's lives get better as a result of you beating this game. It's just like it's got all those dynamics, and then some. All these follow on effects. Greg Beaumont (00:11:46): It's like being an athlete and enjoying the sport that you compete in. Rob Collie (00:11:50): Yeah. We're never going to retire. We're going to be the athletes that hang on way too long. Greg Beaumont (00:11:56): Yep. Rob Collie (00:11:58): So, unfortunately, I think our careers can go longer than a professional athletes, so there's that. I can't even really walk up and down stairs anymore without pain, so. So what about before Microsoft? What were you up to beforehand and how did you end up in this line of work in the first place? Greg Beaumont (00:12:15): Sure. And I think that's actually something where listeners can get some value, because the way I got into this line of work, I think today, there's much more opportunity for people all over the world from different socioeconomic backgrounds to be able to break into this field without having to kind of go through the rites of passage that people used to. So, I was actually a Biology major from a small school. Came from a military family. I didn't have corporate contacts or great guidance counseling or anything like that. My first job right out of school was I said, "Oh, I got a Biology major. I got a job at a research institution." They're like, "Okay, you're going to be cleaning out the mouse cages." And it was sort of $10.50 an hour. Greg Beaumont (00:12:53): So, at that point, I said, "Okay, I got to start thinking about a different line of work here." So, I kind of bounced around a little bit. I wanted to get into IT, but if you wanted to learn something like SQL Server, you couldn't do it unless you had a job in IT. As an average person, you couldn't just go buy a SQL Server and put it in your home unless you had the amount of money that you needed to do that. Side projects with Access and Excel. Small businesses did things probably making less than minimum wage and side gigs, in addition to what I was doing for full-time work to pay the bills. Eventually caught on with a hospital where I was doing some interesting projects with data using Access and Excel. They wouldn't even give me access to Crystal Reports when we wanted to do some reporting. That was really where I kind of said , "Data is where I want to focus." Greg Beaumont (00:13:41): We did some projects around things like Radon Awareness, so people who would build a new house now, they're like, "Oh, I have to pay $1500 for that Radon machine down in the basement." But when you talk to a thoracic surgeon and their nursing team and you hear stories about people who are nonsmokers, perfectly healthy, who come in with tumors all over their lungs, you realize the value there and by looking at the data of where there's pockets of radon in the country reaching out to those people has value, right? I think it's that human element where you're actually doing something that makes a difference. So, that kind of opened my eyes. Greg Beaumont (00:14:14): I then after that job, I got on with a small consulting company. I was a Project Manager. It was my first exposure to Microsoft BI. It was actually ProClarity over SQL Server 2005 and we were working with data around HEDIS and Joint Commission healthcare performance measures for one of the VA offices. So, I was the PM and the Data Architect was building the SSIS packages, built out kind of skeleton of an analysis services cube. He asked me to lean in on the dashboarding side, and that's also where I started learning MDX because we were writing some MDX expressions to start doing some calculations that we were then exposing in ProClarity. And at that point, it was like, "This is magic." Greg Beaumont (00:14:57): From a used case perspective, what they were doing traditionally doing was they'd send somebody in from some auditing agency, who would look at, I think it was 30 to 60 patient records, for each metric and then they take a look at where all of the criteria hit for that metric, yes or no. And it would be pass/fail, how good is this institution doing of meeting this particular expectation. So, it would be things like, "Does a patient receive aspirin within a certain amount of time that they've been admitted if they have heart problems?" Something like that. With looking at it from a data perspective, you can look at the whole patient population, and then you could start slicing and dicing it by department, by time of day that they were admitted, by all of these different things. Greg Beaumont (00:15:38): And that's when I kind of said, "This is really cool, really interesting. I think there's a big future here." And I kind of decided to take that route. And from there, I got on with a Microsoft partner, where I stayed for about six years. And that's kind of where I was exposed to a lot of very smart, very gifted people. And I was able to kind of learn from them and then that led to eventually getting a job at Microsoft. But to make a long story short, today, you could go online and get Power BI Desktop for free. There's training resources all over the place, and you could skill up and get started and get a great job. I'd like to tell people take the amount of time you spend every night playing video games and watching television, take half that time and devote it to learning Power BI and you'll be amazed at how far you get in six to 12 months. Rob Collie (00:16:24): That's such good advice. I'm not really allowed to play a lot of video games, so I might need more time than that. But I had my time to do that years ago, learning DAX and everything. A couple of things really jumped out at me there. First of all, you're right, it was almost like a priesthood before. It was so hard to get your foot in the door. Look, you had to climb incrementally, multiple steps in that story to just get to the point where you were sitting next to the thing that was SSIS and MDX which, again, neither of those things had a particularly humane learning curve. Even when you got there, which was a climb, you get to that point and then they're like, "And here's your cliff. Your smooth cliff that you have to scale. If you wanted a piece of this technology," right? Rob Collie (00:17:11): You wanted to learn MDX, you had to get your hands on an SSAS server. The license for it. And then you had to have a machine you could install it on that was beefy enough to handle it. It's just, there's so many barriers to entry. And the data gene, I like to talk about, it does. It cuts across every demographic, as far as I can tell, damn near equally everywhere. Let's call it one in 20. It's probably a little less frequent than that. Let's call it 5% of the population is carrying the data gene and you've got to get exposure. And that's a lot easier to get that exposure today than it was even 10 years ago. Greg Beaumont (00:17:50): I'd completely agree with that. The people in this field tend to be the type of people who likes solving puzzles, who like building things that are complex and have different pieces, but who also enjoy the reward of getting it to work at the end. You've had several guests that have come on the show that come from nontraditional backgrounds. But I'm convinced that 20 years ago, there were a lot of people who would have been great data people, who just never got the opportunity to make it happen. Greg Beaumont (00:18:14): Whereas today, the opportunity is there and I think Microsoft has done a great job with their strategy of letting you learn and try Power BI. You can go download the dashboard in a day content for free and the PDF is pretty self-explanatory and if you've used excel in the past, you can walk through it and teach yourself the tool. I think the power of that from both the perspective of giving people opportunity and also building up a workforce for this field of work is amazing. Rob Collie (00:18:42): Yeah. I mean, all those people that were sort of in a sense like kind of left behind, years ago, they weren't given an avenue. A large number of them did get soaked up by Excel. If they're professionally still active today, there's this tremendous population of Excel people if they were joining the story today, they might be jumping into Power BI almost from the beginning, potentially. And of course, if they were doing that, they'd still be doing Excel. But there's still this huge reservoir of people who are still tomorrow, think about the number of people tomorrow, just tomorrow. Today, they're good at Excel and tomorrow, they will sort of, they'll have their first discovery moment with Power BI. The first moment of DAX or M or whatever, that's a large number of people tomorrow who are about to experience. It's almost like did you see the movie The Game? Greg Beaumont (00:19:36): I have not. Rob Collie (00:19:37): There's this moment early in the movie where Michael Douglas has just found out that his brother or something has bought them a pass to the game. And no one will tell him what it is. He meets this guy at a bar who says, "Oh, I'm so envious that you get to play for the first time." Also, this is really silly, but it's also like the ACDC song For Those About To Rock, We Salute You. For those about to DAX, we salute you, because that's going to happen tomorrow, right? Such a population every day that's lighting up and what an exciting thing to think about. Do you ever get down for any reason, just stop and think, "Oh, what about the 5000 people today who are discovering this stuff for the first time." That is a happy thing. Greg Beaumont (00:20:16): Yeah, I actually had a customer where one of their analysts who turned out to be just a Power BI Rockstar, he said, "I'd been spending 20 years of my life writing V-lookups, and creating giant Excel files. And now, everything I was trying to do is at my fingertips," right? And then within a year, he went from being a lifelong Excel expert to creating these amazing reports that got visibility within the organization and provided a ton of value. Rob Collie (00:20:42): And that same person you're talking about is also incredibly steeped in business decision-making. They've been getting a business training their whole career at the same time. And it's like suddenly, you have this amazingly capable business tech hybrid, that literally, it just like moved mountains. It's crazy. We've talked about that a lot on the show, obviously, the hybrids, just amazing. And a lot of these people have come to work for us. Rob Collie (00:21:09): That's the most common origin story for our consultants. It's not the only one. I mean, we do have some people who came from more traditional IT backgrounds, but they're also hybrids. They understand business incredibly well. And so, they never really quite fit in on the pure IT side, either. It's really kind of interesting. Greg Beaumont (00:21:26): Yeah, I think there's still a gap there between IT and business, even in kind of the way solutions get architected in the field. It's understanding what the business really wants out of the tool is often very different from how IT understands to build it. And I think that's where people like that provide that bridge, to make things that actually work and then provide the value that's needed. Rob Collie (00:21:47): There's such valuable ambassadors. It's just so obvious when IT is going to interact with a business unit to help them achieve some goal. It's so obvious that, of course, who you need to engage with IT. IT thinks, "We need to engage with the leaders of this business unit." They've got the secret weapon, these hybrid people that came up through the ranks with Excel. The word shadow IT is perfect. These people within the business, like they've been Excel people for their entire careers, they have an IT style job. Rob Collie (00:22:22): Almost all the challenges that IT complains about with working with business, you take these Excel people and sort of put them in a room where they feel safe. They'll tell you the same things. They're like, "I had exactly the same problems with my 'users,' the people that I build things for." And yeah, there's such a good translator. And if the communication flows between IT and business sort of through that portal, things go so much better. That's a habit. We're still in the process of developing as a world. Greg Beaumont (00:22:51): Yeah. And in healthcare that actually also provides some unique challenges. With regulation and personal health information, these Excel files have sensitive data in them, and you have to make sure it's protected and that the right people can see it. And how do you give them the power to use their skills to improve your organization, while also making sure that you keep everything safe. So, I think that's a hot topic these days. Rob Collie (00:23:15): Yeah. I mean, it's one of those like a requirement, even of the Hello World equivalent of anything is that you right off the bat have to have things like row level security and object level security in place and sometimes obfuscation. What are some of the... we don't want to get to shop talky, but it is a really fascinating topic, what are the handful of go-to techniques for managing sensitive healthcare information? How do you get good BI, while at the same time protecting identity and sensitivity. So often, you still need to be able to uniquely identify patients to tie them across different systems, can identify them as people. It's really, really, really tricky stuff. Greg Beaumont (00:24:02): And I think just to kind of stress the importance of this, you can actually go search for look up HIPAA wall of shame or HIPAA violation list. When this information gets shared with the wrong people, there's consequences and can result in financial fees and fines. And in addition to that, you lose the trust of people whose personal information may have been violated. So, I think a combination of you said things row level security and object level security as a start, you can also do data masking, but then there's issues of people export to Excel. What do they do with that data afterwards? Greg Beaumont (00:24:37): And then there's going to be tools like Microsoft Information Protection, where when you export sensitive information to Excel, it attaches an encrypted component. I'm not an MIT expert. I know how it works. I don't know the actual technology behind it. But it attaches an encrypted component where only people who are allowed to see that information can then open that file. So, you're protecting the information at the source and in transit, but you're still giving people the flexibility to go build a report or to potentially use data from different sources, but then have it be protected every step of the way. Greg Beaumont (00:25:11): So like you said, without getting too techie, there's ways to do it, but it's not just out of the box easy. There's steps you have to go through, talk to experts, get advice. Whether it's workshops or proof of concepts, there's different ways that customers can figure that out. Rob Collie (00:25:28): Yeah. So because of that sort of mandatory minimum level of sensitivity handling and information security, I would expect, now that we're talking about it, that IT sort of has to be a lot more involved by default in the healthcare space with the solutions than IT would necessarily be in other industries. Another way to say it, it's harder for the business to be 100% in charge of data modeling in healthcare than it is in other industries. Greg Beaumont (00:26:02): Yep. But you can have a hybrid model, which is where the business provides data that's already been vetted and protected and there might be other data that doesn't have any sensitive data in it, where it's game on, supply chain or something like that. But having these layers in between, the old way of doing things was just nobody gets access to it. Then there was kind of canned reporting where everybody gets burst in the reports that contain what they're allowed to see. But now, you can do things in transit, so that the end users can still use filters and build a new report and maybe even share it with other people. And know that whoever they're sharing with will only be able to see what they're allowed to see. It gets pretty complex, but it's definitely doable and the customers that are doing it are finding a lot of value in those capabilities. Rob Collie (00:26:48): That's fundamentally one of the advantages of having a data model. I was listening to a podcast with Jeffrey Wang from Microsoft and he was talking about it. And I thought this was a really crisp and concise summary, which is that the Microsoft Stack Power BI has a model-centric approach to the world whereas basically, all the competitors are report centric. And what does that mean? Why does that even make a difference? Well, when you build a model, you've essentially built all the reports in a way. You've enabled all of the reports. You can build many, many, many, many, many like an infinite number of different reports based on emerging and evolving business needs without having to go back to square one. Rob Collie (00:27:28): In a report-centric model, which is basically what the industry has almost always had, almost everywhere, outside of a few notable examples, Power BI being one of them. When a report centric model, every single change, I remember there being a statistic that was just jaw dropping. I forget what the actual numbers were, but it was something like the average number of business days it took to add a single column to a single existing report. It was like nine business days, when it should just be a click. And that's the difference. And so, preserving that benefit of this model centric approach, while at the same time, still making sure that everyone's playing within the right sandbox that you can't jump the fence and end up with something that's inappropriate. Very challenging, but doable. Greg Beaumont (00:28:15): Yep. That reminded me of an old joke we used to tell in consulting and this was back in the SharePoint Performance Point with Analysis Services days is there be a budget for a project, there'd be change requests along the ways, they discover issues with the data. And at the very end of the project, they rushed the visualization to market. And they're like after six months, with 10 people dedicated on this project, "Here's your line chart." Rob Collie (00:28:39): Yeah. I had a director of IT at a large insurance company one time, looking me in the eye and just brutally confess. Yeah, my team, we spent three months to put a dot on a chart. And that's not what you want. Greg Beaumont (00:28:59): Right, right. Rob Collie (00:29:01): That was unspoken. This was bad. To the extent that you're able to tell, what are some of the interesting things that you've seen in the healthcare space with this platform recently? Anything that we can talk about? Greg Beaumont (00:29:15): Yeah, so I think I'd start with how everything changed with COVID. Just because I think people would be interested in that topic and kind of how it changed everything. I actually had a customer yesterday at a large provider who said, "COVID was the catalyst for us to reconsider our investment in analytics, and that it spurred interest from even an executive level to put more money into analytics because of the things that happened." So obviously, when it hit everybody was, "What in the world is going on here?" Right? "Are we even going to have jobs? Is the whole world going to collapse or is this just going to be kind of fake news that comes and goes?" Everybody was unsure what was going on. Greg Beaumont (00:29:50): At the same time, the healthcare providers, a lot of them were moving people to work from home and these were organizations where they had very strict working conditions because of these data privacy and data security considerations, and all of a sudden, you're in a rush to move people home. So, some of my counterparts who do teams, they have some just amazing stories. They were up all night helping people set up ways to securely get their employees to a work-from-home type experience, so that they only had essential workers interacting with the patients, but then the office workers were able to effectively conduct business from home. Greg Beaumont (00:30:25): Additionally, there were use cases that were amazing. So, Microsoft has now what's called the Cloud for Health where we're effectively taking our technology and trying to make it more targeted towards healthcare customers and their specific needs, because we see the same types of use cases repeat from customer to customer. One of those use cases that came out of COVID was called Virtual Visits. And I actually know the team that built that solution, but because of patients who were on COVID, they didn't know how contagious it was. Greg Beaumont (00:30:56): There were people being put on ventilators, who weren't allowed to see their families and they were setting up a team's application, where people were actually able to talk to their family and see their family before they went under, right? There were chaplains who were reading people their last rites using video conferencing, and things like that. So, it was pretty heavy stuff, but I think from a healthcare perspective, it showed the value technology can provide. Greg Beaumont (00:31:21): And from our perspective in the field, it's like we're not just out there talking about bits and bytes. It kind of hit home that there's real people who are impacted by what we're doing and it adds another kind of layer of gravity, I'd call it, taking what you do seriously, right? I had another customer, they were doing some mapping initiatives with some of the COVID data because they wanted to provide maps for their employees of where the hotspots were. Greg Beaumont (00:31:46): And we were up till I think 11:00 at night one night working through a proof of concept. And they said, "Yeah, what's next is we also want to start mapping areas of social unrest." I said, "Wow, social unrest. Why are you worried about that?" And they said, "Well, we expect because of this lockdown, that eventually there's going to be rioting and issues in all different parts of the world." And at that time, I just kind of didn't really think about that, but then a lot of those things did happen. It was kind of just interesting to be working at night and hearing those stories, and then seeing how everything kind of unfolded. Greg Beaumont (00:32:18): Another example, look it up, there's an Azure COVID Health Bot out there and then there's some information on that, where you can ask questions and walk through your symptoms, and it will kind of give you some instructions on what to do. Another one that is even popular now is looking at employees who are returning to work. So, when people return to work find out vaccination status, "Are you able to come back to work? Are you essential? Are you nonessential?" I don't think a lot of customers were prepared to run through that scenario when it hit. Greg Beaumont (00:32:48): So, having these agile tools where you can go get your list of not only employees, but maybe partners that refer people to your network, because you might not have all the referring doctors in your system. So with Power BI, you can go get extracts, tie it all together and then build out a solution that helps you get those things done. I'd say it was eye opening. I think for customers and also for myself and my peers, that we're not just selling widgets. We're selling things that make a difference and have that human perspective to it. Rob Collie (00:33:20): Yeah, that does bring it home, doesn't it? That statement from an organization that COVID was the catalyst, evaluating and investing in their analytic strategy? Greg Beaumont (00:33:29): Yep. Rob Collie (00:33:30): Being in BI, being an analytics is one of the best ways to future proof one's career because at baseline, it's a healthy industry, there's always value to be created. But then when things get bad, for some reason, whatever crisis hits, it's actually more necessary than ever because when you've been in a groove when a an industry or an organization has been in an operational groove for a long time, any number of years, eventually, you just sort of start to intuitively figure it out. There's a roadmap that emerges slowly over time. Now, even that roadmap probably isn't as good as you think it is. If you really tested your assumptions, you'd find that some of them were flawed and analytics could have helped you be a lot more efficient even then. Rob Collie (00:34:14): But regardless, the perception is that we've got a groove, right? And then when the world completely changes overnight, all of your roadmaps, your travel roadmaps, none of them are valid anymore. And now, you need a replacement and you need it fast. And so, what happens is, is that analytics spending, BI spending, whatever you want to call it, or activity, actually increases during times of crisis. So, you got a healthy baseline business. It's an industry that's not withering and dying in good times, but it actually it's like a hedge against bad times. Rob Collie (00:34:47): When I saw that research years and years ago, when I was working at Microsoft Corporate, we just come out of the dot-com crack up, we'd seen that BI spending it across the IT industry was the only sector that went up during that time where everything else was falling. It's like, "Oh, okay." So, not only do I enjoy this stuff, but I really should never get out of it. It's like one of the best future proofing career moves you can make is the work in this field. And so, I mean, we've seen it, right? The early days of the COVID crisis, you're right when no one knew the range of possible outcomes going forward was incredibly wide. The low end and the high end were exponentially different from one another. Rob Collie (00:35:29): And so, we experienced in our business, sort of a gap in spring and early summer last year. We weren't really seeing a whole lot of new clients, people who are willing to forge a brand new relationship. Again, what happens when a crisis hits? You slam on the brakes. No unnecessary spending first of all. Let's get all the spending under control, because we don't know as a company what's going to happen in the industry, right? You see a lot of vendor spending freezes and of course, to other companies, we're a vendor, right? So, our existing clients, though, doubled down on how much they used us and how much they needed us. Rob Collie (00:36:08): And then later in the year, the new client business returned, and we actually ended up, our business was up last year, despite that Q2 interruption and sort of making new friends. And this year, holy cow like whatever was bottled up last year is coming back big time. And so, yeah. You never really want to be the ghoul that sort of morbidly goes, "Oh, crisis." From a business perspective, yeah, anything that changes, anything that disrupts the status quo tends to lead to an increased focus on the things that we do. Greg Beaumont (00:36:43): Yeah, I think something you said there, too, was when you don't know what's going to happen was when the business intelligence spending increased. I mean, the intelligence and business intelligence, it's not just a slogan. The purpose of these tools is to find out the things you don't know. So when there's uncertainty, that's when BI can provide that catalyst to sort of add some clarity to what you're actually dealing with. Rob Collie (00:37:06): Yeah, I've been using, even though I'm not a pilot, I've never learned to fly a plane or anything. I've been using an aviation metaphor lately, which is windshield is nice and clear. You might not be looking at the instruments on your cockpit very much, right? You know there's not a mountain in front of you, you can see how far away the ground is. And you could sort of intuit your way along, right? But then suddenly, whoosh clouds. And oh, boy, now, you really need those instruments, right? You need the dashboards, you need the altimeter, you need the radar. You need all that stuff so much more. Rob Collie (00:37:37): And so, and our business has kind of always been this. The reason I've been using this metaphor is really for us, it's like given how fast we operate, and I think you can appreciate this having come from a Microsoft partner consulting firm before Microsoft years ago, our business model, we move so fast with projects. We're not on that old model with the original budget and the change orders and all of that. That was all dysfunctional. Rob Collie (00:38:01): It was necessary, because of the way software worked back then, but it was absolutely dysfunctional. It's not the way that you get customer satisfaction. So, we've committed to the high velocity model. But that means seeing the future of our business financially two months in the future is very difficult relative to the old sort of glacial pace, right? If there's a mountain there, we're going to have months to turn around it. Krissy Dyess (00:38:26): To add a bit to your analogy there, Rob. I am married to a pilot and I have gone up in the small tiny airplane. And before the gadgets, there's actually the map. The paper map, right? So, you had the paper map, which my husband now would hand to me. And he'd tell me, "Okay, let me know the elevations of different areas to make sure we're high enough, we're not going to crash into the mountains." Krissy Dyess (00:38:47): What's happened is people just they got used to different ways that they were doing things. They were forced into these more modern ways. And I think even now, this wave of seeing this catalyst we can change and how are other people changing is also driving the people to seek help from others in terms of getting guidance, right? Because even though you've had the change, it doesn't necessarily mean that the changes that you made were 100% the right way and you can learn so much from others in the community and the people that are willing to help. Krissy Dyess (00:39:24): And I think that's one of the things too, that our company provides as a partner, we're able to kind of go alongside. We've seen what's works, what doesn't work, what are some of those pitfalls? What are those mountains approaching? And we're really able to help guide others that want to learn and become better. Rob Collie (00:39:42): Yeah. I mean, this is us getting just a little bit commercial, but you can forgive us, right? That high velocity model also exposes us to a much larger denominator. We see a lot at this business that accumulates. The example I've given before is and this is just a really specific techy, so much of this is qualitative, but there's a quantitative. It's sort of like a hard example of like, "Oh, yeah, that's right. This pattern that we need here for this food spoilage inventory problem is exactly the same as this tax accounting problem we solved over there, right?" As soon as you realize that you don't need to do all the figuring out development work, you just skip to the end. Rob Collie (00:40:22): And really, most of the stuff that Krissy was talking about, I think, is actually it's more of the softer stuff. It's more of the soft wisdom that accumulates over the course of exposure to so many different industries and so many different projects. That's actually really one of the reasons why people come to work here is they want that enrichment. Greg Beaumont (00:40:38): Yeah, that makes sense. Because you see all these different industries and you actually get exposed to customers that are the best in the business for that type of, whether it be a solution or whether it be a product or whether it be like a framework for doing analytics or something like that. So, you get that exposure and you also get to contribute. Rob Collie (00:40:55): Even just speaking for myself, in the early days of this business, when it was really still just me, I got exposure to so many business leaders. Business and IT leaders that, especially given the profile of the people who would take the risk back in 2013, you had to be some kind of exceptional to be leaning into this technology with your own personal and professional reputation eight years ago, right? It was brand new. So, imagine the profile of the people I was getting exposed to, right? Wow, I learned so much from those people in terms of leadership, in terms of business. They were learning data stuff from me, but at the same time, I was taking notes. Greg Beaumont (00:41:33): Everybody was reading your blog, too. I can't count the number of times I included a reference to one of your articles to help answer some questions. And it was the first time I was introduced to the Switch True DAX statement. And then I'd print that. Rob Collie (00:41:47): Which- Greg Beaumont (00:41:48): Sent that link to many people. "Don't do if statements, do this. Just read this article." Rob Collie (00:41:53): And even that was something that I'd saw someone else doing. And I was like, "Oh, my God, what is that?" My head exploded like, "Oh." Yeah, those were interesting days. I think on the Chandu podcast, I talked about how I was writing about this stuff almost violently, couldn't help it. It was just like so fast. Two articles a week. I was doing two a week for years. There was so much to talk about, so many new discoveries. It was just kind of pouring out in a way. Krissy Dyess (00:42:24): Greg, you came in to the role around 2016. And to me 2017 was really that big year with the monthly releases where Power BI just became this phenomenon, right? It just kept getting better and better in terms of capabilities and even the last couple years, all the attention around security has been huge, especially with the health and life science space. And last year, with this catalyst to shift mindsets into other patterns, working patterns using technology, do you feel like you've seen any kind of significant shifts just compared to last year or this year? Greg Beaumont (00:43:05): Yeah. And so something that burns my ears every time I hear it is when people call Power BI a data visualization tool. It does that and it does a great job. Rob Collie (00:43:11): I hate that. Greg Beaumont (00:43:12): But it's become much more than that. When it launched, it was a data visualization tool. But if you think about it at that time, they said, "Well, business users can't understand complex data models, so you have to do that in analysis services." Then they kind of ingested analysis services into Power BI and made it more of a SaaS product where you can scale it. There's Dataflows, the ETL tool, which is within Power BI, which is an iteration of Power Query, which has been around since the Excel days. So, now you have ETL. You have effectively from the old SQL Server world, you have the SSIS layer, you have the SSAS layer. With paginated reports, you have the SSRS layer. And you have all these different layers of the solution now within an easy to use SaaS product. Greg Beaumont (00:43:55): So this evolution has been happening, where it's gobbling up these other products that used to be something that only central IT could do. And now, we're putting that power by making it easier to use in the hands of those analysts who really know what they want from the data. Because if you think about it, the old process was is you go and you give the IT team your requirements, and they interpret how to take what you want, and translate it into computer code. Greg Beaumont (00:44:21): But now, we're giving those analysts the ability to take their requirements and go do it themselves. And there's still a very valid place for central IT because there's so many other things they can do, but it frees up their time to work on higher valued projects and I see that continuing with Power BI, right? But like we're adding AI, ML capabilities and data volumes keep increasing then capabilities I think will continue to expand it. Rob Collie (00:44:46): Greg, I used to really caused a storm when I would go to a conference that was full of BI professionals. And I would say that something like, "What percentage of the time of BI project, traditional BI project was actually spent typing the right code?" The code that stuck, right? And I would make the claim that it was less than 1%. So, it's like less than 1% of the time of a project, right? And everyone would just get so upset at me, right? But I just didn't understand why it was controversial. Rob Collie (00:45:19): Like you describe like yeah, we have these long requirements meetings in the old model. Interminably long, exhausting, and we'd write everything down. We'd come up with this gigantic requirements document that was flawed from the get-go. It was just so painful. It's like the communication cost was everything and the iteration and discovery, there wasn't enough time for that. And when I say that the new way of building these projects is sometimes literally 100 times faster than the old way. Like it sounds like hyperbole. Greg Beaumont (00:45:53): It's not. Yeah. Rob Collie (00:45:54): It can be that fast, but you're better off telling people, it's twice as fast because they'll believe you. If you tell them the truth, they'd go, "Nah, you're a snake oil salesman. Get out of here." Greg Beaumont (00:46:07): Yeah. And I think the speed of being able to develop, too, it's going to basically allow these tools to be able to do things that people didn't even dream of in the past. It's not just going to be traditional business use cases. I know in healthcare, something that's a hot topic is genomics, right? Genomics is incredibly complex then you go beyond Power BI and into Azure at that point, too and Cloud compute and things like that. Greg Beaumont (00:46:31): So, with Genomics, you think about your DNA, right? Your DNA is basically a long strand of computer code. It is base pairs of nucleic acids, adenine, thymine, and guanine, cytosine that effectively form ones and zeros in a really long string. Rob Collie (00:46:46): Did you know it effortlessly he named those base pairs? There's that biology background peeking back out. Greg Beaumont (00:46:52): I did have to go look it up before the meeting. I said, "Just in case this comes up, I need to make sure I pronounce them right," so. Rob Collie (00:46:59): Well, for those of us who listen to podcasts at 1.5x speed, that is going to sound super impressive, that string there. Greg Beaumont (00:47:05): Yeah. I should call out, too, though that I'm not a genomics expert, so some of what I'm saying here, I'm paraphrasing and repeating from people I've talked to who are experts, including physicians and researchers. So, this long string of code, if you sequence your entire genome, the file is about 100 gigabytes for one person, okay? At 100 gigabytes, you can consume that, but if you want to start comparing hundreds of people and thousands of people in different patient cohorts, all of a sudden, it gets to be a lot of information and it gets very complex. Greg Beaumont (00:47:35): If you think of that strand of DNA as being like a book with just two letters that alternate, there's going to be paragraphs and chapters and things like that, which do different things. So, one of the physicians I spoke to worked with Children's Cancer. Here's kind of where the use case comes in. So, you take something breast cancer where there's BRCA1 or BRCA2, BRCA1, BRCA2 genes where if you have it, there's a measurable increased probability that you'll get that type of cancer within a certain age range. There's a lot of other diseases and cancers, where it might be 30 genes. And depending on different combinations of those genes, it changes the risk of getting that specific type of cancer. Greg Beaumont (00:48:17): But this physician told me that there are specific children's cancers, where they know that if they have certain combinations of genes, that they have a very high probability of getting this cancer. And when the child actually feel sick and goes to the doctor, it's already spread and it's too late. So, if you can do this sequencing, basically run it through machine learning algorithms, so it will determine the probability, you could effectively catch it at stage zero. Because these cancers, it's something that could be related to growth hormones and as you're growing up, and as you become an adult, you're then no longer at risk of getting that childhood cancer. So, if they could identify it early and treated at stage zero, instead of stage 4, it sounds sci-fi, but the tools are there to do it. Greg Beaumont (00:49:01): It just never ceases to amaze me that you watch the news and they talk about self-driving cars and identifying when a banana is ripe, and things like that. But it's like, you know what? These same tools could be out there changing people's lives and making a measurable difference in the world. I think just especially post COVID, I'll expect to see a lot more investment in these areas. And also, interest because I think that might be one of the positives that comes out of this whole experience. Rob Collie (00:49:27): I do think that the sort of the worlds of Medicine and Computer Science are on a merging course. Let's not call it collision course. That sounds more dramatic. There is a merging going on. You're right DNA is biologically encoded instructions by an RNA. The mRNA vaccine is essentially injecting the source code that your body then compiles into antibodies. It's crazy and it's new. There's no two ways about it. Rob Collie (00:49:56): mRNA therapies, in general, which of course they were working on originally as anticancer and sort of just like, "Oh, well, we could use it for this, too." And there's all kinds of other things too, right? Gosh, when you go one level up from DNA or some point of abstraction, you get into protein folding. And whoa, is that... Greg Beaumont (00:50:15): Crazy, yeah. Rob Collie (00:50:16): ... computationally. We're all just waiting for quantum computers, I think. Greg Beaumont (00:50:20): Now, I'll have to call out that I'm making a joke here, so people don't take me seriously. But if you think about it, the nucleus in each of your cells contains an important model of that DNA, right? There isn't just a central repository that everything communicates with. You have a cache of that DNA in every cell in your body, except red blood cells, which perform a specific task. There may be more of the power automated the human body. But cheap attempt at a joke there, so. Rob Collie (00:50:44): Well, I like it, I like it. Let's go in with both feet. I've also read that one of the reasons why it's difficult to clone adult animals is because you start off with your original DNA, but then you're actually making firmware updates to certain sections of the DNA throughout your life. And so, those edits that are being made all the time are inappropriate for an embryo. Greg Beaumont (00:51:09): Yep. Rob Collie (00:51:10): And so, if you clone, you create an embryo, right? And now, it's got these weird adult things going on in it. That's why things kind of tend to go sideways. It can all come back to this notion of biological code and it's fascinating. A little terrifying, too, when you start to think of it that way. I've listened to some very scary podcasts about the potential for do-it-yourself bioweapon development. There was this explosion back, in what, in the '90s when the virus and worm writers discovered VVA. Remember that? We call them the script kiddies that would author these viruses that would spread throughout the computer systems of the world. And a lot of them, the people writing these things were not very sophisticated. They weren't world renowned hackers. Greg Beaumont (00:51:53): For every instance where you can use this technology to cure cancer, you're right that there's also the possibility of the Island of Dr. Moreau, right? You go look up CRISPR Technology, C-R-I-S-P-R, where they can start splicing together things from different places and making it viable. And 10 years ago, they had sheep that were producing spider webs in their milk and it's just, there's crazy stuff out there if you kind of dive into the dark depths of Biology. Now that we went down the rabbit hole, how do we correct course, right? Rob Collie (00:52:23): Well, we did go down a rabbit hole, but who cares? That's what we do. Greg Beaumont (00:52:26): Even you kind of step it back up to just kind of easy use cases in healthcare, so one of the ones that we use as a demo a lot came from a customer, and this was pre-COVID. But something as simple as hand washing, you don't think about it much. But when you're in the hospital, how many of those people are washing their hands appropriately when they care for you. And there's some white papers out there, which are showing that basically, there are measurable amounts of infections that happen in hospitals due to people not washing their hands appropriately. So, a lot of healthcare organizations will anonymously kind of observe people periodically to see who's doing a good job of washing their hands. Rob Collie (00:53:04): I was going to ask, how is this data collected? Greg Beaumont (00:53:06): This customer actually had nurses who were using a clipboard and they would write down their notes, fax it somewhere, and then somebody would enter it into Excel. So, there was this long process. And with another TS, who covers teams, we basically put a PLC together in a couple days, where they enter the information into a power app within teams, so they made their observation, entered it in. It did a write back straight to an Azure SQL Database at that time. Now, they might use the data verse. And then from Azure SQL DB, you can immediately report on it and Power BI. It even set up alerts, so that if somebody wasn't doing a good job, you could kind of take care of the situation, rather than wait for two days for the Excel report to get emailed out, and maybe lower the infection rates in the hospital. Greg Beaumont (00:53:53): So, it saved time from the workers who are writing things down and faxing things just from a sheer productivity perspective. But it also hopefully, I don't know if it will be measurable or not, but you'd have some anticipated increase in quality, because you're able to address issues faster. And that's the simplest thing ever, right? You can spend a billion dollars to come up with a new drug or you can just make sure are people washing their hands. Rob Collie (00:54:17): Both data collection and enforcement, they happen to be probably the same thing. There's like, "Oh, I'm being watched." The anonymity is gone. That's a fascinating story. Okay. What kinds of solutions are you seeing these days? What's happening out in the world that you think is worth talking to the audience about? Greg Beaumont (00:54:38): We're seeing this ability to execute better where the tools are easier to use, you can do things faster, but there's still challenges that I see frequently out there. So, I know something that you all are experts in its data modeling and understanding how to take a business problem and translate it into something that's going to perform well. So, not only do you get the logic right, but when somebody pushes a button they don't have to go to lunch and come back, they get a result quickly. That's still a challenge. And it's a challenge, because it's not always easy, right? I mean, it's the reason cubes were created in the first place was because when you have complex logic and you're going against a relational database, the query has to happen somewhere, but like that logic. Greg Beaumont (00:55:19): So take for example, if somebody wants to look at year over year percent change for a metric and they want to be able to slice it by department, maybe by disease group, maybe by weekend versus weekday, and then they want to see that trend over time. If you translate that into a SQL query, it gets really gnarly really fast. And that problem is still real. One of the trends I'm seeing in the industry is there's a big push to do everything in DirectQuery mode, because then you can kind of manage access, manage security, do all of those necessary security things in one place and have it exist in one place. Greg Beaumont (00:56:00): But when you're sending giant gnarly SQL queries back to relational databases, even if they're PDWs with multiple nodes, it gets very expensive from a compute perspective, and kind of when you scale out to large number of users, concurrency is still an issue. So that's something where you look at recently what Power BI has come out with aggregations and composite models. That's some of the technology that I think can mitigate some of those problems. And even if we think about something like Azure synapse, right? You can have your dedicated SQL pools then you can have a materialized view. A materialized view is effectively a cache of data within synapse, but then you can also have your caches in Power BI, and kind of layer everything together in a way that's going to take that logic and distribute it. Greg Beaumont (00:56:46): Does that make sense? Rob Collie (00:56:47): It does. I think this is still a current joke. The majority of cases where we've encountered people who think they want or need DirectQuery, the majority of them are actually perfect poster children case studies for when you should use cash and import mode. Right? It turns out the perceived need for DirectQuery, there is a real percentage of problems out there for which DirectQuery is the appropriate solution and it is the best solution. But it's the number of times people use it is a multiple of that real ideal number. Rob Collie (00:57:17): I think part of it is just familiarity. Still, I've long talked about how we're still experiencing as an industry the hangover from most data professionals being storage professionals. Everyone needed a database, just to make the wheels go round. The first use of data isn't BI. The first use of data is line of business applications. Every line of business application needed a database, right? So, we have minted millions of database professionals. this is also why I think partly why Power BI gets sort of erroneously pigeonholed as a visualization tools, because people are used to that. They're used to, we have a storage layer and reports layer, that's it, right? Rob Collie (00:57:56): Reporting services was Microsoft's runaway successful product in this space. Paginated reports is still around for good reason. And I think that if you're a long-term professional in this space with a long history, even if you're relatively young in the industry, but you've been working with other platforms, this storage layer plus visuals layer is just burned in your brain. And this idea of this like, "Why do you need to import the data? Why do you need a schedule? Why do you need all this stuff?" It's like as soon as people hear that they can skip it, and go to DirectQuery, they just run to

The Aussie share market is set to open higher, with the futures suggesting a 0.3% lift, taking the market to another record all time high. What to watch today: In economic news, inflation data will be released on Wednesday. It is expected to show a 3.8% rise in inflation over the year in the last quarter. The oil price lifted slightly to US$72, continuing to bounce back from last Monday's fall. The copper price rose 2.7%, while iron ore rose over 1%. Following these gains, BHP in New York lifted 1.1%, so it is expected that Australian listed commodity stocks will also do well today. Mining and energy stocks given oil and iron ore rebounds. Trading Ideas: Health club business Viva Leisure (ASX:VVA) was reiterated as a Citi BUY stock, with a slimmer $2.50 price target, implying 38% share price growth in a year. BrainChip (ASX:BRN), Damstra (ASX:DTC) and FireFinch (ASX:FFX) are all giving off bullish charting signals according to Trading Central.  

In this video I discuss why more stuff means more stress for you and how to avoid falling into the buying traps and impulse marketing that is everywhere. Video Chapters ================ 0:00 More stuff = more stress 2:00 3 questions: life better ?, add value to my living situation?, enjoyment over 6 months ? 4:00 Essential vs non essential 6:00 The last 5 non essential things you bought 8:00 When in doubt give away something (VVA or good will)

oh, oh, also eigentlich wollte ich gestern im REICHTUMwarmUp ausschließlich Fragen beantworten, einen reinen Q&A machen. Und zack kam das Leben dazwischen.😉 Was haben wir – mein Team & ich - gehört in den letzten Kurstagen? ... jede Menge Drama-Stories, NACHDEM der Input lief zur VVA, zum Schöpfertum, zu Ursache&Wirkung, zu Gedanken sind NICHT die Wahrheit usw.usf. Es schrillten sofort meine Alarmglocken!! -- He, wenn Du REICHTUM wirklich, wirklich anders erleben und andere, bessere Ergebnisse einfahren willst, dann MUSST Du anders denken, fühlen, entscheiden, handeln. ab sofort!! UND Du MUSST andere Geschichten erzählen!! auch ab sofort!! (Ja, hier gehört das MUSS-Wort rein!). -- Jede Deiner Seufz-Ächz-Drama-Stories ist eine Ursache und zieht eine (fatale) Wirkung nach sich. Das Gesetz von URSACHE & WIRKUNG gilt IMMER!! Es ist fundamental wichtig für Dich, DAS zu erfassen, zu akzeptieren und dementsprechend zu handeln. (Davor steht natürlich: Es ERFASSEN zu WOLLEN!! >> Wie ALLES ist auch dies DEINE WAHL.) Ansonsten bleibt ALLES so, wie es ist. Bestenfalls ... Komfortzonen - treffender finde ich Leidenszonen - schrumpfen bekanntlich. -- In der heutigen Episode tauchen wir tief ein ins Gesetz von Ursache & Wirkung, damit Du einmal mehr rauskommst aus dem Theoriemodus, dieses fundamentale Gesetz für Dich erfasst und anwendest. Und dann ist – hurra - freie Fahrt für Wunder in Deinem Leben & in Deinem Business. Ich freu mich auf Dich & bis gleich, Deine Katl -- Hier erfährst Du mehr über mich: >> Am 13.05. startet #REICHTUM >> 5 starke Live Trainings für innere Fülle & fröhliche Geldflüsse in Deinem Business. >> Hier geht's zu weiteren Infos: https://katrinziebart.thrivecart.com/reichtum >> Komm in meine Facebook Gruppe für coole, taffe MacherInnen: https://www.facebook.com/groups/KLARtext.katrinziebart.de >> Hol Dir den kostenfreien MINDSET Video Kurs: https://katrinziebart.de/mindset-video-kurs/

In this episode, Christian sits down with Kevin Gold of VVA. With over 28 years of architectural and project management experience, and a veteran of VVA for over 16 years, Kevin has completed some of the largest, most complex technology, financial services, education, residential, retail and law firm projects for VVA. He maintains an active position directly managing consultant and construction teams while ensuring schedule, budget, and value goals are met. Prior to joining VVA, Kevin worked as an Architect and Project Manager for such prestigious clients as DoubleClick, Cadwalader, Pillsbury Winthrop, Jones Day, Chase Manhattan Bank, Morgan Stanley, and Bankers Trust. He has held positions with prominent Architectural firms including Butler Rogers Baskett, The Phillips Group US/UK, and Rafael Vinoly Architects. https://www.vvallc.com/ https://theantiarchitect.com/

Common voice, ecco i link dell'annuncio:saveriomorelli.com/commonvoice/r/aprile/Questo è il link LinkedIn: https://www.linkedin.com/posts/saveriomorelli_contest-cv-project-activity-6779697163480944640-4iXD"Mozilla Italia, dopo aver realizzato CV Android: contest sperimentale (Resoconto Mozilla Italia Contest Sperimentale), ha deciso di organizzare un nuovo contest di durata maggiore e con maggiori gadget in palio, al fine di promuovere maggiormente il progetto Common Voice, specialmente per la lingua italiana dal 1 al 30 Aprile."Quindi vi dico: scaricate la app non ufficiale che e' fantastica e regalate la vostra voce ! ;-)"Quindi, con il supporto dell’applicazione CV Project (open-source) disponibile solo per Android, ma non ufficiale Mozilla, sarà possibile partecipare a un contest che ha come obiettivo proprio la promozione di Common Voice nella lingua italiana. Anche in questo caso, per incentivare gli utenti a partecipare, abbiamo deciso di mettere in palio vari oggetti."Per ottenere maggiori informazioni, leggere il Regolamento oppure il thread riepilogativo 2 con anche altri link."Caffe20.it e' partner dell'iniziativa !

linee guida n.202/2021 sui VVA virtual voice assistent di edpb, dopo la cnil :)

Autoiglut, eli lumiset autot, puhuttavat Perttiä, Juliusta ja kuuntelijoita, kaikki tietävät niiden olevan vaarallisia liikenteessä, mutta onko kukaan viaton? Yön äänenä kuullaan Vva ry:n yökiitäjä-partion Veskua ja Tumppia, jotka auttavat asunnottomia. Sen lisäksi heitellään ketteriä sanaleikkejä ja kiperiä kysymyksiä puolin ja toisin.

David Novac from Wealthwise Education and Francesco De Stradis from Ord Minnett go in-depth and stock-specific. Stocks: CBA, FSA, WGX, ASM, CWY, VVA, WES, LGP, DDR, XRO. Stock of the day is Magellan Financial Group (MFG). See acast.com/privacy for privacy and opt-out information.

If you want to get something done in Congress then the Military Affairs Committee is the place to go. Congressman Greg Steube shares an insight into the operation of the Veterans Affairs Committee and what is planned in the future for our veterans.

Verantwortung hat nichts mit Schuld und nichts damit zu tun, alles selbst, für andere oder alleine machen zu müssen. Du bist verantwortlich für alles was du denkst, machst und fühlst. Du gibst den Ereignissen deine Bedeutung. Darüber wie du denkst und handelst, erzähle ich dir am Ende noch etwas. Verantwortung für das ganze Team übernehmen, bedeutet volle Verantwortung für das eigene Leben zu übernehmen. Wenn wir uns entwickeln, entwickelt sich unser Team mit. 8 Bereiche im Buch "Mit dem Herzen führen" von Deepak Chopra: Gedanken, Emotionen, Wahrnehmungen, persönliche Beziehungen, soziale Rolle Umgebung, Sprache und Körper.Du entscheidest, ob dir der Regen den Tag versaut oder ob du glücklich bist. Hinterfrage deine „aber“. Sind sie Ausreden, um die Verantwortung nicht bei dir zu suchen?

VVA VSO Ron Adams tells us how it is. From is time in Vietnam, to how hard to was to come home, and how he ultimately found his call serving his brothers. Tune to to learn in about how benefits from the expert from a 30 year Veterans Service Officer!! VVA giving guidance and mentoring my Generation of Warriors!! --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/vincent-morales8/message Support this podcast: https://anchor.fm/vincent-morales8/support

Tinh tế radio 30/12: Cổ phiếu Apple cao nhất mọi thời đại; Yamaha Exciter 155 VVA không phanh ABS

Könnten wir mitsamt Ausrufezeichen so stehen lassen und in blinder Hoffnung auf Besserung nach 2021 rasen. Nur glaube ich, dass es so easy peasy nicht wirklich funktioniert. Ohne das Learning im Alten zu erkennen, es zu würdigen und bewusst zu verabschieden, wird nix mit dem fluffig Neuen. Möglicherweise ist auch genau das - nicht hinschauen wollen - einer der Gründe, warum sich die Menschheit in 2020 eine kollektive Ernte eingefahren hat, die noch immer fassungslos macht. Dieser Punkt ist - meine ich - essentiell, wie es für alle und für jeden einzelnen in 2021 weitergeht oder neu beginnt. Einfach Hände in' Schoß legen und abwarten, dass sich die Dinge von alleine zum Positiven verändern, oder dass andere es schon in Ordnung bringen, bleibt - klar - ein verlässlich erfolgloser Ansatz. -- Es ist dran, dass, wer sich eine andere, bessere, freiere Welt wünscht, den Popo bewegt, die Mir-geschieht-Rolle entschlossen abwählt, erwachend BEWUSST wird, sich für SELBSTverantwortung und die eigene, gewaltige GRÖSSE entscheidet und beginnt zu ERSCHAFFEN. Weil DU, ich, wir ALLE sind die SCHÖPFERINNEN und SCHÖPFER einer freien Welt, wie WIR sie uns wünschen, wie WIR sie leben wollen. -- Ich lade Dich in der heutigen Episode ein zu einem ehrlichen Rückblick. Und zwar nur und ausschließlich auf Dich. Das Außen ist und bleibt das Außen. Die Anderen bleiben die Anderen. Beide - das Außen und die Anderen - sind NICHT Deine Angelegenheit. #VVA ... you know ... 😉 -- Ich freu mich auf Dich und bis gleich, Deine Katl -- Hier erfährst Du mehr über mich: Der MEO dampft am 07. Januar los - 25 hochintensive Tage für Dein MACHER-Mindset: https://elopage.com/s/katrinziebart.de/mindset-express-online Du willst über mehrere Monate mit mir unterwegs sein? In 2021 so richtig in die Tiefe gehen UND da heraus satt und gewaltig durchstarten? In Dir heilen UND Grenzen sprengen? Du willst mit Deinem Business so richtig, richtig Fahrt aufnehmen UND wach sein für (das garantiert nächste) Oberlimit & Co? Buche hier ein kostenfreies STRATEGIE GESPRÄCH mit mir: https://katrinziebart.youcanbook.me Komm in meine Facebook Gruppe für coole, taffe MacherInnen: https://www.facebook.com/groups/KLARtext.katrinziebart.de Hol Dir den kostenfreien MINDSET Video Kurs: https://katrinziebart.de/mindset-video-kurs/ Stöber auf meiner Website: https://katrinziebart.de

„Du, Katl, ich mache schon seit Jahren Persönlichkeitsentwicklung, Mindset und so. Ich weiß da echt Bescheid. Kenne meine Themen und arbeite dran. … „ Okeeey ... Und weil ich das echt hin und wieder höre, machen wir heute Butter bei die Fische und reden Klartext bzgl so einiger Irrtümer rund um die Mindsetveränderung. -- Ein Irrtum ist zB dieser hier: „Ich bin immer mal wieder dran am Mindset ...“. >> NEIN! Du kannst nicht hier und da mal ein bisschen „Mindset machen“. Persönlichkeitsentwicklung geht weit, weit, weit über Bücher lesen, Vorträge hören, Seminare besuchen hinaus. Und zwar SEHR, SEHR WEIT!! Ausschließlich Deine Taten transportieren den Grad Deiner Ent-Wicklung. Wenn's flutscht, hat jeder, der schon mal vom Mindset gehört hat, die Theorie drauf. Wenn das Leben (vermeintlich) Breitseite liefert, hört der Spaß bei den meisten Menschen auf. Mimimi und Projektion laufen ruckzuck auf Hochtouren. Die alten Muster übernehmen die Führung. VVA und Bewusstheit rücken weiter weg als der Mond. Das Außen, andere Menschen und der Coach sind als Projektionsfläche einfach zu verlockend. -- Von Irrtum No 2, 3, 4 & 5 erzähle ich Dir in der heutigen Episode. Das schon mal vorab: Heilung, Wachstum & Erfolg gibt es nicht zum Nulltarif. Abkürzungen funktionieren hier erst recht nicht. Du bist hier, um DICH zu erfahren und zu erschaffen. Und um wirklich, wirklich die SCHÖPFERIN, der SCHÖPFER Deines Lebens zu sein, braucht es Willen, entschlossene Entscheidungen und die stete Einmal-MEHR-Nummer. Ich freu mich auf Dich & bis gleich, Deine Katl -- Hier erfährst Du mehr über mich: Du willst über mehrere Monate mit mir unterwegs sein? In 2021 so richtig in die Tiefe gehen UND da heraus satt und gewaltig durchstarten? In Dir heilen UND Grenzen sprengen? Du willst mit Deinem Business so richtig, richtig Fahrt aufnehmen UND wach sein für (das garantiert nächste) Oberlimit & Co? Buche hier ein kostenfreies STRATEGIE GESPRÄCH mit mir: https://katrinziebart.youcanbook.me Der MEO dampft am 07. Januar los - 25 hochintensive Tage für Dein MACHER-Mindset: https://elopage.com/s/katrinziebart.de/mindset-express-online Komm in meine Facebook Gruppe für coole, taffe MacherInnen: https://www.facebook.com/groups/KLARtext.katrinziebart.de Hol Dir den kostenfreien MINDSET Video Kurs: https://katrinziebart.de/mindset-video-kurs/ Stöber auf meiner Website: https://katrinziebart.de

In today's Federal Newscast, Vietnam Veterans of America and DHS’s Cybersecurity and Information Security Agency now say they’re trying to stop disinformation campaigns targeted military and veteran communities.

*Trigger Warning* Sexual assault in the military needs to end. However, until that day comes we are grateful for Sexual Assault Response Coordinators (SARC) and Volunteer Victim Advocates (VVA) like Capt Mia Keith-Schwartz who respond to the needs of the victim and connect them to critical resources. 08:38 - Mia shares her background and path into the Air Force as an Intelligence Officer13:42 - The different positions and roles in the SAPR program (see AFI 90-6001 Sexual Assault Prevention and Response: https://static.e-publishing.af.mil/production/1/af_a1/publication/afi90-6001/afi90-6001.pdf)23:20 - SAPR in deployed locations26:21 - The people who get involved in SAPR34:46 - How to become a SARC or VVA?37:31 - Resources availabe on the SAPR program (see SAPR Commander's Toolkit: https://www.sapr.mil/command-toolkit)41:53 - Restricted vs Unrestricted reporting51:20 - Is the SAPR program working? (see DoD Safe Helpline: https://safehelpline.org/)59:48 - Commentary Contact Mia by emailing us at airforcepodcast@gmail.com and we'll forward it to her.If you need your local SAPR hotline/your local SARC’s contact info, find it on https://safehelpline.org/search.cfm or call 877-995-5247.Music provided by Carlos Rivera. Follow on Instagram: https://www.instagram.com/carlos_r15/Send inquiries to: carlos.a.rivera15@gmail.comEmail your questions and comments to airforceofficerpodcast@gmail.com. Join the discussion about the podcast, the Air Force, officership, and the Profession of Arms at https://www.airforceofficerpodcast.com/.Facebook: https://www.facebook.com/AirForceOfficerPodcast/ Instagram: https://www.instagram.com/airforceofficerpodcast/ Twitter: https://twitter.com/afofficerpod Reddit: https://www.reddit.com/user/afofficerpod Share your officer stories of all flavors using #shootthewatch.

Kristofer Goldsmith is the chief investigator and associate director for policy and government affairs at Vietnam Veterans of America, a congressionally-chartered veterans service organization. There he has been leading efforts to study the targeting of troops and veterans online for the purposes of fraud and disinformation campaigns by foreign entities. Kris's policy portfolio at VVA centers around "New Veterans," covering a broad range of issues from healthcare to education, and military personnel policy to post-service employment opportunities for veterans. He is the founder of High Ground Veterans Advocacy, a small nonprofit organization which trains veterans to engage successfully with government on policy changes meant to improve the lives of servicemembers, veterans and their families. Learn more about your ad-choices at https://news.iheart.com/podcast-advertisers

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.09.08.288654v1?rss=1 Authors: Deemyad, T., Puig, S., Papale, A., Qi, H., LaRocca, G. M., Aravind, D., LaNoce, E., Urban, N. N. Abstract: Inhibitory control of excitatory networks contributes to cortical functions. Increasing evidence indicates that parvalbumin expressing (PV+) basket cells (BC) are a major player in maintaining the balance between excitation (E) and inhibition (I) in the cortex. Disruption of E/I balance in cortical networks is believed to be a hallmark of autism spectrum disorders (ASD) and may contribute to sensory alterations seen in ASD. Here, we report a lateralized decrease in the number of PV+ BCs in L2/3 of the somatosensory cortex in the dominant hemisphere of adult Shank3-/- and Cntnap2-/- mouse models of ASD. The dominant hemisphere was identified during a reaching task to establish each animal dominant forepaw. Double labeling with anti-PV antibody and a biotinylated lectin (i.e., VVA) showed that the number of BCs was not different but rather, some BCs did not express detectable levels of PV (PV-), resulting in an elevated number of PV- VVA+ basket cells. This lateralized reduction was not observed in the number of interneurons from the other two major groups that express somatostatin or the serotonergic receptor 5HT3a. Finally, we showed that dominant hind paws had higher mechanical sensitivity (i.e., lower mechanical thresholds measured with von Frey test) but no difference in thermal sensitivity (measured with Hargreaves test) when compared to the other hind paw. This mechanical hypersensitivity in the dominant paw correlated with the decrease in the number of PV+ interneurons and reduced PV expression in the corresponding cortex. Together, these results suggest that the sensory hypersensitivity in ASD could be due to decreased inhibitory inputs to the dominant somatosensory cortex. Copy rights belong to original authors. Visit the link for more info

Mathan Somasundaram from Deep Data Analytics and Carl Capolingua from Think Markets go in-depth and stock-specific. Stocks: RIO, REA, AMA, FBR, EML, VVA, BCC, SPL, SOM, KSL. The stock of the day is Pointsbet (PBH). See acast.com/privacy for privacy and opt-out information.

John Rowan was re-elected to an eighth term as the National President of Vietnam Veterans of America (VVA) at the organization’s 19th National Convention in Spokane, Washington. During this interview, he spoke of how, when our vets came back from Vietnam, there were no ticker-tape parades and even some of the mainline veterans' organizations turned their backs on the vets. Hence the start of VVA to serve the unique needs of the cast-aside warriors. We think that was a result of what these men faced coming home is the basis on which Americans have built greater respect for our current servicemen and women. Listen in to hear how the organization is still serving veterans and their families, many of which are still paying the Agent Orange penalty.

Vollverantwortlichkeit, dieses schöne Wort, ist meine fröhliche Eigenkreation. J Das „Ding“ dahinter basiert auf den Ansätzen von Hirnforschung, Bauer & Universe und ließ mich vom Persönlichkeitsentwicklungs-Junkie endlich reinwachsen in die Position der souveränen, erfolgreichen Frau. Wie Du mit der Übernahme der vollen Verantwortung – zu satten 100% - in JEDEM Lebensbereich einen beeindruckenden Durchbruch in Deinem Leben kreieren kannst, was VVA wirklich bedeutet (und was nicht), davon erzähle ich Dir in dieser Folge. Hier erfährst Du mehr über mich: Stöber auf meiner Website: https://katrinziebart.de Du willst mit mir gehen? Mich als Coach an Deiner Seite haben? Buche hier einen kostenfreien BUSNESS TALK mit mir: https://katrinziebart.youcanbook.me Lerne mich live, echt und in Farbe kennen und komm zum HELDINNEN TAG nach Köln am 06.06.2020: https://www.eventbrite.de/e/heldinnen-tag-in-koln-am-06062020-tickets-92690193865 Hol Dir den kostenfreien MINDSET Video Kurs: https://katrinziebart.de/mindset-video-kurs/ Komm in meine Facebook Gruppe: https://www.facebook.com/groups/katrinziebart/

A two-year investigation by the group Vietnam Veterans of America has concluded foreign online trolls are persistently and systematically targeting US service members and veterans. Troll farms backed by the Russian government are some of the biggest malefactors, but they're far from the only ones. VVA said stopping the campaigns is going to require serious work by both the government and social media companies. To talk about some of those steps, Federal Drive with Tom Temin was joined by Kristofer Goldsmith, VVA's associate director for Policy and Government Affairs. He's also the lead investigator on VVA's troll report.

Recorded Live from Greenwood Park Beer Garden (555 7th Avenue, Brooklyn). This episode is just over 1 Hour from Saturday June 8th, 2019. The first half is a mix of classic rock & pop tunes. The second half features a live 2 piece band. On site sound issues made the live recording difficult but if you were there you know a good time was had by all. Thanks to everyone who came out to support our Veterans and all who made it possible.

Tjeerd van Veen en Kees van Dijk bespreken in de allereerste VVA podcast het onderwerp: 'Herrie in de tent', waarmee zij doelen op eventuele conflicten tussen partners, aandeelhouders in vennootschappen en andere samenwerkingsverbanden binnen één bedrijf. Hoe is ruzie te voorkomen en niet in de laatste plaats; hoe is de herrie in de tent op te lossen?

Podcast with Claude LaRoche, one of the VVA staff who runs the Fellow Songwriters Workshop! Also joining us on this podcast is Ryan Wall. Ryan has released several albums and is a partner with Jaime Vendera in the Angel Fire East project. Tune in and learn about the songwriting process from Claude, Ryan, and Jaime!

I first came across the imposter Facebook page by accident. The page was made to look like that of my employer, Vietnam Veterans of America, complete with our organization's registered trademark and name. As an Iraq veteran and the office's designated millennial policy guy, I was helping run VVA's social media accounts.

The Pentagon's Defense Manpower Data Center runs a public website that lets anyone with personal information about a service member - their name, social security number, and date of birth - find more details about them. Details like whether they're still serving in the military, when they enlisted and their separation date. The public database was set up to help financial institutions comply with the Servicemembers Civil Relief Act, which grants a host of legal protections for members of the military. But a new lawsuit by Vietnam Veterans of America claims the way DoD is implementing the website puts sensitive data about millions of troops and veterans at risk. Rick Weidman is VVA's director for policy and government affairs. He talked with the Federal Drive with Tom Temin about the group's objections.

Tiistaina 12.3. nähtiin toinen jakso Arman Alizadin dokumenttisarjaa Arman Pohjantähden alla, jossa aiheena oli asunnottomuus. Arman perehtyi asunnottomien elämään etnografisin ottein: haastattelemalla ja viettämällä aikaa tukalaan elämäntilanteeseen joutuneiden, yhteiskunnan marginaaleissa elävien kodittomien kanssa. VVA ry:n toiminnanjohtaja kertoi jaksossa, että asunnoton voi päästä kiperästä tilanteestaan usein uskaltautumalla pyytämään apua. Avuntarjoajia on - miksei apua haeta? Jaksossa viitattiin useaan otteeseen päihde- ja mielenterveysongelmiin. Antropologialla on pitkät perinteet köyhyyden ja asunnottomuuden tutkimuksessa, ja pintaa raaputtamalla löytyykin lisää tilannetta selittäviä tekijöitä. The post Viinaa ja vertaistukea – katukulttuuri pitää koditonta otteessaan appeared first on AntroBlogi.

Boone and Stu discuss the inner workings or should we say the inner red tape that many Warfighters have faced through multiple campaigns in order to be decorated correctly. Check out this AWESOME American on the links below. thisiswhathelllookslike.com nationalveteransrights.org StuInAfghanistan.blogspot.com StuReturnstoVietnam.blogspot.com.

A summary hour of this years VVA parties. 60's 70's 80's Style. Merry Christmas & Happy New Year all :)

Vailla vakinaista asunto ry on vuodesta 1986 toiminut asunnottomien puolestapuhujana ja auttajana. VVA pyörittää muun muassa yökeskusta, Sällikotia sekä vapaaehtois- ja vertaistoiminnan keskusta. Tilanne on nykyisellään se, että pitkäaikaisasunnottomien määrä on laskenut, mutta muuten asunnottomien määrä kasvaa edelleen. Erityisesti nuoria asunnottomia on jatkuvasti hurjasti enemmän. Jokapaikan Reetta tutustuu Vailla vakinaista asuntoa ry:n toimintaan. Elämän kriisit ja liian kalliit asunnot ovat yhtälö, jonka kautta kadut saattavat tulla helposti tutuiksi. Reetta Arvilan oppaana on matalan kynnyksen toiminnan esimies Jussi Lehtonen. [Jokapaikan Reetta 290114, 00:30:23]

Every year I do a part with Vietnam Veterans Chapter 72 for the VA hospitals 15West ward. We bring food, Santa & gifts and the healing power of music to Vets returning home. I replaced the line dances with 'Candi Staton - Victim' next to last track. It was a good vibe to be there even tho the NS7 was not!

In the present study, the testes of 32 bovine embryos with different crown-rump length (2.5- 90 cm CRL) and of 15 sexually mature bulls (Deutsches Fleckvieh) were investigated using light- and electron microscope as well as glycohistochemical and immunohistochemical methods. The gestation period was divided into 3 stages; early, mid, and late gestation. Developmental changes in the testicular morphogenesis were therefore analyzed in details during these phases. Generally, embryonic development of bovine testis involves the same mechanism described in other mammals. At the first stage of this study (2.5 cm CRL/43 dpc), the anlage of the testes protruded to the coelomic cavity as paired bean-shaped structures on either side of the dorsal mesentery medial to the mesonephros. It consists of primitive testicular cords, interstitium, and rete testis blastema. Proceeding with fetal age, these basic testicular structures are further differentiated. The tunica albuginea is separated into two layers: an outer fibrous layer (tunica fibrosa) with some mesenchymal cells, numerous fibroblast, and much fibrous content and an inner cellular layer with several blood vessels (tunica vasculosa). The testicular cords are surrounded by a marked basal lamina and peritubular cells and lined by two types of cells: a large number of dark polygonal cells with irregular nuclei, pre-Sertoli cells and small number of large light round cells with relatively round nuclei, the prespermatogonia. The average number of the germ cells per cross section of cord increases, particularly form 3.5 to 14 cm CRL, resulting in a germ cell maximum at the end of this stage (14 cm CRL). Although most of the germ cells are located toward the periphery of the cord, some are also found in the center. Pre-Sertoli cells form a complete layer at the periphery of the cords. Generally, these cells are irregular in shape and numerous but considerably smaller than the germ cells. Unlike prespermatogonia, mitotic figures are seen in pre-Sertoli cells during the whole embryonic life. As a consequence of the expansion in the interstitium, the seminiferous cords are progressively separated from each other. The testicular interstitium is rapidly differentiated and is composed of several islets or clusters of polygonal Leydig cells, peritubular flattened cells surrounding the testicular cords, connective tissue cells, and numerous blood vessels. In the present study, fetal Leydig cells were first recognized at 3.5 cm CRL. Thereafter, the average number of these cells is rapidly increased to attain their maximum with the end of the first gestation period (14 cm CRL). This generation of Leydig cells however dedifferentiates progressively with developmental age. A continuous system of basal lamina joins the testicular cords with rete strands from 10 cm CRL and onwards. This system establishes the first connection between these two testicular components via ill-developed uncanalized straight tubules (tubuli recti). Rete testis channels are lined by simple layer of cuboidal epithelium with round nuclei occupying most of the cytoplasm and enclosed by well-defined basal lamina. The adult bovine testis is enclosed by a connective tissue capsule, tunica albuginea, composed predominantly of collagen fibers and few elastic fibers. Most of the testicular parenchyma is made up of the convoluted seminiferous tubules (tubuli seminiferi contorti), two-ended convoluted loops, with both ends opening into the rete testis via specialized terminal segments. The seminiferous tubules of sexually mature bulls are enclosed by a distinct lamina propria and are lined by two cell populations, non-proliferating Sertoli cells and highly proliferating spermatogenic cells. The bovine lamina propria consists of basal lamina, collagen and elastic fibers, and 3-5 layers of partially overlapping myofibroblasts. Additionally, fibrocytes, collagen fibrils, and fibroblasts-like cells form the outermost border of the tubulus. Sertoli cells are easily identifiable elements of the seminiferous epithelium. Adult Sertoli cells are large irregularly shaped cells with their broad bases resting on the basal lamina while the remaining cytoplasmic processes extend upward to the tubular lumen. They are characterized by round or oval euchromatin-rich nuclei situating in the basal portion near the basal lamina of the seminiferous tubules. Adult bovine germ cells are present in four morphologically different groups, i.e., spermatogonia, spermatocytes, spermatids, and spermatozoa. The seminiferous cycle stages are identified using changes in the germ cell nuclei as well as location and shape of spermatids. According to this method, eight stages are defined in the seminiferous epithelium of bovine. The interstitial or intertubular tissue of adult bovine testis consists of Leydig cells, macrophages, scattered lymphocytes and plasma cells, and contains numerous blood and lymph vessels. Not all Leydig cells have contact to blood or lymph capillaries. The excurrent duct system of the adult bovine testis consists of terminal segment of the convoluted seminiferous tubules, straight tubules, and rete testis. The terminal segment can be further subdivided into a proximal (transitional) region, middle portion, and distal part (terminal plug). The proximal region is lined by typical Sertoli cells while the last two parts are lined by modified Sertoli cells. The tubulus rectus of adult bovine testis is composed of three morphologically different regions: a proximal cup-shaped region, a middle narrow stalk, and a distal festooned portion. The rete testis is a complicated centrally positioned meshwork of intercommunicating channels that lies within the mediastinum testis parallel to the long axis of epididymis. The simple cuboidal epithelium of straight tubules and rete testis is shown to contain some lymphocytes and macrophages. The cellular distribution of glycoconjugates within the fetal and adult bovine testis was investigated using thirteen (ConA, PSA, LCA, PNA, GSA-I, ECA, DBA, SBA, HPA, VVA, WGA, UEA-I, LTA) different fluorescein isothiocyanate (FITC) conjugated lectins. In fetal testes, detection of sugar moieties by lectins was carried out on Bouin õ s-fixed paraffin-embedded sections while in adult it was performed on both Bouin õ s-fixed paraffin-embedded and acetone-fixed frozen sections. Only five lectins (PSA, PNA, GSA-I, DBA, WGA) showed a positive reaction in the embryonic testes. PNA, GSA-I, DBA, and WGA were detected in the germ cells whereas PSA, DBA and WGA labeled the fetal Leydig cells. None of the lectins used was observed in the pre-Sertoli cells. Further on, some lectins were seen in tunica albuginea (PSA, PNA, GSA-I, WGA), basal lamina of testicular cords (PSA, WGA), interstitial blood vessels (PSA, GSA-I, WGA), mediastinum testis (PSA, PNA, WGA) and rete testis epithelium (PNA). In adult animals, spermatogonia and spermatocytes were positively stained with PSA, LCA, DBA, SBA, and VVA. All the lectins investigated except that of the fucose-binding lectin (UEA-I and LTA) were definitely detected in the acrosome of round and elongated spermatids. These results indicate a role for carbohydrates in spermiogenesis. Apical Sertoli cells processes and Leydig cells were weakly stained with PSA and LCA as well. DBA binding sites were also seen in the Leydig cells. Immunohistochemical studies were performed using the Avidin-Biotin-Peroxidase Complex (ABC) method for localization of fibroblast growth factor-1 (FGF-1), fibroblast growth factor-2 (FGF-2), S-100, laminin, alpha-smooth muscle actin (á -SMA), vascular endothelial growth factor (VEGF), connexin 43 (Cx43), CD4, CD8, CD68, angiotensin-converting enzyme (ACE), and galactosyltransferase (GalTase) in the bovine testis. The expression of FGF-1 and FGF-2 was further investigated in the adult bovine testis using in situ hybridization and PCR. Immunohistochemically, FGF-1 was seen in the Sertoli cells, Leydig cells, endothelium of the blood vessels, and epithelium of straight tubules and rete testis of fetal and adult testis. It was additionally detected in spermatogonia and spermatids of sexual mature animals. FGF-2 exhibited a striking positive reaction in fetal (from 6 to 30 cm CRL) and adult Leydig cells. Moreover, it showed marked reaction in the endothelium of blood vessels and in the epithelium of tubulus rectus and rete testis. FGF-2 was also localized in some spermatogonia, and myofibroblasts. By means of in situ hybridization, FGF-1 and FGF-2 mRNA were found in Leydig and Sertoli cells as well as in the modified Sertoli cells of the terminal segment. FGF-1 transcripts were additionally recognized in the straight tubules and rete testis epithelium. Distinct S100 immunostaining was observed in the Sertoli cells, endothelium of blood vessels and in the rete testis epithelium of fetal and adult testis. Laminin was localized to the basal lamina of seminiferous tubules, blood vessels, myofibroblasts, and rete testis. Although á -SMA was detected in smooth muscle cells of the blood vessels, no immunoreactivity was seen in the peritubular cells during the whole gestation period. The myofibroblasts surrounding the seminiferous tubules and rete testis showed intense positive reaction for á -SMA in the adult testis. VEGF was detected in the acrosomes of the elongating spermatids. Connexin 43 was localized to gap junctions between Leydig cells in the fetal and adult life as well as to the seminiferous epithelium apical to spermatogonia and basal to spermatocytes, a position correlating with Sertoli-Sertoli cell junctions. The detection of cells positive for CD4, CD8, CD68 within the adult testis interstitium clearly indicate the presence of lymphocytes and macrophages within this testicular compartment. GalTase showed striking positive reaction in the Golgi complex of Sertoli cells, Leydig cells, and some spermatocytes as well as at the cell membrane of elongating spermatids and in the simple cuboidal epithelium of rete testis. ACE positive reaction was found in the prespermatogonia (only at 6-10 cm CRL) and in fetal and adult testicular blood vessels. The functional significance of these immunocytochemically-demonstrated proteins is discussed.

In der vorliegenden Arbeit wurde die pränatale Entwicklung und Morphologie des bovinen Nabelstrangs untersucht. Hierfür wurde die Nabelschnur von Feten ab dem 2. Graviditätsmonat (SSL 2,5 cm) bis zum geburtsreifen Kalb im 9. Monat (SSL 89 cm) verwendet. Neben lichtmikroskopischen (routinehistologischen, immun- und glykohistochemischen) Färbungen wurden elektronenmikroskopische Techniken angewendet. Dabei besitzt die Nabelschnur des Rindes zu jedem Gestationszeitpunkt zwei Nabelvenen, zwei Nabelarterien und einen Urachus, die allesamt in der Wharton Sulze (WS) eingebettet sind. Bis zu einer SSL von 26 cm können in der Nabelschnur des Rindes das extraembryonale Nabelzölom und die Reste des Dottersackganges beobachtet werden. Die Nabelschnur wird außen ausschließlich vom Amnionepithel umgeben. Das Amnionepithel besteht aus ein- und mehrschichtigen Bereichen. Bei den mehrschichtigen Arealen handelt es sich meist um lokal begrenzte, glykogenreiche Amnionepithelwarzen (Plaques), die der Oberfläche einen zottenartigen Charakter verleihen. Ihre Anzahl steigt im Laufe der Entwicklung an. Ab einer SSL von 42 cm (6. Monat) scheinen die nun dicht stehenden Warzen zu fusionieren, so dass nun auch über größere Strecken mehrschichtige Amnionepithelbereiche auftreten. Im 7. Trächtigkeitsmonat (SSL 53 cm) beginnt das Amnionepithel stellenweise zu verhornen. Zahlreiche desmosomale Zellverbindungen und Interdigitationen der Plasmamembranen der Amnionepithelzellen sprechen für eine hohe mechanische Festigkeit des Amnionepithels. Die zum Teil erheblich erweiterten Interzellularräume zwischen den Epithelzellen sowie der hohe Mikrovillibesatz der apikalen Zellschichten deuten auf Sekretions- und Resorptionsprozesse hin. Im Gegensatz zu anderen Gefäßen besitzt die Nabelvene des Rindes eine gut ausgebildete Lamina elastica interna, wohingegen sie in der Nabelarterie fehlt. Die Muskelzellen der Nabelvene sind weit voneinander durch Bindegewebe getrennt, wodurch die Diffusion und der Transport von Nährstoffen erleichtert werden. Beide Gefäße besitzen Vasa vasorum und bestehen während der ganzen fetalen Entwicklung aus α-smooth-muscle-Aktin (αSMA) exprimierenden Muskelzellen. Die bovinen Nabelgefäße sind nicht innerviert. Dies wurde auch durch das Ergebnis der immunhistologischen Untersuchung des S100 Proteins bestätigt. Die Ultrastruktur der Endothel- und glatten Gefäßmuskelzellen der Nabelgefäße gibt Hinweise auf eine hohe Proteinsyntheseleistung sowie auf einen regen Stofftransport dieser Zellen. Die bovine WS wird von zahlreichen feinen Blutgefäßen durchzogen. Sie wird im Laufe der fetalen Entwicklung zell- und grundsubstanzärmer, jedoch faserreicher. Im Gegensatz zu der makroskopisch einheitlich erscheinenden WS, stellt sie sich bei mikroskopischer Betrachtung heterogen dar. Dabei lassen sich der Bereich um den Urachus, die schwach ausgebildete Adventitia sowie unter dem Amnionepithel befindliche WS-Bereiche von der restlichen zentralen WS abgrenzen. Der Eindruck der Heterogenität entsteht durch den unterschiedlichen Zellgehalt, durch die Ultrastruktur der Zellen, durch das Verteilungsmuster der Intermediärfilamente und des αSMA sowie durch das Lektinbindungsmuster und durch die Reaktionen in der Alcianblau-Färbung. Besonders auffällig ist die Entstehung einer breiten Schicht αSMA-exprimierender Muskelzellen in der WS subepithelial unter dem Amnionepithel, wobei ein sphinkterähnlicher Muskelring gebildet wird. Der Urachus weist zunächst ein einschichtiges Epithel auf, das im Laufe der Entwicklung jedoch mehrschichtig wird. Ab einer SSL von 26 cm (4. Trächtigkeitsmonat) wird er von zirkulär angeordneten Muskelzellen umgeben. Um das Vorkommen und die Verteilung bestimmter Zuckergruppen in der bovinen Nabelschnur zu bestimmen, wurde das Bindungsmuster verschiedener Lektine untersucht. Dabei konnte mit Con A, WGA, ECA, GSA I, PNA und VVA eine deutliche, mit SBA, UEA I und LTA jedoch nur eine schwache Reaktion hervorgerufen werden. Weiterhin ließ sich eine altersabhängige Expression der Intermediärfilamente Vimentin, Desmin und Pan-Cytokeratin (CK) beobachten. Dabei konnte der Epithelzellmarker CK in einigen Zellen der Nabelgefäßwand bis zum 2. Monat (6,5 cm SSL) und in einigen WS-Zellen bis zum 4. Monat (26 cm SSL) nachgewiesen werden. In den Gefäßmuskelzellen der bovinen Nabelgefäße werden im Laufe der Entwicklung alle drei Intermediärfilamenttypen exprimiert, während in den WS-Zellen, mit Ausnahme der glatten Muskelzellen des Urachus, Desmin immunhistologisch nicht nachweisbar ist. Da die bovinen Nabelgefäße nicht innerviert sind, muss der umbilikale Blutfluss durch andere, nicht-nervale Faktoren reguliert werden. Dabei sind unter anderem die Anordnung der Gefäßmuskelzellen sowie die Kontraktionsfähigkeit der Nabelgefäße, die sich in der frühen Expression von αSMA aller Gefäßmuskelzellen widerspiegelt, von Bedeutung. Die in den bovinen Nabelgefäßen typische Verteilung der elastischen Fasern spielt diesbezüglich ebenfalls eine wichtige Rolle. Zusätzlich ist der umbilikale Blutfluss von der Struktur und Konsistenz der WS abhängig. Die Zusammensetzung der WS wird dabei entscheidend durch die die extrazelluläre Matrix produzierenden WS-Fibrozyten beeinflusst. Eine aktive Beteiligung des sphinkterähnlichen Muskelrings an der Regulation des Blutflusses ist sehr wahrscheinlich. Einen weiteren Faktor der Blutflussregulation stellen vasoaktive Substanzen dar, wobei die Ultrastruktur der Endothel- und Gefäßmuskelzellen Hinweise auf eine mögliche lokale Produktion dieser Substanzen in den Nabelgefäßen gibt. Der Nachweis von bovinem Progesteron-Rezeptor (bPR) in den Endothelzellen der Nabelgefäße aller untersuchten Feten lässt eine Beteiligung von Progesteron an der umbilikalen Blutflussregulation vermuten.

In the present work, efferent ductules and epididymal duct from male foetuses as well as from sexually mature bulls were investigated using conventional light and electron microscopical techniques as well as glycohistochemical and immunohistochemical staining techniques. The prenatal development of the bovine epididymis was studied in foetuses ranging from 10 cm CRL (75 pcd) to 90 cm CRL (285 pcd). In foetuses with 10 cm CRL (75 pcd) the main event was the establishment of the urogenital junction between the extratesticular rete testis and mesonephric duct via the growing efferent ductules. At the foetal age of 110 pcd (24 cm CRL), efferent ductules underwent a strong coiling. At the same time the mesonephric duct began to lengthen and coil, forming three distinct regions, namely caput, corpus and cauda epididymidis. The coiling was much more distinct in caput and cauda than in corpus epididymidis. At 130 pcd (30 cm CRL) and upwards efferent ductules were organized in lobules which are then arranged in groups separated from each other by connective tissue septa. A similar organization involved the highly convoluted epididymal duct, particularly in the head and tail regions. In addition to the macroscopical modifications in the morphology of extratesticular excurrent duct system, histological differentiation involved both the tubular epithelium and the peritubular mesenchymal cells. The epithelium of efferent ductules was differentiated into ciliated and nonciliated columnar epithelium. The simple epithelium of the epididymal duct increased in height and developed stereocilia on its apical surface. Distribution of WGA-, PNA- and GSA-I-binding sites on luminal surface of the epithelium of efferent ductules, but not of epididymal duct may indicate earlier differentiation of the former. WGA-binding to the peritubular and interstitial mesenchymal cells, but not to the epididymal epithelium indicated that the mesenchymal structures differentiate before epithelial ones. S-100, FGF-1, FGF-2, ACE, laminin and GT were immunolocalized in the epithelium both of efferent ductules and epididymal duct as early as at 75 pcd (10 cm CRL). Also ?-SMA was immunolocalized in the peritubular mesenchymal cells at 75 pcd (efferent ductules) and at 95 pcd (epididymal duct, CRL 18 cm). The epithelium of the adult bovine efferent ductules is simple columnar including ciliated and nonciliated cells as well as some scattered intraepithelial leucocytes. On the basis of their cytological characteristics, nonciliated cells could be categorized into three sub-types. The epididymal duct of the adult bull is lined with pseudostratified columnar epithelium. It consists mainly of tall, slender, stereocilia-bearing columnar cells and small basal cells. On the basis of several morphometric parameters like epithelial height, luminal diameter and width of peritubular muscle coat the epididymal duct could be subdivided into six segments. Ultrastructural studies revealed a well developed Golgi apparatus, numerous profiles of sparsely granulated endoplasmic reticulum and mitochondria as well as rER in the cytoplasm of principal cells particularly in those of the first three segments. Apical surfaces of principal cells particularly those of the proximal segments were equipped with long stereocilia and their apical cell membrane and cytoplasm displayed a well developed endocytotic apparatus. The narrow basal extensions of principal cells were crowded with numerous pleomorphic mitochondria, lysosomes, heteromorphic electron dense granules and residual bodies. Basal cells were insinuated between the narrow basal extensions of principal cells and the basal lamina. They possessed kidney-shaped, mostly deeply-invaginated nuclei and were characterized by a paucity of organelles. Apical mitochondria-rich cells were frequently found in segments II and III and rarely in segments IV and V. Their hyaloplasm was lighter than that of the neighbouring principal cells and their apical surfaces were provided with short microvilli. Apart from a reasonable number of mitochondria, small Golgi apparatus and sporadic strands of rER, they displayed a paucity of organelles. Intraepithelial macrophages were occasionally encountered in the basal third of the epithelium. They possessed many mitochondria, well developed Golgi apparatus and rER as well as small heterochromatic nuclei. Various profiles of lysosomes and dark residual bodies were found in their cytoplasm. Intraepithelial lymphocytes were characterized by their heterochromatic, round and mostly indented nuclei and narrow peripheral cytoplasmic rim. They were often encountered in immediate proximity to subepithelial capillaries. Fluoresceinisothiocyanate (FITC)-labelled lectins (GSA-I, PNA, ECA, WGA, Con A, LCA, PSA, DBA, HPA, SBA, VVA, LTA and UEA-I) were also used for the study of the regional distribution of saccharide groups in adult bovine epididymal tissues. WGA, Con A, LCA, PSA, DBA and HPA bound distinctly to stereocilia of principal cells in the different segments. However, DBA- and HPA-binding sites were confined to stereocilia in caput region. WGA, LCA, PSA, DBA and HPA possessed distinct binding sites in Golgi zone of principal cells, mostly of the caput epididymidis. Basal cells reacted distinctly with WGA, Con A, LCA, PSA and HPA. Intraepithelial leucocytes displayed moderate binding sites for PNA, WGA, LCA and PSA. The basal membrane reacted moderately only with WGA. Epididymal connective tissue showed weak to moderate binding only with ECA and WGA. GSA-I bound distinctly to vascular endothelium and could be applied as a good marker for bovine endothelium. Sperm cell mass bound WGA and PNA distinctly. No binding sites could be found for VVA, LTA or UEA-I. Immunohistochemical studies used the Avidin-Biotin-peroxidase Complex (ABC) method for localization of S-100, FGF-1, FGF-2, ACE, GT, VEGF, ?-SMA, laminin, connexin 43, CD4, CD8 and CD68 in the epididymis. The epithelium of the efferent ductules showed intense immunoreaction for S-100, FGF-1 and FGF-2 and a moderate immunostaining for ACE and GT. Principal cells of the first three epididymal segments exhibited a distinct immunostaining for S-100. They also showed a distinct immunoreactivity for FGF-1 throughout the different segments. Principal cells in the first, second and sixth segment displayed intense immunostaining for ACE. Immunostaining for GT in Golgi zone of the principal cells was intense (segments II and III), distinct (segments IV and V) and moderate (segments I and VI). Basal cells showed moderate (FGF-1) or intense (FGF-2) immunostaining in different epididymal segments. Intense immunostaining for ACE, laminin and ?-SMA was found respectively in the endothelium, endothelial basal lamina and smooth muscle cells of blood vessels. The basal lamina of the epithelium and the peritubular smooth muscle cells displayed a moderate immunoreactivity for laminin. The peritubular smooth muscle cells manifested an intense immunostaining for ?-SMA. CD4+ T cells and CD68+ macrophages were found within the epithelium and in the interstitium. Mast cells were conventionally stained with Alcian blue and Toluidin blue. They also displayed a distinct immunostaining for VEGF and FGF-2. In conclusion, my study supports the previously proposed 6-segment scheme of bovine epididymis. Moreover, lectin histochemistry and immunohistochemistry were not only helpful tools in emphasising this scheme but also in correlating specific functional activities to certain regions. Lectins- and GT-binding sites as well as ultrastructural characteristics point to high synthetic and secretory activities of principal cells in the first three segments, as indicated by the well developed Golgi apparatus. Ultrastructurally, principal cells of the proximal three epididymal segments displayed a well developed endocytotic apparatus. This was reinforced by intense immunostaining for ACE in this region, which reflects extensive absorptive activities in this region. Existence of mast cells in the epididymal interstitium and T-lympho-cytes and macrophages in the interstitium and within the epithelium may reflect their harmonized co-operation in the induction of immune tolerance in the bovine epididymis.