to mute your line when you're not speaking and you can use the chat box as well if you have comments or questions during the presentation and we'll address those questions and comments in sequence after the presentations have taken place and also as usual this is also a reminder that we are recording the webinar today so that we can share it with you and you can share it with your teams for cascading the training to your respective teams in your countries. Also this is a kind reminder for anybody who is on social media to use a hashtag that you see on your screen for ending child marriage. You can also tag us at the handle at girlsinspire and at Cole4g. So anybody who's on Facebook, Twitter or Instagram you can let your social media networks know what we're up to today. So without further ado I'd like to pass on the microphone to Mrs. Frances Ferrara who is a senior advisor for the Women Girls Initiative and the team leader for education at the Commonwealth of Learning to make the welcoming remarks. Thank you everybody. Thank you Cherise. Good morning everybody. I see we are still expecting some people to join us but because of time we decided to start immediately now and not to wait any longer. Today's topic is going to be presented by Dr. David Porter. Innovations in open and distance learning. We have been hearing this word the past few years. Innovations. What is innovation? What is an innovation? You should be innovative and many times people are saying what exactly is innovation? What can I do to be innovative? Well we have some examples amongst us and I think in each of your organizations there's a lot of innovation taking place. We have one very impressive innovation in the work that we are doing from the boat schools, where they take where they're using the boats to take the school to the learners because of the fact that learners cannot go to the schools. So that is an innovation. However today's topic is specifically in open and distance learning. Now we had a previous webinar on gender in ODL so today we want to see how we can bring innovation in ODL as we are working towards achieving the sustainable development goals and more specifically as we are working towards achieving our goals in the Girls Inspire project. Our speaker today is no stranger to innovation. Dr. David Porter is at the moment the chief executive officer of the eCampus Ontario and that is the primary phase of the Ontario online learning consortium. David has a long it's a long time advocate for the benefits of adapting new technology to educational opportunities. So he is indeed then a long time advocate for innovation to deliver education opportunities and he has been involved in ODL since the 1990s and at both the kindergarten to grade 12 K to 12 as well as the higher education levels. He has many many impressive positions that he has held over the past how many years but for the past 11 for 11 years David was the executive director of BC campus during his term at BC campus campus him and his team engineered Canada's first government funded open textbook program a leading edge move in the higher education in 2012. So this was indeed a huge innovation here in British Columbia and we have to be grateful for the work that David and his team did at BC campus. He also worked as a project leader a consultant for international open and distant learning projects and most recently also in Mongolia Malaysia and Vietnam. He's also the co-editor of the International Journal of eLearning and Distance Education and Open Access Journal. So with this information and with this portfolio on Dr. David Porter I think you all will agree with me that he is indeed the person that should speak to this topic tomorrow this morning this morning. So without further ado I want to invite David to speak to our us for the next 20 minutes 20 to 25 minutes after which we will open the floor for discussion where you will be free to ask him if you at one or other point experience difficulties with your mic don't be too concerned you can put in your message your question in the chat box and we will ensure that that question is responded to. David from outside also thank you very much for making the time on such short notice for having agreed to speak to our team today we are indeed looking forward to listen to you. David. Thank you very much. I'm very much very pleased to be here this morning in Ontario time and I realize it's evening and other parts of the world but I'm enjoying the opportunity to speak with you. Since its inception open and distance learning has really benefited from technological changes and in particular the internet which have provided faster ways of distributing learning materials to learners worldwide but I heard Francis talk about the way that some of you are bringing education to students by boat and that in itself is also an innovation it's a technology essentially that you have complete control over and can mold and manipulate to suit a need that presents in your area of practice and so I think it's wonderful that it doesn't have to be a high tech innovation to be effective as long as it solves a problem. I'm not seeing the slides on my screen on my end so I am counting on Francis or Sharice to move the slides for us but what I want to talk about first is what is an innovation and how does an innovation get moved forward. Many of the core innovations that we think about technologically like television radio and mobile phones have played a role in our lives and they also have an opportunity to play a role in the lives of distance learners and these innovations in most cases were developed in well-funded laboratories and built in factories well beyond a scale which any of us can really influence. So the question we're left with often is where can we as educators be innovators and what specifically is an innovation. On your screen you'll see a definition of innovation that I find very helpful and it's really about solving problems with new ideas and that's where it starts. It's about questions and problems and obstacles that you find in your life or your work and you find a creative way to solve that problem that makes a difference for others. When we think about the problem space that we work in as educators it tends to be bounded by what I would call the atomic structure of learning. There are some elements in that atomic structure that we can manipulate and make innovative for our learners and what I mean by that is that learners come to us with a goal in mind and we build courses and programs and training to suit their needs. So it's in this problem space that we as educators need to find our inspiration. It's not about big scale technologies like television or radio or computers that we can't really influence the core technology. What we can do is influence how it affects learners and that means that we have to look closely the innovations that can influence learning outcomes or the way we assess learning so that people can find and understand and realize the success they want or in the resources that we make available for them to learn through or the teaching activities that we create that engage students and make them effective learners. These are the primary areas we can affect through innovation. So what I really want to talk about is only one innovation today. One of the innovation that's come on the scene in the past 10 years that continues to grow and continues to provide opportunities for educators like yourselves like myself to make lives better for our learners. So what I want to talk about is making education truly open. So when I say that I mean making it open in the sense that anyone can have access to learning resources that suit their needs at any time and that those resources are completely malleable and moldable to suit a particular situation. And we find that when we build learning resources one of the things we always have to keep in mind is that we work in different cultures, we work in different contexts and for learning to be truly effective it has to be open so that we can customize it to the needs of the people we see on a day-to-day basis. So the question is why is open and that concept of openness so important? Well for me it's pretty straightforward. Why open? Because openness is really the way that education is created. It's about sharing knowledge and a significant date for the world is 1948 and it was in 1948 that through the United Nations the Universal Declaration of Human Rights was created and it is that declaration that says everyone has the right to education. Education shall be free at least in the elementary and fundamental stages and that is the genesis of the whole notion of education for all that we all deeply believe as educators that everybody has a right to education whether they live in a city a village in a rural community on a river education should be available to them. And so the question that arises from that is how do we make that education available to people and what is the power that is available to us and how does that play out in the real world where people are learning. An excellent example comes from Swaziland where open educational resources and open practices have been used to redevelop curriculum resources and lower the costs of nursing and training programs. There's a problem. How do we make education of nurses more accessible? How do we bring the best resources possible to those nursing students? And how do we use them effectively in the context in which we live and operate? That is one of the power equations that is available to us through the open community. So I want to just continue from there and talk about a few other examples of openness that work in the health education space and just give you a couple of examples. So open education and health care is another part of fundamental rights. People across the world believe that health care is a universal access issue and that we all should have access to good health care. We can't do that unless we have trained practitioners and that we have resources that everyone can use and that they are effective in multiple contexts. Surely no one competes over health care. Health care is a human right and we should be making as many health care resources available as possible to anyone. While I was working in Mongolia from 2010 until 2014, I showed a lot of educators there. Khan Academy, an online video tool to distribute lessons to students who had access to video. And one of the groups that I showed it to was the health care community at the Mongolian Academy of Health Sciences. And immediately they saw a problem that they were trying to solve. How do we train rural physicians effectively? And how could we roll out examples of good health care practices to those physicians using video? And so one of the first things they did was take the Khan Academy model and adapted to health care training in Mongolia and began to voice over videos that they could find on YouTube, some that were created by universities in the United States and in Africa, showing things like rural health care procedures, emergency surgery procedures, and they began to translate and voice over those materials in their own language. What made that possible was that all of the resources that they could find were completely open for them to repurpose, translate, and recreate in their own context. This is an innovation of power. This is a powerful way of providing tools to educators to make ideas and knowledge freely available across a broader population. Developed countries like Canada find this fascinating as well, that many of these innovations that have started in other parts of the world work equally well in our environment too. And so the next slide shows you some textbooks for nursing that have been developed in different locations, but have been repurposed using their open opportunity. That is, the materials are freely available, the materials are provided so that people can reuse them, and they've begun to actively do that to build better materials for our nursing students.  They could fit other contexts too if translated and localized. There are some real opportunities for bi-directional work between work that is created anywhere in the world being localized somewhere else. And I think that that was the opportunity that my Mongolian colleagues saw from videos that were created in Africa on rural health and how those could equally be useful in their context in Central Asia. Now across the world these days more and more of the core instructional resources that students use in universities and high schools are becoming available open and freely. Some examples include very high cost materials that are often required for science courses. These materials are often very much out of the reach of cost for students who struggle to find ways to pay for them. And one of the things that we are now finding is that when we provide free materials to students at the beginning of their course, accessible to them to use on any device or have printed copies made locally, they're more successful in their courses because they have not had to worry about whether they can afford the resource or whether the resource is current enough for their use but that it works effectively for them. Many of our nursing students are finding that the core text they use anatomy and physiology is a great example of a text that works across many science professions. And because it's available for faculty members and instructors to take apart and use only parts of or reuse parts of or simply assign for study parts of it, it becomes a very customizable resource that works well for students. If you look at the next slide, we're seeing these kinds of libraries developing all across the world in Africa, in Asia, in South America, everywhere. And it's all based on a key assumption and that is that we should be granting freedoms instead of imposing restrictions, that the sharing is a fundamental component of teaching and collaboration is a good thing. My colleague David Wiley, who has been working in this space for 15 years and who came up with the idea of open content, believes it is the way forward. That if you are not sharing, if you are not open as an educator, teaching and learning are not as effective as they could be. So the big idea, the big innovation tied to openness, is the notion that instructional resources that enable learning and teaching increase in value because they are free and more importantly because they are open. As you may know, UNESCO has been very supportive of the notion of providing open resources everywhere and allowing people to copy, share, translate, redistribute and remix materials to suit particular purposes. In the Western world, we're very concerned about copyright and so copyright has become the idea that we have innovated with. We have taken the principles of copyright that someone creates a work and can decide how it is used and decided to use it in a much more expensive manner so that others can benefit. And so through Creative Commons, we've created a licensing model that allows people to distribute work more efficiently, more effectively and allow more innovative uses to happen. So a simple standardized way of working forward. And we'll just keep going with the slides until we get to the next one, which talks about benefits. And you can continue to push there. And if you're familiar with openness, it has to do with licenses and the notion of spreading the word far beyond where things are created. It's about giving instructors the ability to customize and contextualize resources for their students. That is something within their control. I talked about at the beginning that we as educators have a scope in which we can probably innovate most effectively. Things to do with learning outcomes, things to do with assessment, things to do with resources, things to do with teaching practices. These are areas where we can be very effective. But we have to actually provide these resources so that people can find them. And if you see the next slide, you'll see how we're beginning to build libraries that invite instructors to find materials, to adopt the materials, and tools to help them modify the materials so that they can become more effective for use in their area. This is an innovation that is big and continuing to grow. Let's continue and just flip through some of those slides. Can you get a sense? But it's more than just a good idea. There is already research demonstrating that this innovation not only leads to more use of free materials, it also leads to more success. And that students do better when they have access to high quality materials that are customized for them. And the next slide shows an example of that kind of research that is happening currently. This is a study, a published study that shows that the outcomes are better when instructors and teachers have access to resources they can customize and make more appropriate for their students. Another benefit, and what I'm calling the beyond free benefit number three, is that students and instructors can begin to work together to build resources. And this is what we would call an authentic learning activity, something that benefits learning, has a better outcome and allows instructors to assess what students are doing in a more authentic manner. The next slide shows a textbook on chemistry that is extremely popular. 5.5 million viewers per month come to this student created chemistry textbook that an instructor has created with his students and allows each successive intake of his students to edit, improve, and make more useful for their peers. That's an important part of learning, being fully engaged in not only understanding the material you're working with, but also helping create new material for your peers to make learning more effective for them. It's not only instructors, it's also teachers that can work together more effectively. We're finding that librarians like to work together to create resources that are more useful for instructors and students. And one of the ways that we've begun to enable this innovation is to use the concept of a sprint, like a race, a short period of time in which a group of teachers or instructors get together to solve a task together. We have a problem, librarians have a problem. How do we make open resources more and better known to our teachers in our schools? Well, they got together to build a common set of resources that would be used in all libraries to help teachers understand the value in using these open resources. Next slide shows teachers working together to create their own textbook. A group of geography instructors decided that they wanted a local geography textbook that would be more meaningful to their students. So they got together over a period of five days and they collaboratively wrote a textbook, gathered images from the internet, gathered text materials, gathered freely available maps and other image resources, worked with writers, worked with illustrators, worked with librarians to build textbooks that were meaningful to their students. It's a textbook sprint. Often we need to look at assessments as well. And one of the ways to do that that we've found is effective is to have instructors work together on a common problem, innovate assessment models that work across multiple schools and across multiple subject disciplines. So that we're beginning to deal with not only lightning the load for creating those assessments, but also creating a high quality set of assessment resources that a number of schools and teachers together can benefit from. We call that a test bank sprint. But it goes beyond that. And one of the most interesting models that's starting to emerge is to use another innovation that's come along over the past few years and to marry it, bring it together with the open ideas to create something even bigger. And so you've probably all heard of MOOCs, Massive Open Online Courses. But often these courses require technologies that allow you to use video and other kinds of high-end technological resources. And that doesn't work in every context. So we need to think differently. And so one of my favorites is one created through the Commonwealth of Learning. And it is about working with a massive open online course that works with small mobile devices and is targeted at a particular subject area in a rural community, horticulture. These kinds of ideas, taking open resources, marrying them to mobile technologies, making them available to thousands of people for free is really an innovation that builds on top of another innovation. It is that kind of synergy is incredibly powerful. A very interesting new concept for higher education will begin in March 2017 through the Open Education Resource Universitas. And it is a collection of 35 universities and worldwide from India, South Asia, Australia, New Zealand, Canada, the United States, South Africa, Great Britain, Ireland, Scotland, who are working together to put together a completely free first year course of study at the university level for students to study by themselves on their own time using mobile or computer technologies. What is interesting about this is not only do you get to study for free, there is also a credential, an authentic credential associated with it. And so to lower the costs for students and to use all of the open principles, these institutions have worked together to put free programs of study available. And what students will be asked to pay for is assessment only. So a different model of practice growing out of open, no course fees, no materials costs, just assessment. This is how an innovation grows from a small idea of making materials free and open. It begins to morph and grow into a new and bigger idea. Look for OERU.org and look for the first year course of study that it will begin to offer starting in March 2017. Now it's only going to grow from there. And there are other technologies that are going to interface with these ideas. And one of them is the notion that fuels internet commerce and in particular distributed commerce, like the kind of commerce that Bitcoin and blockchain technologies begin to support. There is an opportunity to go far beyond where we are now to allow people to take courses and materials and learning opportunities from around the world and bind them together into an authentication pathway that will allow them to be certified at low or no cost. And this is starting to happen right now. So just in summary, if you want to be an innovator, if you want to be effective in innovation, it's really about four things. It's about a problem, a difficult challenge that invites new ideas. It's about organizational support that welcomes that kind of creativity. Your organization, your school, your Department of Education is supportive of bringing people together to try new things, those sprint ideas that I showed you. It's space to experiment and also to fail if necessary, not every idea that we try to implement works. And we need to recognize that the idea is really to fail early, to try things, but to decide quickly whether they are working or not. And one thing that every innovator needs to sustain their enthusiasm and to help them get beyond the thorniest of problems is passion that they believe they have an idea that will help overcome a real problem and benefit learners. And I invite you to think about what kinds of problems you'd like to solve, who could help you solve it, and how you might go about that in improving the lives of learners in your own community. And I'll stop there, Francis, in case there are questions. Can people indicate to me whether they can hear me? Okay. Thank you very much, David. That was a wow presentation. I personally got very much inspired by the sprint ideas. I think there's a lot of issues that you have raised that the team that's now in the room can either identify with or that they can say, I can take this into my context and see how I can use that idea. Because as you say, the conditions for innovations, the one is to know the challenges to understand what the problem is in order for us to find a solution. I like the sprint ideas. I like the issue of collegial collaboration. I think that is something that anybody in any team, if there is an enabling space within that organization can try. Within the work that we are doing, I think the colleagues would see now the value of finding what resources are available amongst the team, say, for instance, in Pakistan or Bangladesh, and see how the different organizations can adopt each other's material and modify it. So you have addressed many things that were there before for some people, but some may not have heard about it. But I think this is an excellent opportunity now, colleagues, to ask David to clarify or for him to give you more advice on an idea that you have that links with what he has said, or for him to give more information on a specific idea that you want to hear more from. I will now ask anybody who has a question to come in. We will see on the screen and then we will ask you to speak. Salim from Tanzania. David, can you see the chat box? Okay, you can see. I am opening the floor. Anybody who wants to make a comment? Mustafa, take the floor. Yes, good morning, Francis. David, it's a very nice presentation. Actually, you explained the term innovation in teaching, learning is in a very nice way, especially you identified the points, the problem, if there is no problem, there is no challenge, the innovation usually doesn't come in. The most important thing you mentioned is the organization's support. So if it is not supported by the organization, then it becomes difficult to bring some ideas to its matured level. So this is very important too. So one question may ask you regarding the sharing of the resources. So if we think of OOIR, actually a lot of materials are available as OOIR, we see different repositories are there. But if you like to use it for the local context where the language is a problem, culture is a problem. I mean, there are differences in culture, language, etc. So what will be your suggestion in that regard? So if our partners or our rural people or women who actually are facing a lot of problems with their culture and language, so how we can adjust these things when they will adapt the free resources, open resources. Thank you very much. You're welcome. Yes, you're pointing out a really real problem. And the issue is organizational support. And so when I gave you the example of recent work I've done in Mongolia, which is an economy that is just developing a very rural population, the government and leaders there, NGOs, have been somewhat proactive in trying to scale up small defined projects. So one of the projects that they decided to work on was to create some video that would be useful in the Mongolian context in their language. And so they did two things. One, they looked for examples like the Khan Academy videos, and they started by experimenting with the voice track, taking the English voice track out and putting the Mongolian voice track in. But that did not fully satisfy them. And so what they began to do was then to start creating their own examples of those videos and created a very small number to test in their schools to see if they were effective. And then went back to government to say, we believe this is effective. We believe it works best when our Mongolian colleagues create based on the model and do it in Mongolia and that the examples we use match our style of teaching and our cultural context. So I think it's a process of starting small. I am a proponent of design based research. So design based research comes from the premise that you rarely get something right the first time you try it. And it is through iterative cycles of building and testing, usually three cycles, that you begin to build the principles for a model that will work in your context. So that's what I would recommend that you start small, get some organizational support to try one innovative model to suit a particular problem you have. But think about it as an iterative approach that you will not only build, but test and then make a decision on whether to proceed or stop. Thank you very much, David, for that elaborate response. Therese, do you want to take the chair? Thank you very much. We've got one question coming in from Salim Apanda from Kehuwere in Tanzania. Salim, I invite you to unmute your line and speak out your question so everybody can hear you. Hi, Salim, go ahead. Thank you, but I'm sorry, where I am now, there is a lot of noises that I can't speak, but if you can assist, I can proceed. Please proceed, Salim, we can hear you quite well. Thank you. Can you hear me clearly? Yes, we can hear you clearly. Thank you. Please proceed. My question was, how can these materials found in those resources, especially most of them are found from the Internet? I wanted to understand if there is compatibility with other countries, especially in their curriculum and the way of presenting them, because I found some of resources editable and anyone can put his contribution that can mislead the lenders as we know that nowadays people are trusting Internet sources and some of them are misled because of these resources. So I wanted to know the authenticity and the security to protect the clear and the true materials. How can we protect them? That's a very good question. I think the authenticity comes from where they are stored. So if the repository that you are drawing materials from is a repository supported by a university or a college or a government or a well known NGO, then I think you can have a high level of confidence that the materials are good and authentic. But I think the philosophy of openness means that we want and we invite educators to actually pick those materials and use them and customize them to suit the needs of their own students. I don't think we are necessarily saying just use them as you find them. I think we are saying make sure it comes from a repository that you trust that is reviewed and fits into a category of knowledge providers that you would feel confident about. The second is that we expect for the most part that people are going to do positive things with learning resources and use them for their intended purpose. It seems like a terrible waste of time for someone to actually go in and corrupt a resource which was intended for positive use. And so that's where the professional education and judgment of yourselves as educators comes in that you review the resources before you recommend them to your students and that you, when you change or update or modify or remix or redistribute those resources, have confidently stated that I believe this is a good resource that will result in learning. I think being overly concerned about the security of the resource detracts from openness. Thank you very much, Salim, for that question. I think that is a very important one in terms of ensuring quality. And thank you very much, David, for clarifying that. We see some comments in the chat box saying that it's a very authentic and inspirational lesson and the emphasis on design-based research, which is a point from Dr. Porter. If there's any other questions or comments, please unmute your phone or type into the chat box and we can address them here. We have about five more minutes to go. So we'd like to take advantage of this expert in our room to draw from. I was wondering, I remember when I was in Pakistan, we discussed this issue of working together and trying to adopt and adapt the materials from each other. Is there any of you in the room right now who are working within your country with one of the partner organizations to adopt their materials and going through a process of adaptation? Or who are planning and need some advice? It's a very quiet class today. Normally we have lots of questions. Yes. Can I talk, Francis? Yes, please proceed, Mr. Fah. Yeah, I think already you started one. You helped Bangladesh Open University to develop a policy for the institutional adoption and development. So it is going on. Maybe we are planning to implement it to develop some materials. As we are in the existing materials, we are like trying to put the license on it. So it was you initiated. So we got the policy and now it is going to be a national policy. So another policy is coming out today. It's just started from there. So we are getting the second phase of the policy at national level. So the Prime Minister's Office of Bangladesh is running to put the resources they got. So they got several types of resources, especially the digital resources, the reviews, etc. So they are planning to put all these resources into a repository under that policy putting some licenses. So these are the development from Bangladesh Open University. It was you initiated. That's why I mentioned that. So if any partner wants to share this though, we can help them to connect with that. Thank you, Mustafa. Thank you. Dr. Porter, within this project, there is some condition for partners when they develop learning resources that they do license it under one of the Creative Commons licenses, number one. Number two, there is also within this by implicitly we are saying we are encouraging them to use OER and to build on that. You are making a good point in saying that adaptation usually needs organizational support and I want to believe that in within these organizations where this specific project is situated in the different countries within these organizations that we do have the organizational support and by way of committing to the Commonwealth of Learning that yes we are prepared to work towards developing more OER and to share it with other partners is a further sort of some evidence that there is this commitment from the organization. We are also is it we are also fortunate enough to have some of the CEOs of these organizations with us in the room at the moment. I see Mrs. Banu from Bangladesh. I see Saria from Pakistan. So they are the CEOs of these organizations so if they had any doubt about adaptations about OER I think your presentation this morning would have given them more insight. Usually also after the webinar we do share the recording of the webinar with everybody to go through and that goes with the slides that you have presented. So I was also thinking that if there are any queries or questions from the team afterwards we normally also sent out to them post webinar evaluation survey a short survey so if there's anything that's coming up from that we will also communicate with you in order for us to get more answers to such queries. In the meantime I've seen there's a lot of chat here if there is something that I need a person to give chance to talk I'll give to Siris to let me know. Thank you very much Francis. We're receiving messages from Salim in Tanzania mentioning how the structure works within the partnership for girls inspire. So Salim is saying in the chat box that Kiweta runs an open school where vulnerable girls are studying. Most of the materials for schooling are from the Institute of Adult Education which is another partner of Girls Inspire and other open university of Tanzania and these materials are adapted to suit the need for open school. Salim if you have anything to add there I invite you to again unmute your phone. In the meantime we're getting some really good advice here in the chat box from Dr. Porter regarding policy and organizational support which means receiving training tools, editorial expertise, graphic design expertise to ensure the quality of the outputs of the materials. It's also great that from what Francis had mentioned we're continuing the conversation beyond this webinar and we're going to take whatever feedback you provide us in those evaluation forms and raise those questions within our community of practice. An initiative that Mustafa from Bangladesh Open Universities leading is that he's creating follow-up conversations on our online community of practice at girlsinspire.org so we can also continue the conversation there and Dr. Porter we're happy to share the link with you where that conversation is taking place. So we have a few more minutes for questions or comments before we go to the closing remarks. Salim thank you we got your message that you're on transit and we really appreciate you joining us and being really active in your participation despite being on the move which is the beauty of open and distance technologies so thank you very much. So if there's any other questions or comments please type them in and in a few minutes time we'll proceed to the closing remarks. Okay I think there's no other comments. I would like to use this opportunity to ask David if he has a last-minute contribution to make if he wants to say something in closing before I sort of say my thank yous David. Thank you very much it was really my pleasure today to be a part of this short conversation on innovation and I think the the lesson to take away for me is that one person can be the initiator of an innovation that grows to include many others and as teachers and educators we most often can affect the kind of atomic structure of learning the things that happen around learning outcomes and assessment models the way education is delivered the delivery model the teaching practices and the kinds of resources we use those are usually under our control in some way as teachers or educators and those are the places to start it's pretty hard to affect the larger scale infrastructure or the core technologies themselves so I encourage you to work with what you have and do the best you can with it and to invite colleagues to play with you. Thank you very much David and once again thank you so much for having agreed to speak to us this was really a wonderful opportunity to speak to you I want to thank each and other each and every person who made time this morning to join us we know we had more than the number that's in the room at the moment who confirmed but we also appreciate of the fact that they may have experienced technical difficulties or any other unforeseen circumstances so we really appreciate the time that you have made coming to the room and to listen to this presentation these are all building blocks as we expand your capacity in certain areas because nobody is an empty vessel we all come with lots of ideas and competencies and skills already but we also believe in lifelong learning so anything new that we can learn anything new that can add value to the way we deliver our work would add to our own productivity but also the organization and in the end it will contribute to make a change in the world where we live so thank you very much I see there's more questions coming for David but he has answered them so thank you very much have a good evening have a good day take care goodbye everyone


Today we'll be dipping our photographic toes into an enticing world of ethereal portraits. We're going to see the surreal normality of apartheid South Africa before revisiting the early 90s music scene. Three very different photographers in a bit of an eclectic mix which we'll just go to show you how broadly you can cast your net when looking for photography to inspire you. A little bit from here, a pinch from there and you'll start to blend your own distinctive imagery and style. How's it? How's it? One of the best things about this channel so far, aside from the wonderful community, is that in addition to being able to share my love for photography with you, I'm also being introduced to photographers who are what they're new to me. It's a constant reminder there's always someone new to discover who will capture our attention, who's going to excite us with their photography. These three photographers I'm going to share with you today have influenced my own photography in various ways and I certainly hope that they're going to inspire you in some small way too.  Now I'm not sure if that's even like a real thing you know subtly complex and it probably isn't but you know what I'm just going to run with it. So I suppose what I'm driving at is that if you look at a Joyce Tennyson portrait quickly it could feel like any sort of run-of-the-mill late 80s early 90s kind of arty glamour portrait especially this image of Jodie Foster. It has that odd vibe that portraiture from the period seems to have you know the canvas background the draped clothing. Now perhaps it's something a little bit deeper perhaps it's just the quality of something that's photographed on film film images seem to have an organic feel to them that digital doesn't quite seem to have. Yes I'm totally aware of the contradictory nature of that statement you know after all I'm now talking about a digital representation of an image and I'm presenting to you in a digital way there is nothing organic about any of this you know it's just that there's something about a photograph that's created on film that has this sort of feel to it so it's somewhat akin to like when audio files describe this or discuss the differences between you know vinyl and cd you know to people for whom this matters it matters a great deal but I think for most people they'll sort of say well I don't see any sort of any where's the benefit anyway no doubt this is going to spark some other debate in the comments below like the previous video did with this Photoshop gate type of stuff. Anyway that's a neat segue into something that I I love love love love love about Joyce Tennyson's work and this is the way that she plays with light physically in her portraits you know so she's not doing any sort of photoshoppery sort of stuff on this and when I first saw them I spent ages picking apart the techniques that I believe she's employing in in her lighting setups especially the ones where there is some sort of painting with light effect going on in all of photography it's the it's this way that light can be physically manipulated that I find so fascinating if you're not familiar with this technique and it basically means you keep the shutter open and everything is obviously pitch blacks there's no light around and and then you you are going to use a source of light to to register stuff on on this on the central the film manually in this case I'm guessing them what was posed you know the studio is darkened and then the strobes are triggered and then a torch of some other sort of light source was then used to paint in the parts maybe like the halo around the head now aside from the the semi-religious and symbolic aspect of some of Joyce Tennyson's images which is not completely surprising given that her parents worked in a convent when she was young what I do like is this painterly quality of the light is absolutely beautiful and it's very simple and this is what we're talking about this sort of this simple complexity you can't just light stuff and and make it soft you have to have shape the light needs to crest and it needs to mold the subject it needs to allow the subject to speak to not overwhelm them but to elevate them to being in the stars of the photograph it's a bit of a bit of a change of pace here from the ethereal to an almost boring normality but it was the one that was at odds with the with the grim reality of apartheid era South Africa David Goldblatt photographed the changing face of South Africa from the 1960s onwards perhaps he was best known for two books which at least for me sort of perfectly sum up this this all weird duality of that time those books are some african as photographed and a book called in boxburg now in boxburg is an excellent example of how personal circumstance and experience so greatly shapes the way that we interpret photography as a viewer especially documentary photography to illustrate this in 1984 my family moved from the uk to south africa into a suburb not far from boxburg now like a lot of places at the time these suburbs looked fairly similar you know all the houses were built by the same company everybody seemed to have these sort of scrubby newly laid lawns and South Africa's in the middle of a drought then so everything was very dry and dusty and there were these wide open stretches of felt between the suburbs and and they're dotted around when you went for a drive with with the minds and the mind dumps of of johannesburg so when i page through the book and i look at these photographs in in in boxburg i don't necessarily see the narrative that golblat is is creating certainly from my you know photographic standpoint i can see see what he's driving out and and this kind of this this juxtaposition of the images and and the powerful messages they have but because of my own personal perspective of these images they don't evoke within me the same sort of emotional disquiet that i would get from say looking at pictures of 1930s Germany this is a tricky thing it makes me feel somewhat uncomfortable that rather than looking at these photographs and thinking of the of the inhumanity that man is capable towards other men they don't they don't do that they remind me of of my childhood you know that that these are places that feel familiar to me that they they evoke nostalgia and and and in fact i feel uncomfortable even admitting that and and in some ways i don't know if i'm going to get any flak for that but it it's i don't see that and it's that's just such a powerful illustration of of how much that when we read photographs or even take photographs that the way that other people would interpret them is going to be so personal so unique now perhaps it's because of the way that goldblatt photographed without any sort of a verb message in mind that allows me to to kind of possibly interpret these these images in some way you know it goes to show that that one doesn't always really need to be in your face you know to ram home a point in photography to create images that have an emotional impact as an aside there is fairly obviously a rich history of photography in in south africa especially documentary photography both from a black and a white photographer's perspective now originally i wanted to talk about alf camalo now he was nasa mandela's personal photographer he was at sharpville and he and he saw a side of a apartheid which which the west and and white photographers most certainly did not unfortunately there is so little of his work that is available online and i very much doubt that it ever will be because after his death his estate has been the subject of legal wranglings and and and all this kind of stuff that somewhat times goes on and all of this is going on his negative archive all his collection of negatives are in a museum that he he started about his photography which is now just slowly rotting away in in a field somewhere near sueto i believe and i think that's a that's a crying shame that for every one vivian meyer there are so many other important photographers who are becoming lost to history and of course that is possibly one of the one of the drawbacks of of the analog versus the digital age in a sort of counterpoint to joys tenison steve double has a more experimental certainly less focused and a more diverse sort of feel to his photography like well pretty much everybody when they are young you know i was quite heavily into music and the pages of the nme which is a a musical newspaper in the uk helped to shape my my early visual tastes along with with my music tastes and at the time steve double was my photographic hero it was the early nineties you know brit pop was all the rage along with grunge and his photographs helped open doors for my own photography they said that i could break rules that i could try different things and well basically just do my own thing because nobody had ever done this before now that's hardly a groundbreaking worldview but it's one that every teenager thinks is completely unique to their generation and it certainly was for me at the time i thought his cropping the use of gel lightings the emulsion lifts and being able to capture these larger-than-life celebrities in in a unique way that was so odd with what i've been told about photography up until that point you know was was was revolutionary but little did i know that i was getting small introductions piece by piece to the likes of ritted avidant and the likes of of david bailey it's fairly hackneyed now and it probably probably was then b&r was i was throwing in some cross-processing into my work i was doing all sorts of things and these photographs piece by piece were helping me to fill in a few paragraphs a few words into my visual dictionary of course looking back now some of those photographs are just like complete bubblegum but of course that's the point you know they were created for disposable newspapers of of what at the time were disposable music stars and of course that's their beauty that they are fun you know that unlike the images of of say kevin cummins who who i greatly admire but his photographs came across as earnest and and serious plus all of the things that steve double did i could copy it wasn't difficult you know it's obviously getting a great photograph is his tricky but the the base techniques are not they weren't that super difficult and that was one of the joys of the pre-digital world that it wasn't too hard to kind of sort of pick apart how somebody created something so i was playing with gels with cross-processing you know all of the techniques he was doing this kind of wobbling the the easel during a print which i'm going to guess is what was was behind this this photograph you know so one part is out of focus all this stuff is about copying and copying is a great tool that you can employ to develop your own photographic skills finding inspiration can be extremely difficult when everybody's drawing from the same pool you know that we're looking in the same places i'd encourage you to look a bit further into times and places that aren't all that well visited you know like me talking about the early 90s sort of Brit pop scene look into your own childhood look at things slightly outside of photography you know maybe you have your album art cover there's stuff like that look at what inspires you and you're going to find a rich rich rich seem of inspiration that you can mine for your photography which neatly goes into the David Goldblatt thing of being on the minds and job as you see what i did there so so clever anyway thank you ever so much for being here once again i you know thanks for watching and i have a good weekend and we'll see you again next week


Hello, I'm Dr. Raymond Steinback, chief of non-invasive cardiology at the Texas Heart Institute. Today I'll discuss non-invasive imaging in patients with chest pain. In late fall of 2021, the ACC published a new guideline on evaluation and diagnosis of chest pain, which emphasizes the role of non-invasive imaging. Almost simultaneously, the American Society of Echocardiography and the European Association of Cardiovascular Imaging jointly published the guideline, Non-Invasive Imaging in Coronary Syndrome, and I will also touch on this document, which is complementary. After this discussion, I hope that you will feel more comfortable making decisions about how to manage patients presenting with chest pain. Coronary syndromes can be divided into acute and chronic. The current guidelines divide non-invasive imaging tests into functional or physiologic stress testing and anatomic testing. Functional imaging tests include stress echo, nuclear stress, and cardiac MRI. Coronary CTA is the test for anatomic imaging. These tests may not be indicated in all patients with chest pain, particularly if there is low likelihood that this is cardiac in origin, or these tests may be used individually or in a complementary fashion. Deciding how to evaluate possible coronary syndrome patients and applying the proper non-invasive imaging study is nuanced, and recommendations have been under evolution for the past 10 to 15 years. Let's start with some historical perspective. How are the current guidelines different or additive to our thinking? Here are the related guidelines published over the past 12 years. The older documents above the dotted line make strong recommendations for when to perform non-invasive testing, but the nuance of test selection is avoided. This is due to the lack of outcomes data for imaging and a tendency to leave the how-to details of specific imaging modalities for subspecialty society documents. In 2013, the ACC published a multi-modality, appropriate use criteria document for detection and risk assessment of a stable ischemic heart disease. This is the first of a long line of appropriate use criteria documents to address a disease process, coronary artery disease, and to address whether or not any functional or anatomic stress imaging test is indicated in each of a long list of commonly encountered clinical scenarios. This exercise was designed to identify areas of potential overuse by consensus of stakeholders since outcomes data for imaging tests were not available. This is a table for the 2013 appropriate use guidelines. And we see the first six of 80 common clinical scenarios in that document. The clinical scenarios here separate symptomatic patients into low, intermediate, and high-risk pretest probability of CAD. Their ECG appearance and the ability to exercise. Consensus was reached amongst a rating panel as to whether any of the non-invasive imaging modalities were appropriate or might be appropriate, or were they in fact rarely appropriate. The rating panel was specifically guided not to rank amongst the modalities in a competitive fashion, so while this document helps to identify overuse, it is not too helpful when it comes to providing guidance on which test to use. The AUC documents remain relevant quality tools, however, for helping to reduce unnecessary use, particularly in stable outpatients, where patterns of imaging overuse have been documented. The Inter-Society Accreditation Commission requires still that labs performing non-invasive tests assess appropriate use as one component of required quality improvement programs. The 2019 European Society of Cardiovascular Imaging Guideline for the diagnosis and management of chronic coronary syndromes states that selection of initial non-invasive tests based on clinical likelihood of coronary disease and other patient characteristics that influence test performance, local expertise, and the availability of tests is indicated. This document uses chronic coronary syndrome as opposed to the ACC's stable ischemic heart disease classification. This newer guideline emphasizes the crucial role of healthy lifestyle behaviors and other preventative actions in decreasing the risk of subsequent cardiovascular events and mortality and discusses the utility of non-invasive testing for potentially influencing patient outcome. This guideline is helpful from a taxonomy standpoint. It identifies six categories of chronic coronary syndromes, two without a prior diagnosis of coronary disease, either with symptoms suspicious for CAD or a new onset heart failure with suspected coronary disease etiology. The remaining four included patients with established coronary disease, either symptomatic or symptomatic, asymptomatic, and late after diagnosis or revascularization or early. And new emphasis is placed on patients with ischemia and no epicardial coronary disease as suspected from non-invasive testing. This is also known as Enoka. And finally, number six, asymptomatic individuals with diagnosis of subclinical coronary disease detected on screening evaluations, and this would include anatomic testing using CTA. All of these are scenarios that are classified as chronic coronary syndromes, but they may involve different risk for the development of future events, and the risk may change over time and non-invasive imaging is important for both disease classification and this risk stratification. This illustration from the ESC guidelines shows why stable ischemic heart disease classification could be misleading as patients with chronic coronary syndromes could become unstable, depending on their management. In the upper right, you can see how this could happen. A patient could become unstable at any time and have an adverse outcome, even though labeled as chronic ischemic, stable ischemic heart disease in the moment. The trajectory can be uncertain depending upon revascularization status and the intensity of risk factor modification. This illustration from the ESC 2019 guideline on chronic coronary syndromes shows how we may think about the risk in these patients with known disease by incorporating symptoms, comorbidity, and echo findings including LVEF when trying to choose the best non-invasive tests. Patients with very low risk on the left side need no testing. Consideration of anatomic coronary CTA is a good consideration in lower to intermediate risk patients without known disease. CTA has a very high negative predictive value. A negative test is truly a negative test and it offers the opportunity to discover subclinical plaque which can potentially improve the trajectory of at-risk patients if preventative measures are implemented. As suggested by the Scott-Heart trial, in this trial it was demonstrated a significant lower rate of combined endpoint of cardiovascular death or non-fatal MI in patients who had management with coronary CTA versus those managed with treadmill stress ECG testing as usual care evaluation. This is presumably due to management of detective subclinical disease, but other randomized prospective trials such as the PROMIS trial have not shown a survival advantage of CTA strategy over traditional stress imaging strategies. The intermediate risk patients, those in the center, benefit from non-invasive stress testing and it may be useful with test choice based on patient characteristics and availability. In high-risk patients, an invasive approach is often needed. Importantly, recommendations from the 2019 ESC guideline include the recommendation for resting trans thoracic echocardiogram as the initial test and the management of patients with suspected coronary disease. This is to rule in or rule out other non-CAD causes of chest pain that could be cardiac in origin, including regional wall motion abnormality detection, determining ejection fraction and diastolic dysfunction. Even functional testing for ischemia or CTA is recommended as an initial test in patients in whom coronary artery disease cannot be excluded by a clinical assessment alone. Let's now consider patients with acute coronary syndromes. We just talked about chronic, but in acute syndromes until this past fall, the most recent guidance was from, again, the European Society of Cardiology in 2020. Patients with suspected non-stemmy acute coronary syndromes, a resting echo, again, is indicated in moderate risk patients and even at patients with high risk who are going for cath, an echo is indicated to assess ejection fraction, regional wall motion abnormalities and for concomitant other cardiovascular conditions and complications of myocardial ischemia. In the moderate risk group, non-invasive imaging may be indicated after a resting echo has been performed and an acute coronary syndrome has been excluded. And now we come to the newly published American College of Cardiology chest pain guideline for evaluation and diagnosis. The document is strongly focused on the patient's overall clinical evaluation as being crucial for establishing a patient's pre-test probability of disease and other factors that dictate whether or not non-invasive cardiac testing should be performed at all. These are grouped into those with acute chest pain with and without established coronary disease and chronic chest pain with and without established diagnosis of coronary disease. An initial clinical assessment and classification of chest pain is essential. Only 10 percent of patients presenting to acute care facilities with chest pain on detailed evaluation can be said to have cardiac or possible cardiac chest pain based on their symptoms alone. The new guideline recommends that chest pain be described as cardiac, possibly cardiac and non-cardiac. If the pain is possibly cardiac it may be either ischemic or non-eschemic cardiac chest pain. Non-eschemic cardiac pain can be from pericarditis, severe valve disease, complications of prior myocardial infarction, aortic syndromes, stress cardiomyopathy, and acute RV failure. The new chest pain guidelines recommend that we abandon the use of typical and atypical chest pain because this can be confusing. Most ED patients with chest pain have nonspecific, plural or musculoskeletal chest pain and these individuals require no non-invasive testing. Only around 10 percent have suspected cardiac chest pain and notice the very low frequency of proven cardiac chest pain in patients younger than age 45. The low accuracy of non-invasive testing in this low pretest probability group of younger patients is well known. Even in older patients with chest pain though, true cardiac chest pain, the green arrows, is in the minority. However, in these older risk, high risk patients with compelling symptoms, the risk is truly high and there's a need for the resources for accurate diagnosis. The guidelines strongly recommend risk assessment guidelines be employed. Many such acceptable clinical tools are available and they are listed in the guidelines. At our institution, we have used the heart score algorithm to classify patients. Using this score based on the history, including symptoms, EKG, age, and other risk factors and troponin results, patients can be relatively consistently placed into low intermediate and high risk groups. Validation studies have shown that low risk patients have a less than 2 percent risk of major adverse clinical events at six weeks without further evaluation and they can be safely discharged and further evaluated as outpatients. For a few years, we have used a chest pain protocol shown here. It is in keeping with the new chest pain guidelines. We do an initial clinical assessment including all of the elements needed for the heart score. It is the intermediate risk patients with possible cardiac chest pain or suspected ischemic heart disease that we then consider non-invasive testing. Please notice that the routine use of resting trans thoracic echo in intermediate and high risk patients to further assess ischemic and potentially non-ischemic causes for chest pain appears in the bright green box. After the initial clinical risk assessment, the test can be further used to classify patients into low intermediate and high risk groups based on the test results and managed accordingly. This flow chart has been very helpful in managing length of stay given the number of patients presenting with chest pain. For intermediate risk results or for an equivocal test result, the cardiology team is typically on board and decides on further management and of course the high risk test results often indicate the need for an invasive strategy. The relatively simple pre-test probability tool from this guideline can also be used with risk based on age, gender, the nature of symptoms and the coronary artery calcium score by chest CT if known. Shortness of breath can be an additive symptom of ischemic heart disease particularly in older men and again non-invasive stress testing performs well in intermediate risk patients and less well in low and high risk patients. Because of the inherent test performance characteristics related to test sensitivity and specificity. We are not going to go through all of the extensive recommendations from flow charts and tables within the guidelines but we will look at a couple. Here we see the stable chest pain with no known coronary artery disease table. In this group, non-invasive testing is recommended for intermediate and high risk, intermediate to high risk groups. In low risk patients no testing is recommended except for select causes where the clinical assessment is inconclusive. In intermediate to high risk patients with stable chest pain and no known coronary artery disease all non-invasive modalities may be indicated as shown in the center box with the blue arrow but one test is not recommended above the others. However, imagers know that in older high risk patients some tests are likely to perform better than old others. No test is perfect and for inconclusive studies in these patients noted by the red arrows layered complementary testing is sometimes needed particularly in complex cases. In patients with stable chest pain with known coronary disease the management decision tree is more complex. This guideline does not pretend to provide the granularity of the nuanced mix of patient variables and test performance characteristics that would be needed to lead to the best test selection in all cases. The new EACVI ASC guideline provides a needed focus on not just when to select the non-invasive imaging in patients with suspected or established coronary disease, it provides a more detailed discussion on which tests should be considered based on more nuanced descriptions of patient characteristics not just when to do but what to do. This document also highlights the importance of patient pretest probability assessment before determining whether or not non-invasive testing should be utilized. Let's look at the relative accuracy of stress imaging tests based on estimates of test sensitivity and specificity. All of the tests have very good sensitivity and specificity when it comes to utility in intermediate risk patients. Let's take a look at the results when we try to perform stress imaging in a very low-risk population. Patients with a pretest probability of only 10% say young adults with possible cardiac chest pain. Let's run 100 patients with a pretest probability of 10% through a test with an 80% sensitivity and 90% specificity. And stress echo would be in this range, a nuclear not far off. In this group, 10 of 100 patients have actual coronary disease and 90 have no coronary disease. If we focus on the 90 patients with no disease and apply a specificity of 90%, the testing process would yield 9 out of 100 patients with a falsely positive test result. And although the test identifies most patients having no disease, the percentage of positive tests that are false positives is 53%. Therefore, when the test is positive in this low-risk group, the test is almost meaningless with a 53% false positive rate. Now let's look at very high pretest probability of disease populations, older patients with risk factors and compelling symptoms. Pretest probability of 80%. Let's run this high 80% pretest probability through the 80% sensitivity and 90% specificity test. Although 80% sensitivity is not bad, out of the 80 patients with real disease, the test may produce 16 of 100 results that are falsely negative. And of all negative tests, 47% than are falsely negative. And the test may miss 16 of 100 patients with real disease due to the high false negative rate. We just saw how we can get into trouble when applying non-invasive testing to very low and very high pretest probability patients. The available tests are very useful for the same reasons in intermediate risk patients. The pretest probability provides the link between test sensitivity and specificity in clinical utility. And because tests are not perfect, even when appropriately applied, the guidelines recognize the need for complementary testing or escalation to invasive testing when results are unexpected or inconclusive. The sensitivity and specificity of stress testing is determined by the physiology of the ischemic cascade as shown here. Very CT angiography, if we turn this cascade upside down, shows this test to be very sensitive in picking up atherosclerotic disease and also for excluding its presence. So it is at the very origin of the ischemic cascade. When absolutely normal, this test is a very powerful test. However, it picks up significant atheroma, so it can be non-specific. Normal flow reserve testing may be needed when this test shows disease that is intermediate or high, highly significant. Nuclear stress testing operates a bit further down the ischemic cascade, but its high sensitivity means that it's very able to predict ischemic perfusion abnormalities. Stress echo operates even a little further down the ischemic cascade with evaluation of left ventricular global systolic function and wall motion abnormalities. Let's look at this case of a 56-year-old male with diabetes and hypertension who presented with no chest pain but worsening shortness of breath on exertion and an abnormal EKG. He was unable to exercise due to foot infection. He developed slight test discomfort and augmented ST depression during debutamine infusion. And there's a suspicion for slight hypokinesis of the mid-lateral wall in this four chamber view, and you can see the nice endocardium even without an ultrasound-enhancing agent. In the apical long axis view, the infralateral wall is normal at baseline in the upper left but becomes hypokinetic rather than augmented at peak in the lower left. This is a typical ischemic response, but it can be subtle as in this case. In our lab, we sometimes acquire global longitudinal strain imaging at baseline and in recovery, so this is not an official protocol. It takes just a couple of minutes, and in this case, the abnormal strain pattern in the left circumflex territory with and without our visual assessment was confirmed with coronary angiography, which shows severe left circumflex disease. So in this case, adding the mechanical indices of global longitudinal strain moved this stress further down the ischemic earlier into the ischemic cascade, making it potentially more sensitive. So this and other non-invasive testing are continually undergoing improvements, and this is a changing environment. In choosing among the non-invasive tests, a positioning statement of patient-centered medicine was recently published. We would take a personalized approach to testing based on clinical information better than a one test for all patients' strategy. For any living clinical presentation, physician's role is to use his or her best judgment to decide on the optimum approach, factoring in the pretest likelihood of disease, patient preference, patient characteristics, equipment availability, and technical and reader expertise which can vary greatly. Thank you for your attention to this talk on non-invasive imaging in chest pain patients and attention to the new guidelines document from the ACC.


So it's the end of the day and I'm clearing out my inbox and Most days I do reach inbox zero zero emails in my inbox I have a particular method for it that has worked for me for over 10 years a Lot of people like this method I teach and I will include a Detailed article about this method in the notes of this video But what I wanted to show you today is that the other thing I clear out, you know on regular basis is my spam box Because sometimes occasionally there are emails in there that I actually need That are from people that shouldn't be in spam But anyway, I wanted to show you how I perceive my spam box a lot of people Think negatively about spam, of course they it makes sense But I actually use I try to put a positive spin To to life as much as I can so that it creates less stress more happiness And therefore more creativity more focus all the good stuff that comes from less stress And so here's how I approach my spam with positivity. I actually look through these things and Of course the quickest way to clear spam is just to look at the from the from line usually gives it away I mean come on. This is none of these are really from real people you can tell I mean nobody does that You know where nobody sends me reliable lazy. Oh sure, you know You know free credit select scores, right, you know, so anyway It's easy to see that this is all this is all spam But but what I want what I do though is I kind of have a funny conversation with some of these just as a positive It's like oh starch for searching for an attorney. Oh, okay. That's a good idea. Thank you Thank you to this person for giving me this idea that oh if I need help I can search for an attorney. Okay Can I trust you? Yes, you can thank you for asking Suzuki you got a new message.  Someone's trying to send me money. How how wonderful of them? Obviously, I know that this is all this is all scams But as you can see I'm kind of having this funny and fun conversation with all these spammers Which I know I'm just gonna delete with a couple of clicks, right? But as I'm just kind of going through them and literally I'm taking more than a minute or two to show you this but literally I do this like this this quickly Occasionally I just kind of pausing for three seconds to say You know home solar panels. Oh, I'm so glad that solar is going more popular now. They're spam with solar, you know I'm happy to reach you today. Oh, thank you. I accept your happiness But do you see how kind of silly and funny but but by the end of going through this I have a positive feeling that so many people I know this is all fake But so many people are trying to reach me with a positive No positive warning. Oh, they're trying to help me out.  So anyway, I hope this video Helps you in some way at least to reframe something annoying in a positive way and I wish you blessings for the rest of your day