Ahoy-hoy and welcome to the channel. I'm Dr. Sumerian not a real doctor back from a two-week break where You don't leave that in because the funny part is that I went I Went on break and then I got sick To the point where I was nauseous Most days just a little bit here and there after eating and then when I got better from that About four ish days ago. I started getting sinus congestion and and while it is mostly cleared up Some of that has settled into my chest and throat. So now I got to wait for that to go away So if I sound a little different, that would be why I spent most of the time sort of relaxing Riding a little not a whole lot and and streaming games on discord on my Server discord or my channel discord server and also looking for ways to help the channel out a little bit, but Today we are moving back into dank memes and the first one. I'm gonna start mentioning these from the When I actually do them or at least I'm gonna try anyway The first one is by underscore shoulder underscore and I believe the first three are by this user researcher at site 88 Hey, I finally found that damn time SCP 6 3 1 3 at that exact moment Just kidding. I didn't disappear into the ether Yeah, so It seems that people enjoyed SCP 6 3 1 3 which is nice another one by underscore you shoulder The SCP foundation on their way to stunt scientific developments by arbitrarily deciding certain sciences are anomalous So this is something that I've actually Understood for quite some time. Thank you for the honk This is something that I've understood for quite some time and in the end a lot of what we consider to be you know Normal today would been considered black magic even a 150 years ago, so or maybe even sooner than that So it's a little bit difficult to decide what is and isn't normal and what is and isn't anomalous Anomalies are just things you don't understand yet Except the anomalies are never really solved. I mean there are a few explained SCPs, but I mean I don't know It seems like a silly way to approach the creation of Science like they're supposed to be studying anomalies so they understand them and then what? There is no that's the one of the few like overarching narrative issues with the scp foundation is that question and Then what so you you keep the anomalies and boxes you until you understand them And some of them you're never gonna understand that I understand that I understand in fact the vast majority of them You will even magic would operate under a specific set of rules and laws and once you understand those rules and laws It's no longer Unanomaly it's just how the universe works.  I know people like them for ease of categorization or whatever, but in the end what? What are you doing? What are you doing? I mean come on? Series one murder monsters cringe 3 a.m. Clickbait youtubers every other scp the wanderers library stuff look The mainstream once with the mainstream once it's just like the heart once with the heart once and if the scp foundations content If the pot if that particular type of content is the most popular content, and that's the most the content that you're gonna see on the channels I've tried numerous timing and there are popular new articles by the way and I think I think that's another approach that you can go towards doing it There are popular new articles and you can cover those articles as well, but if you don't cover what people want to see people won't come to look and for the YouTube game if people don't come to look you don't make enough money to sustain yourself period I am just just that close to not even being able to scrape by myself And I'm just a single person at a computer who records or should say writes records and edits all themselves Can you imagine being somebody with multiple employees trying to make this work? Of course they're gonna go for what's the most popular the people's lives you're talking about Does it suck yes, and also I never read wonders library stuff There's a bot on our discord that links out to stuff and it links out to The wanderers library without telling you that it's wonders library and I remember just every time I click it I'm like all right close I really wish it would tell me before I collect that's all I'm saying some of that stuff on there is great I just don't have time for both Plus the stuff on the wonders library tends to be short story late. So, you know Samarian takes two weeks off me good twice the weight double the memes Twice the weight. I think this is only nine memes total. I think I counted that I saved out of it There were a few the last but the last batch was super small This is part of the reason why I didn't bother I was gonna make a video that day where I announced that I was taking that two week break but the meme selection was so small because of the protest with a blackout protest on reddit that I did there wasn't enough for me to do so I just said, you know, fine I'm just gonna make an announcement video and then go dark for a couple weeks And so mostly you've got just a few memes from last week mixed in with all of the means from this week And I think most of the memes from last not last week two weeks ago Were were from shoulder. So, yeah, that's that's what it is But I'm glad that you're willing to wait and come back because I like doing these videos I like that people like that I do these videos SCP Foundation and Geo see when a huge breach happens SCP Foundation after the breach Yeah, yeah Yeah, Geo see is a highly competent Organization with a lot of resources and men and manpower. So you can't really ignore them during Like all hands-on deck situations with the same time Yeah, they have basically competing the only thing that they don't have competing views on is, you know saving the world Fundamentally they have just completely different approaches to everything You know I talked about this earlier But if you guys use reality-bending and thaumaturgy And surely it must be considered a science and non-anomalous given non-anomal non-anomalous given that you understand it Geo see SCP Foundation Huh? Yeah, no, this is the yeah, this is the and then what that I was talking about before and Yeah, that's a thing. I completely forgot. Oh my god. That's funny. Oh my god That's funny. I completely forgot that the whole time I was supposed to be telling you who made each of the memes That's that's great. I'm gonna have to get better at that I'm gonna announce them off the end of the video that'll that'll just have to be what it is for this time around Because I what I did was I saved the files with the user names so I can see up in the upper corner there Well, I'm going through the thing who made each meme, but okay anyway moving on Anyway, is it the last one? Yes That's the last one so let's go over the listings so the first three memes were shoulder underscore shoulder underscore and then Crusty cheese being and then fanboy x27 and then goo who underscore zero underscore zero and then Human that might exist and then insert something here and then the clown was taken Thank you very much for your memes And I will try to do a better job next time of announcing when I'm looking at the meme who created the meme Because I think that's I think that's just good practice Not not good practice. I'm not practicing something. That is a good practice In in the sense that it is a good thing to do And I should have been doing it. I think from the beginning Anyway, that's it. Thank you very much for watching if you enjoyed the video Scroll down and hit the subscribe button and then hit the notification bell next to that So you're notified when I upload new videos and then head on over to patreon.com Ford slash D's Samaritan and pledge at any level like everybody here on the screen already has it I would like to say If you I'm gonna do the thing I got to do the thing If you're capable of pledging on patreon, please do so. I am Dangerously close to going below a hundred dollars on patreon, which is something I never imagined what happened And I think part of this is on me also because it's been going down consistently ever since I stopped offering Both critique and writing assistance as rewards, so there's a strong possibility I'm gonna come back and re-examine what my rewards are which right now is just special access on discord And the joy of knowing that you're helping me out, which you know, that's kind of selfish of me So that's something I'm gonna take a look at and figure out a way to fix Actually, a good question is all you know, I'll ask this in the comments down below What kind of patreon rewards do you think would make you willing to actually pledge? And I'm gonna start looking at those comments and figure out like What you suggest and what I think is actually capable of my what I'm actually capable of doing Because this is important Getting that close to not being able to support myself anymore. I mean, I know pay patreon was a big chunk Plus the ad revenue and ad revenue is down too. So that's a whole other thing if this is this has been consistent for a little too long And the numbers for patreon have just literally nose dive. I was that close to 500 A matter of months ago, I don't know how many a lot of months I think but a matter of months ago And now I'm down to almost below a hundred. So patreon please pledge if you can it's very important and Thanks for letting me know that I'm not alone out here. I will see you all again on Thursday


Thank you very much for keeping it wide in the morning. My name is Ram Agukul. It is time for the next conversation of the day and today it's all about talking about mental health, especially in the youth. Today, let's talk about mental health and relationships among the youth. How healthy or how can your mental health affect our relationships? Can it affect the way we socialize, the way we interpret information, the way we deal with other people, the way we also raise up our families? Is it possible that our mental health can have a long lasting effects even on our own children and their children after them? Well, this particular conversation that we shall have today, a man with grace karaoke. She is a therapist. She'll tell us more about what she does and she has a good, a very good CV. Karim Sana Grace, thank you for finding time to join me. I am so glad to be here. Thank you for the invite. Kusalamaz. Kabisa.  Yes. Tell us more about what you do and the areas that you always cover. Yes, I am my degree is in marriage and family therapy. And I also do mental health counseling. So anything, mental health, depression, anxiety, panic attacks, stuff like substance abuse, anything that has to do with grief, trauma. I am the person to look for.  You are like our modern day church where you know when people have problems, they go to church. When people have mental issues, they come to grace. They come to grace, yes. Where can we go find it? I do my sessions mainly online after the COVID situation. But I'm based in Ridgeways, which is off of Kimburot. And that is where I do my physical sessions. But mostly I do a lot of online through Zoom, WhatsApp, Google Meet. Wherever a person is able to reach me, I'm really happy to be of help. I also do a lot of social media. So I have a lot of following on IG, on Facebook. And I also have a website that people... That's the way you make an appointment to reach me is to go to my face. Tell us your website and your social media. Okay, my website is www.graceriochi.co.ke. And over there you will find everything. Because you can click... I have a YouTube channel. It's called Live by Design with Grace Karyuki. Lots and lots of information on mental health and relationships.  So one more. Well, Grace, even as we start this conversation, I would like you guys to check her out on her social media platforms and show that engage with us. The hashtag is one in the morning at Ram Agoko. It's my handle at Y254 Channel. It's the station handle at Michelle Ashira, my colleague's handle. Remember to head over to Facebook, drop in your comments. As we continue with this conversation, ask your questions. Ask away.  It's all about mental health and relationships among the youth. Thank you so much for being part of this conversation. Let's start. Let's talk about this from different angles, Grace. Because I know that mental health is so broad. There are so many things that can affect the mental capacity of the mental health of an individual. But before we get into the nitty gritties, is it possible for someone to establish within themselves that my mental health is good enough? Yeah, yeah.  Because this is what happens. Is that you have a thought. That thought triggers an emotion. And that emotion triggers a behavior. It's a process. Absolutely. One thing leads to another. One thing leads to another. So for instance, you wake up in the morning and the first thing you think about is, oh my goodness, this is going to be a hard day. And fun enough, there's a way that particular mindset affects your day. Yes, yes. So now you trigger emotions within you, the emotion of stress. And now because you have predicted that the day is going to be hard, the next thing that you feel is some sort of negative energy. And once you have that negative energy, what do you do?  That's the behavior. But if you wake up in the morning and say, oh, thank God, what a beautiful day.  And you have a good day. It changes what you do. Because at that point, you go, you shower, you have a good breakfast, and you are looking forward to the day.  Now, WHO, the World Health Organization, they say your mental health is as important and probably even more important than your physical health. Wonderful. So young people who are between the ages of 18 and 25, their mental health is very important because they are moving and transitioning from being children into being adults. Now you have the capacity to think for yourself and to make choices.  It's interesting what you're saying, that it all starts from your head. From your mind. From your mind. That's why it's important. It's important. So when you wake up in the morning, tell yourself it's going to be a good day, even though you had a bad day the previous day. If you're going to work, even though you have struggles and disagreements, we are normal in the office. When you wake up in the morning, tell yourself today is going to be a good day and it will affect your day. If you look at some of these behaviors that people show, because you said it affects your behavior, if you look at people in the office or at home, is it possible for you to pick out that this particular individual needs assistance in terms of their mental health or should need to work on their mental health? Is it possible for you to either pick it out from someone else or notice it within yourself? Oh yeah, definitely. Now, let's look at signs that your mental health is good. Exactly. Number one, you don't make assumptions about things that are happening around you. You clarify, you ask questions, you communicate. Number two, you do not judge other people's intentions without having evidence that what you are telling, you are thinking and saying to yourself about why they did it is correct. So for instance, if I'm walking down the street and I meet you and I say hi to you and you don't respond, my first thought is that you have ignored me, you don't care about me and therefore you are mad at me. So that thinking is going to create sadness in me, frustration in me, a lot of questioning until you come to the office and then you say hi to me and then I'm thinking to myself, why are you pretending? I talked to you and you didn't tell me. And then if I don't ask you, I will call you a person who doesn't care. But if I say, hey, by the way, I met you on the road, I say hi and you ignored me completely. And then you tell me, where? Oh, I didn't see you. And then I say, how? Then you will tell me, actually I was hurrying because there was something. Your mind was somewhere else. So if I do not learn how to understand human behavior, then what is going to happen? I personalize everything. If you tend to personalize everything, you know your mental health is not okay. You need to work on it. Now, how can you tell another person has mental health issues? Sadness, you can tell somebody who is sad. Isolation, especially for this age group, a lot of isolation with drawing. Is that from 18 to 25? Yeah, from 18 to 25. You find that there is a lot of isolating with drawing from social situations, lack of interest in things people used to love to do, and then a lot of restlessness. You know, quick tempers, yelling and shouting, and also behaviorally, we develop what we call coping mechanisms.  We should lead to some more problems. Much more problems. Addiction. Yes, addictions and other self-destructive behaviors. Now, the other thing that we need to understand is that our upbringing plays a big role on how we develop in our mental health, our emotional health, and psychological health. There are some thought patterns and some belief system that are created by the way that we experience our parents. Now, this is what I normally tell young people who are in this space in their lives, that take time to get to know yourself. Get in touch with who you are by doing the simple thing. Start writing your life history from the time you are, as long as you can remember. And take segments like 10, zero to 10 years old. What was my experience? What did I experience? How did I experience that? So you're doing that to evaluate yourself? Yes, to understand yourself. How did I used to feel at home? Maybe when you were a kid, you used to wet the bed, you used to have nightmares, you used to really be afraid of the dark, be afraid of snakes and bugs and everything. So you need to go back there and get in touch with that. Those people who experience those kinds of fears early in their childhood, those are the people now who develop anxiety disorders like panic attacks because you are not sure of the environment. And let me say something very quickly here. There are four things that as a child, you need to know and to experience. Number one, that I am loved, I am acceptable and I can give love and it is accepted. Number two, I need to feel that I am competent, that I have the skills and I can develop the skills to be successful in my life. Number three, I need to feel that I am safe, that the environment I am in, I am safe. So I'm experiencing safety because my parents are not fighting. The people in my environment are constantly not in a fight. They are not chaos. People are managing life well. And then number four, I need to know that I have control, that I can make choices and I'm allowed to make mistakes and learn from them. So in this scenario, we're looking at how family affects relationships, especially among those who are growing up. When, how deep can it go? Especially for these, for people who are within this age group. Because we are seeing some of them even getting into family. Some are in the age of 25. In the Kenyan youth of today, some are families, some are children. How diverse can the effects be in the long run even to their own children? Yeah, yeah. Now, this is the thing. We are creatures of imitation. And so when we are growing up, and that's why I said, take some time and do your own life history, reflect back so that you know, how did I experience dad? How did I experience mom? And how did they shape the way I think about life? Many of us, me, I was 12 when I said, when I grow up, I don't want to be in a marriage like my parents are in. You see, we make certain vows because we are experiencing certain negative things happening within our environment. So when we grow up and we get into families ourselves, we do not know, apart from what we experienced at home, how do we know what the other alternative is? We haven't experienced it. Because even the person that you're going to start a family with has their own experience in the family. They have their own baggage that they bring with you. They bring with them. And so that is why it's important. Before, the best way to prepare for a long-term relationship and young people in this age group, that's what your crisis, your developmental crisis is about your occupation. Who do you want to become? Career. And number two, it is your relationships. Now I'm no longer I'm a child of career, I'm a child of my grandmother. Now I am me, myself in the world. Stand alone independently. Yes, how do I now create my own life, my own identity outside of my family? And this identity crisis starts when we are in our teens. We begin to differentiate, we call this differentiating in family therapy, that you begin to differentiate yourself from your family. And that is why teenagers and their parents have a lot of fights. And what is the complaint mostly? That you like your friends more than you like being with us.  And we will get there on the teenagers. But now I'd like you to touch on this particular aspect of how that trickles down to the generation. To the generation because that is one thing that affects people. Absolutely. They say that my father used to do this. Used to do this. My mother used to do this in our family. Yeah, we used to. We do this, you know. And you know, you end up wondering, is this a pattern that should change or should it continue? Absolutely. It's because, like I said, monkey see monkey do. That's the way we are. So when we know that what I have experienced at home, I don't like, you see. But what I want, I don't know how it looks like. Can you change that pattern? Yes, you can. And you can change that pattern if you are self-aware. Take some, that's why I said during your 20s, you during your early 20s, take time to get to know yourself before you couple yourself with someone else. So how do you, yes, it will trickle down because when you get into the situation where you have to discipline a child.  We parent, we parent according to the way we were conditioned. Or we parent against the way we were conditioned.  You see. So in order for you to change that, then you need to take some time to know yourself, understand who you are, understand how you relate to the world.   I love what you're saying, that at the end of the day, you need to re-evaluate yourself.  And I think that's how people end up writing books.  Try to think to the first, very first memory you can remember. And I will tell you mine. Me, I can remember my first memory. I was mother. I was running around, singing, skipping and all. That's my first memory. When I look, when I ask my mother how old I was, I was around three years old. It's not foggy. It's foggy. Your memories begin to form when you're around two and a half to three years old. That's when you begin to retain memories. Because, personally, I can't remember much about how things were, but I remember so many things. Yes, it's very foggy. They're so scattered. And I can't pick out which one is the first memory. Yes.  Our lives are very emotional. We remember things in emotional terms.  Those are the, whenever you have this gaping information, memories in your mind, stop and ask yourself, why is this memory so clear in my mind? What is it about? What are the emotions around it? What does it mean? What did it, how did it impact my life? Because you are remembering a certain situation. Now, it all moves or revolves around self-identity. Yes, yes. It means self-identity has a key role in emotional health. Yes, yes, yes. Now, if you look at the societal expectations, I want us to look at some of these nitty-gritty things that affect mental health of the Kenyan youth. Societal expectations. Yes. People want you to become that doctor. Yeah.  You are 18. And at that time, you're looking at, you know, people who are finishing their high school, they are getting into campus, and they're expected to make career choices, which at the end of the, in the long run brings in that friction between them and the family. And you want to say that maybe stuck you over here, because there's a youth who is suffering from that particular, right now. What do you do? Yeah, exactly. Now, the issue of now self-identity and differentiating yourself, who you want to be versus who your parents want you to be. I normally say that education, going to campus and getting an education, sometimes that education is not so much about what career you will go and do. It is actually about social development.  So your first degree, if you have parents who have decided that this is what we want you to do, I want to say this to young people. You can either fight against it and go into college for four years and come out with nothing. Or you can look at it and you can tell your parents that this is really what, if they are not willing, because at that point they are in control and you don't have much control. You're still under them. Yes. So either you can go in and be bitter. I did that for six months when I finished from four. My parents were not able to take me to college. So one of my relatives was gracious enough to allow me to come to her house and she took me to go and learn how to make dresses, dressmaking. And I felt... Is that what you wanted? No, no. I wanted to be a teacher. And me, what I felt, my experience with what that good Samaritan did for me was Amenidarao. So I spent six months and then three more months of practicum in addressing making school and I never learnt anything because my attitude was rotten. You don't want it. I did not see the opportunity. I saw, I saw Amenidarao. And so my brain refused to accept the info. Today I wish I...  And today, you know, today I have to pay for this dress to be made. I would be doing my deal. I would, why? You see? So what I'm saying to the young people, if you are in that situation and your parent has insisted, I want to tell you, you can either choose to be bitter and not see the opportunity or you can look for the opportunity. Serenity prayer. God grant me the serenity to accept the things I can't change. So I can't change my parents. But I give me the courage to change the things that I can. So what is the opportunity here? The opportunity here is for me to go to college and get a degree and learn. And there is things I'm going to learn in school that nobody or in college, that nobody can ever take away from me. So I'm going to go in with an open mind and I'm going to say, what is the opportunity here? Because after your four years of your bachelors in business administration, then you can now, after that, you can now, you have more, what do we call, more control and you have more opportunity to be able to choose what you want to do.  I wish I had a taro meta here. Here? That's my point. You can choose whether to rebel or not. And this is what many people are going through. I want us to take a short break. We'll be back after this. And I hope you're learning something from home, especially when it comes to this particular conversation on mental health and relationships among the youth. Are you learning something? Are you a parent? Do you have questions? And should you engage with us? The hashtag is one in the morning at Ram Maguko at Y254 channel at Grace Karaoke. It's also where you can find her, correct? Yeah, Grace Karaoke, middle dash in the Rito. That's my Facebook. Yes, on Facebook. Or in IG, GK in the Rito. Yes, make sure that you keep it. You tag her as we continue with this particular conversation on mental health. It is so important. We have a lot that is still coming up. After this break, we want to also look at so much more in regards to mental health. So don't go too far. This is one in the morning. We'll be back in a bit.


Hey everybody Forest here ripping 2022 origins and certified football hobby 8 bucks mixer number 3 random team style you can always find these results at latent sports cards.com and I did drop a link in chat for you as well thanks for joining everybody good luck start with 4 certified it's a nice freshman fabric hopefully some freshman fabric rpas all right starting off with a Raiders Darren Waller 53 of 199 Gold Team Jamar Chase 49ers Danny Gray on the freshman fabric rookie jersey auto number 358 of 399 seal of approval Ezekiel Elliott Federa and Mathis commanders rookie 324 of 399 Patriots rookie Pierre Strong jr. 17 of 99 got Mack Jones certified stars bronze Patriots 121 of 249 Jets Ahmad Saas Gardner rookie patch 25 out of 25 nice patch card Jets Graffiti Isaiah Spiller Chargers Jets had that big win today against the Bills very surprising win Giants Kenny Galladay Jersey Auto piece of the game 8 of 25 Giants Gold Team Patriots Mack Jones and the Orange Parallel 13 of 149 Gold Team Matt Ryan cold sauce again didn't they yeah green Broncos rookie 3 of 5 Montreux Washington Jaguars rookie Javon Walker 134 of 199 Graffiti Titans rookie Traylon Burks and Titans Traylon Burks on the rookie patch card 74 of 199 a red color match I'm ready for him to be healthy I want to see him and we'll leave this together got Titans Rantana Hill 23 of 75 nice thank you Eric R a few more mixer spots came in so that Prisman selects one is down to 16 now almost halfway full and the Sunday fun day is down to 14 nice Caleb's also live on late in gaming guys he has group breaks for a little while longer and I think he's doing personals later tonight as well got Kenneth Walker the third Seahawks rookie graffiti anyone know you know how he did today yeah he's been killing it I don't know how he did today but I know he's been really good Bears v less Jones jr freshman fabric rpa number 392 of 399 certified stars bangles jamar chase jamie ruckert Jets rookie 176 of 199 Rams Matthew 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dropped some we probably we I think we dropped some frames so it wasn't a sounding it was probably just a connection thing yeah it was just a few drop frames on the stream nothing crazy though nothing to like slow it down bad I was just it was a connection thing Mack Jones dark horses I was cheering on Malik Willis too hard Dolphins avian Howard patch card numbered 56 out of 75 let's say game warren's avian Howard bangles there he is Joe mixon 45 and 275 yeah Joe who had fantasy let's go baby bangles gold team Russell Wilson and the league that I have Joe mixon and even if I sat Joe mixon I still won by like 25 my team was otherworldly today good of them to get all their best games out of the way though so now I can disappoint the playoffs that's how it works Chargers is a spiller on the freshman fabric rookie jersey auto 217 out of 299 graffiti eagles Carson strong and a danny gray rookie Niners 110 of 325 come on Malik god Bill Stefan digs numbered 163 of 199 got certified stars Ravens Lamar Jackson numbered 143 of 149 Raiders a mere white on the rookie patch 222 out of 399 Ken Houston Washington mirror signature 16 of 40 Ken Houston that bangles needed a win too and they got a big time gold team Mack Jones Derek Henry 282 of 349 Titans and on the back is a bronze rookie Giants Cape on Thibodeaux 107 of 275 who scored right for origins now prism and select is down to 15 I believe four box mixer guys prism and select let's get it filled up 15 to go now I believe yeah 15 to go the Sunday funding mixer is at 14 to go right halfway or better on the last two breaks of the night to have spots everybody let's get these filled up Derek Henry rookie Jalen Tolbert Cowboys Patriots Mack Jones 181 of 199 and Damian Harris as well 124 of 299 Panthers rookie patch Matt Corral 7 of 99 Lions Jameson Williams rookie on card auto sweet hit lions and chiefs Skymore rookie Jumbo Jersey auto nice hit chiefs Derek Carr Eli Mitchell got Falcons Coral Patterson 168 of 199 and Vikings Adam Thielen 179 of 299 Falcons rookie patch Drake London 19 of 99 oh wow it's the first one of these I pulled passing stars rookie Otto Panthers Matt Corral love the design six of 10 wow passing stars looks fantastic this year that is sick congrats on that one Carolina and Jets rookie Jumbo Jersey auto sauce Gardner Dylan and Evans Lions TJ Hawkinson 144 of 299 Jets Zach Wilson 193 of 199 big dub today for him biggest one of his career Steelers patch card drum badass 13 of 25 rise to the hall commanders rookie Otto Johan Dotson on card 49 of 99 and Patriots rookie Jumbo Jersey auto Taekwon Thornton Trubisky you got rookie Devonte Price Colts Panthers McCaffrey 67 of 75 and Jags James Robinson 116 of 199 Steelers patch card Najee Harris 40 of 49 Jets sauce Gardner gold ink 8 of 25 rookie Otto what a hit for the Jets very likely rookie of the year at least so far through the season and again big win for him today Lewis S nice gold sauce the gold sauce that's filthy and Taekwon Thornton again rookie Jumbo Jersey auto for the Patriots yeah Paul I was wondering if you were still watching that is a filthy sauce Gardner Sausie one sec we'll do a recap guys prism select mixer is at 13 to go what's up sunny I'll do the recap you need some of your thoughts that was a good mixer the four boxer relics here just going to call out name and team name guys Raiders Amir White Cardinals Trey McBride Lions Jameson Williams Titans Hassan Haskins James Williams again Traylon Berks Titans Hassan Haskins Titans Falcon Strike London Panthers Matt Corral Dolphins Xavier and Howard Steelers Najee Harris and Jerome Bettis and a sauce Gardner patch card for the Jets you got autos now Taekwon Thornton twice rookie Jumbo Jersey auto Patriots sauce Gardner Jets Skymore Chiefs Jameson Williams Lions we got Bears Vilege Jones Jr. Niners Danny Gray Chargers Isaiah Spiller Falcons Young Haiku Commanders Johan Dotson Quandre Dig Seahawks we got Panthers Jeremy Chin Washington Ken Houston Jersey auto Kenny Galladay Giants and a Matt Corral um passing stars out of to 10 love the look of that for the Panthers there you got a radical rookie short print from certified Kenny Pickett Steelers not numbered freshman fabric rpa 11 s 75 Titans Malik Willis and a gold ink rookie auto Jets sauce Gardner 8 of 25 we have more football coming up thanks everybody


Hi friends, welcome back to my channel and a very special welcome if you're new here. My name is Jen. I'm a certified weight loss and nutrition coach. It is Saturday, so it's grocery haul day. I actually shopped at two stores. I have new food finds for you. I'm excited. So if you're excited to give this video a big huge thumbs up. Make sure you're subscribed your bells on because I do a grocery haul every Saturday and I do upload five videos every single week. Don't forget to check out the description box down below where you will find nutrition coaching. I do offer personalized to you macros and calories. Highly recommend this is how I've lost 140 pounds and kept it off as well as one-on-one coaching for accountability, to ask questions, or if you just want to chat with me directly. Links and discounts to my favorite things and of course my Facebook group. Come join us there. We would love to have you. So let's head on into my kitchen for the grocery haul. So the first part of my haul this week is from Trader Joe's. I made a quick run over when Lola had chemo on Monday and picked up some staples. So let me show you what I picked up from Trader Joe's. So first is flowers. You guys already know. I love having these fresh flowers. They're so affordable. And the ones I bought over a month ago, actually, you can see them yellow right over there on my kitchen table. They actually honestly look pretty good. They're starting to get a little bit crusty so it's time to swap them out. So I picked these up. I thought these were absolutely beautiful. I did a restock of the strawberry muffins. Troy really, really, really likes these. They're gluten-free and he had no idea. He loved them. So highly recommend. I know that they are seasonal. So if you want to try them out, grab them before they're gone. And then I did pick up another bag of one of my favorite things, the Cascio de Pepe Puffs. These are like a corn cheesy peppery puff. I love them. And then my favorite crackers, as you know, are the multigrain crackers. I love these with tuna fish, cheese and crackers, really just about anything. Some light shredded cheese because this is something we always buy at Trader Joe's. I would have got mozzarella too, but we have a full bag in the fridge. And then I picked up these. These are a summer seasonal chip. I love these so much. It says a mixed bag of sea salt and vinegar, delicious dill, homestyle ketchup and smoked and sweet barbecue chips. It's like a hodgepodge of different chips. It's so good. I'm gonna put these out for 4th of July. And then I did pick up a protein bar. This is one of my all time favorites from the brand Fuffill. This is the salted caramel. They sell them singly at Trader Joe's, so I always pick one up. I grabbed some ham because we already went through all of the lunch meat that we bought at Sam's Club. And I love having a half of a sandwich or a sandwich for lunch. I grabbed the hash brown potatoes for Troy. He loves having those for breakfast. I love putting them in the toaster. You put them in the toaster four or five times. They get nice and crispy. I did pick up a lot of dried fruit, which is something I always buy at Trader Joe's. I have two bags of the Candied Uncrystallized Ginger. I always take a little piece of ginger after I eat a meal. It just really, really helps me with digestion. And the ones at Trader Joe's are my favorite. I also got some dried pineapple. All this is is pineapple. No sugar added, so this is zero points. This is seasonal. They don't have the pineapple all the time, but it looked really, really good. And then of course, of course, I already ate some as a snack, soft and juicy. Mango, I picked up three packs. That is really my favorite, favorite thing from Trader Joe's. I also counted as zero points because it has to say macros as regular mango. Two spices to restock. I grabbed basil and I grabbed cumin. These are $1.99 a piece. Killer, killer deal. And then I always grab the seasonal candle. It is mango tangerine and it smells amazing. Some dog treats, they had, this was new crab paws. So these are soft baked crab flavor treats. I know my dogs are gonna love them. Love the artwork on that. I got their Better Than Leftovers. They love these. They're super, super soft. And then I got the organic chicken and brown rice sticks. And then for fruit, just some blackberries and some pineapple. I've been really craving cottage cheese with pineapple. So I grabbed some pre-cut up pineapple. So that is everything that I picked up from Trader Joe's. Let's jump into the rest of the haul. So the remainder of my grocery haul is actually from fries, which is a Kroger store. So let me show you what I picked up. They had their Thomas English muffins by one get one free. So I grabbed mine, which are the cinnamon protein. I really like these very light on the cinnamon. So I can still use these for savory breakfast sandwiches, but you're getting eight grams of protein. So I really liked those. And then I picked up the sourdough for Troy. He likes to make breakfast sandwiches. And then I always scour the meat department to see if there's any good deals. And I found their 91% simple truth natural ground beef, no antibiotics for 450 a pound, normally 850 a pound. So I bought everything they had, which was five one pound packages. I just throw this into my freezer. It's such a great deal if you can find reduced meat, as long as you cook it quickly or freeze it. Two gallons of 1% milk for Troy so that he can have his cereal. And then we actually finished all the just bear chicken strips that we bought at Sam's Club. I will be restocking next time I go. But for the meantime, I found the simple truth, lightly coated chicken breast bites. These actually have 16 grams of protein and they were only 120 calories per serving. That's even lower than just bear. I think just bears 160. So I'm gonna try these. I really like having these in wraps or on my salad. I did grab some fresh mozzarella because I'm going to be making a pasta salad for Troy. It's a new recipe. It's kind of a Greek inspired pasta salad and it called for mozzarella. I needed a little teeny diced ham for my breakfast meal prep. I will be sharing with you what's on my menu for dinners and meal prep after the grocery haul. So stay tuned for that. For that pasta salad, it called for hard salami. So I got these little rounds. I thought that I could either cut these in half or quarter these for the pasta salad. Can of corn, this is for my lunch meal prep. And then I restocked my favorite sugar-free bread and butter chips. These are so good. They taste just like regular bread and butter pickles but they are sugar-free. They are zero calories, zero points. Pasta salad called for Kalamata olives. So I grabbed pitted from the brand Pearls. And then Troy asked for a refill on ranch. And I found this simply ranch. It's only 50 calories per serving and there's only one gram of sugar. So this is something I would eat as well. And you know, we've been doing a lot of salads lately. I also picked up my chocolate and my low-fat Fairlife milk. This is for Ninja Creamy ice cream. I use Fairlife milk in all of my protein shades, all of my cooking for the added protein. Then just a ton of produce. We're really upping our veggie game and fruit game this month. So I grabbed some baby spinach. This is for my meal prep as well as for salads. I needed peaches for my meal prep. A red onion, a couple of lemons for water. And then I needed a lime for a meal prep recipe as well. I picked up some fresh strawberries for me just to have as a fruit this week. And then I actually grabbed two bags of the Simple Truth Organic frozen raspberries. This is for my dessert for my meal prep this next week. Cilantro and fresh parsley for a recipe.  I've been eating avocado literally every single day. Some green onions for a recipe and some salads. And then I actually picked up yellow squash and zucchini. I'm going to roast up some squash and zucchini for a side for an added punch of vegetables for a dinner this week. So that is everything that I picked up from Kroger. Let's jump into what's on my menu for dinners and what you'll see in Monday's meal prep. So here's what's on my menu for the week. So today, Saturday, we always go out for dinner or do takeout. Tomorrow, Sunday, Troy wants a salad. And I don't know what kind of salad we'll make, but we've been doing really big salads packed with lots of vegetables. And then on Monday, we're doing chicken burgers with avocado corn salsa. You guys will actually see this recipe in next Wednesday's What I Eat in a Day, Tuesday's leftovers. Wednesday, I'm making that pasta salad that I bought the Olive Salami mozzarella for. And then we'll do leftovers Thursday and Friday so we can finish up everything from the week. Here's what you'll be seeing in Monday's meal prep. So for breakfast, I'm doing a cheddar ham oven omelet. So I'm basically making an omelet in my oven packed with protein. And then for lunch, we're gonna do a salad. I told you I've been on a big salad cake but we're doing a peach spinach salad. And then I'm making raspberry bars. These are like raspberry oat bars that you get at a bakery. Super excited for that. So stay tuned on Monday for all three recipes. Thank you for joining me for this week's grocery haul. I hope you enjoyed seeing all the good stuff I picked up from Trader Joe's and my local Kroger store, new food finds, exciting recipes. I can't wait for meal prep this next week. So if you're excited, give this video a thumbs up. Subscribe if you're not. I would love, love, love to have you here. And don't forget to check out the description box for nutrition coaching, links and discounts to my favorite things and come join my Facebook group. We'd love to have you. Happy Saturday, friends and I'll see you in the next one. Bye.


Oh yeah, boy, it's time to go! Time to go, baby! What's the vibe there, fellas? So early in the morning, bro! Boy, after we have to deal with COVID-19, we have to deal with bad breath again. Why is everybody running? What? What? What's happening to me? Whoa, what's happening over there? Oh man, not again! Now, another Halitosaurus is on the loose. It's hero time! Stop right there! Boy, you must be a madfellar! Your terrorizing days are over, Halitosaurus. What is that thing? Minty floss lasso. No! What happened to me? Your bad case of halitosis is what caused you to turn to this, a bad breath monster. Why didn't my friends or classmates tell me before? Not many people feel comfortable telling someone they have bad breath. Brush and floss your teeth regularly and drink plenty of water, especially through this pandemic. Thanks for everything then too. Don't mention it, buddy.


t's no let me finish ah i'm not saying that i'm trying to protect them after 20 years all repeat the consequences it's true that i'm not in my country and i can't hope but all my identity i've been taken by moi je peux vouloir que si un réfugié venait en Uganda s'il a sa carte et s'il a sa son passport qu'on lui remet ça parce qu'il reste congolais d'abord i would like if the refugee can be in Uganda or in other country leaving his passport was the idea because of those refugees but he remained in nationality of my country mais attaquer congolais je peux proposer comment nous identifier au congo nous avons des chinois libanais belge français al map américain qui sont congolais aujourd'hui c'est comme les états et pourquoi ces gens sont congolais aujourd'hui pourquoi ces gens sont congolais aujourd'hui nous n'avons pas des gens congolais par ces gens mais nous sommes congolais par la culture et nos vies le gouvernement de l'organisation autorise d'être donné ou doctoire la nationalité congolais a déjà qu'ils sont pas des congolais sans pour d'apprendre considération de nos valeurs et de notre façon donc de nos cultures je peux apparaître congolais mais tel il apparaît soudanais mais par rapport à ces cultures il est beaucoup plus congolais que moi avec moi je connais toujours la nation zini et je vais les dire aussi à un officier de la nation zini si je vais vraiment vous allez m'excuser comment vous pouvez sélectionner les allemands mais ces allemands on sélectionne un allemand mais qui parle chinois merci thank you we have this mike back so i'll come to the panel it was pointed out to me and i and i i second this that we haven't had many women who have asked questions or commented from the floor so while okay so one already but while the panel are asking can some of the ladies in the room uh i mean if you want to um but please let's uh let's try and make this uh open lina you'll be the next after the panel speaks thank you okay i i think um just to respond to a few because the questions didn't were not specific to the issues uh my brother the the congolais i didn't record his name alex i find it interesting that um i come from western uganda i'm told to be specific and i find it interesting when i'm interested i'm interacting with the the hema in drc whom we share a lot in culture but uh if i was to interact with the lendo possibly i would be just from there so so uh yeah the cultures uh have good and bad and maybe we need to look at how to integrate that because um the truth be told uh when i'm in drc if i introduce myself by my culture in my culture we have pet names and all that so if i introduce myself to the hema with all that i'm as good as i'm in uganda but if i'm in a lendo community i would possibly have to hide my identity because of the so if we had lenders in uganda maybe it would be easy to integrate them and also look at how we can have the others uh there there was a pecos talked about um some congolais participating in politics and others like the the case he talked about in um uh in ramanja where some some refugees are alleged to have gone to drc and uh committed crimes we've also heard them i think uh my colleague would answer a few things around that and i remember there was a time when they came and removed some refugees because they were m23 uh or at least believed to be m23 but that's not the reason i think why we are talking about political participation we should draw a line between peaceful political participation and commission of crimes which is something totally anyone would be against so the congolais in uganda or any other refugees might be could be participating in having their voice heard representation or participating in issues that caused them to run away from their country without necessarily committing crimes that's what i think should be their way um thank you very much uh once again um i will not comment on all questions i will just comment on our pecos's question because the other question went directly to mr inocent and i believe that he is the best person to to answer them um i think that's the way i talked about um you know refugees being prevented from participating in politics it creates um a lot of danger actually because um now like this case that you've spoke about this is not uh participating in politics uh formally but this is again informally but which is really a danger situation to even uh refugees that are in uganda and even uh to the citizen of the country of of their kind of of origin i really think that um there is need um to give refugees a space you know to to formally participate in politics so that uh such issues can easily be mitigated and come up with a clear plan and some limitation on what to do and what not to do thank you thank you so much i'll just answer pecos question participation of refugee leaders uh specifically rwc's uh you mentioned us point that the people that are selected or that rwc's are more lean into the regime let's say the opm and un s era than to the refugees that they are representing my brother the whole equation is just complex because it is not only them the rwc that we have here are not people that present our voices what they give to us is just it's just one sided they only give information what are ideas from the refugees but they don't give us feedback and let me give you an example the the sierra he was mentioning here i was on the meeting on the 31st of january so they had six priorities that they were not selecting they said look in in vanda the refugees are going to be even water uh energies there is quality equation and all those i i i put up my name tag and i asked we are here in this room discussing prioritizing things that has been given to refugees but did you concern them this is the thing that they want if you go to naqibal and they need the same as those who are in ajuan those who are in ajuan might have just arrived on them uh they might just arrive from south sudan after seeing atrocities we just need uh biscuit we don't need food and here we're talking about quality equation when we have not even given access to education yet why do you prioritize quality education when access to education is not which is not in in place as as as plan i did not quote anything about the policies which are in place the guanan policies they say it's very important it's very good and it's being praised all over the globe but are there refugees that are working anyway or that are one creating their own jobs unhcr is responsible for refugees it is unhcr high commissioner for refugees but if you go to the office you will not see a single refugees not even a translator they only need you when when no one so we have these policies which are very good written they are global written but they are not applied so writing policies is one thing writing reports is the second thing but the third thing is implementing them these people are working on the system that are devolved they are not devolved in Uganda the unhcr system is not devolved in Uganda it is they are counted to the states another question i asked about to them was the accountability system that we are having it's only one side why do you know account to the people that give us the money and not account to the people that are receiving the money we are the people that are benefiting from the money that are that has been given to us but we are not given any space to us that this money should not be used for for things like things which are not reported to us right now the money should be used on this they are they are not accounting to us so if the rwcs bring all these questions on the table they are not being given an ear so when they come back to the refugees they have nothing to tell you they have nothing to report to you so what comes there's always a conflict that these guys are being leaned into a to the refugees regime but in actual sense they have the voices being forwarded but there's no one who's giving them any feedback there's no one who's giving them any room people say that we have like the political system we should be given the space to to engage politically if we're not going to credit ourselves there's no one who's going to give us the space so whether it's formally or non-formally we have to make sure that when you are at home you update your kids that you know what if you know you are born in Uganda your country is south Sudan one day we shall go back to south Sudan so you must know the history of south Sudan so if you don't know your history you have to teach your kids their history if they know their history one day they have to go back and then participate fully accountability is something very complex they don't necessarily give us money to be used among okay with the refugees situation here in Uganda and the people that are supposed to change their ways they look at things because they give UNSR and other agencies a lot of time accounting accounting to them not spending time with us you'll find them in the offices reply into emails reply like following our policies instead of coming to us and then talking to us so how do you how do you see that there's transfers in here it's something which is very complex thank you thank you very much Simon I really love seeing this young man passionate and able to express himself I think this is what the government of Uganda can best give that people should express themselves tell Andy that should not account for the donors but account for the the stakeholders so we are no longer in this alone Andy as OPM I think you can see and Andy it's really good and I think Amor is proud to be Ugandan because it's only here in Uganda where we even call the president anything and no one will even bother to come and say why did you say the president you find our president in a cartoon in a newspaper and nothing happens so I think we really have the space we have the space and our refugees have the space but again I push on let us not go beyond yeah okay sorry yes do not test again the other side you have you really we we have the space we can speak we can you know have refugee human rights defenders they can write opinions and we really they also inform but again let us not go beyond to make statements that can cause international or cause states to you know kind of have conflict and any of the day we might cause ourselves problems I don't mean by I say the message yes yes so and because you are you're informed to me that Congolese are going Congolese refugees are going to vote for me this is news and if it's happening it is illegal and we shall not recognize illegalities if it comes to really our our our attention property we're going to have taken it we're going to take it through our external and internal security agency definitely there will be issues it's not proper and I don't encourage the rules are clear and please refugees you cannot participate in the national politics or politics of your country origin if you want to participate in the politics of your country origin you can always go back and we have worries actually it's one of the challenges refugees moving back even without our knowledge and then come back without our knowledge using various Polish borders but it's not a good practice and let us if you're if you want to be Uganda's the national of your country be a national of that country because we also have them here and the rights are really all good so my hypothesis on that is refugees currently are not supposed to participate and if there are some who are doing so it's not proper it's illegal and you risk who you like to face then a refugee welfare council committees this has been even a big concern which has been raised in the recent allegations but we are it's under investigations we hope the reports will be able to tell us but I want to mention that as any elections even in this room if Andy said let us have an election on the reader or if I am at committee I can assure you there will be some co-presents after humanity they are bound to be and for refugee settlements because as I mentioned actually these welfare committee castles these are administrative kind of efforts so possibly moving forward we may need like we have the elections act the national elections act member of parliament elections act we may have the refugee welfare council elections act so that we know clearly who does what there is even an electoral body to conduct that but all this requires resources moving forward maybe in the long term it's what we have to do but these co-presents we've received them and I don't want to go much into we'll be able to get a report and be able to respond most probably on that but it's majorly naturally you'll find those kinds of efforts and Mogisha you asked why are we looking at naturalization yet we are saying it's not possible we all agree that it is very good and that's why for us who are passionate of refugee matters as one of the euro so we are trying to champion it we are trying to push for it to the extent that if there isn't any legal barriers we see how they can be amended or you know replied so that it is possible because I don't find it logical for someone to be here for 25 years and then you're saying I know only Uganda I mean if an alien or another national from Congo is here and it's not been a refugee and can be able to benefit from that why not a refugee and that's our argument and that's what we are trying to but it's something you must take cautiously as you know it touches some political interests so it's something we are pushing and it needs problem-making the acts we are trying to take it slowly to see that it can be one of the alternative solutions to especially protracted refugee caseloads and the last is Alex that Rwandese and Burundians register in as Komori's refugees well it's interesting and definitely it will call if it's happening to call for us to not only even work alone but also work with YouTube who can help us and tell us that actually this is a Rwandese Burundian not a a Kenyan or not a Komori or the other way around of course it also sends a message why is this being done okay because of that so is it because maybe they are security-related issues they don't want to be followed is it because one wants to be registered as Sudanese South Sudanese because South Sudanese are being given prima facie and they don't want to do individual status determination okay is it you to fear to be detected like some might say or yeah that's what I'm saying to get but we've got some cases I want to assure you but it's not easy I'll tell you I come from those who know where it is like Alex said we have people who are speaking but the same language in Rwanda we have the people who are speaking the same language you know the side of DRC so it's possibly myself who can easily detect that this is a Rwandese or this is a Komori the other time I was in the meeting in the Chigari Africa Africa Union but with my delegation every time you know I met the other participants every time we were thinking of Rwand because I look like Rwand so there are those challenges but they are all efforts to make sure that and this is the kind of criminal arrangements are given mentioned about why would you hide your nationalities and if we get to find out under the refugee act it is clear you will your status will be with the drone through the refugee eligibility committee so if you know any as people there as one later slow we shall be able to put that case in the refugee eligibility committee and the status can show that you is drawn according to the act because such a person obtains status through fraudulent or misrepresentation kind of needs so they don't take care of that and as for refugees handling their passports on the arrival you see when you seek asylum you've said my country is no longer able to protect me so you've given yourself to a country to protect you so we don't expect you when you're here as a refugee to again go to Colorado to your embassy to seek services okay that's why when you want to travel out of the country you will even come and we give you a conventional travel look at it so if you want to keep with your passport where do you want to keep with your passport possibly those will be the people who want to fly back to Chinsasa then back to a table then back so for me it does know how you hand it in to the last security measure it's done by security agencies they keep it when you want to go back you go back and they hand you over and you hand them back the refugee documents you can't keep both the documents and a few researchers will go to case actually Mirama Hills where some people were phoned with the refugee documents and again they were entering the country using certain countries passports they can assure you that matter reach to you in the year is excellent and it can't bring your problems that's why I'm saying you'd rather carry one document thank you I'm very sorry we are we're out of time but I think if we can discuss after a massive apologies for Lena for asking you to put yourself forward and then telling you that there's no time left to do so and also to everyone else in the room I'm terribly sorry but we are running out of time and we just need to close I want to I'll hand over to my colleague Anna who will do closing remarks but I just wanted to take another opportunity to thank you so much to this panel for your really sort of insightful views and the interesting conversation that has come about from the floor and and once again just to appreciate the environment we're in whereby we can have these conversations and let's let's all work together to ensure that that continues so thank you very much to the panel so Anna over to you thank you so much everybody just to briefly introduce myself my name is Anna and I work with the Russian Foundation and I complete working with Lena and Armand throughout this project in different phases I first of all I would like to thank Andy and Tigrana thousands of times more first of all for really doing the research and getting all the all the knowledge and all the information on the ground but also for who is gathering today because I think that the value of what what we're doing would have been not even approximately as we could not have this this space here to engage and then discuss I I'm very honored to be able to say a few words in the end it is a bit also difficult to summarize these these let's say complex issues in these central times but let me give you that try from the international relations department of the Robert Koch Foundation or believe that it's important to have an exchange on issues that happen in different parts of the world and really that it's important for people to be able to learn from each other also and this issue has been particularly interesting because it is also not so present in the debate which is in the end of the day was surprising because it it is issue that has an impact in the real life out there it has been discussed in the sustainable development goals are the goals of building peaceful and inclusive society both as a citizenship but also enabling or participation and yet again it puzzles many people when we when we introduce it in different for us and not only government will represent that if it puzzles really a lot of people who are happily state with a question that is not so much present because this is not have not been the dominating question when we have been discussing with democracy and I sometimes wonder why because in the end of the day we all are political beings if Diana the kind of I'm very rightfully suggested refugees are only citizens that for a particular time have lost their protection with their of their country fleeing itself in a way it's also sometimes a political act maybe not against a particular party or a government but it's an acting saying that I don't want to participate in war and that's a statement that many refugees do by being also and even in the in the in the spaces where there where it is difficult to participate as Victor mentioned discussing the cases in Kenya refugees still try to organize and participate and create these spaces of participation in a very local and very very small level in order to improve their lives so considering this not forgetting that also he's a complex issue because of different political context but also because of the personal situation of people who have fled because in the end of the day there is the maybe also the pressure to say okay uh this is a temporary situation and you're wishing to return or this might become a more permanent situation the reality sometimes shows that we don't know how it's going to turn out so considering this from a very individual perspective it's of course what is of course important is to maybe find ways to expand on these opportunities for people to try to to support people to develop also their political skills and to open up spaces in which these skills can be can be practiced whether that benefits the host country the country foraging or both in the end which I hope and assume will be the case that's a different question therefore I'm very very grateful for all the discussion of today thank you so much again for organizing the space in which we can we can do this and thank you thank you everyone for sharing your stories at the end of the day


Our next speaker is Dr. Simmer Singh, MD-PhD, internal medicine resident at University of Arizona College of Medicine, and a member of my research team. He'll be speaking on epidemiology of cardiac amyloidosis in veterans. Thank you, Dr. Dave. So take a little time to talk about some of the research we're doing on cardiac amyloidosis. And then I want to talk a little bit about my journey into data science and how it's been navigating that foray. So cardiac amyloidosis is actually a pretty rare disease. And getting accurate data on cardiac amyloidosis is somewhat hard. It's cardiomyopathy. And oftentimes, symptoms are actually quite not specific. And this makes diagnosis quite difficult. And the median time in diagnosis is actually 39 months. Oftentimes, patients wait years before a diagnosis. This can be nerve-wracking, not only for the patients, but very difficult for the health care system, which is caring for them. And it's unknown, actually, the prevalence and incidence of cardiac amyloidosis in the veteran population. So that's something we sought to address. So number one, we wanted to really identify what the burden of cardiac amyloidosis was in the veteran population and guide the development of screening programs that would help benefit those patients. And along the way, identify a cohort of patients that we can use for training AI models and also looking at other clinical outcomes. And so the way we approached this was to conduct a retrospective cohort study using the VA data and the MD Cloned Atoms Platform. And we surveyed all VA patients with an inpatient or outpatient encounter in 2012 and 2021. And then we used MD Cloned to actually create our case definition. And this is something that went through a rigorous iterative process where we would initially create a definition of cardiac amyloidosis. And then doing a chart survey actually go in and validate those findings. And through this process, we actually found that traditional case definitions relying on ICD codes were actually not very informative. In fact, we lost, I think, a lot of patients or misclassified a lot of patients. So this was a nice iterative process, which was kind of very quick, actually. And then we were able to take that data and provide some statistical analyses and take a look at, in fact, geographic variation, which we'll take a look at right now. So the first thing I want to point out here is that we've essentially assembled the largest cardiac amyloidosis cohort in the world. And not only that, we think it's the most accurate cohort. And so right off the bat, we have data from 2012 and 2021, which shows that we have an increase in incidence. And this is likely to be an increase in detection. So now that more people are looking for cardiac amyloidosis, we expect that we should pick up more cases. Interestingly, cardiac amyloidosis is actually a disease that has a higher prevalence in people of African descent. And when we look at the geographic variation, the data doesn't really show that we're detecting cardiac amyloidosis in places where we expect a higher prevalence. And so that was one of the insights that we really found that we have areas in this country where we need to do a little bit better job of identifying these patients and get them the care that they deserve. So in total, we identified 5,200 patients, which I think would be the largest cohort that we can use for training and further analyses. And so we were able to take a look at the geographic variation here on a state level. And we see that the incidence is higher in the Northeast. And this is possibly due to the fact that there's more cardiologists up there. But also, they just may be better at detecting cardiac amyloidosis. Whereas in the South, where you'd expect, given the higher proportion of patients with African descent, you would expect more to pick up more cases. Prevalence kind of echoes the same findings. And so this is just kind of talking about what we discussed here. So let's skip that. So what we can take from this is that there is a significant regional variation in the incidence and prevalence of cardiac amyloidosis. And this may be a difference in the detection rate, the ability of these separate VA health systems to find cardiac amyloidosis cases. And so this is something that we'd like to use to develop better screening programs for at-risk populations. So with that being said, I'd like to switch over to kind of talking about the user experience, how to kind of get involved in the sort of research. So for me, this is kind of a new type of research. So I've always been a traditional bench scientist, a basic scientist. And then specifically, I looked at epigenomics, metabolomics, and kind of integrating those type of data sets. Then I got to residency and found I didn't have too much time to take part in actual bench work. So I look for different ways of engaging in research. And what I did have a lot of time to do was interact with CPRS in the course of my clinical duties. So I have my continuity clinic at the VA, where it's been an honor to take care of veterans. And my attending on my first day told me, she goes back 10 years of imaging and data. So the first thing we do is we look at our chart. We open it up so it has 2,000, the last 2,000 notes. I mean, that's an incredible amount of data to kind of sift through. So I realized very early on the potential of this sort of data. It's a goal in mind, as many people have said before. And I wanted to start exploring some research questions. So I tried doing that myself at first. And I found this very difficult, honestly. A lot of the challenges and questions we've seen brought up today. I also encountered those. And I'm someone with, well, I consider myself literate. I have three postgraduate degrees. And I still had a tremendous time trying to navigate this. And not only that, as someone who traditionally is not at the VA every day, I found it difficult to kind of do hypothesis testing where I have to email my query using a VA email. And then I have to try to log on somewhere. I had a card reader. And it was very difficult. And then not being there during business hours all the time. That was also another kind of setback there. So it really wasn't until I was introduced to Dr. Dave and Dr. Agarwal. And I was able to join their data science team and kind of collaborate with them. They kind of championed my, I guess, entrance and credentialing process. That really the breakthroughs I think started occur. So we'll talk a little bit about what my advice for future researchers is. But I really think that finding someone who can really get you involved, who has a knowledge of the process, because it is still a difficult process to navigate. And really when I was introduced to MD Clone, I was surprised at how quickly we could go from a question or an idea to having some preliminary data. And this is really the power I was taken back by, honestly. And what it really allowed us to do was to work collaboratively, generate data, look at it, and then keep refining that process very quickly. This was a process that may, I don't think would have been possible if we'd gone through the traditional route emailing a query, getting a feasibility study done. It really was almost instantaneous. And what it's allowed us to do was actually accurately phenotype these patients. For cardiac amyloidosis, there's a lot of noise in the diagnostic, in the charts and the diagnosis. So it's really allowed us to accurately phenotype those patients. And we've created the largest study cohort for cardiac amyloidosis, which I think is no small measure. I think it's something that I'm really excited to do a lot more with. And as someone who's enjoyed being a part of impactful research for quite a while, I feel like this is really a high value, a high impact research. We're working with patient data. We're working with veterans, which I think makes it all the more important. And it's actually not too difficult to learn, use and teach. And in the short time I've been able to work with this data team, we've been able to generate several abstracts, presentations, got two manuscripts in preparation and I hope many more. And really become part of a data science team and it's been the ability to draw on all their different expertise that has really made this an exceptional experience. And we really hope that it's gonna really take care of patients, really improve the way that we care for them. So advice for our future researchers. First of all, it's a great opportunity. I don't think that there's a more rich and more rich and accessible data set than this. And so I would really think of trying to find a PI that can really support you, that can get you involved and help get you credentialed, honestly. And that includes getting a VA laptop. Honestly, if you can get yourself a VA laptop, that's gonna make streamline the entire process. And start this credentialing process early, as you heard, it does take some time. And then get hands-on with the data, start practicing, start building queries in MD clone. I think this is really the way to get involved. And I think I just wanna thank the Southern Arizona VA Health System, Dr. Dave, Dr. Agarwal and our entire data science team thank you for listening.


You can help a child learn about seeds by talking about how they are the same, and different. They can collect different kinds of seeds found in vegetables, fruits, and other plants. You can explain that all seeds come from plants, and can grow into a new plant. Then you can ask, how are they different? And talk about their colors, sizes, shapes, and textures. For example, the child might say, this seed is black and smooth, but that one is white and bumpy. This helps them learn what seeds are and that there are many different kinds.


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