So we're here to lift up the best ideas. We focused this day particularly on solutions, on policy solutions, on care delivery solutions, on community solutions very intentionally because we think there are solutions out there. We hope that out of this day like-minded people like all of us can link arms to get to work on this. And of course there are people working on this right now and in fact as a segue that allows me to introduce our next speaker, Kita Franklin, who has been working on this for many years. Dr. Franklin is the Executive Director of Suicide Prevention for the U.S. Department of Veterans Affairs Office of Mental Health and Suicide Prevention. She serves as principal advisor to the VA leadership for all matters pertaining to suicide prevention. She leads a team of experts engaged in research, program evaluation, innovation, data and surveillance and partnership. Before joining the VA, she served as Director of the Defense Suicide Prevention Office where she was responsible for policy and oversight of the U.S. Department of Defense Suicide Prevention programs. And we know if anybody is concerned about this issue, it is the Department of Defense and Veterans Affairs. She is a licensed social worker who specializes in children and families. Yay, a family, a fellow children and families person. Kita Franklin. Thank you, thank you. Okay, is somebody gonna do the slides back there? Okay, good morning everyone. I'm happy to be here and thank you to Kaiser Permanente for your leadership on this important issue. And I just appreciate the fact that I'm here this morning with so many unfamiliar faces. In part, I talk at a lot of events and we bring a lot of forms together to talk and to advance suicide prevention initiatives. And it's often the same people in the room. And all of us are doing really good work, but it's good when we can advance this across other sectors with the partners that maybe we haven't engaged with yet. So again, thank you to Kaiser Permanente for your leadership. And I appreciate the opportunity to be here this morning as well because I was just with the Veteran Affairs, the Veteran Administration Health Affairs leadership alongside colleagues from the Substance Abuse and Mental Health Services Administration and the NIMH where we were able to address this issue of suicide before the United States Congress just this week, Monday night. It was a late hearing, I don't know if any of you are better in the evening, but I'm not one of them. So it was a seven to 10 p.m. engagement, but we were able to talk about quite a bit, quite a bit of the things that I'm gonna talk to you about this morning. This slideshow and the content comes directly from that work. And it was just a reminder of the vitally important role that policymakers are to this issue of suicide prevention and truly how we can make a difference by using policy as a form of intervention to save lives. So I will talk with you this morning about what we're doing inside the VA. I'm hoping that it will spark some ideas on things that you can do within your own organizations and either independently on behalf of veterans issues or also with the larger population writ large, not just veterans, just across the nation trying to get after this issue. Inside the VA we have adopted a national public health approach, which you heard in the opening comments a couple of gold nuggets about that approach, but I'll dig deeper into explaining what we believe that is. But our secretary has noted just as Kaiser Permanente that suicide is our top priority. It's our top clinical priority. And I think that as a nation we could move the needle if every agency that engaged with veterans and with people in this space identified it as their top priority and then had a series of strategic actions that they were doing to get after this. So I wanna jump into a couple of our important figures just to do some framing so people know what's sort of what's going on within the veteran's suicide space and what our data looks like. In part because that's what defines our approach. And so this is, you'll begin to learn why we're doing some of the things we're doing if you had a little bit of context about our approach. You hear a lot in the media about the fact that there are 20 veterans that end their life by suicide every day, 20 veterans. And you may have heard in the past the number 22 and if you're one of those people that's wondering is it 22, is it 20, it's 20. And so in past there was some analysis done on a handful of states and we generalized it years back across the entire US population and the analysis has progressed and it's a 20 a day figure. You should know in that figure that that also includes active duty. About one of those out of the 20 are currently serving in the military. And you should know that about three of them are people that we refer to as never federally activated former guard and reserves members. And if people wanna talk to me more about what that means cause it's a mouthful, please come see me. But these are our service members that get activated at the state level and they might help with things like fires in California and state level contingencies. And then they come out of those roles and down the road and their life by suicide. And we believe they're a unique population because they are not covered by VA healthcare. There may be a myth also that I think is important to clear up when we're talking about our veteran data. Not all veterans access healthcare through our healthcare organization. So I wanna make sure folks know that actually there are 20 million veterans in the nation and about 30% of them get their healthcare through the VA. And when I talk to the average public about this they sometimes think every veteran automatically can come to the VA and it's just not the case. So I never wanna miss an opportunity to share that. Also back to the data when we look at our rates and this is I think something that you're seeing true with the CDC and I know I have some CDC colleagues here in the room today this morning as well. We're seeing an increase in our 18 to 34 year old populations that are ending their life by suicide. And so when you look at the CDC's data and you're seeing an increase with youth, 18 to 34 I know it's a bit of a stretch but it's I think traveling in a similar direction when we see our highest rates with that group. We're also seeing our highest raw numbers with men over the age of 55. That's a similar statistic with our CDC counterparts as well where they're, you will hear them talking about men in the middle years. And this is a phenomenon whereby we're trying to study what's going on in the context of phase of life issues for men when they reach the age of 55 and older and tending to their needs over time. The reason that we believe of course we have a lot more in the 55 and older group is because we have more of them. We have more Vietnam era veterans that fall in this age group. I also want to talk with you about female veterans. We have an increased rate when we compare our female veterans with non-veterans. Our rate is one point times higher than the non-veteran rate. And this is concerning to us because typically you hear for years those of you that have worked in the suicide field you hear how women attempt more and women use less lethal means and men complete more and use very lethal means like my colleague spoke about firearms and I'm gonna talk more about firearms. But with our veteran data with female veterans completing more than their non-veteran counterpart we are particularly concerned about this population and making sure that we're tending to them in the proper way in the context of perhaps if they have access to firearms in the way that their non-veteran counterpart may not or familiarity with firearms and also any other wartime experiences that may have contributed to their struggles after service. I also want to talk with you about the fact of how our veterans and their life by suicide. You see here on the slide 69% to it with a privately owned firearm. And we have the other data by other methods but this is our primary method and so you can imagine in our strategy we have a unique line of effort tied to protecting the environment which is one of our questions on our safety plans which truly gets after making sure that veterans are keeping their firearms stored properly and safely. And for all of us in the mental health field or behavioral health you may struggle with how to talk about this but this is something we definitely need to talk about and we can't avoid the conversation and we have to find creative ways to make sure that it doesn't get into the political space when we discuss it because it is truly about safety and making sure that we put time and distance between people at risk and any means with which they may harm themselves whether that's medication or anything. So the way that we've laid out our approach inside the VA is to model it off of the National Academies of Medicine's approach for prevention. And so we have an effort and I'm thinking many of you in the room might know this approach I'll skim through it rather quickly but we have an effort underway to make sure we're preventing suicide amongst all 20 million veterans in the nation. And that involves a comprehensive lift to make sure we're tapping into a number of entities where they might live, work and thrive. So we work with veterans with key messages and I'll explain more some of the examples of that. But then we're also trying to work with those veterans that fall in that select group that have an increased level of risk based on what our data tells us. And I already talked to you about some of them. Women, I would also mention that we have a strategic focus on veterans that are in rural areas. If there was somebody standing here with me that were responsible for suicide prevention outside the veteran community, they would probably also be talking with you about rural struggles and access to care in rural areas and access to broadband and bringing in creative IT technologies to rural areas and the host of things that happen. But equally so in that category, falls people that are struggling with mental health issues at the group level, substance abuse issues, people that are known to us at risk based on what our data tells us. I talked to you about the Never Federally Activated Group of Garden Reserve, they're in that group. And then our indicated work which is working with veterans when they come to us in our hospital settings, which I believe is a bit of our bread and butter and we're doing quite well. We have a number of evidence-based practices that we have a clinical practice guideline that we develop in partnership with DOD and this is a standardized tool on how we do our therapies when people come into our medical settings and how we treat them. And I brought a number of other examples with me as well if we wanna advance the slides. Just to get your thinking going in the context of with your own organizations and what you're doing across these three buckets. Are you tending to your universal population and are you tending to those that you know are at risk based on your data?  And these are a few examples on the slide. I offer to you just to highlight this year in the VA. We've made significant strides trying to do universal screening outside of mental health care. And so traditionally in times past we were definitely doing good work. We would screen for mental health and suicide risk, I'm sorry, when they showed up in our mental health clinics. And we just, you know, this is great work. They show up for mental health care and we assess them for suicide risk. But what you see in the data is that people that end their life by suicide have touched a host of other clinics on the days and months leading up to their death. And we think of those as missed opportunities for engagements if we don't fully understand their risk level. So we've spent a significant amount of time in the last year making sure all of our specialty clinics and especially primary care doctors are trained in how to assess risk. And we have a sort of a three step model and it's available online. I can share it with folks if you're interested. And I know many in the room might do a similar methodology already, but know that it's a very simple, single question followed by the result of that question, a more comprehensive six or seven question followed by a very specific safety plan. So this I affectionately refer to it at work in our policy environment as this one, two, three punch, which is make sure we're following all three entities. And then we're collecting data across all three. How many screened positive on the first question? And then as the results of that, how many still screened positive on the comprehensive scale and then what were our safety plans and what was our follow through like related to those safety plans? And then I would also share with you that this year we've also made significant efforts to implement an aftercare model. So much about suicide prevention I think over the years is complicated and complex.  There's never 13 reasons. There's never, and so we do need bundled strategies and that's what public health is all about. And we've spent significant time implementing a simple strategy as complex as it is a simple strategy called caring outreach. Maybe some of you have heard of it whereby we're making phone calls to people after they leave our emergency room. You're telling me to use the clicker or say next slide. Okay, I got it. Very well, thank you. We're making aftercare phone calls when people leave our emergency rooms when they have elevated risk and it's a simple intervention like that calling them the following morning and calling them the third day and within the first week a number of times and making sure that they've made those connections after they've left our ER to sustain their healthcare in the out weeks. It's an important approach and we studied that out through one of our MIRAKS and then implemented it enterprise wide. So we'll go ahead to the next slide, please. Okay, I also would be remiss if I didn't tell you about this new work that's going on in the context of getting after suicide according to the data. We are working in this falls in the universal bucket with something called the mayors and governors challenge work. And this is where we put out a call to local mayors and governors and we asked them to partner with us in the VA and we looked at high burden areas. Where do veterans live? What are the high population density areas? And then where do we have high burdens of suicide? And then we brought those teams in, we asked them to come to DC in collaboration with SAMHSA and we held the policy academy and we taught them a number of the skills that I'm talking about right in this brief this morning. We taught them about the importance of transitions in and out of care. We're teaching them about safe messaging, about peer support, which I wanna talk to you more about, about using their data locally to define their actions and activities and about putting pen to paper on a local plan. If you live in Houston, Texas, you know that firearms are readily available and you're in Houston. What is your local plan for preventing suicide and how can we at the national office help you implement that local plan? And so we're working with 24 mayors in their teams and seven governors in their teams and in collaboration with a technical assistance arm that's offered through SAMHSA. So this is new work. It's only started in the last year, but we're expecting these local teams to catapult their local hospital systems and prepare those hospital systems for engaging with veterans in a way that keeps veterans safe and prevents suicide. And at the heart of this model is also another capability called SAVE. If you're not familiar with it, I have the website here. There's a nonprofit called Sake Armor that partnered with us to develop a very interactive, it is not death by PowerPoint or dry clinician talking on a screen. It's very interactive and it's actually one of our own employees, Megan McCarthy, but talking about suicide risk and really explaining the ways to protect against it and what you can do. It's training for everyday people, not just medical providers. And we have a campaign and I think the nation needs a campaign. May is Mental Health Awareness Month and part of our suicide prevention campaign is just this, again, simple strategy on being there for veterans. It's called hashtag be there. And this year you'll see our campaign roll out to these sub-population groups that are at risk. For example, if we know rural veterans at risk, we're really trying to crawl all over rural America with our be there campaign. And how can you be there for veterans that live in rural areas? Five million of our 20 veterans live right in rural America. And so the way that you deliver healthcare in rural America might be different. And how are you able to be there for somebody with a mental health problem? What are the simple strategies we as a nation can take? One of our key messages inside the VA around this is really that everyday acts of kindness can save lives and small acts. And one of the big principles around this for veterans is just asking them have they worn the uniform? Have you served or what was your service like? And share with me more about that. And creating that type of culture of respect and of being humble on all that we don't know for, on what it means to deploy or operate in a war zone is definitely something that we can do to advance the cause when it comes to getting to know veterans and saving lives. We can go ahead to the next slide right onto the next one on ReachVet. I wanna talk to you a little bit more about a capability that we deploy inside our hospital system and you might have something similar in your capabilities in your organizations as well. We do have a capability called ReachVet that is a predictive analytic tool and this is a tool that assesses healthcare risk and it looks at I think 136 variables across people's healthcare records and it really puts those variables into an algorithm and then provides us a risk value so that we can understand our healthcare population writ large and how at risk they are. Are they missing appointments? Have they been diagnosed with an opioid use disorder? Are they struggling with alcohol? There's a host of variables that go into this capability. But the most important part of the capability I believe is that the risk value is then followed by action. So there's caring outreach that occurs with veterans whereby our own employees are making calls and talking about risk with veterans proactively and trying to re-engage them into healthcare. And so this, we have a whole set of data on what we're learning about risk values and getting people back into care and what we know is that when we are able to touch base with them afterward and through this caring outreach and we look at just the dependent variable of death, any cause of death, not just suicide so like an all cause mortality review, those that have been reached through our ReachVet program and capability are more likely to live. They have increased longevity by those that we're not able to catch and re-engage into healthcare which I think is a little bit intuitive as well. Like get healthcare, take care of yourself, increase your lifespan but suicide is also part of that mortality risk so. I also want people to know that if you have clinicians that are engaging with veterans in your own facilities and you're unsure what to do where you're executing an evidence-based practice and you're stuck or you're struggling, we have a suicide risk management consultation program out of one of our MyRx and this is a program that will take calls from anybody and help walk them through a part of the treatment or the therapy that they might be struggling with and so it's an important part of our portfolio because we believe that veterans are being seen outside the VA and I should have started the talk with that figure, I talked to you about 20. Six of the 20 veterans that end their life per day have seen the VA in the last 24 months leading up to their death and 14 have not. And so we also do have an approach which is there's no wrong door for care and like I said before, we're trying to meet veterans where they work, live and thrive, not just where they get healthcare in our organization. So if they're getting healthcare in any organization in America, we want these capabilities to be available for them. Safety screening, risk protocols, a suicide consultation program, all of this we make publicly available through our website. So we'll go ahead with the next slide. I said earlier, as did my colleague from Kaiser that we can't talk about suicide without talking about firearms and I want you to know we do have a number of capabilities and pilots going on underway about firearms. The first is we have, if you've not heard of this organization, write it down, the National Shooting and Sports Rifle Foundation. This is an organization that is focused on firearm safety as well as a number of other things but we have a partnership with them. We've went into a memorandum of agreement with them whereby they're helping us educate firearm dealers and retail people on the signs and symptoms of suicide risk and it's in its early stages but this builds on some good work that has occurred in New Hampshire and Colorado where they've done similar models and we believe that that contributes to a bundled set of practices to save lives. So again, I'm not proposing that educating firearm dealers about suicide risk singularly results in life saves, although you don't know but it's this bundled set of practices over time that we believe is the most beneficial. We also hand out gun locks in all of our healthcare settings. We don't hand them out in a way where veterans have to ask for them but we have them nearby in baskets and veterans can just pick one up and take them and on the gun lock we have the phone number to our crisis line. And of course, crisis line capabilities are also at the heart of every and all suicide prevention bundled practices. We do have, if you've not heard the veteran crisis line, we offer everybody to put that number into their cell phone and we have all of our leaders across the VA and at the White House and in the Congress, we never miss an opportunity to tell leaders put the veteran crisis line number in your phone. Our under secretary did it at the hearing this week, asked the Congress to pause and enter the number right during his oral testimony. So that is an important part of our strategy. But know that it's not our only approach and I think that that's where we could have done better over the years is to think through more upstream interventions. Crisis line alone catches people when they're at such high risk and with such complex sort of situations. So gun locks, partnerships, training, training firearm people. As well, I want you to know that we have an online training where we train our own clinicians on how to ask questions about lethal means. I myself have engaged in a number of conversations with the NRA over the years about this issue, this notion of bringing your partners close and trying to understand all that you don't know about a particular community is important. And I was pleasantly surprised, I suppose I could say, by all that I didn't know about firearms as a clinical social worker. And the fact that we might turn people off using the wrong words at the wrong time and I could give you just a small example when I was with the Department of Defense, it was not uncommon for us to have practices in our settings that were called lethal means restriction. And that would be a title of a policy. Lethal means restriction with a group of service members that need their firearms and that, you know, think of their firearms quite fondly, if you will. So we really underwent an effort at the time to just think through our language and our terms. It's not really about lethal means restriction and maybe it's about safety and how do we talk about things and is there a difference between the word gun and weapon and firearm? There is. And I didn't know that had I not, you know, engaged with these types of partnerships. And so it's a small, small steps and every little piece of it is important when you're trying to pull together this common thread for saving lives. So we'll go ahead to the next slide. I appreciate the talk this morning also about safe messaging. And this is, again, it's part of the bundled approach. If you can kind of think through all that we're talking about this morning about making sure we're doing our best work in healthcare settings and that we're, you know, we're screening everywhere and we're doing evidence-based therapy and we're monitoring that with tight quality controls in the best possible way that we can. And we're working with lethal means. This is just another strategy in the bundled approach and it's making sure that we're talking about suicide appropriately. And we do have some work to do in this space, I believe. I've been at a number of very official forums with very senior leaders that continue to use the word commit. And I just sort of shrink in my chair because we know we're not supposed to use that word. But we know they don't mean any harm. You know, they're just learning about it too. And there's as complicated as this field is we live and breathe it every day, others don't. And so it's important that we continue to push and educate people on unsafe messaging. And I will also share that I'm quite concerned when I see headlines, particularly about veterans around suicide and especially when we see glamorizing headlines or headlines that show a veteran in distress that's just sort of like, and the headline will say, veteran hangs himself on parents' front porch and it's, those are the type of headlines that could potentially cause harm. When other veterans see those headlines and think, and they'll read the story and they'll see a veteran who's struggling with pain management, financial issues, relationship issues, legal issues, recently had a DUI. I mean, and another veteran reads that and thinks, I have that same set of circumstances. And I also deployed three times like that fellow and that was an okay solution for him. Perhaps it's an okay solution for me. And so we worry about that. And I also, as a administrator of programming inside a large organization, that is a large healthcare organization that's sometimes a hard story to sell because people believe that we can solve suicide with healthcare solutions alone. And if we just had better therapy and if we just had a better magic wand, we could just do better work with this. But I tell you that it does call for bundled approaches and part of the bundled approaches are talking about it appropriately and the media doing their part to not glamorize. And had it not been for the good work of other researchers, I probably wouldn't believe that messaging mattered myself. I'm a clinician by training as well, but Maddie Gould out of Columbia does quite a bit of this work. And there are published studies that speak to the importance of this messaging. And then the nation has pushed out. I have Liz Nealy here with me in the front and she's worked with Colleen Carr, who's also here from the National Action Alliance. And the nation has pushed out under their leadership a guide for safe messaging. And so this is something you should have handy as well if you're engaging with the media or trying to do your own training on these subjects. Cause it is tricky and we can make mistakes if we're not careful. Hand in hand with the next slide on talking and communicating with the media. Now, I think a 2019 or probably it should have been maybe a 2010 conversation is social media and the role of social media on suicide prevention. And maybe some of you have seen this come out on the horizon where Facebook is getting more engaged and maybe one back, I might have had you go too far in the slides, I'm sorry. And maybe there's not a specific slide on social media but know that I wanna share with you for a minute about social media. A couple of things about social media. The first is that people are putting their risks online. So you should know that and think through your own approaches. People are using coded language and if you're interested in studying this more pull up the work of Craig Bryant, a retired Air Force officer who's studied this out of the University of Utah. People are writing coded language.  They're writing that they wish they could go to sleep and not wake up. And so these are serious issues and it's not attention seeking based on what we know so far. The first time I took a brief about this I will tell you I was in California and we had paid for a study and I was receiving the results and all I could think about was my own social media and things that I had seen. People that were at risk based on what I was learning on the brief. I mean that night I made an important phone call to somebody that was at risk that I hadn't spoke to myself in over 20 years based on what I saw on some posts. So know that it is very serious issue. Also, I see the field is trying to get after this with artificial intelligence. I'm not an artificial intelligence expert but they're trying to look at words that appear on pages and match solutions and bring the crisis line number to the side and advertisements and all of that is probably helpful and needed and will probably continue as mental health professionals to engage in the artificial intelligence space in the out years I suspect. Equally so, Facebook has an effort under wages to teach others if you're worried about a post they have this actionable technique which shows where by if you see a post and you're worried about it you can click a button and it says I'm worried about this post for the following reasons and one of those reasons is harm to self. And so then Facebook will generate another pop up message for you that will say here's what you do about it. Here's the crisis line, here's how to talk to your friend at risk. Every conversation I know everybody in this room knows that when we're talking to people at risk we must have them leave or not leave us with some sign of hope. And so Facebook really works with some experts on designing what that language should be so that there's some dialogue around hope. Recovery is possible. I am here for you, can I connect with you? At the heart of this is human connection when we're trying to save lives. Certainly evidence-based practices, medication, therapy and all of that but at the heart of it is building clients capacity for maintaining healthy social connections that carry them through life and make them feel less isolated and less like a burden on society and more like they have a sense of purpose, mission, belongingness and meaning in their life. And this is why this work is so difficult I believe for veterans, although my colleagues that work outside the veteran space would be here giving the same talk on why it's so difficult for any of us. But veterans who have served for over four years or 20 years and they've been in very important roles for the nation's security. And they've deployed and they've done missions and they've had leadership positions that some of us you would be surprised when you see these young O3 captains that are managing 200 troops and they're about 24 year olds themselves and they're leading like none other and then they get out of the military and they have a job that's less important to them. They have less meaning and less purpose and so this is a hard thing to balance. We're studying across the departments right now this notion of what it means to no longer wear the uniform socially. Like we prepare people for leaving the military making sure they transition well and they have a job and they know how to interview and they know how to buy a suit and dress for success, they even call it. But do they know how to tend to their social aspects of no longer wearing the uniform? That's a question to be determined and their identity and how they fit in in life in the out years for that. So I just tell you that we also have a social media toolkit and it's also on our website and if any of it is helpful to you I offer that you use it as your own. That is when we'll be doing good work when we can just further advance these tools to get them everywhere in any place that touches veterans. So we can go to the system slides and I'll cover it quickly. We believe that suicide is never the result of any one single person and I have very good colleague at SAMHSA who always says, you know I have to give him credit. Richard McHugh and I always also say his name wrong. Richard talks about the fact that when somebody ends their life by suicide it's, even when somebody's life is saved it's never the miraculous result of a single therapist and even though I wish it was. It's Julie that their system was working well and we all have a system and so who's in their ecosystem? Is it their school, their church, their family, their neighborhood, their work? If there are gaps in their system and their system isn't working well then that's when we see struggles and we need to bolster their system and so this is part of our approach whereby we're trying to tend across systems and tending across systems from the vantage point of a healthcare system is not easy because there's this tendency to think that I will tend to people's healthcare, their biological system and maybe their aftercare if they've been to me but really we're thinking through and wanting to advance this model that says tend to their life system which is a little bit different than are their organs operating properly and do they have help for their wheelchair when they leave or things like that like more broadly their system. So we do have a national strategy for preventing suicide prevention it's strategically named that, the nation strategy because we know we can't prevent suicide inside the VA alone. I shared with all of you in this room this morning that only six of the 20 that die by day touch our VA system only 30% of the 20 million veterans in the nation touch our healthcare system. So we have a strategy on the next slide I think it might be slide 16, there we go that says it's our 10 year plan and it really takes the national strategy that was written by the Action Alliance again under the leadership of Colleen Carr who's here in this room if you wanna talk with her in a green sweater and this national strategy we VAI's did if you will we took it and we made it relevant for veterans and so when you see it you'll see that it looks quite familiar but there are 14 goals and 43 objectives that are largely come from what I just described this morning there's a goal on social media a goal on safe reporting a goal on lethal means work a goal on healthcare systems and transitions in and around and between healthcare there's a goal on peer support I mean much of what I've talked about this morning and it's designed in such a way that we think anybody can take it and take action and so if you from where you sit if you touch veterans based on what we know about I should tell you based on what we know about the date on veteran suicide I said 20 a day 123 people die by day by suicide 10th leading cause of death in the nation and it's even higher you heard from my colleague for youth second leading cause if we were pushing out these strategies in a community in a hospital setting to get after veteran suicide you would likely get after all suicide I just offer you that but the idea behind the strategy is pick it up and think through what of it could you implement from where you sit anybody so this is an important piece of our call to action and you can go ahead and keep moving with some of the slides I think I described them you'll see the goals the big push in the VA right now is a goal towards working with communities and that's why I highlighted our governor's work and our mayor's work and our outside our hospital system work that's our thinking now how do we prevent suicide outside the four walls of our VA system in such a way that we're engaging with veterans where they work live and thrive not just where they come when they're in a time of crisis or have a mental health appointment I have a short video that's under 90 seconds that I would like to show you that kind of gives a bit of an overview of everything that I've just talked about as well as a number of other resources that are in the slide deck because I think they're available to you and then we'll participate in a Q and A and I'll share with you anything else that's on your mind about this topic I think we'll go ahead and put the slide on the resources just so it's up in case people want to write anything down about that and we can also start Q and A if that's okay with you do you want me to stay up here Okay, very well Thank you Okay So, thank you very much Dr. Franklin, that was incredible So right now I'd like to encourage folks if you have questions for Dr. Franklin if you could go to one of the microphones but I will kick us off Okay You talked a little bit about stigma and I know Dr. Mordecai also mentioned stigma and in the sort of veteran and active duty population it would seem that stigma is a major barrier to overcome not just for suicide prevention but just to address other mental health issues as well Can you talk a little bit about how stigma is being addressed? Yes, this is an important issue and I'm glad that you asked the question so we can talk a little bit more about it because it is a unique issue with the military and veteran culture particularly tied to this notion where I think also over 10 to 18 plus years of war there's been this emphasis on pull yourself up from your brute straps and even outside the military culture I think there's a stigma tied to receiving mental health care and one of the best ways that I see that we've made progress in this space has been when people with lived experience are willing to come forward and share their stories and not only everyday people which are critically important come forward but when leaders come forward so when we see people like Patrick Kennedy come forward and talk about his struggle with substance use years back or when we see military leaders come forward and talk about the fact that they've been in family therapy and that they've struggled with parenting and after deployment when they were diagnosed with post-traumatic stress that they were worried about how that impacted their children and I have seen it where there's a room full of Marines and you can just see their eyes light up whereby they recognize that okay maybe if this general is talking about this maybe I can talk about it too and I can come forward and share my story so I think lived experience is helpful I think language is helpful as well we've made great strides trying to use paid media and social media campaigns where we've said things like it's okay if you're not okay and you can't just say it you have to mean it and so when veterans and troops work in populations where they're struggling with their security clearance and they're worried that if they come forward with a mental health issue that it will impact their job that makes this whole stigma conversation very complicated I try myself to push the focus to getting help early intervention and also successful stories of recovery to help move the needle on it but some of the room might have more to share about that too so. Dr. Mordechai. Thank you for your comments I thought you beautifully illustrated what we're trying to do today which is policy solutions, community solutions care delivery solutions. I had a question about is it is it reach vet? Yes. So we're also interested in predictive analytics and reaching out to people who are at high risk we're a little concerned about what their reactions might be so what kind of reactions have you seen when you reach out to people who maybe didn't know that you were doing predictive analytics on them and came up that they were at risk? Right, this is an important part of the model and I'm happy to share it with you if you'd like because it involved designing a very carefully written script and the protocol must be followed carefully because you can imagine on the receiving end of a phone call you're assessing my risk you put my weight into your variable and your little predictive algorithm I didn't know you all were doing that but thank you and we can turn people off particularly veterans who I think have a predisposition towards thinking that big brother is sort of watching them and things like that too. So we did have to be very careful and put it into our protocols on the front end for informed consent and then also the language and the way that the caring outreach is done is very particular and I'm happy to share it with you. Thank you. Yes, thanks. Well, good morning, thank you so much a terrific presentation. I'm John Auerbach from Trust for America's Health and have been a public health person at local, state and federal levels and appreciate your characterization of the work as being public health related. Increasingly in public health though we're recognizing that a key part of our work needs to be paying particular attention to what gets referred to as the social determinants of health but things related to economic opportunities housing opportunities, efforts to combat racism and discrimination of different types. I suspect that those issues are issues that arise when you're reaching out to veterans in crises and I wonder how are you incorporating the attention to those kinds of issues and needs in the work that you're doing? Yeah, it's an important question and you're absolutely right. These social determinants of health play a big and important part. They're almost at the hub of the wheel of any public health approach and one of the most important factors, economic, when you look at suicide risk across the board everybody in the room should know that the economic factors play an important role and I believe that's even more important with our veterans because in some cases their economic factors are tied to their time in service and do they have a disability and are they receiving monthly compensation tied to that or are they in the workforce and we do have veterans that got out of the military after only four years and veterans that served for 20 plus years and the whole gamut in between and so you can imagine those sort of phase of life issues and there's been a number of studies that have tracked employment and economic factors across our nation's suicide rates and saw where the variables travel in the same direction over time when we've reached critical economic points in our nation you start to see increase in suicide rates and you'll even see areas there's been some data that's published or a couple I'll tell you about like in Puerto Rico after they've had a national tragedy whereby the suicide rates went up. You'll see where the call center volume goes up and areas that have been crushed by economic issues and it's not just economic and so one of the things that we've done or tried to address here this is very, very recently and I don't know some of you may be familiar the current administration, the White House has called for an executive order to come out and they're calling it, it did come out a whole of society approach to suicide prevention whereby they're bringing in agencies like the Department of Labor people that might not have traditionally known that they're social determinant if you will has such an impact on suicide. People that work in department labor might think that they're getting people jobs but from where I sit they need to get people meaningful jobs where they contribute and careers that matter to them and so maybe I need to have more of those conversations with the Department of Labor this executive order will call for all of government every cabinet member to come to the table with the White House and our secretary to take this whole of nation approach agriculture, department of energy who knew that department of energy sitting on a treasure trove of data that we can tap into in a more strategic way so I think that in the future we could see better outcomes when we bring in a whole of society approach to the table on recognizing the role of their social determinant as it applies to work that's most important to me and us but yes. This room. I wanna thank you Dr. Franklin for an amazing job and yes we got the little signs, we got the sign and thank you for the questions. Thank you guys. I'll be here all morning. Thank you. This is good. Thank you so much. Thank you.


All right, this is emissary ingress self-service api's and the kubernetes gateway api. I'm lance austin a principal engineer at ambassador labs I'm flan. I'm a technical evangelist at buoyant. I used to be at ambassador labs, but not anymore All right So we're gonna go over a little bit of an intro a little recap on what's happened since kube con Detroit in the fall and then talk a little bit of self-service configuration and then jump into some stuff about gateway api So quick quick show of hands who here is completely new to emissary ingress All right, I guess we're doing the full intro so If you have not run across emissary ingress before it's an api gateway That means you've got your kubernetes cluster. You have users out somewhere in the internet emissary's function is to sit between those two and Provide access for the people out in the world to interact with services in your cluster It is an open-source cloud native developer centric opinionated self-service api gateway There will be a quiz, but we'll come back to that later. Don't worry It's a CNCF incubating project. We donated it in 2021 2020 something like that. It's been with CNCF for a little while. It's powered by envoy What this basically boils down to is that we use envoy to wrangle all of your data and then we use emissary to wrangle the envoy Since it is an api gateway one of its core functions is traffic management So if you've got Jane out in the cloud and she wants to request a quote from the quote of the moment service Then emissary will go through and accept that request and route it three to one of the workloads If mark asked for the quote of the moment mark may end up talking to a different instance of that workload But yeah, this is all okay API gateways are not just proxies though.  So in particular App security is a big one where maybe Jane is allowed to update a quote but mark is not allowed to update a quote and Emissary gives you a place where you can put that functionality in one place Manager for everybody in one place and not have to worry about all of your application developers getting it right every time in the applications themselves There are a bunch of other things that can happen here There's stuff that emissary does about observability it can do rate limiting it gives you a bunch of resilience features It can do things that make it easier to develop your apps entirely We're not going to go over this whole slide, but yeah, there's a bunch of stuff baked into this overall It is a API gateway But more importantly it is a self-service opinionated developer centric API gateway We'll be coming back to that in a little bit But first I'm going to hand it over and let Lance talk about what has changed since Detroit in this project Thanks, Lynn All right, so recap since cube count Detroit So first we've had quite a few new releases in our three series So 3.4 3.5 and 3.6 we shipped to quite a few new features Better security easier migrations and we'll talk about those in a little bit here In our two five in our two series we ship just critical fixes making sure that we keep up to date on those And we're also doing some we're Kind of a lesson learned from our one series is really making sure we stay up from our our our major dependencies So we're gonna, you know, you know, I'm boy moves quickly So we want to make sure we keep with that cadence So you'll see us continuing to stay up to today with on boy underneath the hood Thank you for not emphasizing how painful that lesson was Yes Same with go laying and other other critical dependencies for the project So key new features that we've shipped just recently so open telemetry tracing That was a great partnership between one of our maintainers Alice and Paul they work together to get that shipped and We're really happy to have that Resolved name ports and ingress if so if you are still using ingress and we'll talk about our our our language here in a little bit So you'll see that but if you are using the ingress resources We got help from Anton. He was a first-time contributor. So that was really great Direct TLS support for ingress fatted that non-blocking ready. Listener again. Thanks for Fabrizio and Tomas That was a good really helped and they were really patient with us. So we were we were happy on that one and so active upstream health checks and we also added support for get ambassador Vs V1 This is to help reduce some of the migration So folks that were coming from older clusters and from the ambassador one This would make sense for for folks that are just starting out and you're you've already adopting V3 we recommend you need to V3 alpha the latest that you see in our docs So again, thanks for our community so since cubecon we had 175 commits 10 first-time contributors We have 9,000 members in our slack channel and 4k hub stars and again just another shout-out to our community and some some some of the folks that have recently submitted Pull requests and commits Pierre Paul and on Dmitri Tomas Favruti. We really appreciate that Yeah And I'll hand it over to Flynn So I said we'd come back to the whole self-service thing and I'm gonna emphasize again This is self-service developer centric and opinionated configuration stuff We talk about this every time we're doing this and the reason is fairly simple. It's important one of the things that gets glossed over a lot at cubecon in particular is That kubernetes is a means it is not an end There is nobody out there who runs kubernetes solely so they can say that they're running kubernetes Everybody runs it because they are trying to get some other application to accomplish certain goals and this is important The self-service part of the self-service developers in your Developer centric opinionated part the self-service part is about allowing your developers to achieve the goals more quickly By arranging it so that they don't have to be constantly waiting for other people to be able to get things done The developer centric part is about allowing the developers to achieve their goals more easily By providing them with configuration tools that are using a set of semantics that makes sense to an application developer The opinionated part is about trying to provide straightforward mechanisms that make a lot of sense as opposed to mechanisms that can accomplish absolutely everything but are ridiculously complex in our world This shows up by the set of CRDs that we did originally We've got listeners that talk about what ports and protocols you're listening on We've got hosts which talk about host names TLS certificates things like that We have mappings which talk about taking chunks of the URL space and routing them through to specific services All of these things could be expressed in a single resource like the Ingress resource If you do it that way, then you tend to have multiple people getting stuck editing the same resource all the time Which is painful so we didn't do it that way Another thing going on here is it is absolutely possible to have a single person going through and Working with all of these resources and managing the whole configuration start to finish But it is also possible to have say your developer crew worrying about request mapping While trusting the operation side of the world to worry about listeners and hosts and certificates and rate limits and auth services and There's a bunch of stuff down there this separation of roles this separation of concerns turns out to be a thing that Really helps Allowing people to get stuff done We're going to be coming back to this when Lance is talking about the Gateway API because this is also a big deal there Overall This is one of those things where the self-service, you know microservices 101 Separating things this way and arranging it so that everybody can work independently in parallel all the time lets you get things done More quickly it does require a lot of trust The developer side of the world has to trust that the ops side of the world is maintaining the infrastructure correctly Likewise the ops side of the world has to trust that the developer side of the world can get their stuff done without destroying the cluster It requires going both ways it can be very uncomfortable for people who are just coming into this world, but it really is worth it It's a good thing It's also worth pointing out It requires trust, but it doesn't require a blind trust There are a bunch of tools available in Kubernetes that permit you to do this more safely our back gives you guardrails We're kind of fond of the coop control sudo sang which lets you Mostly interact with a cluster in a way that's safe and then when you need to do stuff that's dangerous in an audited controlled fashion You know the declarative thing lets you fairly easily audit the world It's fairly easy also to build layers on top of this with you know get ops infrastructure as a service CICD all of those things Give you ways that you can let people go forward quickly in parallel and still have some confidence that the world is not going to come to an end tomorrow and All of this actually ends up tying back into some of the gateway API stuff, which I will let Lance talk about I'm giving him the hard part Yeah, so who here has heard of the gateway API? Who here has worked with it? Okay, a lot of fewer hands. Okay, so we're gonna we're gonna talk about it. We're gonna go quickly over it And that there's tons of talks here at there So hopefully you're already catching them and that'll go really in depth in it But we wanted to touch on it and kind of talk about how it compares to MS area You just saw the MS area language and then kind of talk about where it's cut where we're going with it So so the gateway API is a standard set of resources for service network networking You can think of it as the successor to ingress resource And it's community-driven. I think that's really important. It's being community-driven It's coming from a lot of experience from other projects and trying to take all the lessons learned Similar to emissary where we talked about self-service developer centric developer oriented This is role oriented So it really looks at that what we talked about that developer and that trust between them and the platform operators as well and in general like I said it takes it's been taking learnings from projects like ours contour And then the wider ecosystem of Kubernetes. Oh Before I go back and check it out. There's a lot more content obviously on the the website So go ahead and when you get here download the slides click on there and read about it and tons more So earlier we showed you how ingress compared to the MS area language And you can see we have our listener host and mapping and you can see a similar Thing in the gateway is where it's broken up all the resources are broken up broken up into individual resources compared to the ingress, which was one large one large resource If we dive into them individually You start with a gateway class So the gateway class is similar to ingress controller class if you've worked with that before and so it's saying what? controller wants to listen to these resources and can handle them then We say what is the gateway there's a gateway and so this is similar to what you just saw the host and listener But they're kind of consolidated into a single resource here So this is where you'll actually say what gateway class that you want to talk to you'll say what protocol? Port number if you want to have DNS resolution here This is a wildcard example.com and if you want to terminate TLS certificate Found in a secret and then finally similar to a mapping We have an HTTP route and so the HTTP route is going to give you that ability to shape that traffic so traffic comes into your cluster and it hits a Emissary and it says okay, where do we want to go we want to go to When we see foo example.com we want to go to this back-end ref quote quote 80 If we put them side by side or sorry if we look at it like we did earlier We said there's Jane this developer and she's really focused on her application And so she can go ahead and focus on HTTP routes similar to emissary where you'd focused on Mappings and then there's the platform administrator that can focus on those those cluster-wide things and they'll focus on Gateway class and gateway so very similar in that separation of concerns So now you're probably asking the fun question does emissary ingress support the gateway API and The answer is yes, but not really so if you go out to our docs today, you will see You can search and you'll find the gateway API on there, but it's a much much older version of that and so That's why we've been spending time getting familiar. We've been working with the gateway API team we've been working with on boy gateway to understand it better and And we want to see where it wants to go And so the other question you might be asking is what about the v3 CRDs that we have and what we just showed Well, are those going away is the gateway API going to replace them? Well, that's where we kind of actually we want to hear from you guys So what does that look like? And you know, we've we've for people that have been familiar with emissary ingress and you've been using it for a long time You're very familiar with our language for folks that are new you want to see the gateway API So do you see a hybrid of the two? Do you see it being? Being a backwards translation. Do you see it more of a get ops thing? These are things that we want to talk to the community about see what you're interested in and and actually put that into the product and We do have a contrib fast later So we'd love to have you guys stop by or the OSS pavilion and chat with us about that and we'd love to hear more So just out of summary here Emissary ingresses focuses on self-service ingress because it's a great way to let everyone get things done faster So if you're new to the kubernetes world and to emissary it's definitely something to look at if it when you're setting up your teams and how you want to operate being able to focus on platform and then developers being able to focus on on their piece as well and it takes trust, but it works really well once you get it right We think it's definitely starts to make sense to look at the gateway API and like I said There's a ton of talks here. They're going really far in depth in it But we want to know what it's gonna look like or what you guys would like to see it look like in emissary We emissary input language that we just went over the host listeners all those things They're here to stay there for the foreseeable future but we want to know how would it look with a gateway API and that and So we need your feedback and we would like to really work with you on that in the community So again, we just want to also say thanks to the community as you saw earlier in our slides We had lots of contributors lots of new contributors here And they've been really really pivotal on some key features and so we'd love for folks here that I want to get involved Like I said, we have a contrib fest later today at 430 So definitely stop on by or you can always catch us on slack. I lost one of our Other contributors that's here at the conference Flynn mayors. Sorry. Yes, maintainers and Flynn and myself You can catch us on slack or again at the OSS pavilion Um For any contributors here, I see a few so we just wanted to give a shout out for the tag contributors strategy if You're you know, you're a maintainer and you're looking to Getting more involved in the Kubernetes CNCF world Go ahead and check this out. There's a link here And it has a lot of guides on how to contribute and and whatnot All right Thanks, and then questions questions Is it work, okay My name is Andre. I'm from London. I've been an active user of ambassador stack for years and I was always confused between Ambassador at stack and emissary ingress. Can you? Elaborate on these a little bit because latest changes Venues the the beats the buzzer between them Can you speak up on this a little bit? Thank you? So emissary ingress is the CNCF Project that we're here talking about today and that was like when said 2001 Or sorry, it's my life. Yeah around that time. Yeah age of myself. It was donated around 2021 I think the project started in 2017. So it's been around for a while and so That is the open-source project and then edge stack what you're talking about is is built on top of that So it's added features like authentication provides authentication service rate limiting and those types of things. So You want to add anything on it? Emissary also has authentication to rate limit and all that stuff The big difference there is that edge stack provides you an implementation of the external services that are used For those so emissary has hooks to call out to an auth service And edge stack bundles an implementation of the auth service that does a lot That separation where you've got emissary as the open core of a larger commercial project is very very likely to stick around I It's always fun for me to deal with stuff because I don't work at ambassador labs anymore But I'm fairly confident that edge stack isn't going away. It would it would surprise me a lot if that were to happen Going forward we do expect that where emissary is currently built directly on top of Envoy Emissary is probably going to shift to being built on top of Envoy Gateway. That makes a lot of sense and Then edge stack will continue to be built on top of emissary which is built on top of Envoy Gateway and it's turtles all the way down Thank you Anything else? Hello. Yeah, go ahead and then there's one over here The edge speaking from France, so thank you for the presentation. Absolutely. Thank you for being here a quick question is about Envoy plugins implementation in emersy especially when we look at two is the Jrpc to Http rest to us Jrpc transcoding Because you know the most of public API the arrest API and the developers we speak about the developers experience Enjoy doing a Jrpc microservices so we really need the Envoy that already implemented The Jrpc transcoding to Http. So what you're inside about this. Thank you So the the flip answer is hey PR is welcome Obviously, I'm being a little bit facetious about that one, but do you remember? wasn't there I Feel like there was work that was done to start enabling that one do you remember? Yeah, yes When you look to the cultures there is something but nothing raised Okay, so in that case Why don't I would like to talk to you a little bit more about that one because I thought that there was stuff already in There that could do this If it is not what you're talking about I want to understand that Thank you Hello, hi there. Thanks. So the the scenario that I had was let's say the Product that we have is distributing emissary gateway, but the customer's environment also has let's say Emissary gateway installed but different versions of CRDs Different version of the product or project. Let's say in that case obviously we have a conflict because we want to install Different versions of CRDs. So do you have any? Suggestions on how do we handle these scenarios? Thank you You want that one? I guess not Recent emissaries have a component called a bi x that is supposed to handle the translation for you between CRD versions, so I would encourage you to install the newer It's a little tricky in installing the newer version of emissary should allow Translation for all of the older versions of the CRD that are already in the cluster and that should do what you need If I understand you correctly, you're talking about Different versions of emissary running so there's different versions of the actual CRD itself not Not this not our CRD version. So is that what you're referring to? Okay, so you are referring to that. I wasn't sure if you were talking about just the different versions So Kubernetes itself doesn't allow you to version in the sense of How do I word that things get really tricky if you're using a version of Kubernetes that uses the old Like v1 beta 1 custom resource definition resource I know it trust me. I know Kubernetes itself do you remember what version this changed in anybody Shane? I'm looking at Shane because 1.22. Yeah so in Kubernetes 1.22 support for the custom resource definition beta version went away and You had to use v1 proper and a lot of the rules changed And if you're trying to deal with older versions of Kubernetes and multiple versions of project CRDs Your life is going to be miserable Don't do that upgrade your version of kube If you're using a newer version of kubernetes, so you're using the v1 custom resource definition Then the newer versions of emissary like emissary 3 and higher Should be able to deal with the problem that you're talking about where you need to deal with multiple versions of the emissary CRDs Did that I hope that answered the question instead of making it less clear Thank you Hey for service mesh integrations with console connect and Istio How do you use linker D? Yeah, okay? Well with them starting to support The gateway API as well, how do you guys see emissary ingress fitting into that picture Do we have emissary routing only to non service mesh services or you know? What type of architecture would you guys see that's evolving into? The actual answer to that question is go and hang out with the gamma group, which is worrying about gateway API and service mesh and In the bright shiny future that we all look forward to then we will have ingress controllers and service meshes That are living in perfect harmony configured with the gateway API and everything will be wonderful and we'll all sing kumbaya And the Middle East will be peaceful and yeah I don't actually know how long it'll take to get there, but It's a thing that's yeah It's definitely a thing that we're paying attention to because it doesn't actually make a lot of sense to do gateway API and not Think about how to play nicely with service meshes as well There's there is in all seriousness a lot of a lot of work and a lot of thought going into that in the gamma group some of the Some of the concerns you run into there are deeply deeply fascinating That's that's a good word right Any other questions Okay, thank you. Thank you


What's up, everyone? It's your girl Kenzie here from late in sports cards and I am ripping a Personal break here for Chris G. We've got five 2022 top sterling baseball hobby boxes as well as for 2020 Bowman baseball sapphire edition boxes All right, Chris best of luck super excited for this one. It's gonna be a fun rip Gonna start with the Bowman sapphires Good luck and thanks again, Chris Yeah, every single one of these cars will be sleaze and top loaded for you 2020 Bowman sapphire. Let's see some of these guys on the front, huh? Dominguez got Riley Greene some bullpays And get one prospect auto her box to Ryan Mountcastle neat Pearson Christian Pache and Ronaldo Hernandez See some of those big first Tariq school ball first Dylan Carlson Joe Ryan first and a Adam Hall you go whole whole-sizer Taylor Tramble Brady McConnell and a six-toe Sanchez We got our first auto here. We've got will fair as to Dio. Yeah, there's one prospect auto car Tyler Freeman Brian Camps Juana. Mm-hmm. And first auto is going to be a Tony Debrel Like how it has the sapphire print on the top to Logan Davidson we got an Adley base nice Brace and stop and rookie of a lube. Oh nice one there Lube off Really big on him Elliot Ramos JJ Blede Marco Luciano and first of Jocelyn de la Cruz We've got Glenn Allen Hill Jr. We got an orange orange for now It is a Louise Garcia 39 out of 75 on the orange and the orange sapphire is just I love that Evan whites and cannon Smith Lane has a sapphire part of Riley that I'm Marlon first really really like yeah, Jared Kalnick Josh Jung and Grant little alright I'm pretty sure it's out of this product. Yeah, you said it's a Riley. Yeah Tony Cardenas first Rutherford Valmont and Owen Miller Yeah, sapphire cards can be hard to create sometimes because you can't really the surface is hard to see you know Let's exhibit your Edwards first there. He is Jason Dominguez nice hit there for you Chris That's one of them that you're looking for Jason Dominguez first Magnet for you Julio Rodriguez. Yeah, we've got Franklin Franklin for us. Sorry Daniel Lynch Christian posh a and Ronaldo Hernandez Yeah, most likely we got our auto we have a first of Joe Ryan and Adam Hall Hunter Green and our auto is going to be another met Oh same one Tony de Braille on the first sapphire auto for the Mets Same auto as a first box Ian Anderson Cole Wynn Brady McConnell and six toe Sanchez Andrew Vaughn Jorge Mateo first of Wilfred Astudio and Tyler Freeman Damon Jones first for the Phillies Louise Garcia Bryson Stott and another rookie alubab nice There's a Last pack of box to what year was the Padres 2013 Bowman? Oh, wow Aaron Shortridge first Cal Mitchell Marco Luciano and Jacelle De La Cruz first Yeah, what he graduated I think he was a year older than me in 2013 at a top scone black baseball Of course Luke. Yeah, I'll be sure to rip those all together for you There's quite a bit of people in front of you, but it'll probably be maybe about another hour hour and a half Maybe till I get to yours Not too long probably closer to an hour. I'm on tarot. We got purple here Purple for the nationals a Keane Kavako that is 10 out of 20. Yeah, just the color on the sapphire cards. I just Evan whites and Canon Smith It's funny like I really don't collect too much baseball, but like I have a lot of baseball lacks like sapphires Louise Garcia Jordan Adams Josh young and Grant little my first ever I'm a first-ever That's cool my first ever start against the twins 16th overall the same year I was captain Hadman Brian Matta Matt Manny Mata and Drew waters. Yeah, that's my best friend. Is it? Yeah That's my literal. We have a green auto Green auto coming up. Come on be a rally green name. Say hi first and Nick Bennett's Green green that would be something Oscar Gonzalez and we have for the Yankees. Oh my gosh My gosh 44 out of 50. Oh my god. Oh That is huge Chris. Oh my gosh Oh Wow Wow One of the guys we were asking for My hands just got instant sweat. There we go. Holy cow Wow, we'll make that for you. Let me Yeah, whoo, that's a big Hey Wow, you're probably gonna make it. I'm gonna be debut this year too. Yeah, that that's definite hold. I would man Chisholm Johan Diaz Cody Hosey and Byron Laura first Wow It does that's a very smooth auto too. Wow Nicola Dolo Christian Javier Nolan Jones and force Whitley Holy cow What a monster Wow, and we still have five boxes Anderson gross and Bobby Whit first. There we go Wow, this is incredible. We are off to a hot start this morning Wow, we'll make that one too for you Chris Mike. Oh, yeah We gotta pull a green now we pulled damn near everyone we need Oh, and a Dominguez and well at least not a first on this We just pulled one of those right Christian Robinson Um, Denneberg and Grant Levine, which is weird. Yeah, cuz what is it? Bobby and Adley are the same draft Adley was a first overall. Adley's might be in Bowman 2020 Bowman draft. That's his first, right? Or is it just 21? I can't remember. That's why I was asking you when you're gonna get yours because it's like really weird Like they might not be a first like in this but they'll be a first in Bowman draft or something set to be your Shane Bass, Yvonne, and Grant Little Last box of the Sapphire PSA 10 sold for 3,500. Wow Dalbeck Fardino, Matt Manning, Drew Waters. Card Corey If he gets called up and does well, that's gonna easily Yeah, Amaya Mendoza the first of Sehouse and Nick Bennett first Right, we got our auto coming up here Cody Hosey Bearing Laura first. That's sick Corey Thank you for looking it up. Yeah, thank you. I was curious Johnson India And we've got a for the Padres a grant little Padres auto Grant little and that's on card too, right? Oh, yeah Yeah, you have a orange eyes of Perettus. Come on be the first Padres grant little you got an orange to go with the auto. There you go Chris same box same box Yeah, 13 out of 75 grant little box here You're right. Wolf. You're late to the party man Nolan Jones and Forrest Whitley late for the party Nova rice to rang Bobby wit another one very nice. There you go Chris Another Bobby wit it actually sold today. That's crazy Corey. We'll mag that one plurial Yeah, and like Blake said, we still have five top sterling My goodness, so various hens Denneberg and Grant Levy And see that's a pass. That's a pass from me. I feel you on that Logan Gilbert's Grayson Rodriguez Hazel Sanchez and Braylon Marcus. Wow. What a four box personal there of Bowman Sapphire. All right sterling time Here we go. Good luck here, Chris Let's see something crazy. I'm feeling I'm feeling fishy. I'm feeling like I'm about to go fishing here We have MVP award winners. That could be my trial and a Cy Young award winners I cannot be a No trouts there All right Really no fear All right, let's see first up we have a Greg Maddox that's 21 out of 25 3371 strikeouts All right MVP award winners Let's see Who's it gonna be? Oh, it's a one-on-one Christian Yellich Nice one there on the three colored patch Jersey letter patch card one-of-one We'll mag that one for you. Yelly. All right A Miami Marlins Yelly All right box two We've got 1990s MLB all-stars and 500 home run club That sounds like a good one Let's see what it could be We've got 13 out of 25 a Ryan Sandberg on the dual back 40 home runs Nice sandberg 500 home run club Take a guess Yeah, well wait till you see what what he hit I'll do like a mag recap We have a Ted Williams one-of-one Wow on the dual bat relic card Ted Williams What a person here for you chris Oh my gosh You guessed that We'll mag that one for you That's that's a crazy guess Wow This is that that's a That's a crazy card Yeah sterling legendary relic card world series champions and 1980s MLB all-stars That's why one of the coolest cards we've ever seen That isn't a Ted Williams card Let's do 80s first 80s all-stars Looks interesting All right, what do we have here pretty thick card It is a berry larkin five of five. Look at those patches red color match Wow. Yeah, three color two color two color three color Wow sterling season 1999 beautiful larkin there Yeah, I love the color match on that red just pops on that whole card. All right world series champs World series champs a lot of people Yes We have a walker bueller 17 out of 25 dual relic auto sterling season 2018 viewer Yeah, right those patches are crazy. Well All right box four We have 2000s MLB our solid all-stars So you went from the 90s to the 80s now 2000s and tops all-star rookie cup team. Uh-oh Oh, this could be out. This could be out of the world I was wondering you guys Yeah, I think you were a little bit behind. Well We have One of 25 randed johnson 4875 strikeouts. Are those that relics? Yeah That's what? Randy johnson must have used it can't be that many I don't know All right, all-star rookie cup team Double No diamond back. Oh, I thought you said raise. Maybe I did say All right, let's see what we have here We've got nice ladi guerrero jr. 10 of 10 Nice hit chris Wow 2019 sterling season. We'll mag that one for you All right last box Last box. We'll do a recap of all your mags cards for you Which bad it now just says game used. Well Ooh icons. That's a big one. That is a big one. Let's go last box and stat leaders Let's go icons is what you want to see that was what it was called I'm gonna sing your next A bird feather in there That would be something I'd be crazy Like the odds of that happening are just what's just a crazy beatable. It really is All right, let's see what we have here. It's pretty thick. We've got a one-up one Boba chef box.  All right icons. Here we go Oh, man, I see multiple autos on here and it's red Let's see what we have here, Chris. Oh, man Good luck We have oh my gosh Ichiro Matsui and shouhei Oh Tani. Those are some icons. Oh my gosh Five of five. Gosh. We really were. Oh my gosh.  That is that is ridiculous. Do you think it's a 180? Wow Wow, chris We're gonna get that mag up right now for you. Holy cow talk about a personal rip My gosh, you absolutely killed baseball this morning. Let's do a quick recap of your mags cards Blake's getting that mags up right now for you. You had the vlady jr. 10 of 10 You had the uh 10 williams one of one dual bat relics and game used I gotta take I gotta leave these all out and just take a picture of it the one of one christian yellich I gotta shake this Yeah for uh your sapphire hits you had two bobby wit juniors You had the green vote bay 44 out of 50 green first that might be the toughest hit of the break like the most Yeah, between this and the triple. Yeah Um, I probably say this probably goes for around that too. Yeah the jason demingas first and then The ichiro matsui and otani triple relic auto five of five And then you also had the bobeshet one of one Absolutely insane congrats on those chris definitely be sure to grab some insurance on this package and we'll be getting this right out to you


T F N N headline news update Good afternoon everybody. I'm Tommy O'Brien company live from TF and that headquarters in St. Petersburg, Florida Having a little bit of trouble with the charts as may happen. There we go right now markets near flat territory S&P is positive by three points trading at 31 37. Thou Jones negative by one trading at 27,009 Nasdaq positive by 12 points trading at 86 33 go contract a little bit of a bit up $2 at 1467 we've got oil up 20 cents at 59 22 Notes of bonds a little bit a lower price and higher yield the 10-year negative 4 ticks at 128 27 the 30-year negative 7 ticks at 157 24 and the dollar index negative 145 ticks at 97 499 we'll start things off and we're gonna actually jump around a bit We'll start it off with some currencies dollar index trading a bit lower dollar index 97501 as we speak. There's your euro currency Of course, we have a Brexit vote coming down the line voting in the UK two days from right now on Thursday There's your pound catching some strength as well bottom right quadrant 131 84 and the yen trading at 108 75 jumping over to metals Get there There are your metals gold in the top left. We're as high as almost 1474. There is silver trading at 16 69 gold right now at 1467 how about palladium and platinum 923 and 1871 the price of platinum start things off for the indices will jump over to the charts There's your Dow 30 27,000 918 Markets trading higher this morning on the report that the Chinese trade tariffs set to be put in place on Sunday will be delayed as trade Talks continue Dow 30 just under 28,000 at 27 919 Nasdaq 100 trading at 83 80 just off the session highs that we had as well There's your S&P 500 bumping up against the highs as well the high for the S&P intraday 3142 trading at 3138. There's your crude oil chart $59.24 There is gold was as high as we mentioned as 1473 55 backing off a bid at 1467 and the euro US dollar at 1885 and don't forget folks two weeks only the front page of TFN and get up to a 40% bonus for the TFN and the holiday tiger dollar sale the front page that was good for all TFN and newsletters or services Stay tuned folks We got a man Dave white coming up live at 2 o'clock with the power training hour Tom O'Brien live at 3. We'll be right back


Hey, it's Dr. Kendra here. It's Q&A time where I take your questions from social media and your Apple Podcast reviews. I always enjoy hearing from you. So leave your questions on social media or Apple Podcast reviews. I might just feature one in an upcoming episode. But before I get into it, it's important to note that this episode is simply meant to be informative. If you have any concerns about your health, please speak to your doctor. Okay, let's jump in. Question number one. Dr. Gundry, I know you don't typically eat breakfast, but if you were going to, what would you eat? Well that's a great question. As you know, I like to, particularly from January to June, not eat breakfast and not eat lunch and eat all my calories in a two hour window at dinner time. But I break that during Saturdays and Sundays often. So what I do when I break my fast, which is breakfast, I'll usually have plain sheep yogurt. Recently, I put allulose in it to not only give it sweetening, but as many of you now know, allulose is actually a prebiotic fiber that has some very interesting health benefits. So give that a try. Also I like a bar that I make at Gundry MD. I'm partial to the macadamia nut bar. My wife likes the honey nut bar better. But if I'm going to have breakfast, those are my two probably go-to choices. Lastly, believe it or not, I will often have breakfast as a handful of walnuts or pistachios. And that is a great breakfast that, if you've read Unlocking the Keto Code, does not break your fast. So it's a win-win in that way. All right, number two, from Cecilia Sau on YouTube, Dr. G, since soy sauce went through the fermentation process, the lectins in soybeans should be gone, right? Is it safe to use them? Well, yes, the lectins in the soybeans are usually destroyed, but almost all commercial soy sauce in the United States has gluten, yes, gluten. But it's doing there, I have no idea, but almost all commercial soy sauces have gluten. But there's an easy around about this. Get yourself coconut aminos. Tastes just like soy sauce. There's several companies now that make coconut aminos, and that's your new soy sauce. If you can actually find a tamari that's imported from Japan, you're probably safe, but just don't take the chance. In fact, I have a lot of my patients bring their coconut aminos to their local sushi hangout. All right, number three, from Sculpture and Arts on YouTube, can you talk about the benefits of fennel plants, please? Is it a superfood or a super fad? So fennel is really great for you in all forms, whether it's the bulb, whether it's the leaves, you name it, fennel is a superfood. It has some really great prebiotic fiber. It has a marvelous licorice flavor that most people really enjoy. And as you know, there's a lot of fennel recipes in my books and add fennel to your diet. And raw in salads, cook it for a savory winter meal, chop up the fine feathers and leaves and add it to your salads, add it to your soups. It'll give a great new flavor. It is a really versatile vegetable that you need to get in your diet, and it's really affordable. Great question. Number four, from Ave Bami Dahili, I think I got it right, on YouTube. And a person who is once metabolically flexible become inflexible again. If yes, what are the conditions? Oh, brother, is it easy to become metabolically inflexible? An example that I used in my first book, you can take trained athletes, put them to bed rest for 48 hours, and they will become insulin resistant and metabolically inflexible in just 48 hours. And I can't tell you the number of people who during COVID changed their exercise program. They stopped going to the gym for obvious reasons. They stopped spin class. They stopped yoga. They stopped Pilates. You name it, they stopped it. And some of my best metabolically flexible people became metabolically inflexible. It was shocking to everybody how little it took to get them on the wrong side of metabolic inflexibility. The other place I see it, particularly again during COVID, is people got into the habit of eating comfort foods, eating for boredom, having more alcoholic beverages. And I'm not saying there was anything horribly wrong with the last two years in doing that. But I could see it across the board with my patients. And remember, I see patients six days a week and do blood work every three to six months. You can spot it a mile away. What happened to the vast majority of people making these changes? So yeah, once you're metabolically flexible, it is like that to become metabolically inflexible. You can't rest on your laurels. One last thing I'll say, I'll have a person or people who have glowing results after really focusing on their eating. And I'll give them praise and give them gold stars. The next time I see them, everything's changed again. What happened? They said, oh, I'm doing great. I can lighten up a little bit. I can take it easy a little bit. And I'm telling you, this is a lifestyle. It's not a diet that you're on. Number six, from Ryan Sue on YouTube, can you do a video about how to make non-organic food less harmful so we can get rid of the lectins and pesticides for the most part? Thank you so much. Thumbs up. Well, I recently did a YouTube video on which foods you should try to buy organic and which foods you should not really worry about organic. Let me summarize that, but head on over to YouTube and look up that video. If something has a peel that you're going to get rid of or a shell that you're going to get rid of, you're going to get rid of whatever pesticides may or may not have been sprayed on that. On the other hand, so a nut, you're probably not really critical to get organic walnuts for an example. On the other hand, if you're not going to peel something like lettuces, like vegetables that you're not going to peel, then it's probably well worth your money to get the organic version. And I'll add one more thing. If it's in a plastic bag and it's been prepared for you triple wash, in my next book, I'm going to try to scare you into not buying that product in a plastic bag. And it's got so many mischievous endocrine disruptors and preservatives that you're far better off buying the whole head of lettuce, the whole cabbage, the whole broccoli and chopping it up yourself. Yeah, it takes a little bit longer.  Number seven from Andrew Dunn on YouTube. Big question. How does one simply take potassium if the diet is short in it? Supplementation is typically 99 milligrams while the daily required intake is 4,700 milligrams. No, the daily required intake is not 4,700 milligrams. What you want to do is balance your potassium and sodium intake.  That's 4,000 milligrams. But it's actually really easy to do. For instance, get yourself some pressure-cooked lentils or pressure-cooked beans. Those lentils and beans have up to 1,000 milligrams of potassium in a cup. Get yourself some potassium chloride salt, sometimes called light salt. Easy to use, easy to put on your food. If you have a water softening system and a water filtration system, make sure it's a potassium chloride-based system and you will naturally be drinking your potassium. So almost all of our vegetables have massive amounts of potassium. A cup of spinach has 400 to 500 milligrams of potassium. So in a daily diet with lots of green leafy vegetables, you're going to get oodles of potassium. You don't have to go look for potassium pills. If you want a potassium pill, buy potassium bicarbonate. There's 400 milligrams of potassium in a potassium bicarbonate pill. So easy way to get it. Number eight, from Anna Kovac on YouTube. Hey, Stephen, what do you think about growing microgreens at home? Well, that's a great idea. If you have a green thumb, why don't you make some microgreens? But not all microgreens are the same. First of all, don't eat alfalfa sprouts. They have some of the best toxins known to mankind. Secondly, if you're going to use seeds like grains, like wheat, like seeds from sunflower seeds. In the first sprout, the lectin content actually goes higher. So those guys are not what you want to do.  Finally, if you're going to sprout, use broccoli or radish sprouts. Broccoli sprouts have some amazing compounds called sulforaphanes that really have important factors that stop cancer cells in their tract and also improve mitochondrial health. So if you're going to spend time growing microgreens, broccoli sprouts followed by radish sprouts are two of the best ways to go. Great question. Number nine, this is from Anonymous. Have you or could you do an episode on how to fulfill the essential amino acid profile from plant-based sources, i.e. without supplementation? Thanks. Well, let's put that to rest. Yes, there are essential amino acids that we have to obtain from our diet. And we can argue whether it's 8 or 10 or 12. Some are semi-essential, but no one has ever told a herbivore, a horse, a gorilla, that they need to supplement their diet with animal sources to get all of their complex amino acids and all of their essential amino acids. You can very, very safely and simply get all of the necessary amino acids by eating a varied diet of very different greens. If you're really worried about it, and I'm not, then you can supplement your diet with pressure-cooked lentils or pressure-cooked beans. I personally think that hemp seeds are really one of the best ways to get all the essential amino acids that you need. Mushroom-based foods like corn, and I'm not saying C-O-R-N, I'm saying Q-U-O-R-N, have all the essential amino acids that you need. So don't buy into this. I've got to have each meal have all the various essential amino acids. Beans have some. Rice has another. I've got to combine them. Nobody in nature ever does this. So why should you? All right, that's it for today. Keep those questions coming in. These were great. Thanks so much for watching this episode, but don't go anywhere. I think you're going to love this next one. And most of these you want to try to buy organic. You've probably seen that almost all oats in this country, including organic oats, have glyphosate.


Yeah Rihanna She right, I don't know she like get a rule Some people just don't get on right here.  See you got a first We got those we got those areita Frank You should know that Definitely like Fantasia too, I was gonna say you know what fantasy went over that slump She looked so good and folk forgot that she didn't know how to read until like, you know what damn She don't know how to read.   I'm glad No Hey man, everything going on in the world coronavirus first of all got everything All the show is on pause right now.  These are Right now Well you got to do that too, I just wanted to give a shout out to the black community I'm just He doesn't know a lot of your word Platforms out there right now. There's gonna be a reach the community as a way to the 85 South show Reaches the community and I want everybody to just stay diligent and keep your faith You know, this is the time that we want both of them more dead and read from the Old Testament We not cuz we you know the new testament is the new test here right now We're going through a very challenging Stay free. Let's stay moving. You got to stay prayed up and you got to stay move You see how I have one conversation about a future, but us a brand the whole neighborhood And they're not not looking where we are and that's all they do, right?


Cosmic Rift on him, here comes Twin Blast to join the action, Murio comes in with a big save, over the top, that's the ultimate I've been looking for, pops the Greystone ultimate. What's up everybody, I'm the Mangus, you are awesome and today I'm going to bring you some Fault gameplay, I'm going to try and do this in the style of casting call, however I just do not get as excited about my own gameplay as I do the gameplay of others. So again, if you have recorded some games of Fault on your own and you want to slide them over to me and have them cast, I will be happy to do that, but for today I'm just going to do my own. Now the aspects I'm using when getting in today are Plague Doctor, which applies a burn to other minions or anybody that's around a minion whenever you get a kill. So I'm using that to kind of bully this Countess a little bit, as I get last hits she also takes a little bit of damage and then I'm also using Queen which gives you more energy damage upon more minion kills, however I should have used Magician which gives you more mana regen. I've been bullying this Countess quite a bit this match and she has had enough, she's going to come in after me, I hit her with a Burden, Burden actually does more damage than a Cosmic Rift early game. She decides to go ahead and back off, I'm pretty low on mana but I'm going to keep engaging into this Countess, hopefully she'll come after me once again.   Running through the jungle here after I missed an opportunity to gank right lane, and as I'm coming through, Camara comes out of nowhere with a big ambush, I just zerpa away because he engaged with ambush, this is an important note to make and he's taking a lot of damage from my abilities, so I know two things, I know this Camara is fairly inexperienced because you should never engage on a Gideon with an ambush, you should try to run up on him because if you engage with ambush, he's just going to zerpa away, and I also know that he's not building energy armor, he's taking a lot of damage from my abilities, so I kind of use this opportunity to pick Camara out as a target for me later on. Still playing with Countess in this mid lane, Narbash comes off the top ropes, starts the crash bang boom, I somehow miss the Cosmic Rift, that's embarrassing, hit her with the burden, I tried to zerpa over in ultimate but it didn't work, so hit her with the ultimate here, she is fucked, but no, Muriel comes in for the big save, but Countess thought she was fucked, so she just stands there and eats shit, it was a great play by Muriel, if the Countess would have kept moving, she may have actually escaped all of that, but Twin Blast is coming in, he's going hard on poor old Narbash, I'm trying to stay in front of him, trying to soak any shots fired at him, but it looks like all the shots are missing anyway.   There's something I used to tell my soldiers all the time which is, some of you have heard this before, a bad decision will fuck you sometimes, indecision will fuck you every time, but I am horrible at taking my own advice and I do not right here, I've got this big minion wave pushing up the right lane, and I can see that Twin Blast and Greystone are attempting to take our core out, and I didn't know what to do here, I didn't know if I needed to go back and assist with the defense of the core or if I could just push this wave, and it took me too long, I should have backed a lot sooner or I should have just kept pushing this wave, this is a great example too of when having that count is what really helped, having that fourth person, they're going to come in after us, I'm going to try and defend as well as I can, but yeah this is where they end the game, I land the ultimate on Twin Blast, it takes quite a bit of damage from it, but it's not enough to kill him, I'm going to come back, Greystone is just like I said an absolute monster, Twin Blast coming in, Greystone realizes he needs to take me out, comes after me, and they are able to take me out and pick up the win, so why do I think that they won and we lost, a lot of it had came down to pushing, we didn't push whenever we had the upper hand, and the enemy team was very good at taking objectives when they had the upper hand, so in the end I think that's what screwed us over, I know you were probably expecting a win for gameplay on my channel, but not always, not always, I'm not afraid to show a loss if I think that there's more to be learned from a loss than a win, I hope you guys enjoyed this, would really like to do this with your gameplay if you got it, but for now this is the man goose signing off, you guys have a good one.