I now have the privilege of introducing Alexi Torqui. Alexi is an associate professor of medicine and associate division chief of general internal medicine and geriatrics at Indiana University. She's also director of the Daniel F. Evans Center for Spiritual and Religious Values in Healthcare and the fellowship director of the Fairbank Center for Medical Ethics. Dr. Torqui's research focuses on end-of-life care, patient communication, spiritual aspects of care and surrogate decision-making. She was the first person to describe and analyze the relationship between doctors and healthcare surrogates and her current research continues to focus on surrogate decision-making. In this case, for older adults with dementia, delirium or other forms of cognitive impairment. Dr. Torqui has also done work in medical education, designing and evaluating curricula regarding end-of-life care and clinical ethics for medical students, residents and fellows. Today, Dr. Torqui will speak on balancing the harms of pain and addiction. Please join me in welcoming Lexi. Thank you, Lainey. It's a pleasure to be here. This talk today is a little bit of a departure from some of the things I've addressed in the past years, but it's something I just can't seem to get my mind off of because of my own clinical practice and my encounter with patients. So I have no conflicts of interest. One of the greatest changes in the practice of medicine during my career has involved pain management, opiate prescribing and addiction. I trained in an era of a massive awareness campaign about pain and a resulting increase in opiate prescribing. It is now clear that this approach is one of the contributors to the national crisis of opiate addiction. The pendulum has swung from one side to the other. In this presentation, I will make the case that both the campaign to recognize and treat pain and the response to the opiate addiction crisis while well-intended have ignored some of the most important aspects of good patient care. This has left providers and frequent ethical dilemmas as they care for patients with pain and is resulting in continued suffering for patients. I will first describe the recent history of pain treatment and opiate use in the US. I'll point out some common ethical quandaries that physicians face and we'll end with some policy recommendations that I believe point us forward to healthier patients who have both better pain control and lower rates of abuse. In the book, Dreamland, author Sam Kinonis chronicles the story of the US opiate epidemic. He tells a compelling tale that weaves together several forces that led to the rise of the opiate addiction in the US and I'll walk you through some of them. As any of you who practiced in the 1980s and 90s remember, aggressive pharmaceutical advertising was clearly a daily fact of life. There was a barrage of pens, post-it notes, dinner and so-called advisory boards where physicians could be flown to exotic locations and paid thousands of dollars to be detailed by drug makers. Oxycontin was released into this milieu by Purdue Pharma in 1996 and was aggressively marketed to patients with chronic pain.  And there were also some times where they actually misrepresented evidence in ways that have led to criminal prosecution. Other medications, including MS-contin and hydrocodone products were also aggressively marketed. In the 1990s, there was a growing awareness of the burden of untreated pain. This concern grew into a movement. In 1996, the American Pain Society began a campaign naming pain as the fifth vital sign. The VA and the Joint Commission adopted this approach as well, physicians were encouraged to believe their patients' report of pain because it's a fundamentally subjective concept. There was also a growing belief that the risks of opiate addiction were overblown. This was based on incomplete evidence that few people questioned. At the same time that we were being encouraged to treat pain, visits were getting shorter and shorter and coverage for alternative therapies for pain, such as cognitive behavioral therapy and exercise interventions was limited. For me, practicing at that time in an urban hospital in Georgia, the resources were especially limited. So how did we respond to our patients' reports of pain with a prescription pad, which was quick and easy. With the freedom to prescribe opiates and many new addictive choices, clinics sprung up that did little but prescribed vast quantities of pain medication. Some of these were located in out-of-the-way storefronts. Physicians saw patients for as little as five minutes and then filled the prescription in on-site pharmacies. Some operations were cash only. There was little to no history or physical exam. That only did people come to supply their own addiction. They would bring others to the clinic in exchange for a cut of the pills to resell them on the street. Each of the three factors I've mentioned so far have contributed to substantial increases in prescribed opiates and contributed to one degree or another to a rise in addiction among patients who took the medications as prescribed and among others who used medications from friends or bought diverted pills on the street. This graph shows the increase in opiate prescriptions from 1991 to 2013. And at the right of the graph, you finally see the beginning of a decline in total prescription numbers. There was an even larger rise in the amount of opiate quantities of the amount of opiates prescribed. So as you see here, the amount of opiates prescribed per person was three times higher in 2015 than in 1999 in MMEs or morphine milligram equivalents. This graph shows the concomitant rise in opiate prescriptions and overdose deaths. Now I know that associations, temporal or otherwise, do not prove cause and effect, but they are a piece of evidence for it. And I think the evidence here is really quite striking. An additional force that contributed to the opiate epidemic is the widespread availability of heroin, particularly in mid-sized cities and rural areas where it was not previously available. Beginning in the 1980s, a distribution for black tar heroin spread across the country. This heroin was distributed and sold by individuals from a small area in Western Mexico. They developed a system that has been compared to fast food chains or pizza delivery. Customers would reach a dealer on a cell phone or pager and would set up a meeting place in a parking lot or other location. The dealers carried small amounts of heroin, were generally nonviolent or involved in gang crime, and rarely used the drug themselves. They didn't dilute the heroin or cheat their customers. So the first customers were those who were already addicted to heroin who liked the convenience and the quality of black tar. Over time, however, their customer base grew to include pill users who realized that the heroin was substantially cheaper than pills like Oxycontin. The result of these forces has been a vast increase in the number of Americans who die each year from overdose and other complications of abuse. As this slide shows, the rise in heroin-related overdose deaths has increased by 286% from 2002 to 2013. Recently, solutions are emerging to some of these problems.  Organizations have moved away from the notion that pain is the fifth vital sign. Efforts are underway, perhaps, with limited success to take down the highly successful networks of black tar heroin dealers in America. Family and advocacy organizations are speaking out about addiction, seeking to remove the stigma and increase support for addiction treatment, including treatments as alternatives to prison time. States have imposed regulations on opiate prescribing, which include required databases to track all prescriptions received by a patient, limits on doses and pill amounts in most circumstances, mandatory treatment agreements, or pain contracts in urine drug testing. But the wild pendulum swing from the pain revolution to the opiate crisis has left physicians in ethical binds when treating patients. I'll share two cases that I'm familiar with to illustrate this. So here's the first one. This is pretty close to someone I treated, a 62-year-old man with lung cancer who comes to see his palliative care doctor. She prescribes morphine for pain. At the next visit, the physician reviews the medical record and finds that the patient was admitted to the hospital from jail after he was arrested for trading the morphine for heroin. He now returns out of medication and complaining of severe chest pain at the site of his tumor. His doctor offers him admission to drug rehabilitation, but is unable to find a program that will take a patient without insurance. He now reports 10 out of 10 pain and begs for morphine. What should the physician do? Should the patient walk out of the clinic with no pain medication because he clearly abuses it? The patient has both a legitimate need for pain treatment and an addiction problem. An essential piece of the puzzle is that treatment for opiate addictions must be expanded. There've been some successes in communities that have refocused resources from prisons to treatment facilities, but for individuals who are not in the criminal justice system, access to treatment and coverage of treatment must be greatly improved. Here's a second case. A 59-year-old man with chronic degenerative disc disease in his low back who works as a carpenter comes to see a new primary care doctor. For the past three years, he uses ibuprofen during the day and takes two hydrocodone acetaminophen at night. He feels he's doing well with his pain regimen. He drinks alcohol socially once a week. The primary care doctor said she will not continue prescribing the hydrocodone because it is addictive and dangerous. She also notes that there are many burdens and documentation requirements that are unrealistic given how many patients she has to see in a day. She tries to refer him to a pain specialist, but the health system doesn't have one. He says, I'm doing really well now. I can handle the pain during the day. I can make it if I can come home at night and have some relief.  I am not addicted. The PCP feels terrible that she has so little to offer him, but she has five more patients to see by the end of the day, so she concludes the visit. States have passed laws and regulations on opiate prescribing that make it highly burdensome to write prescriptions. These administrative burdens may exempt situations in which opiates are clearly appropriate, such as palliative care, advanced cancer, and hospice, but they do not address many other situations in which opiates may be appropriate. In my outpatient palliative care practice, we regularly receive referrals from primary care physicians who simply do not have time to treat chronic pain in their 15-minute office visits. They would have to write electronic opiate prescriptions using two login procedures, do a treatment agreement, check the controlled substances registry, and fill out a slew of forms. We see these patients once, but then we send them back to their PCP since almost none of them actually have a life-threatening illness. Then insurance companies add other barriers. In our practice, our palliative care nurses spend a great deal of time each day obtaining prior approvals on opiate medications for a range of diseases for patients nearing the end of life. So instead of doing the things they should be doing, counseling patients providing psychosocial support or doing advanced care planning, they sit on the phone and on their computers, convincing insurers that a patient needs a higher dose, more pills, or a medication to which they are not allergic. I want to talk now about high-quality approaches to pain management. The CDC's current guidelines take us a balanced approach to opiates that supports cautious use and combines their use with other recommended therapies. There are three main principles. The first is that non-pharmacologic therapy and non-opioid therapies are preferred for chronic pain, but opiates may be considered in certain circumstances. Second, clinicians should establish treatment goals for pain and function. I think function is especially important here and monitor response. And finally, clinicians should discuss risks, benefits, and patient and clinician responsibilities for monitoring therapy. I think these are pretty sensible. So now let's look more closely at some of these alternatives or complementary therapies. A recent study in JAMA by Aaron Krebsen colleagues compared opiate and non-opiate approaches to chronic back and knee pain. Regarding their primary outcome function, they found that opiate medications were no better than non-opiate medications. Regarding pain, there were significant differences with opiates outperforming non-opiates, although they noted that on the scales they use, this differences were probably not clinically meaningful. This means that for fairly healthy older adults with chronic musculoskeletal pain, non-opiate approaches are the way to go. For these patients, the move away from opiates is the right approach. The complexity is that many patients that I see, and I'm certain that many of you see, are not like these patients. They have bad kidneys and can't take non-steroidal medicines like Advil and Ibuprofen. They are old and become cognitively impaired with amipramine and gabapentin. So for these patients, opiates might be part of the pain control solution. A second important approach is high-quality pain management. So this randomized trial by Kurt Krenke and others tested a nurse delivered in-person and telephone intervention for patients with concomitant depression and pain. They treated the depression first and then worked on the pain. They found significant improvements in both pain and depression with the intervention, suggesting that high-quality follow-up can improve quality of life. And here you see the results for pain with improvements in both interference and severity. Another extremely important opportunity is the use of non-pharmacologic interventions. A recent really fantastic VA review identified several interventions that are relatively low-cost and effective. These include cognitive behavioral therapy, exercise and movement therapies like Tai Chi, and manual therapies like manipulation and acupuncture. These relatively low-cost, low-tech interventions are rarely implemented because they are poorly reimbursed. So using non-opiate medications and non-pharmacologic approaches are effective ways to reduce pain and reduce needless suffering for patients. An ethical approach to pain management will include these elements. So now to conclude, I think there are three recommendations that will be important going forward to providing high-quality and ethical pain management. First, policy, law, and medical practice must concurrently address pain control and opiate addiction. Swinging back and forth between the two causes is harming our patients. Second, non-opiate approaches to pain should be widely implemented, including pharmacologic and non-pharmacologic approaches, and they need to be paid for. Third, treatment options for addiction must be expanded and availability and covered by insurance or free. So persons with addictions who are ready to quit can find the resources they need. Failure to address these twin problems of pain and addiction will continue to cause substantial suffering due to untreated pain. Also, because people with pain and emotional suffering will continue to seek relief, our current policies will be unlikely to reduce abuse and diversion in the illegal sale of heroin and prescription drugs. Thank you. Well, relative certainly to addiction treatment, I think relative to the harm in lost work hours, productivity, other societal costs of not treating pain and addiction. So I agree that if we're going to do a cost analysis, we have to do a broad view of the aspects of costs that we're considering. I would say saving one addiction would be a low-cost intervention. Rick Kodish from Cleveland, thank you for that very nice talk, something that's certainly been on my mind too. I wanted to know if you have looked into or seen much about sickle cell disease specifically in this problem as a clinician who cares for kids with sickle cell. I have concern that it's obviously vasoclusive pain crisis is a bad problem and opiates work, and I haven't seen much about this issue that you raise in terms of the tension between the policy issues for that specific population. Yeah, I have to say that I'm not specifically expert in that area. I do know, I mean, again, when I was trained, people said that sickle cell patients would never get addicted. That was clearly untrue. So again, in any chronic disease that causes severe pain, I think a balanced approach is the most appropriate. I think we can do risk assessments on our patients. There is growing evidence of patients who are at high risk for addiction, but I think a multimodal approach is definitely a value. But I'm not familiar with cutting edge researcher if there's enough research on patients with sickle cell. Do you know anything about the pharmacogenomics in terms of addiction risk? Pharmacogenomics of what? When you talk about trying to assess our patients for risk of opioid addiction, is there a hope that there will be some genomic assessment of that risk that'll help to nuance it? Yeah, whoa, mic drop. I think that there is hope for that for the future. I think right now it's widely clinically available or more about psychosocial risk factors, although I think pharmacologic risk factors would be important and valuable. Hi, September Williams. I've now been around long enough to have learned a lot about addiction communities and sort of self-help groups, Al-Anon and different places. There's a phrase that always comes up in those communities, which is no think. That when people are addicted, they do things and there's no think. And it occurred to me that the no think principle really applied to what happened when we recognized that people who were dying of diseases that were painful should actually get pain medicine. And then we allowed as a group of professionals and as people who listened to pharmacology entities and as people who were almost simultaneously relinquishing control of primary care doctors or family doctors from their patients and transferring it to piecemeal. We had this bright moment of about 10 years where family medicine was the continuity of care and then the gatekeeper concept came in. So when I think about this stuff, I think about where the no think started and how you can back off of it. So this idea that palliative care is the same thing as chronic pain. So if you could give me a no think point in history or in the history of your own career, I'm just curious, because that's where I see the no think part happened. It's where I just described it. What do you think is the no think? Well, that's interesting. I mean, I think for me in my own training, the pain is the fifth vital sign was the one. I mean, it was, I think, I mean, of course then, now people call everything the fifth vital sign they're supposed to screen for 15 things and they're each the fifth vital sign. You know, I think it's highly problematic to come up with a problem without coming up with a solution. It's very, I mean, I think that was part of the problem as we were told and I certainly believed it as a resident. Believe your patient's report of pain, you ask about their pain. This is epidemic of untreated pain, but we're not gonna give you any tools that are new to deal with it. And I think addressing one side without the other that would be a great definition for it as no think. And then I have just one quick follow up. You know, I know acupuncture is covered in the Affordable Care Act, but I'm wondering how many people are aware that clinicians can use and prescribe other alternative therapies in many states if their license allows them to prescribe. And are you aware of that and do you use that as an alternative? I think issues of prescribing and coverage certainly vary.  For many patients, some of those things are not available. For example, Medicaid in my state covers very little of those kinds of things. So it is varied locally. I hope the expansion of coverage is something that we see in the Affordable Care Act. That's wonderful. It was buried in there. Jennifer Hartlin came back out of retirement to make sure that people knew it was aware that they were aware of it. Good to know. Yeah, thank you very much. Oh, should we take one more? All right, last question. Oh, thank you so much. My name is Hannah. I'm an internist. I really appreciated your talk, learning about how your experience as a resident sort of informed your thoughts about everything. I definitely trained at a time which is current where the opioid crisis is literally talked about all the time. And your case number one really struck me that you mentioned about the patient with pain related to his malignancy who also had an opioid use disorder. And I think there really is a role for things like suboxone and methadone for patients like that, as opposed to completely writing them off as people who don't merit opioids for their chronic pain, because that patient, from my perspective, was not being appropriately treated for his opioid use disorder. So I guess that's more of a comment. And I'm curious what role you think MAT medication assisted therapy has in palliation for patients like that. Great. I think it has an important role. I mean, I do believe that MAT is an important part of the solution, which is medication assisted treatment for addiction. I think patients like that ought to be treated within a treatment, within an opiate addiction treatment program. So for example, I can't prescribe suboxone at all. I could prescribe methadone. I could certainly do that because I can say it's for his pain, but it actually is for his pain and addiction. And so we need more providers who are both able to prescribe medication addicted therapy and second of all, people who are both palliative care expert, have both palliative care and medication assisted therapy expertise. Yeah. Thank you. Thank you very much.


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Can we all tighten in, you guys back here if you can tighten in a little bit, I have a show that you're going to want to be up here to see, you'll be happy that you're there. My name is Snugs and one of the things that we do when we start off our meetups, have you all seen this whole you know mannequin challenge and all that, where people are just like that. So what we do in New York is we have handstand challenges.  So what we're going to do is you're going to count me down, you're going to say one, two, three and on three I'm going up.  I bet you it's the first one, right? Okay, so are you ready? You guys ready for this? Okay, so I was going to be on you all. We have to do a community, one, two, three, up and then clap until I drop. How about that? Okay, I'm waiting for you guys. Keep clapping, keep clapping. My yoga teacher is going to be so happy on that one. Thank you so much. That's a nice icebreaker. I feel good. So great, we're all happy here and we're going to get to business. Now this is a talk that it touches me, I know it's going to touch you. It's taken from the point of some people in history and also some of the words of the people who are in NYCRB and the things that they say. And we're going to get a little bit inside of their heads as well. I can promise you that it won't be offensive because they kicked me out. But it is going to resonate with you. You're all interested? And it's mostly words. So here we go. Why is open source so closed? So semantics of words. When words pop up, they resonate with us and they trigger certain things. Sometimes good, sometimes bad. And so this is right here, can anyone tell me who this is? Augustus Caesar, why is he so awesome? I guess so, right? So usually personalities pop up out of cults. Can anyone tell me what this image is of? Apple One, actually, this was a little culture cult, if you will. They call themselves hacker cults. The homebrew group. So this was where a lot of interesting things came out of. I consider it really the first open source group and before it got a little bit of wrong fingers in a bunch. But if you don't know anything about the homebrew group, it's a little bit a head nod to it when you ever brew and stall something. I won't go into it into detail, but it's definitely something that you should understand about your history. Because out of these cults oftentimes come personalities. So if we go back, this is the homebrew group and it's infancy. And this is the homebrew group around when you kind of knew everyone, but didn't quite know everyone, you see some faces, they come and they go. But there's definitely movement within the organization. So personality, that reminds me of one of my favorite, I love 80s rock, metal, I'm a drummer. And there's this one band called In Living Color, and they had this song called Cult of Personality. And if you've ever heard it, it's just such a song that resonates with me. One of my favorite lines is Neon Lights, Nobel Prize. When a leader speaks, that leader dies. I like it because it's dramatic, so you have the sadness in it. And you also have the happiness because how often can you rock a body glove, like surfer outfit with a leather jacket on while you're rocking on stage? Like who does that now? So now, once people have their personalities, then all of a sudden we feel, yeah, okay, we can do that. That was a little bit of snafu. But once we have our personalities and out of these groups, we have this notion of free, like, my God, I can write code and all I have to do is just, rainbows out of my mouth and then all my tests pass, right? This is the feeling that oftentimes within an organization with NYCRB, we have a churn of people who come out of boot camps and things like that. And that's exactly the feeling that they feel. Now with the problem with the word free, I won't say a problem, but it's used for very many things. There was actually an issue with the word free from back with Open Source, where they stated, well, free, I don't know if you kind of get the word. So the issue with the English language is we use one word for many, many things to words in other languages, like your Latin languages and such, there's explicit words for certain things. So then the word gets out, like everybody, we're gonna go to these boot camps. There's gonna be tons of work for us to do. And you don't have to even really do anything, but just raise your hands up and then press this button and code starts creating itself and stuff. I got a cool scaffold. So after they come out, then there's a notion of demand. When you hear the word demand, how many people, pardon me, pardon me. There we go. Hello. So when you hear the word demand, can I see or raise the hands of how many people feel that to be a positive word? Okay, that's about half the room. How about, I like your answer. How many people see it as a negative word? Can you raise your hand? Interesting. It's like almost half and half, fascinating.  Or the pull request. What about command? How many people see it as a positive word? How many people see it as a negative word? Fascinating. Oftentimes even with demand, how many of you saw it demand as in the matter of economics? Okay, cool. In French, which I study frequently, I'm actually teaching myself. The word command actually is more assertive. I don't wanna really say negative or positive. Demand is to ask. So there's a lot of language differences, especially with Google Translate, where you can say, I want to demand a something and you're really asking.  Because now you're demanding. It's a context even of the words around it. So we hear about, there's so much demand in being a developer when you come out of these boot camps, right? There's demand.  So it happens in two ways. There's pressing horizontally and pressing vertically, horizontally, or let's start with vertically. Vertically would be when the boot campers come out, they're fresh and new.  We're looking to mid to senior level. Who's ever heard that? Who's ever been there where they weren't mid to senior level and they heard that?  So that's horizontal or vertical. Horizontal is, you ever have that feeling sometimes where you're working with someone and they're like, well, why do you do it that way? You should kind of like do it my way. Why aren't you, then this is why we have things like rubocopies, like that to keep us from pulling our hairs out. But this is a real thing and it's tiny. You don't ever really see it unless you squint. And we not only do it amongst ourselves, but we do it to ourselves. And then the supply drops. And what I mean by the supply dropping, it's twofold. The supply of jobs that boot campers thought that they were going to get is no longer there, if it was even real. But that's just a path that they took.  There is still demand, people still want time. But what's fascinating is that demand doesn't shrink, supply actually shrinks. And the ones who control the supply are actually the ones that are in the more control. So what's interesting to me is it seems like developers actually should hold more control of the supply. But it seems like it's flipped because the supply of the jobs are no longer there, or at least that's the impersonation that these people have. I have to deal with it every meetup. Man, I've been looking for this job like I went to boot camp, like everyone said, it's two years now. What did I do? What did I do wrong? So then we find the understanding of the true word of free. Free, there's two forms of it in Latin. There's libre and gratis. But we in English, we utilize it, we say the same word for both situations. Little did they know, they thought they were free. But their version of free was actually gratis. And since it's zero, you might as well get rid of the money. That's what you feel like sometimes, or at least I have.  I'm not seeing any productivity from it. And what's fascinating about this word is I went back in time and did some history about this word. There was a physical sense, which I'm sure we don't have to go there. We all know about that. But then there's this mental. I feel like in this day and age that the mentality of slave is just that in the head. I was talking with my mentor the other day, and I said, in 2016, it seems like slavery is more mental and it's self-inflicted with fear. We say, I don't think I'm good enough to do that. And they have to have someone kind of pick you up and such. And it's like you're beating yourself up for no reason. And then that whole idea replicates, because that's what we do when we have those. I mean, who has ever run a database cluster? That's exactly what we do. We take the same mentality and we let it proliferate. Because remember this talk is about the people who are behind the machines, not just machines. How does our mental patterns translate over to the machines and vice-versa? So then once we feel that sort of, well, what's going on here? Like I know something's not right, but we're all saying the same. And you try to talk to your colleagues, but they're talking upside down too. And you're trying to have civil conversations, but you're doing it, but everything's flipped. And what I say by everything's flipped is because you and I, we could turn our heads and see that that says civil, but everyone else is looking at us like, why are you turning upside down like that? But we don't know that. Then disorder comes, like, I heard there's something new out there. I know what I'm doing is great. I don't even want to look over there. But why do so many people keep looking over in that direction?  What's this clothes sign doing on our door? And we didn't put it there. Wait, why didn't anyone tell me that we were clothes? We're out of business? You could have told me this before. I had some things I had to set up. And you feel sort of abandoned. It's like you know this great skill, but you don't know how to push it out into the world, how to market it. You don't know how to, who do I talk to? I put so much time into this.  So why? Why is this happening? Maybe there is a more radical approach we can take. I was doing some research with a lot of the things that are going on in the world today, and I actually wound up tripping over Dr. Martin Luther King, who does not know who Dr. Martin Luther King is in here. Honestly, you never know, right? So everyone knows who Dr. Martin Luther King is in here. Have you ever heard his, I have a dream speech? Okay, what if I were to tell you that with some colleagues of mine in Stanford and also with some information from MIT, I uncovered a document that not only could be beneficial for us all in how we're thinking, but we can use it in our day to day as well. And I'd be willing to say that the majority of people in here haven't even seen it. But it's just as valuable as I have a dream speech, would you be interested in seeing it? In Bennett College, there was an interview with Dr. King. On 11th February, King delivered a realistic look at race relations to an overpacked audience in Bennett College's Ann Myrner Pfeiffer Chapel. And his address, King, stressed the importance of a ballot. While noting the limitations of the two major political parties, quote, I am not here to tell you how to vote. That isn't my concern, I'm not a politician. I have no political ambitions. I don't think the Republican Party is a party full of the Almighty God, nor is the Democratic Party. They both have weaknesses. And I'm inextricably, nailed it, bound to either party. I'm not inextricably bound to either party. And I'm not concerned about telling you what parties to vote for. What I am saying is this, we must gain the ballot and use it wisely. So at first I thought, I mean, it's really messed my head up because I was like, wait a minute, that's not what I was kind of told before. That's not what was passed down to me. How am I being offered and saying that I have alternatives? It's not that something's better, that's better. Go over there, it's more have alternatives. And I tried to refute it, and he said that you can move mountains doing this. And this is actually in the Washington Memorial, they have it so it seems like he's pushed out of the mountain. I think it's one of the most, like it's a breathtaking structure. And it definitely resonates for sure. It says out of a mountain of despair, a stone of hope. I still couldn't get it though, I'm like, why? I'm like, why? I had to actually take a step back and reformat and reprocess my home brain, because I'm like, wait a minute, I'm being told that it's okay to have options. It's okay to sort of dip your feet in both sides. And then I'm taken back to my good old Uncle Bob, where after about a handle of, I don't know, I think it was 15 shots of bourbon. Tasters, tasters. And he had a talk where he was telling me, he said, look Rashawn, a lot of the ways you're thinking are very innovative. And when the tide changes, there will be people that say, don't do that, instead of saying, this is why you do this. You want to be wary of those people because those people don't realize that that tide is coming in. And he said, one thing that's very important to me, there's two types of people. There are people who swim against the waves. And he says, there's people who know how to surf. And so he's like, you want to surf the waves. When a new technology comes, jump on it and surf it a little bit. Or swim against the waves, the choice is yours. But typically the people who have tenure in their career, that's what they do, hashtag wavy. So that's what I did, I said, I'll take you literally, I'll take you up on that Uncle Bob, and I went surfing. I tested it out, every single place you see there is a check in actually. And I spent about, I'm still on this path. I actually just got off the airport since right before here. I said I would go out and find myself. Other people have said you have to travel when your brain gets to that point where it's like, oh my God, it's like, there is no spoon, everything I know is not real, you have to go out. You have to be mobile, you have to go search, you can't just be inside and sit. You don't have to travel as far as I did, but you could go and say, hey, I haven't talked to you in a while. You know of any stuff that I can work on or anything that I can drum up, you're taking it into your own hands, not waiting for someone. That's that passion Abdi was talking about on Ruby Rogues. So then the word doesn't quite seem so bad once you have like-minded people around you. You put some oer on it, it doesn't sting so much, still the same root. And as I'm traveling around, and actually Dr. King did the same thing, they said that they didn't really understand how the world was until they were mobile. They say that when you travel, you have an extra pair of lenses to see the world through. Some of the greatest problems I've ever solved have been me on an Amtrak train, just like, oh, there it is right there, actually in the bathroom in an Amtrak train. Because they typically say you have your greatest ideas in the bathroom or in the shower or in the kitchen or something like that. Some place where you're at your physiological response side of things. So when I was in France, actually, which I travel too often, they asked me a question. I said, why do you use this two-party system thing that's going on? I didn't know anything about this word. And he says, we have like 10 people. And when somebody wins, they go and they reach out to the other nine people and say, you know what, you had a great idea. I like what you did, Alucard. Your idea was awesome. That one thing, I don't know, buddy, but, however, you did show passion in his idea. So why don't you two work it out? And this is after the electoral process happens. And he said, you don't even have the ability to be set up within that whole two-party system. When Martin Luther King actually went to Sweden after he kind of had that y over his head when trying to figure out what he was doing, he went to Sweden and he met socialism. And you notice that there were no slums.  And there's no slums. There's no bad places. Maybe there were, but to you it was all new. It didn't look like it to you. It doesn't mean that you're gonna stay over in that place. You'll definitely come back, but you'll see the world through a different set of lenses. One of the areas that is often not touched on is capitalism. The fact that we like to make money and feel good and earn things.  And isms are as isms are. However, they are real. There are real people who come to me by the hundreds that say, I'm a junior developer trying to get a senior developer and there's like this chasm right here and I just can't get over that's what I call like the middle class of developer. The mid, you know what I say, mid to senior level. I still have yet to see a mid person yet. You know, I've seen senior, I've seen gray beard. I've seen ivory tower once or twice. I think he was wearing Birkenstocks. And I've seen junior and I've seen, you know, new. And I've seen I'm scared. And I've seen, I've only been writing code for like a month, dude. Like, you know, I can hack up the heck of a HTML page where I know how to, I'm your Postgres guy. I don't know anything else. So how do they make money? Where do they go? One of the things that we don't learn as developers is how to market ourselves. How to actually go out and say, this is what I have to offer you. You can be a great minded person, but if you never open that mind and show other people and solve their problems, it's gonna be very difficult for you to eat.  Not the gratis, well, definitely the gratis, but definitely not the libre.  That means you get freedom for free. You might have to pay a little bit for it, but the amount that you will see from your eyes, now this could be in travel, this could be in front of your computer, in that one little gym that you've been itching to taste, but just cause it has semi-colons in it and curly braces, you don't want anyone to let you see you over there, but you know, that's the oppressed side. And there's free beer, but never forget home. As I was traveling and as I encourage other people to travel, even in their code, I encourage people to travel in their code just as much as I travel physically. Go out and explore other gems and other repositories.  But then again, what's fascinating about Ruby is, Ruby reminds me of America a little bit. At the end of the day, none of us are really from here for the most part, but that would be disrespectful to a certain few because there are some who are the first. We must pay homage to them, but we also have to realize sometimes what we call home, others might tell us, you might want to put air quotes around that, right?  It's all relative, right? So when I got back, or when you do come back, you'll notice that your open source was slightly open because you've seen someone else's and you're like, well, wait a minute, like they got this cool stuff over here, how come I'm not doing that? Perfect example is in the conference room or in the speaker room before, let me check my time here, excellent. Okay, great. In the speaker room before, one of the gentlemen said, yeah, I went over to JavaScript, I tried some things out and it was just, I was so happy to get back to Ruby. It was, was that you?   And I said, well, is it really that bad? Because my mentor, Tom Mornini, who he is a founder of EngineYard, and he put it in my head, and I know I'm saying this wrong, Tom, I know, but he says, it's to the akin of any developer can write equally bad code in any great language. Say that with me, please, let's do it. Any developer can write equally bad code in any great language. So when that happened, I mean, I saw kind of the click in his head, and I said, well, one of the things I got great from JavaScript, I just rolled over there, and I fall onto being a contributor to one of their projects. I find a project called Roll Up, which I'm a contributor to right now, and then I look at the ecosystem, I'm like, well, wow, everyone's using Babbel, but this thing Roll Up is so cool, it's got, I just put my JavaScript libraries into it, and my code was 20% slimmer immediately, and I can throw SAS into this and CSS and templates and all of this, and it just compiles, like, squishes everything down and leaves a thumbprint smaller than Webpack and all. Why didn't no one tell me this? Because they still have me over here programming in CoffeeScript. Like, how come I'm not experiencing all these cool new things? So it was slightly open. Then I started, then I feel that, and then you often feel that sometimes, especially when you go away and then you come back to something and you realize it wasn't just what you thought it was. Hate's a strong word. I often tell people that hate is a form of love. Hate is love that you don't understand. Hate is a word that developers often use when they're learning new technologies.  And then he went wild into JSON and he, two hours later, calls me back, say, hey, man, after the meetup, I went home and I programmed JSON for two hours and I love it, dude, I love it. And I'm like, see, well, you did have a hate for it before, but now you understand it, and now you have love. But we have to really be cautious that hate actually can draw more emotion out of us because we don't understand it, so we'll spend so much time in it. Who sat there so long, like, I'd just be done in two hours, and seven hours later, one more hour, I promise, right? That's the hate turning into the love. Then once you understand sort of what's going on and can shed emotions and such, and whether you're traveling or in GitHub repositories, you see what I'm doing here? When you're in the mind, the mind is an interesting thing. As we said before, my interpretation of what slavery is starts here in your head. Knows no boundaries, no colors, no financial sectors. Probably does more so there than color. What you then do once you understand what's going on in your mind and what you want, you then go find like-minded people. This is the critical part. One of my mentors stated that you find, typically people who are similar-minded look the same, but if you would like, or correction, let me rephrase this, typically, people who are like-minded, you'd expect them to look the same. However, there are many, many edge cases you'd be surprised.  There's many, many edge cases. There's more than you'd actually think. What I mean by edge cases are what I call the line of demarcation, where you have two ecosystems that are landing, and they might call, that might be where the line of scrimmages on a football game or in a battle, that's where that line is. And what winds up happening is that's where the most action and the most learning happens, because he may be programming in React and learning APIs a little bit. I might be in, not able to use this microphone, but I might be programming in, say, Sinatra, and I don't have anyone that can do front-end work. So if I just bump into him, maybe just say something, instead of just kind of in our thing, like, hey man, what have you played around with? We do this all the time in NYCRB. We literally make people get up and say, what are you proud of? What have you worked on? Talk to somebody you've never talked to before. You could be sitting next to a person who has opportunity for you. He's an API developer and she's an awesome graphic designer and if they link up together, wow, I can actually see my code that I've been working on for so long and I don't know CSS for. That's where the ecosystem comes from. So then you actually can do some unboxing. This word's sort of been resonating with me, especially the past week of my life. Unboxing. I've been unboxing emotions, possibly. That's an unboxing. Unboxing. Can someone give me another, if you hear the word unboxing you had to put your own definition onto it. So what resonates to you, mine was unboxing emotions. Sometimes unboxing economics. I have people in my meetup that say, I don't know how to market myself and make money off of my skills. I feel like there's people who are overseas that are undercutting me and I can't, and I'm like, that's fear. Fear is an acronym. It stands for False Entities Appearing Real. Those are the things you want to unbox. You want to get it out of your life because those are energies that can hold you back. So can one person tell me what the phrase unboxing means to them? There's someone in here that it's resonating with right now to unbox something from you. Anyone, can you raise your hand? Someone help me out? Yes. That's a fair assessment right there. You're trying to peek inside something that's a black box. It was opaque to you before. You don't know how to open it up. You might have to bang on it a little bit like Space Odyssey with the obelisk, but the goal is that you don't know what's inside of it, but once you do, you're not afraid to address it. I think that's the most important thing is that we have a lot of baggages that we have that we need to address and get out. When I teach at NYU, actually my number one student was a woman who retired. She was 66 years old. She played French horn professionally and she just wanted to learn a new development language. And I taught her and she wound up being, my gosh, she's one of the greatest programmers I've ever seen. I tried to hire her multiple times and she said, I'm just here for the fun. I just wanted to learn a new language because to me, music and programming went together and all of that. And I was like, you're the unicorn. Come on, let's get this money or something. And she said, no, I really do it because I'm passionate about it. No names, but the worst student that I've ever had was a guy who was a developer. I won't name any names. I almost did for 15 years. And he had 15 years worth of baggage in his head that he would not let go. It was just holding him back too. And he actually quit the class after the first exam because he said, this Ruby, it's just too wild for me, man, it's not even a safe language. I heard it doesn't even scale. So then once I came back, I realized I still had a little bit of ability. I can put both feet into, if this was a line right here, I can dance over here in Ruby and possibly contribute a little bit over in other technologies and such. I came up with a package one day called bubble tape. I remember I used to eat this stuff when I was a little kid. My mom hated me for that. My dentists love me though. And what bubble tape is, is I started venturing off into the Java ecosystem and with the Java ecosystem, they have little, small, tiny succinct tools and I started removing my asset pipeline from my system. I started getting, building more APIs and then I started saying, well, how do I get these templating systems? And I asked the whole Ruby community at NYCRB and even on Gitter and such. And I said, well, what can I use for asset and pipelining for APIs? And everything I just kept seeing was more integration.  And I just said one day, you know what, I'm never doing assets in Ruby again. I'm gonna let something that actually has proven to do assets better in a JavaScript ecosystem that doesn't mean I'm leaving Ruby. It just means I'm building more kick-ass APIs and I'm worrying about things like, well, how do I get this view into my endpoint? Really, we're doing content negotiation and HTML parsing all in a, that's a little rough there. So what I'll do here is, let's get out of here and I'll show you a couple of things before we take off. Now, bubble tape is this, you can check it out too. So what bubble tape does, let's, I'm really good with this marketing talk here. It says, let's see here, six feet that it does. It has ES6 transpilation, multi-entry bundling. So just think when you have these JavaScript libraries that you want to bundle up and it might be this thing has four dependencies, then you just throw it all through bubble tape, which really is just roll them, or roll up with a great configuration and then you have your bundles distributed. That's for my home page, even though it has five different dependencies. It just takes all of your modules and does it in microseconds. You know, the asset pipeline probably still takes a second to load up.  I never heard about that until I went over to the ES6 land. I was like, what is this dead code elimination? They're like, well, if you have module A and B and module B has two methods in it, but module A only requires one method in module B, it's gonna just delete that second method in module B while it's bundling everything up. And I was like, what? Ruby's gotta have this. Does Ruby have this yet? That was his answer right there. Either way, you know where it's coming from, right? Because oftentimes we wanna say, we were the ones who thought of this thing first, but we possibly didn't, right? Where does NBC come from? Did it come from Rails? Where did NBC come from? Java, absolutely. Also, what we do is we process and bundle SAS and let you choose between browser-based testing. Tap, I love it as a format. Guess what, Ruby does tap as well. So now, also I found this, the all contributors here. I got about five more minutes, right? Okay, all contributors.  This is a specification for recognizing contributors to an open source project in a way that rewards each and every contribution, not just code. Ruby developers say, where the heck did these no guys come from all of a sudden? How did they ramp up so fast? You don't have to wait around and talk to you to talk to him, to talk to her, to get back to him, to get my pull requested.  Can you show me how to do that? You get a couple of those, now you're a contributor. What's the worst that someone can do? Submit a pull request. So I admire, if there's any free jewelry to take away for sure, the all contributors, you're going to want to look at that. And of course, bubble tape. HTTP spec, that's a little tool that Tom and I ventured off into, or Tom for sure. He said, hey, how come there's no way to test APIs like straight from the HTTP level? Why is there no ways to test APIs? And then he ventured off into go and I saw him cutting his teeth doing the whole, you know, I'm in a dangerous territory and like, why is this thing so cool? And he told me it was cooler over there. And then he wound up building a framework that is to test your APIs. If you want to test your API endpoints in microseconds, use this tool. It's really that simple. And this was just a proof of concept and it's called HTTP spec, T-mor-nene HTTP spec. Like I said, if you have an API, use that. So we use that to test APIs. I use bubble tape too, you know, that's still node things to do some front and related stuff and I'm now, it's like I'm actually getting more into the pure side of Ruby like I used to. That's what I actually fell in love with. I'm encouraging this to all of the people who are in NYCRB as well. So there's one last thing that I'd like to show you here. Where can you all contribute to all of this? There is the, here, what do we got here? Is this the one? So first, pull requests. This is about, this is a pull request that I worked on with a couple people and I think people don't do enough, do diligence inside of their pull requests. If you see here, we have questions. It's very open. I wasn't even a contributor to this repo but they were just right there answering everything and they're like, dude, okay, that's a great idea. You got it. You get a little nudge or a badge right there. That's really cool. And I was feeling welcomed immediately and I can be honest, it took me a little longer to do that in this community. So that's not a problem. Hopefully I could bring that back to this community, the things, because if we go, we might not, you know, oftentimes we say, well, if I go over to that land, I might never come back. And I promise you, you'll come back and you'll come back bringing some good tidings too as well. So this is last and definitely not, at least I think this is it right here. Here we go. This I couldn't wait to show you all. I'll leave you with this. So I went to Ruby and I said, okay, well, Ruby, let me compare these to, okay, 44,673 commits, that's pretty cool. All right, so we go to the graph so we can actually see some traction because what I wanted to know is what's the contribution of the ecosystems? How did node just hockey stick like that when Ruby's been around twice as long? No, much, much longer actually. And so I was like, oh, wow, there's tons of people here. This is so cool, this is so cool. I wish I knew how many people were in this and the Ruby side of me from the old school way would say, oh, well, let me install this gem. I'm gonna create this gem and wrap up all of these things and, wait a minute, you're in a console, dude, what are you doing? Query selector, I use dollar sign. What is going on with, what? Okay, and so I was like, what, there's a pattern here. There's definitely line items. Let me find out some class on this thing and let me go into the browser and, yep, yep, there, I found it and up some weird mart, oh, it is, oh boy. Yeah, so repo seems to common pattern. So I'm gonna do query selector all repo. By the way, that's all you need for jQuery now. That is jQuery pretty much. So there's a thousand. There's a thousand contributors to Ruby. Wait a minute, wait a minute. I know what I'm about to do next. I am going to see how many are in node. You already know what you all do when no one's looking. 18, what was that number? 18,000, what was it? Did anyone see? Okay, it's like 18,000. Here's the piece de resistance that should, that is, I'm telling you, it's gonna light fire up under your butts. What are the chances of that? Let me pause that. What are the chances of that? What are the chances of that? There are 1,000 contributors to Ruby, which started eons ago. There are 1,001 people contributing to node. So one person in here could actually topple that off. Not to say it's a topple, but why are we so competitive? Why do we have to be competitive? Why can't we be complimentary? Because that's something to not shake a stick at. If you've been around for 10, 20 some odd years and someone comes around and within a couple of years, now they just are one up, they just one up this. So approach it from a non-competitive form but a very complimentary one because look at how fast I got answers. I didn't install Ruby, I didn't install gems or anything, I just went right into platform. And we can go back to my slides here, like one more. Great, so now, since we are all wide open and you know how to go to all contributors, definitely please read it and as you read it try to pass it on to as many people as you possibly can. Famine, that's another word. If you see I've been trying to have trigger words here a little bit but not trolling words.  If you're using my tool, if you're using my tool and I'm not getting the idea out to you because developers oftentimes are very precious. You know, oh, it's just one more little tweak of that thing right there. One more optimization, you have to approach it like the feature you're working on that if the person doesn't have it they're going through famine and one extra day they're not going to eat. Make that person feel important and watch how fast they give back to you. And don't forget to pay homage as well. That's where cyclical mentorship comes. If you learn something, pass it on to him and the minute you learn something, pass it on to him and pass that on to her and you don't have to be smarter than anyone, it's piecemeal. It's not a total thing. If you learn one new cool thing, pass it on to someone else if you expect someone to teach you. Does that make sense? Kapish, everyone? And speaking of homage, this is my buddy here. I told him that he's in NASA and I told him that he was like, well I helped you get your jacket, we got the same jacket, dude. Shop me out, it's Veterans Day and he is a veteran and I just wanted to say happy Veterans Day to you all. If there is anyone that would like to have me pair with you and sort of expose and hold your hand onto this sort of new culture that's emerging here, I am always willing to work with you. I work successfully with 5,000 people at NYCRB and all of them are extremely happy and they're damn sure full of pizza. My, our sponsors have told us that. But happy Veterans Day and thank you for your time and thanks for letting me do a handstand for you. How cool is that handstand? Thank you, thank you.


Yeah, we on boss talk one-on-one Hey, how y'all know this is boss study study and we is at the Magic show in Las Vegas with all the top-notch designers Oh, yeah, I keep it on Oh Right there, you only you only Yeah, yeah, that's all you did. I know you had a baby. I see you look great Hey Yeah Look how you do it Man Right, man, so that's the family right so everybody out here getting to it, man Everybody out here trying to do that magic thing man. So y'all better know it man. What's up, man? So how long you've been coming to the show? Look who we just bumped into man. Hey, man, if you want to do dopest Organize you ever want to fire man. She's some male Missed up with the last time, but we get we get it back on track right now Yo, man. Hey, man. Listen, man. Tell them about the brand again. Oh, yeah, well-timed garment collection Listen man bling bling everything Don't stop don't sleep on your stuff may talk to bosses only bosses if you can't be a boss Oh, what oh what boss?  Happy man It's over we go we got to go interview your brother. Yeah. Yeah We love you, bro. You know that already every Valentine day man. Yeah, we could get him What can I ask him give me give me some? Hell, yeah Give me something. What can I give you? Give me something Let me get this What do you do with you little that you would know without you that gonna let it out the band and ain't nothing bad What did he do oh He probably give me a guy named there was a hard fight that they may know give me a hard fight with a dude That made it kind of nervous like dang when he got into it Give me the guy name No Let's just stop for a second and just thank God for being up here mess Valentine's Day hanging out with miss Jamaica Man, you know what man? Hey listen man All I'm gonna say is man make sure you guys tap in man this year is gonna be a wonderful year It is the season to be jolly. You don't stand Christmas over That's Christmas, but Valentine's Day is the season for lose Sexy to make babies what yes to be in love Man, you're gonna make a baby. Yeah, let's do it. Let's do it tonight. It's going down man All our people back. We go out. We're also gonna have gonna have labor on uh prime time boss I want one prime time. So she'll she'll have the baby on prime time In nine months. Stay tuned the boss talk one of us. I won't both.


The second most important problem for any organization, for any company, for any lab, for any project is recruiting excellent team members to take the vision and turn it into reality. For that, we're creating a talent network that can help groups across the network hire and onboard and train and grow their people. Hey everyone, super excited to be here today. As Juan just said, the talent network, quick overview of it to start. We've built up this talent network to source, hire, onboard, and train as much talent as possible into our network and ecosystem. The really awesome thing is that even though we already have a large network, like you can see in this room and everybody on the call here, we only expect this network to grow in 2023 with more companies, more projects that we look forward to supporting with all the different resources that we have here. The mission of PL Network Recruiting specifically is to export one of our greatest superpowers, recruiting, to all the companies and individuals in our network. This year alone, we have onboarded 75 companies to our network job board, have had over 37,000 applicants with a 30% increase month over month, and we have hired over 270 people into PL in our network, many of whom are sitting in this room here right now. So congratulations. Most importantly, as we look ahead, we've scaled our recruiting team from six to 36 in just the last year so that we have significantly more resources to meet the growing needs of our network as we move forward. PL Launchpad is a six-week onboarding program for new hires to the Protocol Labs network designed to accelerate technical growth in the Web3 space. Since launching Launchpad last November, we've graduated over 200 residents from 20 different organizations and equipped them with the technical Web3 knowledge, PL Network connections, and cohort community and culture to be successful in any company across the PL network and beyond. If you're part of the PL Network, we'd love to help onboard, connect, and train your new hires or hear any great referrals. Please register on the Launchpad website above. The PL Network is also an amazing place to grow, thanks to the awesome systems for supporting and recognizing individual impact across teams. We're working on opening up PL talent resources like PeopleOps Playbooks and Guides, a PLN career ladder, performance review, compensation systems, and many more. If you'd find any of these resources useful, please get in touch with the Starfleet PeopleOps team so we can help prioritize which areas to focus on first. So how can we partner? There are many different ways. The first is basically if you are not on our company job board yet, send us the information we need to put you up there. We actually have the potential to be the largest Web3 Network job board in the world and we have a goal of getting to that by the end of this year, so let's try and make that happen. We also want to know more about your companies. We can't recruit for you efficiently and effectively unless we know information about your hiring needs, what your company is like, the environment, any sort of relevant information would be absolutely awesome. We'll be sending out surveys, obviously that's very manual though, so we'll eventually have some tooling solutions to make that a little bit easier. Lastly, as you saw in the last few slides, there's a ton of different resources that we have available for all the different companies in the network, but there may be things that we're not covering yet that you guys still need, so let us know. Be super vocal if there's something that you need that we're not providing right now and we're more than happy to see if it's something that we can take on in the future. So lastly, we're going to continue to scale our team, implement new tools, implement new processes, and ultimately make the PL network the best place to grow a career in Web3. So thank you everybody.


main entrance. And there you can see the first glimpse of the Indian Prime Minister. What a proud moment for all of us because Prime Minister Narendra Modi, he has been always closely following his vision and mission of neighborhood first, walking towards the entrance where he would be received by the Chamberlain, which is who is the secretary to the king. And they can see now the dancers, the shots of the folk dancers in traditional style. They are welcoming. There you can see with the flags. So there you see every person assembled in respect in traditional style waiting for the Prime Minister to arrive here at the Tashij Zong, which is the office of the king and the other part is the monastery. You can see the dancers followed by the SPG and behind them the Prime Minister. Very soon you will have a glimpse of the Indian Prime Minister. You can see they are also happy. It's a VVIP visit and this tradition of a VVIP welcome in the traditional Buddhist style is given to only a VVIP. So a very proud day for the Indian Prime Minister and at the same time a very crucial day because Bhutan and India go hand in hand for a long time. The monks of the Zong in the traditional style on the terrace and here the ladies there you see on the terrace. They are standing on the terrace. It's a clear vision now. The rains have stopped and all of them they feel like dancing in honor, in respect and in joy. A joyful day for both India and Bhutan. Prime Minister Narendra Modi visiting Bhutan. This is the first visit of the Prime Minister after assuming office for the second time.


Welcome back to our channel. My name is Andrea with Food and Mentory Adventures in Food. Our channel is all about the food. We do taste test, recipes, grocery hauls and what's for dinner. And I am here today with a grocery haul from Trader Joe's. And so Howard's parents are going to be in town pretty soon. They are going to be visiting us and meeting Harrison for the very first time. So I went and picked up some things for them. Some things specifically that they like. Howard's parents eat pretty healthy vegetables and things like that. And so you'll see some of that in the haul. But let me just jump right in. So one of the things that I picked up is some Trader Joe's chai tea. I really love chai tea. This is, it was pretty cheap. I think it was $3.99. And you can make it hot or cold. I've never bought this before so I hope it's pretty good. But all you have to do is add in hot water to this particular one because this mix has non-dairy creamer in it. So you don't have to add milk. And it also has non-fat milk as well. So you don't need milk for this one. So I picked that up. I also picked up some K-Cups from Trader Joe's as well. These are for, I think Howard's mom and I'm not sure if his father drinks coffee or not. But I know that Howard does and he was totally out of coffee cups anyway. So I grabbed some K-Cups for them. And then I saw these on the shelf. There was only one container left. They are cucumber, citrus, base and body wipes. And when I checked out, the cashier said that these things are incredible. So I'm happy that I was able to find the last one on the shelf. Something else I picked up from Trader Joe's. These are for me and anyone else who wants them I really love butter toffee coated peanuts. I saw these at Christmas time but I didn't pick them up. They still have them. So I decided to grab them. Another thing that I picked up are some plant and chips. You know that these things I usually pick up every time I go to Trader Joe's. Howard really likes these. And I don't think that his parents have had these particular, this brand from Trader Joe's or this variety I should say from Trader Joe's. So I picked it up for Howard and also for his parents to try. These are just regular plain plant and chips right here.  Now as you know, Howard is from Jamaica and of course his parents are as well. So I hope that they really like these chips. Howard likes them a lot. And then I grabbed some corn chip dippers. I haven't bought these in a while and I can't remember why.  So I hope they're not as salty as I remember them being but I was craving some corn chips and so I decided to grab them. Another thing that I usually pick up when I go to Trader Joe's is their almond butter granola. I really like this stuff a lot.  He's not a big yogurt person but this is really, really good granola. And it's really hearty and it's very crunchy and it is so good. Another thing that I picked up for Howard and his parents are these sweet plantain chips. Now these are a little bit different because these are supposed to be really sweet.  So I picked up some for her to snack on while she's here. Some things that I picked up to put in our freezer for Howard and I to eat at another time is this barbecue chicken teriyaki. I really like it a lot. I haven't bought it in a while but I remember really enjoying it a lot. I also picked up some fettuccine with mushrooms for Howard and I for a quick skillet meal one day. I picked up some tilapia for Howard's father. He doesn't eat a lot of meat. He mostly eats fish. So I grabbed some tilapia for him. And then I also wanted to try these cheese and green chili tamales. I think it was April at April newly me that has mentioned in her halls how much she really likes these. And I said next time I go I'm gonna grab some. So I think it was her that was always buying these tamales. So you get two in a pack and you can microwave them or you can cook them on the stove top in a steamer. Another thing that I picked up for Howard's family is this cheese tray. His mom mentioned that they like to eat cheese and crackers so I got some, I already have some crackers. So I picked up this variety of cheese for them and Howard likes it too but it's Colby Jack, Swiss cheese, cheddar and pepper jack. And then they also may make some sandwiches while they're here so I picked them up some Swiss cheese. That's their preferred cheese. And then just as a snacking cheese for anyone who wants it I picked up these mild cheddar cheese, mild cheddar snack sticks easy for me to say. And then I personally really just like this puffed, sharp cheddar, spreadable cheese. And I get that not every time I go to Trader Joe's but pretty often and I really like it a lot. Then I picked up some avocados for them for his family. They like to eat eggs in the morning and have avocados and vegetables with them. So I picked them up avocados for that as well as some tomatoes for their eggs as well. And then I picked up an assortment of fruit. I think this thing is, I think it's a pomelo. Howard and I had it before. It's like a mix between an orange and a grapefruit and we liked it a lot. I also picked up this Korean pear and then I picked up these apple pears. So I don't know if his parents would eat these or not but either way they'll get eaten by Howard and I or whatever. I picked up some butter lettuce for Howard and I for dinner. We have a couple of days before they get here so we'll be having after dinner at some point. And then I picked up some zucchini squash for his parents as well when they're here as well as this Brussels sprout as well as these Brussels sprouts. It's easy for me to say I can't talk today. So we're gonna cook this up while they're here as well. I picked up some green onions and also some mushrooms because I'm going to be making a green onion and mushroom fried rice when they're here. And then his mother requested some almond milk sweetened fried in. I've never bought almond milk before but I think this is a pretty good brand and I think most people like it so I got that.  And then the last thing I picked up are two bags of the organic broccoli florets and I'll probably make the mushroom and green onion fried rice the first night that they're here along with these broccoli florets and some type of protein, I'm not sure what yet. So anyway, this is it. This is everything that I picked up for my Trader Joe's haul for the month of January. I hope you guys like this video. I always like to share with you guys whenever I go to the grocery store and pick up some things. I just like to share it with y'all. So I hope you enjoyed it. If you did, please make sure to give me a thumbs up. If you haven't subscribed to our channel, we certainly hope that you'll do so and we'll see you guys next time.


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Hi everyone, I'm Rin Oliver and I use the he pronouns. I'm a non-binary multiply neurodivergent technical community builder at commando You can find me on Twitter at Karen underscore Oliver on github at Salant I'm here to talk to you today about building secure open-source communities from the ground up So let's get started Security best practices in open-source software mean different things to different people So let's figure out some tips and tricks that you can keep in mind to make sure that the open-source communities Your building are secure First things first is that security looks different to everyone when you say security depending on who you're talking to you'll get 20 different answers So what you need to do is define a baseline of what security means to your project or your organization and Improve it alongside your community Whatever security looks like that's unique to your community itself doesn't have to be the same as Everyone that's in your ecosystem. It's going to be unique and it has to be yours security can be Influenced by your peers But in the end it has to be tailored to you and your developer community itself Another thing to keep in mind is to ask how you'll handle when things go wrong Because they're going to if you don't think they well, I promise they eventually will just wait You should have strategies in place that will detail when and how community members should report vulnerabilities what constitutes what a vulnerability is and Evaluate dependency management for your community maintained extensions or public forks or whatever community contributions Those are are you going to require people to keep their dependencies up to date? Are you going to have a policy that says if something isn't updated within 30 60 90 days? You will face some sort of action Etc having those things defined beforehand helps make your security Policies and governance easier especially when your community is scaling at Kamunga in our community hub, which is a centralized location for all of our community extensions We operate on the basis of least permissions necessary Our community members are granted the lowest level of permissions needed to obtain the desired outcome Whatever that may be we're going to give them the least permissions possible So that they can still do what they need to do without impacting the security of the organization as a whole Having a very clear contributor guide with member roles Repository access levels and responsibilities outlined is key to making this successful That way people know if they are a maintainer on a repository. They will get the following Permissions and if they are a contributor they have the following permissions But they might not be able to do everything they typically would do if they're a retainer and if they're an admin They can do just about anything However, be sure that if you are granting admin permissions you understand very clearly what that actually means Read those permission levels and make sure that you're not granting permissions to people that don't necessarily need them So back to that dependency management and vulnerability scanning Here's some tools that you can introduce into your organization that can help make your lives easier Especially for maintainers of open source projects There are a variety of container scanning tools available to you Such as Aqua securities trivy and JFrog and even x-ray Trivy scans Docker files and it works with Kubernetes terraform a variety of operating system configurations and much more and looking for vulnerabilities It also scans for common configuration issues and will alert you if something is configured incorrectly It's also suitable for continuous integration in DevSecOps works with github actions, GitLab CI, Jenkins and so forth JFrog move and x-ray offers impact analysis scans all layers of a move and package Integrates with common CI CD pipelines and also does continuous analysis at Komunda. We're making use of Aqua securities trivy to great success in our community hub and To that extent When all else fails use bash Why because sometimes the solution you want to use might not be the one you actually can use in reality at Komunda we originally had hoped to use Trivy with github actions, but the way our action was written up until recently github actions Did not have the ability to write concurrent actions in that you could not use the uses and with keywords in the same GitHub action now you can do that as of August 25th or so they actually put patch that in but it's still in the works So we had to end up a pair programming across our departments with myself on the developer experience team and Infrastructure team to come up with a way to get trivy into our automated release action without using github actions So we wrote a one-liner bash script that did that and we ended up where the bash script said that if your extension had a vulnerability that was critical it would Return an error code and you would not be able to push your automated release, but if your Extension returned a low or medium security Vulnerability you were able to continue forward with your release if you have a critical release We also coded the fact that it would now update to the github security Advisories tab so that people could see that that vulnerability was there and make an educated decision as to whether or not they wanted to use that extension so Although we couldn't use github actions entirely with trivia at the time Bashed into the rescue and in the end we had to be flexible and we had to cooperate Across teams to get that done and it's working out really well You can take a look at it in the community community hub and check out how we did it and the community action may have a release tool It's really great And it was a collaboration between our developer experience team and our infrastructure team It was a wonderful project and I'm super happy that we managed to get trivia working for our community members There's also a lot of opportunities for dependency management and code quality tooling out there And you've seen these everyone's seen these and I'm pretty sure that everyone's marginally annoyed at some of them because of the amount of alerts ban they can generate But that's okay because that's telling you a lot of things that you'll need to know There's codecub white source renovate and dependabot which is the one that everybody knows because it was recently made part of github itself so codecub is Source code coverage for over 20 languages can't list them all but codecub covers a lot and It's also CICD agnostic. So Whatever CICD tooling you're using codecub probably works with it It's also usable with multiple cloud platforms that works with Azure. It works with GCP, etc It also reduces manual testing via automation codecub will show the amount of coverage test coverage for your code and it automates whenever you push a new release it will Throw out your coverage and shows people about the amount of your code that is covered by testing Renovate is really awesome in that it's an alternative to dependabot and Renovate depending on what you're doing can be better or worse for you than dependabot I'd highly recommend comparing and contrasting the two not necessarily apples to oranges more like apples to a different kind of apples Which is fine But in the end it really depends on what your use case and your scenario is I like both of these things because they do slightly different things and slightly are slightly better depending on the particular use case You're using I right now prefer renovate But that's just because of the amount of projects on the type of projects. I'm working with renovate detects dependencies in a repository and checks if newer versions are available It also creates commits and merge merges pull requests to apply those changes and it also includes release notes Which is really awesome. Love that because nobody likes to write release notes and Renovate will do it for you to an extent. It will at least give you the building blocks to write better release notes Dependable also creates poor requests to keep dependencies up to date And it will slowly open PRs over time unlike renovate which can open about 12 at a time and In contrast to renovate dependabot will tell you Release notes as well and it will also monitor security advisers for eight common languages. So as I said Apples to different kinds of apples renovate will also tell you the amount of Individuals that have actually installed that fix and whether or not they believe it is trustworthy to install it So that gives you an opportunity to say do I really want to apply this right now? And the answer could be yes or no depending on what you are doing in your actual organization Dependabot is great in that it's already integrated with github So that does that means that you don't have to necessarily bring on anything new You don't have to scratch your head and go what should we do? Dependabot is there in github waiting for you to use it and make use of it And if you are part of the alert fatigue You can actually customize renovate and dependabot to reduce the number of those notifications and filter those out to make sure that People aren't getting notifications every time something changes because nobody likes that So go into your settings adjust them and make sure that dependabot isn't sending needless messages that don't necessarily Need to be checked on at that exact moment Another important thing to keep in mind is that this needs to be realistic while you think it might take a week Chances are it's not going to when I first started at Komunda the community hub didn't even exist This was in January of 2021. And so I had to build it from scratch and In February we had started contacting the initial first wave of maintainers and it wasn't until March That projects began transferring into that organization itself. So that in itself of itself took two months in April the first wave of projects had successfully been migrated over and that was great But now it's time to begin the second wave of project transfer, which was May So it didn't take in it took six months to get that second wave of project successfully migrated And that's a pretty long time you think oh transferring things into a different repository. That'll be really quick It was not quick. There were I want to say about 75 80 repos to transfer 80 maintainers to contact that's a lot of people and some of them were no longer maintaining some of them said I don't want to do this anymore and so we had to figure out a Lifecycle for these extensions to say this is deprecated people shouldn't use it Introduced shields I owe badges that gave people a way to navigate directly to that repo and said okay This is deprecated. I should probably shouldn't put this into production probably shouldn't use it in my product And so by introducing those life cycle badges and that life cycle pathway We were able to give people a quick visual into where those were in their life cycles So that they can make a decision as to if they wanted to use that tooling or not So in July we actually started scoping our security management policy and vulnerability scanning tooling seeing what was out there What was available to us? What options did we have and? Security as we all know is not quick or at least it probably shouldn't be So we researched and pair programmed that vulnerability scanning solution that I just told you about into the community community hub back in August So that took a month to do a pair programming and it took two months after that to publish a full security and dependency management policy and that's as of September that was published so this was Nine months to get this from start to finish and it's still not done yet and In the future. It's got a long way to go, but for now it's been kicked off and it's successful But the long story short is that keeping things realistic is key because if you think it's gonna take Whatever time you think it's going to take probably double it. I would say at least double it because doing research and Making sure that you get in touch with all of your community maintainers is key because you've got to also understand that some people May have built something five years ago and they're not into it anymore But you still have to get make sure that people know that that's no longer Properly maintained so or if it's new you need to make sure that new contributors know where to put it Say hey, we have a community hub bring your extensions bring your contributions We'd love to have them this is art This is their home and making that home for those extensions and those community contributions is key because it lets people feel like They're a part of that community in a broader way. So giving them that centralized hub is Really important because it allows people a way to discover everything that your community is doing in that central location So they're not having to navigate through the woods of GitHub If you're if it seems impossible, don't worry. Just break it down Comfermentalize it's going to be okay If by breaking down a task you can make it seem a lot more manageable First things first is to evaluate that task is now the right time. Do we need to do this at this very moment? What will happen if we don't what happens then? So evaluating that task is critical So ask yourself is now the right time and next you should probably do some research Confirm that hypothesis is what I think actually correct or am I going to end up? Sitting there saying this actually wasn't correct and having to go back to step one So by doing research and making sure you have all of your proverbial ducks in a row you'll make sure that you're not going to sit there and go in circles and Once you've done your research and that hypothesis is confirmed you get to implement it do the thing you did it congratulations So by breaking things down you can actually make sure that you're not overwhelming yourself It doesn't all have to be done at once Taking it step by step means that it's going to be realistic and achievable for everyone on your team And it means that you're reducing burnout and that you're not driving people To a place where they can't meet their deadlines and they can't meet their obligations It's very important, especially in these times that we make sure that we're being realistic with our deadlines Flexible and supportive to our team members and that we're also supporting the people that we work with I've got a quote here by one of my friends Alyssa Miller and Alyssa has said As digital transformation trends continue security has to be a part of every phase of our business So why then don't leaders look to grim security expertise in all business functions and Alyssa is wonderful and is that global ratings and is a BISO S&P global ratings and That's a pretty accurate quote If we're not grooming security expertise across the business It can't just be the security team. It's everyone. It's developer relations. It's developer advocacy. It's developer experience It's infrastructure. It's even marketing security is for everyone It's not just for the security people. It has to be across the company and embraced at a fundamentally intrinsic level and Stronger security starts with improving the developer experience So that's super important and each of us here today as developer experience professionals Can bring that security to life and can make sure that we are bringing security to our communities as a whole Thank you so much. I'm gonna take some time for some questions here from the audience if there are any But if there aren't you can find me on Twitter or on GitHub. Thank you so much