This presenter is Antonio, sorry about the pronunciation if I get it wrong. It's Antonio Ignacio Sierra-Garoccio and he's a consultant midwife for normal births at UK NHS Trust, as well as a professional midwifery advocate. He started his career in healthcare in 2002 and has worked across a variety of medical and maternity wards, across Wales, Backshear, Head for Shear and London, both as a registered nurse and midwife. He's passionate about a different aspect of healthcare. His clinical research interests lie in promotion of normality, women's advocacy and clinical education. He's specifically interested in the subject of women's experiences and perception of speech presentation at birth after a cesarean session. He supports the midwifery obstetric and linear terms in clinical practice using the four pillars of consultancy. Clinical and professional leadership, expert practice, service development, research and evaluation, and education and professional development. He's currently involved in a number of local and regional projects that will focus on the implementation of better births. He's clinically involved in the delivery of care, including the design of complex care plans and the running of birth options and birth after cesarean section clinics. He's also a student at the University of East England completing a pre-doctoral program as part of Health Education England's Integrated Clinical Academic Program. His current research focus is in LGBTQ plus health and childbirth. Thank you very much, Antonio. Please welcome him and over to you. Thank you so much. Can you hear me well, Elisa? Yes, I can hear you. Go ahead. Thank you. Thank you for the wonderful introduction as well. Good evening everyone in the United Kingdom and hi and absolutely everyone joining us from different parts of the world.  So my name is Antonio Sierra. Introductions have been done already. So thank you for your time today. I'm happy International Day of the Mid-Web. We've got loads of reasons to be proud about who we are professionally and personally and the contributions that we make to society today. However, we're going to focus, we're going to narrow on this subject of women's experiences of bridge diagnosis.  I feel very strong and very passionate about the subject of advocacy and being that voice for the unheard. And I hope that I can take you through a journey. Hopefully you will enjoy this slide. So we'll be recorded and they can be accessed at a later date. So thank you for your time. Right. So we'll start talking to you about the aim and the research questions. So basically these forms the basics of a dissertation that I completed for my masters in midwifery science. I'll talk to you a bit about, you know, give you an introduction and also navigate through a literature review that I undertook. And then I'll explain what research methods I went for. And also we will talk about the results, the discussion and the limitations of the research. I will inform you of what the recommendations were at the time and what we've managed to achieve to date. And finally, we will be making a point about the subject of the International Day of the Midwife this year, which will be that of birth equity for all. And you will also have a number of references and time to ask any questions you may have. So this was the aim of my research. I was really interested and passionate in exploring women's experience of bridge presentation and also what the perception were with regards to what choices they had and also what support was there available from healthcare professionals in making decisions with regards to a bridge management. So I have three main questions that I wanted to answer with research, with this research. Firstly, I wanted to know what women's perception of choice was. Secondly, I wanted to know what women's perception of support from healthcare professionals was. And finally, what women's experience of being diagnosed with bridge presentation will be at the time of diagnosis as well. I just wanted to make a point when I mentioned the word women, I am talking about women and birthing people, but I may use the terminology women more often than not. But we are advocating the use of the positive language throughout the presentation. So to give you a bit of an introduction for those of you who may not be midwives or for those of you that may want to know a bit more about bridge presentation. So when it comes to the definition of what bridge presentation means, bridge is defined by basically the presentation of a buttocks or feet presenting first, as opposed to a head down presentation. But actually the term is defined in different ways depending on which author you go to. And in fact, there was a Canadian conference that focused on bridge a couple of years ago and they called the conference heads up what's a simple way of describing a bridge presentation. The incidence of bridge presentation at term is three to four percent. Now we have to remember that at around 28 weeks or so, the incidence is around 25 percent. And what happens is there are physiological changes taking place in the body that will allow for babies buttocks or head to come down. There is also relaxation of the lower segments of abdominal muscles that will hopefully allow for better engagement. And then gravitational forces as well will mean that babies head comes down. And this is why the majority of babies will turn to a head down position by four terms. So that is around 37 weeks. When it comes to bridge management, there have always been a variety of options available to women and birthing people, mostly elective disordering section and also bridge vaginal birth until the term bridge trial was published in year 2000. And I'll go a bit more into detail about that in a second. What we saw following the publication of the bridge term trial was a rise in cesarean section that was completely unprecedented. At this moment in time, I'll talk to you about the guidance in the United Kingdom. In theory, we're meant to be offering a full spectrum of choice to birthing people which include the use of complementary and alternative medicine, the use of ECB to try and turn bridge babies on to a head down position. So that would be external, catholic version. Also, bridge vaginal birth and elective disordering section or emergency disordering section if required. And these work aligns with national drivers such as the better birds dated 2016 and also the NHS long term plan 2019. We are encouraged to recommend and make sure that women and birthing people have got access to a personalized care plan and choice. But in practice, what we know and what women tell us is that they have limited choices and there are variations in what choices are available to them depending on which part of the country they are. And this is something that we have to tackle and we have to change. Up until now, the majority of the research that has been done on the subject has focused on offer and success of the different interventions that we're offering. But there has been very limited evidence regarding women's lived experiences. So let me take you on a journey. This is what I did. So I felt that in order to examine the, find an answer for the questions that I had, I had to have a good understanding of breach research. So what had been done up until now when it comes to systematic reviews and randomized control trials so that I knew why we were offering certain options or others. And then from that, I moved on to any research related to perception and knowledge. From there, I looked into the quality of information giving. This is reported from service users mostly. Finally, I tried to search for research on women's experiences. So let's start with the first one and that will be breach research. So the term breach trial for those of you that may not be familiar with this is also known as the HANA et al. Trial or the term breach trial collaborative. And what happened was that this is a multi-center international trial that took place mostly in Canada to say, but it included loads of different centers from different parts of the world.  So what they did is they thought there was an ethical and moral responsibility to stop the trial and stop offering vaginal breach birth to the population at that time or at least genetically. A number of years after, there have been a number of publications from researchers highlighting some concerns and professional criticisms with regards to the term breach trial. So a number of things were identified that actually were concerning to these researchers to include limited internal and external validity. There was also a violation of the inclusion criteria in participating centers, which was only discovered years after. There was also a variation in the standards of care. So for example, when comparing a UK hospital with a hospital in Mexico, we just have different systems, different protocols, different ways of working. They also highlighted a lack of professional expertise to the point that actually there were centers where medical students were participating in the delivery and that violated the inclusion criteria itself. And finally, there was a criticism that we were trying to extrapolate short-term findings and outcomes towards long-term ones. And in fact, a couple of years after the publication of the HANA trial, there was a follow-up of all of those babies who were deemed to be severely disabled following a vaginal breach birth. And out of 18 babies where they massaged, 17 were found to be neurologically normal two years after. So what happened is that, you know, the HANA trial was published very rapidly. It changed practice. There was a complete decline in the offer of vaginal breach birth in many countries. And there are reported rates going down from 72% of obstetricians offering vaginal breach birth down to 27% in certain countries, which is quite a lot as you can imagine. The years have gone by and we have learned that there were loads of limitations to the HANA trial. But also, there have been further studies published highlighting that actually giving birth vaginally to a bridge-presenting baby can be as safe as having an electricity setting section for as long as we follow a strict criteria. So I'm giving you some examples here, including the promoter study, for example. There is now a publication quite recent, 2018, about a bridge vaginal birth at home, and also a very recent publication about upright vaginal breach birth as well. And I am really pleased to let you know that Dr. Walker is actually undertaking a research for NIHR called the Opti-Bridge Project. So we'll hear a lot more about this. But to summarise, we were too quick to change practice and actually I'm not sure that we did women any favour or babies in that respect. We're now going to move on to perceptions linked to knowledge. So quite surprising data here at SAAB at times. There are publications out there highlighting that 87% of women who actually eager for information regarding bridge-presentation have to turn to books or family and friends to find that information, which I find really sad, because we're meant to be here to be helping them in that way. ECB uptake dates. So this is an external, catholic version of only 39%. But actually 72% of women in some studies tell us that they want to be part of a shared decision-making with other healthcare professionals, but yet they are turning to leaflets and books to find information about bridge-presentation because they were unable to access professional advice in a timely manner. There are other studies as well highlighting that actually the uptake of ECB, which will be really helpful to turn the baby head down, it's actually increased when women feel that information is provided to them. So we also have a responsibility here to be a bit more responsive in that sense. Moving on to the third element, I'm just checking the clock, the quality of information. So there are publications out there telling us that one third of women are telling us that they were not aware of what options were available to them when they were found to have a bridge-presenting baby and also that very often obstetricians influence their decisions. Staple-tone telling us that midwives weren't always able to accommodate women's needs when they were having consultations with them, and this is how women felt actually. And finally, women telling us that they expect autonomy and support when making informed decisions. Finally, when it comes to women's and healthcare professionals' experiences, there are studies out there telling us that women rely on obstetricians and midwives to provide information, but yet we've heard that midwives are not always to accommodate that in their current practice. And it's very important that they've got access to us, so they can construct meaning of what bridge-presentation means to them. And finally, women's feelings as well. So the majority of women hope the baby will return, and for some it will happen, but for some others it won't. And they just feel disappointed when a virgin doesn't think that it's not successful and quite doubtful about which way they should be going ahead with the reverse mode of birth. They go through an emotional journey, this is what they tell us, and they also perceive that healthcare professionals have got a preference for elective sedentary section. So I'm now going to spend a bit of time without boring you too much about the research methods that we utilise, and I'll give you a rationale. If anyone's got any questions about this, we can go back to these slides in a minute, because can be quite complex if you're not used to qualitative research. But when it comes to the research approach, I went ahead with a qualitative research approach. I feel very passionate about qualitative research, and the way in which this is defined, I couldn't really find a holistic definition, so I have mixed two of them, and I hope that this makes sense. So it's an objective process used in examining subjective human experiences using non-statistical methods of analysis through the collection of narrative and subjective human experiences as well. So the main purpose of my research was that of exploring the substance, exploratory research, and by that I mean that by concluding the research, we're not aiming to generalise the findings, but instead the findings from this research may be utilised by you or other researchers or healthcare professionals in their practice if they feel that they apply to their population. In that sense, when it comes to research designs, we went ahead with phenomenology. I feel very passionate about these particular research designs. It's a non-experimental research design that aims to explore and search for understanding about people's lived experiences. And what's really interesting about it is that it takes into account the physical, social, psychological, spiritual and finally emotional needs of human beings, so basically who we are as a whole. The setting of the population was a UK District General Hospital just outside London, supporting give birth to 5,000 mothers or birthed people per annum. And the population that we care for is quite multicultural, which is one of the most beautiful things about this particular hospital, caring for low to middle social class population. And this is the inclusion criteria for anyone who may be interested, but pretty much low risk pregnancies up until the time when bridge diagnosis is made. So we went ahead with a purposeive sample and also it was a convenient sample. So obviously I needed to make sure that these women and pregnant people were presenting a bridge, which is really important and a purposeive sample is a non-probability type of sample. When it comes to this type of research and sampling, we aim for transferability more than external validity. So once again, though the findings of this research apply to the population where I am currently providing care, that's the question that you'll be asking yourself to see if you can extrapolate the information and take it with you. So in total, we identified 24 women presenting in bridge at full term over an eight month period. What we did is we obviously provided them with the patient information, leaflets or sheets and also a consent form and send them a prepaid envelope. So they would read all the information and if they wanted to participate, they had the freedom at no cost to return the envelopes to us with a signed consent form. So we had a total of nine respondents and six people consented to taking part in the study, which is appropriate for qualitative research. When it comes to data collection, I completed face-to-face interviews and these were semi-structured interviews. I went ahead with these type of interviews because I wanted to give people the freedom to talk about their birth experience, but I also had the responsibility to guide them through a script that was flexible enough to allow them to talk about whatever was relevant to them, but also find an answer to my research questions. I remain quite flexible with regards to the location of the interviews. Some of them took place in a hospital environment and some others took place in people's homes. I use an interview that had previously been validated at another study that was quite similar. Before I went ahead with it, I undertook a pilot study to test the tool and the feedback was actually quite positive. It worked quite well. So the mean length interview time was 20 minutes and research participants were always made aware of their rights as with any other research. So obviously we draw from the study if they wanted to and also to have their data removed, but obviously confidentiality was adhered to at all times. Data analysis. So I transcribed the interviews word by word, paying attention to the tone of voice as well and any size that they made at the time. It's really important to remember that if you're thinking of using this approach in the future, 10 minutes of tape recording will actually take you around 60 to 70 minutes of transcription, especially if the language in which you're interviewing is not your mother tongue, it may take a bit longer like it was the case for me, but I completed A4 transcripts which were validated by the individual. So basically once you transcribe everything that you've heard, you send it back to the person that you interview and they tell you if that's what they said or not and if they agree to what you're writing. And also my academic supervisor helped with this which adds reliability to this study. I made use of bracketing transparency, consistency and conformability at all times. And I also aim for prompt analysis of the data. This is quite important so that you don't forget about the size and anything else non-verbal wise. I may have happened at the interview and also for you to make sure that there are no queries. You can go back to the participants quite quickly. We adhere to national guidance with regards to application for ethics. So we went through items and also address and we basically adhere to confidentiality and data storage and security as well. Any sensitive issues that came up were escalated through supervision and also management and it's very important that you differentiate between your role as a clinician and that of you as a researcher so that women and bracketing people don't feel that their care will be compromised if one of a sudden they decide to come out of the study. So let's talk about the results. I'm going to be using Colise's framework and we won't really have the time to go into it because I'm trying to summarise four years of master's dissertation into 30 minutes but if anyone is interested you will have my Twitter account and email address. Feel free to get back to me and I'll follow any information that you may find helpful. But in essence what you do is you try to do a thematic analysis of the information and I came through 84 significant statements that were cluster into 15 thematic areas and finally for emerging themes. I'm going to talk to you about those four emerging themes starting with women's feelings so the impact of bridge diagnosis. This is what women told us. They felt shocked, uncertain, quite disappointed and frustrated following diagnosis and these feelings were actually exacerbated if bridge diagnosis had taken place quite late in their pregnancy or if we were already interfering with the process of birth so like induction of labour or anything like that. There were actually a significant amount of women, five out of six for whom bridge was diagnosed quite late and they had doubtful thoughts and answered questions as well. They felt that certain procedures could have been prevented such as induction of labour had they known the baby was presenting bridge. Women tend to report optimism if there is early diagnosis. So these are just some of the quotes and I like to read them. For example, a woman said I was in the midwifery unit and got rushed to the labour war so obviously this is someone who is in labour and just found to be bridge presenting. You can just imagine how shocked they must feel. They are aiming for a low risk. Birth and all of us have been there in theatre within five minutes having an emergency setting section. Let's move on to the second theme. Women's health care expectations with regards to bridge care. Once again, when it comes to accessibility and care provision these variables are affected by the timing of and the response to diagnosis. Some women have quite strong emotions actually and some women reported concerns with regards to accessing care. Women have felt neglected, stereotyped and discriminated. I found this really heartbreaking and I'm sure that many of you will do as well and I'll talk about this a bit more in detail in a second. So women perceive certain skills to be core skills in the wifery practice such as power patients of making a bridge diagnosis through power patients and women's experiences were different if they were accessing NHS services or if they were reaching out to a care operator or someone who was able to provide a complementary alternative medicine through private services. So here you have some of the answers. One of them that I, you know, every time that I read it, it just breaks my heart is that of I feel that I was, there was a bit of negligence. This mother in English was not her first language either. I felt like another pregnant woman being Asian. It is really heartbreaking. And I'm sure that you will agree. So when it comes to women's preferences and making bridge decisions with guidance so overall women reported good care. They were less satisfied with anti-native services and they care that they have interpartumely or postnatally. They felt that they had some information but that that information mostly came from obstetricians and that they obstetricians influence women's choices. So instead of consenting, sorry, instead of making a decision themselves they were consenting to a decision that was already being made. But generally speaking, they were offered either elective section or ECB but also a general bridge berth was mentioned. So once again, the fact they were mentioned in the general bridge berth doesn't mean that, you know, this will be offered as a viable option for all. So that concept of making a decision versus consenting to a decision that somebody else has made. So here are some examples. The doctor said women to an ECB and that was it. That's not, you know, consenting to a decision really. And then someone else said, I didn't feel very rewarded but they said this is an intersection. What's the best options? Obviously they, you know, they fully trust us in that sense. Finally, women's values of professionalism, trust and safe outcome. So this was really interesting and I find this quite moving in a positive sense. So there were certain personality traits that women identified and behaviors from the midwives and the obstetricians that helped. So being caring, being calm, being comforting, feeling safe and also, you know, seeing people, seeing that people were acting quite quickly was quite helpful to them. The professional behavior, friendly staff, efficient and naturally honest. I love that somebody said that. We would be naturally honest, not just doing our jobs, which is great. I think as well. So, you know, once again, to read one of the statements, I felt like people were generally there caring for you and that made a huge difference. So to summarise, you know, the main findings and actually what we're doing is we're answering the main research questions as well. When it comes to perception of choice, women basically tell us that choice is there, but only on demand. They have to ask for it. And yes, there are talk spots that in section ECB and bridge vaginal birth, but not everyone have access to complementary and alternative therapies. A late diagnosis was always seen as a negative feature, of course, and that difference between choosing and consenting to an obstetric let decision. When it comes to perception of support, women felt that there were access barriers and, you know, there is an expectation that they'll have access to care, but actually the care that they receive doesn't always correlate with their expectation. And what's really important, and this is one of the things that we made, is that we need to enhance anti-natal care and make sure that obviously we implement continuity of care, but also looking at those big themes of, you know, women feeling neglected and discriminated, particularly women from black and ethnic minorities. And apologies about the use of the terminology BME. I don't necessarily agree with it and I don't think that it is representative of absolutely everyone who we are trying to capture. I'm really looking forward to a better term in the future. When it comes to bridge experience, finally, maternal feelings, you know, we've already talked about those, but women felt that care was not always meeting their expectations and so women felt quite vulnerable, you know, with regards to the management of the benefit that they had dreamt of for nine months and all of a sudden things are changing, you know, in that sense. So a number of limitations here, so limitations to the research methods we use, so the use of convenience and per-persif sampling. The haythorn effect, I don't know if any of you have heard about the haythorn effect, but basically it's where participants behave in a different way just because they are being watched and they're being heard. And this is something that we have to bear in mind as well. The bracketing was attempted at all times. So this is where the researcher tries to blocks his or her own thoughts and answers to the questions or perceive answers to the questions so that we can analyze the data objectively and then any others related to qualitative research. And I'm just going to speed up because of timing. So things that we do to try to mitigate limitations to the qualitative research aiming for rigor, transferability, credibility, conformability and dependability which we've already mentioned. So a number of recommendations you won't be surprised to hear that I will be talking to you about continuity of current today because this will hopefully address some of the issues that women reported they had with regards to accessing information. We as meatwares have a responsibility as per our regulator to make sure that we are able to offer effective care and that we are able to communicate with women and birthing people at all times. But of course I don't want to underestimate the pressures that we are under in certain parts of the world. As NHS providers we need to look into defining and developing specialist bridge services and this is something that happened as a result of this research. So the trust where the research was undertaken now have a dedicated meatwafer-led bridge clinic and if anyone is interested please contact me and I'll direct you to the right people because I left that unit. Fully implementing guidance that advocates for promotion of choices were really important and finally the big subject of black and Asian women and how you know some difficult to reach groups struggle to access care as well. So I will be ending the chat saying that further research with this particular population is required to explore their experiences of care. So nearly done now talking about birth quality for which is the overall overarching theme for today. We need to maximise access services that are free of charge particularly in countries that offer NHS services. We must improve anti-natal care as well and make sure that everyone has got access to care that we deliver and that there is good provision of services. And finally being aware of women's feelings and vulnerabilities. So I have told you quite a lot about the way in which certain women found their understanding and I am so pleased to let you know that there has been loads of research undertaking on women from a black and ethnic minority population that are highlighting that we have to tackle this problem. There is so much more that we have to do to make sure that outcomes are safe for women who belong to this group as well. So a couple of references there for you, we won't go into detail about that. But there are maternity drivers now the focus on black and ethnic minorities which is amazing from maternity transformation programme, also public health England and the Butterbirds are aiming to provide continuity of care to 75% of people from a BME background by 2024. So another reference is here for you and I just wanted to end with a quote that I absolutely love and this is for anyone who may actually be thinking of wanting to make significant changes while you work and wanting to change the world. I know how you feel and this is what I wanted to do as well when I first started looking at this subject of bridge. I just thought that this was going to be mission impossible but actually if you feel passionate about a particular subject you will go all the way and I'm not just telling you because I've gone through that myself but also because I've got inspirational friends and people that I work with do this day in and day out so of course I had to quote the one and only Barack Obama today and this is what I want you to remember as well as change will not come if you wait for some other person or some other time. We are the ones we've been waiting for and we are the change that we seek so always remember that it is in your hands and you've got the power to make things possible. So don't underestimate what you can do as healthcare professionals. Thank you so much to absolutely everyone attending this conference from once again different parts of the world and I am here to help answer any questions that you may have for me. Please tweet about today at Meet Wife Sierra as well so that we can celebrate the subject of bridge and if you've got any questions feel free to ask them now please. I'm going to have a look at the public chat. Elisa I don't know if you've picked any questions yourself. Yeah I have a lot of comments. Yeah I've seen Loredana is asking about moxibosion. Absolutely this is something that we implemented thank you Loredana this is something that we implemented in the clinic moxibosion which is an alternative therapy that has been used in China for many years was actually implemented in the bridge clinic. So women have access to moxibosion from 34 weeks and they continue to have access to that as well. Loads of studies I can remember Italian studies highlighting the effectiveness of moxibosion in terms of bridge presentation and actually for those of you that don't know much about it when it comes to moxibosion even if moxie doesn't turn the bridge presenting baby it makes the success rate of ECB higher and greater. So you know there are no complications to it if you meet the criteria and I will strongly advise women look into it absolutely. I can see the urinary acupuncturist as well which is absolutely amazing. Yeah I agree with you I believe the moxibosion works as well. So Mary Cronk yes yes I obviously have spoken to Mary Cronk in the past and I happen to give her a call. I came across her telephone number and I just I was very brave I'm not very shy and I happen to call her and she just pick up the phone and we started talking about bridge birth and I felt the luckiest person on earth if I'm completely honest Linda that was really inspirational and I have read loads from Mary Cronk as well just quickly going down to Jane Evans is another person that obviously works with Mary Cronk as well and absolutely inspirational as well going out to home births to support women have a bridge for general births and we've been to a couple of studies and we've collaborated in the past in organizing and arranging study days locally. I'm just reading through the comments. Yes so people are sharing their experiences this is brilliant. I have been very fortunate to be present at the number of bridge for general births and thankfully the majority of them have actually gone ahead they've been quite straightforward I am quite proud to call many of them physiological bridge births. Some others have been assisted bridge births and some others have been bridge extractions but yes it's really important and I was quoting one of the studies before you know the position of the mother when moms are in war for when they are upright how beautifully bridge babies come through and that's been my experience as well thank you so much for sharing that. People are interested in implementing a bridge service that's absolutely fine not a problem just to let you know we were also trained as midwives to do the external catholic versions ourselves so watch this phase and if you want we can follow you any protocols I will contact the right people and you'll have the protocols with you within 72 hours I pledge to that. So yes midwives and obstetricians in the United Kingdom receive yearly training to support a physiological bridge birth but obviously I think that it will be a further statement to say that we have become the skill because of the Hannah Trial you know we haven't proactively advised women to give birth vaginally to the bridge presenting babies of the skills that we currently have and not the skills that we used to have once for the time but we're working very hard in searching for and designing resources to support training in that sense correct. So someone is asking is my research being published so I have had an approval from the British Journal of Midwifery the research was going to be published this month but I think that they've been inundated with COVID studies and I am being told that the research will be published in August, September so watch out for it and you will be able to reference the study as well if you're undertaking a future research but very happy to share anything that I may have. Yeah that's right the Curtini Italian study that is the one thank you Loretana, beautiful study as well reported conversion rates of as high as 87% if my memory doesn't fail me in that sense. You're absolutely right Rihanna sorry you're telling us that doctors get the most of their experience from midwives and that's right I've been in bridge births where the obstetricians have kindly asked if they can just wait by the corner and that's absolutely right yes of course but always making sure that there are good communication systems in place so that if they're not experienced that there is another person you can escalate your concerns to so that they can be readily available in that sense and you know we've had beautiful experiences recently of mums there is a particular service user who I care for who was presenting with a diagnosed patient you know we always started panicking I wasn't panicking really but you know we were interested at the time and actually this was her fourth pregnancy and she had given birth to her three previous babies in bridge and vagina at least so to her she just couldn't really understand the panic mode because that bridge was normal to her if that makes any sense which was beautiful as well so I've got somewhere Loretas I'm asking if there are any plans to undertake another research once we have implemented the recommendations this is a really valid point Loretas I will definitely look into doing this in the future it may need to be with a different population because I've moved on from the place where I was but it's a very valid question and this will be the only way to test if we've implemented really worked thank you so much for that yeah I've got people telling me that it'll be great to implement a clinic like this please get in touch and I'll be very happy to share everything with you Elisa you're thanking everyone I don't know if anyone had any other questions that you wanted us to talk about I think that we will soon be running out of time yeah unfortunately we have to unfortunately could I kindly take this opportunity to thank you all for sparing an hour of your time in this beautiful evening to you know pay a bit of attention to bridge presenting mums and birthing people who also deserve you know our dedication and care I wish you a good day please celebrate widely and for those of you who are from a weekly background or anyone else who supports midwives thank you for your contribution to society thank you for supporting mums and birthing people giving birth safely whatever you are we learn so much from your practice as well in different parts of the world we are really inspired by the amazing work that takes place in under source under resource countries as well as developed countries yeah thank you thank you for your care to women and birthing people you're actually the reason why women, birthing people, babies and their families exist thank you for your time today and enjoy the rest of your evening


I'm excited for tonight's event today because we want a new society on love and acceptance. So welcome to the Kneeling Art Photography Project. This project we started almost two years ago with wonderful people because we believe that our society needs some reforms. We always have this question, what would a good society look like? There are too many people who are oppressed. We have people in our neighborhoods, in our city, in our town who are struggling. And we hope that we could do something. That's why we want to gather together and to start the conversation. How could we build a community where each everyone is welcome, feel safe and feel like is part of the society, regardless of its religions, sexual orientation, skin color or background? So, your presence is a proof that in the state of man, we still have people who believe in social justice. I know how busy life could be in America, but you find time. You find time because you know, is it the right place to be? A place where we could talk, we could open up, express not only our hope, but also what we could do. No one has the right answers. So I can't on your participation is important. Your voice counts, your voice matters.  So thank you so much for your presence. Now I want also to say thank you for all of the panelists. It is an honor for me to have you tonight. You are amazing. I know you do a lot for the community, but tonight you are going to be challenged by the public. Yes. We expect to have the best of you tonight because we want the best state. Men should be the best state in the United States of America because we as a family, we are able to make change. So thank you once again. Now we let Elizabeth to just our MC of tonight to lead the rest of the event. Thank you. Thank you, Titi. Welcome everyone. I'm so glad to have you here. I'm Elizabeth Ross Holmstrom and I am a community volunteer and passionate about raising our vibration of community and love and connectedness and I'm a big fan of Titi's and all of you as I've gotten to know you just a little bit from talking already. My role is to facilitate conversation this evening and I hope that we'll have a lively passionate discussion. We're going to just give you a sense of format. You've got three questions that we're focusing on. Each panelist will have a minute or two to weigh in on that question and then we will give some time for people here that are present that would like to get up and maybe speak about that particular question and then we'll move to the next. So each question has about, we have about 15 minutes to cover each question to be sensitive to our time here this evening and I am the time keeper and the facilitator. So I can do that with hopefully some grace and I live in South Portland. I'm a South Portland resident. I've been in Maine for 35 years from almost 40 years from I grew up in Central California in the agricultural valley and I've probably had every job on the planet that you can think of. I've cleaned hotel rooms and bathrooms and I've picked cotton and I have been a secretary and I've owned three different businesses and you know it's I'm here to say that the paths are all varied no matter what we what people may think when you first see them. So and I'm a high school dropout but I've now since gone to college. So I want to have each of our panelists introduce themselves and I will start off with Miku if you can please introduce yourself. My name is Miku Paul and I grew up in Old Town. My family is from Lower Canada Kings Clear First Nations and I received both a traditional education from my grandfather who was a traditional elder and a formal education in white schools. I learned the value of credentials and having that formal education as a person navigating white society in Maine and I do lots of work around inclusion and Wabnaki curriculum in the schools. And I've been doing that literally for decades now and I'm also a writer and I'm happy to be here today. Thank you. And I'll turn it to Andy. Yes. Good evening everybody. Thanks for coming here and thanks to TT for having this important program. My name is Andy O'Brien. In my day job I'm the communications director for the Maine AFL-CIO which represents about 42,000 workers in Maine and fights for economic justice and workers' rights. I'm from Rockland, a lifelong manor, grew up in Lincolnville and I'm also a writer. I write for a number of different publications. I have a monthly column in The Ballard about radical and labor history, abolitionist movement and in Amjombo, Africa where I write about immigration history, history of immigrants and black history and I'm going to be covering state politics from Amjombo coming in the next legislative session. Thank you Andy. Thank you everybody for coming and my name is Baba Lee and I live in South Portland where I'm raising my four children and my wife, my wonderful wife, where we are raising our children together. I've been living in Maine for almost a decade and before I immigrated from West Africa, a specific country, Mauritania, which is a little bit nearby Senegal, probably you have never heard about this country, but a form of French colony and since I came to Maine so I lived what it means to be immigrating, leaving your home country and coming to live in the widest, one of the widest states in the United States. It has not been easy, of course, I've been very grateful to make a lot of friends and seeing you all coming to listen to me, an immigrant, to talk about this very specific topic, very important, it gives me a lot of hope and I've been since activist working with immigrant communities, advocating for parents in the education system. Thank you. Payas? Thank you very much and I apologize for getting here late. I was driving for about 10 minutes looking for a spot. I couldn't find any and so I'm sorry. My name is Payas Ali, I am from Ghana. I have been in Maine for 21 years. I first came to New York and then two years later I migrated here. I came to visit a friend and I never left. I like to call myself a public servant at large. I have a work in the community with both immigrants and non-immigrant young people, building the skills of young people. I have run an interfaith group where I bring young people, founded and run an interfaith group where I bring young people from different faith and culture background because I believe in people talking to each other even if they don't agree. I co-created with the speaker of the house a leadership program called KIN Fellows. After the principles and values of Dr. KIN, it's a leadership program for BIPOC young people. I currently work or run an organization called Portland Empowered. What we do is we work with immigrants who are new here to get them to understand the way education works in the U.S. so that they can support their students or their kids and during that they also get to build a community. Within the same program we have a program for high school students, build their leadership skills to navigate the education system. We also have a fellowship called Civic and Community Engagement Fellows where we work with immigrant and BIPOC imagine leaders between the age of 20 and 30 to expose them to what we call 21st century skills. All of these, my favorite thing to do is raise my daughter, I have two kids, my son is 27, he lives in Boston now and my daughter is following him. She's going to go to college in Boston, I tried. She said to me that, dad, you came from Ghana, you cannot tell me not to go to Boston and so I gave up. I am also a city counselor in Portland. It's a privilege that I don't take it lightly. I'm honored to be part of that. So thank you and I'm looking forward to this conversation and thank you all for joining us. Thank you very much. Thank you all of you. Miku, I'd like to start with you with the first question and do you believe that Maine's political institutions are taking action to reduce inequities or do you believe they're continuing, they contribute to maintaining inequities and if you have any examples as part of your answer that would be helpful. Well first I don't think that it's as useful to limit that to political institutions but if we look at a context, the governor that we had prior, we did see some changes around that individual's approach to governing and management and we also, because of his behavior and the things that he would say in public speaking, I think we saw sort of a rise in speech, hate speech. So I think that that's important. The way a leader comports themselves, we all know what a model is. Parents are models, teachers model behavior for students. But I think that when you're a public figure, you have to realize that you do create impacts on society based on your behavior. Now we have a new governor, unfortunately, that governor does not support full autonomy and sovereignty for the Maine tribes and so we've had to work with building allyship and repeatedly move through the legal process and make requests so that we can gain the autonomy that all the other federal tribes have. So yes, political institutions in Maine do serve a purpose and they have a lot of distance to go I think in recognizing the necessity and the value of making framework changes which means legislation that will allow everyone in Maine to thrive. Andy, I'd like to go to you with that same question. Do you want me to read the question? No, I can answer that I think in some way. So I mentioned before that I work for an organization of unions and labor unions are a kind of political institution. We're part of the movements that help shape our democracy. We're a democratic institution, but like our governmental institution, we've also long struggled with issues of racism and exclusion and as we were talking earlier, the United States is a very young democracy, probably only what, six, 50 years old or something because how many people were allowed to vote when the country was founded? Because people weren't able to vote in Maine until the 60s, I believe. And so, you know, with labor unions, traditionally there were a lot of unions that excluded African Americans, women, the people of color going back to the 19th century. These were reserved for these craft union jobs that were predominantly white men and they kept out African Americans and women. And they, I even read of strikes that they'd have in Maine to keep, these were union members going on strike to keep black people from getting hired. So it could be used in different ways to either exacerbate racial racism or actually fight racism. And we have a long tradition as well of progressive unions that have fought for racial justice. But we still have had, going up until the 60s, 70s, 80s, we had a lot of unions really trying to keep out African Americans and people of color. At the same time, we've had the CIO recognizing that they want to organize entire shops of workers, including all the people in the lowest-paid positions, which are often black workers, and women and everybody in the shop. And so they had to do anti-racism training with workers and they had to educate workers about that to awaken them to the idea that people with wealth and power are always trying to divide working people on the basis of racism from the founding of this country in the colonial era. That was why the whole racial caste system was created to designate one people as chattel slavery and the others as upper, higher on the caste system. Thank you. Very much. Yeah, I will respond to this question from the lens of an immigrant and the lens of a black man who's been living in Maine for the last 10 years. So I've not been involved in the politics, but I'm watching it from distance and then looking at how it is impacting my particular life, my children's life, and their education. So I would say there is a lot of progress because when I learned about the Civil Rights Movement when it came in, there were a lot of changes, but all of these changes came with a lot of fight. And every move that has been done in the United States in general, which I know it has to take really tremendous fight and also people sometimes sacrificing their own lives to make a little change, like now a little legislation that make a move. And sometimes also the next maybe government will make two steps back. So it's really very complex in a way that I would not say it did not contribute. It did, of course, but with a lot of cost. Thank you. That's a good point. And Pius, we have two minutes. Thank you. I think this country in general is a work in progress. Maybe I should switch with him so that he doesn't say what I want to say. I think like he said, we make two, three steps forward, and then we take a couple of steps more than what we gain. However, by taking that forward step, we've established a change that is possible. We've established a principle that we can all uphold too. An example is at national level, we had President Obama for eight years, and we're all excited about him, right? And about some of the things that he did or what he could possibly do. And we're all hoping for that, okay, maybe next time we'll have somebody that will pick up from where President Obama left. What happened after that? The pendulum switched to the other side and it went all the way as possible as it could. And we also, while we have to endure as a country for four years. And even before then, those of us who live here in Maine have endured that for eight years. So inequality is not just within politics, if I may say. It's cut across every aspect of life in this country. It could be at a grocery store where people are standing in line. It could be, and people do things and treat people differently unconsciously. So I believe that conversation like this, and hopefully it's not just those of us who agree that will be coming to these conversations. It could be everybody so that we get to shift the needle a little bit in our small community here in Portland. Thank you, beautifully said. We are, in terms of time, we have a couple of moments. So I'd love if there's someone that has a viewpoint that might be different from what has been shared and would be willing to share it. You could step up to the mic for two minutes if that, if anyone does, anyone, you can raise your hand if you feel like you have something that you would like to contribute because we want this to be a discussion with all of us as much as it can be given the format that we have here. Is there anyone that would like? Yes, go ahead. So I do have to kind of play timekeepers. You have a couple minutes and please step up. Thank you. Hello, my name is Nora Jean Ferris and I am an artist that works in political activism. Upon hearing the perspectives of all of these wonderful people that came together and knowing also the history of the inception of this country, given the fact that for 500 years and probably more, there has been so much trauma in this country that we're all now sometimes just figuring out, finding out, how do we keep it going? How do we keep it going? How do we, because we know it's only been, what, 200 years since slavery, you know, was not, you know, was outlawed and abolished in this country, but it's still going on and also to the indigenous people of this country are still being subjugated to injustice.  So how do we keep moving when there's been a system that's been in place for so long of injustice? Thank you for that question. And I think that we're here to talk about that and to move, I believe, from talking to action. And so there will be time at the end, which is why we're timing these questions, so that we can talk about how can we move forward to begin taking action. And we'll do that as a collective at the end. And then we'll have a little time after the filming is done, too, to talk. So thank you very much. It's a key question. So Pius, I'll start with you this time for the second question. And the question is, what are ways that we can organize cultural exchanges so that we can... And you talked about some of them in the work that you do to learn from one another, but what are some ways that we can organize cultural exchanges to learn from each other? Okay. Culture is a very complicated... There are many cultures. You have the culture in education. You have in culture in politics. You have culture in sports. And a community like Portland, we have in terms of people's cultures, we have many different things. And I think when we, the mainstream, the people that have the spaces, I think when we have things like First Fridays, that is the first thing that jumps off the distant for me, when we have things like on First Fridays, right? We shall invite people who are the margin of society or the margin of our community and give them a space where they share, the way they do things, and the way they live, their food, and I'm talking about probably immigrants and other racial minorities who live here, right? Including indigenous community leaders and members. Let's create space for them to share their culture, because the white culture is the dominant culture. Whether we like it or not, we are forced to live within it, right? So those of us who live in it, including the white folks who are our neighbors, our friends, we need to work and make sure that the cultures that have been pushed to the margins of our society are giving the space for them to share and for us to learn. I think that will be a good seed to plant, to have a society or a community that talks to each other, that learn from each other. Is it possible? Yeah. Is it going to be easy? No. So. Thank you. Beautiful idea and observation. Baba? Yeah. For me, the culture, we are talking about culture because at some point, I think a lot of people, when we talk about culture, they think about others who have culture, not us. So we are standard, others have culture, which, you know, inside to kind of looking the others in a side way that, you know, they are strangers or they are exotic. So I think to create this change is we have to shift our minds into how we look to the different people in terms of culture or not even quality culture because, you know, who we are, who you are. If we're going to call it culture, we call it culture for everybody. And also maybe to normalize the seeing as a different person, as practicing things differently. And that's all, you know, I would summarize it into openness, being open to see somebody who is normal, even though he's doing it differently. It has not to be like the way how we do it. Standard, I think, is creating a lot of these prejudices because we are standard and they are a little bit exotic. So this language, I think, has to change so that the mind will shift and then everything will follow. Beautiful. Thank you. So I grew up and live in a community that's probably 99% white. And, you know, I used to be a legislator and represented the districts that I heard from a lot of people and talked to a lot of people and talked to people about immigration and things like that. And what I found time and time again is that people have not had interactions with people from different cultures and backgrounds of different races and this is how you stir up fear and hate. I used the example of my band teacher who was a very nice woman but sort of went down this hate-filled rabbit hole where she just became really rabidly anti-immigrant and the family across the street from her, the daughter married an undocumented immigrant from Mexico and she loved him. She thought he was the most wonderful guy in the world. She thought it was great. She loved the family, blah, blah. She went to the party that he had when he finally got a citizenship and was able to stay here, but never would draw the connection between her political beliefs and her personal relationships. And we need to have more of these cultural exchanges. We need to figure out, you know, find out what our commonality is, whether it's through music and food and culture, interest in language and all of these things and create spaces for us to have these exchanges with people who live outside Portland because so many people just think of Portland as this liberal, you know, whatever. They have a lot of prejudice about, nor they're made and so they're made and people want to break off into different mains and things because they don't like what that mains doing. And we really just need to figure out ways that we can bring people together through that and create those spaces. I think we can. I think we can do it through our schools and a number of other venues. Yeah. Thank you. It's hard to talk about this in such a specific way because I think about things like the origins of xenophobia and the way that we other people. You know, as an Indigenous woman, I can tell you that after decades of working with Portland schools and doing some DEI work and using my art as a pathway to hopefully enlighten and educate and engage people around mains Indigenous cultures. I still encounter some of the same barriers. And I'm not sure how we can change that, but I think being celebratory is marvelous as human beings, we love that connection. But I also want to encourage you to consider the encounter. Don't wait for Indigenous People's Day to learn about Chikwamanaki people. If you run into someone and they identify, connect with them. Find a moment of connection where something might be built. Because then I think when you do that, you are actually fostering an awareness of their humanity. And that will make it a lot more, I think, difficult for you to other them. So we know that. And we also know that, for example, children develop pre-bias before the age of five. And I do a lot of work with the web studies. I don't know how many of you know that in Maine, in terms of cultural exchange and connection, we have a 20-year-old mandate to teach Wabanaki culture and history in the schools. And it fell by the wayside as an unfunded mandate. And even when I worked with schools, many times they weren't necessarily funded well. Or I would be up against teachers that didn't understand an Indigenous teaching paradigm. And so then I would end up getting sort of pushed into the category of entertaining people around my culture. And it's OK. It's good. But it's not enough. So a wonderful thing happened to me years ago. I started doing some work in faith communities with Reach. And I met a gentleman who was a Quaker. And he dropped me off at home after some meeting. And he said, can I be your friend? And I was really taken aback. And I said, well, yes. He said, no, I want to be your friend. I want to get to know you. I had never been asked that question by a Wenooch person in my life. It's not that people weren't friendly, but I found it a rather formalized frame. But that connection has now grown into collaborating on professional work and doing work with faith communities and sharing of my culture with a number of people from different areas. So I say, seize the moment. Yes. That's beautiful stories. It's those micro moments that we can take that action and ask that next question and connect with another human being. We also have a couple of moments. Does anyone have something from your heart that we'd like to share? We've got the mic, if you would like to. Yes. I'm Sam Brown. I live in Casco, Maine. I've been living in Maine since 1972. And it's ironic to come to this conversation with that position, because even though I've been here since 1972, I'm still referred to as from away by most people who have lived here from all their life. So the conversation has a number of different levels to it. We have a wonderful community here in the state of Maine. And it is a fact that it's a sort of badge of honor to treat everyone as though they're from someplace else, no matter how long they've been here, and no matter where they come from. And I've lived here since 72, and I meet people who are younger than me that treat me as all from away. And it's somewhat humorous. I'll never forget walking into the small engine shop near our home and telling them that my children were born here and went to the high school. And they said, just because your cat had kittens in the oven, don't make them biscuits. So the conversation has multiple levels, because further on, I come to this in, frankly, I think the position of the greatest privilege. I'm a tall white man. And I try to be sensitive to people of color and people who are indigenous. It's not easy. We all step into piles of poop by making a mistake. But I think it's important to talk about. I don't know what the right path is. I do think one thing, and that is that Maine is the whitest state, rather. It's also the oldest state. And I think one thing that can appeal to most folks is we all want a house. We want a roof over our house, or our heads rather, and we want food on the table. And we want to live someplace where we have opportunity to economic privilege, if you will. We want to make a good living. And I think that what's important to remember is that it's so great that we have this growing immigrant community here. Because what I've seen is, and hopefully we'll see more folks from an indigenous perspective coming forward, because I frankly don't meet a lot of people who admit to their indigenous roots. But that, to me, is what can appeal to everyone, is that a growing immigrant community creates more financial opportunity for the state. It enriches our work pool, our candidates for employment, and any growing company in the state of Maine needs good workers to come forward. And I think that that can help to bring people to a middle ground who maybe are afraid of people from away, because they don't understand them. But if they can understand that it can help us continue to be a really positive place and a place where everyone can earn a living because of a growing population that welcomes people from other cultures and backgrounds in color, that can be a real positive. So that's my thought as I was listening. Thank you. Thank you for talking. We're going to move on to our third question. And this question, I believe, is so perfect to really roll into the, I think we'll have more time for input from everyone after this question. And just reminding that we have a couple of minutes each. And the question is this, what kind of change would you like to see in Maine? And what is one action that we could take, because this is a really important aspect of this, is that we'd like to turn these conversations into action. And so what's one action that we can take to make a difference and to make change that could be many more steps forward and then a couple of steps back won't be as bad. Baba, I'll start with you. So the changes really I would like to see after living here for about 10 years is seeing a Maine that is more inclusive. We are having diversity in a very fast pace within the last 20 years or like last 30 years in Maine, but mostly focused on southern Maine. So what I would like to see is this diversity to spread all the way up to the north. And also the diversity that is existing here, we work toward educating manors who we found here to better understand the newcomers, us, that we are just human being like them and we are not a threat to anyone. And when we take time to know each other, you will find that what you were afraid of is just a fiction. So I want more inclusion. We already have diversity. Now, what to do to change that? That comes to one thing is open up. Don't let your fear win over you because when you are fearful, you are more anxious. It can even impact your health on every day. And these are things that you cannot change. The migration has been with us since this earth was existed. It's not new. It's just like the different people are moving around in different ways. And also, we have to acknowledge that racism is still existing everywhere. It's not just in the United States. Maybe in different forms, but we have to acknowledge it at first to be able to deal with it. What can we do to change many things? First and foremost, I'm going to go on what my friend here have said. I will give you an example. I will still touch on the dominant culture. In the wanting to do the right thing, recently, there's a group of activist organizers who happen to be BIPOCs. And because of the issue that happened with the Nazi sympathizers who were in Augusta, these group of young people decided to organize a rally in Portland. And then they have a very credible information that made it impossible for them not to. And then on social media, someone responded to say to them that, oh, if you are canceling this event, how will you make the like you don't have a backbone, my ways, of explaining what you are giving in to fear, right? And when you look at the person that didn't use their name, it is likely, and I'm going to make a wild assumption, that this person may be white. And this person was not able to look at the situation through the lens of these individuals who are BIPOCs, who have credible fear and had a credible, because they will have to put their bodies on the front line. And they are afraid that they're not going to have protection. But in this person's way of their activism and wanting to confront, because a person of color's confrontation to a system that we live in is completely different from that of somebody who is coming from the dominant culture. So yes, the dominant culture should support us and work with us and take the lead. But please do not look at through your lens. Look at through our lens what our fears are. Or by saying to us that, oh, you're not doing enough. Or you should have done it this way. We have a fear, whether we are from here or wherever we are. I am from Ghana. We're colonized by the British, right? So colonization doesn't just end because, how do we call it, the colonizer pick up their stuff and left. Psychologically, they have left an imprint that will take generations to go away. But for it to, yeah, for a group of people irrespective of where they are to heal.  So people from the dominant culture, one thing that you can do to help in building a society that connects with each other is when you are doing or when you are having your advocacy, please go easy on us. When we say we cannot do this, don't see if that we are afraid or we don't have the courage. We're trying to take care of ourselves. Thank you. Thank you for that perspective. Nico. Speak up for your neighbor. Speak up for your fellow human being, your member of the human family. I know it's not always easy. And there are times when my partner counsels me not to be too outspoken. But I can tell you that this woman has gone into a downtown bank here in Portland around Halloween time and Thanksgiving because they had a string of little pumpkins decorated and the staff were all being asked to vote on the best one. And one of them was done up like a goofy Indian brave. And I went right into the bank and I told them that was inappropriate and I told them why. It's a small thing. But I think that if we look out for one another, if we see something happening, you see it on social media. It's happening sometimes now too.  If we protect each other by speaking out against injustice, that will have an impact. Beautiful said. Yes. We have an old saying in the labor movement, an injury to one is an injury to all. And I strongly believe that. It's sort of how I try to guide my life by that message. I think to Pius's point, one of the most important things we can do as white folks is to listen to people of color in marginalized communities and not just try to take it over or berate them if they're being put in harm's way for activism or something like that. I think we need to look at our areas of influence and where can we can make a difference. I looked at what I could do I could write and I could write about history. I think that the history is very important. I don't think a lot of Mainers get that history. And to your point, we have unfunded mandates about teaching this history. We need to fund those mandates and we need to lobby our school boards. The people that are coming up en masse and screaming at school boards are the people that want us to go backwards and not teach any of this stuff. In my experience, I got my master's in education and I student taught for a while and I was a teacher. A lot of teachers just don't know because they don't have enough time in the day to learn all this information. You need to provide space for them to do it and you need to pay them to do it and you need to pay for their professional development. And we should be lobbying our school boards. My church, I was very disappointed back a number of years ago when Paula Page was taking away assistance for asylum seekers. And it's just, I was just so beside myself because my church wasn't doing anything. I was like, here are people in your own state that are gonna be, we're gonna have a humanitarian crisis. So we need to think about how we do that in our churches, how we make our churches address these issues and stand up for each other in our fights. I heard something once around that this was just recent in a, I was in a program during COVID around, it was a book reading club with Ruth King's book, Mindful of Race. And we were talking about things that we can take action on.  Who, when you have a party, who are you inviting to your parties, to your neighborhood parties? Who are we including? And that really took me because I have business contacts, I have friend contacts, but who is sitting at my table? It's mostly white people, or it was at the time. I wasn't inviting. And I feel like we, the small steps are the big steps in learning about each other. And I wanna open up this question to others too, to comment, this is what this is about. What is a step that we can take that can make a difference here? That we can leave and take tonight, or we can take tomorrow? And if somebody who hasn't spoken yet first, I've, your hand up here, yes. Thank you. And then we'll keep coming around.  My name is Umaru Paldi. First of all, I wanna shout out to my brother, T.T., for doing this, for bringing us together. And for everybody who participated, who shared their thoughts in the book. It's amazing if you don't have it, check it out. One thing that I wanted to say about the whole conversation, I'll start with the conversation around culture. The first thing is for us to recognize that unless you identify as a Native American, I don't say Indian, a Native American, you are one of either the colonizers, the occupiers, or a snooper. We are all immigrants. So the second one is cultural shift starts with the education, the mindset. We have to change the language. I'm a huge advocate for language change, the terms that we use.  Because minorities means that it's a majority. Language is complicated. Majority means also superior. So if we keep implanting that idea of minority majority in our kids' heads, that is gonna keep going. We have to be comfortable to use the word privilege. The more privileged and the underprivileged. I think that makes more sense because that's exactly what it is. There is no majority minority here. If you go to some countries in West Africa, you are white, you are definitely a minoritized person. You are minorities, in the minorities. But does that mean you are inferior to anyone? No, but other people will look at it like, oh, it doesn't know our ways. It doesn't know our cultures. It doesn't know how to do this. So then that means you are inferior because we know better and more than you do. So unless we start with changing the language, the narratives, the expressions, we're not going anywhere. Secondly, we're going through dangerous times. I am so much into the social justice and equity work, but we do not want people like Greg Abbott and Ron DeSantis because when you cannot even teach about social justice, diversity, equity, and inclusion in your schools, we are all screwed. Thank you very much. Thank you. Thank you. We have time for another comment. Yes. I do see you and we will come back. Thank you. What was I thinking? So I'm Carolyn Tkach and this doesn't make my voice lighter, I understand. And I'm from South Portland and I was thinking, I've got so much I want to say, but I'll keep it brief. Yeah, we just have two minutes. Thank you. I can do that. So there's a quote by James Baldwin that I am really trying to get now. We can disagree and still love each other unless your disagreement is rooted in my impression of the denial of my humanity and right to exist. And that speaks a lot to me. You know? Yes. I'm not going to just, when it's not acceptable, it's not acceptable. You know, when it's evil, it's evil. And we don't need to reach out and embrace the unacceptable and the evil. I was thinking on my way in today, because I've been thinking a lot about, how do you pull people together to act? And why are some people seem so blind or they don't care and they have this, you know, when, why can't we get people to show up to do this work? And I realized I was walking down Congress Street and there are a lot of people suffering on Congress Street. And I don't see them a lot. Sometimes I do, but sometimes I don't. It's like, oh wait, where am I? Where am I blind? You know, and now I'll try and be more conscious and maybe we all can be more conscious when we walk down Congress Street to see the suffering that we haven't seen before and to understand the humanity of the people who use humanity. We don't. We're not aware of. Just because, you know, we want to go somewhere. We don't want to have to take in the truth about what's going on. We need each other. I started organizing a group a while ago that is not yet fully coalesced, but after the last year with the Supreme Court's decisions where abortion and all these different communities, rights were taken away or threatened. And I was thinking, wow, you know, it's all these disparate things, but we're really all in this thing together because it's all one agenda. And so I thought, we're in this together. And so I started to be called in it together. And it's about people from different communities and different communities that are targeted, coming together to support, to defend each other, to be in community with each other because alone we're in trouble. So anyhow, I've got a lot more, but that's, I've also got a time limit. So thank you. You have time for one more comment? Yes. Sorry, we're trying to grab people that haven't had a comment yet. Did you get the comment before? Yeah, approximately. My name is Jean Pierre. I try to listen to everybody here. And I'm very hopeful to be here. When I was here before then, I didn't know what's going on. So we get the information, then it came late. It was not late, we came before. But it's a very nice topic, but the big issue, the big problems, it's, you can talk nice, you can think nice, but if there are no results, it's like to turn on the problem. Why? If I have a problem and I come to you to explain my problem, and you show me, you helping me or you want to help me and you don't like to help me, and I have a mindset, I have an idea. I can provide or I can contribute to give how to solve my problem. So I say that, but I'm not good in English 100%, but I think it's a lucky day. Here, when I arrive in man, it's very good society. I can say people are very, they like people. I can say even more than 90%. But I have get a chance for traveling different countries to be raised with different, different, like my brother, they will say different people from the end to be different countries. So last time we make a meeting with the general managers of DHHS and GA, they try to understand the problems of immigrants. We see it's a problem because if a person coming running to you, you try to help him, don't think he don't know that. He know that, but people try to show them we know we have a problem, but we can also contribute to give ideas or to see how to get that problem become a solution as soon as possible. So I'm here like four months, I think. And I have, I'm 49 years. I have 20 years of experience in business and whatever. There is some, I go, I get like a registration for school, one time they ask me something, what did you want to go to school? I say, okay, I want to go to school. I have experience of life, but you can be in the office, but the one person who is outside have that experience who can bring the solutions. Why you don't take that person and you don't ask anything. You ask just to, if I have idea, if I see that idea can work, what can I talk to? We try to go to the city hall. We call the managers. They give you the economy, they say, somebody know you, give them the phone, then they give you the appointment. Sometime you get that benefit and you run too much. So my question is, if I have that idea and turn left and right and whatever, there are some opportunities here. And if there is like a volunteer of government and that thing they take, because you can say there is opportunities and there is possibilities without way something coming from Washington, you understand? We can create that things. We work for free, but I don't know where, who. If I go to one person, I have been to some addresses, they told me. I even internship to work for free and whatever. I do volunteers. Tuesdays, Monday and Fridays and Saturdays. So maybe I take longer. I told you that because I was asking just today, it was just to, they told you they give you insurance, for example, you have the insurance, I'm very sorry. So yeah, we're gonna talk to after, like what you said, what we need, it's just to get just a few minutes to understand and try to help us, we can get something, it's very good. Thank you. Thank you for talking and I wanna say. I'm hearing you that the solutions that we have, you have ideas for solutions. And it's about connecting to the right people to share what your ideas are for those solutions. And that is an action that we can help take together. And I want to honor our time here. I don't think Titi is saying closing words, but I would like to know if, I wanna thank all of you for participating. Is there one thing we've got, I think two minutes, one minute. 10 seconds each, one word. Before we close out. Support sovereignty for Wabanaki peoples in Maine. Thank you. Thank you. For the union is a good way to get equality in the workplace. Beautiful. I would say silence is complicit. Let's collaborate to promote belonging and do our way with ordering. Yes. Thank you all very much. I appreciate every one of your time. Then I appreciate all of you. And when this is done, we will have more time together.


So, you don't understand the differences between materials and smart materials. Not a problem. Now I'll explain this to you the same way my little bro did to me. A smart material is just a material that the professionals have already masked and generated for you. That's really it. Instead of you manually adding masks, dust, and generators for edgeware, you can just grab a preset smart material that has all of that built in out of the box. I remember I spent all day making a metal effect for some medieval knight armor, and then my little bro showed up and he was like, you know, there's a medieval armor smart material, right? And it's probably better looking and more professional than the one you made. And lo and behold, he was right. And ever since then, 90% of my workflow has just been dragging in smart materials, changing the base color, and making minor adjustments to the generators and the edgeware we need to be. But yeah, smart materials save a lot of time, and they look awesome. So check them out, especially if you were working on a tight schedule. Hope that helps, and as always, I hope you have a fantastic day, and I'll see you around.


This algebraic geometry video will be about the Axe-Grotendick theorem. So the Axe-Grotendick theorem says that if you have a regular map from a variety v to another variety v over an algebraically closed field, field k, if f is injective, it is surjective. Of course, if a map from a set to itself is injective, there's absolutely no reason why it should be surjective in general if the set is infinite. And this theorem has an amazingly simple proof found by Axe using some rather odd techniques from model theory. So let's first of all just have a couple of examples. So if the field is not algebraically closed, then the theorem is false because we can take, for example, k equals q, and we take the map f to be the map taking x to x cubed from a1 to a1. So this map is injective, but it's obviously not surjective because not every rational number is the cube of something. You can also ask if a map is surjective, is it injective? And this is obviously false. So there's example one. So example two, let's just take k be the complex numbers and f of x equals x squared. So this is surjective, not injective. Okay, we can just give the proof of the Axe growth in the theorem in a few, almost a few minutes. So first of all, it's trivial if k is finite. Because if k is finite, then v is only a finite number of points. And if you've got a function from a finite set to itself, it's injective if and only if it's surjective. So over finite fields, if it's surjective, then it is in fact injective. Next, it's true over any algebraic extension of a finite field. And the key point is that the coefficients of all equations defining a variety and the coefficients of a point all lie in some finite field because they're only a finite number of coefficients of equations. They're only a finite number of coefficients of a point and they only have a finite number of coordinates. So you can find some finite field containing it all. And that means that if you've got an injective map from an over an algebraic extension of a finite field and you want to show it's surjective, you take some finite extension containing all the coordinates of some point and just apply the theorem of that finite extension. Notice by the way that over an algebraic extension of a finite field, surjective no longer implies that the map is injective. If you look at the argument it's going from finite to finite extensions, the argument for injective implies surjective still holds but the other way around doesn't essentially because showing something as surjective involves finding a point which you can find over a finite extension. So if a map from the problem is that a map may be surjective for an algebraic extension of a finite field without being surjective for the individual finite fields. Well now it's true for algebraic extensions of finite fields. So what you can immediately deduce is true for all algebraically closed fields. So why can't you do this? Well we know it's true for algebraic closures of finite fields and now we just use a result from model theory that if a statement is true for an algebraic closure of an algebraic closed field in characteristic zero if and only if it's true for algebraic closed fields of all sufficiently large characteristic. And the second result from logic says that if a statement is true for one algebraically closed field of given characteristic it's true for all algebraically closed fields of that characteristic. Well this is obviously false as I've stated it. For instance the complex numbers are uncountable and you can find algebraically closed fields of characteristic zero that are not uncountable. So it's not true for all statements. Well it's true for all statements. These have to be first order statements. So I'll explain what first order means in a moment. So this statement here is sometimes called the left shet's principle. So it says the left shet's principle sort of says that if something is true over the complex numbers and it's true over all algebraically closed fields of characteristic zero. And this is nice because to prove things over the complex numbers you can use all sorts of things like analysis and differential geometry and then you find it's true for all algebraically closed fields of characteristic zero. And again not all statements have this property. It applies to first order statements or statements that can be reduced to first order statements. So now I should explain what a first order statement is. So first order is a statement that can be stated in first order logic. And in first order logic the things you're used to make statements are the usual logical connectives like and or not and implies. You're allowed to make statements that use the operators of your field. So we're allowed to make statements like a plus B a times B a minus B and so on. And you're allowed to quantify over all elements of whatever field or model you're working in. So you can say for all X in your model something rather is true. So this is usually abbreviated as for all X. And you can say there exists an X in your model such that something or other which is usually abbreviated as there exists an X. So for example, how do you say a field is algebraically closed? So you might want to say for all polynomials a n X dn plus a n minus one X dn minus one and so on. There is a root. Well, this isn't allowed. This is not a statement of first order logic. And the reason is you're saying for all polynomials and you can't say for all polynomials. You're only allowed to say for all elements of your field. So what can we do? We can say for all polynomials of degree n as this is just saying a n X dn plus a n minus one X dn minus one and so on. And this is a perfectly good statement for first order logic because it's the same as saying for all a n a n minus one up to a naught something or other is true. This polynomial has a root. So how do we say a field is algebraically closed in first order logic? Well, you can't quite. In order to say a field is algebraically closed. It takes an infinite number of statements of first order logic. But taking an infinite number of statements of first order logic is generally a rather harmless operation. All that means is that the axioms for an algebraically closed field are an infinite set of first order axioms. You have all the axioms for field and for every integer n you have the axioms stating that polynomials degree n have a root. So what you can't do is do things like state for all integers n something rather is true that the point is you are not allowed to quantify overall integers. You can't say all for all integers something has such and such a property. You're not allowed to quantify over all elements of the field. So that's roughly what a first order statement is. And next we have rather basic results that the theory of algebraically closed fields of given characteristic P. So P can be 0, 2, 3, 5, etc. It's either a prime or zero is complete. So complete means that every statement you can write down in first order logic is either provable or disprovable. So everything provable or disprovable. Well, if you've heard of Gerdel's incompleteness theorem, this might be possibly a little bit puzzling because Gerdel's theorem says that there are always statements that you can't prove or disprove. Well, if you look at the statement of Gerdel's theorem, it only applies to logical systems that can encode the positive integers in some sense. And the axioms for an algebraically closed field can't actually encode the integers. There is no way to define the integers using the axioms for an algebraically closed field. I mean, if you take the complex numbers, you can certainly define the integers as a subset of the complex numbers, but you can't do it using just first order logic. So you can't actually encode the constructions needed in Gerdel's theorem and you can find complete theories provided they can't encode the integers and the algebraically closed fields of given characteristic are a very well known example of this. The proof that this is complete is actually rather easy that there is a unique algebraically closed field of given characteristic and cardinality equal to the continuum. And it follows fairly easily from a bit of first order logic that if there's a unique model of some theory and some characteristic, then that theory is complete. You can actually deduce this from Gerdel's completeness theorem. He actually has a completeness theorem as well as an incompleteness theorem. The completeness theorem says that if any first order theory is consistent, then you can find a model of it. And if the theory of algebraically closed fields were not complete, then you could find two bigger theories, one of which some statement was true and one of which was false, and then you could find two different models of any given infinite cardinality, which should be a contradiction. So the theory of algebraically closed fields is complete because algebraically closed fields are unique up to isomorphism in uncountable cardinalities. Encountable cardinalities, they aren't unique up to isomorphism because they can have a transcendence degree, which varies. Well, now that we've seen that algebraically closed fields are complete, we can now see that anything true for all algebraically closed fields of large characteristic is true for algebraically closed fields of characteristic zero. And the reason for this is you stop and think about how can you say something is of characteristic zero. Well, you can't say a field is of characteristic zero with just one statement of first order logic. So you might say nx is not equal zero for n greater than zero and being an integer. Well, you can't state this in first order logic because you can't talk about integers in first order logic if you're working in the theory of fields. So that's not allowed. What you can do to define characteristic zero is you can say 2x is not zero, 3x is not zero, 5x is not zero and so on. So we need a countable number of statements in order to say a field is of characteristic zero. And now suppose you've proved something for algebraically closed fields in characteristic zero. So any proof uses only a finite number of axioms because a proof is finite. So it can only use a finite number of axioms. So it can only use a finite number of these axioms. So if you've proved something about algebraically closed fields of characteristic zero in first order logic, it's automatically true for all algebraically closed fields of sufficiently large characteristic because your proof can only eliminate a finite number of characteristics. So true for algebraically closed characteristic zero implies true for algebraically closed and for large characteristics. And conversely, if something is true for all algebraically closed fields and large characteristics, it's also true for an algebraically closed field in characteristic zero just by applying this to the converse statement. And this now implies the ax growth in the theorem because the ax growth in the theorem again, you can't state it using a single statement of first order logic because it's talking about arbitrary varieties and a variety could be of any dimension and defined by any number of equations. But for any family of varieties defined in given affine space with a fixed number of equations, you can state the ax growth in the theorem for that in first order logic. And that's now true in characteristic zero because it's true in all sufficiently large finite characteristics. So the ax growth in the theorem is can be produced as a conjunction of a countable number of statements of first order logic. So when you prove it in characteristic p greater than zero that automatically proves it in characteristic zero. So this is a rather unusual technique because you're proving something in characteristic zero by first proving it in characteristic p and then kind of waving your hands and applying this weird idea from model theory and first order logic. So in characteristic p that there are some powerful techniques you can use like you can use counting arguments as we did for the ax growth in the theorem. You can use the vague conjectures in characteristic p. There are things like Frobenius endomorphisms and so on. So you can use these indirectly to prove things in characteristic zero by first proving them over all finite characteristics and then applying model theory, a famous example of this is Maurice end and break argument where he first proved it in characteristic p by counting and then extended that to characteristic zero. Okay, that concludes the part of the course on regular morphisms. The next lecture will be on rational maps.


My name is Jakub Szusturicz. I'm from team Messi Simplifying Diagnostics. We come from Slovenia, capital Ljubljana. I would like to bring our company on a global level. I would like to bring our ideas, our solutions to every general practitioner, to every cardiovascular surgeon, actually to every doctor working and practicing. Technology that we are developing in our team will consist of modules. There will be a wearable part that you will constantly wear. We don't want to have something that would really bother you. We want to have something that is really not there and you're not thinking about it. We will have other modules placed somewhere in your apartment that you will use for the checkups. And when tricorder will say, okay, I need better knowledge about you, and tricorder will say now take this module, place it on your, I don't know which part of the body and you will hold it there and you will be measured. Overall, we would like to have urine analyzer. We would like to have blood analyzer. We would like to have a module that will closer see your symptoms and a module that will closer hear your symptoms. So everything should be and must be very user-friendly. Like it is when you come to the doctor. With the companies we didn't have problems. They reacted very well. But when we went to the institutes and to the faculties and to the university, those doctors and doctors of science and engineers just didn't know what we were talking about. They left to us what you would like to make a device that will discover 16 diseases.  And it has to weight only two kilos. They just didn't accept the rules and didn't accept the vision that we will be working on. My goal is to deliver humanity good medical devices that will save their lives.


Everybody forced here up in two boxes of 2022 top scrum update series baseball hobby for Dean. I here we go Dean tool Start off with a Josh Rojas Aqua Numbered 153 out of 250 Purple rookie debut Brandon Marsh Painter base Stot Fisk purple Chris Bryant purple rookie JP Sears I'm Jay Melinda generation now purple Jonathan VR Marlins legend. I did not know he was a cub Purple rookie Francisco Morales Joe Musgrove all-star purple Kenley Jensen Red Sox Kenley Jensen Purple Matt Chapman Purple Michael Panetta.  I Don't know that. I was like, yeah He's like an all-star there So I know that either George Springer purple nester Cortez You haven't seen that play where he was like halfway in left field I Mean probably doesn't stick to my memory though purple Nick Castellanos Come on number J rod purple Rodan Say it's a zoo key generation out purple Josh Rojas Purple rookie debut Jaron Duran not a purple Sunday gray or do a USA start tomorrow Purple rookie Anderson Severino purple Chris Archer Purple rookie debut Nick Ladola We're a slurs generation now purple rookie Spencer Torkelson Wayne, right Wayne right, okay. I feel all right You know Wayne writes on the best fantasy baseball team ever this year Stock rookie proper Keith and Roberts. Yeah, mine. Oh Yeah totally No forest purple geo Rochella Man, no one's chatted in a while This is kind of weird me out though What's the the actual feed right? Rookie Shane be a Shane boss debut Purple rookie Jose Miranda Is max Libby purple Rookie Joe Perez What nah wonder from Purple debut say Suzuki. I don't believe you Bobby. What junior Ricky base purple rookie Ryan Pepio Jake what's the lead of it? He was to say something really bad Here Cole rookie purple Mackenzie Gore Purple Corey seager Whenever someone deletes the message it's always it's always Jake. It's never the breaker actually purple Tony Gonsolin That would never happen Purple rookie Jason Creson Especially if it's Donny always got a break blame him purple rookie J rod there we go as we're talking about nice there he is purple Alcantara purple rookie Adrian Martinez J rod base rookie Royce Lewis purple debut purple K Craig Kimbrel Gonna call him keg keg Crembrill purple rookie Cole sands Purple hazy Sanchez Yeah, we always ask crazy questions a minute ago purple debut Mackenzie Gore Guys off the rails fire bucks and purple rookie hunter green Purple green reds Purple rookie Brendan Donovan actually hurts Doesn't feel good at all Purple and Miller workers comp Purple O'Neill Cruz debut Thomas Well, you're almost sorry Trevor story purple rookie Otto Adam aller Adam aller rookie refractor Otto Purple rookie Josh Winder Purple rookie debut George Kirby. That's gonna do it. Thanks again Dean. We'll get these out to you You