Let's talk about generating comics with JavaScript. The slides are already online. I'm Anand. You'll find me on Twitter on sAnandZero. My story really starts in 1984 when, as a kid, I asked my mom, who's the most famous person? I was expecting the name of some scientist. That's who I wanted to be. And Albert Einstein was certainly something that I was hoping for. But she said Walt Disney. That was odd. Now, I knew Disney's comics. I've certainly seen their movies. But I've never heard of Walt Disney. I didn't know that there was a person called Disney until that time. Then I started looking at his work and pretty much reading every single Disney comic and watching every single animation picture, usually standing at bookstalls, graphic novels where and still are pretty expensive. And by 1992, I pretty much made up my mind. My life's ambition is to draw comics for Disney. And I started very aggressively. And in two years, I realized one thing. I can't draw anything. Zero. That was the end of that ambition. But on the other hand, others can draw. So there's nothing that stops me from using these. So I started hunting comics and in 1999 discovered Calvin and Hobbes. So you may know this particular strip where, for instance, Hobbes asks Calvin, haven't you put in your story yet? He says, no, I'm waiting for inspiration. You can't just turn on creativity like a faucet. You have to be in the right mood. And Hobbes asks, what mood is that? Last minute panic. This is like one of my all-time favorite Calvin and Hobbes. In fact, last time, last minute panic is my motto. That's how I work. That's how this slide got built as well. Last minute panic. And I would use these comic strips and create stories out of them, use them as part of presentations, business presentations, technical presentations. I mean, heck, I'm giving JavaScript presentation on comics here. So the trouble, though, was that these comics weren't really discoverable. So I effectively spent seven years of my life, 2001 to 2007, typing out every single Calvin and Hobbes strip so that I could search through it. It was a simple Excel interface that I built some of you may have seen it. And what I would do is sit on a train from Mumbai to Churchgate and using simple macros as I scrolled through each line on Excel, it would change the strip. And I would look at it and say, okay, everyone in the water, I refuse, blah, blah, blah. And as you can see over time, my typing speed also increased if I typed this much. And I was very proud, created a website out of it. So if on this, for instance, I want to search for that last minute panic strip that comes in pretty quickly, or if I want to search for every spacemen spiff strip, I just search for spacemen and go to the next one, go to the next one and I get all of these. And I was totally thrilled, right? So it went on to the front page of Reddit slash dot hacker news and I got a DMCA takedown notice from you comics. That just completely killed it. So that was the end of the next adventure. Over the years I started Grammar and we assembled a design team. And our design team as the organization grew, started growing crazier than usual. They started putting together comics literally on a wall. This is one of the walls in our office which is decorated with, not even sure whether I would call it comics, but it also has comics. They started creating comics for various situations. So for instance, there was a client from the Middle East who called us and said, we want to use big data. Okay, cool.  They said, see, we want you to forecast our revenue and we have the last three years worth of revenue. Okay, what? Daily data, hourly data, minute lead data, yearly data. Wait, sorry, you're gonna give me three data points and you want to predict the fourth. Said, yes, but we can also give you GDP data. What, annually? Yes, because you need Excel. That's really what you need. You probably need paper and pen and we put that together as a comic strip and told people, look for big data, you don't really need much beyond Excel. If your definition of big data is something that fits in less than a gigabyte of file size, right? That's Excel can quite comfortably handle that. And as we put these characters together, we had a discovery. We figured that it's possible to create these in a way that others can use and put together this open source application library called Comic-Gen. It's at grammar.com slash comic-gen. I'll show you how it works. Let's start with one of the characters that we built in the early days, D. You can choose the angle that D is in, the emotion that D shows, the pose that D has and there are different combinations for each of these and maybe flip them around as a mirror image. Ultimately, all of this gets translated into code here.  So now D has an angle straight, emotion is angry, frustrated. If I change the emotion to cry, you just have to put in emotion equals cry and that character gets generated. Let's show you how this works. I'm gonna take the development page here and open an example on code bin. So what you need is firstly, you need to have the library inserted for which the code here is optionally include the style sheet. Definitely include Comic-Gen and that's located at on NPM, but you can just use unpackage.com slash comic-gen. When these libraries are included and that is captured here in the library section. Yeah, so unpackage.com slash comic-gen is included here as a library and you do that and you put in G class is equal to Comic-Gen. Name is D and the angle is straight, emotion is smile, pose is thumbs up. That creates this character with a thumbs up expression. This was literally also just copy pasting from here. So if instead I wanted to have this character, I would copy this pasted in the HTML and that refreshes eventually it's gonna get there, I hope. Yeah, and you have this character embeddable in any part of the HTML. The real discovery was twofold. The first is that simplicity actually wins remarkably well.  It's possible to do effectively the equivalent of emotion transfer, which is why emoticons work so well. You send a smiley, the person at the other end sees you smiling or they smile in themselves. So we found that emotions are pretty powerful and started building a reasonably large range of emotions. The second discovery was that composability is pretty powerful too. So we have characters like for instance, humans, which is an open source library where you can pick from different heads, different bottoms and different bodies. And when you do that, the number of characters starts increasing combinatorially. So that's a pretty powerful feature too. And we started using this in our stories. So for instance, we took one of our 2014 stories where during the elections, the parliamentary elections, the number of candidates with the same name in different constituencies was pretty odd. For instance, there were 11 people called Chandulal Sahu in Mahasamudh, exactly the same name. One of them was the sitting MP and the remaining 10 were obviously independence who were drawn in to create some confusion. There were two Hemamalini standing for election in Mathura. One was the Hemamalini and the other certainly was not. There were, and one of the things that you'll notice about the party is that it indicates which is the party that was affected by the strategy. So if Hemamalini who belongs to BJP finds that there's one more Hemamalini in the same constituency, people might get confused and therefore BJP's vote is affected. And it's interesting, by the way, that there is, but that Congress was not affected by this strategy at all. I'll leave it there. I'll let you draw the implications. I'm not into politics. This is a word comics. And as we went along, we started realizing that now that it's programmatic, it can be controlled by data as well. So you can effectively have these strips changing based on the underlying data. So, which means that we can start including this as part of dashboards to express the emotion that we want people to take away from these dashboards. To give you an example, we took this piece for the World Bank. The World Bank had a study that explained how women face different challenges. They may, they are, for instance, the laws are different for men versus women in terms of how they access institutions, in terms of how they can use property. Let's take access, accessing institutions when it comes back. Here, for instance, there are 19 countries in which married women are required by law to obey their husbands. That includes low income countries like Mali and Afghanistan, as well as high income countries like UAE, Saudi Arabia, Qatar, and so on. Let's pick another random. There are 31 countries in which a woman cannot legally choose where to live in the same way as a man. And that includes countries like Brunei, Iran, Malaysia, and so on. Similarly, there are 31 countries where you cannot be the head of a household. It turns out that these expression varies based on the severity of the situation. So there are only three countries where you can't open the bank account in the same way as a man. But there are 11 countries where you can't apply for a national ID card in the same way as a man. Not just here, we started introducing this into dashboards in other tools as well. So this is a Power BI dashboard where Day is reasonably happy that in the last quarter, there was an increase in sales in Americas. And in APAC also, there was an increase in sales. But it's pretty clear that in EMEA, this performance is not so good and he practically has tears in his eyes. Couple of things happen when these go into dashboards that executive see. The first is a certain level of interest. When you see a comic character, it's effectively a promise from the author that the content is going to be a simple and engaging. And it usually lives up to the promise for a couple of reasons. The first is that the creator is trying to do something different. The second, when they start introducing comics into these kinds of dashboards, there is a natural tendency, even on the part of the creator, to simplify their work, to make it more engaging. So it's a virtuous cycle where there is a promise and the promise is almost self-fulfilling. And we've seen this have a fair bit of traction in the system. So let's create a comic strip now. What we are going to do is take this scenario, D is at JS Fu and she's Skyping and says, I'll call back later, I promise. And hopefully you catch the pun on that. The question is, there was a flicker. So if there are a lot of components on the screen, it flickers. Yes, unfortunately, the artist who drew D drew D with a lot of hair and with very intricate detail and D in particular has pretty low performance. The subsequent characters like Ringo and they have art men who have less hair and over time you'll find that the level of complexity starts decreasing. So, but you're right. When using SVG on complex characters, especially with complex hair, it becomes a problem. So there are two ways we are looking at addressing this. One, PNG. So one of the options that there is is instead of using SVG, use PNG and they are an order of magnitude lighter. So you'd find that there would be less flicker when we take a character like D and choose different emotions. So here you'll find that this and it's not pre-cached or anything. Now it's literally live. The other, of course, is caching. Load all of these upfront and render them. You know the range of emotions. It's not that large. So that's the second. So ultimately three strategies. Simplify the original content itself. Second, switch to PNG and we pre-created those. And third, cash them. I can probably take one more question before I switch over. Yes. If you go to the PNG, we can't scale. It does get pixelated. That is true and therefore the choices between SVG, which you would want to scale and PNG, which you wouldn't scale. The thing though is for the vast majority of the users that we've seen comics put to, people don't really scale it. It's just an empirical observation at the moment. I don't know if that will hold ground. We are just discovering the users to which comics are being put. But so far for the vast majority of the users that have seen comics being put to, they tend to stay roughly at the same size. So maybe it won't matter. We don't know. If the site is viewable in desktop and mobile and the resolutions on both of them are the same. Yes, as you said, it probably should be fine. Let's create a comic strip now. And what we'll do is try and replicate that very picture. We're coming up with a user interface where it's possible to create the comic strip from scratch directly on the UI today. This is not possible. What I'm showing you is still in UAT, but eventually when that happens, we can pick a character such as D. Let me get rid of the older character. And what did we want her to look like? Okay, she from an angle perspective, I think is fine. She should be reading, looking down, and the post should be holding a laptop. And we add a speech bubble, which can be smaller, in which she says something about callbacks and promises. I'll call back, I promise. And that then gets moved to wherever it needs to go. And with that, we have the comic strip created. Put it into your favorite editor. So you can export it as SVG, put it into Illustrator or just take a screenshot, put it into PowerPoint. So yeah, this is literally how I created this strip and it takes a minute or two to create these. You can of course do this programmatically also. So in the documentation on comic gen, there are some more sophisticated characters. Let's take something here at the bottom. Okay, so this is a full-fledged strip that is programmatically created. You can create panels. Are these boxes and right now the boxes are straight. Ideally you want them to be hand-drawn like boxes, but that's coming with caption text. So that just comes in as plain vanilla text. And then you put in the appropriate comic gen characters and position them. You can move the comic gen characters on the interface and it'll give you the exact X and Y. And that gives you this particular strip, which is just plain SVG and with a certain amount of JavaScript that's applied onto it. The next phase that we are exploring is how can we start animating these characters based on data in a more fluid form. So LA Times in 19, somewhere in the 1960s or 70s carried an article in which a person, Sharnoff created a visualization showing how different counties were reporting on their surveys. And he used a very interesting principle. He showed a fat face where people were affluent and he showed a thin face where people were not. He showed a happy face where people reported higher levels of I think income, something that correlated with satisfaction, maybe job satisfaction and sad faces where that was not true. And he used a series of other factors. Now, what that allows us to do is control attributes of the shape in a continuous fashion, not like in a discrete fashion the way you saw earlier. And this can be pretty powerful too. So for example, one of the things that we put together for this election was can we take the candidates and use their profile to create a drawing that characterizes them. So we can have those with a lot of assets as having a round face and those with very few assets as having a thin face. Those that are young have lots of hair. Those that are old have less hair. Criminal cases, the guy on the left is a poor innocent chap whereas the person on the right with red eyes clearly is far from that and so on. So this is what some of the famous people look like. Narendra Modi, slightly innocent face. Rahul Gandhi, not so innocent. Arjun Singh looks positively evil. Rahul Gandhi definitely has more hair. He's among the younger ones. Smiling if they win. So these people won in Amit Shah, they won in their constituencies whereas Rahul Gandhi did not. By the way, it's purely coincidence that some of my slides have anti-Congress messages. That was not the intent. It literally is a coincidence. I'm politically unaffiliated. But let's take Bangalore Central. So this is the result of these are the faces of the Bangalore Central election that happened recently. The person who won is PC Mohan who's smiling because he won and doesn't have much by way of criminal cases and is moderately educated, moderately old, has a reasonable number of liabilities to go along with his assets. Whereas the person who came number two, Rizwan, is unhappy and is fairly rich and maybe slightly younger as well and has similar assets but slightly more educated. Prakash Raj has as much wealth, slightly older but a little more in terms of the crime status. MK Pasha is one of the youngest that stood for election. Poor lad is all we can say. Quite innocent, not very affluent. At a glance, you get a sense of the candidate's profile and it becomes a little easier to read it but it's also something that's engaging and this was a piece that we'd put together for the media. Now while we are exploring this, another thing that we are also looking at is can we animate these characters dynamically? So what does it take to be able to take these sketches and draw them? There is this library, Vivas, Vivas, I don't know how to pronounce it, instant in which you can drag and drop a shape. So for example, this is Priya who's one of the new characters that's coming up. If I take Priya reading a paper and drop this, this SVG library allows me to animate this real time.  So with this kind of an approach, if we are able to simplify the characters to the point where they are mostly line drawings, that allows us to create sketches that look as if they are drawn by hand and are in fact being drawn by hand. So that's an area that we're working actively on. But all of this is very much in development and there are three things that you can do right now to get working on comics. The first of course is to use them. There's a whole bunch of Japanese and Chinese styles that have started using Comic-Gen and are putting them, I have no idea what they're saying, I can't even translate the images because I then have to do OCR in Japanese and then figure it out, which was too much work. But there are a number of people that are tweeting on Twitter with the hashtag hash comic gen, taking these and creating strips. So just using it to see what kind of expressions and uses comics have in regular content, that's an exploration that a lot of people are doing and would be of great help if you can learn and teach the community. The other kind of work that people are doing in the community is creating characters.  These are community contributed characters and Donald Trump is on the way. As of yesterday, we had one person who came in and said, I'm putting together a Donald Trump sketch and this is a portfolio that's growing as well. But as developers, the other thing that you can pitch on on to this library is integrating with plugins. So you saw the Power BI plugin, there's a PowerPoint plugin that's coming in. If you have a framework, library, tool set, whatever and want to build a plugin, the code is out there, you can certainly start integrating it. Building a user interface so that people can create comics in an easier way is something that we're working on if anyone's interested in pitching and that would be pretty powerful too. And improving the main API itself to make sure that it has more functionality. So how do we introduce animation? How do we introduce delays? How do we introduce composition layers? All of these are very open questions. Like I said, this is the early days for this. But this is a story of Comic-Gen. I must end with my story as well. We were working with Star TV and started using Comic-Gen in some of those dashboards. It was talking about how the viewership was dipping across various regions. And Star TV, as many of you know, was owned by 20th Century Fox and early this year was acquired by Disney. Which means that I'm actually now drawing comics for Disney. Comics are just one copy-paste of me. I encourage you to try and create as many comic stories as you can, share them with the world, and enjoy, comics are fun. Thank you. If you have time for questions. So you were affected by copyright laws when you wanted to use calderon hops. So do you foresee yourself suing someone else later when they're using your stuff? So the good part is Comic-Gen is released under a CC by, that is your only attribution license, where the authors want it, or it's created in public domain. Wherever possible, what we're doing is paying the authors and taking that work and putting it under public domain. Which means that not only we, everybody including the author loses the right to sue anyone. Having said that, what's happening though, is let's take times of India, for instance. They have a huge portfolio of characters and they want to use this. So the question is, can Comic-Gen be used there? So in those cases, what we can do is take the technology, give it to them, and say, apply it to your characters and use it internally, or put it outside with copyright, would create a site, a portal, wherever so that the comics come out. See, my inspiration actually came from when after the DMCA takedown notice for Calvin and Hobbs that I got, I reached out to you comics and said, look, I have the code, I have it all typed out. Let me give it to you. Let me create a site for you, whatever I just want to search and a whole bunch of people want to search. No response. So I'm hoping to change that, because if there's a collection of comics, let people use it, and how it happens, I don't know. So, but to your point, yes, there is always a possibility, but as far as possible, we'll try and get the comics out in the open, at least through technology and if possible on the content side as well. Hey, I come from a company who's serving the fortune and clients, but the main problem that we face is something innovative, something creative, or something a little comedial or including comics in one of our dashboards or anything that we create, right? That might not get a good response from the business users, right? And also the business analysts are so-called people who decide the decision boards or dashboards, will not take it very positively. Yes. How do you think that we can change this mindset? So that was exactly the same reaction that I saw internally and externally. The good part is out of every dozen people that say, no, this won't work. There'll be one person who says, maybe, right? So the first thing to do is to catch those people. You ask them, look, do you think it'll work? Do you think it'll work, et cetera? Everybody will say no, but there'll be one person who says it with a little bit of hesitation, catch them. Second thing, don't put it, don't apply it in a scenario, which is business critical. There are always POCs. And in a POC, there'll always be somebody who wants to try something different. Now, what we're finding, for instance, is that Comic-Gen is proving pretty powerful from a marketing perspective. It gets people hooked. So you go to the marketing team and say, I'll create something for you and tell people that this is a whole new rage. It actually is. I mean, there's a lot of research that's being done and mentioned that Gartner has started talking about Comic Generation. They actually have, you can look at some of the storytelling work that one of their analysts, James Richardson, is doing. And that starts building some of the credibility around the seriousness of comics. Also mentioned some of the words like it drives engagement, it drives adoption, it reduces friction, have a portfolio of words which are actually drawn from the research that overcomes their objection. And then it gets into the marketing side of things. Slowly, there'll be a group of people that start using it. Internally, a bunch of people started using it in Gartner, or head of admin, for instance, started sending all of his reports using Comic-Gen because it was easy. And people, after he started sending it, people started reading those reports. Otherwise it was admin, what do I care? Now he sent one yesterday saying, make sure that you book your flight tickets for at least one week in advance because of that we can save a solid 25% on the cost. Wow, every single person read that. So internal communication then starts building the culture internally that this is not unusual, this is part of the norm. And then slowly it starts trickling into projects. So that was our work as well. We started showing it to a few clients. And among the clients, there'll be one or two that are more interested. They'll say, let's start with that. That's how it started. And then when one or two clients do it, the sales team looks at it and says, oh, okay, that means we can now take it to more clients. And this in itself becomes a product offering or a differentiator, very often a differentiator. So short answer, hook the early adopters, get them to touch marketing, drive POCs, then show it in a project, then drive sales. Hello, up here, here, here, here, here. Yes. Yeah, great talk, man. I literally had goosebumps when he said I'm drawing comics for Disney now. It's such a great moment. So yeah, just wanted to ask one thing. Are you also considering making some of these things responsive? Because probably when you do something like that, you probably just take a headshot of the character when they're probably changing screens. So since you're already looking into animating the characters, is responsiveness also and think that you're probably considering with these comics? Thank you for that input. Have not thought about it. I will think about it. I don't know the scenarios where that becomes important in the sense that right now I've been treating comic-gen characters or even parts as just images. And therefore the responsiveness of images is the only thing that I had factored in. However, given that, now like you said, we are looking at animation and we are potentially changing the shapes. Is there a different shape that we should have at different sizes? That's an interesting thought. Let me just think about it. I would love to contribute to it if you. Absolutely. It's an open source repository. Just fork it, create whatever you want, send a pull request or don't, whatever, please. Yes, that would be fantastic. Thanks, sir. Time for one more question. Hi, just wanted to check, in terms of accessibility, so if I use X character, let's say a man sitting on a chair and I put in some dialogue for that character, so does it automatically generate like a transcript that okay, man sitting in chair says so and so? Okay, well, that's a fair question, especially coming after a talk on accessibility. I'll tell you our current state of accessibility on this. Zero, absolutely nothing. Right now the question is, does a person who is fully with site and fully capable in every way going to even want to use this? So right now my question is, is comic-gen worth it? So if it is, then it's something. Let's say I have some blog post and I embed this out there. So I would ideally want that any, like everyone should be able to, like how we do for images, right? You're absolutely right. And it is important. I'm not diminishing the importance. I'm saying it's ultra critical. Right now, what I don't know is whether what we are exploring is something that will even be used. I think it definitely, it's a fingers crossed. And the next hurdle to cross is accessibility. But you are the first person to raise this question, actually out of the hundreds of people that I've seen or heard. And if right now we don't even have a mechanism for figuring out how to bring in that accessibility because we don't even have enough studies on understanding how it is being used. So once we figure that out, I think that's absolutely a positive next step. I'm not saying that what I'm really saying is that we are so far behind on understanding its usage that accessibility seems like a distant dream at the moment. And we'd love to explore the usage on the ground. Right, thanks.


Hello, we're back again. I was just saying that this is an absolutely amazing format and Hopefully I at least will get better as we go on with this But I'm so glad you're all here and our presenters have been so incredibly generous with their time and expertise The next presenter is Melissa Williamson Melissa now dr. Melissa Williamson is an early childhood consultant has been in this field for a long time and She is also co-chair with me of the early care and education Sector work group for the South Texas trauma-informed care consortium trying to bring trauma-informed care and other curricular and Practices to you all who are with children in the most formative years of their little brains so Melissa We're happy Thank you Kathy It's certainly my pleasure to be with you all and and my pleasure to be with everybody out there What a response we've had to an early Saturday morning and Kathy and I were talking Backstage if you will in the green room just talking about the the crescendo of Important topics that we've had today. So it's my pleasure to bring to you today Trauma-informed care in the early childhood setting as Kathy did mention. I am a project manager for Frogs Street Press Frog Street is a curriculum early childhood curriculum company as well as adduct Faculty at the University of Texas at San Antonio so I would like to first say thank you to voices for children for Allowing this kind of event to go on. I know that Sometimes it's hard to get these things put together so I honor your commitment to early childhood educators and guys we've had you just listen to a wealth of knowledge from the doctor to Marta talking about domestic violence and one of the things that I want to share with you today is that In my presentation, you're going to hear and see a lot about advocacy because as early childhood educators as Center directors as nurses as teachers as licensed professional counselors and as parents because I know we do have some parents listening today It's up to you to work towards advocacy and advocacy In this profession is really important. So when you think about The word safe What kind of what jot down what comes to your mind? And I'm going to tell you I am going to give you some homework because 45 minutes isn't near enough time to Get out all that we need to today about this topic typically when I spend Time on this topic. I spend time. I spend an entire six hours with a school or a center or Administrators talking about this and so get your phones out You can take some pictures of some slides that I where I have homework assignments, but this is the first one I want you to jot down when you think about the word safe. What comes to mind? Particularly in our industry in early childhood education I think people think about things like asthma care. We think about especially in the days of That we're living in now right in the days of COVID and how our world has changed you really think about those kinds of things but do you often think about social and emotional safety and That is what I want to talk with you about today We're going to learn a whole bunch of stuff and you see it there on the screen and I think One of the things that I've picked up from the theme of today and you know mark to put it Really eloquently when she talked about Domestic violence and the impact on children. I think we need to keep that in mind when we're talking about trauma informed care and Adverse childhood Experiences so first of all, what's your role many of you like I mentioned before Our early childhood educators are in the classroom day in and day out some of you are leaders in Schools your leaders at your center your leaders in the classroom as a teacher as a provider as a caregiver Some of you are in the helping profession When you think about your role and what it is designed to be and what you have made it How does adverse childhood experiences and trauma informed care sit into that role and Secondly, I want you to think about if you're in a serving profession and many of us are that are on this webinar today What are the goals for those that you serve and Why in when you thought of that goal For someone that you serve or the community that you serve or the center or the classroom that you serve Or even your family if you're parent listening today, what are some goals for for your family? What are some goals for the kiddos in your classroom and how does that intertwine with This topic of adverse childhood experiences one of the things that you're going to hear from me today is some personal stories and some of you are gonna text me and email me and and say that I Probably need to go to therapy and I probably do but I think that when I talk to you about my personal experiences with this Particular topic one of the reasons is is that I'm so passionate about it because I have had some personal experiences with it Secondly, as Kathy mentioned, I recently finished my study and the study that I completed was on all about family self-efficacy and teachers in a role of Educators of families the family portion of that particular study Made me realize just how important This question is to me as a goal for those that I serve in that study what I found was parents and the parents that I interviewed are longing to Find out information about adverse childhood experiences and I had Several parents come back and tell me and I'm paraphrasing from their quotes Just how important this information was to them when they learned about how their actions Truly impacted the lives of their children. It changed the way that they did things when they learned how They could take their own CD-ROM as dr. Becky Bailey calls it and Change that CD-ROM from the things that they learned from their parents to how they were parenting now It changed the trajectory of their child's life and for me That's part of the reason Why this topic is so important to me? I in fact changed part of my CD-ROM Early on as a young parent I You know my kids laugh all the time that I actually talk about this topic though supportive I wasn't the best parent early on I made a lot of mistakes and now this is the way that I give back to write all of those wrongs and I think when you think about your goals as an individual of Educator or whatever your role is to children and families You have to think about it like that and why are you going to be so passionate about that and then finally? I want to ask you what do you know about the subject? What do you know about the topic if you don't know a lot about the topic? You're gonna learn just a little bit with me here this morning, but I ask that you consider broadening That information broadening your your knowledge because the more knowledge you have the better Skills you're gonna be when it comes to really changing the lives of children and families And if you're a parent that goes for you, too You can also broaden your knowledge and as Kathy mentioned I do co-chair the early child care task force part of the sector With her and I think that one of the things that we're so proud that we've been able to do in our community here in San Antonio, Texas is to to bring together people who have the Authority to talk about this kind of taboo topic if you will who wants to air That bad things Happen in the lives of young children who wants to air that bad things have happened in our own lives And I think we have been able to bring together a group that has brought out How important this topic really is and we share it in our community colleges We're now sharing it in our universities. We are sharing it across professional learning opportunities with schools and communities I'm going to be able to share it with with over 3,000 people Out of an organization called the council for professional recognition Next week out of Washington DC that has asked me to speak on the same topic and I think as we go through Today's presentation think about what you know think about what you need to learn think about who can give you that information and Where you're going to spread it? Will it just be in your own household? Because that's an important place to start or will it be to a broader community Like what we do today and and that broader community can be your friends and family on Social media. So let's jump into it So what is adverse or what are adverse childhood experiences? Sometimes you will understand that this is called aces for short and we like to to Use acronyms. So adverse childhood experiences have been defined as abuse which you heard A great deal of abuse neglect and household dysfunction Stories from Marta previously, but I think one of the things that you have to remember is that There can be slight variations of all of these and when I when I think back to household dysfunction You know for those of you who know my family I I want to share with you that I Was in a blended family, right? We were not the Brady Bunch, however my mother had me and She married the man that I know is my father when I was three years old and as a result of that we became this blended unit and The blended unit came with four other siblings that were Probably some of them not probably some of them are closer in age to My mother than my actual father was and so you can Imagine the kinds of dysfunction that that might have created because there was a divorce on on that side and so Even though they're subtle They still can be considered Adverse childhood experiences and then you have your more your way more extreme kinds of things, right? And then you also need to think about these kinds of things natural disasters So I did two days worth of work with an organization in Houston that experienced this great the flood and we've seen hurricanes and we've seen all kinds of natural disasters in Our nation those two can have an impact on children what I heard from some of the teachers in Houston was that when it starts to even rain the behaviors in the classroom really For some children get uncontrollable and it's that that sense of I Remember when or my brain imprinted when it rained that time and we had to walk through the streets That we're flooding we lost our homes all of those kinds of things the other thing that we have to remember too And it doesn't matter what side of the political aisle that you live on is that children of Children and families who are trying to come to the United States who are often separated That too brings about some dysfunction, right? And what they have to do or what they're trying to do to get here Often is is tragic. We've heard many stories here in South Texas About what happens to them and then this is your very first homework assignment This is a video that I want you to watch it is on YouTube and it's called how does toxic stress of poverty? Hurt the developing brain. We understand that not all families who are experiencing poverty experience Adverse childhood events, but what we do know is that poverty can compound Sometimes in some families if there isn't that resilient buffer there It can compound this and so it's a great video Unfortunately, we don't have time to watch it today and then finally We have seen this my husband keeps threatening that he's going to get this Tattooed on him. We have all seen this image, right? When we think about COVID and we think about I was listening to a broadcast earlier in the week and one of the presenters talked about this and what when she was talking she talked about thinking about it broadly It is impacting all of our families different Some of the children that you cared for in the past are going to come back to your center With a parent a grandparent a relative who have been infected and have gotten better, right? Have gotten well Some of the families are going to come back to your center who have lost someone Not to mention when I go back here and I think about the economic impact that this virus has had on families It's sheerly tragic. We have taken Families who were working every day and those median income families and they've lost their entire Income and I'm just thankful and I know that that most of you out there Are to that we live in a country where we're banding together that you see neighbors helping neighbors That we have community supports. I know the city of San Antonio has done a Fantastic job in supporting each other with food with now just yesterday with Rental reimbursements, but when I think about this I think about What the long-term impact of something like this pandemic is going to do As we move into years later and understanding how that had an impact on children And so for those of you who are dying to know do I have any aces This is another one of your homework assignments if you want to do it This is a free screener that's available to you and I really like the screener. It was put out by National Public Radio and Kathy in her work and Voices for Children and the fantastic Saturday opportunities that they bring to the San Antonio community a lot of the work that they've done is Centered around trauma-informed care and adverse childhood experiences and she's given this Quiz out and in paper format and and we've really seen how a Lot of us Have many adverse childhood experiences, right? And so this is just a free screener You know, it's it's one that if you leave around your house and you ask your kids as they're young adults now You know, you might find out some information about what they were thinking as did they ever have any adverse childhood experiences? Let's say I I am I found out about mine that just that way and so after you Take the screener the other thing that I want you to do is it's important that you understand as an adult How childhood trauma affects health across a lifetime and dr. Nadine Burr care She's one of the leading experts and I put this picture up here because this is the video that I want you to watch The one in the red dress I tell everybody that all the time and the video is titled how Early childhood or how childhood trauma affects health across the lifetime and what you're going to hear her say is that Adverse childhood experiences and aces are very common You hear me talking about some of the things that I experienced you're gonna hear me talking about how they had an impact on my family but what we understand now from the research is That people with four or more aces are three times as likely to have lung disease There are 14 times more as likely to have a number of suicide attempts Four and a half times more likely to develop depression 11 times more likely to be a substance abuser and Then obviously some of those kinds of things Create liver disease and and heart damage and and all kinds of things so what you need to understand as an adult doing this work is that How your life was as a child and The impact that it has on your health across the lifetime and then how are you gonna think about things? Differently what are some of the things that you're gonna change in your life? What are some of the things that you're gonna change in your classroom because of the knowledge that you now have? So I want to share with you my friend and colleague Jodie Martin shared this particular website with me and it's a website out of the UK and They have entered into an initiative and it's the 70 30 initiative and so their goal is to Reduce adverse childhood experiences by 70 percent by 2030 and when you think about that I Think about as dr. Nading Burke Harris refers to it's a movement and they have created that movement We have created that movement here in San Antonio and many other communities in Texas and many other communities across the nation that movement to reduce adverse childhood experiences and For you as the individual watching today.  Is it gonna be in your classroom? Is it gonna be a personal movement because what you experienced as a child? So let's talk about and I want to show you this is a real picture that I'm really proud of This is a school that I worked with for the better part of three years on the topic of family engagement and these are parents and teachers working together in a professional learning activity and I said that right these are parents and teachers learning together in a professional learning activity or professional learning training session, whatever you want to call it and What we talked about that day was language development. And so together we were I was able to work with this particular Program and we taught the teachers from the very beginning to two years about the importance of engaging families and I I Want you to think about whatever program that you're in today How do you engage parents and families because I'm telling you if if this time is not Has not opened our eyes to the importance of that engagement Nothing else will and then I want to ask you as an early childhood professional We're gonna switch gears now we're gonna start talking about how important we are as early childhood professionals and how important you are and how Important you are to the lives of children and families you need to think about who we are in this industry and Just like many of you I started out in that classroom my very first job was a I was a two-year-old teacher and I had a mentor teacher And her name was miss Vivian and miss Vivian taught me Lots and lots of things about children But mostly what she taught me is that she created a safe secure environment for the children that were in her classroom And so I've grown up so to speak in in this particular industry and so of my my own children And so when we think about early childhood professionals, what I want you to think about is how you can begin to advocate for the Really important job that you do because it is now time we're seeing the results of Years and years of work in the media now We're having parents understand what we do that. We're not daycare providers We're not babysitters. We are early childhood professionals and and we need to advocate for ourselves and we need to Make sure that other people hear that and so when you look at this particular slide, there's a huge gap in In what we are paid as early childhood professionals to Teachers and elementary teachers and kindergarten teachers and a lot of that has to do with education, right? But what I ask you to think about is our our teachers are Degreeed teachers bachelor degree teachers those working those of you who are working in elementary school How do you also feel about your wages? It's not enough and Now is the time for you to begin to advocate because people are really Listening they're really hearing how important your role is as an early childhood professional and how important your role is as That elementary middle or high school teacher and so when you equate those particular wages And you think about poverty guidelines often some of our early childhood professionals are living in Poverty because of the wages that were paid And so what you need to think about is what is my voice going to be able to do to help support an Increase and what there's lots of organizations that can do that and here's why I want you to think about that So when you think about something called the windows of opportunity and and there's a fantastic video on YouTube And I didn't put it on here It's Dr. Pam Schiller talking about the windows of opportunity and one of the things that she says in here And what we know about brain science is that early education Matters and here's why it matters because these windows of opportunity for all of these skills All of the skills that help make you who you are as an adult today The most fertile time when the brain is able to wire specific skills happens in Early education and I'm going to say that again the most fertile time When skills are wired happens in early education and in early childhood and if that isn't reason enough for you to stand on your soapbox and Start talking about how much early care and Educators matter and how much do you parents at home matter to your youngest child? and I have to tell you if I could go back and Reverse time This is one of the things that I think when I Started this journey that really kind of hit me the most because Did I do these things to optimally wire the brain of my own children as best as I could right and I always joke and say this is what I'm doing to pay it forward I'm going to right all my wrongs, but I think you need to understand that and and I know that you're not going to be able To see part of this little thing on the screen Because of the pictures down there But what I want you to understand is that adverse childhood experiences Begin to occur in the first thousand days This is from conception from conception Because the child's brain begins to wire Early in utero Early in utero and This also Really great quote by dr. Schiller what you teach me birth three will be what matters most to me But what you teach me when I'm three to five will be most likely what makes me thrive 85% of a child's brain is wired by the age of three 90 to 95% of a child's brain is wired by the age of five and so when I think about my Early childhood and how my brain was wired and we don't have nearly enough time to go into that today What I do think about is what impact that it had on me Young and now how did what was that trajectory like and how did I transition that? Wiring into my own family and and I will tell you that it does transition and Sometime when we have more time I can go into that but what I want you to understand today is that early childhood educators and parents Alike you guys are brain architects.   So toothpaste has lots of inactive ingredients in it. It's got things that make it taste good It's got things that make it bubble. It's got all kinds of other things But the active ingredient in a child's life There's only one that one active ingredient in a child's life is you and when you think about that in the terms of classroom The active ingredient in that classroom is the teacher. There's lots of inactive ingredients You can have a great curriculum like frog sheet You can have the best classroom set up You can have the best design activities the the best design materials but the thing the the one thing that makes all of those things work is you the teacher and Even if you do have some of those best designed classrooms those best materials the best curriculum If you the teacher haven't created that sense of safety in that classroom None of those other things are going to work because children Aren't going to have that sense of safety that they need in the classroom So let's talk about if you're a leader and a leader in early childhood I want you to think about what is your purpose leading and caring with a purpose and I thought about this a lot as a center director and I have had a long tenure as a center director and Head start administrator and so when I think about purpose what I thought about was Why are we doing this right? What is our vision? What is our mission? But how important it was for other people to be involved in understanding that purpose that vision and that mission and bringing them alongside of me and quite frankly, I had to do a lot of work in my tenure as a leader on emotional intelligence and I owe part of the reason That I decided to go back to school and pursue my doctorate degree was because I had a fabulous mentor and leader and Melinda told me one time Listen, there's no doubt that you can run a program But we got to work a little bit on this emotional intelligence thing, right? And so then I learned How important emotional intelligence was and so I read everything that I could get my hands on I read I Did all kinds of research on emotional intelligence and ultimately went on to pursue a leadership degree an Organizational leadership and a lot of that had to a lot of those courses had to do with this very topic And so when you think about being a leader, what do you think about? When it comes to the EQ how you perceive emotions of others accurately All the the kinds of things the interactions that you have with your staff members every day I think that's important emotional intelligence doesn't always have to be with a Supervisor subordinate it's in every walk of life. It's in everything that we do and so I want to Share with you this book another homework assignment whenever you get can get around to it If you're an early childhood leader an educator, this is a fantastic book by Holly Alyssa Bruno what you need to lead an early childhood and part of the education and training that My colleague Jenny Martin designed was centered around this book And one of the things that we've learned from that book is she talked a lot about early childhood and it not being the typical business Because I saw in the chat room From the previous sessions how parents confide in you and a lot of a lot of different things You are the ones that talk to them when their child is sick, right? it's not this typical business you're entering into a relationship where you are caring for their most prized possession and And it not that children are possessions, but you're caring for vulnerable They're vulnerable people and so what you have to understand is that Relationships are truly at the heart of learning whether it's your relationship with your staff members Whether it's your relationship with other people in your family Whether it's your relationship as the classroom teacher Mentor or caregiver to the children that are in the classroom whether it's your relationship as the nurse to the patient and I'm working with my my a family member right now who has a critically ill child and that child has been in the hospitals that she was born in December and We kind of talked about this relationship about how you know You want to suggest things as a parent but you're afraid to because you don't want to hurt the relationship of the nurse, right? And so for all the nurses out there the relationship with their patient the relationship with their patient's family and For the clinicians the relationship that you have with your client and so anytime you're in a position of learning You need we need to remember that Relationships really are at the heart of learning and so what we know Maslow taught us a long time ago about the hierarchy of needs, right? it's that lowest sense of Safety that is important in a relationship. It's that lowest sense of safety that that is important in a relationship and we heard Marta talk about unsafe families and So often when we're working with families and when we're in our own households what we and I'm going to Go back for just a second Empathy fuels connection. This is Brené Brown and This is your next homework assignment if you don't have an opportunity to watch it today I promise you this is a really good YouTube video and you're not going to want to miss it. This is her little rendition of empathy And I want you to watch it because it really does bring it home and what she says at the end is she says empathy fuels connection and sympathy drives Disconnection and so when we're working with our families I Asked you to think about in In the very beginning we talked about goals Are we empathetic and the reason why you need to think about Some of those things is because of the staggering statistics that we have on adverse childhood experiences 90% of Families or kiddos who had been in the juvenile justice system Have had multiple traumas at an early age Some of those people in that juvenile justice system have children that they're bringing to you every day Some of the families that we serve are from homeless are homeless and in foster care Just look at the statistics and think about in your daily walk in educating young children is empathy a part of that and So when we think about Social-emotional well-being and I go back to safety. I asked this question to you What is social-emotional well-being and does it really matter and I think that we have talked about How much that it matters and how much you matter in the lives of young children and families? so social-emotional learning Has lots of different competencies that are interrelated, right? It's about self-awareness self-management or self-regulation Social skills relationship skills responsible decision-making and all of these things are taught at a very young age and in that early childhood classroom The other thing that we have to think about is Who we are as a person and I think about this often when I think about How I raised my children did I have a good understanding of this as a mother? and did I have an understanding of The key that self-regulation and how important it is more powerful than IQ Right and when you think about self-regulation skills every one of us out there know somebody who's off the wall smart But just can't get their life together well enough to do anything with those smarts, right? And so what dr. Bruce Perry said about educators is that From a child's perspective every important caregiver and teacher is a potential source of love caring comfort simulation But from a neuroscientist perspective every important caregiver and teacher has the potential to shape a child's future And I think that is important in any role that you play You really are shaping that future and Kathy Fletcher brings us lots of really good opportunities in San Antonio with voices for children and I think one of the things that she does is bring Congress every year and The one of the most impactful Presentations that I saw was father Gregory Boyle when he came and he talked about the work that he does in Los Angeles and What he reminded me was that listen you As an adult can't if you can't calm yourself down You're not going to ever be able to teach others to suit themselves You've got to go through some attachment repair first and that was a really good message And I hang on to that message in the work that I do now And so let's talk about how we all know how important you are, right?  You're gonna you are that safe place You are that safe one that and sometimes when we're that safe place That's when you see Explosive behaviors and that's a whole nother topic to talk about But you need to understand that you can work to be that buffer that helps create children's resilience And I want to introduce you to my granny and my granny from birth to age three was the one that created help me to create that resiliency buffer and She took care of me for the first three years of my life And if it wasn't for her I go back I often go back and I wonder What kind of resilience would I have now as an adult? So why does all this matter to you? It matters mostly because Aces advert childhood experiences have a lasting impact on your life It has an impact on you it has an impact on our providers our teachers And so what are we going to do now that we're adults to help us understand this just a little bit better And then I want you to think about The children that you come in contact with every day regardless of where you work or if you're at home with with a parent as a parent We need to have a perspective shift and this perspective shift is the shift of What's wrong with you to what happened to you and how can we help and it wasn't until I had my own child that I understood and I went through Dr. Becky Bailey's conscious discipline Institute that I remember how important Understanding this shift actually was so we know that every kiddo is going to go through some positive stress Right there there's going to be some things that you know happen shots all those kinds of things that you know happen Tolerable stress, you know if it's buffered you can come back from that tolerable stress but toxic stress that kind of stress that creates those biochemicals in our brain and I Can actually give them to Our children in utero stress is dangerous very very dangerous one of the best books that I ever read was them How the body keeps score to read it if you haven't had a chance Stress is really bad for our bodies. It gives us lots of bad chemicals that do lots of harmful things to our bodies and what it did for me was This is my son who was born over 30 years ago who was born with a congenital heart defect and He passed away when he was 10 months old and so this was after several miscarriages That I had I then got pregnant again with our our beautiful now young adult Daughter, but what I want you to hear is the impact that that stress that that pregnancy had on her because remember Adverse childhood experiences occur in the critical first days of life And so her brain was she came out wired in that fight flight or flea mode, right? She was she was already in that stance and I thought it was colic and I tried everything under the Sun But it wasn't colic what I know it now is that stress is really harmful to brain architecture and So we know that stress in children in in a classroom and in any environment Kiddos are who are typically developing they think least about survival Kiddos who are in trauma think most about survival That's just kind of how the brain works and so trauma affects learning over a lifetime It affects the executive function skills, which are working memory control Cognition it really does change the trajectory of the brain, but there's good news We now know that our brains plastic right that we can change the way That we think about children But it's up to you to make that shift and that trauma informed shift that informs you to not Think about what's wrong with you, but to think about what's happened to you And so you can certainly be a part of the solution You have to understand first that relationships are at the heart of learning You have to understand just like that toothpaste is going to remind you every day You are the person that is the active ingredient in that child's life And so here's a question on the screen and what I want you to think about is How Do you react? How do children react when you come into the classroom as a leader? how Do your staff members see you as a professional? How do those you work with see you and Even at home you're going to hear dr. Nading Burke Harris in that video refer to What if this bears coming home every night and I think we heard Marta really bringing that home and How important it is to understand where children are coming from so We know that typically developing children live in this great particular a predictable world, right? but if you they're living in a situation of profound adverse experiences they understand that the world isn't safe and That they think that it's never going to get better and So when you're thinking about the children that you have in your classroom every day These are the things that you need to think about and what are how are you reacting to those things? and what we what we don't understand sometimes are the triggers and Triggers can be internal or external There's a another great video called removed that I show and It could be something as simple as this little dress that the foster mother picks out that children who are Experiencing trauma are impacted by trauma. They often misread cues. So think about your affect The your face structure. How are you your proximity to children because they often misread cues? And then in a trauma uninformed environment We are really trying to think it's the kids.  That's a really uninformed response But now we understand that these Kinds of things that have had an impact on them early on It's just this difficulty in regulating their emotions It's that they don't understand How to do this? It's the trauma and their brain architecture has really Changed the way that they think and and operate in their free parental cortex And so you can be a part of that movement You can begin to think about Instead of what's wrong with you what happened to you and more importantly as an early childhood educator How can you help? And so who do you need to think about first you right? and We need to advance our profession and become good advocates for what we do every day And then I want you to always think about this is the ultimate goal This is the happy and healthy child that you want to have in your classroom and in your home even and How you are that important ingredient you are the most active Ingredient in that particular child's life and then lastly I want you to think about what methodology are you using at Frog Street? I think one of the best ones out there and I owe my a lot of Gratitude to the work that I do to Dr. Becky Bailey and loving guidance in her work in conscious discipline because it was there that I learned How some of the things that I did early on had an impact on on my children And so what methodology and so this is just one of many Remember relationships do matter as an early educator you are building brains you are that brain architect and Again, as Kathy mentioned I'm proud to be the co-chair of the early care and education sector and this is just a little look of what that sector is and There's the website for the sector down there and the takeaway for today is you'll be able to consider the importance of Trauma informed approach wherever you are whether that's a classroom whether that's an office whether you're a nurse or Whether you're a parent and most importantly we need to do something with that I invite you guys to take a look at our early childhood conference that we have at Frog Street It's coming up Probably will be virtual or hybrid but take a look and if you'd like to continue the conversation with me You're more than welcome to do so and connect with me. That's my my cell phone number down there My address or you can connect with me on LinkedIn, but Kathy. Do we have any questions? Yes, so the biggest one the most number of questions was can we get a copy everyone get a copy of your presentation? We will do that another one actually had to do with what I would think of is advocacy which is Centers take care of so many children who receive subsidies and given what the state is paying at least in our state and my guess is others It's very hard to even pay minimum wage or to do the kinds of things we need to do financially so What do you do? If that you are absolutely right it is about advocacy and I think a testament to that is That you started this presentation today with two elected officials Advocacy Speaks loudest when you go through your elected officials You are constituents. You vote them in office and you vote them out of office And there is not any better voice to an elected official than their constituent So if you're not registered to vote and you don't practice Voting on a regular basis All of these things that funding is spent on aren't going to get any better and still until they start hearing from you Yes, she's absolutely right Okay Yes, social emotional intelligence question is many years ago High emotional intelligence was considered a precursor to just standard intelligence What is the current research say and how can we help parents recognize? That social emotional well-being is more important than their abc's in reading at two or three So I I think I told you briefly about the study that I did with parents and teachers And and you're absolutely right What I think you're going to find when you start doing the work with parents number one When you begin to do the work with parents and families you have to understand How to engage families? first secondly Then after you've built this Bridge so to speak and how to engage families and develop their trust You really have to start educating them on this And I'm going to tell you the presentation that I did for hundreds of families in this particular school district Was not much different. It was long quite a bit longer But not much different than what I did for you today And I had some I had one out of an entire audience walk out. They weren't ready to receive the information, right? But the majority Were ready to receive the information and the feedback that I got from that particular session And the feedback that I've gotten from the study is that parents do really want to know about this So you um have the opportunity to begin educating them with that and if you ever need any help I am more than willing to um walk that path alongside of you feel free to reach out to me anytime Thank you, Melissa. The only other question the other question real quickly is what age group do the studies define as early child Early child care. I would guess the first thousand days and then births to three is the most commonly What do you see? What do you think? Right, I would agree and then in our national organization the national association the education of young children Obviously that extends through um age eight, but you're looking at Birth to three will be what batters most of them 80 to 85 percent of child's brain is wired by that time 90 to 95 by the age of five. So That's what we need to consider in our uh profession Well, thank you so much for sharing It's been a pleasure experience and also your own life experiences. Thanks you guys everybody stay safe. Stay well Bye. Bye. We'll see you in 15 minutes or less. Sounds good. Okay. Bye. Bye. Bye


I'm Secretary of Commerce Gina Ramondo. I'm thrilled to participate in the release of the 1950 Census by the National Archives. The Census Bureau has always been an essential part of the Commerce Department. In addition to being used to redraw electoral districts, the Census informs decisions about allocating hundreds of billions of federal dollars to communities all across the country for hospitals, fire departments, schools, roads, and other critical services. Historical records like these from 1950 also give us insight into how Americans lived and worked in the past and how we've evolved. The 1950 Census came at a time of great change in the wake of the Second World War and at the beginning of the baby boom. Home ownership increased 55 percent over the decades since 1940, and the percentage of houses with electricity increased from 79 percent to 94 percent. By 1950, 96 percent of homes had a radio, and over 5 million had a television. And just as in 1950, the Census remains a vital source of information about the American people. One of my first actions as Commerce Secretary was to deliver the 2020 Census results to President Biden. But the Bureau doesn't just provide data once per decade. It conducts over 130 surveys and programs every single year. Every day, businesses and individuals can find data on topics like broadband from the American Community Survey, supply chains through the Small Business Pulse Survey, and the effects of COVID-19 through the Household Pulse Survey. The Census Bureau's surveys all have one element in common. They rely on the American public to respond, so your participation is critical. Your answers become the statistics that help businesses and governments make informed decisions about education, employment, and housing, to name a few. So thank you to the National Archives for your work to release the 1950 Census, and thank you to the American people for your continued participation.


Fianz Station to board the best ship and the best Navy in the world comes with its own set of challenges both military and personal We come from both near and far United by our commitment to our values and our desires to serve but also by the unique circumstances and stressors that can Be born from life at sea This is why our Navy has made an investment in mental health on the waterfront Ensuring that we are able to supply the resources to our sailors where they need them the most I'm lieutenant linear this embedded mental health provider on board the USS Theodore Roosevelt a ship and a crew That is the very definition of mental resilience Out on the deck plates What I see are a crew that has battled through COVID back-to-back deployments and extended time away from their families a Team strong in mind body and soul On board we have a number of resources from the medical to the personal with chaplain Deployment resiliency counselor our many gyms our morale welfare and recreation team and activities as well as our sailors on TR we also created a TR tough series that reflects on the mental hurdles that come with a life of service How to get through and how to get over those challenges? Connecting the lessons learned and planted during bootcamp to the life lived by our successful sailors on the deck plates Our sailors are strong our sailors are resilient and our sailors are successful We are here to be a shoulder a help and a voice to remind them every day how strong they are


The topic for today's discussion is health. As you know, governments intervene enormously in health markets and health insurance markets. In the U.S., this consists, most importantly perhaps, of subsidies for purchasing health insurance under Medicaid, Medicare, the Affordable Care Act, also indirectly via the favorable tax treatment of employer-paid health insurance premiums. Another broad area of intervention is the licensing of physicians, nurses, other healthcare professionals, regulation of hospitals, and so on and so forth. Still a different category is that the Food and Drug Administration requires all new medicines and medical devices to be approved by the FDA before they enter the marketplace. And there's much other regulation as well on whether, say, a new hospital can arise in an area without prior approval from the government. This is an area where there is, of course, broad support for government intervention. Healthcare is now viewed as a right, as a something that everyone should have, and not just sort of minimal or basic healthcare, but broad kinds of healthcare, state-of-the-art healthcare, and so it's something that is politically extremely difficult to address because current opinion is so strongly unfavorable of government taking a large role. Libertarian position says, of course, healthcare is good, having health insurance is nice, it's understandable why everyone wants it, but of course everyone would like to have all sorts of things, but they cost money. So the interventions are going to likely do much more harm than good. We're going to be providing something at low or no cost to people who are not paying for it themselves. So that's going to generate all sorts of negative effects in health insurance markets. So in a nutshell, it's going to be incredibly costly to provide healthcare at nearly a level and nearly the expansiveness that we currently do. And in the process, we're not only going to make it more costly, we're going to have huge negative effects on the healthcare system and make health worse for almost everyone. So I'm going to discuss sort of five major areas in today's discussion. First, what are the arguments for subsidizing health insurance in the first place? Should we take those as compelling or should we think that there's not such a strong case to begin with? Second, given that we are subsidizing, what are the costs and negative effects of that type of government involvement? Third, what sorts of effects, positive or negative, does the food and drug administration, does the prior requirements on introduction of new medicines have? Then turn to licensing, and we've discussed a little bit already in the previous lecture, but we'll discuss more specifically in the context of doctors, and finally talk about immigration restrictions, which play a surprisingly large role in healthcare in the United States. So to begin, why should government be subsidizing healthcare in the first place? It sounds like a crazy question in this day and age because almost everybody takes as given that we should be subsidizing healthcare, but there are all sorts of nice things that people like and enjoy and are important for their lives from food to housing, etc., that we don't subsidize or don't subsidize nearly as much. Why is healthcare different? Why should that be something that gets special treatment from government? So there are three main arguments. The first argument is known as the adverse selection or the asymmetric information argument. It says that private health insurance markets won't work very well, and they won't work very well because people differ in their health types. Some are healthy and they know it, some are unhealthy and they know it, but insurer who is considering what price to charge someone who's seeking to purchase health insurance can't tell who's a good health risk or a bad health risk, who will have lots of health expenditures that have to be immersed by insurance and who will have relatively few. And so the insurer faces a dilemma as to what price to charge because it can't tell who is who. If it charges the same price to everyone, say the average price of all the expenditure across all types of people, what's going to happen? What's likely to happen is that people who know that they are good health risks and won't have very high expenditures on average don't want to purchase that insurance. It's a bad deal for people who are good health risks. It's only a good deal to purchase that insurance for people who are bad health risks who have lots of need for health expenditure. So the insurance company will go broke if it charges the actually fair price, if it charges the average cost of everyone in the entire economy. And that means that either private health insurance might not be provided in the first place or if provided will only be available to the very unhealthy at very high prices, all the other people who would like to have insurance against the variability in their health expenditures won't easily be able to get it or will have to pay excessively high prices. And there's an argument that says if government comes in and mandates that everyone has health insurance, then this adverse selection, this tendency for only the bad risk to apply for insurance doesn't happen because everybody has to get insurance. And so the government can in principle have solved this problem that private health insurance markets might not work well on their own. So that's one argument. The veil of ignorance argument is somewhat different. It says that behind the veil of ignorance, before you are born, say, you don't know whether you're going to be very healthy or very unhealthy. You might be willing to pay something in terms of your future consumption or give away some of your future income to know that you will be taken care of if you turn out to be unhealthy, if you have higher than average health risks or very bad health or something like that. And so the idea behind government provision is to provide a kind of social insurance insurance against being born unlucky with bad health and therefore we can in principle make everyone off better off because everyone would ex ante want to make this trade give up the right to some of your income in the future. That is the income you'll pay in taxes for government provided health insurance in exchange for being protected in the event that you have very poor health. Finally, an argument for subsidies is that we simply should be helping people who are poor who can't afford much health care or health insurance. That is, we should just be doing this as one part of general redistribution. Now thinking about those three arguments, it's fair to say that each has a grain of truth. It is absolutely the case that there's a tendency for adverse selection in all sorts of insurance markets for people with particular characteristics who know they'll get a better or worse deal from the insurance to be the ones who want to buy it or not buy it. So that's a risk that might be there. Private health insurance markets might not work great. It's certainly the case that the veil of ignorance applies to everyone. It's a logical framework. You can imagine it making a case for some degree of government health insurance or some degree of government redistribution. And likewise, many people, not necessarily libertarians, but many people feel that we should be protecting the poor via government policies. That said, none of those arguments is likely to imply that we should provide anything like universal health insurance. At most, they're likely to apply that there should be a small amount of health insurance for people who are truly poor. Why? Because providing the health insurance is going to have huge costs. And so any benefit from fixing private health insurance markets, from addressing the veil of ignorance in terms of just simple redistribution, have to be balanced against all the negatives that government provision of health insurance will tend to create. So that's the next thing we need to think about. So what are the costs of subsidizing health insurance? The first, the biggest, by far the most important cost to think about is what is known as moral hazard. The idea that once people are insured, their behavior is likely to change because they know they're insured and therefore the risks they face from different kinds of behavior are different. If you know that your bicycle is insured against theft, maybe you don't bother locking your bicycle.  If you know that you have health insurance, maybe you don't go to the gym as often, maybe you don't take as good care of yourself and so on. But even more importantly in the health insurance setting, if you know that your health care is covered, you're likely to demand any kind of health care that might have any beneficial effect on your health, even if that benefit is small or in particular small relative to the likely cost. On the other side, your doctors and all the other health care providers knowing you have health insurance are going to feel free to recommend whatever it is that might be useful for you. Partially the doctor wants to make you better, so wants to do every test that might be useful. Partially the doctor doesn't want to get sued for not having done every possible thing to diagnose your condition or treat your condition. And partially the doctor knows since you're not paying for it and he's not paying for it, why not do these additional tests, these additional surgeries, these additional procedures? After all, to doctors doing health care stuff is fun. That's why they became doctors or one of the reasons they became doctors. So the existence of insurance is likely to huge increases in the demand for health care. That's going to mean way more care than is economically efficient, way more care that doesn't generate much benefit compared to its cost, and therefore much higher expenditure on health insurance and health care system. And not only is there that excessive expenditure, but that excessive expenditure then leads to other bad effects. If government is the one paying, and it will be because government created this by subsidizing, then government is going to see its expenditure on Medicaid, Medicare, Obamacare and so on, go up quickly. It's going to realize that's a problem. It's going to try to stop that with rationing and price controls and other mechanisms. And that's going to lead to an incredibly distorted health care system where you're told you can't have this procedure or you can't have that procedure based on what governments have decided are ways to reduce cost, not on your willingness to pay for the procedure and or your doctor's recommendations about which procedures, medicines and so on are good for your health. So the end result is going to be a mess. And we have seen this in many, many countries, a lousy health care system that has, because it's trying to keep the expenditures very low for the poor and most of the middle class, possibly a pretty good health care system in parallel that the rich pay for through private clinics, private hospitals and their own private contributions. So we end up back where we were almost before the subsidies with low income and middle income people facing lousy health care and the rich being able to still probably afford reasonable quality health care. So the subsidies, however well motivated are just incredibly costly and likely to lead to huge distortions and misallocations in the health care system that are bad for almost everyone. Turning to the food and drug administration. In under US policy, manufacturers drug medical devices have to first demonstrate that these things are safe and efficacious before they're allowed to be put on the market and they have to demonstrate that through these long clinical trials that are very time consuming and very costly. So the issue that arises is what's an alternative and how would that compare? If there were no FDA, there would of course be private mechanisms that would try to discipline bad drugs, devices from getting on the market. They would do clinical trials. They would do all sorts of standard things to test their medicines and medical devices, but they might do it more quickly. They might do it in more cost effective manners. They would be checked by private mechanisms like consumer reports, a new versions of those that would arise to deal with it. Physicians of course would not prescribe medicines and procedures that they thought were going to kill their patients. That's just bad business in addition to the fact that most physicians want to improve their patients' health and so on and so forth. And so in a private system with no FDA, there would of course be checks and balances. There would of course be ways to prevent bad outcomes that the FDA is trying to prevent, but it would be done with an eye to benefits compared to cost. The FDA knows that if it lets a new drug on the market too soon, and something bad happens, there is some side effect that shows up three, five, ten years down the road. There are congressional hearings, heads roll at the FDA, all sorts of bad things happen for the FDA. If they impose extra trials, they take extra time, they try to be extra certain about everything, they introduce delay. That delay doesn't lead to big protests, it doesn't lead to hearings, it doesn't lead to people getting fired, but it kills people because all the drugs which turn out should be on the market have been delayed in being allowed on the market. And that's very, very costly. So the existing evidence suggests pretty strongly that the FDA is airing strong in the direction of too much caution. A private system would get that balance much better. And note, the private system would still have the tort liability, a partially government system in the background. People who are injured would be able to sue manufacturers of faulty medications and devices to collect that exercise as another source of discipline on manufacturers of medicines and devices. So the next aspect of the healthcare system to discuss is the licensing of physicians. In the U.S. and most countries, to practice as a physician or a nurse or other kinds of healthcare professionals, you have to have graduated from an accredited medical school, passed various tests administered by state licensing boards, and so on. The reason for that is an attempt to improve the quality of physicians, even knowing that it will reduce the quantity, because most patients, according to this view, are not able to make good decisions on their own, choose good doctors, evaluate the advice that they're getting, and so government has to make sure that only good doctors are in the marketplace. That argument is unpersuasive for several reasons. First of all, their private mechanisms that would do a lot to discipline doctors who are giving bad advice, malpractice insurance. That's what doctors want to purchase, so they're not subject to huge lawsuits. So malpractice insurance companies are going to be careful not to provide that insurance to doctors who don't seem qualified. And the tort liability system more generally allows people to sue doctors who've injured them, cause them harm in ways that were not justified by the risks they assumed ex-ante. There are other private mechanisms, such as equivalence of consumer reports for rating doctors, or larger organizations that provide lots of health care to people and acquire reputations as being organizations that consistently provide high quality health care, such as health maintenance organizations. So overall, the argument for license of physicians, just as the argument for licensing more generally, is not convincing. It is clearly reducing the quantity of health care professionals and raising the cost substantially. There is little evidence that it's actually improving the quality, and so everyone is getting a lousy deal out of the licensing system, except of course for those doctors who do get to be licensed who thereby earn higher salaries and compensation than they otherwise would. But that is not the right objective of policy. The objective of policy should be to help consumers, not to help the providers of a particular service. Finally, another key intervention in the market for health care is restrictions on immigration. There are lots and lots of medical professionals who would move to the United States and practice the United States if they were allowed to do so under the immigration system. Indeed, many of them trained here, partially at the expense of U.S. taxpayers. So our current system is both spending U.S. dollars to train people and then sending them away and not letting them come back and have the advantage. If the H-1B limits, H-1B is part of the U.S. immigration system, were substantially larger, there would be far more doctors or other professionals who could re-enter or stay after having received their training here, doctors from other countries, that would increase the quantity, maybe even increase the quality by having fewer restrictions. That's a win-win for everyone, of course, except the existing doctors, the existing U.S. doctors who are the ones who don't like it, but that of course should be ignored in setting policy, policy to determine based on the welfare of consumers, not the welfare of the people supplying a good in an industry. So to sum up, the existing interventions in health care and health insurance in the U.S., libertarians are, you should be drastically cut back and probably eliminated. Certainly eliminate Medicare and the Affordable Care Act, eliminate the tax subsidy for employer-paid premiums, at a minimum scale back the FDA so its procedures were far less costly and far less time-consuming and probably eliminate that entirely, similarly with licensure, there might be some case for very mild licensing if it were done thoughtfully and carefully, but that's unlikely to be the case, so probably eliminate that as well and at a minimum cut it back. And loosening the immigration restrictions is just a no-brainer, letting people who are talented and trained and want to work in the United States and supply their services work here is good for almost everybody other than the doctors who have to compete with them. All these problems are efficiency problems in part. We're making the health care system less effective. The one thing which is a slight exception, which is an exception, is Medicaid. Medicaid is justified mainly as redistribution. It is possible that in a really thoughtful system of redistribution you would partially help people via cash, via welfare payments or something like that, and partially via subsidized health care. So Medicaid is a slightly more difficult one to address if you take as given that government should be redistributing, but even that has substantial scope to be cut back and made more efficient by introducing bigger copays and deductible so that people think about how much health care they're getting. So overall, government intervention health care is doing far more harm than good. It wrecks the health care system and is incredibly costly to


Hey guys, this is Kevin. Today we're going to solve this problem that the printer has a cartridge problem and the cartridge is missing or not damaged. Usually it's caused by you didn't click the cartridge in the slot, so you didn't push it down enough. On the bottom of the cartridge, there's a computer chip. If that chip doesn't have a good contact with the printer, the printer cannot read, so that's why it says missing. If you still have problem, it's probably this cable is bad. So this cable come in from here and go all the way to the front of the assembly. Check out the video link above to see how you take off the scanner. And quite frequently Don't pay attention to those two big cables. If something wrong with the big cable, it will show you that the printer is damaged, but it's this little cable here. And sometimes those get worn out or doesn't have a good connection. If the cable is worn out, it's very easy to tell because you're going to see those pins either halfway missing or completely missing. And to get a replacement cable, you can go to bchtechnologies.com and go to printer parts and go to HP FFC cable and those flat cable called FFC cable. You will need this four pin 0.5 millimeter pitch. Pitch is the distance between the pins. So this four pin and if it's damaged, you're going to see one of those or like more multiple of those missing halfway missing. So this one is a good cable. You don't have to take the whole carriage out. I'm just use this as an easier demonstration. You can do it inside the printer. And you can see the data get released in here and it go all the way to the front. And the all pins are good. And this is a good one. So I just use this as a demonstration how to replace it. To replace it, we need to take this cover off and this cover has a hook. Then have two tabs. You need to push those two tabs to the front. So one here and one here. For some reason, I found that the Phillips screwdriver do this the best. So the upper one and the lower one. By the way, when you're doing it, use your finger. Bend the top cover to your left and it'll help you to release the tab. When you install, just push the hook to the slot and push the tab in or lock in place. When you install, remember the shining part of the cable is towards your right. And the white part of the cable is towards your left or towards outside. If you're not sure which side goes, just take a closer look of the base. You can see the middle part is on the right. That's why the shining part should towards right. So this cable looks okay. And so the next thing we're going to try is to replace the motherboard. Okay, you can get this motherboard from bchtechnology.com and put a link there. And also I'm going to show you how to order it. We'll go back to bchtechnology.com and go to printer parts and scroll down to HP and electronic board and assembly. And here is the 8022 motherboard. Okay, here's another experiment. This is an 8022 printer, but I'm going to try 8025. I have lots of 8022, but my theory is they're the same motherboard. Just look the same. So I'll swap it and the same works and it'll be exciting. Everything is here so it's pretty easy to swap. So I disconnect the power. Okay, those two, the big cable. So here, so make sure you get both of those little cables. One is narrower, one is bigger. Remember the blue side is up toward the sky and the same thing here, the blue side. Oh, I forgot there's a screw here, so you have unscrew it. So once you unscrew it, there's a tap here, just there's a tap here, and there's a tap here, tap here. Use counterfeiters, that's good because I mean this is the way HP scare you and they tell the kids use, so they detect the cartridge that's used. Okay. And they don't say we detect some use cartridge, they tell you like we take some use and counterfeit, so just scare you. Just okay, so done this. Oh, what's the problem here? Oh, okay, classic mistake. Okay, take a good shot here. This is normally caused by a darker cable is not between the reader. I'm terrible at installing this cable, I'll ask a second hand to do that. You might have to push those back cables down some to be able to. There it is. Wow, okay. That should be in it now. This is what the cable should look like, it's between the readers. However, for this one, although it's in the correct position, it still cannot read its position, so it turns out that it has a bad carriage and we have to replace the whole carriage. I don't want to bore you over the details how to install the carriage. Basically, this video is about if the cartridge can not be read and what you want to troubleshoot is the cable that goes to the reader and also maybe there's something wrong with your motherboard. Okay, I hope this video helps. Please visit us at www.bchtechnologies.com or locally, Greensboro, North Carolina. Cheers.