WaterWare is a waterproof cover that can be used with Sonnet 2. It allows you to swim and do water sports with your audio processor. Before attaching WaterWare, first switch on your Sonnet 2 with a standard battery pack cover attached. Carefully insert the coil into the WaterWare sleeve. Hold the battery pack between your thumb and forefingers and insert the ear hook and turn it until it reaches the end of the cover. Hold the control unit with one hand and use the other hand to pull the WaterWare cover over the battery pack. It will be a tight fit so there will be some tension. Make sure WaterWare fits snugly around the entire processor without any wrinkles or bubbles and check that the coil cable is not twisted inside the cover. With clean, dry hands, apply the adhesive strip to the bottom of the battery pack following the shape of the processor but do not seal it completely. Place Sonnet 2 on a flat surface. Hold on to the coil and run your fingers along the cable to press out any remaining air. Seal WaterWare completely by applying the rest of the adhesive strip. There should be no gaps between the strip and the cover. Check again that the audio processor is sealed on all sides and that there are no wrinkles or bubbles. Each adhesive strip can be used only once but each WaterWare cover can be used up to 20 times. We recommend using an additional fixation device during swimming such as a swimming cap.


is a day to celebrate the goodness of God and make sure that we spread the light into the darkness. Welcome to Hope Today. We're so glad that you're with us. I'm Anna, and I'm here with Sydney and Tom. And Tom, we have a great guest today. Yeah, I mean, most of us grew up in families where we would be very encouraged to follow after Jesus. But what if you grew up in a family where that was not looked on as a good thing? Well, Jeff Siegel, I had a chance to talk to him earlier and he grew up Jewish. And when he found Jesus, it was not all happiness and sweetness in his family. But you're gonna hear his story. And you're also gonna hear about his ministry, Go Global Ministries. I've had the opportunity to go on a trip with them and they do some fantastic things around the world. And guys, but his story is powerful. It's a great one. I always love hearing people's stories because, you know, there's so many, I think a lot of times we take for granted with our Christian faith that, you know, we've received Jesus, we're walking with Jesus. But a lot of people can be very, very controversial, like, you know, here in America and around the world. So really looking forward to hearing Jeff's story today. Yeah, absolutely. Same. I just think, you know, we all have people in our lives where we think, gosh, I mean, they weren't brought up in the Christian faith. What have they heard about Jesus? Is it possible for them to come to know Jesus as their Lord and Savior? And truly, you were called to do the works that God calls us to do and share the love of Jesus. But it is the Holy Spirit's job, the Father, God, the Father's job to draw his people to himself. And I just love that Jeff, somebody who didn't believe that Jesus was Lord and Savior, ultimately came to know him. Yeah, absolutely. And you know what, we just have to give a shout out to Yukon, Connecticut University men's team. I wish someone else would have won, but congratulations Yukon.  You know what's in sports sometimes, so they talk with Jake, my husband about this, is where I feel like, you know, the brackets and all this stuff, and I'm like, if I'm like a top seed, I'm gonna dominate and win. I'm very competitive, so I'm just like, you know what, go ahead Yukon, good for you. What about the girl's basketball? Yes, we gotta talk for that for a minute, LSU. Yeah, Iowa, of course, Jeans from Iowa. So Iowa was, I think, expected to win, and LSU won, and they're all about this now. Angel Reese, I was just saying, I'm like for it, I was like the great competition, I know there's all this controversy right now, people are like, bad sportsmanship, but this background story is, is that, Kate Litt, I can't remember her last day right now, it's like I'm drawing a blank, but she did some, from Iowa, like did the same thing to another player, so Angel did it the same thing. I think it's all in good fun, and it's great. I just, see me, now you see me, now you don't. You can't see me. It's all, it's all in good fun competition. Yeah, we'll be having a trash talk, do you? I am the terrible trash talker. I can't imagine you trash talking. I try, people just laugh at me, and they're like, Anna, just don't.  Well, we're going to something else, we're going to trash talk on in a second here, right? We are going to trash talk on, because you guys might trash talk on about us, but it's time for Stump the Host. So our producer, Neal, said all these questions today are based on the Resurrection Sunday, and here we go, help us Jesus. Okay, after being resurrected, Jesus shows himself to the disciples beside which sea? Sea of Galilee, right? Oh, yeah, I was going to say the Sea of Galilee, because right, I don't know what others, or Red Sea, where there's Galilee. Wait a minute, is it the Dead Sea, or the Dead Sea? The Sea of Galilee, I think. I'm saying Sea of Galilee. Yep. Yay! Come on. It has two names, Tiberius or the Sea of Galilee. 21. All right, here comes our next one. Again, we haven't seen these, so play along. What did Jesus say would cry out as he rode into Jerusalem on Palm Sunday? Oh, yeah. It was the rocks, because the children were praising him, and the Pharisees didn't like that, and because he was accepting worship, by the way, which shows you that he was God. But anyway, we're going to say rocks. We're saying rocks. All right, all right. Rock stones. Yeah. So here we go. Tom, you're on fire today. So we're going to, like, we need you out right now. Okay, according to the Gospel of John, which High Priest was Christ led away to first? Okay. It was a Caiaphas. I'm just, that's the first thing that Caiaphas. I think we have, this might be a trick question. So Pontius Pilate was not a High Priest then. No. So Caiaphas. Oh, Anas. Anas is like Anas, I was kidding. I don't know that name. I better go back and read my mind. See, there were, Anas was the father, and he had been the High Priest before. They took him to, oh, well, all right. So anyway, thanks for playing along with us, and we're going to take a quick break, and then we'll be back to talk to Jeff Siegel and how he found Jesus. Cornerstone Television has believed in the power of prayer since insinception 44 years ago. We invest heavily in our prayer line to provide you with 24-7 personal prayer, knowing it brings breakthrough, healing, and wisdom. Last year alone, we received over 65,000 prayer calls, and if you had partnered with us, thank you so very much. And when you give this month, I am so excited to share with you my new book, Praying On Another Level. It's a 30-day journal to take your prayer life to a new dimension in God. You see prayer as how we separate good ideas from God ideas. It's how we unlock the door to revelation, and it's where we get our strength to build up our spirit man to hear from God throughout our day. All that and so much more. So call us now at<PHONE_NUMBER>, or give at ctvn.org forward slash donate to request your copy. It is time to take your prayer life to another level. As believers in Jesus Christ were all called to go into the world and make disciples. Do you ever think about making disciples? How can you ever do that? Well, somebody who is really doing that is our next guest, Jeff Siegel.  I've been with Jeff. I've seen him in action. Jeff, so good to have you here on Hope Today. Good to see you. Wonderful. So tell me, we're gonna talk about your ministry and we're gonna talk about how people can be involved in just a minute.   You gotta let us in on that story. Well, I had the privilege to play baseball at the University of Illinois. And from 1973 through 1977, I was challenged by a group of people from the Fellowship of Christian Athletes. Teammates on the baseball team and other sports teams began sharing with me the gospel. At the University of New Mexico Spring Trip, my friend went to hear Billy Graham speak and invited me to go too. Well, and he was my roommate. He also played on the football team and said, "'Hey, Siegs, why don't you come with me?' I said to myself, "'Jewish kids from Chicago don't do this kind of thing. "'That's a Gentile gathering. "'Hey, I'll take a rain check. "'Tell me what Mr. Graham had to say.'" He comes back to the room that night and said, "'Siegs, you really missed it.'" I said, "'What did I miss?' He said, "'I got saved tonight.'" I said, "'What did you get saved from?' He says, "'Well, I became a Christian.'" And I said, "'Now I'm really confused.'"  I said, "'How does a Christian become a Christian?' He said, "'Well, Mr. Graham made me realize "'just because a mouse is in a cookie jar "'doesn't make him a cookie.'" My senior year, through the fellowship of Christian athletes, my same friend said, "'I'm going to the FCA gathering.'"  I said to myself, "'Jewish kids from Chicago don't go "'to these kind of gatherings.'" I went out with my Gentile buddies on the baseball team, disco dance in the night away, but this Gentile, we really liked him. We asked him if he would be in our Jewish fraternity house. We grafted him in. He came back that night and said, "'Sigs, you really missed it.'" I said, "'What did I miss?' He said, "'A famous Christian woman "'was invited to our huddle. "'Her name was Corey Ten Boom.'" And she was hiding Jewish people during the Holocaust. They got caught, the whole family. She ended up in a prison or a concentration camp sharing the love of Jesus with Jewish people. I said to myself, "'Why would a Gentile, during the Holocaust, "'want to risk their neck for a Jew?' I said to myself, "'Whatever the real deal is, "'whatever the real Christian is, she's it.'" Well, then I'm getting ready to pitch against the University of Michigan State, my last day of college, my Jewish roommate, my best friend since we were little boys, nine years old, comes and tells me that he became a Christian and I said, "'Neil, you're not Jewish anymore.'" And he said, "'No, no, he said I'm a completed Jew.'" And he said, "'I've read the complete Hebrew scriptures "'and I've come to the conclusion "'that the only one who could have fulfilled this "'is Jesus.'" I got away from my Jewish friends, I got away from my Christian friends and I had a Tanakh Bible that was given to my brother as a present. So I borrowed it, I took that Bible and I held it up to heaven and I said, "'God, I have a problem with the Trinity." I think Gentiles believe in three gods, but my friend Neil said that the Trinity is one God. And I said, "'You gotta help me with this concept.'"  I am the God of your fathers. I'm the God of Abraham, Isaac and Jacob. Identity crisis in his life over. And God told him his purpose. I said, "'Was I born for a reason? "'And could my burning bush be Jesus?' So I started on the first page of the Hebrew scriptures and see the Hebrew language goes deeper than English. It said, "'Bereshis Barah Elohim.'" In the beginning, God created the heavens and the earth. Eme at the end of the word could make it plural. Verse 26, "'Let us create man in our image.'" All of a sudden, like the Apostle Paul, spiritual scales were falling from my eyes. And I said, "'Who's up there with you, creating? "'Because you never created an angel in your image, "'although they could take the form of man. "'Who's up there with you?' And then I read the prophecies and I came to Isaiah 53, that a servant would die for them and all. And so even if you don't believe them as the Jews, the Jews are still part of all. And I said to myself, "'Well, wait a minute. "'This can't be the Jews in the Holocaust "'because the blood sacrifice has to be perfect.'" So the Jewish people, how could a people who need a sacrifice be the sacrifice? That's impossible. And I said, "'Well, the only one who's perfect is God. "'But the only way he could be that servant "'is to come in a physical body, "'I fell on my knees. "'I go, the only one who could have fulfilled this "'is Jesus.'" The book of Daniel chapter nine reveals the timeframe that the Messiah would come and go before the second temple was destroyed. The Messiah had to come before the second temple was destroyed. So even if people don't believe that's Jesus, he's the only one who could have fulfilled it. I fell on my knees. I said, God, I don't know how to do this. Dear Jesus, please come in my heart. I'm a sinner. Please forgive me. You are that sacrifice. You are the only one who could be my Lord and my Savior. And, well, I told my dad what I had done. And he said, but were you baptized? I said, yes. He said, you're not my son anymore.  Don't ever come home again. 26 years later, my brother started, my baby brother, who's five years younger than me, began to go to Willow Creek Church with his wife. He said to me, when you gave your life to Jesus, I thought you were a Meshugana, a crazy person, but I realized today that you're not. He said, I'm sorry for having rejected you. Could you tell me your story? I did. He gave his life to Jesus. Three months later, he asked me if I would tell our dad. My dad had softened toward me what he had done. Dad, after a careful examination of the Hebrew scriptures, Bruce has made the same decision. My dad broke down and cried. He said, Jeff, I see the reality in Bruce's life. And he said, I realized today that you are more Jewish than me. Will you forgive me for what I have done? He said, will you pray for me? I said, Dad, do you wanna believe in Jesus? He said, yes. And so, Corey Ten Boom said, there is no pit so deep that Jesus Christ isn't deeper still.  After doing missions all around the world, God circled back on me and my family and he began to return them to me. That is fantastic. Thank you for sharing that. I mean, I know we wanna talk about your ministry, but to hear where the heart of it is from, from your story, from your story to the world. So again, thank you. That just gives me the chills just hearing it. But let me ask you about your ministry.  Okay, it was global baseball back a little bit. And I went with you in 2018 to Cuba.  So tell me about the ministry there and what God is doing. Well, go global ministry. So obviously we have transitioned from a baseball ministry to all sports, but God has given us multiple platforms that continue to include the sports. Go global ministries, we live to make disciples of Christ. Here's how we do it. Sports, medical, humanitarian aid and training pastors. So after the pandemic, couple weeks ago, we returned to Cuba with 20 people from all over the United States with various realms of influence. And Tom, one of the greatest needs in Cuba is they have no medicine. We bought, brought probably 30 bags of over the counter medicine and we had three days of medical clinics and 350 to 400 people came and heard the gospel through medical. We did baseball, we did basketball and soccer, home visits, street evangelism and speaking in the churches. We spoke in seven different house churches. That's fantastic. I mean, to remember the street evangelism with our group that you helped lead there and brought us there and to know that usually the police stopped by but it didn't stop what we were doing either. Well, when we were together, not only did the police stop by, you remember, but see a famous national baseball team player got saved. And I've been working to disciple that brother for over 20 years now. And when they saw Raul and also Victor were there, Raul went to the police and they were shaking hands, Raul, you know. Oh, these are my friends. Oh, no problem. Yeah, exactly. But thank God that Raul was there. So you're still gonna be back to reaching out into what God's doing in Cuba. What else is God doing? Well, through miracles, years ago when I was in the greater New York area, I met a Filipino pastor who at the time, we were doing outreach for three years in a row among the Jewish people. And this pastor so liked it, he invited me to speak at his church in Queens, the spring festivals, the first coming of Jesus, the fall festivals, the second coming. What I didn't know when he invited me to Grand Central Station in the year 2019 is that he was a bishop of 62 churches in the Philippines. He invited me to come January and February of 2020. I did what was called a grafted in conferences. He explained to me that the Philippine churches love Israel, Genesis 12. They were the tie breaking vote in 1948 for Israel to become a nation and they let Holocaust survivors in. You know, God doesn't forget his promises to any people group who bless Israel. God revealed to me at that time a great revival was coming to the Philippines than the pandemic hit. And through Zoom, we were doing Bible studies throughout the whole Philippines and Asia and Israel and other places. But in April of 2022, for three months, I went from city to city working with Filipino pastors involved in the very revival that God told me was coming. And so the Filipino said, Jeff, we want you here. And then November 19 on a Saturday, we held a large revival in the Cuneta Astrodome Stadium in Manila, 7,000 people showed up and were revived by the Holy Spirit. And you said the Lord had spoken to you while you were there that the revival was coming from the Philippines. God was gonna give the Philippine churches a great privilege that they, that revival would sweep through their first. It's a Christian nation and they love Israel and that God was going to unzip spiritual rain clouds over that country. But the revival would go from the Philippines to Asia into the Middle East and eventually Israel. But along with revival simultaneously, a great awakening is hitting. And so many people are giving their life to Jesus. It's like catching the fruit right off the trees. Yeah, wow, fantastic. Now, let's talk about opportunities for people to be involved. I know you have trips planned to Cuba and also to Israel. You take groups to Israel as well. Tell me how people, what are those like and how people can get involved? Well, through our website, Go Global Ministries, we have a trip June 23 through July 1 to Cuba, eight days. Another one November 2 through 10. And we have an incredible 11 day trip to Israel, October 9 through 21. That's going to be magnificent. Well, and so again, if you didn't catch that, what's the website again? Goglobalministries.com. Okay, goglobalministries.com. We will also have a link on ctvn.org to that. So you can take advantage of that there. And I just want to say, I went to Cuba, I got in, I got out, I didn't get arrested while I was there or anything. There was an opportunity to share in house churches. There was an opportunity to preach the gospel. I may mention through miracles in favor of the American government to go, we go fully legal, but the Cuban government, because I've never gotten involved in politics, we have religious visas of which you had. So there is no risk of getting arrested because they have fully approved. They said to me years ago, we don't have an issue with Jesus, we have an issue with people who want to overthrow our government. And I am not there for political purposes. Right, and I even got to play baseball for the first time in a long time, actual hard ball for the first time in a long time, and it was a lot of fun. But Jeff, thank you so much for all that you do. And thank you for sharing your story with us today. Yeah, you're welcome. Hey Tom, what you doing? Oh, I can't find anything good on YouTube to watch. The commentaries, the blogs, the tier videos, the gaming videos, it's all boring. Oh, have you thought about subscribing to Cornerstone's YouTube channel? Cornerstone has a YouTube channel? Of course it does. Hold on, taking a pause to remind you to subscribe to our channel. Hit that like button and ring that bell for notifications. Now back to the video. I'll show you how to subscribe. Just search for Cornerstone Television Network and hit the subscribe button so you can stay up to date getting filled with the Holy Spirit with consistent uploads every day. Keep up with your favorite moments and never miss a beat. Will you help us as we race to 100,000 subscribers? We can't do it without your help. The content is never ending with countless hours of entertainment. So subscribe to the Cornerstone YouTube channel today. Hope happens here. Well, welcome back to Hope Today. We're so glad that you're with us and hope that you enjoyed the conversation with Jeff Siegel. We always like to bring a scripture to you and then unpack just what we heard in that rich conversation with Jeff. So today our scripture comes from Matthew 28, 18 through 20. And it says this, Jesus came and told his disciples, I have been given all authority in heaven and on earth, therefore go and make disciples of all the nations, baptizing them in the name of the Father and the Son and the Holy Spirit. Teach these new disciples to obey all the commands I have given you and be sure of this. I am with you always, even to the end of the age.  We do, and even as you're talking, and I think sometimes we have to look introspectively, I'm like, am I really doing that right now? And just even taking the beautiful gift of the gospel and going out and sharing it with so many that I love. And I love Tom's conversation with Jeff Siegel about how he's even sharing about his family members of like that, you know, his brother and his dad and just being able to lead them to Christ. I think sometimes some of the greatest pain in the heartbreak is in our family. And I love that maybe today a simple step as you know, people are getting ready to celebrate with their families this weekend as we are celebrating the resurrection of our Lord and Savior, Jesus Christ. Maybe you take a time to talk to that family member or to just share your testimony and your story to that loved one because I think those, Tom, are those little seeds that we can plant that go a long way. Well, and think of what his father is first reaction.   And it was not like an instantaneous transformation of his father and his brother. It's, I think if I got the timeline right, it was like 25 years later before they came to the Lord and that's the thing though. He took a stand. It's interesting, his father asked him, were you baptized? That verse, we kind of go right over that verse and where it says, baptizing them because that is the statement, the statement of I am following after Christ when you're baptized. And I was just hearing about the Jesus Revolution movie. I was listening to a podcast about it today. There's people that would walk out of the theater. They were baptizing people in the fountain outside the theater because people were so affected by that, but that's the commitment, the public commitment to follow Christ. Yeah, absolutely. And whenever you're with somebody who experiences that baptism so often, you hear the testimony of them saying what a powerful experience that was where when they're put down into the water that represents being buried with Christ that all the sin, everything that they're carrying, the bondage, it goes down into the grave to stay there. And then when they're lifted back up out of the water, they are that new creation. It's like when Jesus rose from the grave and he conquered all sin and death.   And when you accept him as your Lord and Savior, you are that new creation clothed in robes of righteousness and new life in Christ to become who he made you to be. We love you. Thank you so much for being with us today. And if you need prayer, remember that our prayer partners are always here at<PHONE_NUMBER>. Have a great day. Tomorrow on Hope Today, learn how to release anxiety and encounter God's extravagant grace. Bible teacher and author Crystal Ward encourages us with biblical examples and prayers on how to resist anxious thoughts and receive the gift of God's abundant grace. That's tomorrow on Hope Today. Cornerstone Television wishes to thank all our faithful viewers whose consistent prayers and financial support have made this program possible.


Target's driving growth through all the great investments we're making to re-imagine our store experience. As we continue to open flex format stores, we're focused on three areas, college campuses, dense suburban areas, and urban neighborhoods. We then curate our assortment and our store design to what's right for the local neighborhood, and our guests love the experience. My name is Jillian. I work here in the Rittenhouse area at a nearby restaurant a couple blocks away. I find myself here a couple times a week. It's kind of turned into my convenience store. The fresh fruit and produce is all here right when you walk in. There's a peril right at your fingertips, and then you only have to walk a couple steps away to find everything else that you need. It makes me feel at home, which is really, really awesome. My name is Camina Carpillette. I live in Long Beach, California, and I'm a working mother of two. I like shopping at this Target because it's very convenient. It's right next to where I work, and it gets me in and out quickly. I come to the store at least three times a week.  I also can go online and make a shopping list, order it up and just pick it up.   Where can I go? And I just tell them right up the street, there's a Target. I'm a third year at UC Berkeley, and we're at my neighborhood Target store. What's most Berkeley about the store is probably the size, and its location definitely, according to campus, it's pretty conveniently located.  I love most targets just because there's always that cheery bright red, but I definitely love the artwork on here. I think it's really custom and different. I grew up with my mom going shopping at Target, and now with this location downtown in Berkeley, I feel like Target's definitely growing with me. This is Lakshmi Sharma. I'm Vice President, Cloud and Compute, and platform engineering at Target. I'm going to take you through the IT transformation journey that's happening at Target to deliver the best-guest experience and how it is happening. It's happening through continuous learning process, using technology all around, putting agile DevOps, using open sources, all of it using networking, data, all of it in action at scale, and how we are doing it. I'll take you through some of the glimpses of that technology transformation and the business drivers behind it. Some of the pieces I will cover, what's the investment that's behind? What are the business driver? What's happening in infrastructure and operation space? What's happening in connectivity? Connectivity is about networking, data center networking, cloud networking. How is this whole thing getting connected? The video that you saw, I will keep referring to that video in how technology is driving that evolution that you saw here and how data is being used, how analytics is being used to drive the entire experience I'm going to take you through. And how could you help? So what are the direct feedback from some of the consumers of this technology, which is our users in the stores and the team members at the stores? I've taken some of the feedback and brought it here to share with all of you. So some little bit about us. Target is 1,806 stores, 1,806 in United States. 30-year distribution centers continue to grow. 323,000 team members all across these stores and headquarters. We are headquartered in Minneapolis and we have a global team in India. We are the fourth most visited retail website in United States and more than 26 million unique visitors and unique mediums and unique visitors each month on average. So when I'm giving these numbers, think of it as IP addresses, think of it as the data endpoints, IOTN, and multiply them by some number, X numbers to get to your IOT devices. So that's the scale of the data and that's the scale of the network bandwidth and latency I'm talking about and that's why technology transformation is important. So $7 billion. In February, our CEO, Brian Cornell, he announced an investment, capital investment of this much amount over the next three years in various categories to drive the sales, to increase the market share and to increase the guest experience at all levels, at digital levels, at mobile phones, stores, all around, all across the sectors. So all of that and the thing that is driving it the most is technology and our supply chain. So innovation in those two areas, innovation and digital, that's all is driving and that's where the investment is happening. And what are the pillars that are going to be used in order to kind of fuel this growth and get us to the market share that we are looking at? Digital first and three pillars. We'll be looking at stores, digital channel and supply chain. How do we bring them? How do we bring them together and make them a smart network? A smart network from a supply chain perspective and smart network from connectivity perspective and what else do you put on top of it to drive the efficiencies across all of them to get to our vision and get to our goal of high scale, high efficiency and the best user experience, best guest experience. So we have five priorities that we have identified and not all of them may sound to you directly as some technical priorities, but think of all of them somehow connected through some technology, somehow being delivered through software or some hardware experience. On-demand shopping, it's not just online. On-demand shopping means anytime, anywhere, same shopping experience. You have your cell phone and you're going to an online. If you have an app on your cell phone or you're using a laptop or you are in-store using a laptop, you're in-store using a phone, no matter where you are, giving you the same experience, same quality, you being able to ship an item which is ordered from online to your home within a time that you want. You can go to a store and be standing in a line, somebody coming to you and getting your order delivered when you're thinking that you have spent more than 15 minutes in the line. Think of all those possibilities and all of them means on-demand shopping experience. Merchandise categories. On the item side, yes, we need to continue to evolve on what are the categories and what are different brands that we will continue to kind of add to our portfolio. Localization and personalization. Now I'll refer back to the video that you saw. And combining the next bullet, which is small format. So a lot of investment that we have announced that's going to happen in the next three years is in a small format stores or in remodernization of a store. So what does that mean? So when we are going from a big general-purpose store format to a small format, which if a lot of customization need to happen in the inventory, a lot of space consolidation need to happen. You cannot buy the same size store as you buy in some remote area. The similar amount of money and the similar amount of inventory, you won't be operationally efficient if you use the same kind of capacity in say San Francisco City or in New York. So in order to address the local needs of the market, in order to give the personal experience to your guests in the store, the small format stores are going to be key. But what it means is that there is a huge amount of innovation that needs to happen in supply chain. Now you cannot use those big trucks sending big boxes of items. Now you are thinking about really your personalized experience of five items of each type or one item of each type coming to a store. Now visualize, each item has an RFI tag. And each item needs to be placed somewhere to be brought from hundreds of locations to that store. The small format store, they may not have any inventory in the store. So how a distribution center is going to send them in the time so that that small format store, which is sitting in a university, which is sitting at the corner of a very populated densely populated diverse kind of area. So all of that is technology. You are talking about how you pull the inventory same day within an hour from a fulfillment center. How do you deliver that to the guest? You know, ship to a guest. All of that in this new format world, supply chain, software and technology, they all get merged together. While we are focusing on the priorities, it's really important that we continue to look at transformation in a way that we continue to simplify our cost. We call it N minus 1, N and N plus 1. So every time we are looking at N or N plus 1, we will continue to kind of look at how do we retire or how do we consolidate N minus 1 technology? How do we consolidate it? Business processes which are N minus 1 before we get to N plus 1. Otherwise the number and the variations of the processes and technologies that we use will be out of control. So connecting with our guests. So target one and a half year ago, like in July 2015, target opened this, target opened house. It's a place of connected device concept. So it's a place where we can invite our guests, we can invite our partners and some customers and vendors. They can touch and feel what an IoT experience looks like. How should we put things on the shelf? How do we use technology to address the needs of this flexible fulfillment we are talking about? The speed and delivery to our guests across different channels we are talking about. So there have been like around 13 months, more than 150,000 guests and customers and partners and even some friends from the retail world like our partners from that industry have also come and they get to experience and feel how technology is put into action. A really good place to see how IoT works. And once we get that input from our guests, when we get that experience from our partners in technology and business, we take that experience to put the best case into use and try to operationalize that into our stores and other experiences. So a good concept. So far we have learned a lot from this and will continue to do so. All the transformation, at any time you are talking about word called transformation, people are the key. So culture needs to be able to support that. People need to be able to support that. Technology transformation needs a lot of investment in people and Target has done all of that. Continuous learning does not happen if you don't allow your team members allow your teams to invest into that learning, invest into that training. So we have gone and invested into people practices around agile practices around DevOps, formal training, informal training and putting special programs in place so that we make it and put it into action in real time. So there are investment in people investment in technology. So when I talk about technology again going back to supply chain putting that format, putting a store like open store concept all of that is about training and continuous learning. So me being there only five months as of this month but a huge investment has already happened here and that's the reason to be honest I feel like we are ready just ready to take that investment that our CEO has announced and put it into action to the right use and to really be a leader in the space. So if this investment has already been happening if the culture is ready what's changing? It's the speed. So if you want to open these many stores just change the way you are putting your format and putting your supply chain being almost real time inventory management on your shelf distribution center or shipping it takes a lot of speed and a focus on that speed and delivery. Linear to smart network what does linear means for just very quick kind of definition from retail like going from a merchandise or a shipping comes from some place X place to a shipping place it goes to some distribution center or some fulfillment center if it is digital then from their distribution center it goes to a store and from store it gets fulfilled or it gets sent to a send to a guest if they have ordered it to ship from store otherwise it gets just directly sent to the guest from a fulfillment center. So think about all of that. So now what's changing from linear model to a smart network means that it can directly go from maybe a shipping place directed to a customer to a technology change. Now when you're those of you like if you're thinking network think of like what kind of bandwidth would be required for those stores what kind of backup links what are you thinking about how do you serve a small store versus a big store you know satellite links all those kinds of concept backup link what would be that like what would be the latency for that be like how does this change it's a technology change as well digital infrastructure we are re-platforming we have re-platform our digital site and we are re-platforming it more and more to support the scale to support the new number of customers and give the agility to our developers so that they can continue to give these applications every day. We have scrum teams that are one day we have scrums that go one day we just put things sometimes in five minutes so that's how truly DevOps we are and in order to support that scale you really need that technology and those people culture and mindset and support re-platforming mobile channels so when you visit a target store you see team members with devices in hand so they can come to you and they can offer you the same online experience as you get from your mobile phone or from your laptop so that needs some platform as well because you are thinking about that being able to we being able to from data center deploy applications to all those 323,000 team members I talked about imagine the scale platform running on those many devices maybe into two into three x devices and then that platform should be able to deploy those applications that I talked about which are being deployed every day so that's the technology transformation I'm talking about more speed, more performance, stability capacity so how much capacity would you need on an Android device versus how much capacity would you need an iPad versus data center the server where you are actually running these applications where you are building these applications so a lot of those decisions to be made but at all the time scale is in our mind that's the scale the number of team members, the number of stores and how fast you kind of move around your items across them how fast you deploy a promotion or a coupon to a guest who is coming online that's all, it's a huge scale we are looking at and all of that would not happen if you don't have a feedback mechanism if an item gets, if you see a shelf which is kind of empty you would feel like oh my god is this store going to close so even from like how do you fast kind of put things on the shelf and if you are bringing experience online experience to a customer how that customer only gets the items and things something which we are all used to doing it but at the back there is some personalization there is some identity management there is some analytics playing the role in order to get you the inventory or in order to get you the items on your screen that you want based on your previous behavior so behavior analysis and the data analytics identity management, they all play a role in order to get you the flexible and the experience that you want for yourself so while we are executing fast we cannot lose the focus focus is on operational efficiency, we make sure that operationally we are right you cannot just deploy an application which doesn't work because when you are getting a sales store we call them pause point of sales or the cash registers that you see, imagining an application going bad at the deploy and you kind of halting all those pause just cannot happen there is no scope for making it happen there is just no scope for failure in those cases you kind of somehow putting an application or an upgrade on digital in imagining digital site going down and think of those 26 million plus subscribers that happen so there is no scope for error when it comes to configuration management deploy, it has to be real time and it has to be right core business investment our core business in digital core and supply chain and the user experience that you get from it that's core business investment store shopping experience I talked about there was an application that just really was launched two weeks ago by our CIO and we were able to save the sale so you go online and then you save all the items there you go to a store, you are standing in the line and then somebody can come to you and they will open your inventory from online and they will just look at this and will be able to serve you so like as if you have bought that into the store so you can just choose your items from any place anywhere online and then you go to any store and you will get that delivered and get that experience delivered of online into a store so mixing both of them, converging both of them and it's all of it is about how you're developing application how you're connecting the inventory in stores where is the data getting stored how fast do you replicate that data what is your data replication strategy so that the information that you put into online that gets reflected onto the cash register where this person is going to be fulfilling your experience so think of replication, think of data here and learn and innovate we are continuously learning and we have a culture of learn if it doesn't work because it's like we are talking about a day cycle we are talking about scrubs running for 2 or 3 days so it's very fast you learn, innovate and you continue to drop the things that don't work and then you just move on with the things that are working so what we have done so far is we started with the information so we started by reorganizing teams what it means is that we are very outsourced focus so we just turned it around now we are insourced we have a lot of engineering talent the ratio has reversed we used to be around 70% off-shore outsourced to 30% insourced number has changed so a lot of hiring in the past 2 years a lot of people who understand all this technology is brought 50-60 PhDs they are data scientists and the artificial intelligence category there are a lot of people like author of spinnaker people who have authored like dockers from all Netflix and Google and Facebook or Cisco or Brocade so we have people from all over working on this technology in order to support this growth very laser focused so the company used to run in a services model which is like project based model it went from project based model to say product model so we have used DevOps agile in order to drive the products use data and continue to use the data to focus on priorities how we operate we have product model agile DevOps we work like and continue to reduce our technical debt and all the newer applications they are using like new technologies like containers and CI CD newer CI CD pipelines newer way of networking all of that so how do we deliver to that experience application and data so everything that is our APIs they are built using every application that has to be written using APIs as the interfaces externalization which is like public facing APIs as well as internal APIs data is all there and then we put layer on top so that you can consume that data so data is a service being offered to any application that is written risk profiling of application and data continuously cloud and compute we are into public cloud use private cloud private cloud based on open stack Kubernetes all of that so all the choices we have all those options we make decisions every day in how do you redesign the application and what load goes where and what is the load balance and through the global load balancer like internal products for the internal load balancing all of that in action continuously use connectivity to give a consistent user experience faster response time to over network all the network segmentation that you that you are aware of very importantly application based VPN when you try to rewrite an application and try to put some components of that application in your private cloud for some reason and some part in public cloud you are thinking about think of NFV but in an application layer so now your network becomes key security of your application becomes key and how do you deploy that application how do you make sure of the keys and the security and the identity of the user who is deploying it and the network that is serving it so all of that segmentation and running at application level I call it application VPN so managing keys and managing security at application level which is distributed across clouds and data centers identity becomes identity federation role based access all of that plays a role in there because you think about these hundreds of thousands of customers hundreds of thousands of team members trying to access these applications identity management is very important or any device can be taken outside a store and then how do you kind of manage that identity devices all the devices that I talked about the team members using like iPods and Android so writing applications for all of them the platform that can here it's not just public cloud or private cloud the cloud that is sitting on your android device and a team member that's a cloud for me that's that's a place where I have to deploy my platform but choice of the platform for that device would be different for the one that you are running in public cloud or running in private cloud and we are huge users of open source huge users of open source so the focus is in infrastructure and operations the focus is simplifying the environment using open source standardizing on compute storage and networking when I use what compute in IT word compute storage and the elements around it they are all kind of same we do kind of talk about that hey administrator is a network administrator of computer storage but lot of convergence has already happened at least for us so we are into converged infrastructure journey we have converged like almost a block with compute storage and even the networking layer has kind of come and converged from a software defined perspective into kind of compute so we have already made that kind of journey and done a lot of performance testing and monitoring in what makes sense in the converged infrastructure so I believe in converged infrastructure and we are making that happen so we have automated infrastructure recovery so today like if somebody calls from store before they call from the store there is already lot of reliability, lot of troubleshooting already happened in the background and that has all happened through automated recovery and automated healing I will quickly run through my slides because I am running out of time so we are we have our own api gateway that offers security, key management everything is like continuous delivery have invested a lot if you think about apg for example from google think of an equivalent of that at api gateway level so all of that developed, managed by us, by my teams at target we are a big user of Spinnaker to do CICD deploy pipeline our same pipeline drops images across all the clouds and data centers I talk about Spinnaker pipeline running drone, driving Kubernetes deployment all of that has already happened because the hybrid cloud and the journey doesn't happen without all of that integration so big users of open source like Kafka, Cassandra Spinnaker, OpenStack, Kubernetes, a lot of investment and all of those we have a lot of experts on the team who are working in this and putting that to action so open source adoption to us means like it's a titan control so we can own our product delivery roadmap because we can deploy and we are not dependent for every single key element of our delivery on the vendors and the partners so our teams believe that open source and adoption of open source has given us this CICD and the DevOps like the way we are doing it because we wouldn't have been faster if we wouldn't have built this on our own and have the support of the open source platform that we have so this is a view of without putting public clouds and clouds of how we are connected like stores to data centers to cloud we have three huge data centers all in Minneapolis and we are into public cloud we have our own internal public facing cloud as well that said we use OpenStack and Kubernetes technologies so using data evolution and some of the technologies we are big users of deep learning machine learning, web skill distributed so when you think about stores you are really talking about not terabytes of information you are talking about terabytes of information in some cases almost every day and then how do we store that information what do we drop, what kind of analytics do we put on top of it that's all part of that whole journey I am talking about using data as a service it's a big, big thing for us we are really sure that it is delivering to the promise that we have how you can help so this is a feedback coming directly from the users or from the deployment people at the stores and other places so better utilization into VPN connectivity performance so we run into these challenges when you are trying to connect to different stores or to clouds or data center so if the VPN goes wrong like IPsec VPN or your MPLS VPN there is very less kind of control we have there and now think of these people who are coming from DevOps and troubleshooting experience they just want to know what is going wrong because they want to be able to fix that so there is very less trending and reporting like it just takes hours and hours to get that troubleshooting going clear recommendation so this is just very recent so it seems like we are already talking about 5G but there are still challenges and LTE is the right thing for us or Wi-Fi is the right thing for us at this particular location versus another location still kind of need more help there like from service providers offering managed services to us self-serve offering if you are bringing applications if you want us to use software as a service please make it a self-serve experience for us because we have moved pretty fast in agile and the DevOps world self-serving is really the key how do you consume being very prescriptive in how do we use applications and make it easy to support those services give the same experience today it's a different experience for on-prem troubleshooting versus off-prem or how do we consume on-prem versus off-prem that takes us lot of time two days of kind of training here and one day kind of training there that's lot of time and different kind of focus that requires so a consistent experience for deploying and troubleshooting on-prem off-prem so those are some of the things that I believe like would help our teams so with that like thank you very much


In a diverse session, our first speaker in the afternoon will be Dr. Sarah Scarlett. Dr. Scarlett is a resident, a surgical resident in general surgery at the University of North Carolina Health Care in Chapel Hill. Sarah holds a master's degree in public health from the University of North Carolina. She was awarded the American College of Surgeons at McLean Center, Surgical Ethics Fellowship in 2017-18, and prior to this she was an active member of the Hospital Ethics Committee at the University of North Carolina. Dr. Scarlett's interests in ethics were inspired by her clinical work as a trainee and her personal interactions with the healthcare system. Early in her training, she became an advocate for improving the communication practices of surgeon trainees regarding critical illness and of life care and high-stakes decision-making. Her specific areas of interest include the integration of the health system with the criminal justice system, which has led her to work on the ethics of healthcare for incarcerated patients. She's also quite interested in ethics education for surgical trainees. Today, Dr. Scarlett will be speaking to us on the topic workplace violence in healthcare, just part of the job. Please join me in giving a warm welcome to Sarah Scarlett. Today, I'll be talking about a topic that I find to be incredibly complex, and that's violence in the healthcare workplace. At least in my field, among individuals who provide trauma care, we often think of how to address interpersonal violence that exists within communities, namely how to identify, treat, and prevent it. Far less, we think of violence as something that can occur within the seemingly safe walls of our hospitals. But it can. And importantly, just as we can experience violence as clinicians, we too can perpetuate it. Before I go any further, I'd like to acknowledge that speaking about violence can be stressful or distressing, and just please be mindful of this as you listen to my talk. I started getting interested in this topic based on my work on the hospital ethics committee at UNC. And during my time working on the committee, we noticed an uptick in consults related to safety threats and violence against healthcare workers. And we were asked to weigh in on challenging decisions, like one of the consults that I featured here. This is a 31-year-old woman with a chronic medical condition, and she was cared for by the same medical team for the majority of her life. And she had recently struggled to afford the cost of her healthcare. And she applied for disability benefits, but was ultimately rejected, and this was an incredibly stressful time for her. She blamed her physician for this, and tensions began to rise. And it started off with some comments in clinic, and then she ultimately called the clinic and threatened to kill her doctor. And this medical team was incredibly distressed, because they wanted to care for this woman. They've been caring for her for a very long time. They tried to develop workarounds and avoided formal reporting mechanisms for this behavior, and ultimately trying to shield the physician from even knowing about this threat, and trying to transfer her care to another physician. And that's when we got involved. In the United States, with the exception of law enforcement officials, we healthcare workers are more likely than any other professional to experience violence in the workplace. This is important, because violence effects are well-being, and that of our patients can lead to injuries, missed workdays, attrition, burnout, decreased productivity, and poor quality healthcare. Oftentimes, violent patients have vulnerabilities. So like many of you, in thinking about your areas of interest, I too went to the literature to see how has the medical community defined workplace violence. And I found this excellent paper from JAMA in 1892 called Assaults Upon Medical Men. The profession is pretty well-disciplined to expect to hear of assaults on medical men by insane persons or patients, but for them to be assailed by persons in normal mental condition is fortunately a decidedly rare occurrence. An incident of this latter kind, however, is said to have transpired at Chattanooga, Tennessee on February 24th, and this is actually an incident in which two parents threatened a physician after their child had a poor outcome. The author goes on to say, at the same time, no physician, however conscientious or careful, can tell what day or hour he may not be made the object of some undeserved attack, malicious accusation, blackmail, or suit for damages. For sufferance is the badge of all our race, and all of which may give a glimpse of the possible conditions that may surprise the practitioner almost any day that will be encountered as a rule, patiently and silently. Because dignity, silence, and patience are the lessons inculcated in the school of medical experience. And it's interesting that this paper is written in this way because many of the accounts of workplace violence and how we perceive it as clinicians, there's a pervasive attitude that it is simply part of the job. And in reading this, I wonder, might this indicate perhaps the origin of this attitude? So the World Health Organization defines violence in this way. The intentional use of physical force or power threatened or actual against oneself, another person, or group, or community. OSHA, the Occupational Health and Safety Administration, defines violence like this. Violent acts, including physical assaults and threats of assault, directed at persons at work or on duty. And there's some important distinctions in these definitions. They have an emphasis on physical violence rather than verbal abuse, which is at least studied by people who, in the literature and workplace violence. And then there's an emphasis on intentionality in the World Health Organization definition, but not an OSHA's definition. One more important thing to note with thinking about workplace violence is it's stratified into many different types in terms of who the perpetrators and victims are. And the literature suggests that greater than 90% of the incidents are type 2 incidents, where a perpetrator is a customer or patient, could also be a family member. And for the purpose of this talk, I'll mainly be focusing on this type of violence. And then there's one more important aspect of this to note, which is, did the patient or the person who committed the violent act mean to do it in a criminal way? In the context of the law, the mens rea, or the guilty mind, refers to criminal intent, which must be present for an individual to be convicted of a crime. But in our work, we often encounter violence in the context of illness that can alter one's state of mind. And that may actually alter how we think about it and respond to it. Our patients may have altered capacity or disordered thinking. Are they truly capable of violence or crime? Violence can present as medical or mental illness. An acutely psychotic patient could end up striking a staff member. Things like pain and anxiety can lead to regression of behaviors and cause people to behave violently. And there are important consequences of recognizing whether a behavior or medicalizing a behavior versus criminalizing a behavior. Medicalization is known as defining a problem in medical terms, using medical language to describe it, and adopting a medical framework to understand it, and using medical interventions to treat it. And it has important consequences, at least partial absolution of moral culpability for the condition, at least partial decriminalization, a preference for a therapeutic response over a punitive one, a tendency for optimism regarding the effectiveness of its treatments, and an increased legitimacy for the medical profession's role in controlling deviance. Now I'll shift gears a little bit and talk about epidemiology of workplace violence. This is probably the largest study on workplace violence out of 5,385 interdisciplinary staff at six US hospitals. Almost 40% reported at least one episode of violence during the year preceding the survey. And this is a survey of nurses in an emergency room that found that uniformly they had experienced at least one episode of verbal violence, and many of them had experienced physical assault. And while much of the literature focuses on nurses and aides and people who provide direct patient care, some of it does focus on physicians as well. This is a study of emergency room physicians across the US and found that of trainees and attending, 78% had experienced workplace violence during the past year. It's important to note how healthcare workers compare to other professions. On this graph it shows the violent incidents based in a year, and on the Y-access cases per 10,000 full-time employees. And what you can see is we're the green line. The experience of violent injuries is far higher than other professional sectors, including retail, construction, and manufacturing. This is from the 2017 healthcare prime report looking at 222 American hospitals, and the rates of certain types of violent crime based on per hundred beds. And what you can see is that the rates of assault and violent crime are about 10 per 100 beds. Thinking about a place like my own hospital with 900 beds, that's a whole lot of incidents. People who work with patients who have a history of violence who are under the influence of drugs or mentally ill have a higher risk of experiencing violence. Reports of assault are proportional to contact time, so people like nurses and aides experience the highest rates of violence. Women, people who are small, people with less experience, and maybe even those delivering bad news are at higher risk of experiencing violence. But there's a lot that we don't know. Most of the research involves high-risk settings like psychiatric wards and emergency rooms. There's a lack of consensus regarding terminology, and I hope that I've convinced you that there's some important distinctions to be made in these definitions of violence. And under-reporting and reporting outside the formal mechanisms is quite common, which may be due to varying perceptions about whether or not violence is part of the job. Something else that's really important to note, as I said, is that violent patients often have significant medical needs, and they can have vulnerabilities. This has been described as a patient care paradox, or a simultaneous need to protect this population while incurring direct threats to personal safety. Violence on behalf of patients or family members can result in poor quality care. Staff might not want to dedicate time to spend with these patients if they're scared of them, and they don't have the tools to help treat them. Restraints are often used, chemical and physical, or even discharge or transfer, in response to violence. And restraints can cause harm. Discharge can eliminate access to care. And restricting family access in the setting of trespassing, which is done at my hospital, can influence support that patients receive, and even bedside care. And so we wanted to know at my hospital what was the experience of workplace violence among our staff. In 2017, we added four supplemental questions to the AHRQ hospital survey on patient safety, and the participants who responded were all staff at two of our largest hospitals within the UNC Health System. And we compared reports of violence in this survey to actual reports that the hospital was aware of in our patient occurrence reporting system. This is who completed the survey. I was largely completed by nurses, but you can see there's good representation from many of the healthcare disciplines. Physicians made up about 10% of the respondents. And these are our findings. So the first thing we looked at was physical violence on behalf of a patient, regardless of mental status or medical history. And of the 3,000, 3,500 people who responded to our survey, almost a third of them had experienced at least one episode of physical violence. We asked respondents about verbal abuse, specifically on behalf of patients or their family members or visitors. And we found that about half of all respondents reported at least one episode of verbal abuse from a patient. And 33% reported verbal abuse from a non-patient. We wanted to know if these behaviors occurred in isolation, or if experiencing one type of violence put you at risk of experiencing another type of violence. And then surprisingly, we found this to be true. Experiencing any type of violence, verbal violence on behalf of a patient or a visitor or physical violence was associated with experiencing other types of violence. And 17% of the people who responded had experienced all three types of violence. And this is unsurprising and well-described in other literature, such as the literature on intimate partner violence that suggests that violent incidents tend to escalate. This is the staff who experienced physical violence stratified by position on the x-axis. There's prevalence, and on the y-axis, it's the position. What we found was that therapists who are reporting the highest rates of violence followed by patient aids and nurses, which is not surprising given that increased contact time. And I will say in this population, the number of therapists who responded to the survey was lower, so that is a little bit skewed. If your staff who experienced verbal abuse on behalf of patients, again, therapists, nurses, and aids were experiencing the highest rates of violence, but people throughout the hospital, throughout multiple disciplines were experiencing these behaviors. And here's verbal abuse experienced on behalf or perpetuated by non-patient visitors. And what we found is that something didn't really add up. 2011 people reported experiencing violence, and during that time, there were only 356 calls to hospital police, and 45 assaults or incidents reported to our patient occurrence reporting system. Not to say that every episode or incident of violence warranted a call to the police, but the mechanism by which the hospital is seeing these incidents, there's a discrepancy here. And so we looked at the literature. This is from a study examining why people didn't report episodes of workplace violence. Common reasons were that the event wasn't serious enough. The individual wasn't physically harmed or there wasn't an intent to harm. We just said it's simply part of the job. So thinking about an ideal response to violence, it ought to clearly define the institution in regards to violent behaviors. It should involve prevention, identification, response and employee support, and drawn input from people from diverse backgrounds, including patient representatives. And it shouldn't be purely punitive, but rather focus on boundary setting and prevention. And there are many aspects of this response, but they include things like clinical care, changing structural design, hospital policies and procedures, and as a last resort involving the criminal justice system. I think this was really important in the context of the doctor-patient relationship, because the last thing any of us would want would be to seeing us colluding somehow with law enforcement. This is a poster from the NHS and their campaign to reduce workplace violence. So this work has left us with very important questions. Have we normalized violence in the healthcare workplace? It has our emphasis on patient autonomy and that patient as customer attitudes somehow increased our tolerance of certain behaviors. How can we balance our duty to care for people who are violent or care for patients whose families may be behaving violently with our duty to protect each other? And when, if ever, is it appropriate to terminate the doctor-patient relationship? And then thinking about violence as medical and mental illness, did the intentionality of these events matter? Or should it influence reporting? So in conclusion, data suggests a large proportion of US healthcare workers experience violence. Accurate estimates are very difficult to achieve and we mostly have data from high-risk settings. They're important nuances related to identifying and labeling violence in healthcare related to intentionality, criminal intent, and thinking of violence as medical and mental illness. Violent patients have vulnerabilities and are often in great need of medical care. And it is my opinion that it is our institutional and personal duty to develop ways to care for patients such as this and also protect ourselves. And any response to violence ideally should focus on prevention rather than a punitive approach. I'd like to thank my many mentors at UNC and here at the McLean Center and for inviting me to give this talk. Thank you. I have a quick question because I actually have been in positions where I've been violently attacked and I'm a pretty gentle person as a clinician. Does your UNC program include in the training program two things, one is how to de-escalate violence and bystander response? So our program is very early and I think there is a huge need for training of individuals and how to respond to these behaviors. I think of my own field and how often as a trauma surgeon or in caring for trauma patients, I'm expected to be able to respond to violence that happens to people before they get to the hospital. But I don't really have any training or not in the standard fashion of how to de-escalate, how to respond, who to call, when to call. And I think this is incredibly important and one of my future projects will involve the training program for physician trainees. Well, I would give you some advice, which is that I worked in emergency rooms for 30 years and never was trained how to deal with violence except in psych settings where it's given the hell doll. But where I did learn was in very large, long-term care settings that were also secondary hospitals. And it was a very detailed and annual review of how to work on de-escalation, what bystanders should do. So you might wanna go to people who work with demented patients and psych patients as opposed to people who work ER because you just call the police when you're in the ER, right, so. Yes, I'm curious if you're familiar with the case of, I think it was about a year or two ago, a nurse who I think it was in Colorado refused to give personal information about a prisoner that was in custody at the time and receiving care and the police ended up basically forcibly arresting her. Because in Utah, it was bubbles, yeah. I don't know if you had any thoughts on that or it's sort of similar to workplace violence, but from the people who we should sort of trust the most. So how to answer that or the specific comment, I think it's a little bit different than the issue that I'm interested here. I think that the notion of seeing physicians and clinicians don't wanna be seen as colluding with law enforcement. And in that circumstance, that nurse was trying to advocate for a patient who wasn't able to consent to a blood draw and was being asked by law enforcement to do it anyways. And she ultimately stood up to that and was arrested. There are policies that are at some places trying to prevent that issue, but I think it's very important that we separate ourselves from law enforcement officials. Hi, Steve Genheim, I work at a state hospital in Wisconsin. Violence is, we have a lot of training, I think it's good training, but violence is common enough at something we think about every day. It would be hard to go to a unit and not find a staff who hasn't been physically assaulted. I was assaulted twice, including going to emergency room and getting stitches. Verbal abuse is probably a daily occurrence. There are staff who've been disabled, but it's a relatively, I don't wanna say common, but it's far from rare. It's something that we just live with. And I guess it's part of the workplace on inpatient psychiatry. It's different than outpatient psychiatry, which I did for years, but patients can be very, very violent and feel they have little to lose and not always psychotic when they're violent. Sometimes it's very significant personality disorders and there may be 15 or 20 staff that respond. We have lots of techniques for restraining people humanely, but patients can be very violent. I think that's right and I think it's up to us to develop ways to mitigate violence and still care for people. Hey, Sarah, thanks for that talk. My name is Hannah. I just had a quick question for you. How did you define for the surveyors that you'd made through your, the data that you showed, what verbal abuse means? Like, what was that? How is that defined? Yeah, many examples are provided on yelling, screaming, physical, or threats of physical violence and we gave, we provided examples of the physical.


What's going on everyone? Sam here with late sports cards for a rip in 2022 panini score football hobby six box break number six random teams Here's looking at your random results As always you can find these on the website under the results tab as well as the link in chat So good luck everybody If I'm not mistaken vet base is split evenly Yes, that way that base is split evenly your rookies and inserts will all get Sorted and shipped to their respective teams same with your autos and numbered stuff obviously But that base will be split evenly that base is always on the front. So we'll just scroll through that Start with a David Bell. I'm gonna do a dice roll on these This is how it's gonna go one two three four five six so one two three four five six and Whatever team of those three will get the card for the entire break unless it's a one-of-one a goal They're agreeing that a six It's gonna be a three. So it's gonna go to the bottom left. It's gonna go. So this one will go with Debo in the Niners and Then we've got a Jordan Love Seven of ten nice one there for the Packers Third year Jordan love. How weird is that to say? There's Marcus Colston, right? Got Shannon Tyndale That's going to the Dolphins nice red six of 20 Congrats on that Miami And intrigue I can already see that's points That'll be a random to all at the end Malik Willis Rookie Charles Cross and Magi Sanders on the gray Rookie There's a breakthrough Cam Acres five of 35 Nice one there.  Go Eagles Fletcher Cox Gray Eagles Desmond Ritter gonna be starting Yeah By week starter Trevor Lawrence second year on the gray Got Aiden Hutchinson nice one there going to the Lions on the rookie auto congrats Detroit Hutchinson Miles Garrett and Jake Plummer both on the gray two grays in that one. There's Kenny Pickett Of course a lot. I'm assuming the gray from last pack was supposed to be in that pack So no gray or any numbered on the back got CJ Moseley for the Jets Pull one there congrats in New York and Cortland Sutton Gold 23 of 50. So I'll just hand you over the base Yeah to start Rookies and inserts every like two boxes Guys a link to this Devon Smith second year gray The Eagles everyone James Gray for the time Malik Willis. Oh, this is Don's boy Jalen Rieger Hey, hey, hey nine out of 20 Go to the Eagles and then Drake Jackson orange one of ten There's a Charlie Kohler for the Ravens Nice one there and Tyler Linderbaum for the Ravens Honestly surprised three or even Yeah, I must have some extra stickers line around Mark Brunel Right the jazz Here, I thought he was gonna take over for Jefferson. I guess Supposedly the next beast. Yeah, Philly There's breakthrough orange one of ten Michael Carter Congrats Jets Bryce's thing was he said we didn't use them correctly. That's why he didn't pay it off Or just sucked yeah Bryce then has to defend It's kind of pick it rookie my Bryson defending There's David a job. Oh this time for the Ravens. Nice one there Two Ravens all and trail on birds. Yes. They're just boys. I guess Bryson and Jalen Rieger. I guess so It's like the only plausible explanation there, right Michael Vic. That's awesome. Go on the Falcons Congrats in Lanza. That's pretty sick right there. And Lanza is Brian and Trey Hendrick's great Curtis Martin and last back box to gold Carson Wentz 41 50 for the Colts. These are rookie inserts This is base. All right on to the next one. Good luck everybody Drake London 25 out of 35 in the blue NFL Draft nice one there again Falcons Drake London. Yeah, nice That's one to just stash for a bit. I think no the league will us rookie There's Adam Thielen 7 of 10 on the green die cut to the bike Yeah, sure like drop like 20 or 30 points again this time wild card rent all right Yandre Hopkins For the cardinals Jalen Petrae nice one there for the Texans starter and Trey Juan Smith blue to 35 6 of 35 Almost missed the picket. Can you pick it rookie guys? Drilled the camera there. Oh, you got it. Thank you I'm dropping you guys the link to a flawless time to go on that still breaking a little bit later on tonight Thank you guys for getting it Partially filled up. I do appreciate though. We're almost there almost there on a full set up tonight They're Aidan Hutchinson can't go wrong with that Congrats Detroit again. Nice one there Lions Mike. I'll stop that is 33 50 on the gold Cordero Patterson on the Super Bowl auto going to the Patriots. That's awesome. Nice CPAT and And Logan Hall right like Evans on the break for the book and his last pack of boxers One or two seasons I did get them I did get them Chad. Thank you. I got him yesterday. Thank you Joe Montana 92 of 100 on the blue. I did did get them. They're at my house now. Thank you. Thank you again there Chad I'll just give you in every box now. That's insert Appreciate it Chad. Thank you. Thank you. It's up a loses that's blue Zach Wilson to a hundred What was the Wilson we hit you out of Chad? I forget now because that wasn't how to flawless was it? It wasn't that flawless diamond auto, right? Am I thinking of the right break or am I thinking of the wrong break? There's been so many breaks.  We sent that very well Very well priority. Don't you worry Chad? Got Micah Parsons nice 45 or 44 out of 50. There we go. Cowboys. Congrats Dallas second year Micah and Legerious Snead to 50 as well for the Chiefs Yeah, no problem Chad Glad we were able to hit that 40 man. I think it's I think it's kind of nasty to 10 to Awesome. Oh Trayvon morrig second year for the Raiders nice one there stood on defense and Jordan Davis Gray rookie for the Eagles. The last car was a banger. Yes, sir. Yes, sir. Yes, sir.  I appreciate you there Chad like I said, glad we were able to hit you that was awesome Cooper cup in the zone. I don't think that's oh, no, that is number two hundred eight out of a hundred. There's Dontario Trummond Cowboys a couple packs to go in box four. Oh mark Gaston now For the Jets nice hit there Jets Lou Robert Woods to a hundred Don's dropping guys the link to flawless Only a couple of spots left tend to go Break in it soon Jake Ferguson for the Cowboys nice one there and John Ray That'll do it for box number four Inserts Box five. Oh, we've got a sauce car and James Williams on the gray rookie Nice one there for the line. Oh, Marcus Callaway for the Saints nice Nice penmanship on that one. Congrats. Thanks. You're my Woosikora moa There's Ed Reed on the gold 28 out of 50 for the Ravens Jealous of that drop you guys the link again to flawless tiered random team style Every spot you take gets you one team from the top tier one team from the bottom tier Very good way to do flawless and it is $300 off of what we originally were asking for this country. Let's die Hey Hacks Patrick sartan auto is ease ojolari the Giants looking Wilson so Mac Jones From the second year nice one there for the Patriots got that's that's doing pretty well Evan Neil on the gray Rookie for the Giants Yeah, it is a tough year to be a Broncos. They need a new head coach That's what it is. Hack it. Hack. It's not a head coach.   There is slag 31 There you go, there's that Is he really pretty much I think let's surprise me I think before Gardner got hurt him and slay were the top three in the top three of quarterbacks and like guards allowed It's like it's good man. Oh, yes, always always good down to nine to go on flawless Think of their Adam Appreciate you drop you guys that link into the single digits now Into the single digits. There's Jonathan Allen. That's five of six nice one there for the commanders on the green He's a beast. There's Matt Corral Grave for the Panthers Blake Willis there's Charlie Joiner. It's kind of sick going to the Chargers 38 out of 50 nice throwback auto there la Frank and Really? we my buddy had a hookup with Some guy was getting a group together for an NFL Hall of Fame they had like a golf scramble Huh, and every group got the play with a whole paper. He was our guy. That's awesome. Yeah, that's really cool Roger McCreary fun. No, he's a very good butter Is he actually you have some Taylor? Color match for the Colts. Who else was there? Do you know any of the other I now top my head Who is the titan for Tampa a while back he was super dominant Shows Tampa It was it's not all stop Might have your My buddy was a big fan of his though. He was he was there I I'm curious to see who all was there. I think John greener. That would be pretty cool. Yeah There's Carson Wentz for the Colts base auto Federion Mathis Manders wasn't wrong These guys were like like old-school old-school Jerry Rice was there. I didn't know about it. That was cool I'm awesome. Yeah, Charlie Joyner is still pretty cool though. Yeah, he's Tray McBride He was a cool guy base auto for the Cardinals and red cheese Claypool for 20 I worked out another golf course and they had We hosted an event for like the NBA. Oh, but it was all like scouts and Like Like that kind of thing like one guy I met was a Use a scalpel for I think the Vicks Yeah, absolutely Last pack of the break guys. Good luck. This is going to Devo Samuel 200 and the Niners We get this random set up really quick guys and then we'll do a quick recap and we will move on So we're doing a week random for wild card points and 400 This over the random screen really quick Random for a wild card and 400 points gonna roll the dice whatever team is on top After seven times we'll get the points and the team that's in second. We'll get the 400. So good luck guys one two three four five six seven 49ers getting the wild card the bills are getting the 400 All right guys do a quick recap here Tray McBride Cardinals Carson Wentz Colts Roger McCrary Titans Charlie Joyner Chargers Mack Jones Patriots markets Callaway Saints Jake Ferguson Cowboys Mark Gassin O'Jets Tramon Morrig for the Raiders Michael Parsons Cowboys Coral Patterson Patriots Super Bowl auto in Hutchinson Lions Jalen betray Texans Michael Vic for the Falcons David a job. Oh Ravens Charlie Colar Ravens Jalen Rager for the Eagles CJ Moseley Jets in Hutchinson Lions and Channing tinned out for the dolphins I'll do it for the break guys. Thanks again for the fill next up. We've got our mixer


Hi everyone, in this tutorial I'm gonna be showing you how to reverse a list in Python language. I'm gonna show you two ways how you can do this. In order to do that, I'm gonna create a list which is gonna contain names of few cities in the USA. Next thing that I want to do is to simply print this list. Next way to remove this list is to call the reverse method. This reverse method is gonna be without any argument and we're gonna call this method to our list and let's print our new reversed list. I'm gonna run this code and as you can see this list is reversed by using the reverse method. The second way how we can reverse this list is to use slice function. So I'm gonna reverse this list by using the slice operator. First two things in slice operator start and end will be omitted and the last one thing called step is gonna be minus one, so that means that we're going from the last element to the first element and we can save this list in a new list. I'm gonna call it reverse list and let's print now this reverse list. I'm gonna run this code again with this second method and we get the same result again. This list is reversed by using the slice function. That's all in this tutorial, don't forget to subscribe to our channel, see you in the next tutorial, happy coding.