And hello, we're live. Welcome to the live stream. I'm Monica Wahee and we are now live on May 14th at noon Eastern time. And this is for my lecture tips and tricks for giving professional written feedback. And so welcome if you're joining me. So those of you who've been to my live streams lately know that we have this ongoing saga where I'm using this restream software and I'm trying to stream to LinkedIn, YouTube and I think I'm also streaming to Twitter, okay? If you're watching this on Twitter, I don't know if you can interact with me like if you can chat or anything. If you're watching this on YouTube, you can chat with me. In fact, I'll turn on this chat overlay and you're gonna be able to chat with me if you're watching this on YouTube. If you're watching this on LinkedIn, you will wanna chat with me. You might type in comments and you'll see them as LinkedIn comments, but I won't see them cause I'm using the software. I'm not going from LinkedIn live. And in fact, I figured out later I can go on LinkedIn and I can answer all the comments. So if you're on LinkedIn, I won't see any of your comments while I'm streaming. So how you can solve that is either you can go out and go and see me on YouTube. Those of you who are subscribed to me should be able to find my YouTube stream. Or I think I also put it on the LinkedIn. I think I put a comment on the LinkedIn one because of this problem. So that's one thing you can do if you're on LinkedIn, just go to YouTube. If you're, or you could just stay in LinkedIn and just be patient and I'll come back and answer all of the comments. What I do on YouTube is usually like the next day or day after that, I go and I update the description. I give you links and stuff to whatever we discuss because I want these live streams to not, to be interactive. It's just, I gotta kind of hold them regularly and attract an audience or you guys won't show up and ask me chats. And of course I have to start using an application that works so I can see your chats. But anyway, the reason I'm holding these live streams, I guess I could say this, those of you who know me know what I'm all about. But those of you who are new to me, I'm Monica Wahee and I'm a data scientist. I'm an epidemiologist, but I do a lot of different things. And so one of the main things I do in my business is I help people graduate. I help them get their PhDs or their master's degrees or their data science degrees or whatever degree they're trying to get. Another thing I do is I help them after they graduate, I help them do their jobs, like I provide mentoring and I also just do stuff. I do data science work. Those of you who've taken, who go on LinkedIn Learning, take my LinkedIn Learning course as you see, I've done a lot of data curation. I run data warehouses, I have a book on that. So I do a lot of different consulting. I sort of like half and half I do consulting and education. And so that leads me to, I started doing these live streams because I started realizing that there's sort of this connection between my consulting and my mentoring and my YouTube videos and my LinkedIn Learning. And that is that people tend to have the same problems with the same things. And also people are diverse. So they solve their problems different ways. So people who hire me to mentor them are people who need mentoring. But there are a lot of people who use like my YouTube videos or my LinkedIn Learning courses because they don't really need mentoring. They can figure it out themselves. They just need a little push. So I started holding these live streams to start presenting on topics that a lot of my customers come to me about and say, Monika, I need your help with this.  You guys can see my advice on it in one hour, what I would tell you, you know? And interact with me and ask me questions about it. And then if you need more information, you know who to go with. So this week, so sometimes it's gonna be on data science stuff. Sometimes it's gonna be on public health stuff because I'm an epidemiologist. Sometimes it's just gonna be on anything. Just stuff, just work or school. Stuff you have to do with work and school. And that leads us to today's topic which is tips and tricks for giving professional written feedback, okay? Now I don't think of myself as like this expert giving professional written feedback or anything. Like that's not why I did this. I did this because, oh, let me highlight, my friend is here, C.J. Hutchings, okay? You'll know that I'm collaborating with him. He's a musician. If you listen to some of my videos, he's put some music on there. Recently, he's been publishing his music on YouTube music.  So I really want you to try it out. It's good stuff. It's very nice. So hi, C.J. Thank you for showing up. I'm glad I didn't show you some of my live streams. Makes me feel like there's a lot of people like her, right? Thank you, C.J. You're so nice. All right, so today, I'm gonna be presenting on something, on a topic that it's like, I don't think I'm an expert. I mean, I'm good at it and I'm good at teaching it. But it's because everybody keeps asking for it and it's how to give professional written feedback, okay? And I actually have slides. So I'm gonna share my screen with the slides and because this is a low budget, except when C.J. is around, it's high budget. But he has to go, he's got work to do. So now it's gonna be low budget and I don't have any moderators. So I'm just gonna have to be showing these slides and every once in a while, I'll look back and I'll try to see if there are any questions, okay? And these slides will be available afterwards when I update the YouTube. I try to add a comment in both LinkedIn and YouTube when I do that. So tips and tricks for giving written feedback. So why are people always asking me about that? Well, because what I realized is, a lot of times we, in our personal lives, give feedback to each other, but we just do it like we're talking, right? Like maybe I make some banana bread for C.J. And I asked C.J., do you like the banana bread? And he says, yeah. In fact, once I made a different recipe and he said it was too sweet, so I didn't make that recipe again. So that's feedback, right? It's useful feedback, it's just constructive. But the thing is, it's a lot easier when I'm like with C.J. and I give him something and I see his look on its face and see it's too sweet for him that I know what the feedback is and I know what the solution is. Like don't make that recipe again or don't sweeten it that much again. The problem is we are faced a lot in business and in school, in the academic world and in industry and just a lot of different professional domains where we cannot give verbal feedback or just giving verbal feedback is not very efficient. And I'm thinking of like software development, you send something to a customer and the customer's got to give you a list of things to change. Well, that's not very helpful if they just have a meeting with you and talk. Somebody's got to write this down, right? So you start to realize, okay, well, maybe we need to write down the feedback. Maybe that's a better way to do it, but then how, okay? So that's what this is about, is I have found that my different customers will have different needs for having to write down feedback. Like I just gave you one example where they have to review like some software and explain what needs to be changed or a webpage or something like that. So I'm going to give you in this presentation tips and tricks for figuring out what you're going to want to communicate in that written feedback. Cause you just, you don't want to write everything and you don't want to write forever.  Like a lot of times people don't really realize that, but yeah, you want to think about what am I actually going to write, you know, and deciding what to actually do. You know, like if you're in person, you can just discuss it. You can be like, oh, maybe it's not too sweet or maybe if you had as more salt or whatever, you know what I mean, but when you're doing written feedback, you've got to kind of just decide what are you really going to say? What's worth saying, right? Then the next step is once you decide what you're going to say, what's an effective way of actually giving the feedback. So it improves whatever is needing to be improved. So I gave you one context in which you would give written feedback. Like you're reviewing some software, you're reviewing a webpage and it might be like you hired a vendor and you have to make a list of what's wrong with it or whatever. You know, I'm going to go see if any of this is a good question. Nope. Okay. So I'm going to give you some scenarios that I encounter a lot where I'm teaching people how to give written feedback. When I'm working with college students, I usually work with grad students, but sometimes I work with undergrads. And sometimes they'll give this assignment, especially the undergrads where you write an essay. And then they give the essay, you give the draft to your peer, somebody else in the classroom, and they have to give you feedback. And I always get really angry because the teacher never really teaches, well, what exactly should you be doing, right? Because what is the feedback on is to try and make it improve? Like what is the improvement? Like what are we trying to do in this essay? So it's like they want you to learn this, but they're not even really teaching it, okay? Another thing that happens is, and I noticed this a lot when I taught in an undergraduate program online, because I was giving feedback. I was just, I would, you know, like review essays and then I'd just give some written feedback. And I realized I had to be very clear in my writing what I was talking about if I was saying something was good or bad about the essay. And so I'm a professor and I'm trying to write this so that my students who are learning from me can understand.  And I'll be like, oh my God, I have no idea what that means or what, what, you know? So it's like, when you're a professor and you write feedback to the student, you're basically teaching the student how to write feedback. You're like role modeling it. And if you don't know, then you don't know what you're doing and they don't know what you're doing and it starts this chain of confusion. So that's where you see written feedback in college a lot. Then if you just move out of the college context into the bigger academic context, peer review, right? So those of you like me who publish in the peer reviewed literature, you know, you write up your manuscript, you submit it, and then you get peer reviews back from other youths, you know, other scientists. And what I'm gonna talk about in this presentation is super applicable to that. Because, you know, when you're teaching in a college, like in an undergraduate program, maybe you write some feedback to students and they don't always have to update their essay or revise it and then you have to look at it again. But in peer reviewed articles, if the peer reviewers give you feedback and you revise it, then they have to look at it again. And if you're the peer reviewer and you gave somebody feedback and now they fixed it, you need to make sure you feel like it was fixed. So you've got to know what you were talking about, basically when you told them to fix something. And the same thing if you're a professor and you're giving students feedback on their assignments, you're saying, you've got to fix this. Well, you've got to be clear with them and you've got to know, be able to tell whether it's fixed or not, you know? Which seems very obvious, but not, it isn't if you realize how difficult just writing is and just if you're telling somebody, write something differently or present something differently, like do they get what you're saying and then do you know if they did it? So it becomes kind of vague. And also in academia, when you move on to doing like a master's thesis or a dissertation, if you're in a PhD program, typically you have a proposal which you have to defend and that's a big thing you have to write. And then you have a dissertation, which is the end, you know, after you do the project you add on to the proposal and it's the whole dissertation. Or some programs have you just published three peer reviewed articles. Regardless, in the process of producing those documents you have a committee usually or at least an advisor and they're giving you feedback and usually that's all done in writing. Often you'll meet with them, like you'll meet with them and they'll go over their writing, which is good, you know? That's not, in fact, I often do that. I'll write it and then go over it if I'm really trying to teach somebody something. But you still have to, it's good to have it written. People who program software and databases, they like it when you write a list of stuff for them to do because they can just check it off and make sure that they did it or give you feedback if they could. So it's really good accountability to be good at writing what the feedback is you have for the student or for the teacher, whatever, and then getting back. Finally, a lot of people will try to avoid academia, you know, maybe they'll just work in industry. And they, but still in industry, I find, like in business, I find a lot of times there's an issue with, like in business, you find that people are doing presentations a lot because they're trying to communicate stuff very quickly. And they'll ask each other, it's my presentation, any good. And I feel like that this is a place, you know, like by email or whatever, that you can really use these skills to quickly tell them what's up with their presentation. In fact, somebody just asked me about a presentation they sent me and I was thinking of this, you know, because I would give some feedback. There's also in the industry, like let's say you apply to get something approved, like a drug approved or like a new protocol approved, there's often feedback about approval applications, you know, where they'll say, okay, we agree with this, we don't agree with that, whatever. And whether you're the person writing it or you're the person reading it, it's good to understand how to do that with feedback. So these are just the context and under which the things I'm gonna tell you sort of apply. Now I'm gonna look and see if anybody has any questions. Oh, hi, Rucheli is here. Hello, everybody. You know, I think you, did you write to me? I can't remember. I think you wrote to me, right? You were talking about your conference. That's you, right? I can't remember. Somebody's having a conference. I think it's you, Rucheli. But if I'm wrong, whatever. But if you're the right one, if you're the person I'm thinking of who's having the conference, go ahead and put the link in the chat if you want. And if I'm wrong, I'm sorry. A lot of people are having conferences right now and I'm trying to remember. I know you write a lot, so. And welcome, welcome to the stream. And so maybe this is useful because you give some written feedback. All right, so now we're gonna go back. So this is my first tip to you. So let's say that you're in the situation where you have to give feedback to somebody about maybe like a written thing or about a presentation. The first thing I say is avoid micromanaging style. And what do I mean by that? Well, I will often be tutoring somebody who has written something with me or I've coached her. And then she gives it to her professor for feedback and that person will use track changes. And once you know that person will go and change our however to moreover, that person will change like silver to gray. Okay, think about what you're telling people when you do that. The message you're giving people when you do that is, first of all, that I'm smarter than you. I'm silent, I'm classier than you. You don't have the right words, I have the right words. Okay, another thing is you're sort of getting rid of their identity. You're sort of removing the thing that makes them. It's really a sign of insecurity.  So when I am coaching people who are newly becoming professors and stuff, I'll say, okay, I see all these track changes that you've done. Let's just go through and remove like half of them. Because if it's okay, just leave it. Like, especially when I'm dealing with people who English is not their first language and they're writing in English, some of these are right, some sort of goofy sentences. But I really try to preserve the sentence as much as possible. I try to just make it correct in English. I try to rearrange things. I try to preserve that person's voice. So that's why I say avoid micromanaging style. It's a waste of your time to do and you wanna preserve their voice.  I'll give you an example. I was working with a surgeon named Steve. He was a surgical educator. And we worked together a lot of things, but I'm not a surgeon. I'm not a surgical educator. And I wrote a book chapter with him. I wrote the first draft. And it really didn't sound right, you know? And he pointed it out to me. He said, Monica, some of this writing just doesn't sound right. It doesn't sound like a surgical educator. So I said, okay, why don't you go through it and change it? And what was interesting is he hardly made any changes but where he made changes, I understood. It was changes where I was talking about how students think and how students act. And I realized, I don't know how students think and students act in surgery, you know? But he did, he taught them.  What I was saying didn't look naive. And that's kind of a way that I think when I'm changing the English of people who are not that good at English is I want them to be saying what they're trying to say but just not sound goofy or weird about it. Okay? Now, sometimes I'll see people who are giving feedback and they're like, you need to add this. You forgot that, mama. Well, you do need to make sure they cover everything. That's important. But space is always limited, right?  You know, the journal has rules, right? You can't just add everything. So I always ask myself, I really need to tell them to add something. And if I need to tell them to add something like they're missing something, I have to kind of tell them what can be sacrificed so they can make room for it. So decide, if you really want them to add in a porn point, you think it belongs there, then you've got to also tell them where we moved up. And then just finally, as a general rule, if something is obviously wrong, be very clear about what it is and why it's wrong. And I will review papers where there is a critical study design problem that is gonna make it so that they can't analyze the data. They can't really make anything of their research. And I will just say it. Those get published anyway. I mean, I'll see them published elsewhere, but still the best you can do is just be honest and compassionate and kind, but just be honest. All right, so that's about prioritizing what needs to be changed. And what's kind of good about doing that is you don't wanna just write randomly a lot about everything. You wanna just pick out what's important and write, because you're gonna write this and they're probably gonna have to change it. So just prioritize what's important. All right, so then the next tip is once you sit down to write and you say, okay, I've decided what's wrong, communicate clearly about what you want changed. And think in terms of the outcome. Like if they actually changed it and returned it to you, what do you wanna see it look like? Do you want to see a table in it that wasn't there? Or do you want to see a discussion, a paragraph about some sort of thing? Explaining what you wanna see is a lot easier than saying how you want it changed. But sometimes you sort of have to get into that. Like I'll say, remove this section because it's not necessary. Like a lot of times people are not very clear. Like they don't know what they're doing with their statistics and they'll just make a million tables and I'll tell them only these, you only really need these tables. But in that space, I want to see a discussion of your methods, which you missed. So I think about the outcome and I'll even like literally say, okay, write a paragraph and put it here. Write a sentence that says blah, blah, blah and put it there. And you'll see that other people give feedback a lot. Sometimes they'll do that too. And you might be like, okay, this is a pain or irritating, but it actually is super helpful because you can just copy and paste it and you know that person's gonna be happy. And so in other words, if you think when you're giving the feedback in terms of what you want the revision to look like, it's easier for you to communicate the feedback and say, this is what I wanna see rather than what's wrong. Like, oh, this table is so unclear. I can't understand which is the standard deviation. I can't understand where the columns are. No, you just say, well, when you fix this table, I wanna see three columns. In this column I want this, in that column I want that. You know, that's sort of how I do it. And I'll tell you, examples really help. So you'll see on the slide, there's a link and it's a link to a paper that I wrote with my co-author who I just love, I will meet with her later today. She and I did a study and the study used the Maslach Burnout Inventory, which is an instrument. So those of you who use instruments, you know, they're sort of like special questionnaires that you can score. You can make a score out of it and the score means something. And as you can see on the slide, there's a table there from the paper that shows you how to interpret the MBI scores. There's three domains or three sub-scores. There's emotional exhaustion, depersonalization and personal achievement or personal appreciation. They call it different things. And you'll see that in that table, it says there's a low level burnout, moderate burnout and high level burnout. And just the classifications of those scores.  Okay, and actually we did that.  You can read the paper. And then we also did a scatter plot between satisfaction, we did a satisfaction instrument on them and their emotional exhaustion. Because as you can see, you know, the more satisfied you are with your job, the less emotional exhausted you are and vice versa. I know this is like, is this a surprise? Well, of course, my colleagues are very concerned that people are exhausted and burnt out at her workplace. Like, I love her. She was smart to do the study. And so they had to do something about it, you know. If you want a vacation at work, just copy your study design, right? But why am I telling you this? Why did I even put this on the slide? Because I, even though the study is not like some landmark study, this way of presenting instrument scoring rules is super clear. And whenever I review instruments, most of the time, like papers that have instruments in them where they're using, I don't know, like anxiety measurement or a management measurement, management styles or things like that, they usually forget to put the scoring rules or any sort of scoring information. And so when I give them feedback, I always refer to those papers. Whenever I want to see a scanner plot, I refer to this paper. Even though it's a scanner plot about jobs satisfaction for Dennis and burnout in Dennis, you could be doing a scanner plot of like systolic blood pressure and diastolic blood pressure. You know, it doesn't really matter. It just is an example. And then I can say, because when you're writing, you often can't show a picture, like you can't even put an emoji.  See how it says emotional exhaustion and Dennis satisfaction score? Instead, make it be this and this and do this, right? Like literally I'll do that because then that kind of really tells the story of what I want to see. It really communicates my ideas of what I see. And also, if they can't do it or if it comes out a little goofy or whatever, or they do something else, they can explain to me that they got it, but they decided to do something else, you know, whatever. It just improves communication back and forth because that's what's happening. All right, let me just see if anybody's got any questions. Oh, hi there. I'm so glad you're here. Welcome to the air. Your teachers are quite educated. Thank you very much, Monica. Well, I'm very happy you say so. Excellent. Okay, well, I don't see any questions. Thank you for giving me some encouragement. All right, so moving on to just kind of a summary of do's and don'ts for giving written feedback. So for my do's, do be clear about how you want the document to be after this change, okay? And do provide examples from other written works and a references to support your points. That's another thing I'll do is if I'm saying, hey, this point you made isn't quite right, I'll often look up references in the literature and put links and stuff that will say, these people explain it. Basically, you're trying to help the authors do a better job of making their points. You're trying to be on their side and you're trying to help them. Which is sort of a weird way of thinking about things. Like when we're teachers, we're like, now, now, you aren't getting an A. But if we're really teaching in grad school and stuff, we're teaching our colleagues, right? So we should be acting more like, honey, let me help you do a better job of this. Let me help you be clear about this. I kind of see what you're doing. Let's go. We really should adopt a collegial voice.   She's doing a study with a dean. So it's not her dean, a dean of a different college. They're collaborating on something. And she's the head of the study group. She's a PI. And she said, Monica, I feel very uncomfortable giving feedback to the dean about this research stuff she's doing. Like she wanted to do certain research questions and things. She goes, I feel uncomfortable. She's a dean. How do I do that? I don't have the right attitude. Like I'm a junior or a person. But what actually happened to me is this kind of feedback. I'm usually giving to surgeons, like my surgeon friend, right? Doctors, you know, what am I? I'm not a doctor. I'm not a nurse. I'm not anything. I'm a PhD, right? Like I don't have a PhD. So how is it that they accept my feedback? Well, if you talk about it in a, like I said that, that sort of collegial way, like, okay, here, let me help you. I kind of see what you're doing. Let me help you make your point. Or I think I know what you're trying to do. You know, that approach, along with just turning it into something that's not really emotional.  But if you check your emotion and you just say to that person, like, I am looking at your bar chart and I am having trouble understanding it. Like I can see myself typing this. I do not really understand what the bars represent. I do not know what their height means because there is nothing written on the Y axis. I think that you mean that you are comparing two groups because there's two colors, but I don't know which these groups are because there's three groups in your study.   How much will to figure this out? Like that's what I'm thinking. But when I write, I'm writing, I see you're trying to make a comparison but I am confused as to what comes. Notice I use the word I a lot. If you say, I, I, I a lot, people don't feel attacked. If you say, you, you, you, that's attack, right? So I just kind of say I a lot. I use I statements in my feedback and I'm telling the truth. Like, often, like I'll say, I didn't understand the sentence, I look for a reference and I couldn't find what, well, maybe I'm just bad at looking for references. So it just, it preserves a lot of, and remember all of this is written down. People are going to read it.  And I'll even talk to the students that way. Even students who don't really know what they're doing it are becoming kind of rude because sometimes it breaks barriers, you know, they start to students, people look up to you, they start copying you no matter what, like even if you don't really think about it. So if you do nice things and treat them nicely, sometimes treating you nicely by accident, which brings me, I'm going to start with the don'ts. Don't be 100% negative in your feedback. Most of the time, I try to find, well, I'll just say most of the time, naturally there's some really good things about what I'm going to be feedback about and it just bubbles to the top and it just comes right out. I say, oh my God, look at this gorgeous visualization or I really love how you organize this argument. You know, I'll say it and I'll use I too again. If I find I'm writing a lot of sort of constructive but kind of negative feedback, like I don't understand why you did these statistics. I don't understand why we have all these figures. I think you only need two figures. You know, like I'm saying some stressful stuff. I often will just go and pick out something important that is good about it. Like I'll say, you know, this is a tough topic and it's hard to visualize, but it's really good that the authors are tackling it because they're experts and they're willing to do the work and try to communicate this, you know, things like that. And I'm honest, you know, I don't BS. Everybody knows me says like, knows I just am too honest actually. Like I can't make it up if it's not good, but there's usually something good about everything that you read, like even just people calling attention to the issue can be a good thing. And the, okay. The next thing is don't criticize without offering a fix. In fact, I usually focus on the fix and not so much the criticism. Like with the bar chart thing I was giving the description, you know, that whole thing is so confusing. It's hard to focus on a fix. But if it's like something like, if you're like, okay, this table is great, but there's too much in it. Just move X, Y, and Z to a different table. There, that's it. That's the, you know, criticize. Here's the fix. Don't criticize without trying to figure out what the authors are trying to accomplish. So one of the things is people do some goofy, goofy things. Some weird things. I've seen just like the weirdest things. And the first thing I want to say is don't like stop. Oh my God, I can't handle what you're doing. Like they'll, for instance, give you all the data.  And, but before I go, oh my God. I sit down and go, why did they give us, give me the whole data sheet? You know, why, why did they do this? What were they trying to do? Like I'm remembering particularly one where there's a long time ago. It is a paper that's been published where when I was actually a public health student, this guy came to me, it was a friend of a friend and he showed me this pie chart that looked like a color wheel because there were so many categories. There was like 20 categories. You're not supposed to do that with a pie chart. So I said, sweetie, what are you trying to do here? And it turns out he was trying to sort of make like a dendogram, like a flow chart about how decisions were made in a path lab about different slides. You can probably look it up. Maybe I'll link it to it on the description. But when I looked at that pie chart, I was laughing. He has a sense of humor. But I said, well, what were you trying to do? You know, I really tried to understand. Well, if I had been giving written feedback, what I wouldn't have been able to ask him, I would have tried to read everything and see why isn't he gave this really ineffective pie chart? What was he trying to explain? And then I would have probably proposed like I did in real life this flow chart instead. And again, my final don't, which actually was the first thing I said because I feel so strongly about it is don't micromanage style. And I sometimes have to tell myself that too. I remind myself, if it's not incorrect, leave it alone. Like if it's not wrong, just leave it, okay? Because that person gets to say their thing. They get to use their voice. Okay, let me go ask, see if anybody's asking questions. Oh, it's spaghetti dude. I think you will not, I always remember you. Who can forget spaghetti dude? Thanks for coming by.  I just like imagine this, like the superhero made out of spaghetti. I don't know, do you throw yourself against the wall, so to speak?  I'm just happy you showed up. All right, well then let me get back to the special here.  Show up to my live stream or watch the recording of my live stream. That's what happens when I don't have a moderator. I have to think and talk at the same time. So this is what I'm gonna do is I'm gonna give you a special offer of a file review. I said file because I was gonna say document, like you could give me a peer reviewed article you're trying to write or a grant or something. But I realized somebody might give me a website they're making or a dashboard they're making because we're in data science, some of us, and or something else like a presentation.  I'll give you feedback. I'll give you written feedback like I've been describing I do. And I got dry mouth just like, I think that's water. So pick out anything you want me to give you feedback on. I guess if it's pretty long, I won't give you, I probably won't give you feedback on the whole thing, but in the short, I'll give you feedback. Sorry, it's just been so dry around here. So the process would be is that you have to send me my email or LinkedIn, your current word version of the document, or if it's PowerPoint, or if it's a link or whatever, just send it to me and explain what you're doing.  No, I think she reformed it. I'm gonna ask her when I talk to her today. So, you know, whatever it is you're trying to do, what is this document, what is this file? Then I'll send you a PayPal so you can pay the fee. And then I'll write you a professional peer review in Word. I'll send it back to you. And then that will give you both an example of me giving feedback, hopefully you can learn from. And it also I'll give you feedback. I'll give you some good tips to improve whenever you're writing. I'm sorry, I don't know why I have this. I'm having this problem with coughing. Good thing we're at the end of the live stream, right? Let me stop sharing this. All right, so, sorry, I'm coughing now. All right, so to summarize, there's a lot of different situations throughout school, work, your professional life, where you're stuck giving feedback through a written medium about other things.  So these were the tips and tricks that I use to try and make that process go as good as possible and also to keep relationships positive because especially if you have like a customer and you're always going back to them and getting feedback or they're giving you feedback, you don't wanna piss them off and have bad blood between you two. So it's really good to use these compassionate, clear sort of bureaucratic, removed, accurate ways of communicating and also just deciding, prioritizing only the most important things, only what's really necessary needs to be changed and then we'll go from there. All right, well, unless I see any more questions and again, I apologize. Those of you, I guess I probably should repeat this. Those of you who are listening to this from LinkedIn, although I see Ruchely's chat came through, a lot of chats don't come through from LinkedIn. So if you asked, if you said anything and you don't see it on that chat overlay, I didn't see it either. So you'll just have to wait, I'll go back and I'll answer it. I figured out how to look up the comments on LinkedIn and answer them. All right, and then also if you're hearing this and later, like this is recorded or whatever, in the next day or two, I'll go through the description to this video and I'll update it with some timestamps and some links and stuff and you can get these slides that I showed and then that way. So those of you who are listening on LinkedIn and you're thinking, okay, I wanna come back, you probably wanna come back onto YouTube because the description will be there, it'll be easier to navigate. So I'm trying to hold these every Saturday. If you connect with me on LinkedIn or subscribe to my YouTube channel, it should be easy for you to find these live streams and then you can show up and ask me questions and get some tips and tricks. All right, well, it's a beautiful Saturday day. It's a lovely weekend and I hope you have fun and enjoy it and I'll talk to you next week. Bye-bye, everybody.


and the deadlines are coming up at the end of October now there's a bit more information that you need to do if you are going to do bear forms to get a reimbursement it is a direct reimbursement from USAC it is a direct electronic transfer they do not issue checks to you so you do have to give them your banking information and you use the form 498 to do this this form you only have to do once and then it's in their system for the future so you do not have to do this every single year if you're ever thinking of the you might do reimbursements you're not even sure just get this information in there when you have a free time so that it's ready for you because it can take some time for this 498 to be processed and approved I'm talking like a couple weeks and if you don't want to delay being able to do your bear form and get your money you want to just have this information in there ready to go it's your basic banking information routing number account number etc they do need your federal employer ID number your tax ID that is used either by the library or the city for payroll they also will ask for Dunn's number Dunn in Bradstreet it's another number used to do business using it recently this year for different grants as well you can get one for free you can go on the Dunn's Dunn in Bradstreet website to look up and see if you or your city already has one you can use either or apply for one applying for one of these is usually pretty quickly so that doesn't take too long the processing of the 498 use that to take time so to submit your 498 it is not a form you use regularly it's not up here with these other three it's actually in that menu items under when you hit welcome and going to your libraries info so you hit your library click your library's name over here and on your menu items you choose related actions and this giant list of things you can do comes up and somewhere down there it will say create FCC form 498 now if you haven't done this yet you'll see that option there if you have already done this that they have been doing in this direct deposit and you might have done this or someone else had done this previously before your time you don't know if you don't see the option that means it's already been done so once you submit that 498 that option is removed from this list of related actions as something that you can do but when you go on that same kind of thing you give it a nickname and you just start entering your library information and your numbers and everything I'm not going to go through all this but it's your basic information you can see your financial information organization numbers all those basic information after you submit your 498 they will send you an email just an email directly to you asking for documentation just like doing a direct deposit of something you have to give them either a copy or avoid a check or a statement about that bank account they have you submit this to a separate database a separate system it's not connected to e-rate so for security it's kept somewhere completely different so use that link in the email to submit that documentation and then it can take some time for USAC to get that documentation look over everything and approve it eventually you will get then a notification saying your 498 is approved ready to go and now you can go ahead and submit your bear form so all of this information is to be done in their system before it will even let you do a bear form and get your reimbursement remember this is only if you're doing paying bills in full getting a reimbursement after the fact if you're doing getting discounts on your bills from your search provider none of this bear stuff applied to you starting this year they changed how you access the bear form which is actually great it used to be in what they call their legacy system this was the one form that you had to go somewhere different than the epic system to submit a different website but now they finally got it into the epic yay however because not everybody does this you do have to request access to it it's not automatically available to everyone I've given you a link there at the bottom there's also a link on our e-rate website where you go to request bear form access what it is is an Excel spreadsheet that you enter all your basic library information related to e-rate submit fill all that in save it go into your epic account open up a customer service case submit upload this document to them and then they will email you back when your bear form access has been set up I'm not sure how long it might take for that to come through this is something new but definitely you know same kind of thing do it ahead of time get your 498 done just whenever request your bear access as soon as you receive that 498 notification and then you're good for any future needs of submitting bears all of this is a one time thing to get just set up in there and then you're good for all future funding years once you are set up for bear access when you go to log in remember this screen from the way back in the beginning we had our two choices now you'll have a third choice of the FCC form 472 bear that you can use just to do that form so not exactly in the epic system but it's the same place you log in to get into epic when you click on that then it goes to what you might recognize as the what the legacy system used to look like and all you have to enter here is your entity number that build entity number they no longer require a pin number to access the bear form this is also a great thing to pin numbers if you remember this is from there's a previous incarnations of online access to doing e-rate and it was this convoluted numbers and letters and symbols and you always had to have that to log in every time it wasn't a password you created yourself it was issued by USAC and you couldn't change it and even though we had epic since 2016 you still had to have that pin number for this one form now you don't anymore you just need to know your entry number there once you submit your bear form you will get a notification and your service provider will too just letting them know that's been done and then no matter which way you're doing it either discount on your bills or reimbursement you'll start getting quarterly reports showing you telling you who USAC has sent money to so take a look at these reports and compare them to your banking your bank account or your bills to make sure you're getting the discounts so for example it will if you decide to go to bear it'll say hey we sent this amount to this bank account check to make sure it's there just to play it safe it will also say your provider is doing a spy form and we've sent them this amount of money check your bills and make sure you're getting the discount on your bills and you're getting the appropriate amount because this is telling you this is the money USAC has sent out and that is the end of the e-rate process with the invoicing you did it all so I only have a couple more slides just some basic info but I want to know if you have any other questions we've gone through the whole process all the e-rate forms do you have anything you wanted to know anything I didn't answer any questions you're wondering about as we went through this process and if you'd like me to explain a little more detail about anything we've talked about today what's eligible what you can get a discount on how you submit a form how anything works go ahead and type into the question section let me know if you have any questions before we wrap things up for today I'll give you a couple of a minute or so here to do that that's okay if you don't have any questions right now that's fine you all know where to find me you can ask me questions anytime you want to so just to wrap the last few things up here I have been mentioning that we do have an e-rate website a page on our Nebraska Library Commission website specifically for e-rate that's the URL there nlc.nobrasca.gov or a link to a lot of different things that can help you out I'll show you that in just a second here also every fall USAC does do applicant training before the COVID-19 pandemic these were multiple workshops in person in various locations around the country last two years they've done them online of course and they did these last month in November and all the recordings of their sessions are now on their website too so if you want to you're welcome to go and watch any of their trainings they did three days worth of workshops online they also have some self-paced training modules and these great USAC videos which are step-by-step of all the different forms showing everything that you need to do and they do have for some of them some pdf user guys if you prefer and do better with learning and following instructions that are instruction guides like that I also mentioned their customer service is called their client service bureau and this is their 800 number<PHONE_NUMBER> you can reach out to them with any questions you have too if you want to and there's a contact link in your Epic system to send the messages from there as well and of course as I said my job here you can contact me my 800 number here at the library commission my email address call email me as I said as your state e-rate coordinator for public libraries I am here to make sure you get these forms submitted and get your e-rate funded that is my main job but in this case now I want to show you the e-rate website that I've been talking about here here's our web page on our library commission website where we have lots of different links here I just want to highlight a few things that we have there is a timeline a general timeline here just so you can keep the track of generally at what time of year different forms should be submitted and what's coming up these don't have specific dates for each year but just in general when you would be doing various things once we do have an application filing window for the 471 I'll do one of these specific funding year deadlines for the upcoming year some basic notifications here here's a link telling about the recordings for USAC's training that they did I will be there today's is when this session is done we will have a recording of my e-rate workshop here that you are welcome to go back to and watch again if you want to that will be linked here once we are done with these in live sessions and the links to their training modules and I want to show you these USAC videos that they have these are there are some specific for each form not too long some of them 5 minutes 10 minutes long some basics about the program a few of these to get a little longer on how to file a 470 they take a little more in depth there but these are great videos I highly recommend watching them they are not too long and they are updated each year for any changes to the forms or any changes to the rules so definitely use these if you want to as more help also I want to point out here where I have a link to that toward gigabit libraries toolkit to help you figure out what you have in your library the reduced lunch counts from the Nebraska Department of Education I have a link right there to that looking at your FCC registration number is here different tutorials the bare form access the new bare form access information about that and where that spreadsheet is I have a link right there USAC website it is not always easy to find something so I try to pull out things that you more most often go to here my basic information about SIPA what information from the FCC and ALA and some resources for looking at different options for filtering and then if you are interested all this e-rate information is public out there for anyone to see it is a public program and we have here going back to 1998 if you want to know who in Nebraska has received e-rate funding each year and how much you can see what is received alright so that is our e-rate workshop for today any last minute questions or comments or anything you want to ask of me while you have me here type in the questions section if you go to webinar interface I can explain anything more detail answer anything you are confused about elaborate on anything thank you you are welcome thank you for coming in just definitely reach out to me as you are doing your e-rate call me e-mail me if you have any questions or issues or confusions that is what I am here for I want to make sure you get your piece of the e-rate pie alright thank you very much for being joining me today and good luck with your e-rate application bye


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The next item of business is a member's business debate on motion 4825 on the name of Alexander Burnett on Lyme disease. The need to do more. This debate will be concluded without any questions being put, and I would ask those members who wish to speak in the debate to press the request to speak buttons now. I call on Alexander Burnett to open the debate. Seven minutes are there about, Mr Burnett. Thank you. Thank you, Deputy Presiding Officer, and first of all, can I thank members from across the chamber in helping me to achieve cross-party support of this motion to come to debate, and in doing so, helping to increase awareness on Lyme disease, a devastating disease which is silently affecting thousands of people across the United Kingdom. I would also like to welcome many people in the gallery who are all working to tackle this disease. I'm honoured to have been able to facilitate the attendance of charities such as Lyme disease UK and Lyme disease Action, as well as businesses and groups from across the country. Those include the Outward Bound Trust, Forestry Commission, the Grampian and Angus Glen's Moorland group, among others. I would also like to welcome constituents and others from across Scotland who have taken the time to attend the debate in Parliament today, many of whom either suffer from Lyme disease themselves or have a loved one or friend that does. Thank you for coming and listening to what I expect to be an informative debate for all. Turning to the issue at hand, I am sure that many here today will go through the statistics and rightly so, but what is Lyme disease? Caused by spirocatal bacterium from the genus Borrelia, it is a most common human tick-borne infectious disease in the northern hemisphere. Ticks carrying these bacteria are responsible for it being endemic across the UK, particularly in woodland or heathland areas, as well as urban parks and even city gardens. Now, if detected early, Lyme disease can be treated effectively. However, if not, a person can live for years with devastating symptoms. One of the most common early symptoms is the bullseye rash. However, one in three people with Lyme disease will not develop this. If not detected early enough or left untreated, serious symptoms can develop several weeks, months or even years later. These can range from joint pain and swelling, nervous system complications, heart problems and inflammation to the membranes surrounding the brain and spinal cord. This can sound very scary and it is. As the motion has stated, there is a need to do more. Now, after having a quick look on several hill walking websites online, I was surprised at the lack of information on the dangers of tick bites. We need to ensure that all mediums promoting the use of our woodland and heath areas are not only outlining the potential weather dangers but health risks too. I want to emphasise that I do not wish to deter people from taking advantage of our fantastic Scottish countryside. However, for people to be able to continue enjoying themselves, they need to know how to protect themselves from infection. Notably, the World Health Organization has confirmed that there is a 65 per cent increase in Lyme disease cases each year worldwide. These are only the reported cases. With a lack of action now, we could be reaching epidemic levels within a decade. However, those can easily be prevented and we have a chance to change this trajectory now. It does not have to be complicated. We have all heard the saying before, education, education, education. In our schools, we need to educate our teachers on the dangers of tick-borne diseases so that they can protect our children. If young people decide to take part in fantastic schemes such as Duke of Edinburgh, Scouts or Girlguiding, or just to explore the countryside on their own, they need to be aware of the potential risks. In our local communities, we need to educate our charities, families, friends, neighbours, farmers, gamekeepers, gillies, rangers, and I could go on. They need to know how important it is to protect themselves and others from tick bites and how vital it is to be aware of minor symptoms. In our health service, we need to educate our NHS to ensure that, when they review symptoms, they do not exclude the possibility of Lyme disease. Whilst the Scottish Government's recent response to a question of mine stated that they are considering improving knowledge of Lyme disease to our health professionals, I would urge the Cabinet Secretary to ensure that these methods are effective. Our charities here today are finding increasing numbers of people being told inaccurate information by their doctors, but they could have been helped if the right course of action had been taken. Herein lies the problem. Our NHS guidelines for treating Lyme disease are outdated and not fit for purpose. In the United States, where the town Old Lyme in Connecticut gives the disease its name, they have been fighting this disease for some time, and many agencies over there have been working together to find a preventative and medical solution. We can learn from their example. I would therefore urge the Scottish Government and the NHS to collaborate with local charities, businesses and other groups to update our approach to tackling this disease and to help to stagnate the rate of infections in Scotland. Only by working together to educate everyone across Scotland on Lyme disease do we stand a better chance of preventing more lives being shattered.  Because this disease does not discriminate, it affects the healthy and the young and robs people of years of their lives. That is why I would like to express my personal support for Lyme disease's UK campaign to help to increase awareness of this disease. For any members here today who would like to find out more on Lyme disease UK's campaign and what we as parliamentarians are hoping to do to help tackle it, I hope that you can join me at an event that I am sponsoring after this debate in committee room 2. Thank you very much Mr Burnett. I now call for the open debate. Mary Todd will be followed by Donald Cameron. As you know, I am unable to stay for the full debate, so apologies to the chamber. Mr Burnett, I do hope to join you at your event but it will be much later on. As you all know, I grew up in the Highlands and I still live in the Highlands. Ticks are a pretty normal part of life up there. In fact, the Highlands has been described as tick heaven. In our family, we routinely check each other for ticks after a day outdoors, as do lots of folk who live in the area. What are ticks? I've discovered one of my staff that comes from Northern Ireland and he wasn't half as familiar with ticks as I am.  They can carry a bacteria called Borrelia burgdorferi, which can cause an infection in humans. That infection is Lyme disease, and it can be pretty nasty, particularly if it's not diagnosed or treated early on. If you don't check for and remove ticks promptly, they can remain unnoticed, feeding for several days before they drop off. They do get easier to spot as they've been feeding because they've become more swollen, but the longer the tick is in place, the higher the risk of transmitting Lyme disease. That's why everyone at home checks for ticks after they've been outdoors. Early symptoms, as you mentioned, the target-shaped rash and feeling unwell as if you have flu, are reasonably common. If it's caught at that stage, it's pretty easy to treat with a course of antibiotics. The problem is that not everyone has the rash, as you've said. Doctors need to have a pretty low threshold for giving antibiotics if they think that Lyme disease is a possibility. That is, of course, at complete odds with the usual advice designed to avoid the spread of antibiotic resistance. Education around that is vital. Another complication at that early stage is that you can't really rely on blood testing because lots of people aren't positive very early on in infection. If the disease is left untreated or treatments delayed, you can go on to develop a chronic illness. That illness is sometimes called the great imitator because the symptoms are nonspecific and similar to those experienced within a number of other conditions. The diagnosis then becomes very tricky. Last year, I had the pleasure of meeting Dr Roger Evans and his team in Rhaigmoor hospital in Inverness. He's one of the UK's leading experts in this disease, and they're doing fantastic work up there to collect data and to improve the quality of testing. If this research is fruitful, it could transform testing and care of folk with Lyme disease, not just in Scotland but all around the world. One very important piece of work that they did was testing samples from blood donors to get an idea of the prevalence in Scotland. What they found was that 4.2 per cent of the population were tested positive for it, but that rate was more than doubled in the highlands, 8.6 per cent of the population. I have to say that it's no wonder that we are leading the way in research into this condition. I want to mention this book, Finding Joy, a newly published book by a fellow Highlander Morvan Mae McCallum, who I'm hoping is here in the chamber tonight. We had a bit of a mix-up when we tried to meet before the debate. Her book provides really powerful insights into the daily struggles of living with this condition. My book club is reading it at the moment, and from the discussions that we've had so far, they would heartily recommend it. We can all try to avoid tick bites where possible. There are various ways that this can be done, such as wearing long-sleeved and light-coloured clothing, avoiding long grass, wearing insect repellent, prompt tick removal, treating our dogs so that they don't get ticks. Although a lot of us in the highlands are aware of ticks and Lyme disease, not everyone is, and we have a huge number of tourists who visit every year, many of whom haven't even heard of the disease, let alone the pitfalls that they've to avoid. One simple solution that was suggested to me by Ingrid Watt from the Lyme disease support group in Inverness would be to have information boards or signs at popular walking and camping spots. The support group is worth knowing about. They meet every month and provide a space for people to share knowledge and to support anyone who knows someone with Lyme disease or who suffers themselves. I'll finish up. I think that we can agree that much needs to be done to educate both the public and health professionals to help improve diagnosis and treatment of those affected by Lyme disease. Acurat testing and data collection are absolutely vitally important, but raising awareness is the important first step. I thank my colleague Alexander Burnett for bringing this issue into Parliament today. I would also like to extend the welcome to representatives from Lyme disease UK and other associated charities and individuals who are in the public gallery. This is an important opportunity to discuss an issue that connects rural affairs and public health, and I'm delighted to be able to contribute. I think that it's interesting that we have members from across Scotland in the chamber tonight, which I think demonstrates how prevalent the disease is throughout the country. Just on my way into the chamber, I spoke to my colleague Jamie Greene, who spoke about the issues in Arran and her group there are dealing with the disease. Members, I'm sure, will cover the broader aspects of the issue, but I'd like to talk about how Lyme disease affects a particular area of the Highlands and Islands region, and that is the Western Isles, in particular the US, which Lyme disease affects more than any part of Scotland. According to a report by NHS Western Isles, the presence of ticks is particularly common in the grasslands of the US and in areas that are frequented by deer. The Royal Forestry Society notes that there are around 1,200 confirmed reports of Lyme disease each year and around 100,000 worldwide. However, in the Western Isles alone, that area contributes 33 cases of the rash in 2016, of which six were confirmed positive following diagnosis. The rash, as we've heard, is often, although not exclusively, the sign of early stage Lyme disease, sometimes in the shape of a bullseye, and serology is the blood test often used to confirm that case. Between 2010 and 2013, there were 33 confirmed cases across the Western Isles, which were a population of less than 30,000, making the incidence rate significantly higher than the UK average. Indeed, the US accounted for 20 cases of the rash in 2016 alone. My colleague Alexander Burnett noted that there is a clear need to improve public awareness of the disease so that, when the early signs appear, diagnoses can be carried out quickly and treatment can begin. Like with many infections and conditions, early intervention is vital to ensure that the public is protected. Given that Lyme disease is, as we know, acquired following the bite of an infected tick, this is particularly relevant. I'm delighted to have this in common with Marie Todd, because, as the father of three young children, we make a point of checking them and us for ticks every night in the summer, especially if they've been out and about. Like the Western Isles, Lochaber 2 has its share of Lyme disease, and it is there that I first heard of a friend catching the disease 20 or so years ago, and then it was unusual, almost unheard of, and it's only recently that it's become much more well known. I suspect that that is because of greater public awareness, which we have to keep working at. In the cases of the Western Isles, I welcome the seriousness with which this issue is being taken by NHS Western Isles, and indeed I welcome the actions that they are pursuing to raise public awareness. Along with the Scottish Health Protection Network, NHS Western Isles is organising a symposium on Bermbecula in August, which I hope to attend, an event that aims to raise awareness nationally of the public health priority relating to ticks and Lyme disease and to explore possible interventions. It will allow delegates to consider how, in the Western Isles, the experience there can be applied to the wider Scottish context. NHS Western Isles has also developed and implemented an awareness campaign, which they launched in South Eust in March this year, and resources have been sent to businesses, shops, GP practices and other locations. Information packs have been sent to schools, which is crucial, because if we can make our young people aware and able to deal with potential tick bites early and safely, then we are well on the way to addressing some of the issues. The NHS Western Isles is looking to collaborate with the research arm of Public Health England to help further the understanding of Lyme disease. In conclusion, it is vital that we continue to support efforts like those and learn from them in order to lower the incidence of Lyme disease. One issue that has been mentioned is improving the testing so that we can get those early diagnoses. I congratulate NHS Western Isles for their good lead on the matter and welcome the efforts of them. All efforts from the charities represented here tonight to improve public awareness. I thank Alexander Burnett for bringing this important issue to the chamber this evening. As Labour's public health spokesperson, this is one of a number of debates on raising awareness of particular conditions that I have spoken in over the past few months. I think that I am correct in saying that the last one a few weeks ago was on hypertension or high blood pressure, as it is more commonly known. A couple of weeks after that debate, I received a text message from a GP surgery inviting me to a well man check and you have guessed that I was promptly diagnosed with high blood pressure. I rise to speak in this debate this evening with an element of trepidation, wondering what may happen next after yet another debate on a really important health condition. On a serious note, Lyme disease, just like hypertension, is a condition where early detection, diagnosis and treatment is so crucial to avoiding a more severe outcome at a later stage. That is why raising awareness of what is a potentially devastating condition is so important. As previous speakers have highlighted, if left untreated, Lyme disease can result in joint heart problems, chronic pain, neurological or cognitive problems to name just a few. Treatment is more likely to be effective if it is diagnosed at an early stage. Raising awareness is also crucial if we are to learn how to protect ourselves, our families and our pets from this dangerous disease. That has become increasingly important as Lyme disease is a growing problem in Scotland. The number of diagnosed cases has increased from less than 30 in 1996 to 220 in 2015, and GPs estimate that only 20 per cent to 40 per cent of cases are referred. With a growing number of cases, it is an appropriate time to re-evaluate our approach to research, identification, treatment and public knowledge surrounding Lyme disease. In the south of Scotland, the region that I am proud to represent and have been brought up in, we are blessed with beautiful countryside and abundance of woodland and open spaces. It is still very much the case that children spend most of their time playing with friends outside. Families enjoy the benefits, including the health benefits, of spending time outdoors, often while walking with their family pets. However, that can bring with it danger, in this case, danger in the shape of tiny blood-sucking ticks that feed off animals and humans. The consequences can be nasty. During the recent spell of good weather, we enjoyed and made two young boys from Cullin near my hometown of Dumfries contracted Lyme disease after playing the park close to their homes. The accounts from the boys' mothers were truly harrowing.  Aaron was eventually diagnosed with Lyme disease and needed an MRI scan to rule out more severe neurological problems. In March, the second of the two boys, Dylan, aged just eight, had to undergo surgery to have ticks removed and was given a three-week course of adult antibiotics for treatment. But he was back in A&E last month after a further tick bite made his back swell up badly. Of course, children cannot be wrapped in cotton wool and denied the pleasures of playing outside, but we can do more to make the public aware of the dangers of ticks and how to minimise the risk of bites, whether that stain on paths, using a repellent, covering up one in long grass, checking yourself and your children and pets regularly for ticks when walking in a high-risk area, and if you find ticks, removing them correctly and quickly. We can also do more to raise awareness among medical professionals to ensure that the collection of symptoms of Lyme disease can be recognised at an earliest possible opportunity to avoid serious complications. Although testing is available, concerns have been raised about the effectiveness of such testing. Lyme disease action has stated, and I quote, that there are no conclusive tests for Lyme disease currently in routine use in the UK, and that will accurately diagnose Lyme disease or distinguish from past infection. The similarities of symptoms between Lyme disease in many other conditions and also the co-infection that often comes with being bitten by ticks also causes difficulties with diagnosis. However, if Lyme disease is diagnosed in a timely manner, ideally when early symptoms such as a bull's eye rash and flu-like symptoms are noticed and has not developed the treatment is thankfully straightforward with antibiotics, it is imperative that testing and public awareness of Lyme disease is improved. In particular, we should ensure that the current testing is available and extended to all bull's eye species found in Scotland and more reliable tests that do not rely on antibiotic responses are introduced. I would like to congratulate Lyme disease UK on their wake up to Lyme campaign and the work that they have done in raising awareness of how people can prevent Lyme disease by protecting themselves from tick bites as well as increasing recognition of the early symptoms of the disease and information on how to remove ticks. I am sure that Alexander Burnett's debate this evening has added to that awareness. Thank you very much, Mr Smith. I call John Scott, to be followed by John Finnie. Mr Scott, please. Thank you very much, Presiding Officer. I am declaring an interest as a farmer and one who has been bitten many times by ticks. Could I just briefly say how pleased I am that nationwide concerns about Lyme disease are again being raised in our Parliament? It is many years now since Mike Russell MSP and I first raised these concerns in the tick committee, but the problems caused by this disease still remain. At that time, a hotspot I recall was at Tinnabruch, where conditions for ticks are ideal, and their GPs were only too well aware of the problem. Raising awareness of the disease and its causes is what today's debate is succeeding in doing. That is why I am pleased that Alexander Burnett is hearing this subject today and congratulating him on his motion. As ticks have been known for generations to cause diseases in both cattle and sheep, a huge amount of work has been carried out by the modern institute in general, and Hugh Reid, in particular, who developed the well-known louping ill vaccine widely used in the sheep industry. The problems that Alexander Burnett and others graphically explain to me have, to some extent, been resolved by vaccination in the sheep industry. Perhaps, and I appreciate that it is very difficult, but perhaps a vaccination could be developed, too, for human use, for those who are most at risk from this debilitating disease. In the meantime, better awareness and education of the risk of tick bites is essential and should be a Scottish Government priority. However, if a vaccination could be developed, there would self-evidently be a worldwide market for such a vaccination. I hugely welcome our Parliament picking up again where the tick committee of 10 years ago left off. I wish the charities ever success in resolving the problem, and I hope to briefly attend their reception later this evening. I call John Finnie to be followed by Liam Kerr and Mr Kerr. We last speaker in the open debate. Mr Finnie, please. I congratulate Alexander Burnett for bringing this important addition to the Parliament. I can also thank two constituents, Janice and Liz, who have kept me very informed and who stoically go on despite the debilitating effects of the illness. It seems like my childhood playing in Heather in a work-life in the rural environment seems to have been quite reckless in some respects, given what we have heard here. We know that Health Protection Scotland monitors the incidence of Lyme disease, and certainly on one of the checks I made, the number of people affected by it, it was a 15-fold difference between the two figures, and that is to understand the discrepancies due to several factors, including the difficulty in diagnosing, and that the symptoms are often nonspecific and overlap with other conditions. In response to constituents' concerns, I have raised a number of matters. I raised issues with the blood transfusion service. Concerns expressed about screening of donations, assured that it was not transferable, and as far as evidence shows, it is not considered a risk factor. However, there was also the advice that those diagnoses should wait at least four weeks after diagnosis before donating. I also put a parliamentary question down about whether Lyme disease should be a notifiable disease in Scotland, and I will briefly quote from one of the part of the response, which was, although endemic in the UK Lyme disease does not cause outbreaks requiring urgent public health action following diagnosis of a case and is not transmissible through a person-to-person contact, as a result, it is not a notifiable disease in Scotland. However, it is important to note that the organism that causes Lyme disease, which I will not attempt to pronounce, is a notifiable organism under the act, and there is also surveillance of any positive blood tests by diagnostic labs in Scotland. As has been mentioned by my colleague Maree Todd, the Scottish National Test and Labor at Inverness in the Rheigmore hospital in Inverness, I commend the work that has done there, and I would share with many others the importance of education, which is absolutely key in this, as it often is with illnesses. The prevalence in the Highlands Islands was touched on, particularly in the US, by a colleague Donald Cameron. Clearly, there is a balance to be struck between providing information and not scaring people. The reality is that I do not think that anyone wants anything other than people to go out and enjoy the countryside, but to understand the potential effects of that. That is about knowledge, and it is about early intervention to prevent the chronic implications that can occur. That is where testing is keen. I will also take the opportunity to write to the cabinet secretary about two issues. One relates to a UK matter, and that is that, in response to a petition last year to the UK Parliament calling for improved testing and treatment protocols, the UK Government response included, in a quote, three separate systematic reviews on the diagnosis, treatment and transmission of Lyme disease. We are talking to say that they would provide evidence to inform future decision making. That is expected to be published in the autumn of this year. A nice guidance on the diagnosis and management of Lyme disease is currently in development and expected to be published in July 2018. I am keen to understand whether the Scottish Government is engaged in that process, because clearly the disease does not know any boundaries and we want collaborative working across the UK and indeed beyond. Finally, one of the constituents raised with me was the question of Scottish Government funding last year for multiple sclerosis and motor neurone disease. A concern expressed that it was unfortunate that that had not been given what we had said earlier about the confusion between diagnosis and that the opportunity had not been used to include Lyme disease in that. Just to quote Liz on this, because I think that it is important to say that this doctoral programme was yet another missed opportunity to raise the profile of Lyme disease in Scotland. Hopefully, by flagging up the submission to the powers that be, it might be incorporated in future research programmes. I believe that Scotland can be a leader in Lyme disease research as well, especially the Highlands, with our landscape being a natural petri dish for a never expanding university campus. Our location is ideal for transatlantic European partnership in scientific research for Lyme and other tick-borne diseases. I hope that, in future, that will be picked up and I will conclude there. Thank you very much. Mr Finlay, I call Liam Kerr, please. I thank Alexander Burnett for bringing forward this motion. He's titled it, Lyme disease we must do more, and I strongly agree. I knew a bit about Lyme disease before today, but not a lot. That is the problem. The average person doesn't know that a study by Public Health England showed up to 48 per cent tick infection rates, that four per cent of Scottish blood bank donors unknowingly had Lyme disease, that there are 1,200 confirmed reports of Lyme disease in the UK each year, perhaps 200 in Scotland, that the WHO confirmed that there is a 65 per cent increase in reported Lyme disease cases each year worldwide, such that, even with a conservative extrapolation, that will be at epidemic levels by 2028. That's just people. The big tick project found that one in three dogs have an undetected tick on them. 12 per cent of grey squirrels are carrying Lyme. The welfare impact on animals such as hares, sheep, deer, many birds is extraordinary. The Angus Glen's Moorlands group sent me some photos which I intended to bring in today, but they were genuinely so distressing that I thought, I better not. John Scott, MSP, who knows this piece inside out, talked me through loping ale. It is just awful. You would think that the public health system would be all over this, yet there are apparently no accurate figures for Lyme cases in Scotland. According to the Codwell Lyme disease patient survey, 56 per cent of sufferers were not diagnosed by NHS doctors or testing labs, which is perhaps hardly surprising given that five separate teams of researchers have found the reliability of the NHS test is lower than 60 per cent. Then there's the personal and social cost. Lorraine Murray, who I think may be here today, has been left virtually housebound. She was bitten by a black deer tick in 2014 while walking her dog and has since been diagnosed with three co-infections. She was initially diagnosed with chronic fatigue syndrome and spent £20,000 of her own money abroad to finally be diagnosed with Lyme disease and get private treatment. What have we must do more? To effectively protect ourselves and avoid cases being misdiagnosed or missed entirely, it is vital that people have knowledge. Public Health England produces public information leaflets on how people can protect themselves against and what to do after a tick bite. Similarly, Lyme disease UK is sending education packs to all schools, which include risk assessment checklists for school trips as well as lesson plans for all key stages. However, we need more. Unreliable medical testing and treatment seem to persist. Doctors must be equipped with the knowledge and skills that are essential to spot symptoms earlier. Currently, less than 3 per cent of GPs have taken the free online RCGP course on Lyme disease. Lyme disease UK are to be commended for encouraging them to complete the course. The UK Department of Health must be recognised for commissioning three separate clinically-driven evidence-based reviews on the diagnosis, treatment and transmission of Lyme, which are expected to be published later this year. Treatment must be intensively reviewed. Using doxycycline for a few weeks may not work, and we must investigate a more multifaceted approach using, for example, different antibiotics, biofilm breakers, cyst-type antibiotics and immune support. The estates should be listened to. The SGA floated back in 2013 potential funding for a scheme to treat deer and hares with anacharicide within a fence test area between April and June, similar to the South African system. Those animals could then be tested and monitored as to control of ticks, and if successful, this could be rolled out further. It is important to note that an awful lot of tick control is being done by the estates, especially on the grouse moors. Through awareness and education, Lyme disease can be treated effectively and efficiently, and further infections can be prevented. It is crucial that we encourage the further training of doctors to continue to explore the issues surrounding treatment and diagnosis and to be proactive in raising awareness. Thank you very much, Mr Kerr. I call on Maureen Watt to close the Government. Minister, seven minutes are there abouts, please. Thank you very much, Presiding Officer, and I welcome this member's debate. I am grateful to Alexander Burnett for the opportunity that he provides to highlight— Minister, can I get to start your microphone? To highlight the important issue of Lyme disease and what actions are being taken in Scotland to address the burden of this disease. I thank all members for the specific issues that they have raised. I can assure members that no one is being complacent about Lyme disease. I would like to recognise the very good work that has been undertaken in recent months by professionals across Scotland. Lyme disease is an important issue in Scotland, but it is a complex disease, as many members have said, for various reasons. There are issues that are not just in Scotland, but many countries are grappling with. Understanding the true incidence of infection, considering how to improve surveillance of the disease, getting better quality laboratory tests and understanding how the impact of the local ecosystem in different parts of the country affects tick populations. Scotland's multi-agency health protection network has absolutely recognised the importance of Lyme disease. It is for this reason that a specific multi-agency Lyme disease subgroup was established last year. The subgroup met for the first time in February 2016, and it quickly identified three areas of work that it viewed as being priorities. Those were workforce education and development, improving public awareness and improving surveillance and diagnosis. I would like to say a few words about each of those. In terms of workforce education, we absolutely must ensure that our health professionals know what Lyme disease is, how to spot it and how to treat it. The Lyme disease subgroup has taken forward several pieces of work to help in this area. Resources have been produced or are being developed, including webinars and podcasts aimed at front-line health professionals. There are also information resources on the Health Protection Scotland website and the NHS education for Scotland website. Work is also under way to develop and place articles in professional magazines. I know that the subgroup is actively looking at other ways of raising awareness among different health professionals. For example, in the first three months of 2017, a series of professional development sessions on Lyme disease have been delivered to community pharmacy groups across Scotland. The subgroup will also consider how to make use of existing resources that can be deployed in Scotland. For example, I know that the Royal College of General Practitioners has developed an online course on Lyme disease. That will be considered in terms of its appropriateness to the Scottish context. It is equally as important that we raise awareness, as all members have said, amongst the public. The subgroup has reviewed and refreshed a number of public awareness resources and targeted those who are most likely to come into contact with ticks, including Health Protection Scotland's public information leaflet. Work has also been done to develop an information campaign to go live this summer called Stay Healthy in Scotland's Outdoors. The subgroup has been working with key partners such as Scottish Natural Heritage to ensure that the messages in the campaign are right and effective. The Lyme disease subgroup is also taking forward work to raise awareness through youth and outdoor recreation groups to ensure that children and young people are knowledgeable about Lyme disease. I am, of course, aware that there are other groups seeking to raise awareness on Lyme disease. Like Colin Smith, I welcome Lyme disease UK wake up to Lyme campaign that ran during the month of May, and I look forward to hearing more about it at the drop-in session this evening. The more people talking about Lyme disease, the better. The third area of work about Lyme disease subgroup prioritised is in relation to better understanding the true incidents of Lyme disease in Scotland. John Finnie asked about this. The group is looking at how surveillance data currently collected through primary and secondary care can be improved to ensure that we have the best possible intelligence on the extent of the disease in this country. An important component of building good quality surveillance information is being able to accurately diagnose the disease. For technical reasons, that is not straightforward at present. There are gaps in the effectiveness of laboratory tests used to diagnose Lyme disease. Tests are not sensitive enough to detect the early stage of infection. Current tests cannot differentiate active infection from past infection, which makes it difficult for clinicians to make inaccurate diagnoses and start appropriate treatment. I can just finish this point. Our Lyme disease subgroup has representation from the National Lyme Boreolist testing laboratory at Regmore hospital. It collaborates closely with experts at Public Health England and elsewhere in order to keep the testing offered in Scotland under constant review and to think about what could be done to address some of these challenges. John Scott. Thank you, Presiding Officer. Minister, are you aware of any work that has been done here in Scotland or in the United Kingdom or worldwide in developing a possible vaccine? It would need to be not a live vaccine but a dead vaccine, but any thought has been given towards that preventative treatment rather than dealing with the problem once it arises. I am certainly not aware of any background work that I have done in coming to this debate today. I have not heard of any work being done on a vaccine, but if there is anything, I can certainly write to the member and let him know about it. The testing is not the only work in this area. At the UK level, the National Institute for Health and Care Excellence, as we know it, is expected to publish a review on the diagnosis and management of Lyme disease next year. They might have considered that in their work, Mr Scott. Our Lyme disease subgroup will, as part of their regular discussions on priority, discuss this once it becomes available. In addition to the excellent work that is being undertaken by the subgroup to address Lyme disease in Scotland, I would also like to take, as some members have taken the opportunity to highlight the importance to continue supporting hill farming in Scotland. Liam Kerr mentioned sheep. They are known as sheep tickmops. I watched them myself on one of the estates in Upper Aberdeenshire not all that long ago. Sheep are considered an important control of Lyme disease because they collect the ticks from the pasture that are killed when the antiparasitic treatment that is administered to them is taken and that reduces the amount of ticks in the environment. It is no coincidence that the number of confirmed cases of Lyme disease markedly increased in 2006 and has remained at that high level ever since. That coincided with the decoupling of support and the move to single farm payment when we know that the number of sheep on the hills declined significantly and we saw effective land abandonment in some areas. It is key that we continue to support hill farming in Scotland through ELFAS or that that will lead to further land abandonment. That in turn could cause a huge increase in the number of ticks and therefore increase potential exposure to Lyme disease. Hill sheep farming is the backbone of many of our remote and fragile rural areas and therefore the UK Government must respond to the repeated requests of our Cabinet Secretary for the funding of ELFAS payments to be maintained beyond Brexit. As I said at the outset, I am grateful to the member for securing this debate and absolutely agree with him that this is a very important issue. I hope that I have been able to provide some reassurance about the work that we are doing and the fact that our professionals absolutely recognise the importance of Lyme disease. The multi-agency Lyme disease subgroup will continue to co-ordinate work in this area and this will be an on-going priority that I am happy to update on in the future. As always, I would be very happy to hear ideas of what more could be done on this matter and how we can work together to make a difference. I look forward to dropping into the session after this debate.


Is narcissism seen in over 50% of the population? This is just a short video, but I felt that I had to make a video about this. I was watching a very interesting video of the other day. It's called understanding the narcissist. Why do they treat you in this way? It is a med-circle interview with Dr Ramanee who is a psychologist and a narcissism expert. I was watching this video and I thought it was very interesting what she said 9 minutes into the video. For those of you who have not seen the video yet, I am going to quote what she said. Narcissistic personality disorder. We only see it in maybe 1-5% of people. Narcissism. I'm willing to tip that number over 50% at this point. After I heard her say that, I knew I had to make a video about it. Not because I disagree, or because I'm surprised to hear someone say that, but because she's a psychologist and she's saying that. While psychologists tend to downplay what it really is, because maybe they're afraid of the backlash or criticism, but she was open and honest about it. She said what she really believed, and I have to say that I completely agree with her. As she said, narcissistic personality disorder is only seen in 1-5% of people. And while that may not seem like a lot, that number could be anywhere between 78 million and 390 million people in the world. While Dr. Armani believes that narcissism may be seen in over 50% of the population, which would mean over 3.9 billion people, narcissism may not be quite as extreme as narcissistic personality disorder. But it is still affecting people. It is still causing problems in people's lives. Narcism could be defined as a tendency to think very highly of yourself. To think that you're special or superior to other people, to lack consideration for other people, and be excessively concerned with your own profit or pleasure, to show an excessively high opinion of your own appearance, abilities or worth. These types of people do not care about the world or anyone in it. They only care about this delusional, idealistic view of themselves, which isn't even who they are. So they're constantly detached from reality. They have this ghastly mindset where it's every man for himself. Or they have to get you before you get them. Really dangerous people to be around. And they are very envious and jealous. They are always trying to take something from you while giving you nothing in return, because they have nothing to give. They operate in this delusional, idealistic view of themselves, which doesn't even exist. So all they can do is take from people to prop up this false self that they've created. And Dr Ramanee believes that this could be seen in over 50% of the population. Which I completely agree with. Just look at the news and the politicians. Large corporations. Social media. I'm not here to convince you. I'm just here to make you aware. And I am very interested to know your opinion on this. So please let me know in the comments below. Do you think that narcissism can be seen in over 50% of the population? Do you think that narcissism is growing? Please let me know. That's all for this video. Thank you for watching and I will talk to you soon.