In the previous video, we just went over a short introduction of one-to-one functions and then also inverse functions and this was the definition, just the informal definition of an inverse function that I gave you. So recall that an inverse function is the complete opposite of the original function. So that means it includes the opposite operations of a function but also the key thing to remember is they also have to be done in the opposite order. So in this video, we are going to look at finding inverses to functions when we're given the equation. First, we'll just look at how to do that using this idea of the opposite operation in the opposite order, but then we'll also look at a method to do so algebraically. If you look at this function, what we want to think about are what operations are being done to x right here? So if you were going to plug in a value for x, what would you do first? And the first thing that we would do is we would multiply that value by 2 and then we would subtract 3. So what we have to remember when we're finding the inverse of this is we're going to do the opposite operation in the opposite order. So we start from the bottom and that becomes our first operation. So we're going to start with the opposite of subtracting 3 and the opposite of subtraction is addition. So we first will add 3 and then we're moving our way up this column here. And so the next thing that we had done was multiply by 2 and the opposite of multiplication is division. So we will then divide by 2. So how do we write this out as an equation? Well, we start with our x value. We add 3. That was our first step and then we're going to divide all of it by 2. So you just have to make sure that you are applying that second operation to the entire function. Okay, let's look at a second example here. Let's look at g of x equals the square root of x minus 4. We're going to start by listing the operations in order that are being done to x. So if you look here's our x and if we were evaluating this function, the first thing we would do to evaluate is we would first subtract 4 and then the second thing we would do is we would apply the square root or take the square root. Now recall the inverse is the opposite operations in the opposite order. So we start at the bottom and we work our way up. So the opposite of taking the square root is going to be to square the function and then as we work up the opposite of subtracting 4 will just be to add 4. And so our inverse will be x squared. That's our first thing and then we add 4. Now both of these examples are fairly basic in finding the inverse. There are a few examples that can get a little bit trickier. So we are going to look at a couple examples. Again, they're too hard, but we just want to look at how we could find the inverse algebraically. So what I first want you to do is on your paper, we first want to find the domain and the range of this function. So if you want to, you can type it into your graph. Just pause the video, type it in just so you can look at it. But remember the domain is all of our possible x values. And if I just sketch a little picture of the graph here, it should look something like that. The domain of this function is going to be all real numbers or an interval notation, negative infinity to infinity. While the range of this function is from the bottom to the top and these, although they are increasing and decreasing just slightly, these will continue to increase or decrease. So our range is actually the same as the domain. So if you look, this graph passes both our horizontal and our vertical line test. So it is one to one, which means we can find an inverse. So our next step is going to be to find the inverse. Okay, now here's a way that you can find the inverse just algebraically if you don't like using the idea of the opposite operation in the opposite order. Instead of writing this as f of x equals, I'm going to just write it as y equals. And if you remember from the previous video, when we're finding the inverse, the x and the y values just flip-flop. So in the equation, we can just trade the x and the y values and now we just need to solve this new equation for y. If we can do that, then we'll have our inverse equation. So in order to solve for y, start from the outside and work your way in. Here, to get rid of a cube root, I would cube each side of the equation. That would give me x cubed on the left and then the cubed and the cube root cancel out. So I would get x cubed equals y plus 2. And then to solve the next step for y, I would subtract 2 and I end up with x cubed minus 2 equals y. Once the y is by itself, you have come up with your inverse equation. f inverse, I'm trying to use our notation, equals x cubed minus 2. So our second example is g of x equals x squared minus 3. So again, I want us to start out by finding the domain and range. If you want, pause it, type it into your graphing calculator and we'll take a look at it. Here, I'm just using my ideas of transformations in order to get a rough sketch on here. So if you look at this, we have an issue that hopefully you see right away. If I were to draw a horizontal line through this graph, it hits the graph twice, which means it is not a one-to-one function. And if you remember, functions can only have inverses if they are one-to-one. So what we can do in order to still be able to find the inverse is something called restricting the domain. And what that means is you want to take just part of the graph that still gives you every single y value possible, but it makes it so that you only get each y value once. So here, if I look at it, if I start down here at the vertex and I just include this half of the graph, just that red piece of the graph will pass the horizontal line test. So I'm going to restrict the domain, and rather than saying my domain is all real numbers or negative infinity to infinity, I'm going to restrict it and start right here so that I can actually find the inverse. So my domain is going to go from zero to infinity, and then the range, it should still include all of the values on the range of the original function, otherwise you should pick a different piece of the graph to restrict it. But here our lowest value is negative three, and the highest is infinity. So when we find the inverse, even without finding the equation for the inverse, we already know what the domain and range of the inverse will be. The domain from g of x will become the range, and the range will become the domain. So the domain of our inverse will be negative three to infinity, and the range will be zero to infinity. And those you can just check at the end, but let's find the actual inverse algebraically. So we'll use the same process that we used in the previous example. We start by switching our x and our y. Next we're going to solve for y. So first in this case I would add three to each side of the equation, and then next I am going to take the square root of each side of the equation. So what I end up with here is I end up with the square root of x plus three equals y. Or in other words, g inverse equals the square root of x plus three. And if you were to just sketch a quick graph of that, or type it into your calculator, it's our square root function shifted to the left three. And if we shift to the left three, that gives us a domain of negative three to infinity, which is what we thought would happen, and a range of zero to infinity, which is what we thought would happen as well.


Ieithio, gynorth, mae Llyr Gruffydd yn ei gwybrion i gael gwahanol a'u gweithio i ddysgu'r sgwrdd anghytfwrdd hcymhwgol jyrnau hyn oedd y prifyfliadau sgwrdd 1000 ar unrhyw o gweithio gweithio chi, mae'n byw yn bryd i'r fydd. Felly, mae'n dweud i'r gweithio sy'n ddweud hyn o'n ardal gyda'r lleol hyn, mae'n byd i'r sinold i'r cynnigol, ac mae'n byw'n ddyliol, cwestiwn sy'n gweithio bawb o'r pethau, ac dros y buiadau oedd yn amgylch Nothing? Rwy'n fide Nonetheless, mae hynny'n du o'r cwestiynau a'r unrhyw yw Gwyrdd Cymru, gan gilydd i'n gweithio iaethach. Rwy'n fide accusing mewn ac i ddyw y môr, mae'n ceisio ddim yn gwneud o'r pethau, ac mae'r bwysigrach ar y gweithg BiD, ac mae'n ddrygio i'n gweithio er mwynol i'r pethau. A oedd y dyn ni'n cael ei ddwybolaeth, oswalt chi'n 10 munud. I welcome the opportunity to update members on the Scottish Government's response to Ralph Roberts's review of maternity services in Murray. As a result, I am delighted to set out the next steps for the reintroduction of consultant-led maternity services at Dr Gray's hospital in Elgin. That will not be easy, but with effort and targeted investment, I believe that it can be delivered. I understand the urgency and the importance of the issue. It has been imperative for me to hear directly from those most affected, namely local people and the clinicians working in both Dr Gray's and Ragemore hospitals, and indeed of course the local elected members before making my decision. I know across this chamber that we all want maternity services across Scotland to be delivered safely and as close to home as practable. The Murray maternity independent review commissioned by my predecessor Jeane Freeman was carried forward with a thorough and consultative approach. I want to again record my thanks to Ralph Roberts and the review team for their excellent work. Those have not been decisions that I have taken lightly. I have taken time to consider the recommendations in discussion with a range of interested individuals and groups. I started that process in December when the review was first published and concluded last week with a visit to both Ragemore and Dr Gray's, where I met senior teams, clinicians, local people and elected members. I thank everyone for taking the time to provide their thoughtful contributions to the discussions and for welcoming the wide-ranging views that were presented to me. Ralph Roberts' team explored six potential models of service delivery from maternity services in Murray and made 37 recommendations for improvement to care. The report recommended that, in the short term, NHS Grampian and NHS Highland moved to a community maternity unit in Dr Gray's network, primarily with Ragemore for consultant-led care, but with women requiring tertiary maternity care or neonatal care going to Aberdeen. That was titled as model 4 in the aforementioned report. It went on to recommend that NHS Grampian undertake a review of the role of Dr Gray's hospital, potentially moving to a rural consultant-supported maternity unit in Dr Gray's. That was titled as model 5 in the report. Mr Roberts also made a number of recommendations in relation to short-term changes. They were around leadership, culture and workforce and, indeed, on recruitment. As I have talked to people over the last three months, I have heard the full range of very different opinions about the future for maternity services at Dr Gray's. There are differences in opinion on the way forward. What I intend on doing today is setting the destination of where we want to get to and, in doing so, I will be up front about the scale of the challenge ahead of us. I have concluded that we will progress with model 6, a full consultant-led maternity unit at Dr Gray's, with model 4 as part of the development towards that final destination. I hope that that will see 80 to 90 per cent of Murray births taking place at Dr Gray's on the realisation of a consultant-led model, similar to the numbers that were taking place prior to the changes that were made in 2018. I said at the beginning of the statement that delivery of a consultant-led service will not be easy and it will require significant investment both in infrastructure but also in workforce. It will involve us collectively having to find solutions to really complex systemic problems that have challenged the Grampian region for many years, such as recruitment and retention. The priority for women of Murray is that they have access as soon as possible to the widest range of maternity services that can safely and realistically be delivered as close to home as possible. Let me be clear. I expect work on model 6 to begin immediately. The first step in that journey is working through the detailed timeline of what is required by when. That will be done with independent oversight and clinical input. As I have said, model 4 will be a critical component on the journey towards realising model 6, a consultant-led maternity unit. Model 4 includes enhanced specialist anti-natal and post-natal care and Dr Gray's to vastly reduce the need for women from Murray to travel to access those services. The additional infrastructure and resource that will be invested to achieve this goal will act as a bridge to the delivery of a Dr Gray's consultant-led service and accompany a wider plan for regeneration of services beyond maternity services at Dr Gray's. As Ralph Roberts's report recognises, it is essential that a consultant-led service is taken forward within the context of a revitalised vision for Dr Gray's. That extends beyond maternity services to include increasing services at Dr Gray's for the whole population of Murray. NHS Grampian has already outlined plans to the board for development of a strategic vision and future plan for Dr Gray's, developed in collaboration with local communities and to re-establish the public faith in the sustainable future of Dr Gray's. However, we know that that will not happen overnight. I know that local people understandably want those services back as quickly as possible. We are committed to investing in the staff and delivering the required infrastructure to put those services in place in a secure and stable footing as quickly as possible. Now that I have stated clearly our intention to restore a consultant-led maternity unit at Dr Gray's, it is imperative that we develop deliverable timescales for the interim service provision at Rhaigmore and, of course, the full service at Dr Gray's. Having listened to clinicians, I understand the importance of making changes in a phased manner to ensure safety for the women of Murray and the women of the Highlands. I also recognise that facilities in Rhaigmore and Dr Gray's will need significantly improved to support this move. That is why, as a starting point, I will make £5 million available to invest in Dr Gray's to support moving forward with the changes in Murray. In addition, it is clear that clinicians in Rhaigmore have concerns about the current facilities in which they are operating. With that in mind, we have made an initial provision for a further £5 million for redevelopment of Rhaigmore within our capital plan. That will allow plans to be brought forward to redevelop the maternity unit in Rhaigmore to provide an improved environment for the women of the Highlands and the interim for the women of Murray who choose to have their baby there. Once planning is further developed, we will also look at what additional funding may be required. I again repeat my commitment to providing the necessary resources to support the change. This is an immediate commitment of £10 million from this Government to enhance maternity services in Dr Gray's and Rhaigmore. The interim networked service will be developed with service users and will include delivery of the maximum possible amount of consultant-supported anti-natal and post-natal services at Dr Gray's, reducing the need for women to travel to Aberdeen or Rhaigmore to an absolute minimum and also delivering continuity of care for women in Murray. Having the clarity of a safe model 4 will enable us to focus on maximising the number of women who choose to deliver in Dr Gray's by building trust, confidence and, of course, understanding of choice. That has the potential to significantly increase the number of women who can give birth at Dr Gray's. Those women who need obstetric lead care will have the choice of Rhaigmore or Aberdeen for their care until such time as consultant-led services have returned to Dr Gray's. The chair, chief exec and executive team at NHS Grampian have sought to assure me of their focus and unstinting commitment as a board to the delivery of the model. I know that there are concerns, and I heard this very clearly from campaign groups in Murray, that once model 4 is in place, there will be no desire for further change. I heard this from not just local campaigners, but I also heard this from elected members in Murray 2. Let me be clear. Model 6, a consultant-led maternity unit at Dr Gray's, is what we will deliver. No one has been left in any doubt about my decision. Implementing model 4 will be a key component to achieving a consultant-led service, not an alternative to it. In addition, providing choice for Murray women will also significantly improve the birthing environment for Highland women. NHS Grampian and NHS Highland have already started to pave the way for change, and with a clear destination, we can start work immediately on the progression of planning and developing implementation plans. A process of accelerated planning will begin now, and we will conclude in the summer in relation to model 4 changes, and we will aim to have a clear timetable for the restoration of a full consultant-led unit as soon as possible thereafter. The plans will provide a timetable with milestones for delivery of both model 4 and model 6. Ralph Roberts made a number of other recommendations within the Murray maternity review on leadership, on workforce, on recruitment and on culture, and I accept all those recommendations. In his report and action, we will begin to take those forward, including in particular work to improve remote and rural staffing to support delivery of the staffing requirements for both model 4 and model 6 as they emerge, and commitment to providing the necessary funding to support delivery of those models. There will be an external assurance process built around that, which will include expert clinical input. I know how important that is, in particular to local community groups and in detail elective representatives. I have spoken to them in conclusion, planning officer having made this decision. We will waste no time at all and work to progress with implementation, which will begin immediately, and we will urgently drive forward our work to restore consultant-led maternity services to Dr Gray. I will be happy to keep Parliament updated when I have further details on milestones and timescales. Thank you very much, cabinet secretary. The cabinet secretary will now take questions on the issues raised in his statement. I intend to allow around about 20 minutes after which we will move on to the next item of business. Helpful, as ever, if members who wish to ask a question would press the request to seek buttons or place an R in the chat function. I call firstly Douglas Ross. Thank you very much, Deputy Presiding Officer. Can I start by recognising the outstanding contribution made by Keep Mum and the Murray and Bamp Maternity Voices Partnership, who have campaigned tooth and nail for the last four years to see the restoration of a consultant-led maternity unit at Dr Gray's? That is how long this has been going on for. Since 2018, we have been without that vital service in Murray. The last time I addressed this issue with the cabinet secretary in this chamber, he accepted that it was unacceptable. My fear today is that we are still a long way off from the restoration of that service. That has a huge impact, Deputy Presiding Officer, because Jill Skeen from the charity Lantnam, which is a maternal mental health support group from the north-east of Scotland, said this in the P&J today. Speaking of Elgin, I do not actually know if I have met a mum who is not suffering as a result of being very worried about childbirth or as a direct result of a traumatic birth from that area. They have said that Elgin is the worst area for mental health issues pertaining to childbirth and pregnancy anywhere they work. That is so obvious, because since Ray Roberts and his team produced their report, we had a statement in this chamber. Up to today, we have had more and more traumatic stories from Murray mums. Many of them have been very well articulated by the Keep Mum group, but one, Alexandra Naylor, stands out above all the rest. She spoke of her horror and her terror at having to give birth in a labai on the 96th. She was being transferred from Elgin to Aberdeen in Labour and could not even get there. That is the situation that we are dealing with right now. As I also alluded to with the cabinet secretary when he came to Murray last week, that is not just a one-way journey. You have to come back again. If I can just for a moment, Deputy Presiding Officer, speak about my personal experience. I have spoken in the chamber before about how Crystal had to go through to Aberdeen to give birth, and that was traumatic. That is something that I do not want any other mum or family to go through. However, we had to come back again. Our son was born at 1.45 a.m. and we were released from Aberdeen at 9 a.m. Less than eight hours old, we are taking an infant child back to Murray. He had to sit in the car for two hours. I have not spoken about this, but shortly after he was born, James spent almost a week under the excellent care at the Royal Sick Kids Hospital in Aberdeen, because he had breathing issues and chest problems. Ever since then, I have had to wonder, is it because of that journey that he was forced to make as such an infant child? Did that have a contribution to his problems a few weeks later? Every time I saw him in hospital, being fed with a tube down his nose and getting oxygen pumped into him, so helpless, I had to wonder, could that have been avoided if he was able to be born in Elgin and just be 10 or 15 minutes away from home? Those are the issues. It is not just the worry about childbirth, it is the worry then about coming back to Murray. The health secretary has confirmed today, and I welcome this, that model 6 is his preferred option. Of course, he confirmed that almost a year ago. He stood on a manifesto commitment to restore a consultant-led maternity unit at Dr Gray's. It was a commitment that I introduced to the Scottish Conservatives manifesto, and I was delighted to see in the SNP manifesto. We are where we were this time last year, but model 6, that restoration of a consultant-led maternity unit, must be the focus and the priority, because he is right. There is a genuine fear that model 4, with more Murray women going to Inverness, will become the norm, and that cannot be acceptable. So, how does he reassure people in Murray that that will not happen? Also, I have raised in the chamber before clinicians from Redmore who raised serious safety concerns. They said, and I quote, that findings of the Ralph Roberts report, and model 4 in particular, were unworkable and unsafe. Have they now been reassured by the Cabinet Secretary and have they changed their position? Will NHS Grampian fully support what the Government is proposing today? How does he answer the serious concerns again relayed in the independent review from Ralph Roberts that there has been a lack of investment in Dr Gray's for years? NHS Grampian has neglected our hospital for years, and there are serious concerns that they are not fully behind those plans. As Ralph Roberts said, Dr Gray's has not had the investment in similar hospitals elsewhere in Scotland, and that has to be addressed. I would be very interested to know what the Cabinet Secretary's response is to that. What will the investment at Dr Gray's be, and when will that take place? When will the full consultant-led maternity unit be up and running? We have no timescales, no milestones, and we need a date. What is happening right now for women and families who have to endure a blue light transfer to Aberdeen or Inverness and the staff that have to go with them? Finally, the Cabinet Secretary said that his aim is for 80 to 90 per cent of births at Dr Gray's. We all support that, but we need to know when. Will it even be during this Parliament? Can we get a date—a month, a year—when that will be done so that we can hold this Government to account, hold the health board to account, and pledge the restoration till of the services that people in Murray so desperately need? I thank Douglas Ross for his questions, and I also join him in praising Keat Mum, Murray Voice's partnership and all the other local campaigners. I can also praise the cross-party campaign—I think that it has been an excellent cross-party campaign and genuinely cross party—as far as I can see. His questions on pace and concern that model 4 will become the norm and there will be little work done on model 6 is a fear that I understand and community groups also share. That is why it is so important for me and I suspect that it is important for the campaigners and elected members that we have an independent assurance process alongside any work that is done. I heard very clearly about the distrust that local campaigners have towards the health board. They also no doubt distrust, to some extent, what we are saying here in the Government. I want to give them an absolute assurance that I am committed to model 6 and to return to consultant-led maternity services, but to give them additional assurance that we will have that independent oversight. That will include independent clinical oversight as well. In terms of his own story, I thank Douglas Ross for sharing his own personal circumstances once again. First of all, I hope that his son James fully recovers. Obviously, I do not have the clinical knowledge to say whether or not the journey back contributed to his breathing difficulties. I will say that, regardless of that, what I can say is that the journey back, when a child is hours old, is not something that I would want for my child. I suspect not what somebody would want for their newborn either. I cannot imagine, even from a parent's perspective, how tired she would be after supporting your partner through birth and how tired she would be the woman who has given birth. Therefore, that journey would be a difficult one. We want to minimise that absolutely. He says that model 6 is something that we are committed to. Model 5 is also a rural consultant-led model 6 that goes a bit further. That is why I have made the decision to go with model 6. I think that it matches the aspiration of the community. That will be the focus. I can give him an absolute guarantee that it will be the focus. He asked a couple more questions, and they were around Rhaigmoor clinicians. I met Rhaigmoor clinicians, as he knows. They did express difficulty, concern and anxiety about the current facilities. They have also written to me, and members know that, because they have made those letters public. What I will say is that I hope that they have got some assurance from the fact that I have put investment on the table for an improvement in their facilities. NHS Grampian does fully support the direction of travel. I have spoken to NHS Grampian. They understand my expectation around model 6, but I again fully understand that the independent oversight will be exceptionally important to community groups and elected members. On the timescale, which is the last question, the reason why I cannot give you a date right now is because, frankly, if we did that now, we would be plucking it out of the air. Now that I have set the destination, what we can do is work backwards. What does it take to get us to model 6, to get Dr Gray's full consultant-led maternity service? What investment is required? What staffing is required? What needs to be done in terms of some of the systemic challenges that Grampian has faced over the years? However, I can promise him two things. One, I will keep him and the Parliament updated on those timescales. We will be open and transparent about them. The last thing that will end on this is that we will not shirk away from our responsibilities in terms of the investment that is required for model 6. 2. Rhoda Grant I join with Douglas Ross and Payne tribute to Keith Mum and Murray Voices campaigners in Murray for consultant-led maternity services. I welcome the promise to reinstate consultant-led maternity services at Dr Gray's and the very much needed investment at Dr Gray's and Regmore, but I cannot welcome the short-term option. The cabinet secretary tells us that he is listening to what those involved are telling him, but he is obviously not hearing what they say. Clinicians from NHS Highland wrote to him in February saying that the board did acknowledge on this occasion that staffing and the built environment requirements for model 4 cannot be met in the timescale proposed in the report, i.e., two years. That is of profound significance as it confirms that model 4 is not an option for the short term. In addition, our lead pediatrician gave his opinion that our neonatal facility is at capacity and that any increase in birthrate at Regmore before major upgrading to staffing and facilities will put babies at risk. They were on to make the point clearly that neither was this a feasible option because they were unable to currently fill staffing vacancies and existing staffing were facing burnout. Many of those points were also made to him by the chief executive and community campaigners in Murray at meetings that I also attended. Will he therefore reconsider option 4? It is simply not safe. Will he outline what he is going to do in the short term to keep mums and Murray safe? As far as I am aware, Nather Order grant is a clinician, so she is right to put forward the views of clinicians in Regmore. Just before the meeting that I had with Rhoda Grant and Murray last week, I was having a meeting with clinicians from Dr Gray's. Almost all the clinicians in that room supported model 4. We have a difference in clinical input. I accept that clinicians in Regmore have a concern. I am hoping that what they will be reassured by is the £5 million that I am committing immediately. I am putting on the table. That is also why a timetable is exceptionally important. I said in my statement that I would return in the summer to give a detailed timeline of model 4 of what milestones will be achieved by when. Of course, I continue to reiterate that that will have clinical input from the clinicians at Regmore, of course, and clinicians from Dr Gray's, but also independent clinical input. Absolutely, timetables and timescales are important. I hope that our investment that I am putting on the table for Regmore and, of course, the investment for Dr Gray's. I hope that those will give clinicians assurance. I will continue the conversation with clinicians from Regmore, as I did last week. As the cabinet secretary has set out today, safety is the absolute priority in ensuring enhanced services in Murray. Can the cabinet secretary outline how NHS Grampian will support staff training and development across the multidisciplinary team? I can be brief and say that this was part of my discussion with the chair and chief executive of NHS Grampian. This is one of those issues that we have to grapple with when it comes to model 6, but also in the interim and the bridge model 4 solution 2. We know that there have been changes since 2018, and there is a question and concern about making sure that staff are appropriately trained, having not done a certain procedure since 2018. That is all part of the consideration, but I have had an absolute commitment from NHS Grampian that that training element will be core to developing model 6 and model 4 in the future. Given that the Scottish Government hope a version of model 4 will be delivered in two years, and as Douglas Ross rightly highlighted, there is no indication yet of how long model 6 will take to deliver, it is likely that there will be a considerable ongoing reliance on transferring maternity patients to hospitals out with Murray for the next few years. The cabinet secretary did not answer Douglas Ross' question on blue light transfers for Murray and the ambulance service was not mentioned once in his statement. Can the cabinet secretary advise me what impact the ongoing need for patient transport relating to maternity services will have on our already under pressure ambulance service and what discussions he has had with the service on any additional support that they will need to undertake this role longer term? That is a really good point, and forgive me that I tried to take a note of many of the questions that Douglas Ross asked me as possible. There have been conversations with the Scottish Ambulance Service around that point. They are under extreme pressure, of course, that is why we are investing in additional recruitment. Of course, the Scottish Ambulance Service, and it is yesterday that they have had a record year of recruitment over the last financial year. Scottish Ambulance Service will be critical to part of the solution. Of course, we hope that, when we implement the full model 6, there will be much lesser reliance on the Scottish Ambulance Service, but 80 to 90 per cent of births, we hope, when model 6 is up and running, will be in place. Even once model 6 is there in place, there will still need the involvement potentially of the Scottish Ambulance Service, so it will be critical in terms of the discussions that take place in relation to restoring consultant-led maternity services. The increased investment in services at Dr Gray's and Raghmore is very welcome. Can the cabinet secretary outline the improvements in Raghmore that the new investment is expected to deliver? Can he offer any reassurance to those within Raghmore who may be concerned about capacity issues during the interim option 1? I visited Raghmore myself, and anybody who has been to Raghmore maternity ward will see very clearly the constraints under which they are operating. Obviously, I had time to speak to some of the consultants and nurses and the midwives who were in the unit at that moment in time. The money that we have put forward is part of the redevelopment of that infrastructure. Clearly, there is a need to improve that capital infrastructure, which we are also looking to improve staffing or increase staffing, because we know that there are staffing challenges. It is not just recruitment—I should say that what we are doing is working with NHS Highland, and that will be the same for a Grampian, no doubt, but it is not just about recruitment, it is about retention, and that is going to be really important moving forward. I know that there are concerns currently about the infrastructure at Raghmore. I hope that the investment that we have put in the table will help to give some element of hope and reassurance to people that we are taking this, not just seriously, but putting our money where our mouth is. We know that there are significant pressures already placed on the existing workforce in rural health boards, such as the NHS Grampian, and it is, as you say, struggling with staff recruitment and staff retention. Could the cabinet secretary therefore tell the chamber what plans he has to remedy existing staffing difficulties, and indeed why Parliament should trust that this Government has the plans in place to ensure that its actions on workforce-related recommendations will have an effective and lasting impact and deliver for both the services and those that rely on those services? People can trust us on staffing because, under this Government, we have record staff in our NHS with 28,700 more whole-time equivalents and a 22 per cent increase since 2006. We can trust that we will grow the workforce, but it is not just about growing the workforce, as I said a moment ago. Retention is hugely important, and that is why we will be working with Grampian, but not just with the health board. There must always have to be a multi-agency approach to retention, and that is why we will work with the local authority on accommodation, for example, and on schooling for families who wish to move to Moray. I spoke to a couple of consultants who had moved their family to Moray. I am going to ask them why they have always looked at what was the reason for coming to Moray. The lifestyle came up as almost the number one issue for them all. I think that we should capitalise on that, but we have to ensure that the appropriate support is also there for people who uproot themselves from other parts of the country to Moray. It is an attractive place to work, and there is great opportunity there. Now that I have announced Model 6, I think that there is a really attractive vision for the future of Dr Gray's, which they can be a part of. It is very welcome that the voices of families and service users in Moray have been listened about in the process. The cabinet secretary has set out how continued stakeholder engagement will be delivered as the service is developed going forward. I commit absolutely to the investment that is needed. I commit to keeping Parliament updated. We will invest in the staffing and infrastructure. Of course, it is important that we are talking about Dr Gray's, but I am keeping a conversation with Grampian whatever is needed to be done at Aberdeen, although the facilities there are excellent. I should also say that this is a cross-portfolio approach, although I am leading on this understandably so. You can imagine that I am speaking to the likes of the transport secretary and others around improvements that can be made for those who have to travel to make that journey easier. I will return to the earlier point of order, given the number of members who still wish to ask a question and mind it to accept a motion without notice under rule 8.14.3, to extend by up to 30 minutes the business. I would ask Douglas Ross to move such a motion. Is the chamber agreed? That appears to be agreed. I now call that the extends business by up to 30 minutes. There will be consequential implications for the rest of the business, including decision time, but at this point I call Alex Cole-Hamilton to be followed by Karen Adam. The issues at the heart of the review are not unique to Murray. Expectant mothers in Caithness currently face a 100-mile trip to Ragemore to give birth. Sometimes they make that journey in the snow and in the dark. If he will commit here and now to a similar independent review of Caithness maternity services, and if he won't, can he explain to those expectant mothers in Caithness why they cannot expect the same level of service as mothers in Murray? He knows that the best start north review was commissioned jointly by NHS Grampian, NHS Highland, NHS Orkney, NHS Shetland to look at the challenges facing maternity services across the north of Scotland. The review is being carried out in consultation with local people to develop the best possible sustainable model for maternity services in the future. The review of course includes services that are delivered from Caithness. Changes to Ragemore and investment that comes with that will improve the services for all women in NHS Highland to travel to Ragemore to give birth, as well as accommodating women from Murray. I have agreed publicly last time that I travelled to Murray, but when I was asked about that, I will meet with the campaign groups in Caithness and understand their concerns about the current situation, but hopefully to give them a reassurance about the fact that the issue around Caithness is being considered and as part of the current review under way. Adam, who joins us remotely to be followed by Ariane Burgess. We know that a number of factors contribute to making it more difficult to recruit staff to work in rural areas, and the cabinet secretary outlined if there will be fresh approaches to recruitment and contract, such as hub and spoke models, with larger hospitals to ensure that specialisms can be delivered in Dr Grace. That has to be absolutely part of the solution. We know that, of course, we have to make posts attractive. That might include, for example, working in different sites. That is absolutely correct. It might also be mixing a clinical role with an academic role. Whatever we can do to make those posts more attractive, we will absolutely look to do and explore. Ariane Burgess, to be followed by Sue Webber. Can I join with colleagues across the chamber in recognising the hard work from community groups like KeepMum that have kept Murray maternity services on the agenda? I welcome the announcement that the Scottish Government will progress model 6, which will see a return to full consultant-led maternity unit at Dr Grace and its commitment to recruiting more specialist staff to deliver this. How will the cabinet secretary engage with stakeholder groups to monitor progress on this project? I will continue to engage with all stakeholders, from clinicians to elected representatives to the local community. In fact, I am due to speak to KeepMum in the campaign groups straight after this, although it might be slightly delayed, given the extension to business. I will continue to engage with local community groups and be absolutely involved in the process. I hope that the transparency that we are providing will give elected members plus local community groups the reassurance around what they can expect by what time. Sue Webber, to be followed by Gillian Martin. The cabinet secretary mentioned that model 4 was a bridge to model 6, but this in itself could take up to two years to establish. As the cabinet secretary will know, and as we have heard already today, getting to model 4 will require substantial investment in both recruitment and the existing workforce. Given the existing and long-standing issues with recruitment and retention in the health boards, what immediate steps will the cabinet secretary take to ensure that the workforce is in place in time? Importantly, can the cabinet secretary confirm that the two years for the establishment of model 4 is the very limit of time and not to target? That is precisely why we want to bring forward a timetable in an open, transparent way. I would not expect it to take longer than two years to answer Sue Webber's question directly, but, of course, I want that work timetable to be done. That is why it is so important that that is done and I update the Parliament on that. It is so important that we get that clinical input, because all of us—I do not think that there is a difference between what all of us want. We want to see sounds like all of us who have spoken want a return to a consultant-led service in Murray. We all want it as quickly as possible. I have got to be guided by the clinical view about doing that safely, because I certainly am not intending to be the health secretary that makes the decision that puts women at risk. I completely accept the point that there is risk in the current model, which I can hear people saying. We want to improve the situation as best we can. Of course, making employment sustainable is absolutely a part of that. I hope that the investment that I have put on the table and the Government are bringing forward is, again, an indication of our commitment. It is the initial investment, I suspect. There will be further investment in the years to come, but it is an initial commitment to restoring consultant-led maternity services at Dr Gray's. Taking the motion without notice, a number of colleagues have pressed their buttons. I will take a couple of them, but I am not going to mind it to take all those that have pressed their buttons since then, as we need to move on to further business. I call Gillian Martin to be followed by Miles Briggs. I also want to ask about recruitment challenges. Scottish Health Service has seen a reduction in the number of qualified staff from Europe applying for positions in Scotland's NHS since Brexit, impacting rural services like Dr Gray's. Can the cabinet secretary outline what discussions the Scottish Government has had with the UK Government to enable us to put in place migration policies that are better suited to the needs of our maternity services and the women who use them, particularly in rural Scotland? We have had conversations, as we can imagine, with the UK Government right across portfolios on the impact of Brexit on the workforce, and that is on various different workforces. I think that what I am really keen to do is to ensure that, from an NHS Scotland perspective, how do we take a co-ordinated approach to international recruitment? That will include, of course, EU recruitment. For example, when I visited NHS Fife recently at the Victoria hospital, I met nurse recruits from India, from the Philippines, from the UAE, and what we need to do is take a co-ordinated approach, because Scotland is an exceptionally attractive place to work, and Highlands and Grampian are exceptionally attractive places to work. What we have to do is ensure that the support for all the people who come here, that wraparound support, is there for them. I think that doing that, targeting particular countries, including those in the European Union, we should do that. I am not expecting additional help, I have to say, from the UK Government in that, but I will continue to push them in this regard. Two very brief supplementaries. First, Miles Briggs, and then clear up. The cabinet secretary outlined £5 million, which will be made available to an NHS Grampian, to support moving forward changes in Murray. Can he outline what this funding will be used for? As has been outlined throughout the statement, there are significant challenges being faced by families being transferred to Aberdeen. What additional support will be provided to those families, especially with regard to accommodation, when they are in the Granite City? The £5 million will be there to support the restoration of the service. That is clear. We will again come forward with further detail in an open, transparent manner about how that money is being sent. I will look at his request for additional support. I do not think that it is an unreasonable one, having heard from a number of parents that have had to make that journey, so where we can provide additional support for accommodation or for any other purpose, I am open minded to that.  In the intervening period, although the changes have been implemented, what reassurance can the Cabinet Secretary give that the perinatal and postnatal mental health of mothers will be protected and that they will get the support that they need in this intervening time? I spoke to NHS Grampian and NHS Highland about that very issue, about perinatal and postnatal mental health. There is a key consideration, particularly as we move towards model 6, but that interim optional model 4 is to provide as much of that postnatal perinatal support as we possibly can, and that includes mental health support too.


Okay guys, what is up everybody? Ricky Karuth here. So, recently, Co-Star Group agrees to acquire Homesnap, a residential real estate search portal for $250 million cash. Okay, that deal is expected to close by the end of the year. Now, what in the world does this mean for real estate agents, real estate buyers and sellers and investors? Well, I can tell you this, the more I dig into this deal, the more I realize that this is going to be an incredibly positive situation for all those involved. And one particular thing that I really enjoy seeing is the fact that I believe that this is going to give Zillow a run for its money. Now, I'm about to dive into the details of this deal and as always, I would love to hear your thoughts in the comments. It's still really early here with this acquisition and where this is going to lead the industry but I believe over time we're going to see that this was a monumental moment. Now, before I get into today's video, I want to let you know that Cyber Monday has already begun for real estate agents. I'm going to put a link in the description but you can go ahead and start your constant contact deal. They're giving you 40% off for the next six months to use their software to build your weekly email. My weekly emails went out every Wednesday since 2007. It's literally how I sell 100 properties every single year. RedX is going to be doing their discount Monday only and you're going to be able to save up to $300 depending on what package you choose. I'm actually going to go live from the RedX office real early Monday morning. I'm going to give you the link for RedX first thing Monday morning so you can lock in those savings and Webinate, the company that created all my websites, will build you a custom IDX website that you actually own and they're doing it right now for no setup fee. You walk in, they build your website, custom built website, no setup fee. So I hope you partake in Cyber Monday this year and really get your business set up and all the tools that you need going into 2021. 2021 is going to be an amazing year and that's why December 11th at 4 p.m. central I'm going to do my 2021 goal setting and planning session for real estate agents. Okay I'm going to put a link in the description for that as well. It's going to be webinar style and it's really going to be something else because I'm going to release my brand new 90-day action plan. Okay guys so I'm super excited about everything I just said moving forward 2021 is going to be I think it's going to be that year. I think it's going to be one of those years that that we say wow how did this happen because I think it's going to absolutely explode just my thoughts. Let me know what you think the real estate market is going to do in 2021 as you simultaneously smash the like button for me. Okay so let's dive into today's video so back in 2002 when I got in real estate there was no Zillow, there was no Facebook, there was no social medias, there was barely an MLS. When I first got my license and I joined a company and joined Exit Realty and Gulf Shores the agents there were telling me how spoiled I was because I came into the business before MLS was around. They said before that they literally got a book every month that agents put their listings in and that's what they would use to figure out what was on the market so information on that booklet could be 30 days older or more. So it was very interesting to to look at the market from that perspective. Coming in in 2002 around the same time MLS came around and now towards the end of 2020 as I look back at all the technology that has come into the market since then and everything that we can do digitally now it's absolutely amazing. It's incredible how we can communicate with people so much better so much quicker. We get documents signed electronically. When I got into the business that was something that I probably couldn't even wrap my head around at the moment. When I finally realized and DocuSign and Dotloop and all these different companies popped up where you can actually get documents signed electronically through email that was groundbreaking for me because I was in a situation where I had to fax a listing agreement they signed it faxed it back when they when I faxed it to them it shrunk it when they signed it sent it back it shrunk it a little more sometimes we would do contracts and negotiate back in four three four times and by the time we got the deal done that the actual contract was like this big on a on a regular sheet of paper it shrunk it down to to a size that you you couldn't even read it so literally had to rewrite the contract to the agreed upon terms and that was our process back then so we've come so far in technology and the way that real estate is actually uh conducted and I'm just I'm so glad to have went through all that and be able to sit right here realize how much of an advantage that we have right now this it makes our job so much easier okay however they're still the liability they're still the relationship that has to be put in place the buyer the seller they still have to find trust in a real estate agent and trust them to look after them through the deal and make sure that everything's going smooth and handle the inspectors the lenders the title companies and all the different pieces of the puzzle that make the transaction work so although technology's come a long way and it's where we can operate a lot quicker I still feel like we are absolutely worth every dollar of commission that we get and that's been the thesis of the market so far commissions haven't went down at all since I started real estate I was getting five or six in 2002 today I get five or six so technology has literally put us in a position where we can help more people in less time which means what higher sales production but that's only if you take advantage of it right a lot of agents aren't taking advantage full advantage of the opportunities that's right at their fingertips for example redx finding phone numbers with the click of a mouse and then turn around and auto dial them one after another right with the snap of a finger did not exist when I was coming up I made a hundred thousand cold calls with my finger so technology's come a long way and I'm really happy to have rode this journey up to this point to watch the entire thing unfold and that brings us to the content of today's video costar group I love costar group I've been reading a lot about them lately and I love everything about what they're doing if you don't know costar group is more of a commercial real estate based website they have commercial real estate brokers and buyers and sellers and they've created such a great culture and brand around trying to connect real estate agents commercial real estate agents commercial buyers commercial sellers it's an incredible tool in that sense but what they've done up to this point they've acquired many companies okay I'll go over that a second but the biggest one here lately is home snap and what does home snap do home snap is a residential real estate search portal okay so what does this mean they're moving into residential more and more and more they also purchased apartments.com okay they also purchased 10x which is an auction site that owns auction.com okay residential auctions so they're moving into the residential real estate space and they're taking everything they learned over the last 30 years of costar's existence and they're going to start applying it to the entire real estate market not just commercial sales so the CEO of costar is Andy Florence okay this guy I've really been you know reading a lot about him and learning about him and everything and I love everything this guy is saying okay but he says that the addition of home snap to costar's portfolio adds clients and information covering 90% of the $27 trillion US real estate market that is massive they've literally stepped right into a situation where they own so much data and as you guys know data is the new black everybody is after data you know Zilla wants data even companies really regular real estate companies like Keller Williams and Remax why do you think Keller Williams implemented command why do you think Remax implemented Booge their CRMs they're wanting you to put all your contacts information in there so that they would have access to all the data why do you think Zilla bought Dotloop okay Dotloop is one of the the most widely used of document storage cloud companies for real estate transactions out there why did Zilla buy that so that they own all the data and speaking of more data costar has also been linked to the potential acquisition of core logic okay it's a real estate data an analyst firm that says it has a client base and more than 1.2 million agents across the US and Canada so here's one of things interesting home snap has so far failed to compete with the Zillows and the Red Fins of the world in terms of consumer eyeballs so basically home snaps portal is built as a joint venture with Broker public portal which is a project backed by real estate brokerages and real estate trade associations through their multiple listing services so basically they've been kind of on the back end they haven't really been in front of clients so the acquisition by costar to come in is going to be that extra piece of the puzzle they were looking for with costar's experience they can actually take home snap and take it mainstream to get those consumer eyeballs that's what's going to make this thing very very interesting because the reason why everybody feels like this is going to be you know costar versus Zillow is that costar is going to come in and do it completely opposite of Zillow okay Zillow takes a select few agents makes them pay a lot of money to put them on other agents listings and costar is going to do the exact opposite they're going to do your listing your lead policies so this is going to be an interesting matchup i can't wait to see how this all plays out but in addition residential property agents okay spend an estimated 10 billion every year on software and marketing while influencing another 21 billion in such adjacent markets such as lending insurance or relocation services so this is a huge market in terms of the amount of money going into the market from agents okay this is where Zillow makes its money costar is going to come in there and try to reverse the entire situation so like i said i think this is a monumental moment in the history of the real estate industry and i'm going to follow this story as we go along i'm going to keep a close eye on it and report back to you every time i hear something new about it let me know in the comments what you think about this where you think this is going i would love to hear and let me say really quickly before i go i really appreciate you watching my videos and clicking the like button subscribing doing all those things if there's anything in the world that i can do to give back to you more than a rdm please reach out and let me know i'll link a video below called the 10 reasons why real estate agents fail that i made about a year or so ago it's a really good video if you haven't watched it so i'd appreciate that and we'll see you on the next video let's go


Okay guys garden update week five I think it's week five anyway Here we go This one here is growing big it's got one little tomato down here on it This one with the three tomatoes the tomatoes are getting bigger But I don't see another I don't see any more blooms or tomatoes on them This one here they're they're growing great, but it's like they're not This one doesn't have any tomatoes on it or blooms The cherry tomatoes hops come over here at the side They're all three producing very well. These are the the grape tomatoes So they're They're really doing well, and then here's the other cherry tomatoes there It's got a little one up here. It's got these These so it's it's really for it's coming along nicely This one's got some buds on it, but I don't see any peppers yet the same way with this one I don't see any peppers yet But on this one There's my cayenne peppers. I counted them. There's like 12 of them on here So doing very well see a branched off or stuff more over here So it seems to be doing all right The rain I think helped them I don't know why the buds the blooms the little flowers quit blooming. So alright guys, so there you go Give me another look at it there pretty cool. It's doing well I'll probably have to water them today. I don't think it's supposed to rain today. So I'll probably have to water them some but Yeah, I keep them nice and moist so alright guys There you go Week five, I believe so Jay bear the myth the man the legend gone for now. Thanks for watching guys. Bye. Bye. We'll chat soon


Hello, my name is Leslie Mariel Gonzalez and I'm a perfusion student at Texas Heart Institute. I first got introduced to perfusion as a respiratory therapist and I had the ability to actually work on an ECMO team and work closely with perfusionists there on staff as a primer, so I was very fortunate to have a mentor kind of guiding me through it all since respiratory school. I didn't know at the time that perfusion was something that I wanted to pursue, but six years into my respiratory career I decided that it was going to be the perfect fit. I decided Texas Heart Institute because it was simply such a well put together program. There was so much history there as far as how cardiothoracic surgery came about and to be able to actually learn from the people who started it all just seemed like the best place to be. You know, you don't only get knowledge base, you also get that inspiration from where it all started and to see how people will still continue to want to teach and want to come and work here and want to pursue careers here. It's just amazing. It's an amazing opportunity. I wanted to pursue perfusion education as a student because I have been introduced to a lot of volunteer work in the past. As a respiratory therapist, I was actually a preceptor for respiratory students and I also got really in touch with the school that I had graduated from and would actually lecture their students and get to work with them in the clinic and I figured doing a mission trip was going to be that much more rewarding with being able to actually learn from others and still teach from what I know. So I first learned about the Amsec Profusion Without Borders Scholarship through one of my great mentors and teachers by the name of Deborah Adams. Whenever we first started school back in July, she presented this opportunity to us and mentioned how great of a trip she had been on because she had done multiple mission trips and to be able to see and learn from that just seemed like an amazing opportunity for me to actually apply. My name is Deborah Lowry Adams. I'm the program director of the Texas Heart Institute School of Perfusion Technology. I'm a clinical perfusionist at CHI St. Luke's and I love what I do. I trained as a cardiovascular perfusionist in 1983 at the Texas Heart Institute School of Perfusion Technology and I have been a practicing perfusionist and involved with perfusion education since then, so 37 years and still loving it. Let's see, my first mission actually was in 1985. I actually went with a cardiothoracic surgeon that was here training under Dr. Cooley and he was from Bulgaria and so at that time that was part of Eastern Europe and Dr. Cooley arranged for me to go back with Dr. Boy Jeff and train his perfusionist for a month. Very life-changing experience. After Bulgaria, I traveled to Hong Kong with Dr. Jonathan Ho into China who is still with the Texas Heart Institute in the transplant and research. I've been to Peru with Dr. Novik and then I started going with Dr. Novik with the cardiac alliance on multiple trips to the Middle East. So I've been to Iraq on four trips. I've been to Pakistan several times. I've been to Iran and I was planning on going to Ecuador before the pandemic. So I've been on several trips and I plan to do more as time allows. When Leslie talked to me about wanting to apply for the scholarship with Amsept and her interest in medical missions, I was elated. I'm always excited when I see the passion in a student's eyes that not only do they love perfusion technology from the onset of interview to wanting to give back more than just for self-interest. And so you can see it in the twinkle in her eye and her work ethic. That's the gift, the privilege that I have is being part of that journey. So I was thrilled and I was so happy when she wanted to do it. I was going to help her even if she didn't get the scholarship with Amsept and so that just was kind of the icing on the cake. You realize that you get so much more than you give. But you learn about your own skill set. You learn how to improvise. You learn how to troubleshoot. You learn how to communicate in nonverbal ways because sometimes that isn't the language that you know or they know. And you learn that we're all connected. Profusion without borders started all the way back in 2006. And it was an initiative that was created by Robin Sutton. She was one of our Amsept members who had the idea of creating a group inside the Amsept that would work similar to Doctors Without Borders. She held on to that position, shared that group for several years and handed it off to Jim Rieger, who is now the Amsept president. And then after Jim had shared that for several years, he handed that off to me. We originally envisioned this as a group that would promote missions activity and it would educate profusionists on the opportunities that they had globally to volunteer and to serve outside of their regular work in their local hospitals. Over time, the purpose of that group has evolved and the strategy that we have been taking is that everything that we do inside Amsept, we try to have it function within the main mission of Amsept. The mission of Amsept is to educate and to support profusionists around the nation. So what we've realized about profusion without borders is although it is a great opportunity to be able to serve others who are unserved in populations that have very little access to healthcare, it's a very noble effort and it's a real feel good activity and a charitable deed. But what we've also been aware of is that it's an incredible educational opportunity for profusionists because many times what happens is that when we're walking into third world countries that don't have a lot of access to medical services and medical supplies, in reality it's a lot like stepping back two or three decades into the past. Brian is a very active member, Brian Forsberg, a very active member in our group and he works with the Novik Global Cardiac Alliance. They have sponsored several of our missions, the majority of them and he's been a very active member and we've been so grateful for all of his help. Myself, I work with a charity that's called Cardio Start and we don't have quite the production that the GCA does but we go out right now on average between three to five times a year to different sites. I will say that missions itself, the entire strategy is an evolving project and it's been interesting to see how it has changed over the decades. My first mission was to Peru and I only did one. I went out, it would have been about 15 years ago now and I went with Cardio Start, it was the greatest experience I've ever had and I still got a photo of the first patient that I worked on. I remember and I've never really lost track of the feeling that you get from taking the skills that you have and then being able to give them to someone for free. Each one of us makes our own decision on what we best think would be the ideal student to win that scholarship. And then what we do is we go through all of the applications, we process our ideas together and then we meet over the course of several weeks and make a collaborative decision on who's going to be the winner of the application. I can tell you that for myself what I'm often looking for is somebody who really gets the concept of what the award is for. And I look a lot at previous volunteer activity because somebody who has been volunteering in the past is somebody I know has the right motivation and they're in it for the right reasons. I also look at somebody who has the maturity to realize that they're going to learn something as part of this process that they're going to be able to apply to their career down the road. And then I also look for somebody who's going to be able to have the maturity that they're going to be able to hand that off to their other peers as well. And of all the committees that you can serve on inside our national society I honestly think this is one of the most rewarding because at the end of the day we have this great opportunity and we're able to hand it off to somebody. The one thing we regret is that we can't just hand it off to everyone because every single year I am so amazed at the quality of the applicants that come out and applications that we receive. But it's a wonderful feeling to work with these students that they are so bright and so motivated. We've been able to do this ten times now. Ten years we've been able to give out this scholarship. At this point we have given it out to eight different schools of the profusion schools around the nation. Those students have been able to have their mission experience in countries around the world including Asia, South America, Central America, the Caribbean, Europe. We had students that went to Vietnam, to Ecuador a couple of times now, the Dominican Republic, Bangalore and India, Honduras a couple times to the Ukraine. We've been all across the globe that they've been able to share that mission experience and we've been able to do this with three different charities. We were so impressed with Leslie's application and I just wanted to mention that one of the things that really stood out to us about our most recent scholarship winner Leslie Gonzalez was she was a first generation American citizen first in her family to graduate from college. R.T. active in a research recipient of many awards. Everything about her just said motivation and I think to me that is what clearly made her so worthy of that scholarship. She was a self motivator that you could see was just pushing herself all the way through and accomplishing so much. That made me so proud of her and I was so excited to be able to offer that scholarship to her. Leslie, there was a quote in a piece that Texas Heart Run ran and Leslie had said that one of the most significant accomplishments that she felt that any person could have was to make a difference in someone's life and then be able to, she said the chain of compassion to be able to spread that to others. I would say what's so impressive about Leslie is the differences that she made in her own life as well. She made things happen for herself and motivated herself and challenged herself and I think that was just incredible to see and we were very, very happy to see her accomplishments. It's quite interesting. I have gotten some questions as to how I came about to winning the scholarship over everyone else but in reality I was just presenting myself. I was able to talk about my background, how I grew up on a small town border and not too many people are doing what I'm doing right now. So it's been really amazing. I chose Novik cardiac alliance because my background was in neonates and pediatrics. The fact that this group of very skilled physicians and surgeons and medical personnel have been established for over a decade was very intriguing. It was very intriguing for me to actually work with this team and actually see how well put together they were and how they actually accomplish everything that they do every single year for all these different tribes. I was able to go to Medellin and Tokyo in Columbia. We went to this clinic that was called Clinica CardioV, which is actually from what I came to find out one of the best hospitals there in Columbia to actually go get heart surgery at. I feel that I accomplished a lot while I was there. Not only did I get to learn from the surgeons and the surgeries and the staff that was there, but I also got to learn a lot about Columbia itself. I think my absolute favorite was just the atmosphere of how closely everyone works together. The communication in there was amazing. Once I am a practicing perfusionist, I would definitely go on other medical missions. The things that you learn from there, it's just stuff you can't get here. We're so used to using and being able to have the ability to have what we have. If you were actually the one living out somewhere in a country where you don't have the resources that we have here and you don't have the ability to have what you have, I'm pretty sure you would want someone to definitely come and help you out in the best way possible. The experience that you will get is unforgettable. The people that work there are amazing. They're extremely proud. I feel like it's truly a life lesson. Being able to get the opportunity to go and push yourself and push through these boundaries and actually see that there is more to life than what you think is important. Money comes and goes. People come and go. But you're time spent and you can't get that back. So it's important to invest it wisely in what you really want to do.