To another week in my life vlog, I just got dressed, I cold-punched and I feel very alive. Today isn't a very productive morning. I got some work done, I went on the walk, I cold-punched and all the things.  I just, I don't know, I really want all paper but you know, we'll get there eventually. These earrings guys, I think these are fun, like if you're dressing them up, like super cute. They're like $12 on Amazon and then this sweater is, I think like 30 bucks on Amazon. It's a little long I will say, like I wish it was like a little bit cropped but like still very cute, very on trend I feel. Very Christmassy today. It's time to get some stuff done. I listened to the How to Tenet Your Life podcast from Edmai Lett today for the third time. Like I love it. Okay guys, I was watching the cancel podcast. Macy, you know what? I would like if we just started consuming the same content. Besides, we have no common ground. I know. That's where our age gap really shows. I tried to start reading. I know, well you've really done that but I was listening, it's Chris Olson and Megan Traynor. Oh, I would actually like this. You would and they're talking about all the content they consume and like that's me. I know everything you're talking about. But I just don't have someone to talk about. And here's the thing is like I know all this content from TikTok clips but not in depth. Like I know exactly everything that's going on. I'm more of like a YouTube person. I know all the YouTube stuff, you know. Okay, Macy said she got me a gift. Also guys, I just want to say I know you would never judge me but I am away in a glow-up right now. I have to wash my hair but I'm having like a full glow-up so if you guys want that routine let me know. I ordered pimple patches, I'm dying my eyebrows. When I break them to Kenzie's I like don't really have a cup. Like I'm always just filling up water and random cups and I kind of feel bad. And so I saw these on TikTok shop. And I just thought that you could benefit from having like they're the perfect size. Like iced coffee, water. Look how cute these are. You got one for me and one for you. Yeah, but they're gonna be kept here. Yeah, perfect. Because I have cups at my house. Wow. But like look how cute these are. Like imagine just like how fun. No it is so cute. I literally bought them from TikTok shop because I was like driving home from Kenzie's and I was like oh I need to get a cup there because I always like I never think to bring my Stanley because I'm like that's so heavy and I'm always like bringing stuff over here. Yeah. No honestly having something that isn't a Stanley though. I know. Stanley is my home cup. Like look how cute these are.  No it's so cute. You did such a good job and you know how I feel about a glass straw. I know. Wow. Wow. These are my Kenzie's house cups. Wow. Well but if I come over. I love them. If I come over and it's not for you. No it's someone else is like using the cup. I'm like you know like Timber Territories. I'm like I'll give a gift but I'll make sure you remember who gave it to you. Oh my god. And don't worry I'm gonna take this box home because I need to reuse. It's the era of reusing not gifts but like gift packaging. Totally. So. No actually keep every box PSA. Keep all your boxes right now to wrap your gifts in. Yes. Because then you're just gonna be screwed. Like for example I have a sweater to wrap it in a box and I recycle all my boxes. It's not. It's a smell. Why don't we file a part. Oh my god I'm reading Kenzie's emails. You guys will not believe what I'm seeing right now. It's an Urban Outfitters partnership guys. It just is an offer. It's not even actually a deal. Wait I can't tell them. What. My health issues. Guys this is huge because I've been so concerned about my health issues. Yeah. So I am known to have they're like just ailments. Like I'm always. Like so many. I'm not always complaining about something but like I'm in pain a lot and it's just random. Something is always off. Nothing's ever 100% with me and I first for like okay so I went to the dentist yesterday and I was like I have a really bad jaw pain. Like I wake up every day I'm going like this. I'm massaging myself 24 seven like my jaws always hurt and I told the dentist and he was like and I told him I was like everyone says that it's from grinding your teeth but I don't think I grind my teeth. He did a breath airway test on me to like see how I breathe throughout the night. Turns out my tongue like literally blocks my airway and I clench so hard while I sleep just to get a breath and I have disordered sleep disorder breathing and it's causing so many ailments because I don't breathe when I sleep. Isn't that crazy? Yeah guys my jaw pain. If you have like health issues all the time look into that. Like you might have that. Like my jaw pain, my trouble falling asleep, my focus issues like turns out I didn't have enough oxygen in my brain. I'm like so much. So much. So like it's all coming together. I literally didn't have oxygen. Like these people are like okay we don't care about your health issues but like I do. No we care. I'm just drinking my eyes coffee getting some work done. Guys I got an infrared sauna that's coming very soon. I'm very excited. I did tell them yesterday but I was vlogging yesterday and then yesterday afternoon something just hit me like I had the most anxiety I've had in so long but actually no I'm lying something didn't hit me. I drank too much coffee that's what happened and then my mom came over and we were setting up my new garden bed. We were setting up my new I got closet organizer all the stuff and like I literally thought I was gonna have a heart attack. Yesterday? Yeah. Oh my daughter's order is coming. Hello. All right. This thing. You know how I feel about it. Yeah. It's a great thing to have. Don't mind me. I got rid of my dead pants too. I kind of like having leaves everywhere because it feels like fall. Wow I wonder where you're working on. Guys don't tell them. I just look over and switchy drink. Hi hoody johnson k. Guys I'm in my new truck for the week. I wish it was mine for good. GMC gave me a truck and I just feel so amazing. I've been wanting it. I actually like really do want a truck. Life with a truck is just better and it would make my life a lot easier. Like I would in a hundred in like two seconds trade in my car for a truck. Like look at how stunning the interior of this is. It feels I mean it is so nice. I'm getting used to driving it right now. I love the colorway. I mean oh my gosh. Thank you so much to GMC. Like amazing on Thursday we're gardening. We're going to get rid of a bunch of stuff in my garage because I have a sauna coming and we're doing garage makeover. I need to get rid of boxes. Like I just as a homeowner and a girl in Texas. I need a truck. Anyways I'm picking up Macy. I know we're literally always together. We do literally everything together. So anyways we have a hello. We have a holiday bucket list and we're doing things from our holiday bucket list every single week so that we're having a very festive Christmas. Tonight we're going to Starbucks to get hot chocolate and we're going to go look at Christmas things and we're doing an Amazon return of mine. Do returns. Yes I do. Okay return mates wouldn't pick this one up. So that's what I was asking like return mates. Um wait guys do you remember last year's vlog when we got hot chocolates? Oh wow that's so cute. I know. I love this car. No isn't it like the interior is so big. This is exactly my dad's car but he has a little bit of a more like bigger one. Yeah this just looks like a little it's like a cute like little version of it. I feel so safe and like protected in my dad's truck. Yeah I love this interior.  Oh my god. It's so stunning so. I want it. I know I do too. Ah the lights. It's so magical. We should just get. Okay what is it? Is it going to man's man's playing at a park? Because we just have the muskines. Oh there they are I think. No maybe not. These police officers literally just explain. They're not real police officers by the way. Like security parking tickets. Yeah like Highland Park maybe like like parking lot please. That was probably the most action they've gotten in a while. No like oh I hear him. Okay like I was pulling in I was parking the truck and I had to like back up and then park so it was like a little close and I was close to the car but I was watching him doing it really slowly and then he comes and he literally man's playing at a park for the next like 10 minutes. See people stop. I mean it was just so bad. It was so bad. So anyways um off to Starbucks because apparently this one's closing. No god forbid I just parked there. Okay it was so bad and then basically he was getting angry. He was gonna like throw a temper tantrum. Well Merry Christmas. We were hard for pouting. No we were like oh my god Starbucks is leaving. No Starbucks is like leaving and we're like what's replacing it. Ralph's coffee. Bye. Bye. We'll miss you. Bye. That was kind of crazy when I wanted to do that. Well Merry Christmas. First they managed to find parking to us. Now we're literally guys. It was insane. We're not past it. We're like still. Turn the wheel. No the other way. Like I felt like I was at the DMB again like in 15 minutes. My favorite thing is when you get mad because it's so rare. But what you do it's like but it's not and it's a different kind of mad. No it's like a no it's like a different tantrum. Like when we say oh when he's throwing a tantrum again like we're not getting. But like I literally was shriveling up in a ball. Yeah and I was like I had to be like I don't have a choice because that was mad mixed with overstimulated. Yeah because it's two police officers yelling opposite things with the car. A line of cars waiting. And I literally was like I literally want to like run away. Like my Dallas girls will understand how awful that is in this in this parking lot. The car got out fine. It's a new car now. No no it's actually a new car. But still I'm gonna get in and out of this car just fine. It was crazy. Anyways we're gonna go look at Christmas lights. Oh my god. I just am so happy. We are doing an interpretive dance. Okay. To say goodbye to Starbucks? It was really a heartfelt goodbye. But once we figured out Ralph's coming I was like bye. It's like when you're like sad about a boy and then you get better one. Literally. Hey what dance should I do? I just like need you guys to see. Hanging out with us is exactly what you'd expect. She's having me hold the front camera. We see that was so good. I wish I could have seen it. I mean where did that come from? Wait see that was incredible. I'm not kidding the guy. I actually think you're a good dancer. Like I'm so serious. One more. Wait at least draft that. I drafted it. Okay I always do. Okay like just so you guys can like hopefully get this. Oh wait there's so many cars I have to stop. Guys. No like you perform better under pressure. How do I explain like no we can't give you this parking lot. My friend is dancing. She's doing an intro for us. At rehearsal. Yeah That's so good Macy. It's okay. No I can't. Macy you have it. After this one. Okay but they want our parking spot so they're not going to leave. No we're literally looking at the lights. Yeah look. I'm going to do a tiktok. Do you want to go look at lights? Yeah. Sure. Okay you go. I'm dying of these. They were people. They were so good Macy. This was crazy. That was your driving caption this or? No. No caption. Nothing else is needed. Like you don't even need music honestly. They're literally about to hit us with their horse. Happy Tuesday. I hope you all are celebrating because the dance with the stars night. By the way this is my truck. Okay I'm so excited about it. Guys we found the Christmas trees on our festive night that Macy's trying to distribute for her for dancing with the stars even though we've had these plants her week. So she'll get her when she gets there. No no no. I'm good to take my time but like you guys know Tuesdays especially with the final five left it's going to be exciting. Totally. I think I'm just more so sad that you're not into the show. I want to be into it. I've gotten too late so next year. Whoa. Okay I like the tall ones. It's actually oh wait that one. Smells so good. She just realized Christmas trees are $500. $9.50. Don't mind me. I'm just putting my firewood in my truck bed because I have one of those. Oh wait. You're definitely going to own a truck by like next week. Anyways seriously it's so easy.  Really so easy. I can't say anything easy. Good morning y'all. I'm on my way to my workout. I have my ice coffee, my Hill House Puffer. I'm just in such a great mood. We had such a great Christmas night last night. Tonight we're shooting the next card game for Friend of Mine which I will inevitably end up showing you later in this vlog. It's coming out in January so I'm very excited. We've been working on like restocks for the recipe journal and all this other stuff. I'm very excited. It's 7 a.m. so I'm a little tired. I had a really hard time getting up this morning. I've been getting up at 6 every day and today was rough. All right on my garden bed it's ready to go. I'm going to pick up the soil tomorrow. I'm just going to try some bulbs through the winter and then obviously actually start gardening later. But I got this garden bed from Amazon. It's six feet so it's actually pretty big. It's basically I would say around double the size of the garden beds that I had in my townhouse. But it's very exciting. I also have like no idea where that hose even came from. I don't know like how else can I make this cute like this side yard. I want to turn into a garden high fit so eventually I'll probably just add more beds but like what are other things that I could do. I would love to have like a flower garden too. I don't know I'm really making use of every single square inch of this house so you guys let me know like what y'all think. I'm currently catching up with the gals. I was actually just texting Brooke about our plants next week because the girls are coming to Texas. I am already I didn't film today because I was working it was boring. I haven't changed some outfit yet. I'm waiting for my hair to fall a little bit. Should I really want an olive pop? Would that have been amazing if that was like a brand you know? Like I should really want an olive pop. No. I actually am just olive pops number one fan. They've never paid me a dime. They're so good. Okay drum roll please. The next product for a friend of mine is our next version of the card game. So these are the night cap cards. They match the dinner cards. I want the dinner cap.  You can obviously play all these cards whenever.   Worst hookup story? The last thing you think about before bed. What's relationship looking back? You could have handled better.  I would say you need both card decks. Like we have like craziest drug related story but we also have like do you believe in fate or free will? You know? They're just amazing. You could think of these also as an expansion pack. It's fully like another 59 questions. I think you need both but I'm so excited. Anyways these are the things that we're using for the shoot. I have this plate from the set. I'm gonna put some like cookies on there. I have these two um little like tea mugs that I thrifted that we're just gonna put coffee in and then I have these that I also thrifted that we can put anything in. I don't have stuff to like make. I just put some more tea in these.  Anyways I'm excited my outfit that I'm wearing is so cute. It's the Princess Polly one from the last vlog. The like holiday one that I am literally just obsessed with. I'm just so obsessed with this look. As much as I said when I got this coat I didn't know if I was like so over the like teddy trend and if I was even gonna wear it. I wear it literally all the time and so many of y'all have bought it so I don't know what I was thinking. I feel like yeah this is my vibe and I'm wearing like real heels. I never do as we know but I have my hair up because I put body oil on and I wanted my body oil to dry but also what I've been doing to do my hair which I feel like is like giving it that blowout look that I've been wanting. Just been curling it like inwards and then I just take a clip and then I hold it up and I let it sit until it cools down and then it gives me that like blowout look that I've been looking for. So that works way better for me than blowing out my hair with the Dyson. Like blowing on my hair with the Dyson it has other benefits but I don't get the exact blowout look that I'm looking for. Like I just can't do it. I don't know what it is. I think my hair like can't do it. I just made my coffee. Today is a very big day. It's been on my calendar for like a month at this point and about 10 minutes the people from order in your court are coming over and they are organizing my pantry. My pantry is so unorganized and awful and ugly. It was organized. Like it started off organized. My grandma and I moved my stuff in. My mom and my grandma love organizing. I am too. It just like takes too long and they love doing it with me but then it's like a whole day ordeal and like I don't want to do that you know. So the people from order in your court are coming and they're going to organize my pantry. I already have a lot of things I'll show you guys before. Just know it's like really bad okay. Like it's really really bad and like don't judge me because we've all been there. I just keep throwing things in. Like it's really really bad and like all those glasses really are supposed to go in the hosting closet. There's just like so much alcohol like it's just really really really bad.  What happened to you? Just know it's because my closet or my pantry is organized. And then I am going to go through and start organizing my garage more. I've slowly been doing it. We still have boxes and stuff that are not supposed to be in there that haven't been moved from like literally months ago but there's nothing I can really do. So I'm going to get out at least all the trash just because my sauna is like on its way here to rise in like 10 days. So I just want to like get things going while I have the truck. So that's why I've been waiting. So I'm going to use the truck for that and then we're going to do a home depot and then I'm going to get a bunch of soil and stuff for my raised beds. And I might get other plans. I don't know. I'm just going to get basically everything that I possibly can right now because it is my last day I think with the truck at home. Tonight I'm going to a Dallas Cowboys game. Kendra Scott invited Macy, our Dallas Cowboys cheerleader. So I'm going as her plus mom which is very exciting. Yeah. So good morning everyone.  I'm not quite there yet but like we're going to get there you know. Thank you guys. Say goodbye. Bye. I got so much in my garage actually organized and I'm running to home depot right now but I literally cannot get over this truck guys. Guys, Cody Johnson's new album is so good. I have had it on loop for so long. I'm also obsessed with this truck. I keep saying that. So I just got Smoothie King. It is raining but it's only going to get worse throughout the day and it's my last day. So I have to go to home depot. I think I'm going to get some pansies. I'm going to get some soil. I do need new gardening gloves because my gardening gloves they got rained on and I need to use them today. Got Smoothie King. Angel food. Remember when I used to always accidentally say angel hair for this smoothie? But now I get confused because I'm like wait which one was I supposed to say which one's right even though angel hair pasta just feels so right in the world listening to Cody Johnson driving a truck going to home depot like this is where I thrive also update. So I've always wanted to be like close up my neighbors but then I had that one neighbor we really mean to me so then I kind of just hid in my house because I felt like everyone hated me but then my neighbor across the street and I we got each other's numbers and I love her and she's like I just see you like a daughter and she's been helping me with so much of stuff and this is what I wanted. I wanted my neighbor to feel like a community. So this morning she was helping me with stuff we were donating things and oh my god it was just so fabulous so anyways oh I wonder where I should park so that I can put my I'm gonna move over this way. I will say like parking a truck is very different than parking my normal evoke.  I personally really like this one. I just think I should I think it's more practical and the thing is like it's not even I don't even think I would really be saving money I would love for my car payment to be less but I don't know it just feels right. This is my truck by the way it's so cute. I'll have the details on the screen but I love it. Y'all prepare to die. I cannot believe this first off took them only like four hours I thought it would be like a 12 hour day. Second off oh my god it is literally never ever ever looked better like I'm actually dying oh my gosh even like chia seeds brown rice like you know how helpful this is quinoa like this is just so amazing all of my pastas my stuff for s'mores I that's it's sweet but basically I'll have a s'mores um all of my alcohol up here which is so amazing oh my god you know what oh my gosh guys I have a s'more teeny stuff I could have used that last night I didn't realize it for the shoot dang it thing I actually think on the rocks is another Dallas brand um oh my god I'm just so excited flower baking soda baking powder oh my gosh I mean they just absolutely crushed it so oh my god I will have their Instagram linked below I am so excited to their website or whatever whatever works but oh my god guys like amazing they're Dallas based if y'all are watching in Dallas this is just the best thing especially in the new year all right guys it's later and I am going to the Cowboys game as you got invited by Kinder scott's so I'm very excited very exciting thing so this is actually pretty much the outfit that I wore to macy's 100k party um Abercrombie Abercrombie skim's t-shirt my favorite revolved bell that's only 40 bucks these like anything with a belt buckle any sort of belt they just get so expensive you know so great price my favorite Jacobas these are jose's and then I'm bringing this Louis bag I got on the real real years ago so I can bring y'all with because this camera is pretty big and then just putting on some perfume I'm gonna drive to macy's and then we're gonna Uber to the game um and I'm excited for some snacks I'm really I'm really pumped I'm hoping that they bring macy onto the field obviously because as you guys know she is a Dallas Cowboys cheerleader but she does work her well so this is like her Stephen ball honestly it's a really big deal okay macy how are you feeling about the game and your performance totally when you're normally down there totally into like give back it's been tied with you know a little me and you would never forget your fans you want to be one with them good morning y'all I'm so tired we went to the Cowboys game last night and we didn't get home until like one in the game ended at 10 30 it took forever to get an Uber and then all the cars we for some reason just didn't leave early like we waited the whole game but anyways it was really fun now I'm on my way to work out it's 8 20 so this weekend is my family's like lake trip weekend for Christmas I've logged it last year I still am going back and forth I'm gonna vlog it this year I just love having the videos and like memories um but I have so much to do today before I leave hopefully around noon which I don't even know if that's gonna end up being possible guys I'm dying that this is what I look like right now I'm rushing to finish all my things I need to do before I go to the lake so I don't wash my hair get myself a blowout do all that stuff which is so time consuming when you have extensions and I'm currently wrapping my white elephant gifts like listen normally my white elephant gifts would be my dinner cards which is the best white elephant gift um but it's my family and they have them so we're doing cars against humanity family edition I'm so hungry and I don't even know why I'm like putting the pressure on myself to like get there at a certain time because it literally doesn't matter I'm still gonna be the first one there but I need to like get work done there before everyone else arrives I should have you know packed and done some things yesterday but I did it anyways I don't know if I've told you guys yet I cannot remember but I have decided on my wrapping paper for Christmas it's literally just this brown wrapping paper from amazon and my ribbon from my trees I got a bunch for like 50 off on black Friday which is such a good deal so what we're doing that and it looks really cute I'm sure you guys have probably seen it in the background um it looks really cute by the tree and I'm literally okay this is actually perfect I'm using you know when like you just have like a random piece of wrapping paper left this is I mean it's barely not covering in a certain thing but I'm not being wasteful the only issue with this wrapping paper is that this tape shows up a ton and honestly if it was anyone besides my family I would oh why did I do it this way I would um be working on covering it better sorry family but you know we can see that it's fine look at how cute this kinder scott ornament is I love it so much I feel like oh this is what I'm wearing right now also I'm just rushing myself for literally no weak reason I'm going to the lake house but I'm just ready I do this every time I'm like have to pack up my car and go somewhere I actually did this completely wrong and it looks crazy the thing is it falls and it ends up looking good but like it's not even close to what I was supposed to do I just put a vest or coat on and I act like it's you know an actual outfit it's obviously not but to me it is I hope you guys aren't getting my stress that energy okay so I have this vest on and then I don't need to zip it up I think like that looks worse and then I saw my eggs I'm using this um away bag as my bag to go and we're off I'm vlogging this weekend so keep up unbox something before we get off the vlog guys I've been wanting one of these lucky love's bags if you guys have seen them on tiktok or instagram or whatever for so long I'm I'm in a rush as you guys know um so I actually haven't I didn't tie this right like I need to make it look better but look at how cute the bag is and then there's just like a big bow oh my god I need every color this isn't even really the color that I wanted but they're selling out like crazy right now but so cute oh my gosh I just love it so much says lucky loves this is like my dream friend of mine collab but like look at how cute they are oh my god obsessed so that is it for this week's vlog I'm going to start the lake house vlog it's gonna be a cinematic masterpiece I hope you guys enjoyed this like chill hang out week of my life vlog love y'all so much and I'll see you in the next video bye


hallmark card when you carry it up to send the very best let's bring you and Baxter in the covered bridge on the hallmark playhouse hallmark brings you Hollywood's greatest stars in outstanding stories and presents as your host one of the most distinguished actors of the American theater mr. Lionel Barry. Ladies and gentlemen this is Lionel Barrymore tonight's story is woven round one of the old beloved landmarks of the American scene the covered bridge you can readily see in reading his novel that Herman Peterson must have been deeply moved by those bridges and the legends that surround them for he's written a strong poignant story of some events that were a part of the history of one of these covered bridges and against the background of this bridge he's placed a woman of unforgettable courage and determination Zoanne O'Day and as our charming guest tonight on hallmark playhouse we are happy indeed to present and Baxter and now here's Frank Goss from the makers of hallmark cards one of the particular joys of Christmas is sending and receiving Christmas cards while the pleasure Christmas cards bring can never be measured isn't it good to know that hallmark cards are priced the same this year as they were last year and the year before and the year before that and that the quality of hallmark cards has constantly improved throughout the years yes today justice for many Christmas seasons that hallmark on the back of your card is looked for and welcomed it tells your friends you cared enough to send the very best Lionel Barrymore appears by arrangement with Metro Golden mayor producers of the Technicolor picture Plymouth adventure starring Spencer Tracy Jean Terny Van Johnson and Leo again and now here's the first act of the covered bridge starring and the story of Zoanne O'Day is strong and beautiful woman who lived in the Shenango Valley in the years following the Civil War she was up before the Sun one fine June morning she walked along the river and when the Sun rose she stood quietly looking at the covered bridge tomorrow my son will be married on the covered bridge and a dream that began when I was no older than he is now will have come to completion a dream that began when I was no older than he is now I was 20 when I first talked to Michael about the covered bridge we stood on this very spot looking across the river oh my how long a living of the memories all memories of you here beside the river I'm a girl again and you're beside me and all of life is once more ahead of us Mrs. O'Day Mrs. Michael O'Day even after a year I can't believe it no other world Zoanne and all the thunder and fire and excitement of the world and I'm no match for you no one is more aware of that than I am Michael you're all the happiness in the world darling but what have you been thinking about you've been staring across the river for almost an hour I've been thinking about the future there's 400 acres across the river I'd like to own 400 acres Daniel Stone owns it now but Daniel Stone has been buying a lot of land lately I don't think he's going to be able to hold on to it all it's good farming yeah good farming land one third of its under water we can build a ditch the river and drain it then we'll have 400 good acres ready for the plow oh it just isn't practical so and even if we did all that it wouldn't be a good investment do you realize how long it would take to get plowing over there and men would have to go way down to the town bridge to get across and we cost too much to farm it wouldn't cost too much if we had a bridge we could build our own bridge right here and join the land now it's build a bridge is it do you realize what a bridge would cost it's no pasture creek that's a river even the cheapest kind of bridge I wasn't thinking of the cheapest kind of bridge Michael I was thinking of the most expensive I was thinking of one that was sturdy and durable built to stand against the years a covered bridge why all this talk of land and bridges oh and why do you suddenly want all that we've got to start a kingdom Michael a kingdom for your son my son the spring our first child will be born I want him to be born to a kingdom and I want a bridge here on this spot to be the entrance to his kingdom you about the river land my husband and I'd like to buy it we'll pay a fair price land is not for sale mr. stone you bought up thousands of acres for miles around you own the mail you own the town bridge you own the dam you won't have to buildings in town that 400 acres can never mean to you what it means to me it's not for sale mr. stone I wonder if you haven't been the law in this town a little too long the prices are too high at your mill the wood and your bridges cheap and rotten never here it gets washed up when the water spilled over your dam and the whole town is crippled till you get around to fixing things if you don't like the way things are I'm afraid that's just too bad Mrs. Oday I don't like them Mr. Stone and I think I'm going to do something about them and the first thing I'm going to do is get that land if you were the last man alive and I was starving you wouldn't get that land I thought he'd be here before too long he's mad as a wet hornet what have you done to him I found out there was a mortgage on mr. stone's land across the river that he hadn't made any payments in two years he's land poor Michael so I bought the mortgage and I had him notified that if he didn't pay I'd foreclose where did you get the money to buy this mortgage your father loaned it to me you know he hasn't any more love for stone than the rest of us come on darling let's not keep him waiting very good evening to you Mrs. Oday and my congratulations when do you intend to foreclose the mortgage I don't intend to foreclose Mr. Stone unless you force me I've offered you a fair price for that land my offer still holds why should you buy when you can foreclose because I consider it the fair thing to do you'll get no gratitude for me in exchange you and I are for this night shall we meet at the bank at ten in the morning to sign the paper a woman I've never met before I feel like a woman I've never known before it's a wonderful feeling to stand up to injustice Michael I've been afraid of many things in my life I don't think I'll ever be afraid again let Daniel stone do his worst I'll be ready for him oh Michael darling just think we own the land now now we can build a covered bridge and I could plan the bridge I walked here beside the river one morning but Michael and his father on either side of me the money that would build the bridge was Timothy's but the dream was mine you see this bridge of yours oh and I see it just about here going from this no where we're standing across to that one see it's almost directly on it's all right that's too long a span don't forget the old days of building this bridge out of their own pockets it's not a town project well then let the old days build better than the town teach everyone a lesson in economy where would you build across the shorter you do that your bridge will be swept away when the river rises just as Daniel stones is every year we're gonna do it let's do it right let it stand high above the flux strong against the elements build it from the knowledge of today and yesterday and whatever vision we can glimpse of tomorrow's station conquers the wilderness in terms like this a bridge a mill last it stood as I dreamed it feet long roofed and sided like a low barn open at both ends it was completed one day in June the day our son was born he looked like you Michael I want him to look like you looks like his mother don't like his mother I swear he opened his mouth and roared where's my bread they finished it today yes they drove the last nail did anyone cross no I wanted you to be the first he must be the first to cross him and blankets take him down the day now walk across the day he was born and mark the day on the bridge Michael June the night the year 1868 and you think you'll remember no we'll remember there'll be other things for him to remember about the bridge Michael took our son in his arms and crossed the bridge for the first time and I lay back on my pillows and wept for joy later I ran through a midnight weeping with panic and rage seeing flames leap up from my bridge and the night on fire I've got to do something about our fire last night on the bridge yes I heard you'll be sorry to hear that we managed to save it some of the floor timbers will have to be replaced but we saved it what do you mean I'll be sorry we found the remains of the fire that had been built under the bridge Mr. Stone and beside the fire we found this coal oil can it has your name on the bottom of it now see if you're trying to Mr. Stone but understand this if you ever so much as set foot on our land again I'll come after you myself you don't belong in a country like this you don't want to give anything to it you want to take what you can exploit the land but not contribute anything to it and what do you want to do Mrs. O'Day I suppose you tricked me out of that land for purely altruistic who wanted to give something to the land didn't you I intend to give something to the land I intend to cultivate it make it you don't intend to do anything different than I intended don't try to whitewash yourself woman or not you are playing the same game you know the railroads were coming across that land and that's why you wanted it no I didn't know the railroads were going to cross that property and I still don't know it but if they come we'll cultivate the land on either side the land is the important thing Mr. Stone the land in just a moment we will return to the second act of the covered bridge starring Anne Baxter have you discovered that you often know who said a certain Christmas card even before you glance the name inside something about the color or design or the getty or formality of the greeting you have in hand seems to say this is from the Johnson's just like their farm in New England or I'll bet Janet chose this car she loves everything in shades of blue it's true that a Christmas card almost always reveals the taste of the person who sends it and that is as it should be for nothing you give your friends all during the year expresses your feeling of warmth and love so completely and one pleasant way to find that perfect card for you or your family is to select from the Hallmark Christmas card albums you'll find that the collection is widely varied and that Hallmark cards are the ones you'll be proud to have printed with your name and here's a wonderful plus that Hallmark on the back of every card you mail gives added meaning to your message because it tells your friends instantly you cared enough to send the very best now back to Lionel Barrymore in the second act of the covered bridge starring Anne Baxter quietly beside the covered bridge it was the day of my son's wedding and her heart was full everywhere she saw peace and beauty but it hadn't always been like that it hadn't always been peaceful and beautiful at the covered bridge yes the covered bridge was completed the day our son Marsh was born the seven years that followed were busy happy years we drained the land across the river began to farm it and in time so part of it the railroads for the money we realized we built a mill I had little time to think of Daniel Stone and yet I was always aware of his presence I knew he was biding his time waiting for the hour when he could strike again and at last the hour came late one night I remember remember one of our farm hands pounding frantically at the front door Daniel Stone he's coming this way with a gang maybe 40 50 men I heard about it in the village and cut cross country as fast as I could come Stone's been buying drinks for hours they say they're gonna burn the bridge in the meal in the house they're gonna destroy the crops all right all right how soon do you think they'll be here 15 20 minutes come on we'll wake the hands I want you to stay here in this house this is work for the men oh no Michael this is our land it's my work as much as yours I'll fight precise you'll stay in this house where you belong Michael we're wasting time don't argue with me so Anne you'll only be in the way out there take the shotgun down from the wall and stay in this house take care of Marsh I'll do my best out there to take care of you both window and Marsha's bedroom cold and shaking afraid for Michael afraid for Marsha afraid for all we planned and built and dream I sat by that window helpless unable even to cry out as I saw the mob of men turn in by the gates all their lanterns flung at field and building their rough shouting voices now and then I saw flames leap up and then flicker out in their light I saw the figures of men struggling now and then I I fancied I could distinguish voices Michael's voice the voice of my father-in-law the voice of Daniel Stone my night was endless and I longed and yet feared for the dawn last dawn came and big Tim O'Day walked into the house carrying Michael in his arms as he put Michael on the bed he told me Daniel Stone was dead but Stone was no longer important no one was important but my husband lying still and white on that bed wet you've been crying night is over you and Marsh will never have to worry about Daniel Stone again Michael so and teach our son the ways of the land you he'll make a good farmer he comes of generations of men who loved the land so I'm take my hands Michael don't spoil them with tears don't cloud them with be glad of what we've had is as I am glad thought you were asleep come here son is something wrong father I have loved most come Marsh you must go back to bed yes mother good night father sleep well father we lived again in his son sometimes watching Marsh follow his plow I could almost believe it was Michael and always when he spoke of the land it was Michael's voice I heard he had the same feeling for earth and crops that his father has Michael would have been proud of his son mother mother it's time you were getting dressed for the wedding yes Mars you've been standing here for hours I watched it from the window as I dressed what have you been thinking about oh I've been thinking about the past and the present I was about to think of the future when you interrupted me and how does the future look to you mother away the future should look good full of hope a good crop in the barns of good planting in the fields how did it look to you on your wedding day well across the river was swamps and wild uncultivated land and here on this side was a house in a few well-tilled acres when we looked about us we saw what you see now we saw a covered bridge and we saw well-tilled land across the river we saw the mill what do you see Mars well I see more land across the river if we could buy the property or joining ours and clear it good the country must grow Mars on the dreams of the young people and you'll give to it and your sons after you it's all part of a pattern Mars a good pattern a strong pattern you just the best the most creative pattern in the world symbol of your father's dream and my dream the covered bridge and now it's yours a bridge from the past to the present to the future and death to me may it mean only life to you and promise and happiness Christmas how would you like to delight your friends with an original painting of New England by Grandma Moses or a vigorous landscape by Winston Churchill or one of Norman Rockwell's lovable pictures painted with his delightful heartwarming touch it's such an easy thing to do if you choose the Christmas card you want imprinted with your name from the Hallmark gallery artist series you'll find that all the beauty and magic of the Yuletide season has been captured by the artist who create Hallmark cards there are traditional themes to Holly candles poinsettia cards aglow with fireside scenes or elegantly lettered informal gold and you need only make your selections now at the fine stores where Hallmark cards are sold in order to have them in plenty of time for leisurely addressing so when I plan to treat your friends to the cards they'll love to display you can count on it once they see the Hallmark on the back of the card that bears your name they'll know you cared enough to send the very best here again as Lionel Barrymore it's good to have you with us on the Hallmark Playhouse tonight thanks for a wonderful performance I'm so glad you invited me Mr. Barrymore especially tonight I wanted to tell you personally how stirred I was last Sunday night when you read my country to the V and then urged us all to get out and vote as Americans oh thank you thank you you know I believe this election was good for all of us never before have so many of us shown such an interest in an election and never before have so many of us voted but the most important thing that seems to me is what it can portend for the future what's that Mr. Barrymore that we've learned that a democracy is a working partnership and we the private citizens must also be active and vigilant if we've learned that as I believe many of us have then it looks like America is headed for the greatest period in its history then we will not be just election day Americans but everyday Americans expressing ourselves forcibly for all that's good for America and expressing ourselves forcibly against all that's bad for America and we'll all be active citizens all year round and that's the best thing that could happen to our country I think all of us feel just as you do Mr. Barrymore but very few can express it so eloquently thank you and now won't you tell us about your plans for next week's Hallmark Playhouse well next week on Hallmark Playhouse we'll present the story of a small town lawyer his family and the place in the community when we dramatize Bellamy Partridge's novel Fun to Shower and to play the leading role we've invited Edward Arnold to join us a Hallmark Playhouse as every Sunday our producer director is William Gaye our music is composed and conducted by David Rose and our story tonight was adapted by Gene Holloway well until Sunday then this is Lionel Barrymore saying good night Bert and Friendly Service remember a Hallmark card when you carry enough to send the very best and Baxter will soon be seen in the Warner Brothers production I confess the role of Michael was played by Lamont Johnson others in our cast included Ted DeCorsia as Stone Polly Bear as Timothy Eddie Firestone as Marsh and Sammy Aug as the boy every Sunday Hallmark cards present two great programs for the whole family's enjoyment on radio the Hallmark Playhouse with host Lionel Barrymore and on television outstanding dramatic entertainment on the Hallmark television theater consult your paper for time and station this is Frank Goss saying good night to you all until next week at the same time when Hallmark Playhouse returns to present Edward Arnold in Bellamy Partridge's Thunder Shower and the week after that Jane G. Austin's Stendish of Stendish starring John Haudyac and the week after that Bruce Lancaster's The Secret Road on the Hallmark Playhouse this is the CDF Radio Network This is KMBC Kansas City, Missouri


Good afternoon and welcome to the ANS webinar for today. This is the third in our series of health and medical webinars. I'm Kate LeMay and I work at the Australian National Data Service. We're a federally funded body that works to make Australia's research data assets more valuable for researchers, research institutions and the nation. I have a history of being a pharmacist and then working in medical research in primary care programs to help patients manage their chronic conditions more effectively and now I'm a research data specialist at ANS. I've got with me three panellists today and they are Connor, Phoebe and Amundi. Phoebe is the head of Legal at the Murdoch Children's Research Institute in Melbourne which has about 1,500 researchers and Phoebe manages all legal agreement for the institute with a particular focus around research projects and collaborations, clinical trials, engagement with industry partners, management and licensing of intellectual property and risk management. Phoebe also provides advice on diverse legal issues such as privacy in the context of medical research and data storage, biobanking and informed consent requirements and works closely with the ethics committee to deal with these often complex issues. Amundi is a civil law qualified lawyer from Belgium. Prior to coming to Australia she worked at a Belgian law firm for three years where she was in the IT and intellectual property department with a strong focus on privacy and data protection issues. She's been at the MCRI for just over a year and she works closely with Phoebe as a member of the legal office. Connor is an Australian medical graduate with a research doctorate in respiratory muscle physiology and a master's in bioethics. She has hospital based clinical care, clinical and pharmaceutical research experience as well as research and clinical governance roles. Connor has served on Human Research Ethics Committees for 20 years in the UK and Australia and she's currently the chair of Marta Miserie Connor Day. I can't say that Connor. Human Research Ethics Committee and QUT University Human Research Ethics Committee. So I'm going to hand over now to Phoebe and Amundi and we're going to speak to us about legal issues around data sharing. So we've got 10 minutes to cover a pretty big topic here legal considerations for data sharing. So I'm going to jump right into it. Quick outline of what we want to cover off in this 10 or so minutes. Give you a feel for what personal information is and a bit of basic information around the privacy acts here in Australia that we deal with. Then we're going to dive in just looking at personal information in the context of medical research, which is what we're doing on this webinar. We'll touch on how to de-identify personal information or the proper forms in which you can share information and strip out identifiers. And then we've got a few additional legal recommendations and wrap up. And we'll do questions at the end at the end of the webinar like Kate said. So Amundi and I are going to flip from slide to slide so she's kicking it off. Thank you, Phoebe. So I think the first thing to understand is the notion of personal information. I won't be too long here as I'm sure most of you have a pretty good understanding of what is or what is not personal information. So personal information is any information or opinion about an individual identified or who is reasonably identifiable. So it includes opinion, not any factual information and it doesn't matter whether the information is true or not or whether the information is stored in manual or electronic form. Health information and genetic information are a subcategory of personal information which is considered as sensitive and therefore the rules around that information are more strict. Any information which is unmanumous or which has been de-identified is not personal information because it is no longer about an identifiable individual or individual who is reasonably identifiable. So really one of the key elements is to assess whether someone is reasonably identifiable or not. The answer to this question depends on the circumstances. So there are a few things to take into consideration which include the nature and amount of information, who will have access to that information how the information was received and whether or not it is possible for someone holding the information to identify the person using available resources. The notion of personal information is crucial to understand because Australia has a specific legal framework around the handling of personal information. So as you can see on this slide there are three layers of protection. So without entering into too much details we can see that there is a privacy act and the APPs at the Commonwealth level. So this act applies to Commonwealth government entities and most private sector organizations. There are a few exemptions such as the small business exemptions so any businesses with an annual turnover of less than 3 million are not subject to the act. However if that business provides a health service and holds health information then the act will apply. Then at the state and territory level we also have some privacy legislation for the public sector in those state and territories including public hospitals and universities. In three states in Victoria, New South Wales and ACT we also have specific health privacy legislation which applies to public and private sector in their relevant jurisdictions. In this presentation we will only focus on the federal act and the APPs. This is first because the MCRI when we work is subject to the privacy act and also because the other regimes are not too different from the federal legislations. And then the last source of protection but not the least includes all the statesmen's warranties representation related to privacy that are made by your organization or your agency to your patients or your clients or any individual. So it includes the privacy policy you may have, the privacy statement, the consent form. So really everything that you say in those documents is legally binding and the individuals whose data is being dealt with can expect that you comply with what you say in these documents. So for instance if you put in your privacy policy that you will never share your patients' data with anyone else but then you do, then you could be liable for misrepresentation. So diving into looking at personal information more in the context of some of the research you might be doing, really I think all the privacy legislation like Amandine said we're focusing on the Commonwealth Privacy Act here but all of them really have at their core the central idea of ensuring that you manage an individual's personal information you're collecting in a really open and transparent way with that person. So a few key things to consider when you're collecting personal information as part of a study is really having a good think about only collecting health information that you really need for the study and not collecting unnecessary information. Obviously you're all across the fact that you need to have the individual's consent to collect their information and that consent needs to be voluntary, it needs to be informed and there's a thorough process that must be followed there. It needs to be current and a research participant needs to know that they can withdraw their consent at any time so that needs to be made clear. It needs to be really specific so I think who, what, why when all those things are really good questions to ask and present to an individual who's participating in a research study. So why are you doing this study? For what purpose? Being specific around details like we're working with X number of research collaborators and will be required to share your data with our collaborators in Queensland for instance is really important because it's that scope of the consent that really governs how you can use it going forward in the future. Obviously an overarching thing to remember is that you have to respect the individual's rights to know, to access, to correct and to withdraw their consent at any time. And one thing to set up at the beginning of any study is to ensure that you've got good team accountability around the management and security of research data that includes personal information. So that might be setting one key person up in your team to manage access permissions to the data having a process in place around off-site transfer of information is a really key principles that you need to consider before kicking off any research study. So once you've got your research data and that may contain personal information just touch on how you can go about disclosing that. So there's these three sort of subsets of types of data. We've got non-identifiable data which is information that really doesn't enable identification of an individual and this really means that those personal identifiers need to have been permanently removed. If that's the kind of data you're dealing with and you've collected in that way, stripped out all identifiers and intend to share it, you can share it generally freely. It's not only considered personal information so the Privacy Act doesn't overlay there. Reidentifiable data is probably the most common form of data you're dealing with and this is where a code has been linked to a research participant so the personal identifiers have been stripped out but there's one hopefully just one person who has the master list that would enable re-identification to happen. As long as that master list with the codes stored separately and not shared along with the re-identifiable data, that subset of data that's had the identifiers temporarily stripped out can in most circumstances be shared. Again you need to think about who's at the receiving end of it. If they could in any way re-identify it, then it's not really something that's had the important stuff stripped out but generally that's okay to share as well. Then you've got identifiable data and that's really where the personal information is still in there. I think we caution you around the need to really share identifiable data and we always encourage researchers to strip out identifiers wherever they can but if that's the case and you need to share personal information it's really important that your consent form covered off on that and you have consent around that because that's the main situation where you'll be able to do it. So how to re-identify personal information? I'm pretty conscious of the time here so I'll try to go quickly on that one. So as Phoebe has mentioned if you don't really need to share personal information you should only share re-identified data to assess whether your data is re-identified enough. We depend on their circumstances. Some people consider that it is always impossible to really have re-identified information. I guess if re-identification is hard in terms of resources, if it involves a lot of time and money, if it's highly unlikely to happen because of the nature of the information that you're going to be sharing on the type of recipient, then the information would not generally be regarded as personal information. The ANDS has published some very helpful guidelines on how to re-identify data. We put the link on the slide here and we really encourage you to download the guide because this is really helpful. And prior to conclude some additional tips or recommendations from a legal point of view so firstly it's really important to understand what are your systems? What kind of information you have at your organization? Does it include personal information? Why do you have that information? For which purposes did you collect that data? Where is it located? Is it internally on your own server? Or is it externally? Is it in Australia or overseas? Do you have a good understanding of how it works at your organization? Then it's important to have and implement some procedures outlining how that data must be handled and what steps needs to be undertaken prior to sharing that data to external people. Finally, prior to sharing any data you should really ensure that you have a good contract or agreement that your legal team has approved and so that contract should cover such issues such as liability is always good to have kept liability for, for instance, loss of data, some warranties ensure that your contractor is obliged to comply with Australian privacy laws. It's good to have some security obligations in line with the sensitivity of the data that will be shared and a process in the event of a data breach. As you might know, there is a mandatory notification regime which will enter into force in February next year. So it's important that the recipient of your data notifies you in case they are victim of a breach so that you can then comply with your obligations towards the privacy commissioner and the affected individuals. So I think this is the end of our presentation. Fabulous. Thank you so much, Phoebe and Omondine. That's a really great overview of the privacy legislation and things that people need to consider. So I'm just handing over to Conor now. Okay, thank you. I'm going to talk about planning for data sharing but from the research ethics perspective and what ethics committees are particularly concerned about. So the primary principle which guides research review is that it is in the common good so that the premise is a utilitarian one and all ethics committees are aware of that and we understand that the purpose is good and that research should be maximised with public benefit for the common good. And this also applies to data sourced and used in research. And the primary principle around that value of research is balanced with others that the committee looks at which are focused particularly on the individual so about justice, beneficence and respect. And so we're interested in understanding that benefit is maximised for those participants and the risks and burdens are minimised.  That the privacy and confidentiality issues are well attended to so that there are no elements of data which either during the research or subsequent to the research could lead to identification. And of course as Phoebe and Aberdeen have already said that can be quite difficult but also we're aware that there is necessity to ensure the efficient use of research effort and funding so how will it be used in the future to the best effect. There's a range of relevant guidance that ethics committees refer to and the national statement on ethical conduct and human research is the most well known and the one that we apply to the greatest extent and refer to the greatest extent. The Australian code for the responsible conduct of research is something of particular relevance to researchers and to organisations which undertake research. And then in more recent years the issue of data sharing and further use of data has come to the fore and the NHMRC has responded to that with a statement on data sharing and also a fairly detailed consumer guide to the principles for accessing and using publicly funded data for health research and that I would suggest that everybody tries to access if they can. The NHMRC has more recently provided a set of principles about accessing and using publicly funded data for health research and that isn't just research data but it also refers to other forms of publicly funded data. And this is in agreement and in concert with other international guidance such as from the Global Alliance for Genomics and Health, International Cancer Genome Consortium and the Wellcome Trust. And there are no doubt other ones as well but these are perhaps the most well known. So the NHMRC supports data sharing and public access to data and to the outputs of NHMRC supported research and it says to the public that the use of these data for research provides our greatest opportunity to unlock the value in these records for the benefits of all Australians and that's a very powerful promise but they offset this promise or they in addition promise to participants that data are collected subject to rigorous privacy and confidentiality conditions and the use of the data will maintain these requirements and in addition to that, that any research which accesses such publicly funded data are subject to very strict ethical approval processes so in order to establish that the research project is worthwhile and will add to that knowledge. So those are very important statements and promises that are made to participants in research. So the NHMRC therefore views research and data sharing from the premise that it's important to promote it but it is equally important, more important to maintain trust in research endeavours and to ensure that it can be seen that the guidance is followed. So we focus on the participant interests and the perspective of the participant. We try and consider what the research will mean to a participant. We're interested in knowing that research is facilitated and achieves its end so it's feasible and there is going to be the outcome that's promised. But in relation to data sharing, it's important that conclusions can be confirmed through data sharing and reanalysis and that the data that has been collected can be reused and therefore the benefit from all of that effort can be maximised. And we're also interested in understanding that all the stakeholders along the line of custody of those data do understand the responsibilities and will follow best practice guidelines. So in particular we look at research merit and for that we're interested in the basis for the research whether there's a good literature surrounding the reasons for the research which can justify the aims and also as I've said there will be a particular benefit that will flow from the research which will have a public and community benefit to it. We're interested in knowing that responsibilities are passed on with the data and the references that I've given here all relate to the national statement which relate to which is at the bottom. Where there is a new project which is going to rely on previously collected research data, we want to know that either the aims are closely related to the original research questions or there is some provision for seeking further consent. And that there is adequate respect demonstrated for autonomy of the participants, their expectation of quality as said in the national statement on data sharing and that any prior agreements are followed through. So this means that we may wish to refer back to consent, the nature and the quality in the original study and that this is sufficient for the further aims and if that's not the case then we will want to understand how participants are to be re-engaged and to have their consent agreed to. Now if that's considered not possible then there may be an opportunity to consider waiving the expectation of consent but that would be a very rigorous argument that would have to occur regarding the quality of the research proposed and the protections that are in place for the data. The other concerns and interests that we have are relating to justice beneficence and respect. So we want to know for example that the population from which the cohort is drawn is likely to benefit from the generalisable knowledge which will result from the research or in some way the application of the findings from the research. That if there are any implications from the research for participants and others, so community, the broader community, family members, that this will be acted on and this may relate to returning study findings or addressing potential harms and benefits. And we're also interested in understanding the rigour of the controls and the governance around data and any agreements regarding access use and release of information. So again that goes back to how the data managed and the confidentiality and privacy undertakings. So this is just a summary to really wrap up what I've already said that there's a lot of guidance around the use of data in the future and the benefits that may accrue from it. The research studies should satisfy these certain quality standards and demonstrate that there will be a benefit, that that benefit will be maximised including in terms of the future use of the data. That we're interested that the protocols and the agreements and the information provided in the reviewed application define these future possibilities of sharing. And we wish to know that participants are well informed about the current and the future research and they're given options of consent to each so that they may be asked to consent for the current project but also are alerted to the fact that there would be future research. And depending on the nature of that there would be an additional agreement for them to include their data in that future research. And that the research data when it's used in future research must comply with the prior consent agreements unless these can be renegotiated. Thank you. Thank you very much Connor. We've got a couple of questions that we received. So someone asked do ethics committees treat data differently if data for sharing is captured from secondary sources and what they have explained that to be is electronic medical record documentation rather than directly from a patient? Not really. Data which is captured in health records is collected for a particular purpose and that is clinical care. The problem with that is that patients are not generally informed that their health data collected for that clinical purpose for that individual is going to subsequently be used to address a research question. So in fact it complicates the issue if there's no consent. So in the case of a patient who is engaged and asked whether or not they'd be willing to have their health record data used collated and used to answer a research question then adequate information can be provided and they can consent to that knowing exactly what's going to happen. In the case of health records and secondary use of data the patient doesn't know that. And so the issues of a waiver of consent have to be considered and those are things like the merit of the application whether or not there's any reason to consider that a particular participant might not have agreed to more generally. The risk level of the research has to be low. So it's and it's got to be a fairly simple question and we would expect normally that it may be related to the reasons why are the health data collected in the first place. So perhaps related to the condition that the patient had and also that all the legal requirements are fulfilled. So quick answer is it's more complicated if you're going to access secondary data where there has been no prior consent. Phoebe and I and Dan, does this have anything to do with the S95 and S95A sections of the Act as well? It does. So it's that section of the Privacy Act that essentially leaves it to the discretion of an ethics committee to make the call on whether the research is in the public interest and a lot of those steps that Conor just took us through and in certain circumstances will allow an ethics committee to waive the need to consent for a particular research study. But it's not overly common. I think one other factor that Conor did mention that is also a consideration is sort of how many people you'd have to potentially go back and talk to to get their consent and the efforts of getting that consent. You sort of balance that essentially with the risk of running the research project. So if it's low risk with high impact it's related to the clinical information about them. It's already been collected and an ethics committee makes the call that it's unlikely to make participants really uncomfortable that their data is being used for that kind of research. Then there are the sort of circumstances where an ethics committee would feel comfortable maybe granting a waiver. Yes. First you're absolutely right. I should have added the point about practicability of returning to potential participants to gain their consent. And we would normally expect to see very large numbers or that a very large number of the population which you wish to go back to are just inaccessible for some particular reason. So thank you for that Phoebe. Excellent. And I just want to ask one last question and any other questions that we have in the question pod we can address later where you can answer them in a written format and have them up on the ANN's website. So a few people have asked about image data. For example CT scans whether they can be de-identified. Are they identifiable only if they've got the patient's name on or how are those able to be approached? Yeah. So that's an interesting one. So I guess as CT scan on its own strip of identifiers in terms of your name, date of birth or the vast majority of cases would be considered not personal information as my take. But I guess you always have to look at who the recipient of that information is. So if you just hand the CT scan to the doctor who's had that person in their care for the last five years, you know, there might be something there that they instantly recognise that's linked to that individual. So it's a big thing to think about. What's the knowledge base of the person you're handing the information to and is there anything in there that's going to be identifiable to them immediately? And to some extent how common whatever thing that you're looking at or something that might be in that scan is, for example, if it's something that makes their bones look a certain way and only five people in Australia have that, that makes it more identifiable than x-ray of a broken arm that is a very common sort of type of break. That's right. And then what other information is coupled with so that the hospital where it was at and the age, it's a bit of a judgment called in some instances. And you don't have to be putting the person at the other end receiving it is sort of, you can sort of assume it's the reasonable person with some knowledge but you don't have to think about exactly who it is you're giving it to and what their knowledge base is as well. So I think Conor, perhaps in the case of image data in general, probably the best first place to think about is not, I mean, in terms of de-identification, definitely taking off names and immediately identifiable information but not then trying to de-identify an image but rather looking at informed consent from the patients. That's absolutely right. I mean often images accompany a description of that image and one of the problems with that is that that may increase the likelihood of re-identification of an individual, particularly as Phoebe says it's something, as you said Kate, something that's a little more unusual about the case that's described. So it's particularly the case reports. And under those circumstances we would definitely recommend people go back to the patient to seek their consent so that they understand that those images are going to be used but also one needs to be very, very careful how if you can't obtain a consent but you still have a fixed approval to use that image and a description that the utmost is done to really remove any identifying features which will be included in the narrative as well. So it's not just names, places and things like that. It's also unusual features. Absolutely. Thank you very much. There's a couple of other questions that we'll address in our Q&A document after. So I just want to thank Phoebe and Amandine and Conor for coming in on our webinar today and speaking to us. It's been really valuable information. So thank you everyone for coming.