Hi everyone, Joe for jaspyscasebrake.com coming at you with the second half of that NT break we did last night 2020 Panini National Treasures Football This is half case break number 12 random teams Big thanks to this group of people right here for getting in congrats again to the people who won spots and Thanks very much the people who bought their spots straight up There's all 32 teams they're in let's roll it. Let's randomize it one out of five six times for names and teams one two three four five and sixth and final time Got Matthew all the way down to Chad one and a five six times for the teams one two three four Five and sixth and final time got the boys down to the Finns All right, so here's how it shakes out Matthew with the Cowboys Chris with the Panthers Andrew with the Falcons Matthew Shira with the Seahawks my Raiders and the Chargers Chad with the Chiefs Chris with the Buccaneers and Texans Matthew with the Cardinals Chris with the Steelers and Ravens William with the Fly Eagles Fly. They're actually playing right now here on the Thursday night June the 10th It's a pretty exciting game Eagles at Giants, but it's 31 17 At 31 17 Giants with six minutes up to the fourth quarter. There's no way the Eagles are coming back in this game Patriots bangles for Matthew Shira and the Rams Chris with the Jags Jordan with the Bears Michael with the Washington football team Reuben with the Jets and Browns Matthew with the Vikings Daniel with the Saints Tom with the Packers Chris with the Broncos Matthew Shira with the Titans and Lions Chris with the Niners David with the Colts Chad with the Bills Chris with the Giants and Chad with the Miami Dolphins All right, let's sort this by team name here and we're gonna pause the video when we come back We're gonna see if there's any trades and then we will have the break stick around BRB. All right Welcome back folks. There were no deals done and we've got an exciting finish to this Nets Bucks game. Things are only like A dozen seconds left drew holiday just hit a layup Give the Bucks a one-point lead All right, thanks everybody for making this happen. Remember I marked this grade 12, so we know it's from the same case Good luck everybody 2020 NT football We're in team 12 All right, Cooper cup to 25 since the last possession for the Nets 11.4 seconds left Almost loses the ball no good and They got the foul. Wow Brooklyn misses the shot There's Cooper cup Rams that'll be for Matthew Shira Donald driver To 99 that'll be for Tom and the Packers That's century materials Michael Irvin 24 out of 99 Dallas Matthew Shira with the boys 72 out of 99 T Higgins dual relic for Matthew and the Bangles My god for the Vegas Raiders the silver and black patch Brian Edwards 13 out of 99 nice dual relic a lot of Raiders fan hoping to see Another step in his evolution in his game and and just be healthy Matthew with my Raiders Quad relic Joe burrow Joe mix in Tyler boy T Higgins 31 out of 99 nice Matthew Shira with the Bangles and we got the autograph Brian site 8 out of 10 treasured moments Cleveland Corback named 1980 NFL MVP. That is a good moment and that will be for Ruben Cleveland This is for you got cam acres 41 out of 49 prodigy Three-color patch and autograph that looks really cool.  No, there's no way Eli Manning is just gonna eat Just gonna eat up to the last three minutes Sean D nailed it Joe burrow notable nicknames card number two Joey B Nice one for Matthew Shira got randomized the bangles. All right nice first box Second box are you checking the clock game? That's game Another redemption on the bottom here And he guesses on that redemption. This is the blockchain redemption another Joe burrow prodigy patch autographs goal a nice digital card of Joey B Matthew Back-to-back Joe burrows 7 out of 10 Jim Kelly for Chad in the bills Nick chubb 4 out of 99 Logan guessing chase Claypool on that Redemption that's a good guess Clyde Edward D. Lair is Sean D. His guess Colossal relic Terry McLauren 86 out of 99 Michael in the Washington football team Triple relic James Connor Juju Smith Schuster chase Claypool 99 out of 99 on that triple relic for Chris and the Steelers There's Julius Peppers 29 out of 49 Piece of his jersey going to Chris and the Carolina Panthers keep is also guessing Clyde We've got a dual relic We got Former Packer Aaron Rodgers and another Aaron Aaron Jones 14 out of 25 unless they somehow Kiss and make up Aaron Rodgers in the front office There's a Tristan Werff's Yeah, Logan Packers fans like that's not funny Futurator Aaron Rodgers Can you imagine the AFC West with Aaron Rodgers in it Patra Mahon's and Justin Herbert 12 out of 50 Tristan Werff's and if Denver gets like to Sean Watson That'll be for Tampa Bay Chris with the spot that he won. Oh, look at that patch Wow, that's two out of five. That's definitely a game used right two-color patch and autographs Zach Moss Buffalo Bit of the turf on the middle of that patch. That's pretty sick That's Chad Coleman with the Buffalo Bills with the spot that he won Chad all aboard the Big Hit Express One more and then the redemption nice Christian McCaffrey six out of 15 Jersey and autograph Carolina Go into Chris. All right, and the redemption I don't think the Jazz are gonna win by 35 points Logan, but I do I do think the Jazz are gonna win J-Doc All right, we got rookie material Sanctuary RPS numbers green What is that is that numbered to is that out of five? Let's go to cardboard connection calm 2020 National Treasures football let's search that First on the search Let's go to the set checklist Let's go to rookie Material signatures, and that's card number 19. I have material signatures There's rookie material signatures green might be I don't know green Jersey Might be 99 or less. Maybe I got a little too excited about this at least it's numbered It's gonna be a Land Landry. Oh, LeVisca Chanel jr. For the Jaguars He might have with Trevor Lawrence slinging it around in Jacksonville Chris Maxwell with the Jags Could be some really nice upside for LeVisca Chanel jr. People liked him last year He's got a year of NFL experience under his belt He's got a hot quarterback prospect slinging it around Jacksonville Could help him out Thanks everybody, I'm Joe for Jasper's case breaks comm another grade NT break in the books Keep your eye out for more in the store, and I'll see you next time for the next one. Bye. Bye


This could use a brand new coat. That's not allowed, I'd warn you don't. That guy is crapping on the ground. Eh, it happens. Wait, how's that even allowed? Because you're living in a cloud of work. Cost of rent is getting dear. We should build our new neighborhood here. Two housing builds.  Well that's acceptable in cloud. He's saved that disabled lady. Wrist his life to save two babies. Booster yet? Well I've had COVID and I had an adverse. Looking for a new job in cloud.


Everybody forced tier-ripping two boxes for my here be my here has A prism no huddle football from 2021 and a 2022 tops F1 sapphire Thanks, my here and good luck Start with sapphire make Schumacher green Dennis Holger 51 of 75 Carlos signs in jay hondara vala who's Hamilton Grand Prix winners Spain George Russell sepia number 37 of 100 Daniel Ricardo Philippa Djurgovic I was in her album another numbered card here gold Max Verstappen 13 out of 50 Pretty good. Yo, that's sick. We're gonna mag that one Old sapphire Max Verstappen very nice Joe Quan you rookie in a Lewis Hamilton Grand Prix winner 2021 round 15 Esteban Alcom Rain is sunny Christian Horner Joe Guan you another never parallel. We got Jack Duhan followed by a chartreuse future stars tale for sure 191 of 199 Callum Williams future stars and F1 award winners card Daniel Ricardo Carlos signs future stars Philippa Djurgovic and a Carlos signs George Russell did another never parallel. This is crazy man. Aqua Daniel Ricardo 37 of 99 That's one, isn't it? Magnuson and Lewis Hamilton Grand Prix driver of the day Spain. Why not one more? Max Verstappen Mike crack rookie Joe Guan you and Max Verstappen. Alrighty. I was a really good box 2021 prism no huddle now Last box of the night as well There are gonna be a few left over for tomorrow Disco rich Ganon All night. No way. I have my one day off this week now I got a Coming out on my day off to I do like the idea of ordering pizza big Palmer rookie This go emergent rookie trailance. If I ordered pizza, I'd be too tired to eat when I got home at this point Like if it's not here, I'm not gonna be able to eat it pizza Tell the lock at disco blue disco Tyron Matthew 39 of 79 the Haunty Badger Patrick Jones Ricky blue disco Ernest Jones 7 of 79 Ernest plays football Joe try and fireworks disco Aaron Jones. That's great. Rookie disco auto Nico Collins Nasty Nico What Sam calls it? Far more purple disco DJ shark numbered 2 of 35 trailance base rookie All out Kyla Murray Mitchell disco break C lamb Najee Harris rookie disco lockdown chase young Ronald Jones the second blue disco numbered 55 out of 79 Rookie disco. I think that's the photo variation of yet is the variation of Kyle Pitts Hopefully he can bounce back here. Hopefully him and London can just take off together It's a good play callers in there Purple disco rookie Frank Darby number 27 to 35 they would never throw it to like them. They've never given to the best players Right, exactly. It just ran about so much Patterson got hurt. They're like, oh, I don't know Rookie disco Dianne Brown red disco Antonio Brown 31 out of 50 I would look you think about putting Patterson out of like a whiteout in my knowledge here He's the main running back disco JK Dobbins It's getting better right backs disco CD. You am hype On the back that'll do it for you right here. Thank you again. Really good sapphire box. It's an okay No, huddle box there. We will get those out to you


this word will be an encouragement for those of you wondering what does God want me to do in this life? I mean really what's the next step? Because sometimes we get stuck or we get lost in the wondering. We get lost in the confusion. We say Lord I want to do something for you but I don't really know what to do. I want to live my life for your glory but Lord I've not really received specific instructions and there's this fear, a common fear that I recognize in people they're afraid of angering God by getting the call wrong. They say if I do something incorrect or if I do something I wasn't called to do, God's going to judge me harshly. Now of course there's a lot to be said of obedience to the Holy Spirit but also remember that the Lord makes room for our mistakes. He knows we're not perfect. This doesn't mean of course that we go living in a willingly ignorant, willingly sinful life. This simply means that there's grace to cover when we get it wrong. So as we pursue the call of God let's not be fearful. Let's continue to pursue the call of God knowing that He's faithful to complete that work in us. Now there's this how shall I say this almost like an old wives tale in the Christian world. The idea goes that one day you're going to stand before God and He's going to look at you and He's going to say wait a minute you were a nurse. I called you to be a lawyer. I'm going to judge you now harshly for that. Or wait you were a preacher. No no I called you to be a businessman. I'm going to judge you harshly for that now. But I don't think that's the way it is. I'm going to show you that in the scripture. Now of course there are certain things that are definitely the will of God. You want to know the will of God? Read the word. God wills that we pray. That we pray faithfully. That we read the word with devotion. That we live holy lives. That we worship Him with everything that we are. That we live in harmony and unity with fellow believers. That we evangelize passionately, lost. There are certain things that we do that the word of God has instructed us to do. Another example would be serving in a local church using your spiritual gifts. And we all know these generic general commands. We all know these calls to action. All of us do when we read the scripture. The frustration comes when we don't know what God specifically wants for us. So we know we should live holy. We should pray. We should read the word. We should live in unity with our brothers and sisters. We should worship. We should evangelize and so forth. But what does God want me to do specifically? What is the specific will of God for my life? I want to show you. Go to Matthew chapter 25. Matthew chapter 25. Once you've looked at those basic ways of living for the Christian. Once you've implemented those commands in your life, the question then arises, okay, now what do I do? I'm living holy. I have a prayer life. I'm reading the word. I worship. I evangelize. I love people. I go to church. I serve. But now what does God want me to do specifically? And that's really where believers feel like they hit this wall. So Matthew 25, I'm going to read verse number 14 and onward. Again, the kingdom of heaven can be illustrated by the story of a man going on a long trip. He called together his servants and entrusted his money to them while he was gone. He gave five bags of silver to one, two bags of silver to another, and one bag of silver to the last dividing it in proportion to their abilities. He then left on his trip. The servant who received the five bags of silver began to invest the money and earned five more. The servant with two bags of silver also went to work and earned two more. Verse 18, but the servant who received the one bag of silver dug a hole in the ground and hid the master's money. After a long time, their master returned from his trip and called them to give an account of how they had used his money. The servant to whom he had entrusted the five bags of silver came forward with five more and said, master, you gave me five bags of silver to invest and I have earned five more.  Well done, my good and faithful servant. You have been faithful in handling this small amount. So now I will give you many more responsibilities. Let's celebrate together. The servant who had received the two bags of silver came forward and said, master, you gave me two bags of silver to invest and I have earned two more. Verse 23, the master said, well done, my good and faithful servant. You have been faithful in handling this small amount. So now I will give you many more responsibilities. Let's celebrate together. Then the servant with the one bag of silver came and said, master, I knew you were a harsh man harvesting crops you didn't plant and gathering crops you didn't cultivate. I was afraid I would lose your money. So I hid it in the earth. Look, here is your money back.  If you knew I harvested crops I didn't plant and gathered crops I didn't cultivate. Why didn't you deposit my money in the bank? At least I could have gotten some interest on it. Then he ordered, take the money from this servant and give it to the one with the 10 bags of silver to those who use well what they are given. Listen to this, this is powerful. To those who use well what they are given, even more will be given and they will have an abundance. But from those who do nothing, even what little they have will be taken away. Stewardship. Taking care of what God has entrusted to you. Ministry is not a reward. Ministry is a responsibility. Ministry is not about status. Ministry is about stewardship. It's about taking care of kingdom affairs. You know, when God created man and put him in the garden, his intention for man was always that he would have a partner in man. God started the earth. Man was to steward. God created. Man was to cultivate. God spoke things into existence. Man is called to speak things into order. There was always a divine partnership that was intended for us to have with God. God gives us responsibilities that we might take care of the things that he's entrusted to us. This includes your life. Your life is not your own. Your life belongs to Jesus. Your time belongs to Jesus. Your family belongs to Jesus. Your possessions and finances belong to Jesus. Your energy belongs to Jesus. Your mind belongs to Jesus. Everything that you are and everything that you have belongs to him. It's on loan. You're taking care of it for him. So, getting back now to this point I was talking about earlier, this specific call of God. This is the point of frustration for believers. They're waiting for the heavens to open and God to give them very specific instructions. They're waiting for some prophet to come to them and say, you're called to this city to be this type of minister, to reach this type of people. And we want God to speak to us very, very, very clearly in the natural realm with super specific information. Now, this does happen sometimes, but generally speaking the believer is guided by the wisdom of the spirit and by the word of God. So what do you do when you're pursuing the call of God for your life? What do you do to actually make impact in the way that God purposed you? Because God has created us with purpose. And if he created us with purpose, that means he has intentions. He has desires. He has expectations that he wants us to fulfill. Now, if God was going to judge you so harshly for not getting every little detail correct, then he would have made every little detail clear. So we can take peace. We can find peace, I should say, in knowing that God is very good at communicating to us the things that we need to know. So we can at least be at rest in trusting him that he will guide us as we go. But in order to be instructed, you must be moving. In order to receive guidance, you must be on the go. Why is God going to reveal step four and five if we haven't even taken step one? So we know what the will of God is. Win the loss. Be there for your fellow believer. Live holy. Worship. Serve in the church. How are we to do these things specifically? The answer to the specifics is found in how he created you. He gave you a certain voice, a certain look, a certain way of thinking. He gave you a gift set, certain abilities, certain things about your personality, nature and character. He gave you certain qualities. He put you around certain people. God created you with intention.  What is the specific will of God for your life? It's simple. The specific will of God for your life is that you would take your specific abilities, resources and energy and invest them into God's overall command to reach the world. So the question then is this, how can I get involved? What can I do?  Yes, Lord, I didn't call you to witness to them. And now I'm going to judge you harshly for that. It's not that specific. There's a general direction. And as you walk in that general direction, you receive specific instruction on a daily basis to the Word and to the wisdom of the spirit. So as you move through your life, ask yourself, what are some of the things God gave me? I think of Pam Mays and Joanne. These are two precious women who support our ministry. Really, they're part of the ministry team. You know, they have great gifts for hospitality. And after every service that they're a part of, we will go in and they'll have a room prepared for us or somewhere that they're staying. They'll rent a space for the team and I or they'll get an Airbnb house and invite us all back. We'll get there and they'll have meals. They'll have things ready. Now they probably received instruction from the Holy Spirit to work with our ministry. But I guarantee you, the Holy Spirit didn't call them and say, hey, I've called you to make this specific type of pasta for David and his team. Now what did they do? They just do as they do, as they're gifted. They plan as they're gifted. They act as they're gifted. I think of people like Timothy Lay who does all of the media and production. Could Tim have done something else for God? Possibly, yes. But what did he choose to do? He chose to take his creativity, his eye for art, his passion for camera equipment and lenses, his personality for getting along with people to manage the crew and he takes those resources that God has given him and he invests them into the kingdom. I think of Stephen Mark de Zuma. God gave him a voice to sing. God gave him a warm personality to help the team gel together and what did he choose to do? He chose to invest that ability in this ministry. Now he could have gone and done that just at a local church and done that and worked a regular job and I don't think God would have judged him harshly for that. I think that was a path that the Lord would have allowed. At least he's doing something for the kingdom. But no, God called him and gave him this as an option and said, do you want to do this? And Steve did. Ruben Vargas, someone who's very gifted and very organized. Every time I get in his car, it smells like he just pulled it off the lot, like he just bought the car. This guy's house is very organized. Even when he stays at a hotel, you wouldn't know he was staying in the room with you because his bag and all of his stuff takes that one little corner off to the side. Very organized, very clean, very focused on details. He pays attention to those kinds of things. So what do he do? He offered that ability to a ministry and he's investing it in a way that's reaching people. Now one day, I believe Ruben's going to go and preach and God's going to branch him off into his own ministry. But here's what he's doing right now. Is God going to judge him for that? No. Did he hear specifically, did the heaven split open? And Ruben, I've called you to be an event quarter? No. He just followed the guidance of the Holy Spirit that inner pool as he moves to life and he applies his gifts to the will of God. So again, the will of God for your life is simple. You're called to use your specific gifts and abilities to fulfill God's broader plan. You're called to use your specific gifts and abilities to fulfill God's broader plans. And by the way, as we see in the book of Acts that the apostles were trying to go into Asia and every time they tried to go into Asia, the Holy Spirit would stop them. You know how I know they didn't pray about going into Asia? Because on their way there, the Holy Spirit told them no. Had they prayed about it beforehand, they would have never even have tried to go in. But what did they do? They saw an opportunity. They saw a way to serve. They saw a need. So they said, we're going to fill that need. And it was on their way to fill that need in Asia that the Holy Spirit said, no, no, no, not yet go a different place. And sometimes that's what we have to do. You want to know the will of God? Look around you. Where are the needs you can fill with your abilities? Where are the needs that you can fill with your talents and your time and your resources? That's what we're called to do. And as you go, God will guide. If he wants to prevent you from walking through a door, he'll do it. He will do it. For example, when we were trying to purchase that building in Eliso Viejo, I told the Lord, I said, Lord, I want this too badly to have good discernment. That's what I told him. I said, Lord, I want this too badly to have good discernment. I said, if you told me no, I wouldn't know it. If you told me yes, I'd go for it anyway. So I said, Lord, I want this too badly for me to have good discernment. There were so many emotions wrapped up and I was so excited about it. And I said, Lord, if this is not you, remember, Steve, you were with me in the prayer room. I said, Lord, if this isn't you, slam this door in my face because I'm very persistent. I'm going to do what I can to make this happen. So I said, Lord, if this isn't you, slam this door in my face. And he honored that. And he slammed the door in my face. And he was faithful to protect me from what I was not supposed to do. And so as you go along, you can trust the guidance of the Holy Spirit. I don't trust my ability to hear God. Some people are very convinced in their own ability to hear God. And that's when they start to get off track. That's when they become prideful. I don't trust my ability to hear God. You know what I trust? I trust his ability to speak to me. I trust his ability to communicate with me. He's good at communicating to me. I'm flawed. He's not. I miss it sometimes. He never misses it. So you can trust him as you go. But don't be frozen in paralysis and say, I don't want to do anything for God.  I want to point something out to you in this parable. Notice that when the master went away on this trip, he never once gave the servant specific instruction. He simply gave them the bags of silver and went away. He didn't say to each of them, now here's what I want you to do with this bag. Here's what I want you to do with my resources. There was nothing that he instructed them to do. They just knew they were supposed to do something. And the only one who was rebuked was the servant who did nothing. Why didn't he do anything? Because he was afraid that he would anger God. He was afraid, well, I don't want to make a move because I might miss it. And he got rebuked for that. The Lord called that laziness. I think sometimes we live in fear and we call it wisdom. And that's a dangerous place to be because then we're convinced of our own way of living. Notice also that the Lord gave to each of them in proportion to their abilities. So I may not have the same starting point as another individual. I may not have all of the gift sets as others, but I have something. And rest assured, God has given you something, something with which you can do good, something with which you can accomplish God's will in the earth. So ask yourself today, what has the Lord given me? What are my abilities? What are my personality traits? What are my resources? What are my connections? Now, sometimes we're a little harsh with ourselves and you may hang your head low and say, well, God hasn't really given me much. He's given you breath. He's given you a mouth. He's given you eyes to see, ears to hear. He's given you a connection, some connections around you, family, friends. There's, there is something that he gave you. God has given each and every one of us something that we can use for his glory. God has invested something in each and every one of us that can be used to bring about the kingdom of God in the earth. And if you don't know what to do, then do what you know to do. If you don't know what to do, then do what you know to do. Well, you're waiting for God to confirm the specifics, at least do the general, waiting on God to confirm where you should live, then serve locally in the meantime while you can. Are you waiting for God to tell you what kind of ministry you have? Then serve in another ministry while you wait. Are you waiting for God to confirm what job you should take, what school you should attend, or what people you should surround yourself with? Then do something that you know is God in the meantime. Evangelize, pray, live holy, reach out to the fellow believers and encourage them. Do something in the waiting and as you go, God will guide. Father in the name of Jesus. I thank you for my partners and friends, our wonderful spirit family. And I pray, Lord, that you would cause us to see, give us the discernment, open our eyes, Lord, to see the needs and opportunities before us. Help us to be attentive as we live, that we might see those little details that can be taken care of. Lord, reveal to us what you've entrusted to us and help us to use it well for your glory and honor we pray. In the name of Jesus and I want all of our friends to say amen. Also, help us spread the gospel of Jesus Christ in the power of the Holy Spirit. Make a one-time donation or become a monthly supporter by clicking on the donate link now.


We wanted to share this with you guys real quick to get some perspective on what you are thinking in this closest image of the Sun ever taken so to start with this image We see plasma being ejected from the Sun and this is listed as a coronal streamer We also see what is listed as the planet Mercury fair enough, right? But look closer at this image guys. What are those black objects? They are appearing to be in an orbit around the Sun just as Mercury is in the image Now what if we were to tell you that NASA has listed these anomalous objects as dark spots as a result of Background correction those spots are weird in itself and the fact that they have not explained them in the photo Raises an eyebrow or two Could they be deliberately editing a photo in such a way to monitor the public reaction? You have to wonder let us know about that But what we really wanted to show you guys is this it has long been theorized that Mercury has a moon But never confirmed could this in fact be the first capture of a moon in orbit around the planet Mercury One was briefly thought to exist in the early 1970s, but it turned out to be misinterpreted data From a star Observation of a moon of Mercury from Earth would be difficult because Mercury is relatively close to the Sun For example, Mercury was not observed in the infrared spectrum until 1995 a moon of Mercury was for a short time thought to exist on March 27th 1974 two days before Mariner 10 made its flyby of Mercury Instruments began registering large amounts of ultraviolet radiation in the vicinity of Mercury that according to one astronomer Had no right to be there by the next day the radiation had disappeared It reappeared three days later appearing to originate from an object that was seemingly Detached from Mercury some astronomers speculated that they had detected a star But others argued that the object must be a moon Sighting not only the two different directions from which the radiation had emanated But also the belief that such high energy radiation could not penetrate very far through the interstellar medium Argument in favor of a moon were strengthened when the object's speed was calculated to be four kilometers per second Which matched the expected speed of a moon could the latest mission from the Parker solar probe really have just discovered a moon Why are they not announcing it to the public instead? They are posting photographs with no clear explanation other than mass ejection from the Sun Are they really more focused on the Sun activity that they have not even noticed this it is strange All right, and it could turn out to be nothing But from decades this elusive moon of Mercury has bewildered astronomers One day it is there the next it is not the data showed it existed in the 70s And now it seems that this image the first released by NASA at such a close distance of 16 million miles Shows an object that appears to be in orbit around Mercury. What do you think about this anyway comments below and as always? Thank you for watching


This new technique, called fast cloning, is a fast, easy, and cost-effective way to clone DNA fragments into vectors or cDNAs. It requires fewer PCR cycles than traditional methods, eliminates the need for gel purification, and reduces the risk of random mutation. Additionally, it can be used for chimera construction, insertion, and multiple mutations in a short stretch of a cDNA. This article was authored by Lugia, Shunbenchang, Wenayun, and others.


Diane's been is the midwife has been a midwife in the UK for the past 14 years. She has been working with the NHS Aside from being a midwife She's interested in creating awareness about autism and which is not surprising she's going to tell us How she's going to do that and how the promoting of autism awareness in midwifery practice is very very important She's going to take us through that Aside from that Diane Baines Is interested in hypnobutting which is a form of having to allay fear and anxiety in the moda In an attempt to promote her physical and emotional well-being She's also a hypnotherapist, which is a form of alternative medicine by using keeping using hypnosis and then She's also interested in Reiki, which is a form of energy healing Welcome Diane Baines to the virtual International Day of the Midwife Need to give you the rights Right, that's great. Thanks, Lima. Hi everybody. Welcome to a presentation. Thank you for tuning in So I'm going to talk a little bit about promoting autism awareness in midwifery practice I'm just going to give you an overview of autism I know some of you will be aware of it and some of you won't some of you will have Experience of it and some of you won't I'm just gonna give you an overview of the Things that I think is quite important for you to know as a practitioner as a midwife and give you an idea of some of the techniques that you can use to help support your women that You'll see you're having babies and also helping them on their initial journey into motherhood as well So the topics that I'm going to cover are an overview of autism presentation specifically in girls and women Also, I'll cover a lack of diagnosis and what this can result in which is the manifestation of subsequent mental health issues in women and Then I'll go on to the impact of the lack of support That this has on women's ability to hold relationships and to understand what the relationships are and How this affects the family planning choices that they make Which is obviously where we come in and give support I'll discuss an overview of Masking techniques that are used by women to try and Cope in day-to-day living and how this manifests and how as health practitioners that we can spot these issues and Then I'll discuss about how to support and advocate for these women throughout the journey how birth and then also How we can raise awareness of autism in our own workplaces and in our own community And also for some of us among our own families as well once we have the extra knowledge So I just want to give you a really easy visual that When I'm talking about autism We now understand that there are a whole a whole spectrum of Learning issues that affects lots of people all over the world and some countries have worse for all of these issues And some countries do not So some countries might have things like tension deficit disorder autism and Where some countries might just see individuals as not quite fitting in and to the expected norms of behavior usually from childhood and so we're looking at Leo Kanner in 1943 he looked at children and basically he started to see that there were Issues within children that really didn't fit the model of mental health diagnosis such as schizophrenia and bipolar Etc. And his further research led to his name being given to that research and then from there These children were able to access support and then research grew from there And so that's nearly 80 years ago and we're still now Developing our research within the spectrum of autism and within the spectrum of learning issues So if you're in a country that recognizes autism great, how is your country responding to it more? Importantly, how is your midriff service responding to it and recognizing it? And if you're in a country that doesn't even know the word autism yet then Once you've got an awareness of some of the issues that can be apparent then You might be the first person that says actually this person might have autism How can we support that within a midwifery context? So I just want to draw your attention to the statistics that by the age of seven Which to be fair some children will have autism. That's very obvious such as non-communication not meeting milestones Depending how your country looks at child health And usually by the age of seven our ratio of diagnosis from boys to girls is one to four So for every one girl You'll have four boys in a classroom for example that have been diagnosed So the importance of that is to recognize that Only one girl has that support in place Whereas the four boys they have all that support in place all through their schooling and then through to their adult life that recognition So there'll be three girls as you can see by the Statistics by the age of 40 the ratio is shown to be more even so we thought traditionally that autism was more of a Boy issue But actually the research is coming out especially in the last few years is suggesting that actually Girls have autism too as much as boys, but girls are better at covering up And boys just can't cope given an environment such a school where there are so many expected social norms Then it's as physical aggression and that's what's dealt with rather than the underlying issue So there'll be girls that we come across as Childbearing mothers who might have some of the characteristics of autism that I'm going to discuss with you But I've never had a formal diagnosis Never had any support in place and might not even recognize themselves that have autism or that's why this may be Struggled in some situations throughout their life And and then there's a big thing now in the UK more and more women in their forties are actually getting diagnosed with autism And because of this growing awareness So it's just something to bear in mind that when you're interacting with ladies, they might have autism But they've never had an official diagnosis So I'm going to go to a word that is New Zealand In our region and it's from the Maori language and I know there's a coupler out there from New Zealand's way and Apologize my pronunciation by going to say tacky one tanga And and this is great. This word if you don't remember anything else from the presentation take this word away with you So in New Zealand They have a luxury of not yet and have not yet having words for certain Issues and autism was one of them. So the guy that was put in charge of developing the new words for autism in the Maori language Fantastic and he did a little news piece and he said when he observed people with autism he recognized that they had their own timing their own spacing their own pacing and their own life rhythm and So he came up with the word tacky one tanga, which means in your own space and time and That really does epitomize what autism is Basically, you've got an individual that is got their own way of doing things their own timing their own understanding and They find themselves Especially here in the UK having to constantly fit into social norms that cause them a lot of distress and then what happens is they're Their mind kind of wants to shut down and then he's not able to process or not able to interact with the world around them So in their own time and space is a really really good definition of autism and then this particular official went on to say that and He specifically chose words that Put a positive spin on autism So he was focusing on the ability rather than disability to ensure that terms are non-judgmental And I thought this was fantastic because here in the UK We talk about disability and we talk about all the learning issues that People have as disabilities Whereas truthfully it really should be seen as just another way of looking at the world and Increasing our tolerance and To not everybody fits into a way that we think we should be and we are having lots of tolerance with other issues such as gender In the world. So why shouldn't we have this tolerance with learning issues as well? So this is a really good graphic which talks about autism spectrum. So autism has Lots of different kind of nuances and definitions within that one title of autism You might have heard of autism spectrum disorder ASD This has come about because we used to think that autism was linear So you'd have say starting point here if you can see with the cursor where you'd have someone that was Non-conversant kind of mute and then all the way up here You'd have someone as able to socially interact and then he had what appeared as some superficial issues But that's kind of being put by the wayside now and we talk about autism spectrum. So people can have and some Speech issues for example, but be highly intelligent as they used to think someone who can't speak didn't have the intelligence there as well and depending what country you're from then your National psychology will still think about things in a different way along that Along that spectrum So we have our classic autism which is can is who's already mentioned Leo canna who first came about with let's observe children rather than just giving them Psychological labels such as schizophrenia Let's actually observe their behavior then came about with actually there they have not got mental Incapacity it's actually a learning issue or an environmental issue And I would say the best way to think about that is with someone with autism You they are a square peg and you're trying to make them fit into society so trying to make them kind of fit into a round hole and You wouldn't do that normally, but we seem to kind of want to do that with our children some time especially in the UK and especially within our current Education system we want to Try and get all children to Perform the same and be the same in the way that they have that Attitude but that's not always the case And that's not necessarily the best thing either for their mental health And then we also have Asperger's syndrome, which you will sometimes hear referred to as high-functioning autism and So in that category you'll have people That may have average or both average intelligence and are able to interact socially to some extent but actually underneath they're trying to Go through the issues that they've occurred during the day and make sense of them and they might appear that they On the outside that they're coping well in a social situation Actually, all the things they're having can be quite overwhelming and then you've got pathological demand avoidance Which you might have heard of or you might not have heard of at all Pathological demand avoidance is considered a form of autism where an individual will be motivated by anxiety mostly and they will like to have control around them so any kind of demand Can interfere with their sense of self and this can manifest as outbursts or meltdowns and this is one that might be really really Personate to midwifery because you might have a woman that you're looking after and you think of course She's not really interacting or she's being really Obtuse or she's being really argumentative to everything I'm discussing especially in labor when they feel very vulnerable And you could actually ask yourself or has she got this pathological demand avoidance is every command being met with negotiation and then oh actually and I think she might have that let's approach this in a different way and Once you've got the heightened understanding of these issues when you're looking after your women It can really improve the holistic way that you care for women so classical autism and You can have levels of severity with that. So what kind of things are we looking at? We're looking at things like ability to interact socially social communication impairment imagination impairment and repetitive activities So You could have someone that's quite aloof and indifferent so from a midwifery perspective your patient isn't engaging with you They can't maintain eye contact. It feels like they're not really listening to anything. You're saying but these are Issues that are powered because the social interaction to them is really overwhelming if you're looking at Somebody who has autism in the face and you're asking them directly That can be so overwhelming that their capacity to deal with the situation is just they're going to shut down mode and Then you can have people that are able to socializing groups but they need some Formal support within that as well and then you have social communication impairment So you can have a variety where people can't communicate at all Or they might have selective mutism to people that are really Talk a lot and they don't have kind of the social cues that actually their companions might not be Listening to them or actually it's now time for someone else to have a little talk in the conversation and then also You can have imagination issues where they might have limited play They might have isolated play prefer to play on their own and they might have Certain objects that they like to Play with we call them here in the UK fidget toys and stim simulators like something with a click Something like it's got a click on it Fidget spinners and children will sit and play with those It's quite commonplace now in the UK in school settings for children to have these And it helps them maintain control really through that social situation And then repetitive activities and you might have someone that has repetitive Issues they might do rocking issues and that's a self-soothing issue and then you might have people That have particular interests Things in particular that they know about Maybe for boys. It might be something like trains that they're obsessed with trains and so Going back to autism spectrum and the ASD that we refer to so this is a really helpful graphic So you're looking at people there could be anywhere on here just like anyone that Doesn't have autism or is nor a typical as we say it could be anywhere on here So you could have someone that's totally mute doesn't speak at all But actually they're really intelligent and their executive function is really high. You could have someone with sensory issues Who doesn't like loud sounds? But their perception of what's happening around them is really quite high. So this is a really good visual and then going further through to Aspergers high functioning autism as we've discussed already and Someone with a both average intelligence. They have less speech issues. They have language processing They do have a high sense of anxiety They can be overwhelmed and often this can be misdiagnosed from mental health point of view as depression anxiety especially in young young girls and but it's not it's under underlying underlying issue of autism rather than the mental health issues and here and you And it does seem to be more of a focus on the mental health side rather than Oh, actually this child might have autism. Let's support them with that They can find every day interactions really hard They can find building rapport in a social situation quite overwhelming and there might lack of a way Cues within a social situation as well and then most Importantly for us to be aware of this life is that they have sensitivity to sounds taste texture smells touch and light so they for a normal typical person they could be in a room and For someone with autism they could be in a room They could hear maybe lots of noises going on their hypersensitive to noise can be overwhelming for them if they Then have to like sit and eat in that situation and the food and the texture of what they're eating They don't like and then again that can be overwhelming for them It's a century issue rather than a like issue and then also there might be Find a smell somebody else's dinner if they're sat at a table quite overwhelming all these things are over stimulation of the sentences And and so it can lead to like what we would call maybe a meltdown And we also refer to that as the coke bottle effect So if a child for example has been at school all day, they've been trying to fit into a situation They can't articulate they haven't got the words To explain their Inner feelings then they'll come home with a parent typically they'll Explode like a coke bottle as once they get home. They feel safe in their home environment and Then again as we discussed the pathological demand avoidance So this will be someone typically who resists ordinary demands of life So not uncommon for them not to like to brush their hair or clean their teeth or even Be active in self-care of washing themselves They'll use distraction excuses renegotiation To get through any heightened anxiety issues and it may appear sociable, but they lack the understanding and They can have excessive mood swings and impulsivity And their behavior can be focused on other people This is one in particular that I think has mid-wise We might see in our women and we think oh, you know, they've got a psychological issue Actually, it might be that they've got pathological demand avoidance. They've got autism, but they've never had a diagnosis to work with What can we do to help these women? So strategies for PDA and for autism? What can we do in our society, especially in the UK? We expect people to conform to social norms and throughout school throughout education and within the workplace and What we need to do with autism children with autism is give them that Tacky one time there. They give them their own time. Give them their own space Don't expect them don't overload them with demands. So this is what we can do with our women with autism, especially through their Labor and also in the anti-native period as well be flexible with them Build relationships with them. Give them the extra time Is it really overwhelming for them being in a waiting room? So by the time they come to see you, they're so overloaded They don't have any ability to articulate any of the questions that they have Or during your routine anti-native clinical appointments. Could you be flexible? Could you see them at home? Could you see them at the beginning of clinic to take away that stress for them even having that conversation with them? Will help them think of this person that understands some of the things that I'm going through and already initiates that Relationship on a much higher level than you would normally offer the individual choices Do they want to Have one particular midwife can can you offer them continuity of caring your current role in your current model that you have where you work? and Also, choose your words carefully. So people with autism might think very literally so if you have a conversation about something and They will not appreciate kind of subtle nuances or Kind of subtle jokes. You have to be very literal and and you have to have that Understanding relate back to you that they have understood what you have talked about and use humans You can try and always remain calm. It might be you think cool. They're not listening They're not doing about as I've asked them especially in that labor environment You might think all they're not behaving as I want them to behave or as they should behave Then try remain as calm as you can and that will in itself just give them an extra time the extra space and That will allow them to think this person is is with me And it allows them their brain just to calm down and then react More progressively and try and reduce any direct demands And this is something that is you have to really think about so if you're talking to somebody say and And you want them to in labor Assume different positions or do something just say you have to kind of say would it possible for you to go to the toilet now? Would it be possible for me to and do an examination? Try and avoid any direct commands and because then they might initially be be met with resistance So again as we've discussed specifically in girls We're looking at what we're calling here in the UK now a hidden gender these girls Unfortunately, I'm not being diagnosed and not got the support that they needed at school And then they've gone out into the world and in and into adolescence They're not too secure about making their relationships And and it makes them especially vulnerable and and then they come to see us as young women pregnant and sometimes in quite a vulnerable relationships and So what are we looking for in girls in school setting and within that midwifery? So we're calling them say the hidden gender So the presentation in boys And maybe they'll have obsessions things like that be quite obvious who's in girls not so obvious They might have an obsession with the latest pop band But they're able to fit that in with the social norms.  They're really helpful and but they're actually Seen on their own it looks as though they're around people and they've got all that friendship group Actually, they'll be on the periphery of the friendship group and the teacher in a class of 30 children has got actually able to see that fully and Then obviously by the age of seven or eight as children trans trans As children go into them Pre-puberty basically then these issues become more of more obvious So we talk about girls having masking techniques So a foreign peer trends and that urge to fit in and they'll copy behaviors and then you lose a sense of their true self And basically that can lead them feeling exhausted and overwhelmed and these things are all the same if you're looking at a mother in Pregnancy she's she's acting like she thinks she should act she thinks that she should be happy about being pregnant She thinks that she should be bonding with her child. So these kind of things and Sometimes a little bit of a struggle with for women with autism. So symptoms of autism. I love this graphic Let's talk about all the positives. So someone with autism never gives up. They're a loyal friend Trustworthy and dependable. They're a true seeker who wants to do what is right? They're caring and fatic sensitive and creative their abilities to hide hyper focus and analyze and systemize and They love details. They notice patterns others may miss They perceive the world in a unique way They're passionate about ideas and solving problems and they have an amazing long-term memory They can share the information So used in the right way, we have two really strong Exponents Greta Thunberg who's had a lot of coverage this year and she's been a fantastic role model for girls with autism aspergers and she's been very open that she has aspergers and that makes her who she is and she Epitomizes really that she sees the world in a different way She works raisin wellness of climate change and she's made such a massive difference to everybody and She Epitomizes what autistic people see is that they see a truth underlying truth that other people can't always see and Temple Grandin some of you may have heard of she's a big exponent of autism in the US This books are really good books a really good starting point for anybody that's interested is available on audible Really accessible and it talks about her childhood growing up with autism and actually how she's been able to become very successful With those traits in the workplace as well So we'll revisit our one to every four boys diagnosed And we are looking at our Looking at our girls that do not get diagnosed. How can we support them in midwifery? So lack of diagnosis might lead to subsequent mental health issues and So these money might manifest all the way through childhood and adolescence So when these girls come to us, they might have inability to recognize someone's ulterior motive in a relationship So it makes them More vulnerable to risk of abuse and exploitation Mac seagulls that have had substance misuse drugs and alcohol and they're not making very good relationship choices and Not making good family planning choices Because they haven't had that extra social education about Making good relationships and also making choices about their health and and their Reproductive health as well Just practice point right at the end and then we're we're finished with the presentation is that Just imagine you've got A lady called Jill she's comes into hospital to live her first baby and she has autism She likes her routine and gets very anxious in new places and around new people She's never met her midwife Helen came into the room forgot to introduce herself She switched on all the lights which as she told Jill She was too busy to look at her birth plan and would just do what was needed to get the job done Jill and she told Jill she needed to move things along otherwise her baby might be very poorly or die as Her blood pressure was too high We all know there are lots of issues with that kind of a midwifery care But it can happen. So how would this make Jill feel? She's feeling Out of control. She's got no safe place She's feeling very anxious very scared and confused and quite rightly so but she'll be feeling this to an Extortion extent where a whole senses are overwhelmed and for Jill this might manifest as really extreme reaction to situation And it will have poor outcomes for her and her baby What could the midwife have done differently? Well, what can we be doing for these women? What extra care can we be putting in place in our birthing units? Introducing ourselves offering tours of the room or the unit prior to admission So that can alleviate any anxieties and fears whether women know where they're going to go We can offer them a pre-birth plan Going through that with the midwife or a midwife that might be looking after them in labor but having awareness of The effect of light sounds smells voice tone and touch and any demands for that whole interaction of labor Outlining a clear plan of care with the patient before they come into hospital and having no direct requests or demands and Thinking that autistic women can think literally so being told your baby might die She actually might think that her baby might die and that's not something that anybody wants to He or keep repeating You know as they go through that journey of motherhood and here in the UK. We have lanyards with Some flowers on for autism awareness. They started using the mini Heathrow in the airport Showing people that needed just a little bit of extra support going through the process through the airport So could we introduce something like that into our health care systems here? So we have a lanyard or wristband that shows all health care staff that people need extra support with what's happening to them Also in the UK with it. We have a health care passport as well Which is bought up by the National Autistic Society And that gives an outline of what each person needs extra to help there Help their journey through the health care And I would advocate you all to watch them this lovely short film by Disney called float It's a very short film about six minutes and it's done by this guy Bobby Rubio based on his own relationship with his son with autism and if you watch that film You'll have a little bit of an idea about what autism can do for a child and how it affects the parent and the relationship as well And I've put that on my Facebook page as well if you want a quick link to that and then the resources here in the UK National Autistic Society Temple grounding books and the autism toolbox Which is a website from Scottish the Scottish NHS? and some really good talks on Ted talks on autism and Sarah Hendricks is somebody that I would look for on YouTube as well and Then I just like to say thank you very much for your time It's been a very quick overview there if you need to know any more information just contact me in Facebook Or email me not a problem at all and I think Halima is there. I'll hand back over to Halima if you're there Hi Halima Hi there Yeah, thank you very much for that presentation Well who would like to take questions from the audience though we have very short time for us to take this question We have just five minutes for us to end this session Then we'll go to the next two groups where another presentation is coming up Today, are you happy to take questions now? Yes, that's fine Yeah, yeah, if Before the question comes in if I may ask Can you you mentioned something about the NHS health passport? Can you tell me more about the NHS health passport and how it is used to support people with astronaut degrees? Yeah It's the National Autistic Society that have developed it which is a charity here in the UK And basically it's a little Page document and it gives an insight into the individual that's been treated for the in health care And There was a young lad who had autism had underlying Health issues and unfortunately because the staff weren't really aware of his autism how that manifested for him or how they could support that And he actually died and his mum has been a really good advocate about bringing forward this issue and As lobbied the UK government and as a result of that the UK government this year Announced that all health care professionals It's compulsory for them to have autism training and for all health care students coming through and midwifery students That it is in compulsory for them to have training on autism in their in their studies and the health care passport Is a four pages document and it just gives a simple overview Of what the issues are for this particular individual and how health care staff can support them and what they like and don't like And also That is being transferred over to the education setting now as well And it takes away a lot of that Where family or parents will have to advocate on a child's behalf It will be written and put in the medical notes and it can be used by medical staff um And some people wherever in the UK and some people aren't and more people need to be using it more to support our um Our children and our women in midwifery That's quite a good arrangement. Thank you very much. Diane I want to ask one very important thing before we go. Um What treatments do you think a midwife should be aware of when supporting A child with a special a woman with autism and labour please They need to be aware that um that we are with every woman that they are the individual who needs to treat them as such Um, but with women with autism, they might not be able to always articulate everything that they need So really I would specifically say let's show these women the room where they're going to be delivering their babies Let's talk about home birth options as well Um, let's think about um interaction. How do they need the lights? How how do they need? Everything in the room ask them. What do you need us to do for you? How can we facilitate your birth? And also have the um kindness and understand that they might not react to things as you expect them to And their underlying um emotion might be anxiety driven and how you can support that as well I want to say thank you very much Diane for this amazing presentation. Thank you, Halime