So as I said, I'd really like to welcome the presenters from India. There are four presenters today, Professor Baby Venkatesh, who is a professor in a statistics and has undertaken her undergraduate and postgraduate studies in a statistic and gynecological nursing. Her main area is the interest for adolescent health, nursing education and moulding students to be the best they can be. She's published several articles and research paper and is pursuing a two-year fellowship program in the Foundation of Advancement of International Medical Education and Research, and she's currently pursuing her PhD. The next speaker is Professor Christy McCayla and she's a professor in community health and has undertaken her postgraduate studies in community health nursing. She's currently pursuing also her PhD and she's a resource person for training the trainers involved in the Global Fund for Aids, Vocavocas and Malaria program. Mr Santhi M.D. is also an associate professor in a statistics and has completed her studies in a metric and gynecological nursing. She's also published several papers and is pursuing her PhD. And Ms Anci Nathu, Anci hails from Kerala and has completed her postgraduate studies in OBG nursing and her main area is the interest in pain management in labour. And she's about to get married in a month's time and is awaiting to start her professional marital life. So welcome to the Four Ladies from India and I'll now hand over to them to start their presentation. Okay, Davey would you like to go ahead? Yes, yes, Jillian. Thanks for your introduction. Some PSG and Coimbatore, we wish you all a very happy midwife's day. We are here to present on safe motherhood initiatives from India. Just before going on to the entire topic, this is where we are, India. India has 28 states and 7 union territories. These states are further subdivided into districts. Current population of India is expected to be 1.27 billion, males comprising 655.8 million and females 614.4 million. The state where we are here is Tamil Nadu. Tamil Nadu is one of the most important states. This is even largest in terms of area, 7th most populous state in the country. Population of Tamil Nadu is around 70 million according to the 2011 census. It's one of the most adorned states in India and this stands second in total employment and holds 6% of India's population. The city where we live is Coimbatore. This is also called as Kovai, the second largest metropolitan city. It is the textile capital of Tamil Nadu. Fourth largest metropolis in South India. There are numerous temples around the city and there's a home to 7 universities, 3 medical colleges, 35 political colleges, 70 arts and science colleges and 64 engineering colleges. It is the educational hub of South India too. This is our institution, the PSG institution. The own alliance of Tibet and multi-speciality hospitals which caters adjacent population. This is our campus PSG. PSG institution has a medical college, nursing college, pharmacy, therapy, engineering, all the courses in it. Adjacent picture what you are viewing is our college, PSG college of nursing and this caters the student population of 325, inclusive of undergraduates and post-graduate. Majority of the faculty are undergraduates and those being their doctorate programs. So this is one of our classroom, model classrooms for final year classroom. Today's topic for our discussioner, I'll be discussing on the maternal mortality rate and trends in India, current education system of preparing midwives and maternal rights programs offered at the central government and at the state level. India's second most populous country in the world next to China. Currently there are about 61 births per minute. More than 50% of the India's population is below the age of 25 and over 65% below the age of 35. 72% of India's population lives in rural areas. Rest of the 28% are urban areas. And when you take the population of India, every year India adds more people than any other nation in the world. In fact, individual population of some states is equal to total population of many countries. According to the state census 2011, most populated states is Uttar Pradesh with a population of 19.96 crores. The least populated state in the country is Sikkim with a population of 6,7,688. Some of the reasons for India's rapidly growing population are poverty, illiteracy, high fertility rate, rapid decline in the death rates or the mortality rate and there is a lot of immigration from Bangladesh and Nepal too. Along by the swelling population, India started taking measures to stem the growth quite earlier. India by launching the National Family Welfare Program in 1952, India became the first country in the world to have a population policy. The family planning program has yielded some noticeable results bringing out significantly highly the country's fertility rate. So this is a global scenario of the maternal mortality rate. The global MMR in 2010 was 210 maternal deaths per 1 lakh live births that is down from 400 maternal deaths per 1 lakh live births in 1990. The MMR in the developing regions has been 15 times higher than in the developed countries. Sub-Saharan Africa had the highest MMR at 500 maternal deaths per 1 lakh live births while Eastern Asia, that is countries including China, Korea, Japan, Mongolia had the lowest among the minimum development goals in developing regions, that is at 37 maternal deaths per 1 lakh live births. This may be owing to China's one child policy adopted by China in 1978 that has brought about the tremendous results for China. The policy plans to have prevented between 250 to 300 million births from 78 to 2000 and 400 million births from 79 to 2010. The MMR of the remaining million development goals developing regions in defending all the maternal deaths per 1 lakh live births in Southern Asia, Oshania, Latin America, Northern Africa and Central Asia. The direct causes that contribute to majority of the maternal deaths include haemorrhage, sexes, unsafe abortions, eclampsia and obstetric labor. And since the rural population is more, the access to healthcare facilities are little less in the rural populations for which the government of India and the state government is working. This is the MMR of the statistics of maternal mortality rate in India. India currently the maternal mortality rate is 212 per 1 lakh live births. We have started working towards the minimum developmental goals. Already three states, Tamil Nadu, Perilla and Maharashtra have reached the minimum developmental goals and other states are on the way to reach the minimum developmental goals. As we know this minimum developmental goals are as numerical and time-bound targets to measure the achievement in human and social development laid down by UN, goal 5 concentrates on improving the maternal health and indicator is the MMR. India by its all the programs are on the way of reducing the MMR and reaching its way to minimum developmental goals. So it is not sufficient that adequate planning is done from the part of the government but also we need a health force that is sufficient enough to implement these programs. As a part of that, the government has taken a lot of steps to improve this workforce. So to improve the nursing workforce, what are the initiatives taken? I hand over the session to An Singh to continue on the workforce centering. Thank you ma'am. Thank you all a very happy International Advice Day. Midwife means with the woman. Midwife is considered to be one of the world's oldest provision and India has got a rich tradition on midwife. In the traditional practice, women from within the community have turned into midwives and they were attending the deliveries. Today, these traditional midwives are replaced by trained certified midwives. Indian midwife free practice is based on midwife free model of care. In this, after this model pregnancy and childbirth are considered as normal physiological process and only assistance will be provided to the mother who is in labor. The components of the model of care includes monitoring the physical, psychological and social well-being of the mother throughout the childbearing cycle, providing the mother with individualized education, counseling and prenatal care and hands-on assistance during labor and delivery, minimizing the technological interventions, identifying and referring the women who are in need of surgical attention. So, initiatives for training midwives in India, initiatives for training midwives in India is taken by Indian Nursing Council established under Indian Nursing Council Act of 1947. There are various programs offered by Indian Nursing Council which includes auxiliary nurse and midwife free with the basic qualification they need is a 12 year of schooling and it is a one year program and they will be designated as registered auxiliary nurse and midwife. The next program offered is general nursing and midwife free. The basic requirement is 12 years of schooling, it is a three and a half year course and they will be designated as registered nurse and midwife and they can work in the primary health centers and hospitals. The third program offered is basic BSE nursing program. It is a 12 year of, it also needs a basic schooling of 12 years. This is a four year degree course and they will be designated as registered nurse and registered midwife. And the fourth program offered is master's degree in obstetrics. The basic qualification needed for this is a four year basic BSE nursing program and this master's degree program is for two years and they will be designated as registered nurse and registered midwife. They can practice in the hospital setting as well as they can be in the teaching side. So even after having these many programs, there is still a lag of 3.50 lakh nurses against the total need of 10.43 lakh nurses in India. So Indian Nursing Council along with the trained nurses association of India have introduced the program of independent nurse practitioner which is already being implemented in the states of Kerala, Tamil Nadu, Gujarat and West Bengal. Under this program, trained nurses are expected to take up normal deliveries in the sub centers and primary health centers in the absence of doctors. As for this independent nurse midwife practitioner, this program is focusing on utilizing the knowledge, skills and authoritative power of midwives and they will be accountable for the care what they are doing. Along with all these things, along with the female, taking care of the female they also take care of the male patients also who are suffering with sexually transmitted disease or reproductive tract infections. And under this program, a continuity of care is expected out of the midwives. What is the scope of midwives practice is they can, even after doing their specialization, they can further specialize in areas where they are interested like they can work as lactation consultants, they can focus only on postnatal care or they can focus on complementary therapies which can be provided during labor like acupressure, refluxology, on naturopathy and other things. So India is expecting that out of all these programs there will be a decrease in the maternal mortality rate and infant mortality rate and the Millennium Development Goals will be achieved. So the other programs which is conducted by the central government and state government will be discussed by Professor Christie. Thank you. Hi and warm greetings from TSC College of Nursing. I am Christie. I am Christie here. I wish you a happy International Advice Day. India is a developing country and we are in industrial demographic stage. That means we have high birth rate and low death rate. We have achieved the death rate here. Our nation is taking diverse steps to reduce our growth rate. So from the starting from history in 1946 exactly both communities have recommended the primary health care focus and in 1952 we have started with family welfare program. It is the first nation we are concentrated on towards control and comes to after that 19, like 1978, it is a millennium we have changed in the primary health care concept after the Alma Atta Conference held in USSR in 1978. Based on this we have started with nation health policy in 1983 and we have given 12 targets including maternal mortality rate and infant mortality rate, like MMR we are focused to reduce to 2 and IMR we are focused to reduce to 60. But we have started in the year of 1992 child survival and faith motherhood. Here mainly we are concentrated on how to bring the child survival rate and bring the faith motherhood. And after that it is 1997 it is reproductive child health program it is started. Here we have it is incorporated with child survival and faith motherhood is incorporated with RCKH. So the components of RCKH is family planning, child survival and faith motherhood, prevention and management of reproductive tract infections, sexual transmitted disease and HIV and AIDS. Also adolescent health care and family life education and last one is client opposed to health care. These are the focus we have started in 1997 and when we are reaching 2001 census actually we have kept the target for 60 IMR and 2 per 1000 MMR but we have reached it is almost 4 per 1000 MMR and 72 per 1000 IMR. So on one goal we have achieved this death rate that we have reduced to 6 per 1000 actually we have reached our goal. After 2001 again we have revised the nation health policy in 19 2002 and 2005 we have started with NRX program. So in the RCKH program mainly we are concentrated like decentralized health care and what is the main shift of this paradigm is vertical program into integrated service delivery. Like earlier in our nation it is a very many states are here so they have focus from central they have focus all the states and they have concentrated all the programs. But now it is integrated from the peripheral level they have to start working and they have to tell their needs and demands from the peripheral level. That is the main paradigm shift it is happen here and it is earlier it is camp oriented like we will conduct camps and we will reduce collect all the mothers of family planning everything will collect the people. But here it is client oriented they have to come forward they have to take initiative. Then target oriented we have set the target and here it is goal oriented and we have focus quantity earlier and now it is quality. So quality wise we are improving the whole health service and the peripheral rural level. We are incorporating all the health system services and we are developing the resources in the rural areas. And mainly in RCKH program we are concentrating three that is early obstetrical care, essential obstetrical care and emergency obstetrical. Here we are focus with mobile services then they are need they have mobile services to come to the hospitals or rural health centers. And here this program it is providing safe delivery kit also so wherever the delivery is taking place we have to have a clean and more or less safe environment to conduct the delivery activities that is the main focus in this RCKH program. So after that in 2005 we have started with national rural health mission. It is mainly focus on first 18 states in north and states. Here we are in southern part so actually southern part the literacy level and MMR is very less compared to north and states. So these are this program is mainly concentrated in north and states to reduce MMR and total fertility rate and improve the control and prevention of disease like emerging and re-emerging diseases and non-communicable diseases too. And to provide accessible, affordable, accountable and effective and reliable primary healthcare and bridging the gap in rural healthcare because all majority of our 72% of people they are living rural service. And as earlier this mention it is accredited social health activist she is working in rural areas to reduce the birth and we have GDP how much we allotted it is earlier it is only 0.9% of national GDP it is allotted. Now it is increased to 2% is more or less we are concentrating on preventing and poverty services for faith motherhood. And also we are increasing public-private partnership because public-private we are combined together only because this huge population we can meet and we can meet the targets and promoting IEC information, education and communication because women will be educated from the earlier states from up tactical and during adolescent period also they will be educated and during adolescent they will be providing iron-rich supplements plus iron and folic acid tablets because here in India the HB hemorrhage is the first cost in the IMR, promoting IMR. So we are concentrating on hemoglobin level among adolescent age group and maternal, during maternal period. And next program we have is in the NRK mainly is Jananis Raksha Yojana. It is during pregnancy period they will be given concentration and they will be providing rupees 700 it is almost also 13 US dollars. It is only to bring the nutrition to develop the nutrition status of mother and they have early registrations it is must and registered care and faith industry, institution deliveries we are encouraging and early newborn care and family oriented care also we are providing here. This is this program also it is concentrating first north and part of India and it is almost 18 states it is benefited out of this. And we have family planning program here we are focusing small family norm that is in India we have total fertility rate it is almost around 2.9 or almost 3 and that means all reproductive age group human they are giving birth to minimum 3 children. So we are bringing this norm small family norm that means only any one child either male or female one child if you are giving birth it is too good and we are focusing for NRR that is net reproductive rate is 2.1 actually it is our rate is 1.5 we are focusing for one all even though all these things we have one more thing a problem is major problem is female infant is like the female 6th case when we are seeing in north and part it is 800 per 1000 in southern part it is doing well 900 around 930 they are doing well so all the whole nation we have average of 930 per 1000 and we are promoting girls child protection act also we are taking care of. These are the main merits and demerits we have we have limitation like highly populated country and lack of resource trains professional midwives when we are seeing midwives the ratio doctor population ratio we have is 0.7 per 1000 and north population ratio is 0.8 per 1000 and midwife population rate is 0.4 actually we have R and M R and register nurse and register midwife in India we have combined that is midwife and nurse certificate program is we are doing but still we have in actually nurse midwife and trained birth they are trained people to conduct delivery and mainly for focusing on midwife these are the limitations we have also we have all these limitations we have one strong meritus we have family system traditional and cultural practice when we are going to cultural practice this is a picture that it is like during the pregnancy period the family is taking care of the mother and this is occasion they will have 7th and 9th month they will do one day they will celebrate the mother and they will wear all the new silk fairies so she will be decorated and she will be wearing bangles all the relatives and neighbors will wear bangles this mainly actually focus that this glass material it will give more sound this will produce the cognitive into the cognitive field of fetus this is the actual practice we are following and this shows we are our family system and tradition also taking care of our pregnant women I wish you all the best and have a nice day I will just hand over to Santhi thank you man so warm good evening to one and all wish you all very happy international midwife day till now we have seen various national level schemes along with the other schemes also that state government was implemented they are this scheme was implemented in the year 2006 it is a monetary benefits scheme for the mother in order to compensate the wage loss during pregnancy to get new tissues diet and to avoid delivery of low birth rate babies this scheme was implemented for the mother the total money they are giving to the mother almost $222 this also they are giving in three installment basis in each installment the mother is getting around $74 the first installment they are giving at the mother who avails their required antinatal services in a concern primary health center second installment giving at the mother who delivers at government institutions third installment giving to the mother who is completion of immunization for the child up to third dose of PTT, hepatitis D and oral polio vaccine the eligibility criteria are it is restricted to first two delivery funding the pregnant mother should be at the age of 19 years and above the pregnant woman should be in the below poverty line group that means the mother's annual income should be around $222 and second program birth companionship program this program was implemented in the year 2004 it is a key component of midwifery model of care the development of this program is based on shared responsibility mutual trust understanding and empowerment this program is followed in all over the world but they are including a birth companion but in India only woman will be allowed as a birth companion the eligibility criteria are the woman should have undergone the process of labor compulsory and she should not suffer from any communicable diseases she should be willing to stay with the mother throughout the labor the benefits of this program are it gives increased satisfaction with your birthing experience and gives reduction of postpartum depression gives increased suffering success and better interaction with mother and baby and also shorten the duration of labor it gives less pain and fever medical procedures during labor and also reduction of instrumental material birth and featuring delivery and third program is integrated child development scheme this scheme was implemented in the year 1982 it gives service to both antenatal and postnatal mothers that means they are doing they are doing weight monitoring for the mother periodic medical checkup, subliminal nutrition subliminal iron and calcium medications and immunization monitoring compulsory the subliminal nutrition is the main mode of this scheme they are giving this subliminal nutrition to children below 6 years of age, antenatal mothers and lactating mothers each pregnant and nursing woman the diet covers around 600 calories and 18 to 20 grams of protein per day along with this they are giving health education about childcare to the postnatal mothers also till now, due to this scheme 718,000 children 156,000 pregnant women and 875,000 lactating mothers were benefited through this program next program, comprehensive emergency obstetrics and newborn care unit this hospital is initiated mainly in rural areas because in order to reduce the mental mortality rate in emergency conditions because 70% of population were resided in rural areas this scheme was implemented in rural areas according to gross domestic products the government allotting 4.7% of income to implement this type of centers it is very equipped with both manpower and equipment to require to give care for the mother and baby this center has crowned the class obstetrician, pediatrician, doctors, staff nurses lab technician and other supporting staff on duty the services available are it gives representation of all emergency conditions blood transition facilities supportive lab and imaging studies prevention of parent to child transmission services free 108 emergency ambulance system and emergency treatment protocols in the labor room and also in the newborn care services the next program is medical mobile unit this unit was developed in the year 2009 the aim of this unit are to improve the institutional delivery to identify the iris pregnancy and it is easy to approach for the population and also refer for emergency care the services available from this unit are doping immunization monitoring antenatal care, postnatal care family welfare services and referral and counseling services and next scheme is one day modern scheme it is a voluntary scheme the indoor doctors will display one day modern logo at their clinic so they are providing iron and folic acid medication, TT injections and oral pills at three of cost through this state level of scheme the Tamil Nadu achieved in the year 2007 to 2008 99% of mothers were at institutional delivery and only 0.1% of mothers are delivered by untrained personnel at home due to the institutional delivery the material mortality rate was reduced gradually in both state level and also in national level thank you I will hand over to purpose the day demand so with all aiming towards the million development goals there is no doubt world needs us more than ever India also celebrates on April 11th National Safe Motherhood Day so that citizens and communities and other stakeholders take a path, deliberate on the maternal health situation in the country and look at what interventions are working and what more is needed to be done this April 11th is a birth anniversary of Kasturiba Gandhi and Safe Motherhood Day is commemorated to mark the occasion I now let the forum open for this session thank you very much ladies that was a lovely presentation there are certainly a couple of questions that are coming through and I prefer the first one one of the participants was just asking in relation to the education we noticed that the midwives and nursing education were together are the midwives referred to as nurses or are they called midwives baby could you answer that question please we have a basic program of DSE nursing so this DSE nursing those who graduate on that will be able to work as educators and also as a clinical midwife and after a post graduation also they can work as educators and a clinical midwife the option is for individuals to choose either of these areas they can be allowed for both education and also in the practice setting is it clear Arjunian? yes lovely alright thank you very much for that one of the other questions that came through was just in relation to the slide that you had about caring for the mothers and wearing the bangles even if the mothers appear to be quite well supported postnatally do you have any idea in relation to the levels of postnatal depression that you experience in your country? yes this bangles ceremony is almost done in south India this is kept that a day is marked an auspicious day is marked so people all get together to make the mother happy where bangles usually it is done in the seventh month we can also state that this also improves the acoustic skills the hearing abilities of the newborn which the mother will be wearing this bangles till her delivery and also mother has given a lot of nutritious food throughout the pregnancy her relatives will be bringing her sweets fruits and things so that they care for the mother not only as a family but also as a society her relatives all too which will be keeping the mother happy too okay excellent now I think there is a question from Sona Sona can I you've got the microphone can you ask your question please yeah we have we have noted up certain questions like in India majority of the birth are mostly handled by doctors not necessarily because there are a lot of areas where midwives are conducting and not necessarily all the doctors are in the hospital or conducting institution deliveries majority of the time they are too prescribed they are too suggestive procedures and midwives are the one those are carrying out everything for they have the responsibility starting from pre-construction care till the mother gets delivered and if only complicated we refer to doctors as that and we have the next question already there is in the fact that there was an answer on it there is a independent nursing midwife nursing practitioner program yes of course there are already three states that is on the way to delivering of this independent practitioner program there is and there are a lot of initiatives to further make more nurses practice independently then there were like why men do not go for vatakthami usually it's a men do go for vatakthami but in our very quite less numbers majority of the permanent contraception is underbound by seniors and temporary contraception of course both equally opt for it okay thank you very much for that Soma we have a question from Penny and she said with the dramatic rise in institutional birth and doctors attending so a specific model of care how much care do you feel is women centered and how is this good yes as we discussed earlier 72% of the India's population lives in rural areas so majority of these births we are trying to make it institutional because to avoid the complications the transport facilities they get from the rural area to the building centers less and also since it's a very much rural area even the availability of nurses there is difficult so all care is women centered only but promoting institutional births to avoid complications of the delivery thank you okay so they are trying to encourage the amount of institutional birth to prevent obviously the mortality rate is that correct yes yes this is to reduce the complications of delivery and side birth okay I know one of the other questions that was put forward before is if the doctors are handling most of the births I heard one of the presenters say that the midwives' roles and responsibilities are certainly involved around the post-natal area and complementary therapy so just to clarify do the midwives actually do any of the births or assist the mothers to do any of the births midwives definitely do except like even in hospitals midwives do deliver but there is a little of presence where complications arise with the two doctors and the majority in primary health centers are limit wise deliver and main responsibilities are like starting some histories assessment, monitoring the fetus and the mother maintaining a pathogram conducting the delivery maybe there is a teaching institution medical colleges attached so there is a tendency for doctors to get practice too excellent thank you very much does anyone have any other questions so by the way I can answer you can please raise your hand in the chat box if you want to there is a question to like increasing number of cesarean sections that yes there are increasing number of cesarean sections maybe again to avoid complications of the to reduce infant mortality stale births and mortality rates that's why they go up for a cesarean section excellent one of the questions from Henrietta here is what is the cesarean section like in India this we cannot specifically point out maybe around 50% to 10 to 10 to 20% that depends on no 10 depends on the mother 10 to 20% so that's in the public arena because I'm taking it on the chat box it's going 50 to 80% in private hospitals is that there is increasing number of cesarean deliveries we do agree some private hospitals they pay some other for cesarean section but it is not the condition throughout India okay excellent there is there is association called SOMI there is association we all belong to train nurses association of India and mid-vice belong to this yearly there is conferences and there is a network that is between the mid-vice okay thank you Sana do you have a question I'll just enable your microphone Sana do you have a question if you've got your question please no problem you can type it I'm answering for you well we're just waiting for her to do that Penny just has a question here do you think mid-vice would be interested in autonomous practice currently there are some like several mid-vice coming up I think in the future definitely there will be a lot of mid-vice doing autonomy practice okay Priyanka I've just enabled your microphone do you want to she's got her hand up sorry I can see that you don't have unable to use the mic so she said isn't Henry doing to high rate of induction in hospital rather than hemoglobin levels alone I don't think so Henry is not related to induction in our hospitals Henry is the cause but that is related to anemia less hemoglobin levels it is not of not related to induction but related to hemoglobin levels levels yep excellent okay isn't there going to be further questions no Henry is not much linked to induction here in India Henry is related majority to anemia so into anemia very good thank you very much for that ladies do you think that do you think that the induction rate obviously is increasing too and I suppose there's a you know obviously there's got to be a correlation if you're having more institutionalised birth with your induction rate and can I just ask when is your induction rate what is generally the cutoff for women to be induced is it 41 weeks 42 weeks we couldn't get this again can I just ask what is the most common time for induction in India do they normally induce women at 41 weeks or 42 weeks 40 plus weeks 40 plus when the baby is mature enough above 40 okay so that 40 okay that's great it's just very interesting to hear the different rules around induction in different countries here in Australia normally about 41 plus 3 or 40 plus 10 days so and that's just dependent you know in what area but that's generally the norm here so it's just very interesting to know what was the norm in India definitely then I think you're talking on the nutritionist or grants that has definitely reduced the anemia rate in women excellent does anyone else got any more questions they'd like to put forward the hemorrhage may be linked to induction but that is not the cause of majority of the hemorrhage here lovely ladies well thank you very much for that presentation it's just been wonderful to have the four of you and I think that presentation went so well it was really very clearly it was lovely so thank you very much I'll just turn the record


Aloha, this is Matt Darnell with Supporting Your Tech, joined as always with faithful companion Greg Jackson. Greg, good to have you here. Thank you. I kind of did a jig there, kind of a Greg and a Jackson. I've been called worse. All right, great. So today we're going to be talking about managing your email inbox. This is part two of our talk on that, but as usual we're going to be starting with some current events and some things that caught my attention out there. And the first one here is wireless headphones. And what caught me about the title was their claim was that wireless headphones are improving faster than any other tech, solar, electric cars, autonomous cars. And they said that, and their point for saying that was that with the wireless headphones, they're taking advantage of all the different kind of improvements, like the assistance.  And the battery technology, so much so all these improvements in battery, you know, they're able to do that. The new Bluetooth, you know, there's the Bluetooth, they can switch between there's a Bluetooth low energy and standard Bluetooth. So when they're close to your device, they automatically switch without skipping the music, they automatically switch to the lower technology. So that was just interesting that of everything that's happening around us, that headphones, wireless headphones, are able to take advantage of all these things the better. Can you think of anything that you think is progressing faster? The wireless headphones? I actually didn't think it was progressing that much. I've got a set of Bose, but I can't use that for my conference calls. You know what I'd really like is a Bluetooth headset that I can use for my phone that does the noise cancellation, but I don't sound like a tin can. But compared to anything else, I mean, I don't know, I thought the watches were the smart watches. And I think that that's up there as well. And now they've got the biofeedback rings, I mean they've got some really cool stuff out there. And one of my favorite Seinfelds was when George was talking about toilet paper, about how in his lifetime it hasn't progressed. And you know, a thousand years from now, it's going to be the same. And squeeze the chart. Right, they disagree. That comes in sense now. There's multiple plies. There's colors and anyway. So just when you think something hasn't changed, when you're not looking, yeah, so these new wireless headphones, they are expensive.   I have a Beats set and the Bose. The Bose are way better. Really, when you bought them, were they about the same price or was one more than the other? I think they're in the same. Yeah, yeah, exactly. Because I didn't get them retail. So you stole them. Well, I got a good deal. OK, OK, all right. I got them from a co-worker, so. OK, I stole them from a co-worker. OK, I just want to make sure. She might think so. Yeah, OK. So what I got was the Bose were nice. They were, you know, they look pretty durable, really hard on the head.  But they didn't have really the noise cancellation I was hoping for. They were a little complicated to work. Bose were a lot better. But I like the Beats squeezed you hard. Oh, yeah. Yeah, they were easier to collapse. But what I noticed was that the Bose had better noise cancellation. I can maintain some phone calls on it. But it still doesn't, it does noise cancellation for me. But it doesn't help the person I'm on the phone with. OK, because I don't want to walk in down the street. They're here in the wind noise. Exactly, yeah. I'm at Starbucks. And I'm trying to, you know, I'm listening to my tunes. I get a call. Now I got to switch headsets. So that's, and I don't know what happened to Jawbone. I'm not, they were doing a really great job. And I can remember when the Walkmans first started coming out. You know, this is back in the 80s, right? It's just a couple years ago. Yeah, yesterday, right? The Walkman with the cassette tapes and the A-tracks.  Now you got to have the skinny ones deal with the metal and the small little things. And even a couple years ago, I mean, when I would see somebody walking around with those big old things, you know. I wonder what the age gap would be, if I said like this. I think, you know what that means. That's a boobox, it's a boobox, right? OK, all right. So now, something that, anytime an Apple product comes out, I don't think, and just, we'll just, I don't think Samsung's any better. Huawei's any better. OnePlus is any better, as far as that. But somebody was talking about right to repair. Meaning that if something goes wrong with, again, we're just going to pick on Apple here, with your iPhone.  They put a new screen on there. It works fine. Should Apple ever release software to intentionally kill that touchscreen? Which they do all the time. Yeah, I think it's under some guise of, you know, it's an update and sorry, we just can't accommodate everybody. It's a security. Yeah, I think that's the challenge. But, you know, I don't, when it comes to this kind of stuff, I think, you know, you're buying it because of the ease of use and you want to support. Apple's got to make their money. They probably make it in other ways. So I know they're real tight with how they manage their software. And I would imagine that if it's their ecosystem, they probably want to be able to control it more. Well, and what they usually say is, if someone does use a third-party, like for instance, my Apple Pencil Hero, if somebody was to make another compatible, they would have to use a security hole to be able to get in and have it talk. So Apple is saying, well, we just, we fixed the glitch, you know. Sorry, your third-party stuff ain't going to work. Yeah, they were using undocumented APIs or this and that. So of course, they changed all their stuff not to use it and then they killed the third party. So I think that's really going to be huge going forward.  That's the dealers, they count that. Okay, when we sell this car, well, the next 10 years, we can expect X-Revenue from just oil changes and obviously that does, we got Jiffy Loops. I mean, imagine like Jiffy Loops was outlawed. The oil that they used, your engine would reject and just dump it right out. And I don't understand why tech's any different. You know, if I choose, if I buy something, I choose to have you repair it. I don't want the manufacturer doing something actively but the only reason they're doing it is so that it won't work and I have to go to them. I'll ask, I'll ask you, I mean, this is one of the reasons why I don't do Macs. I mean, I do PCs because I get to control it. I mean, I don't know what your thoughts are, but I don't go into a Mac. You know, we work with a lot of Dell's and I almost said compacts. And Gateway 2000s aren't, they're not any better. But you know, we would do a lot of Dell's and when those power supplies go bad, I mean, that's not a standard brick power supply that you're gonna find somewhere, right? In a desktop. And when you're buying one of those little micro teeny-weeny ones, I can understand that you got some non-standard parts, but I've got a full desktop. I mean, and they try to make it easy. You pull one tab and the power supply comes out and another tab, the hard drives come out and that type of thing. But those are not, you can't go to Best Buy or CompUSA and buy that power supply. It won't fit anymore. So I think in some cases, those days are just gone. You know, of having a beige box with a standard AT power supply in there and then you could buy it from 100 manufacturers. So it's hard. So even on PCs, I don't think it's as intentional as, I mean, the RAM is not soldered into the motherboard, you know, on that as you would find on iMac and of course they say it's about space savings and heat and that. Well, I mean, if you look at, you know, a gaming PC, there's, you can customize that. So when you're working with some of these manufacturers that have large manufacturing models and they're trying to reduce the cost, I mean, I kind of get it. I mean, it's a waste of money if my Samsung breaks with a $1,000 phone and that's tragic. Well, and if the screen is cracked and Samsung says, okay, it's going to cost $500 to replace that or a guy down the street can do it for 50, you know, that's a real hard thing to do. So yeah, this is right to repair. I think it's just going to get bigger and bigger and bigger. This is going to be class-action lawsuits and that. Okay, so fax machines. And this is something that we see daily, right? And a lot of people think that fax machines are secure, but beside writing some- The government thinks it's secure.  You know, because people, when you think of like medical information, you know, HIPAA talks about encryption when data's in motion, encryption when data's in rep. If you fax anybody, anything, it's not encrypted. So I don't understand how like doc and doctor's offices are the worst. We, you know, we have a fax, you know, as you know, we have a fax server and at least twice a week, I get a fax from this particular medical office with somebody's medical information on it. And we've called them and said, hey, you know what? You guys got a little bit of leak here. So you have that. I mean, there's no verification that the right person is getting it at the other end. It's child's play to be able to intercept the fax and just receive everything that someone is getting. But it's, they're still so prevalent. I've never, I mean, this is like eight tracks. I mean, I've never understood why fax machines are so popular. I'll tell you why. Why is that? I'd love to know. It's simple and it works. It's easy. It's good enough, right? It's simple and it works. When I hit the phone number and I hit go, it scans all the sheets and then I walk away. I don't have to worry about it. That's what all, I mean, when I was in the healthcare, doctors were very, very, very, that's what they wanted. But were they conscious that they were violating HIPAA when they would send that information via fax? So it's not, it is HIPAA compliant to send by fax. The problem is is how you're managing the data once it gets in and out. But that would be like sending it in an unencrypted email. Yes, but HIPAA requirements. And the HIPAA is really one of those weird things where they have a framework, they're not specific. So the people that have the, so that from the time it hits the machine and it's how it's being stored in the machine, so it's gotta be encrypted on the machine. But when it sends it, they accept that. I mean, you and I both know that if you just tapped into the phone line, you could intercept the fax. It's, yeah, it's really weird. You can have no control over the other end. I mean, it's like putting someone's medical information in a bottle and throw it in the ocean. Who's gonna get it? I don't know, you know. Oftentimes they're in public places, people can walk by and take it. Well, and the stats say that the average fax is read three times before it gets the person it's supposed to. And if it's interesting, it's read seven times. If it's got salary information or evaluations or anything. So security numbers, I mean, that's really crazy. And there are, people don't realize there are exploits with fax machines. You literally, cause usually you get these all in one things that they're network printers, they're a scanner, they're a copy, they're your fax machine. And what they were able to do is create a fax, a malicious fax. If you can believe it, a malicious fax that if I sent it to you, it would cause your fax machine to do a buffer overflow which I could exploit. And because that thing was on your network, I could fax it again and program it to start mirroring all the data, sniffing your network for passwords.  A lot of the IT shops don't manage it either. They don't have any ability to manage it. It's just there, yeah. So again, this is Matt Darnell and Greg Jackson with Supporting Your Tech. We'll be back in a minute and we're talking about how you can help to manage your email inbox. Hello. This is Think Tech Hawaii, raising public awareness. I just walked by and I said, what's happening, guys? They told me they were making music. Aloha, I wanna invite all of you to talk story with John Wahee every other Monday here at Think Tech Hawaii. And we have special guests like Professor Colin Moore from the University of Hawaii who joins us from time to time to talk about the political happenings in this state. Please join us every other Monday, Aloha. All right, so let's talk about your email box. If you're like me, if you're like anybody else, it's too full, too much in there, too much unorganized data. And we're going over the mop method for email inbox. We talked about M, we spent time on M. M is minimize. Yes. All right, so how we can do that? So now, talk to me about O, what is O and how does someone use that? So O is organized, which you really wanna focus on is how you're organizing your email. So I'm gonna just kinda go over a few tips and tricks. There's some real obvious ones. You wanna be able to use your folders. Gmail's got it, Outlook has it. You wanna create folders on the left. You wanna click and drag emails into those folders manually if you need to. If you can, you wanna set up rules so that things just automatically pop into a box. So for instance, if I have tickets, if a ticket's coming in, I want a ticket folder. All the tickets will go right into their own folder. If I have a specific VIP customer, I can have all those emails come in. It'll actually ding, it'll alarm, and then it'll go into a bucket. You can even make copies of it so you can keep all of it. So I don't, how do you not lose, my issue with that is, back 15 years ago, I mean, you go crazy, right? You have folders and folders and folders and folders and folders, and you set up the auto routing rules, and then it never hits your inbox, you never see it, and you lose visibility, right? I mean, it's not there, it's not there. So how do people organize, sort, put them that way? And what I ended up doing was going through then creating like follow-up. You know, you can flag for follow-up, and pretty soon that 400 things, that were flags for follow-up. So how do you keep visibility on what's important when they're, it's out of sight out of mind, right? I don't see it in my inbox, well, it must not be a problem, you know, I'll ignore it until it bites me the butt. So there was, I don't know if you'd heard David Allen, he does, he writes some books, he talks about organizing, those are some more manual processes. You can use those same processes for organizing your email. And what you're talking about is time and attention. If you're gonna be living, if you're getting that many emails where you're living out of your email box, you wanna set time aside and you wanna restrict your time to doing certain tasks. One of them is just looking at your email, like literally, we talked a little bit, I don't know if I mentioned it last time, but what you wanna do is you wanna schedule time and you wanna let people know, email's gonna be coming into my email box. I'm gonna be checking my email maybe three, four times a day and that's it. How do you let people know that? You put in your email signature, you can let them know. I mean, this is one of those things about culture we were talking about a few weeks ago when we started this series and you've gotta get a sense for, okay, maybe internally, maybe your coworkers, maybe your boss, maybe the people you work with, you've gotta be able to, sometimes you do things and you create habits without being open about it. Sometimes you have to be that way where you just don't respond to your email, you literally put the phone down, turn off your alarms, don't look at your email because really the most important stuff that happens is face to face. Second one is the stuff that you're actually talking to somebody on the phone. Email, again, like I said before, you're not gonna get an award or a certificate for answering lots of email. You look at job descriptions, you rarely see a job description that says lots of email and if you can process a thousand emails, you're hitting your mark. That's really about what the email represents and that's one of the things that you've gotta be aware of is that you've gotta be able to organize your day into okay, I'm gonna spend this much time on email. That commits you to not investing too much time into something that's not gonna reward you. So one of the things you wanna do is you wanna organize your emails, it comes in, you wanna organize your time and there's different ways to do it but Outlook has a lot of different ways that you can manage it. Got a few different, do you have any questions? I've got a couple things I wanted to go over. And so time management is obviously a huge thing. It's huge, yeah. And depends on your job, right? I mean, in our business, we can have a day planned out to the minute, right? What we're gonna do. And one phone call happens whether it's a fantastic sales opportunity or a fantastic problem-solving opportunity, right? One of those too, can completely change everything. So that's the hard part with, when you work in a small business. Now, if I worked for the government or something and the chances of something surprising me, I worked my butt off but the chance of something surprising me that's gonna be really day altering is probably pretty low, right? I've got my things I can do. I see that a lot.  They're driving around. They're on their tablets. They get home at the end of the day. And then they've got to sort through all these kind of things. So I think for dinosaurs like us, we're more most comfortable sitting in front. But just like now I was talking to my son and you ever heard that when I told him what we're gonna be talking about today. And he said, what's a fax machine? And he's 13, 14 years old. But he literally, he said, how does it work? And I explained, you put the paper in, it comes out the other side. And he, wait, how does it work? And he goes, why don't you just take a screen capture and send it to him? Yeah, I mean, that was his instant, tell me again why you do that? So, but that's these younger generation. They don't, I mean, they don't have folders. I mean, do you do folders on your mobile phone or do you create them on your PC? Well, so that's one of the, I can't live in the folders because of what you just said, which is oftentimes if you try to live in the folders, you're gonna get lost because now you've got 20 folders. Which ones do I check first? And David Allen talks about a tickler file. The other thing was, you know, the four hour work week by Tim Ferriss. That was one of the tips he gave was exactly that, which is segment your day, don't invest your time into something that doesn't have the amount of importance. But does anything written on organization before 2005 have any prevalence to the next generation to what we're in today?  I mean, that's, I don't think it's ever gonna change. Well, I say it's never gonna change, but that's when, how do you make somebody like you when all you do is email with them? Is entirely different from how I make you like me when we're face to face, right? How I look at you on my body. Anyway, so I say they're never gonna change, but that, you know, as we move more, I mean, if you're on the, if you live on the moon and I live here, how can I make you like me, right? So is there value in reading these ancient books from 15 years ago, from 10 years ago about organization and time management and that type of? I think email makes us more aware of what's actually functional. I think it's just a different method. So when we look at the technology, some things are timeless, how you communicate with people, the words you use, you know, sometimes we get into conversations with people and you hear something like that someone says something and then the response you get back is, you know what I mean. And an email, that happens all the time. I send an email, don't forget the office keys.  Make sure you don't forget the office keys. Guy comes back, hey, did you get the office keys? Guy says here, pulls out his keys from his pocket and shows it to me and I go, the office keys, the ones, the Microsoft office keys.  So, you know, are we doing it all? That's funny by the way. It's real funny. You know, what language are we using? What words are we using? You know, when we do training and when we do the handouts, we, you know, sometimes we have to ask people to, hey, this is a really good time to look at the documentation because when I'm not here, that's all you're gonna have. So, let's go through it exactly word for word. Because some people are just kind of like, let's go, go, go, go, go. With email, you know, we're processing so much information. You can use technology to facilitate some of it, but we still have to care about how much time we're sticking into it, how well we're communicating, when we're sending it, what are the words we're using. So, you know, there's definitely different techniques. Even we were talking on the way here, and one of the things we're talking about is, what about AI? You had talked in one of the previous shows about, when is, when are the programs gonna get smart enough to know that when I get an email from Matt, I probably need to look at it. Like, if he sends an email, I probably need to look at it because it's either urgent, important. What about VIP, right? The email program should be able to do that. And I think we'll get there. There's still some training of the AI that we're gonna have to do, but it's, I think it makes me pay more attention to how I communicate with some people. Well, and when you and I are chatting on teams, my Microsoft teams, and anybody that doesn't use Teams, it's really a fabulous, fabulous application. It's kind of the next evolution of Skype that's got presence and telephony, email chatting, and all those kind of things that either integrates with SharePoint, so I can share 10 gigabyte files with people and very, very seamlessly. But as we're chatting back and forth, I'll tell you something and then you'll say, and it's very clear to me that it's just, I'm getting an FYI, and then you say, oh, should I do this? I said, no, don't do anything. It's just an FYI. So, when you organize, how much responsibility should the sender have on making sure what they want is clear? And what I hate is, especially in internal, I have the answer for you. In internal things, I'll get an email, it's to you, but there's six of us C-seat. And I think, okay, what action are they expecting me to take? You know, how, how, how am I able to do that? So as a sender, I mean, is that training that we need to give people? Well, it's a culture you build because the answer to that, and this is not my quote, this is somebody else's quote, communication is what the sender does. So you have to be able, if you're going to speak, you know, I'm not trying to get, you know, philosophical on you or existential, but as we speak, we're trying to convey an idea. It's our responsibility, if we're going to say something that we get the clarification, the message was received. There's a lot of feelings involved, right? So the receiver's got to be mindful of how they're receiving the message, but it's really the sender's responsibility. And sarcasm is very hard to detect in an email, right?  It's hard to detect, so. The memes help. Yeah, exactly. I'm big on the memes, right? I started yesterday. I'm huge. I'm in, I'm locked into the memes, right?  I never would have thought that a business application would have had that in there. So real quick, real quick. All right. When we talk about organize, organize your time, organize your focus, organize your language. Who are you talking to? How are you going to convey that message? So this is outbound email. This is everything, even how you're receiving it. Like, you know, when you send an email and you're using language, where does that go? How is that landing with me? We have to remember that 70% of that communication is lost. This is 100%. An email comes in, I'm only getting 20, 30% of that message. How we've got to organize ourselves and go and get in the right frame of mind and say, I'm receiving this email from this person or I'm sending it out when, how, what. Don't use too many words. Don't ask too many questions. I'm classic for that. My emails tend to be a little longer. Well, and I think it was Mark Twain who said, I wanted to write you a short email. He didn't say email, but I wanted to write you a short email, but I didn't have enough time, so I wrote you a long one instead. That's a skill to be brief and brevity. More communication is better. Yeah, so okay, and you can't let emails pile up. No. A lot of it, I think, is disciplined. It is. Like for a little while, I was going with a zero inbox. I said, okay, before I go to bed, my inbox is going to be empty. That's hardcore. I worked for about two days. We did that. All right, so just to get people a preview, so mop, so we've done minimize, we've done organize, and what is peak? Prioritize. Prioritize. Okay, you heard it here, all right. So again, this is Matt Darnell and Greg Jackson with Supporting Your Tech. Tune in next week, week after next, and we'll be talking about prioritizing and how you're able to help manage your email inbox. Aloha.