The final item of business this evening is a member's business debate at 5992 in the name of Carol Mawchen on Allied Health Professions Day 2022, helping people to live their best lives. The debate will be concluded without any questions being put. I would invite members who wish to participate in the debate. The presser requests to sweep beat buttons now or as soon as possible. I call on Carol Mawchen to open the debate for around seven minutes, Ms Mawchen. Thank you, Deputy Presiding Officer. It is an honour to secure this debate tonight, and people will know that it actually is a debate that was moved. It was tonight, an evening, that we were in the chamber voting, and I believe the HPs who are with us, there were many more on the evening, had an event in the Parliament, which I believe was very successful. So we were voting, they were having a successful time, they tell me it was networking, but I have heard that there was a bit of a party that went on as well, but it is absolutely lovely to see here in the chamber tonight. This debate presents an opportunity to celebrate the work of Allied Health Professions in Scotland to recognise their contribution, but also to highlight the challenges and difficulties they face as the third largest workforce in Scotland's health service today. However, I will start by saying hello to the gallery again, but also to those who are watching on parliamentary TV, because many people were not able to come through for a second time, but I am assured that a number of HPs watching is this evening. They have come, I am sure, not just to hear words and soundbites about how much they are valued, but also to go away knowing that this Parliament and this Government will take action to show how much they are valued. HPs are a diverse group made up of 14 professions, and I take the opportunity to ask members to visit them whenever they can. The Allied Health Professions day was on October 14, so we have obviously missed this date, but I think that there still would be opportunity for members to go in their constituencies and visit HPs around their regions, and I am sure that they would be very welcome. I also want to say thank you to members from every party represented in this Parliament who supported the motion that went through and allows us to debate tonight. Further highlights the recognition that HPs deserve and confirms that there is an interest in the Parliament to debate the ways in which HPs have improved and support people in the community. On behalf of Scottish Labour, I thank our Allied Health Professions for what they do every day across the health and social care service and networks, and I hope that they realise that we are pleased to have them here with us today. Allied Health Professions day is about helping people to live their best lives. Like other health service workers, HPs continue throughout the pandemic because although buildings were closed and, in some ways, lives were put on hold, the difficulties facing many of the Scottish population remained, and it was incumbent on HPs and other health professionals to continue to deliver services against that backdrop of a pandemic that was taking lives in every community. We thank the HPs for that continued work through those very difficult times. They deserve a huge credit, and I am pleased to be able to put that on the record here in this Parliament this evening. Some in the chamber will know that I started my working life with a career in dietetics, one of the Allied Health Professions. It is not an exaggeration to say that it set me up for a life in politics like no other. It was a job that I did for nearly 20 years, that I met so many lifelong friends, patients and service users that shaped my life and my belief system. My friend Michelle was at the event, which is not in the gallery today, but I know that she is watching. We met in the matriculation queue at Queens College Glasgow, and I am absolutely sure that Michelle does not wish me to divulge how many years ago that was. At that time, the professions were in different areas, whether you were a physio, dietician or occupational therapist or some of the many professions. However, I know that in my time and knowing some of the students coming through, it was an area where you were well supported as a student. We were always thankful for the support from the colleges who trained those professions as well. I met patients who needed assessments and treatments throughout my career. They showed me kindness and strength of character when often they were facing life-changing illnesses. What I describe as the best job ever, I met service users because I was one of the HPs lucky enough to go into the field that was really about society's role in maximising the best life possible in my job with their disability services. We worked across communities as many HPs do. That nicely leads me to discuss some of the diverse services that HPs provide and the overall aim of that work. The umbrella term well-being can have many meanings depending on who you might speak to and what well-being means to you. For HPs, well-being is, as mentioned in today's debate title, helping people to live their best lives ever. Everyone will have a different view of what their best life is with different end goals, targets and indeed means of reaching those targets. It is the first-class assessments, treatments, specialised groups and community work of HPs in Scotland today that helps them to get there. When members visit local HPs services, they will be greatly impressed with the diverse work and working styles that this group of healthcare professionals undertake. It is my view, my long-standing view, that health provision delivers best when it is local and on the doorstep of those most in need. Health provision delivers best when services go to people rather than waiting on people coming to the service. In a world of digital communication and over-the-phone appointments, it is so important that we maintain strong connections with our communities, utilising the expertise and work of our HPs. That allows them to do just that. As mentioned in the motion, prehabilitation, early intervention, prevention and rehabilitation are four key areas where allied health professions play a significant role in the development of strategy and in the delivery of services to meet the needs of all of Scotland's population. It is in local health centres, community hubs, schools and local third-sex organisations and beyond that allied health professionals need resources to provide that service and allow people to make the best life possible. It is in towns and communities that we know are suffering due to the impacts of the cost of life in crisis where the work of HPs are most impactful. In towns and communities that have been impacted by austerity agenda from the Tories and Westminster and we cannot forget in towns and communities where there are impacts of cuts to local councils and services. Although we come here this evening to commend the work of our HPs, the contribution they make to health and social care provision is the third largest workforce in our health service, I cannot, in good conscience, make my remarks without calling out the actions of Governments in this Parliament and at Westminster. I know that the minister would expect no less of me in that regard. Early intervention in particular is a key area across many services in speech and language therapy, physiotherapy, occupational therapy and beyond where there have been significant failings at a national government level putting considerable pressure on the ability of HPs to deliver those vital services. Therefore, it is important that we hear from the minister tonight how the Scottish Government will deliver clear plans for supporting HPs in the workforce focusing on prehabilitation, early intervention, prevention and rehabilitation. A HPs are in the gallery tonight not just for warm words but to hear clear plans for actions and investments. It is right, however, that we thank the HPs again and I thank the members for joining me in the debate tonight. Thank you, Deputy Presiding Officer. I encourage those who have not yet done so to press the request to speak buttons. I call Christine Graham, who will be followed by Tess White, for around four minutes. I congratulate the member on securing this debate, which focuses on what White term the unsung of the health service. Indeed, if you were to mention to someone at the bus stop that you were speaking in a debate applauding the contribution of allied health professionals, then I suspect that many would not know who you were talking about. But, of course, it is a whole vital range of professionals that most of us have dealings with over the years. It includes a wide variety of expertise. In therapy, for example, it includes art, drama and music therapists. Those therapists help mental and physical wellbeing. There are also the more well-known, perhaps physiotherapists occupational and speech therapists. It also includes radiographers, both therapeutic and diagnostic, podiatrists and, of course, the paramedics. That list is not conclusive. Their professionalism extends well beyond the medical interventions but, as so often, the TLC, tender loving care, the good words, the kindness, the listening to the anxieties of their patients. Those professionals are essential to the wellbeing of my constituents in Midlothian, South Tweeddale and Lauderdale and, indeed, myself. I have had to use the professional services of a physio on more than one occasion, and I can tell you I am thankful for that. Similarly, a podiatrist who was taking referrals during Covid, I have decided since then to take much better care of my feet. They are more important to me than I ever knew. The intervention of these health professionals cured me of pain and increased my mobility, as they do for many others.  It is also therefore saving pressure on our GPs, the NHS and our hospitals. There is no doubt, too, that, as the population ages, and I know what I am talking about, we will need more therapists in particular physios. However, I will now turn to the work of paramedics in our ambulance service. They provide specialist care and treatment to patients who have been involved in accidents, emergencies and other crises, and need the ability to make swift decisions and stay calm and calm their patients. Often arriving before a GP and ensuring that patients are stabilised and enroute to hospital without delay. Two examples. A few years back, out with the Borders Police and patrol, there were small hours over a Saturday night into Sunday morning. We were called out blue lighting to a Borders town where a poor woman had thrown herself from a bridge on to the river below. The river was low, so she fell on to rocks. I watched police, fire and rescue and paramedics in synchronised action, without a word having to be exchanged, each playing their part in that rescue. Police sealed off their own fire and rescue and lowered equipment to the river level to raise it up, and paramedics were already there, had descended and wrapped the woman in foil and placed her in a stretcher. The second event was in the course of my profession as a solicitor. I had the tragic case of a woman who tried to cross a railway line, nearly managed to haul herself on to the platform but fell back and was hit by the train, trapping her underneath. The driver was about to move the train but was stopped by the paramedics as the wheels were acting as a tourniquet on her legs. To move would have made her bleed to death. They had crawled underneath the train, covered in hot engine oil, comforting her and taking those early medical interventions that saved her life. Now, not all call-outs are so awful, but many involve road traffic accidents, and like other services that I have already mentioned in attendance, police and fire and rescue may need cutting equipment. They face sights that many and must do impact on them. In conclusion, I thank the member for bringing forward this debate and thank all who work as those allied health professors. I hope that anyone listening to this now realises exactly what allied health professionals are. Thank you, Deputy Presiding Officer. I thank Karen Mocken for securing the parliamentary time to mark allied health professionals day 2022 after the debate was delayed last month. It's great to see people in the gallery here today. I hope that my colleague Ms Mocken is going to get you a hot cup of tea for braving the weather to get here. This is an opportunity for us MSPs not just to thank allied health professionals for the work they do and their commitment, compassion and dedication during the pandemic but also to reflect on the contribution that AHPs can make to the delivery of healthcare and public health more generally. AHPs make up the third largest workforce in NHS Scotland, employing just under 13,000 allied health professionals. Their impact on their patients' health and wellbeing cannot be overstated. The new mother who needs postnatal physiotherapy following the birth of her baby, the victim of a car accident who needs a prosthetic leg and lifelong care, the young child who is struggling to talk and who would benefit from the intervention of a speech therapist. For sufferers of neurological conditions like Parkinson's, a multidisciplinary team spanning a range of allied professions can have a huge bearing on their quality of life. As a fellow of the Chartered Institute of Personnel, I do feel qualified to say this. There are unfortunately high vacancy rates in the allied health professions and they have almost doubled in the space of four years, from 4.4% in March 2018 to 8.2% in March 2022. The number of vacant AHP posts has increased by 43% in a single year. The new mother who needs a physiotherapist to help her postpartum recovery is having to wait weeks to be seen. In NHS Grampian, the wait is around 24 weeks for routine pelvic dysfunction physiotherapy. Many women are seeking private treatment because NHS waiting lists are simply too long and as we seek to address the gender-related health gap, this risks only further entrenching inequalities. I've challenged the health secretary many times on the SNP's plans for NHS recruitment and retention. NHS workforce planning is a massive issue and one that the SNP has managed to get spectacularly wrong. We know the coming months are expected to be extremely challenging for Scotland's NHS. The Scottish Conservatives believe that we would utilise AHPs to their maximum potential in workforce planning, the diverse skills and expertise of the allied health professions can add a huge amount of value to primary and secondary care, but we need to ensure that supply is commensurate with demand and that the NHS is able to keep the AHPs that come through the pipeline. Finally, against the background of potential strike action by NHS staff over the coming months, it's especially important to understand the pressure that they're working under. They're tired and overstretch, and their voices must be heard. I thank Carol Mockin for bringing this debate forward, marking allied health professions day, sadly slightly delayed, but nonetheless, importantly highlighting the vital role of our allied health professionals in health, social care, education and the voluntary sector. Their tireless commitment during the Covid-19 pandemic and the positive impact that they have on people's lives. I think of my own experience, the compassionate response to my elderly father from occupational therapists after he fell through a glass door and completely lost his confidence. The radiographers who x-rayed my son's broken arm on three separate occasions at the Royal Aberdeen Children's Hospital and the physiotherapists who patiently supported my brother-in-law learned to walk again after a life threatening stroke. We know that people are emerging from the Covid-19 pandemic with increasingly complex health needs, and the approach set out in the right to rehabilitation and the once-for-scotland rehabilitation framework recognises the demand associated with pre-existing long-term health conditions and people living with the long-term effects of Covid-19. It's important to acknowledge other pressures, staffing and recruitment challenges, our ageing population climate change and health inequalities so starkly brought into focus recently in the Glasgow University report linking austerity measures with excess deaths in Great Britain. However, today is about recognition and appreciation of the contribution made by a skilled, experienced and committed allied healthcare workforce. I very much welcome additional funding for psychological therapies and interventions, the launch of the national conversation to improve support for people with dementia and their carers, and this week's announcement of £37 million of Scottish Government funding over the next four years to help future proof our NHS against rising demand. There is no doubt that we are experiencing radical changes in the delivery of healthcare, as such the knowledge and skills required by our allied health professionals has changed too. I would like to cite an example of a small-scale but innovative approach that is supporting students in their practice-based learning. The School of Health Sciences at the Robert Gordon University in my constituency in Aberdeen South and North Concardin has been leading a very contemporary community-based education opportunity, bringing tangible benefit to older people in the most deprived areas in my constituency. The Thursday physio drop-in is a weekly student-led physiotherapy clinic comprising an over 55 exercise class, advice on mobility, posture and strength, all followed by a cup of tea in a familiar setting within walking distance of their homes. Building on that, a new student-led law clinic recently launched in a busy GP practice in my constituency will offer law students the opportunity to gain experience, providing free legal advice to people on low incomes. Barriers to health and wellbeing are complex—housing, finance, negotiating consumer rights—all barriers to the basic requirements of a healthy life, our best life. A first in Scotland, the community law clinic, is connecting justice and allied healthcare to tackle the root cause of issues that contribute to poor mental health and physical health, particularly relevant during the on-going cost of living crisis. I commend Hannah Monego from the Robert Gordon University and Dr Adrian Crofton, lead clinician at the Tory medical practice and everyone else involved in establishing this truly multidisciplinary project. To conclude, I commend all our allied health professionals for their commitment, resilience and contribution to making life better for us all. I again thank Carol Mocken for bringing this really important debate to chamber this afternoon. I thank my colleague Carol Mocken for bringing forward this motion to celebrate allied health professions day 2022. I am grateful for the opportunity to contribute to the debate. Carol, of course, normally replies to members' debates for the health team, so I am delighted that she is leading one herself today. Allied health professionals include 14 different professions. Christine Graham outlined almost all of them, including physiotherapists, radiographers, podiatrists and dieticians, all of them who help us to live better and healthier lives. The work that they do ensures that our approach to health and social care is holistic and is based on prevention. In many of our areas, there are also community link workers working with physiotherapists in the main and helping people to improve their social, emotional and physical wellbeing through prescribing a daily practice of exercise, helping them to develop a healthier lifestyle. However, those key posts at community level might now be under threat because the Government have stripped £65 million out of the primary care improvement fund, some of which paid for these posts. It would be helpful if the Minister could clarify in closing that there are no plans in place for these much-needed additional staff to be cancelled as a result. In our hospitals, for those who are unfortunate enough to succumb to ill health or suffer an accident, it is the allied health professionals working in radiology who perform the scan to help diagnose the disease or injury. It is the allied health professionals who work in prosthetics who do life-changing work in developing and providing artificial limbs to patients who previously thought that they would not be able to walk again. For those suffering with perhaps daily pain and discomfort in their feet from conditions like arthritis, it is the allied health professionals working in orthotic services who can help people improve the quality of their life. In every aspect of our health and social care system, it is allied health professionals who are central to its delivery. However, we are seeing record numbers of vacancies in our NHS with profound consequences for patient care and safety. Over 1,150 of them are in allied health roles. Concerns have been raised around the number of physiotherapists in Scotland that make up the largest area of vacancies within the allied health profession. Statistics show that, although university programme numbers in England have risen by 83%, the increase in Scotland is only 4%. There is a similar story with a lack of radiographers. The Government must really do better at workforce planning or we will store up problems for the future. However, the problems are not just in recruitment and you will forgive me for being parochial. In my constituency, the Vale of Leven hospital physiotherapy service has had to share its location with the minor injuries unit as a result of Covid. They were happy to do that, but they are now being relocated to another part of the hospital, which frankly is unsuitable. Consequently, they are only able to see fewer patients than before and the service suffers. The Government needs to prioritise the remobilisation of rehabilitation services, especially in NHS Greater Glasgow and Clyde. It is vital that we do more to not only attract people to those roles but to retain them, too, with decent working conditions that allow them to do their job. Given the pressures that the NHS will face over the coming winter, what the AHPs do around early intervention, prevention and rehabilitation strategies should be at the forefront of our recovery plans, with full support and fair wages given to staff. In closing, I want to take this opportunity to pay tribute to all the allied health professionals who work tirelessly in health and social care across Scotland. We need to support and value them as we work towards our shared objective of helping people to live healthier and better lives. I now call Stephanie Callaghan to be followed by Gillian Mackay for around four minutes. I am delighted to be able to reschedule this debate and celebrate allied health professionals tonight. It was definitely a party the last time from what I saw, and I hope that you all will be partying again tonight as well. When we think of our NHS, it is usually images of doctors and nurses that spring to mind, but the 14 allied health professionals make up the third largest group of healthcare workers in our NHS, and others, including Christine Grahame, have identified these tonight. Allied health professionals play a vital role in the delivery of health and social care services to people across Scotland, and they are rightly valued by professionals, patients and families alike. We have watched our healthcare professionals go above and beyond the call of duty over the past few years, not just adapting their practice, but sometimes their whole lives and showing a selfless determination to provide essential care to others. That includes our allied health professionals, and many of us are forever grateful. Allied health professionals often help reduce or remove the need for medical interventions, helping drive service improvement and sustainability across community and acute sectors, and they are set to play a vital role as we build a national care service fit for Scotland's people. A couple of local stories. In South Lanarkshire, the actual autism hub supports autistic families, including my own, and I remember quite a few parent career sessions organised through the arch with a range of AHPs. The one that stands out most in my memory was a visit from an occupational therapist, and what she did was set out some tasks designed to give parents a flavour of how autistic kids experience the world. For the first exercise, all the parents were given a set of boxing gloves and were instructed to open a packet of crisps, and trust me, it's not easy, it's almost impossible. Next, we were handed a set of binoculars, and we had to turn them around back to the front so that everything looked really, really wee, and then try to step inside some empty boxes. To be honest, it was absolutely hilarious, and I won't ever forget that feeling waving my foot around as I tried to land it inside a large box when my proprioception was thrown right off-kilter. It was really simple, but it was really, really effective, and I was able to experience my child's challenges for myself, and I'm still really grateful to that O.T for giving me that little window into his world. It inspired patients when my child struggled with tasks that others perceived as being really easy, and it really did make me a better parent. Arch also works with a couple of allied health professionals from NHS Lanarkshire, who are trained as specialist autism advisers. They deliver a range of workshops focusing on sensory issues and life skills such as eating, washing and dressing, and offer lots of practical strategies that empower autistic people to really go out there and live their best lives as independently as possible. These AHPs are often described by colleagues as superstars. In Ramon Hutchison, the project coordinator talks enthusiastically about their passion, their curiosity and empathy as they work with families to really understand and support them through the challenges that neurodiversity brings. A second organisation in my constituency, Enable Scotland, places huge value in the allied health professionals that they work with, highlighting their skilled approach and input to multidisciplinary teams as they work to support individuals with really complex needs. I'm told their focus in achieving those outcomes that really matter to individuals is always key from supported self-management to rehabilitation and therapeutic services. Enable Care told me the story of a young Lanarkshire man who spent several years in hospital and how they eventually secured a home where he could live at home in the community with support. That was far from a simple task. It was fraught with complexities and difficulties and it took a long time, but the team's determination actually made that happen. The support of AHPs was really, really critical. It just couldn't have happened without them and this young man got his life back. Presiding Officer, it's only fair we celebrate and showcase the contributions that AHPs make to individuals in our society. So to all our AHPs, we see you and we thank you tonight. Thank you very much, Ms Callaghan. I now call Gillian Mackay, who joins us remotely, who will be followed by Emma Harper. Ms Mackay, around four minutes please. Thank you, Deputy Presiding Officer. I'd like to thank Carol Mocken for bringing forward this evening's debate and thank all those allied health professionals in the gallery and across the country. Tonight's debate gives us an important space to discuss the valuable work by allied health professionals, the length and breadth of Scotland. Allied health professionals, as we've heard, are a wide and varying collection of professionals, including speech and language therapist diagnostic radiographers, art therapist, podiatrists and many others. Those professionals play a vital role in supporting and improving patients' wellbeing in health settings and across our communities. I'd like to thank Movement for Health for their work in highlighting the great work done by allied health professionals on a range of issues. Amongst their policy asks, they highlight the importance of social prescribing, an issue that I've raised many times in the chamber and in committee. Though we all recognise the importance of our physical health, the importance of wellbeing is becoming an increasingly familiar part of the dialogue within discussions on health. EHPs have the potential to support a wider transition towards more preventative health interventions and for many provide vital support, without which some may have had health issues deteriorated. Social prescribing can allow for more individually orientated healthcare provision. That approach puts the individual at the heart of decision making and outcomes, as opposed to pre-subscribed or genetic outcomes. Without such talented allied health professionals trained across so many various sectors of healthcare, policy initiatives like social prescribing would surely not be possible. In Lanarkshire, in my central Scotland region, there's a well-established social prescribing programme that's been shown to help people by improving self-confidence and self-esteem, reducing low mood and feelings of stress, and helping people to develop positive ways of coping with the challenges of life among other benefits. We must view the relationship between health and wellbeing this way, with both necessary and where helping one improves the other. I must also thank movement for health for highlighting some of the issues raised in the health committees tackling health inequalities in Scotland report. As noted in the report, community link workers are one of those services linking the wider array of allied health professionals to those in the community. One of the report's recommendations was to further embed community link workers across GP practices in Scotland. Community link workers have the potential to further support health and wellbeing and allied health professionals, particularly in areas of deprivation on poor health outcomes, by tying in the expertise of a wide range of social, mental health and physical healthcare providers, including AHPs, and by being able to advise patients on financial and social security issues. As we've heard, allied health professionals make up the third largest workforce in the NHS. Much like other sectors in the NHS, appropriate resourcing is essential to the delivery of good health and social care. Brexit has been a significant driver in recruitment issues in our NHS, and I'm sure many colleagues across the chamber will share my alarm at the announcement of £18 billion worth of public sector spending cuts. The knock-on effect that those cuts would have in Scotland's public sector could be really damaging. As parliamentarians, we have to acknowledge those real and prevalent challenges, especially with the cost of living crisis and the impacts of the Covid pandemic, and ensure that allied health professionals don't just hear our warm thanks but our support in their delivering crucial health and social care benefits, and that they are not left behind in those circumstances. Thank you very much indeed, Mr Kayert. I now call the final speaker in the open debate, Emma Harper, for around four minutes, Ms Harper. Thanks, Presiding Officer. I, too, congratulate Karl Malker on securing this debate. As we've heard already, AHPs encompass a range of health professions, and they make up the third largest workforce in NHS Scotland. I know Tess White said that as well. I, too, welcome those to the gallery in your Parliament this evening, and so it's great that you've came out here this evening. AHPs include dieticians, occupational therapists, orthoptists, physiotherapists, speech and language therapists and, among many others, that have been named as well. Notice how I said dieticians first, Karl. I learned so much about insulin and carb ratios and counting carbs to help manage my type 1 diabetes from a fab dietician, so thank you for that. The breadth of AHP skills and their reach across the age continuum—the third sector, communities and health and care settings—makes AHPs ideally placed to be leaders within the public health environment. Their expertise is used to support prevention, self-management and promote wellbeing, and it's right that we celebrate the contribution of AHPs to the health of the people in Scotland as well as to the prevention agenda and our NHS. Even before the Covid pandemic Scotland, like the rest of the UK, was facing a number of significant public health challenges due to its change in demographics. That change in demographics is driven by improvements in life expectancy of people living longer, but, along with that, people are having fewer children and having children later in life, as well as younger people moving away from remote and rural areas, such as my South Scotland region, towards towns and cities. We know that that brings both opportunities and challenges for the delivery of public services and society at national and local levels. Those challenges have broadened the need for AHPs to ensure that people are being seen by the most appropriate skilled professional. AHPs act as a catalyst by champion prevention and beneficial lifestyle changes to improve health and wellbeing, thus maximising an individual's potential to live full and active lives, so that people can thrive. AHPs can significantly improve productivity, quality and effectiveness by working in collaboration with their medical, nursing and social care colleagues. Complex problems require teamwork within the multidisciplinary team. I know from my former NHS colleagues and from my direct working life in my previous NHS clinical role, that AHPs support patients' flow throughout the whole health system. AHPs are experts in assessment and rehab, and their expertise brings different ideas and perspective to the delivery of services. The role of AHPs is integral to many clinical pathways. However, there is always a huge opportunity to increase and better utiliser AHPs, including them in such as NHS leadership roles. Carl Mawchen is right to ask members to visit local allied health professionals. Just last week, I visited Specsavers in Dumfries, where I was met with her director of NHS services, Stephen McAndrew and the Specsavers' Dumfries director, Elaine Campbell. I was totally impressed by how Specsavers have worked with the Scottish Government, particularly over the pandemic, to ensure that patient needs were met. We discussed glaucoma, visual impairment, vision loss and the excellent knowledge and skills of the team in Dumfries. Specsavers and other optometrists have a demonstrated track record of improving eye health and of dealing with eye problems to avoid hospital visit or admission. I also heard how they are now moving in to do more work to do with audiology. I said welcome an update from the minister on the Scottish Government's work to support and enable audiology into primary care and to ensure access to audiology service for all, as we know it can contribute to productivity, people staying in the workplace longer and they have a better quality of life. I welcome the work of the Scottish Government in committing to raising greater public awareness of the work of AHPs, including through the Scottish Allied Health Professions Public Health Strategy Framework Implementation Plan. With our NHS under so much pressure currently, I would ask if the minister has plans to increase the awareness raising efforts so as to ensure that people are being seen by the most appropriate professional and to prevent secondary admissions to hospital. In closing, AHPs do a fantastic job every day and I thank them all for what they do and I agree that we need to increase awareness of the invaluable role and the contribution of allied health professionals. I invite the minister to respond to the debate minister for around seven minutes please. Thank you very much, Presiding Officer. I'm very grateful for the opportunity to close the debate on behalf of the Scottish Government and I'd like to thank Carol Mocken for moving this motion. I have to say that when I arrived at that reception after many hours of sitting in this chamber it was an absolutely full swing and I was reminded as I have been many times in my professional life of just how can do allied health professionals are. They didn't wait for the politicians, they just cracked on and got on with it. I'm acutely aware that when some people think of our health service they think of ambulances and operating theatres and of accidents and emergencies but what today's debate has shown is the extensive and multidisciplinary roles played by the third largest healthcare workforce our allied health professional community. From physiotherapists to art therapists, from radiography to podiatry, across health, social care, housing, education, prisons and more it is our 14 unique allied health professions who so often are at the forefront of delivering healthcare in this country and I want to thank each and every one of them for the invaluable role that they play in our society. The past two years saw the world face a once in a century event, one of the biggest crises our health service has ever faced and our society has ever faced. The gravity of the situation weighed heavily on the HPE family but day after day they found innovative new ways of working they are can do. I was awd by the way they rose to the challenge. This country and its people owe all the HPEs a debt that can't be repaid as we continue along our road to recovery we will continue to rely on the HPE community to see us through and now it's more important than ever to take an explicit public health focus on how we prioritise the delivery of health and social care. The breadth of services that HPEs provide in communities schools and health settings makes them ideally placed to continue to build on good practice and public health with their focus on early intervention prevention and well-being and that's why the Scottish Government supported the development of a united and collective approach to public health for the HPEs as set out in the Scottish allied health professions public health strategic framework implementation plan. This implementation plan signals a key milestone in expanding the role of HPEs in promoting public health in Scotland along with goals and actions needed to realise this vision. The overall ambition for the role of allied health professionals in public health has been set through collaborative work across the four nations with the development of the UK HPE public health strategic framework 2019 to 2024. It has been important to ensure that the ambition and the goals from the UK strategic framework are relevant in Scotland's unique context and a national oversight group is currently being established. That group will build momentum and monitor progress as we implement the strategy at local level. The Scottish Government recognises the need to recruit and train the next generation of these professions. The Government believes in the power of education and we want anyone with an interest in delivering health care to see a viable path to professional registration and ongoing career development, whether that's investing in a real difference making bursary for paramedic science students worth 10,000 per year or the three tuition fees that are a guarantee for all undergraduate HPEs students or through our commitment to increase reporting radiography training places by 30 from 2020 to 23 as part of our integrated workforce plans. To date 35 students have been funded to complete this training and in addition funding was made available to train 12 assistant radiographers. We've also committed a total of 4.5 million to increase musculoskeletal physiotherapists working in primary care through a funded scheme to increase the number of graduating physiotherapists working in the NHS. 37 students are due to complete their training December 2023 with a further 53 students due to complete training in December 2024. In addition, our funding of the type 2 diabetes prevention framework has enabled the expansion of the dietetic workforce in Scotland and increased patient access to expert dietetic care. With NHS Education Scotland we're investigating the need for dieticians to work in new roles within primary care settings such as GP practices to deliver more prevention, early detection and early intervention as part of the multidisciplinary team. We have also produced a once for Scotland rehabilitation approach published in June 2022 and based on the six principles of good rehabilitation it addresses the challenges of individuals who are emerging from the pandemic with increasingly complex physical and mental health needs that require rehabilitation and the approach has been developed with NHS health boards health and social care partners and third and independent sectors and recognises the crucial role that allied health professionals play in rehabilitation. Finally, I want to mention an investment that I'm really delighted with. Over the next three years we're investing in a new programme of work to support early intervention so that our speech and language therapists come work with our children and their families helping to build confidence and capacity for staff working in early learning and childcare settings, joining up the efforts from across key public services such as health visiting. Colleagues across the chamber have highlighted some unique examples of how EHPs continue to shape the delivery of healthcare across the country but what does the future hold for these professions? How can we make sure that the current approach is consistent with the needs of the people of Scotland both now and in the years to come? That's why the Government's carrying out a review of allied health professional education and workforce led by Scotland's chief HPE officer Carlin MacDonald. Leaders across the profession are working collaboratively and at the centre of the review offering their guidance to chair important work streams or dedicating their time and expertise as a member of the wider oversight group. The scope of the review is unashamedly wide-ranging, looking at the whole system. Everything from recruitment to advancing practice to educational delivery models are being considered and we're doing it in partnership with the EHP community because their continued participation and leadership in this space is absolutely vital to its success. I want to close today's debate by thanking all those who've participated and shared their stories of this inspiring group of professionals. Today we've helped to shine a spotlight on these important roles. Occupational therapists might never have their own BBC drama or maybe my OT pals are going to tell me different. Dietitians might not get a running commentary on the evening news, but each of these unique 14 professions should be celebrated for their continuing commitment to their vocations and the care and support that they provide each and every day across our communities. Now whether that's the physio helping a patient to find their feet after a catastrophic injury or the art therapist providing a means of expression for people in the justice system, they are so often working in areas that we would never think to look. I hope that what we've said today demonstrates the regard in which this Government holds our EHP family. Thank you Presiding Officer. Thank you very much Minister. That concludes the debate and I close this meeting of Parliament.


Hey everybody, this is Brian and welcome to the first Python tutorial. I've been wanting to do Python for a while, I should dispel a few myths first.  So everybody thinks of this little guy right here. It's actually not the case. Python's been around for a long, long time and it was actually named after the Monty Python. If you have no idea who Monty Python is, I feel very sorry for you and you should Google it because they're hilarious. Their comedy is actually timeless. But it's the whimsical nature of Python. It's the language that's tried to emulate that. So if you go to python.org, we'll be working with the newest version, Python 3.43, that may actually date this video at some point if they drastically change Python. But you'll see it's available for Windows, Mac, Linux and pretty much everything in between and it even comes with full source code. Some things you should know about Python before we get started is they really say batteries include this kind of the lingo here for Python and that's, I've got to agree with it. It's very powerful and it's not very chatty and what do I mean by chatty? Some programs you have to write hundreds of lines of code just to print something on the screen. Python, it's just dirt simple. And if you're in a university, a lot of universities are actually replacing Java with Python as the learning language. So I wanted to kind of get into it. I have a heavy security background and Python has actually become the language of choice among hackers. Not all hackers, but a vast majority of them love Python because it's just very easy to work with and very powerful. Python does come with a built-in IDE called idle, which I personally cannot stand, especially for teaching purposes. So I'll be using JetBrains PyCharm.  Now, that disclaimer being said, I am not going to hold your hand through this whole process. We're going to take our seat belts off and dive right in. So let's just go to it, maybe, if I can find PyCharm. There we go. So we'll load up PyCharm. I'm using the Community Edition 4, which is absolutely free, and I'm just going to kind of move the window out here. I should note that you're going to need Python installed before you do this, and you'll know because if you go to create a new project and you don't get a Python version here, then you need to do something about that. And what you do is you go out to python.org, download the version that's right for you. If you're on Windows, it's just a normal install or click next, next, and you're done. If you're on a Linux, Unix, BSD, Mac, whatever derivative, you're going to actually have to compile it by doing slash configure. And if you've done this before, you've done this a million times, you just go into the directory, you do slash configure, make test. Make test on my machine actually failed, but then you do sudo make install. It actually installs it as Python 3. So you can open a command line here and you'll notice if I just type Python, it says Python 276, which is the older version. So I'm going to control D out of there. I'm going to do Python 3. And there's 343, that's the version we'll be working with right here. So just bear that in mind if you have the old version of Python, you'll want the new version for these tutorials. And when I say old and new, I should really explain that when you go out there, and let's actually just rewind here a minute, when you go out to Python, you go to downloads, you'll see, you get the option between 34 and 279. The reason is back in, I want to say somebody out there will correct me if I'm wrong because the internet's full of experts, but it's like Python 2.5. They actually made a radical change to the Python libraries. I shouldn't say radical, radical enough that it broke legacy code. So they've kind of branched it off here. So they've got the old version of Python and the new version of Python. And there's some gotchas. So if you try to use my code with the old version, it just simply won't work because it doesn't understand what you're trying to tell it. So just bear that in mind, you'll need the newest version. Why am I starting off with the newest version? Well, eventually the old Python will get phased out and render my tutorials useless. So what's the point of wasting my time in yours? All right, so once you've got Python set up, if you're kind of like a little computer nerd like me, you're going to want to look and see what's in here. And you'll see there's the Python binary. And there's all the little files that it created. Pretty awesome, huh? And if you go out to use your local bin, you'll actually see there's the the symbolic link for Python 3. Jumping back into PyCharm here, we're just going to pick the newest version. We're going to call this videos. Why not? And hit create. And ta-da! There's PyCharm and all its glory. I'm going to resize this a little bit here. Now I know I'm probably going to get a million messages saying why are you using PyCharm? There's better IDs out there. You know, I tried a few of them and I wasn't impressed with a couple of them. So I just, I really like PyCharm. I don't know what it is. I'm not in any way affiliated with their company at all. I haven't even bought the product. I just really like the ID. All right. So first thing we're going to do is make a Python file. And we're going to call this, hmm, we need a descriptive name. Let's call it video1 because this is our first video. And you see this author root shell. Well, that's my username on my computer. So I'm going to change that for future tutorials. And it puts that in there automatically for you. Now we are going to do the obligatory hello world program. And what do I mean by obligatory? In every language, your first introductory program is hello world where you literally just print hello world on the screen and it's this big awe inspiring thing and there's harps and kittens and rainbows and don't expect fireworks. It's actually pretty fast in this one. You just do parentheses and then quotes hello world.  And that's actually why I chose pie charm because it's very easy to see what's going on. There's no magic behind the screen and you can see everything that's going on here. And if there's an error, it'll print it out, you know, pretty plain English here. If you try this and you get an error message, it's because you're running the old version of Python, which is expecting something like this hello world, which as you can see, it's saying, hey, you know, end of statement expected. Now, if you don't know what a statement is or any of that, you're very new to computers. Don't worry, we're going to cover all this in future tutorials. That's it for this tutorial. Like I said, painless, no fuss, no muss, we're going to dive into these head first and you really should go out to my website voidrealms.com and click on tutorials and it's not there yet. But I will add a Python folder in here and the source code for this and all the other tutorials I've done are out here. Also visit Facebook and join the void realms Facebook group. There's like 200 programmers in there. So if you have questions, instead of emailing me and waiting six months for me to find your email, it's much easier just to say, hey guys, I got a question. Thanks for watching. I hope you found this educational and entertaining.


Halloween 6, The Curse of Michael Myers, is directed by Joe Chapelle. No relation to Dave Chapelle. No, sadly. Imagine if Dave Chapelle directed a Halloween movie.  Yeah, I think it would.


We know that vegetarians tend to be slimmer, but there's this perception that veg diets may be somehow deficient in nutrients. So how's this for a simple study? Let's just analyze the diets of 13,000 people and compare the nutrient intake of those eating meat to those eating meat-free diets. They found that those eating vegetarian were getting higher intakes of nearly every nutrient, more fiber, more vitamin A, more vitamin C, more vitamin E, more of the B vitamins, thymine, riboflavin, more calcium, magnesium, iron, potassium, while at the same time eating less of the harmful stuff like saturated fat and cholesterol. And yes, they got enough protein. And some of those nutrients, look, are the ones Americans really struggled to get enough of. Fiber, vitamins A, C, and E, calcium, magnesium, potassium, and those eating vegetarian got more of all of them. Even so, though, just because they did better than the standard American diet isn't saying much. They still didn't get as much as they should have. I mean, yes, those eating vegetarian ate significantly more dark green leafy vegetables, but that comes out to just two teaspoons of greens more. In terms of weight management, the vegetarians were consuming on average 363 fewer calories every day. That's like what people do when they go on a diet and restrict their food intake. But that seemed just like what vegetarians ate normally. So a vegetarian diet could be considered an all-you-care-to-eat version of a calorie-restricted weight loss diet, naturally inducing weight loss, and also helping maintain healthy weight status long-term. So just following a vegetarian diet alone without focusing on calorie reduction could result in weight loss. How sustainable are more plant-based diets long-term? They are, in fact, among the only type of diets that have been shown to be sustainable long-term, perhaps because not only do people lose weight, but they often feel so much better. And there's no calorie counting or portion control. In fact, vegetarians may burn more calories in their sleep. Those eating more plant-based diets appear to have a 11% higher resting metabolic rate. Both vegetarians and vegans in this study just naturally seem to have a revved-up metabolism compared to those eating meat. Having said that, the vegetarian diet pattern in this study included eating eggs and dairy. So while they were significantly slimmer than those eating meat, they were still, on average, overweight. As we've seen before, the only dietary pattern associated with, on average, an ideal body weight was a strictly plant-based one. Still, this study does help dispel the myth that meat-free diets are somehow nutrient deficient. In fact, in response, the editor-in-chief of the Journal of the American Dietetics Association asked, what could be more nutrient-dense than a vegetarian diet?


We are back with another behavior beast episode. We're still working on Cooper here in Inhoard. We are right at the beginning So we're gonna talk a little bit about behaviorism There are lots of different types of behaviorism just like there's a I was gonna say rocks, but there's only like one or two Rocks by me. So that's a bad bad example There are lots of different types of behaviorism. So let's focus on the first one The first one would be what Watson did, right? So that is a stimulus response So you have an S and an R and notice I didn't do anything magical. They're just an S and R So a stimulus response psychology If you want to think of stimulus response psychology, the best thing to think about is Pavlov, right? So he was the one that really went to work on this the classical conditioning piece that that That connection between a stimulus and the response and how you can I don't know What's the term to Replace one stimulus with another one through pairing processes to evoke new responses in other words to modify reflexes well Watson comes along and there's lots of great stories about Watson including he was voted most handsome professor at his university, which is I Don't know why that's relevant, but it is just so you have a little bit context anyway so here's this totally hot guy talking about stimulus response stuff and he's talking about psychology and Watson really kind of overdid it I mean he really took the idea of stimulus response psychology and applied it across the board his core argument Was that you could basically Create or select for any particular type of person that you want any particular skill set that you want Using a stimulus response procedure SR, right? So he didn't account for consequences of behaviors, right? That's a totally different type of behaviors and he focused just on the stimulus and response So but that's really not the big picture of what Watson was doing that was important the more important part about Watson was that he Really got this idea of a thoroughgoing science of behavior moving He wasn't the first one to talk about science of behavior. He wasn't the last He wasn't the most influence flu influential, but he did kind of push it even a little bit further. He wrote this paper called the psychology as the behaviors views it and It was a really intense sort of calling out of how the whole field had been for the last 30 years or so All right, so keep in mind we're in the early 1900s here So he was reacting to how the field already was and he wanted to improve it make it better and make it more scientific and make it More effective and really really really push and hit home on the fact that we can use the principles that have already been discovered in the laboratory To do work in the real world. So Watson again then when a set out about measuring and seeing how Organisms specifically humans change when you modify these sorts of When you modify their environmental constraints when you connect different stimuli with other stimuli and you select for new responses But you do it in this hyper controlled fashion again He was really really pushing home this this science of behavior in this really heavy focus on being scientific and rigorous and empirical And you know, we can get into all the fun stuff He did, you know with his graduate student that he eventually married Watson and Rainer.  It wasn't in a right You can go watch the other videos on that on YouTube. There's plenty of stuff out there But it was absolutely amazing and Watson realized the implications behind that and how much we actually learn as an organism and How little we're born with in terms of how we respond to our environment So I think one of the things that I really like about Watson is about this this also this focus on the environmental experience and how an organism Comes to the world prepared to respond to their world They don't come prepared with how to make something so to speak right. I wasn't born knowing how to make houses I learned that I wasn't born knowing how to polish cars. I learned that I wasn't born to do all these different things But my experience has led me To get to those things and to have that particular experience. So anyway, I think that's enough on Skinner or not You know where my brain's going with it. I think that's enough on Watson right now We're gonna come back and talk about methodological behaviorism and Skinner's radical behaviorism in a little bit So hope you don't forget to subscribe and give us some food because that's how we get our food is through your Subscriptions and we really appreciate your time. So come back watch another video. Take care


And thank you for the introduction. My name is Justin Slesman. I'm a perfusionist at Stanford Children's Hospital in Palo Alto, California. Relevant to this presentation, I serve as the AMSEC perfusion liaison to ELSA. And within ELSA, I represent perfusionists by sitting on their technology, conference planning and steering committees. I am joined by two perfusionists for this panel discussion on the COVID-19 joint perfusion task force. Luke Puiz joined us from Belgium and Bill Riley at a Boston, Massachusetts. First off, on behalf of all the speakers for this presentation, I would like to say thank you to the Texas Heart Institute Conference Planning Committee for inviting us to present at your annual conference. Obviously, our profession is indebted to the foundational educational work that Terry Crane and all THI personnel who were or are involved in building, maintaining and now growing the perfusion program at THI for the betterment of our profession. So we thank you. The group has no disclosures. Our focus for this presentation is to share the development and evolution of the COVID-19 task force. Then Luke will share some of the work he has done emerging CCPs and ECCPs in this process, followed by Bill highlighting institutional experience and lessons learned as a COVID-19 pandemic spread in the Northeast region of the United States. Lastly, we'll reserve 15 minutes at the end of our lot of time for a question and answer session. Okay, so who and what is the joint perfusion task force and how did it come to be our forum? As COVID-19 pervaded our world in healthcare systems, I say with a heightened anxiety and concern, peaking in mid-barch, there was an increasing need to formalize a hub to help answer questions and lend support for perfusionists. Leadership from AMSEC, notably Jim Rager and Tammy Rosenthal, aligned with Bill Riley at the Academy, supported by Brad Crullot and Angarico at our foundational American board who began the process of combining their knowledge, resources and networks to construct and disseminate information using this platform. As word spread, we were a standard with a swift addition and participation from various organizations, societies, employers and industry on a global scale. This slide shows this exceptional display of collaboration and all parties involved. The website URL, which you can see above, please take some time if you haven't visited it. If you're looking for any information on COVID-19 and also please contribute any information that you think pertinent for this task force. So we needed the website which you saw and had to decide on the main content which you can see here. First, the discussion board was created to quickly share the early experiences and hardships for perfusionists, clinically supporting patients with COVID-19. And I think this was the right thing to do just to get something up quickly where we could all share our experiences with potentially just case reports to starts on lessons learned, but just something quick that we could share on this task force website. Secondly, Braylee Millen, election on health and wellness providing links to resources for all of us who might be struggling with concerns and uncertainties with COVID-19 and mental health. We reached out to Elsa who quickly responded that all CCPs will be given a one-year free individual membership, enabling access to their extensive ECLS COVID-19 resources, webinars and protocols which are ongoing and present today. Next, Shelley Brown led the legislative and governmental resources section as questions emerge on licensure and employable state boundaries, staffing regulations and FDA leniency and products to help guide CCPs to better face this pandemic. Current and publications were posted, webinars were established and perfusion industry partners continued to update on the supply distribution and projections, especially as we now head back to the operating room for elective cases. So as Zoom and social distancing became the norm, these webinars were a welcome tool of information sharing and I think I'd say some FaceTime with colleagues. We started with centers that were first seen these patients in the greater New York City area and Seattle, Washington. I think I, like the majority of us out there, personally and institutionals, that we were ready for a surge but had yet to see one COVID-19 patient in early April. Nick Mellis, who's the chief at Montefiore Medical Center in New York City, his presentation during the first webinar was eye-opening to me and I think others as well. You could feel as calm yet urgent tone over the webinar and how to prepare your staff for the stress that will come if faced with a surge of COVID-19 patients at your institution, specifically in the ICU setting. So we started with Nick, Seattle, University of Washington, Swedish Medical Center in Seattle as well and our first three which were sequentially April 2nd, 9th and 16th weekly, were more case reports, institutional experience that we could share that knowledge. In the fourth, fifth and sixth webinar, I'd say they are more systematic approaches and we reached out to kind of our colleagues across the pond with ECCPs and URA ELSO. So the fourth one was patient transport, URA ELSO data kind of digging deeper into that and also looking at some of the technology that might help serve these patients, even if that was some of the older technology such as cytosorb that was available but might have a place for COVID-19. Then we asked MDs to support us in our endeavors here for these webinars and had a lot of MDs talk for patient treatment and also going into reopening of ORS and CPP. Our last webinar, which is held on May 28th, I think was a welcome addition from manufacturers and profusion service organizations. Those organizations mostly being specialty care and comprehensive care services which provided us a deeper dig or deeper look into where was the dip in case volume and are we seeing it come back now and geographically where are these locations? And we absolutely support, we appreciate the support of the manufacturers industry and highlighting that they are ready for, if there's a potential surge to meet that demand for ECLS equipment. So these numbers reflect the initial views from the two tools used to watch the webinars, zoom and profusion.com's YouTube live stream channel. So we wanna thank profusion.com, Brian Lynch and his colleagues at profusion.com for assisting and gaining this information out and making this available on a webinar format. As you can see, like we said before, I think we met the demand initially in April with 785 initial views. Now these views are just who is there present for the first offering and they are still available on the joint profusion website and profusion.com's YouTube live stream. So I suggest if you haven't viewed to go check them out if you're looking for information on COVID-19. But I think this reflects that we did meet that demand in the beginning. We hopefully answered some questions for our colleagues in the profusion community. And what's good to see also is that we still have a strong presence and strong viewership here with 327 for the last webinar. But I hope this reflects a trend back to the operating room and some normalcy as we move forward. So in closing statement, what I find most valuable about this task force is that now the framework has been established. Whether we have a resurgence of COVID-19 later this year or we are faced with another global emergency down the road, this collaborative platform can serve as an educational hub and voice for our global profusion community. And I regret not mentioning Kate Maude as Smith and Bucklin, who is the absolute glue of this entire operation pulling us together on a weekly basis. With this, Sid, I'll now pass the presentation over to Luke Puiz. Thank you. Thank you, Justin. Thank you for this very nice introduction. I will go briefly, I would like to thank Texas Heart Institute to allow us to talk here as members of the COVID-19 task force. And I will briefly go on to describe how profusion organizations from Europe got involved in this global joint profusion task force. And here you can see an overview of all the members of that task force. And there are three European organizations, namely the European Board of Cardiovascular Profusion, the Society of Cardiovascular Profusion Scientists, that is basically the UK organization for profusionists, and then the Tiny Profusion Leather, which is basically myself. So I cannot speak on behalf of the UK society, as I don't know who is representing those and how they got involved. But the Tiny Profusion Leather got involved by someone saying that I should be, someone saying to someone else that I should be on the profusion task force. And then through the Tiny Profusion Leather, I was involved. There you go. And then I suggested also to have the European Board of Cardiovascular Profusion in the joint profusion task force, so we could exchange information. I would just like to remark that I regret that there are no profusion organizations from Asia or Africa represented in the task force. And we are busy with talking to them how we can include them for the future. So the Tiny Profusion Leather is a weekly newsletter, which gives you 10 articles, one or twice a week, once or twice a week on scientific literature regarding profusion. We did a few extra additions on COVID related literature. And if you're interested, you can always subscribe here. And this Tiny Profusion Leather is also on the website of MSECT and on a few other websites. And this is how we got involved into the COVID-19 task force by providing literature. And then the European Board of Cardiovascular Profusion is in fact the global, not the global, but the association of most perfusion societies in Europe. They try to unite the European perfusionists regarding standards in training and education and professional status of perfusionists in Europe. There are about 29 countries united within the EBCP, as we call it, we have 27 European countries and then there's Saudi Arabia and also South Africa who use our platform to use our standards for education and training. So you can find all their information on their website, ebcp.eu. And they are basically represented by the Secretary General of EBCP and the liaison between EuroElso and the EBCP, just like Justin, there's a liaison between the EBCP and the EuroElso organization. And so then there's a third representative as a backup. And the way we are involved in the joint perfusion task force is that we provide networking opportunities. We find speakers for webinars and we even organized one, the fifth one, I think it was. We exchange our experiences as we have a lot of ECMO experience, namely in Italy and France and Belgium, which I can speak of. We participated in the meetings and the webinars and we provided answers and questions to the discussion forum. Or when, for example, during the webinars there were still questions after the webinar, we provided, we tried to get answers by providing the questions on the different discussion forums of the different organizations. And we also provided literature to answer the questions on the forum. So as Justin said, the future role of the joint perfusion task force would be that we continue networking and I've met a lot of people by joining the task force. I've met a lot of people learn a lot new things and we will continue the exchange of the experience and knowledge that we gained. And we are in this way ready, as Justin said, ready for new events in case there's a second wave of COVID or if there is another H1N1 pandemic, we can now exchange way more rapidly all our knowledge. This said, if we can go beyond COVID then we could try to get a global curriculum for profusion education and training and try to set a standard for certification which would allow easier exchange of certification, jobs and recertification across the globe. And we could also agree on more uniform research needs and methods and even re on a curriculum. So now I give, thank you for your attention and now I give the podium to Bill Riley. Thank you very much. Okay, thank you. Sorry about that, folks. I wanna thank the Texas Art Program Committee for trusting us with a live feed and a heartfelt congratulations to all of the profusion school graduates this spring. These times are crazy and we get it. We can't wait to see you guys in the workforce. All right, sorry folks. So I'm joining you today and I came to the Joint Profusion COVID-19 Task Force as the current president of the American Academy of Cardiovascular Profusion. I'm also the director of profusion services at Mass General Hospital in Boston. So here's American Academy was one of the original members of the JPCTF as we began to call it and we were very excited to be joined by other members from all over the world. It was a wonderful collaboration to be part of. So what I'm gonna talk to you today is a little bit about what it's like, what it was like for us as a major metropolitan medical center in the COVID-19 pandemic so far. We became quite a referral center for a lot of other hospitals and I'll talk about that in a bit. And then at the end, we'll be able to answer your questions. So my first doses of COVID-19 reality actually started early in March. I looked back in my emails and saw that on March 3rd, I sent out some fairly explicit emails to some representatives from industry asking about PMP oxygenators other than what we typically use. And I think that was my first hint that something might be afoot. After that, we moved along pretty quickly. We had our first MGH official COVID meeting with cardiac surgery folks March 12th. But for me, it was March 17th of this year. We had an issue in one of our rooms with a breaker that kept tripping off and we called buildings and grounds and a guy showed up with a bunny suit on over his dark blue work uniform. And he had a tie on that had beer signs and shamrocks all over it. And I looked at it and I thought to myself, that is the most unprofessional thing I've ever seen in my life. And then I remembered, wow, it's St. Patrick's Day. For a guy named Riley to forget St. Patrick's Day in Boston, that means something's going on. So that was the first like, wow, these are strange times we're living in. March 25th, I'm gonna step forward a little bit. We went live with COVID passes here. We have to go on our phone. There's an app every morning and a test to having no symptoms before we're let in the building as an employee here. And then with the COVID pass, you're let in the building, you get a squirt of hand sanitizer, a new mask, then you're free to go on your way. And again, a sign of the times, my jury duty for the state of Massachusetts wasn't just postponed, it was canceled. I mean, there are some silver linings if you look hard enough, I think in all of this. So staffing in the face of our reduced caseload because of COVID was tricky. We use Amion as our scheduling program here for monthly scheduling. And then I usually take that and I'll send out the schedule for the following day. MGH and Partners Healthcare, actually now called Mass General Brigham Healthcare, was very generous in allowing folks to work from home whenever possible to keep everyone healthy. So thanks to that, I was able to bring in about half staff for six weeks or so. And then I increased that with our ramp up phase. So the weeks I'm showing here are Amion, the tall skinny one. This is the week of May 11th to 15th. So we were pretty close to three quarters feet at this point. But you'll see the tall skinny photo there is Amion. That's what we usually use. And then every Wednesday night and Thursday morning, I'd work on an alternate schedule to bring in as few people as possible, but still be able to cover our very, very diverse caseload. We kept the call folks as scheduled. And I tried not to assign anyone on my new schedule that wasn't already assigned for the day in Amion. So there wasn't really much to do on your day off around here, but I tried to respect everyone's time off and it worked out pretty okay. I'll be working on a clinical out practice guideline for how to do this at some point. So if anyone's interested, please reach out. You know, one of the realities of this is I needed to have buffers for positive employees or people that just didn't feel well, even if it wasn't COVID. So this is a lot of responsibility and a lot of creativity went into this and an awful lot of support from my team. Everyone really stepped up every time they were asked to. And now we're pretty much at 75% capacity. We actually have six cases going on right now. That's why I'm in scrubs, not on my fancy dress shirt, but you know, we're managing and we're just happy to be getting back into business. So we have a, like I said, we're ramping up. MGH proved to be a COVID hub for the region. We're about a thousand bed hospital. At one point we had about 350 COVID positive patients in-house, nothing like New York City. And I'll echo the sentiments about Nick Mellis' talk, the first webinar we had, I think everyone was blown away and everyone was braced for that here, but luckily it didn't really happen that way for us. We had, I think a total of 12 ICU floors. I had a hard time actually confirming that, but right now we're in the phase of starting to get back to business. So ICUs for COVID are now being converted back. The nurses that were deployed there going back to their original floors, the ventilators from the OR and storage are being brought back to their original spots after thorough cleaning from the Biomed departments here. And I think everyone is gonna walk away from this a little bit smarter and I'm not gonna say better off, but I think we all learned a lot of lessons here because I think just being responsible, it's very likely that something like this could come back to some extent in the fall. So I'm sure there's gonna be a lot of conversations like that over the summer. And hopefully we still have a forum to share whatever we're talking about when the dust settles, we have a little bit of time to think about that. So again, I wanna thank you on behalf of the Joint Perfusion Task Force, Luke and Justin, we worked together on this and it was a pleasure working with you guys. So we have time, I think 10 to 15 minutes left, it looks like for Q and A. So I'm going to relinquish my control and thanks very much. Lied. What does work from home look like for a perfusionist? Since we're pretty much clinical people, what were your staff doing on their work from home? So we have a very busy service but being Mass General, we're involved all over the hospital. So we're involved in research on many levels, we're involved in different protocols. So we use this opportunity to go through and buff up many of our dozens of protocols and clinical practice guidelines. We developed a few new protocols and clinical practice guidelines that we found we didn't have and everyone was also on call technically. So there were a few times where we had to call people in. So it definitely wasn't, doing a third time re-op every day, but we kept busy. For Luke and Justin, alternate working that your staff did or did you ever feel that you were short staffed having to work with staffing in the crisis? I can take it on the, I work at a children's hospital and so our biggest concern, we're your neighbors with the adults, cardiac center at Stanford. And our biggest concern is that we're gonna have overflow from the adult ICU into the pediatric ICU. So a lot of us, the cases were on hold for a concern that we wouldn't have capacity to treat those patients or potential COVID patients that would come in. Our staffing model, we didn't change because we didn't see a huge fluctuation of COVID-19 patients, luckily. But we did talk about a process to implement potentially, all of us would be on for two weeks or off two weeks. I think Cincinnati Children's adopted that philosophy. So we did have, let's say protocols in place, but fortunately it did not affect our staffing model on a day-to-day basis. Yes, and I can be very briefly, I am in between jobs. So during the first three months of the COVID-19 from March to end of May, I was in the United States, but I was not working. So it didn't affect me. And we do have a question about students and teaching these skills. Obviously we've not lived through a pandemic in our lifetimes, but what do you think are the takeaways that we need to maybe incorporate in perfusion education? I think for me, the take-home message is that you need to maintain your scientific knowledge about your equipment. I think a lot of us, not to say we're caught off guard, but the questions of how does COVID interact with a membrane of different styles of membranes? Are we properly exhausting our oxygenators? Are we wearing our certain PPE that would be relevant for COVID-19? So I think the student in me, which is always there hopefully, is that you have to go back and read and make sure your knowledge basis is adequate on the equipment that we use. I think, as I said in Elso, I always try to carve out a niche for us perfusionists is the fact that we are the experts in technology. And this is a great instance of where we should be the experts in technology, knowing devices and knowing how COVID-19 could potentially interact with the equipment that we use. I'd like to speak to this, Justin, if you're all set. I'll speak to our perfusion students who I think it was March 16th. I had to cut them loose and that stunk. We didn't like to do that at all. I think I'll take a page from what we're learning with my two boys who are in middle school and high school. I think perfusion schools need to be ready to do a little bit of distance learning in the event that something like this happens again. I think we're all getting really good at Zoom, some better than others, apparently, sorry, again. But I think perfusion programs are gonna have to build in some component of distance learning capability, even if they have it tucked in their back pocket, ready to go. I don't know if simulation somehow can come into play, but I think this is, again, a first-off thing, but something we need to be prepared for again. What this pandemic has told me is that that there are many things that we don't know and probably there's a lot of room for a little bit of research there. Like Justin said, those viruses are they in the blood and do they go through the oxygenator? There was a recent publication about it, but they were not like, they were conclusive that you should be aware of it, be careful, but without much evidence. So maybe there's a role for that. And also like we saw that people were creative in creating solutions for looking at their ECMO from a distance, learning about coagulation and how the virus affected the coagulation cascade. And it's really an opportunity to learn here. So, and I think students, I think most schools just suspend that education or try to find ways of distance learning. And I think that we'll see more of that in the future, the distant learning. But of course, perfusionists still need to be in the UR to learn. That's a challenge for sure. And we do have a question from the chat regarding COVID and use of ECMO at times for it. What has been the prognosis just in y'all's experience? How well is it going? How well do they do? Bill, do you wanna take that one? Yeah, sure. You know, we at first had a triple of ECMO patients about what we expected. And then we thought we plateaued and fairly recently we had a big spike to the point that we were kind of at emergency mode. And a lot of these patients are presenting with long, like long-term proposed ECMO runs. With the perfusion team here is involved with ECMO but we're not really the administrators of that service. So I'm really not 100% confident to speak numbers, but we've put, I think over 20 COVID patients on now so far, but I just don't have the numbers to speak to how well they did. I know there were a few high profile weans off that, you know, we're in the news and stuff like that, which is great. But that's obviously just the tip of the iceberg. And is it predominantly VV? Yeah, we went with VV, fem-fem VV, just because at first it was to protect the folks up at the head. If we were gonna be putting a dual lumina and we didn't want people working so close to the nasal pharynx and stuff like that. So we did fem-fem VV, I think we're still doing that for almost all of our COVID patients. We did have a couple of VA COVIDs with the acute myocarditis, but that all needs to be worked out to figure out exactly what happened there. If I, I can not speak from personal clinical experience, but there is a survey of ECMO for COVID going around in Europe. And I think they have now more than 1,200 ECMO patients in that survey. And I think in beginning, people were really taken, taken aback by the severity of some of these patients of these patients with COVID. But I think now, if I'm not sure, but I think around 50% is the survival rate or the mortality rate, like I think it's a 50-50. I don't know, Bill, if you can speak from that experience or I mean overall, not every center has those figures. I'm curious. I think if you combine and you look at the URL also data and our also.org data across the board right now, discharge home is 54%. And at first I think that, you know, we didn't know how to apply and they were figuring out how to apply ECMO and versus VA, VAV, VV. Now obviously majority, VV of course. And so those numbers have improved as we've defined, kind of, you know, who is the ideal candidate or when to use ECLS support for these COVID-19 patients. But for more information, you know, reference the COVID Task Force webpage, hit the link to ELSO or URLSO and there's great data and information on the entire volume of ECLS use globally. And Justin, you bring up a good topic. What it's ELSO doing for the COVID ECMOs in terms of data capture and also I saw that there was people could participate maybe without paying the usual ELSO participation fees. Can you tell us a little bit about how people could either use ELSO for data to look at or participate with their ECMO patients? Sure, and so participation, it would be a little more challenging, but viewership is available with that initial membership. It's under the, if you are a center of ELSO and you're included there, the data includes those centers. So it's important to know that, yes, we're not gonna be able to capture all of the cases that are COVID-19, but it is a great database of over 500 centers that are submitting their information into this database to give us kind of information on is ECLS proper use and when is it proper use for these patients. So the membership to CCPs, which we're thankful, thanks ELSO for doing that, is waived. So you can go in there, look through the data, join the webinars, potentially contribute at some capacity for a year while this COVID-19 pandemic continues. Thanks for sharing that. I don't think people realize that they can participate without spending money or doing a membership or something like that for this time. We do have another question from the chat for all of you. For your patients, COVID-positive needing surgery, are you changing your anti-coagulation protocols? Is there anything different for the regular heart surgery patients that are COVID? We have not at MGH. I think it's very important to try and not put people on bypass with COVID-19. Of course, there's always these urgencies, but I think you should have tried to avoid it at all costs. And if you have to put them on bypass, I think you really have to be careful, but I have no knowledge of protocols of putting more heparin in or I cannot speak for that. And I think your question is for ECMO, right? Not cardiopulmonary bypass, would that be correct for ECMO? No, actually for cardiopulmonary bypass. Okay, okay. So I think time will tell on that one as we get back to the operating room. Obviously, I think as we learn more through ECLS is the frontline of extracorporeal circulation for these patients. Obviously a lot of places that were maybe, no anti-coagulation for BV ECMO has switched because of this hyper-coagulable state. So hopefully we'll learn that and translate that information to the operating room, but I think we're still a little too early to know because hopefully all these patients that are coming to the operating room are screened for COVID-19 and they're not going to elective heart surgery until negative or antibodies. Yeah, I think also people who are really having a hard time on with anti-coagulation are the real severe patients and hopefully they will not need surgery at that point. So I think it's fair to say we haven't, you all haven't seen one, you haven't done a COVID patient on bypass so far. We've had patients that were COVID risk because they either came to us unable to be tested or with too acute to test. And I think now you need to have two negative tests 48 hours apart in order to be deemed negative. So we have a lot of COVID risk patients, but actually to my knowledge, I don't know that we've had a confirmed COVID patient on cardiopulmonary bypass. There are some... P-U-I's. Sorry. There are some case reports of people getting put on bypass which were unknown to be COVID-19. I think the mortality was really high postoperatively because of the coagulation problems. There was a EBCP webinar yesterday or two days ago where the Alzheimer's gave a talk on that. And there are a few case reports in the literature if you really need to know. And I can say we had one unknown. So it came positive two days later and it was a regular cab. And obviously we didn't know so we didn't do anything different but just one experience. Yeah, as time goes on, it'll be interesting to see if the COVID positive but asymptomatic folks behaved differently on pump from the COVID positive and symptomatic. But I think we're a ways away from how the numbers would need to determine that. I think that's kind of the theme. We've all, as Dr. Coulter pointed out, we've only been at this for 12 weeks or so in the United States, which is why I thought the international component of the task force was so helpful just to know what people ahead of us had experienced and done just to know. I think I agree, the very first webinar was humbling out of New York just to know what they were experiencing, what was happening. I think that's a lot of it. People just kind of fear the unknown and the sharing and just talking about it, I thought was helpful. And I'd ask all of you, what have been your takeaways from the task force and participating, and what have you gotten out of it that you think people should know? I think all three speakers said is that we're set up for the future. It was a lot of hard work in the beginning to organize personnel, get the website going, define content. Now that that's done, I think I'm probably most proud about is that this kind of transcends all organization societies for perfusions on a global level that we can go back and reference this and then build upon it as we face such things as COVID-19 or COVID-20, who knows yet. But I think that's what I take from this is that like you said, the networking, the ability to communicate whether your social distance at home or at the hospital, I think is paramount to its application. Thanks. Yeah, nothing to add to that. Yeah, okay. I think we're at time. So for a live panel, I thought it went pretty good. Thank you so much for doing this and taking it off. Appreciate it. It's from overseas. Yeah. You're welcome. Thank you, T.A. for having us. Yeah, thank you. Thanks. Thank you. Thanks.


Equality is important to me because I like to have everyone feel included. It always is not an uncomfortable feeling to make others not be involved with what you're doing or what somebody else is doing. In my workspace, nobody is ever not able to do something. We're always trying to make sure everyone is at the same level as everybody else, so equality happens every day. Equality is important because everyone wants to have the same opportunities no matter if it's sexual orientation, gender, creed, religion, culture, but everyone wants to have the same opportunities towards their profession and workplaces. What others should know about equality is it could be a deciding factor in changing someone's life. You never know what anyone has going on in their personal world, so make sure that we're including everybody in what we do. I think this goes back to one of those old sayings of treat others the way you would want to be treated. It's not fair or right to just hate on someone else because they're slightly different than you. We all come from different backgrounds, but we all join the Air Force for the same goal. The Air Force has taken steps to include equality by including more gender-neutral activities as well as relaxing on regulations such as hair policies for women. Equality supports the mission by leaving no one out and having everyone multi-capable and prepared for whatever may come.