American Tonksido vs. American Kempo, this is the last of three videos that we are making in collaboration with Sensei Justin Ichikawa from TO Westlake Rate in Thousand Looks California as well as Sensei Ichi YouTube channel. Now we've been doing a fun exploration by comparing the basics of our systems. This is a friendly debate, this is not a who's system is better. The first episode compared our blocks, the second one compared our strikes and today we're going to talk about kicks and Sensei Ichi is going to walk us through some of the Tonksido kicks and then we're going to analyze them and see how they compare to Kempo. Now be sure to check out the other half of this video on his channel afterward in which he analyzes the Kempo kicks. I have posted the links below in the description. These are basic kicks. We have snapping kicks, we have thrusting kicks. Sometimes the thrusting kicks do snap depending on the situation but generally we like to keep them separated for the beginners or we have snapping kicks and thrusting kicks. Snapping kicks include round kick, inside cresting kick, outside cresting kick, hook kick, and heel kick. So we have five snapping kicks that we use. The round kick is universal, some people call it a round house kick. We have different versions of it. We have standing, slide up, and we have spinning which we teach to our beginners. For our white belt and yellow belts, we just teach round kick. That's the only snapping kick. The higher rank you get in terms of intermediates then we do inside cresting kick, outside cresting kick, hook kick, and heel kick. So again, all snapping kicks. When we do our snapping kicks, I'll have three principles, fold, snap, and recoil. So let's say we're doing a standing round kick which is really basic.  So I'm going to do that snapping round kick this way and here. I'm throwing that snapping round just like that. That's our standing round kick, real basic. We also do a slide up version and then a spinning version. So slide up round kick here, this way here, then spinning back leg kicks and I'm snapping just like that. Nice and relaxed, nice and chill. That's pretty much it for the round kicks. For the cresting kicks which are the little more intermediate kicks, we have inside and outside which actually mimic the inside and outside defense.  I started the 45 and end so I'm snapping kicking with the instep of the foot on the round kick. We kick with the top or the shin and the ankle. So in this one, I'm kicking instep. So I'm starting across this way. I'm kicking inside cresting kick that way. Outside would be the opposite. He flips the target over. I'm going to be kicking with the front leg this way, knee folds 45. So on the outside cresting, I'm going to be kicking on the outside edge of my front foot. So standing outside cresting, I'm pulling this foot, kicking across that way from outside cresting. And then the next kick we have is the hook kick. So on the hook kick, I'm going to be kicking with the back of the heel or you can kick with the bottom of the foot. One is for reach. So if I'm kicking up here, boom to his head, I'm kicking with the bottom of my foot. If I'm kicking to the kneecap, bam, I'm going to use the back of the heel. Kind of drive him down on the ground. So hook kick in here, boom, I'm kicking this way. It's not the most powerful kick in the world, but it's really strong because you're hanging with that heel so you can kind of nuzzle in into a sweet spot. So that is the standing hook kick. And we have the turning heel kick. We're going to be doing basically like the hook kick, except it's going to be a full 360 turn. So it's turning heel kick standalone, back leg kicks. I turn, I kick the target and it ends up in the back. I'm going to kick up here today here, on this way here. So that is my turning heel kick with the back of the heel. And that is it. Those are our basic kicks in terms of snapping. We take all those kicks and progressively they get more challenging. We had skips, we have lunges, we have leaps, we have jumps, jump turns, and we just make them more advanced from there. Sometimes we have doubles for our black belts. But in basic, those are the basic snapping kicks that we have. So our thrusting kicks, we only have three. We have front kick, back kick, we have side kick. We do, same thing as on the snapping kicks, we have standing, slide up, and then stepping. We also have the intermediate students skip up, and we have lunging and jumping, etc. But these basic kicks we have are just the three. The theory behind thrusting is that we thrust certain kicks because they're meant to give driving power, and they're meant to be giving stopping power. So if he's walking at me, I'm able to stop him with that front. So my back leg is kicking. I'm kicking real quick and I'm locking that leg out so it kind of stops him in his tracks so I can follow up. So we have for driving power, if I'm kicking through him, I'm thrusting all the way through to drive my attacker back. So we do standing front kick, which I just did. We have standing side kick as well. Again, front leg kick. When we do the standing side, just like the other kicks, three principles, fold, thrust, and recoil. On the side kick, we implement hip turn, and sometimes ankle blade. So we're doing hip turn instead of kicking straight up this way. As I kick, I'm turning my hip over here like that. An ankle blade, if I, let's say, I won't have, if I, we didn't have the target and I want to hit in those little spot in the ribs. So what I do is I've bladed my ankle off to the side like this, so I'm able to find little nooks in the knee and the rib cage. I can use that blade of things. They're kind of almost like the spear hand to fit through. The last kick we have is the turning back kick. When we do the turning back kick, it's one of the more powerful kicks that we have, but it's a little more challenging because we have a blind turn, just like the heel kick.  Just like a side kick would, it's just a little more hip turn. We are kicking with our heel. So those are all the basic kicks that we teach our beginner students here in our studio. What do you think about these? Are they similar to your kicks? Are they as good as your kicks? I tried to do as good as you did, but we all can't be the coolest guy in the world. So I'm sorry. I tried. But what do you think? How are they similar and how are they different? It's okay, sensei. At least it's the effort that counts. So my first impression here is that our kicks are pretty similar and the difference seems to lie more in the categorization of them and some minor variations. Now, you mentioned that you group your kicks by snapping kicks and then thrusting kicks. And I think the difference that we have is in the way we use the word snapping and thrusting. Your snapping kicks have a nice crisp technique and actually, well, they snap with a strike while your thrusting kicks have the driving power. In Kempo, we classify thrusting and snapping to just about every kick. But in our context, snapping means the kick recoils at the same speed that was delivered at, kind of like a jab, out and back at the same speed. Our thrusting is when we are driving through the target, often advancing forward. Now, we have four primary basic kicks.  And these are actually the four kicks that are taught in kicking set one, which is a minor kata that teaches beginners different ways to deliver these kicks while traveling. Now, we also have the hook kicks, crusting kicks, axe kicks, sweeping kicks, and the like. But those are taught later and demonstrated in kicking set two, which is about halfway through the curriculum. So I'm just going to group these by our basic four and then touch upon the advanced kicks. Now, we also teach each kick with the front leg and rear leg variation. The dynamics differ between them. And as I mentioned in the previous episode, Ed Parker, the founder of American Kempo Karate, had boxing experience. So there's, there are trace elements of boxing concepts in Kempo. Much like in our punches, the jab and the cross, our jabs are used with the front hand because they are closer to the target and can snap out quicker to make quicker contact. And our rear hand delivers the power punch. So basically set up and knock out. We take a very similar approach with our kicks. When we kick with our front leg, we treat it like a jab. It's usually a quick shot, usually to cancel the opponent's height, width or depth. And in our rear leg, which is used to deliver the powering hit or driving through the attacker. And as with all our kicks, as you do, and as you described as the fold kick and recoil, we simply call it the chamber extension and rechamber. So the front kick, we kick with the ball of our foot. And if we're using the front leg, we're going to deliver it as a quick snapping kick, either to the knee or the groin or general pelvic region. Now we stress with new students not to lean back to free up that front leg, take that weight off of it, because that will compromise our balance. But we should be able to just lift and snap the kick and return it. Lower strikes like this tend to bring the opponent's height downward a bit. And because as a general rule in Campo and our self-defense portion, we like to keep kicking to about waist or belt level for common sense and safety. We don't do a lot of head kicks. So we like to bring the targets down, which also takes away their ability to kick in that instance. So if they're leaning forward, their weight's forward. They can't really lift that leg to kick. And sparring, of course, you'll see a lot more of the head kicks. With the rear leg, we're going to deliver the power. Now either it can be still snappy motion in that it goes out and comes back at the same speed or step through motion as if we're actually trying to walk and step through the person. The scenario dictates the action that we're going to take. So typically if we're going to advance, we'll land forward with the kicking leg and we'll use that to check off their front leg. So maybe to prevent them from kicking or trap them and work our way to some sort of entry or combination. Now I also noticed that our delivery of the front kick differs slightly as you show it a bit of a slight lean with your kick. And I've seen this in Tonksido and Taekwondo and I've wondered about this. I once had an old instructor mention that it was for reach and another one mentioned that it was for counterbalance purpose. So I'd kind of like to hear your take on this. What is your reason for that? When we do the front kick, we keep our body upright almost as if we're doing an exaggerated step. Even if we're going to return backward to kick or advancing forward, we keep our body straight up and we drive forward. So it's really kind of interesting to see our difference in the execution of the front kick. Our side kicks are also incredibly similar. We have the same two variations, the rotating hip side kick and the blade edge kick. We usually use the blade edge kick to blow out the knee or kick out the back of the knee to drop the opponent's height. The rotating hip side kick is a powerful kick and we usually apply it to the ribs or the chest. Now we'll teach them stationary at first as well as later we'll add shuffles, pull drag, slide ups or even cross behind steps which just add even more power to the kick. And also if we're going to do a side kick with our rear leg, we're typically stepping forward and advancing with it. Now the round kick is pretty much standard as the same as you described it. Snapping with the front leg or twisting and delivering the kick with the back leg. Now we will use the instep part of the foot and later in advanced levels we will teach them the kick with the ball the foot which can get a little bit more penetrating power. The round follows the same concept.  So we'll also use the front leg a lot in quick strikes to the inner thigh or the groin or even the kick out of the leg to disrupt balance and our rear leg kick is also sometimes used as more of a downward angle similar to a Muay Thai leg kick.  Now we use the back kick a lot but in terms of self defense it is almost exclusively used as an exit move. We don't typically like to expose our back unless we're sure the opponent has been neutralized. So you'll typically see us deliver a back kick from a rear stance to kick and push off and then cover out or spinning kick to blast them and then exit from there. And in regard to alignment you are correct. There is a level of blindness to delivering the kick. So we teach our students to look over the shoulder of the leg that is kicking because our rule is we need to see our target before we fire. In the beginning stage of the kick we will add a small step which helps align the hips perfectly for the kick when the spin is applied. As a student gets good enough and advances with this motion it will be smooth out and often worked into an advancing step through. Now as far as the advanced kicks the inside and outside crescent kick is pretty much exactly as you described it but like I mentioned previously we often try to bring the head down for a lower easier to hit target but the execution of the kicks are the same. The hook kick is pretty much the same as well but what you differentiate it as the hook kick and in the turning heel kick we just call them both the hook kick. One is just spinning and one is just using the front leg and using the exact same snap method that you demonstrated. This is not to be confused with a wheel kick which has more travel and more locked out like a spinning crescent. Not a kick you're going to see in Kempo as often. Now I would like to share this. Since you have great snap and delivery to your spinning kicks and that reminds me of a drill that my first instructor taught us to how to learn to properly deliver a spinning heel or a hook kick. New students have a tendency to extend the kick early and elongate the path of travel. So he would have a stand in the doorway and tell us okay do the spinning hook kick from there. It forced us to keep that chamber in tight and only snap it out and back when we have that window that the right point of rotation. I'll personally vouch for this practice because once or twice kick in a door frame and you get the idea very quickly. Now in addition there are a handful of minor kicks that I'll throw in. One of Kempo's signature kicks is the lifting heel kick. It's a close quarter kick and it usually comes at the end of a combination. From the reverse stance we will quickly shoot that heel up or even hook it a little bit and it will cover out or re-chamber and deliver a back kick from there and then cover out. We also have the scoop kick which is like a modified front kick that kind of hooks the groin. It's often delivered from behind the opponent. Alternatively we can replace that with a lifting shin kick and it really depends on if you just want to ring the bell or jam the radar. Two other variations of the front kick that I like a lot is a sweeping kick that I like to bring up higher to the stomach areas to prevent them from advancing. I use this a lot in sparring and I find some success with it. There's another kick I also like to call an angled or inverted front kick because the original name for it in the written manuals isn't exactly politically correct but it is good for getting around lower defense and sneaking in a quick shot. So I hope all of you enjoyed this collaboration. My favorite part of working on this channel is learning how other people do their techniques especially if it's different than the way I was trained. We all have two hands and two feet but it's the mentality and principles behind them that put the art in martial art. Thank you so much for watching and again a great big thank you to Sency Ichi for his time and energy. I highly encourage all of you to go check out and subscribe to his channel. The link is in the description below. He has a ton of fantastic content as well as the other half of this video. So let us know in the comments if you like this three part series and would like to see more collaborations or anything more along these lines in the future. Please subscribe. Click on the bell icon for notifications for future episodes. Thank you so much everyone.


guys subscribe and turn notifications on leave a like and drop a comment down below get here first and win giveaway calls i will pin as first comment on some of my videos be fast and good luck what is going on guys welcome back to the channel and i appreciate you being here today i bring you another destiny 2 video and today i bring you this epic video on how you can actually make wishes in the last wish read could this lead to how we get the wish end exotic ball well i'm sure we will find out people but before we go any further if you guys do enjoy the video and would like to show your support you can by hitting that like button it really does help me out and if you are new around here and enjoy daily destiny 2 videos be sure to subscribe okay guys so i've massive shout out to my friend the rcgninja for telling me about this little bit of information which is absolutely epic his channel can be found linked within the video description if you do want to go and show him some love so there is a secret wish creator found within the raid which actually grants wishes now this system which grants wishes works on a basis of patterns found throughout the raid and i believe other places in the solar system thanks to those brainy folks over on reddit we have found many of these puzzles which grant wishes now to get to this room make your way into the last wish raid this can be done solo by the way but instead of entering the first encounter of kali follow the path i take you will eventually come to this room right here now to activate it stand on the center pad then shoot the black button so to speak on this wall each shot shows a different symbol match the symbols with patterns found throughout the raid and i believe many of the parts on other planets to grant wishes now we know the name of these wishes already thanks to the database i believe there are 15 in total and they are well the first one ish wish to feed an addiction second one a wish for material validation third a wish for others to celebrate your success fourth a wish to look athletic and elegant fifth a wish for a promising future sixth a wish to move the hands of time seventh a wish to help a friend in need eighth a wish to stay here forever ninth a wish to stay here forever tenth a wish to stay here forever eleventh a wish to stay here forever twelfth a wish to open your mind to new ideas thirteenth a wish for the means to feed an addiction fourteenth a wish for love and support and fifteenth this one you shall cherish given of a thousand voices now at the moment 15 players to represent these wishes haven't been found i believe only a 10 at max has been found in total the first one at the moment is unknown the second one is the pattern you can see on the screen now effects at the moment are unknown the third is this pattern which you receive an emblem for absolutely sick the fourth is this pattern here which warps you to shiro too so these colors can warp you to different encounters absolutely crazy the fifth pattern warps you to more depth the sixth walks you to the vault this pattern is on screen now the seventh at the moment is unknown the eighth wish plays a song the hope for the future the ninth wish is unknown tenth is unknown eleventh is this pattern on screen now and it's crazy adds a grand birthday party style effects to headshots in the raid twelfth 13th 14th and 15th at the moment are unknown but as soon as they are guys i will update you for sure but this is absolutely amazing i do have a feeling this here has something to do with the wish and the exotic bolt it has to right maybe the 15th wish maybe you have to enter or 14 wishes before that then enter the 15th and then you get a quest for this bolt i mean it makes sense the last wish raid this thing that grants wishes and a wish and the exotic bolt well it makes sense in my opinion but for sure guys as soon as more it bolt is gathered i'll bring you an update video for sure but guys enjoy this and let me know what you find and on that note we have come to the end of the video if you guys enjoyed it leaving a like really helps me out and if you are new around here and enjoy daily destiny videos like guides top fives gameplays reviews just about everything make sure you subscribe and if you never want to miss a video turn on notifications by hitting that bell button but thanks again for stopping by hopefully i will see you on that next one


Hello, this is Laptop Media, and today, we will show you how to open the Lenovo Thinkbook 13X Gen 2 and what's inside of it. There are 9 Torx head screws that stand between you and this laptop's internals. After you undo them, pry the bottom panel with a plastic tool and remove it from the chassis. Be careful with the wireless charging ribbon cable. Please remember, it would be of great help to us if you just hit the like button and subscribe to our channel. That would motivate us to make even more and better videos for you. Inside, we find a 56 watt hours battery. It got us through 6 hours and 30 minutes of web browsing, or 9 hours of video playback. Should you want to remove it, unplug the connector from the motherboard and undo the 5 Phillips head screws holding the battery to the chassis. As you can imagine, the memory is soldered to the motherboard. You can pick from configurations of 8, 16, and 32GB of LPDDR5 RAM. Respectively, the storage comprises 1 M.2 PCI-EX4 slot, which fits Gen 4 SSDs. For cooling, we see 2 heat pipes, 2 heat sinks, and 2 fans with very small profiles. Thankfully, the VRMs are being cooled by a heat spreader. If you'd like to see more disassembly videos of the latest notebooks we would highly appreciate if you hit the like button and subscribe to the channel.


Just looking out of the window Watching the asphalt You know I'm black on the inside know the words the good times well that means you're black inside welcome back everyone glad you're here I'm drone tech and if you're watching right now It's probably because you want to laugh at the cringe fest that is Chris Cuomo brother to sausage enthusiasts and grandma killer Andrew Cuomo There are so many memorable Cuomo cringe moments when he told people not to look at Democrat scandal-filled wiki leaks Because it was illegal. No you had to go to CNN to see that or when he posted the profound Cosmic question where in the Constitution does it say protests are supposed to be peaceful? We have no idea sensei. That's why we come to you here are some of the responses to Cuomo's coming out as black inside Managing editor of sister-to-sister magazine and news onyx clearly raised space publications how progressive But she was of course very offended saying quote.    Oh time for a little critical race theory reeducation It's fair the woke are nothing if not completely inconsistent So you can say that you feel like a man or a woman on the inside Even though you have no idea what it's like to be the opposite sex and to even question that is considered hateful and Actually denying their right to exist but somebody can make an offhand comment in a genuine attempt to show solidarity as Pathetic as it is and suddenly that previous worth logic is just right out the window It's just more proof that these people who buy into woke ism aren't actually thinking through any of it It's a purely emotional based response to whatever the outraged flavor of the month is So I'm obviously not a fan of Chris Cuomo or anything, but I think this outrage towards him is just so Transparent and indicative of what we see from the inconsistent woke left Now I do want to pivot here a little bit and show you guys some clips from the media that I find very Concerning the media seems to be generating a lot of hate and fear and in fact violence towards their political opposition in the Republican Party The GOP is a mix of white supremacy and fascism and dangerous lies and hypocrisy. It's a dangerous cocktail That's the GOP. I mean people get really mad when you people like you and people like me say that but prove us wrong I don't know what all you can say about this I'm not a huge fan of Republicans But I don't for a second think that they're a party of fascism or white supremacy Their only purpose here is to wipe out all political opposition Having the way for one-party rule for the foreseeable future and it goes even further than that because if people really buy into the stuff These people are saying they're gonna feel completely justified in taking some sort of action because essentially what these media Propaganda start telling them is that there is these evil armed up monsters that are coming for them actively read even says it herself saying quote I mean people get really mad when people like you and people like me say that But prove us wrong, of course, there's no possible way of proving them wrong again It's just like the sand on lich trials you could be accused of being lich But there's no way you could ever prove you weren't the only way you could save yourself was just to admit You were a witch and then join the mob and accusing other people of being witches That's exactly what we're dealing with here I want to remind everybody about the GOP baseball game shooting where a Bernie supporter Showed up and started unloading on the Republicans that were there while saying this is for health care This all happened after weeks of the Democrats and their media Hammering Republicans claiming that they want you to die and now what we're seeing is something very similar where they're essentially saying Republicans went all of you to die But now we're gonna get to the point where they start actually inciting violence towards Republicans All right, that's all the hate and vitriol I can take from the Democrats state media for one day Don't agree with me join the official drone tech politics discord server And we could schedule a live chat on whatever topic you would like to discuss and to that point You can watch me discuss so-called kids in cages tonight with a guest who has a beef with me from last week's debate on Dylan Burns Hippie Dippy debate stream you can catch that here tonight at 9 p.m. Eastern if you enjoyed this video Please hit that like button share and subscribe and I'll see you all next time


Thanks very much for coming in. I had COVID a month ago so I get a little bit nervous but I want to thank you all for the work you do every day. Under enormous pressure with inadequate funding and that's what I want to discuss. And thank you for traveling long distances to get you. Bottom line is that in a rural state like ours when somebody dials nine will run. Pretty good idea to have somebody answer the call and get to the house in the short of time as possible. And I sometimes think you know when we talk about the health care crisis in America something that I get involved in a whole lot with some chairman of the committee that deals with it. We talk about the high cost of health care. We talk about the inadequate number of doctors and nurses and dentists that we have but we don't talk about what first responders do. And at the end of the day if I have some kind of medical emergency in my home in a rural community if I don't get the care I need as soon as possible that's going to have a significant impact on my outcomes, right? And I think we don't pay enough attention to that. And I think we have a very bifurcated system which I want to talk about. How we improve it.  We have taken this issue seriously over the last couple of years. We've managed to get some not enough money into the fire academy. Who's with the fire academy? Alright so you're going to double the number of cadets we have, is that right? Alright so that's a big deal. We didn't you know there are a lot of young people who might want to work at volunteer fire departments. You haven't been able to train an adequate number is that a fair statement? Alright so hopefully we'll be able to do more than that. I don't know if you know that we got some money for Dr. Wilson who couldn't be here with us now he'll be here later actually it's been a great job. And he's going to be training paramedics for virtually for very low cost. One of the impediments has been if I'm going to be a volunteer and I have to pay thousands of dollars to get training that doesn't make a whole lot of sense. So we got him some money and I think he is developing a program which is starting off well. We got some money for Waterbury here. Senator Maggie Bird. Hey one of the students in that program. How's it going? It's going great. Thank you very much. Okay good and we got some money for Waterbury to hopefully help build a new facility there. So we want to stay on this issue. I want to get your ideas as to what kind of federal programs could be most useful and how we can improve the situation in Vermont. So it's a just fire away and tell me what's on your mind. I start off and then I also want to talk about you know EMT services often run out of fire departments and that's an historical thing but fighting a fire or dealing with chemicals in a house that fire departments do it which is enormously one is a very different situation than going out for somebody who's overdosing with drugs. What's the connection? How do we develop a rational system? Is what we have rational now? I talked to the fire chief here in Burlington. I think he said Katie what the three-quarters of the calls now are medically related. It's a different world than fighting a fire right? Fighting a fire is enormously important. We got to be prepared to do that. What's the connection? So let's think short-term what we do to help immediately. Let's think longer-term what is a more rational system. All right that's kind of what's on my mind. What do you got? Good to see you today. I've seen you in a while. We've been getting together for what 20 years isn't it? Yes usually in Washington. The one thing is it's not exactly short-term where it is but the extender bill runs out and this this year you haven't signed on to the bill S3236 which it always gets passed at the end of the year but the extenders and forandans and the Senate bill that you have actually adds a little bit more than it was before 3 it goes to 4.3 I think for the world. Okay we'll be on it. Good thanks. The other thing is on the workforce bill if you could I know you if you can have hearings that include EMS but add some language somehow that adds EMS for the future so that bill has not been completed yet and that's a good point. All right we my committee we deal with apprenticeship programs we are working on a big one which absolutely should include health care and EMS. Thank you. Thank you. All right why don't we start short-term and then we'll go to long-term. Senator Dan Dean. S930 which is the bill that would make cancer a line of duty death. People that die of cancer their family would be eligible for the PSOV. That's been almost a year now since I was introduced. I'd love to have you sign on to that. Okay good thanks. Hopefully we could get that through because it was it's a retroactive bill and it would certainly help families we have a family in Addison County that the chief died of brain cancer. Senator that was on cancer. And we think it's related to the work that he was doing. After 45 years of his family him and his family giving to the to the service to be ineligible for benefit just doesn't make any sense. Okay now I don't have to tell you that the Congress today is not the world's most efficient operation and we have to we only have a budget we have to extend it until continuing a resolution until March but hopefully there will be a decent budget and some of these things can be included. Okay other thoughts? Let me get around the table. We're in St. Johnsbury we're actually right now been working with our local EMS agency to combine our two services because there's been a drastic falling off of staff availability people that are interested in this line of work and so let me ask you why is Brett why is you're not why are you not I mean there's a label shortage all over the state why are people not attracted to line of work? I think there's a variety different reasons but one of the most glaring really is it's just when you look at the wages it's just not competitive it's not close to competitive and there's people that leave the service they go to New Hampshire because you can get quite a bit more in your salary and they go to other states. Let's stay on that point is that is that an issue that all you guys are running into? Yes the wages we've increased our wages over 25 percent in the last year and of course the payments from Medicare and Medicaid can't keep up with that but the real problem is in a rural state like Vermont where you have an aging population with not as many young people staying as one thing but then once you start to train them into the EMS actually a lot of hospitals because their shortage are hiring them. We lost 17 I think in the last two years. You've lost 17? Yeah that's what you know they're moving up but we can't afford to pay with hospitals. Is that a statewide problem? Dan you want to jump in on that? Yeah I think so I think we've certainly seen that I think certainly retention is not all about money but it is when you when there are exit points that give you a lot more money in other places nursing working in the hospital as an EMT I think that's always going to be a pull away from our system so we've seen that not just with you Jim but with lots of other services as well. So if I wanted to drive an ambulance for you how much are you going to pay me? To start not as a 24 hour course it's $19 an hour you become an EMT it's 21 50 an hour you're an A EMT it's 24 50 an hour a paramedic this is just the starting wages is 26 29 dollars an hour so the pay isn't terrible but again when you were in competition with the hospital next year it gets gets harder and it's not putting anything on the hospital but we have to have enough money to be able to pay enough to retain them. Regionally our to answer your question for central Vermont our regional first in the door basic level providers getting $15 to $16 an hour there are signs on our Barry Montpellier Road advertising for $17 to $18 an hour just to flip burgers but these are the people who we are putting our communities our neighbors our lives in their hands to get us to the hospital when need even more alright well that's one indication of a crisis in a system that is not working well the cost of readiness to you know what's the what the cost of readiness so our service as a call volume about 800 calls that doesn't mean we don't still need to pay those folks we're responding to those calls so the income that we're getting from the calls that we're going on doesn't supplement the cost right that we need to pay our employees I understand there's different reimbursement rates for Medicare for Medicaid for private insurance what happens with somebody doesn't have any insurance you eat it well you send a bill and then you write it off is that a decent percentage of your calls that no people don't have any insurance on your community you can be as high as 30 to 35 percent there are some agencies in central Vermont more of the city or large-town agencies that are writing off between 25 and 35 percent just because they don't see it all right let me ask you you know what we are seeing in Burlington we're seeing in Vermont we're seeing all over this country is fentanyl and you know but we have hundreds of overdoses who would believe that I mean if we were here 10 years ago we would not be saying that in the state of Vermont this small state we'd have several hundred people dying of overdoses right nobody would have dreamed that and that's about the national average we're losing about a hundred thousand people a year all right who wants to talk a little bit about what's going on there how do we how all we were responding to it who wants to say a word on that yeah I will so senator a hundred percent a hundred twenty-one thousand actually this year is actually two thousand twenty-three number yeah so I think EMS has a lot of potential in that right you saw during the pandemic the capabilities of us stepping up to do vaccinations and testing and all that and people at this table here certainly were deeply involved in that I think there's some really interesting we were just down at a national governor's association a collaborative meeting talking about what EMS can do we talked about the lead behind kids the connection to resourcing one of the big challenges that we have is some of the confidentiality requirements around this stuff like HIPAA and some of the other legislation around that which means that if Drew goes and takes care of the person who overdosed and the guy says you know I don't want to be referred to treatment we're done dead in the water can't can't give his name off to somebody else to even a recovery coach to call him up and say hey have you thought about coming in there's even some more that's pretty irrational isn't that well what's what's especially especially irrational is the notion that he says yeah I'd like to get a call from a recovery coach and we can't share his data from our state system to the to the substance abuse advocacy groups and that's been a significant impediment to doing any of that sort of thing so there's some of that pieces but I think there's what you're sitting around the table and I want to go back to what Maggie said senator and said we don't get paid for readiness the model of reimbursement is flawed in that you get paid only for putting the patient in the back of the stretcher and taking him to the ambulance like you don't get paid if you don't try and spark yeah so that means when Maggie goes out and gives that person Narcan on the scene wakes him up to a point of consciousness and decision-making capability and he says I don't want to go she's eating the cost of that of that call so that's a fundamental challenge there as well but the other piece that I think weaves into this is that system the way we're reimbursed right now favors the the agencies that have high call volume right with a lot of transports you have more income coming in when an agency like Maggie says 800 calls a year that's difficult that's difficult to cover their bills if we could find some things that are reimbursable for her to do in the downtime like give vaccines give a venture testing think about some of the some of the other models around opioid addiction and quite frankly about a lot of other things so the community paramedic the mobile integrated health model let's make sure that her people are being reimbursed and doing good for their community and available for emergencies at the same time I think in a month or so within the next month I'm going to go to Baltimore where Johns Hopkins has a nurse outreach program and they literally knocking on doors in their undeserved areas you know trying to get to people before they end up in an emergency room that makes sense that type of thing you should also go to Bennington talk to Bill Komarta and Bennington rescue because they're doing a very similar out really I didn't know that okay look I don't have to you don't want to hear a two-hour speech from me the health care system is dysfunctional we tried by the way on my committee to put a whole lot of money to revolutionize primary health care in America to make sure that we spend on money keeping people healthy responding to people's crises rather than get sick and then do you know major operations in the hospital that is what we do right now so there's a lot of work to be done but I agree with you I think you guys have well what do you think I mean is Dan right about that can we be doing more outreach stuff who wants to say a word on that please so we're doing some of that now me were you from rescuing down in Brattabereau okay so not only during the pandemic did we you know do the outreach with vaccinations and monoclonal antibodies but we're active in the mobile integrated health environment going out and seeing patients ahead of appointments at the hospital in order to help keep them out of emergency rooms and try to help them make the right decisions towards all right you know we also got some money for the community health center FQHC gonna be a they move it along they're moving along they're not active yet but getting there eventually that'll be I think help to win them county yeah absolutely access to primary care is is critically important and I think EMS can play a huge role in that you know we are the kind of the ultimate safety net yep 24 hours an a7 days a week people can call 911 and receive EMS services one of our challenges is right now we don't have a lot of options our options are to take that person to the hospital emergency department or to leave them at home there's not there's not those are quite often not the right options so as we hopefully expand what we can do in the world of mobile integrated health we can provide other alternatives such as mental health counseling substance abuse coaching and I don't have to explain to anybody here they're going to an emergency room is an extremely expensive proposition ten times more than cost to go to community health center let me detour a little bit it's also our emergency departments are overflowing there there are people there waiting days there to get out of the emergency department so the rooms that would normally be available for us EMS we are now forced to sit on a wall for hours on end we just to get our patients in the right yes sir and what is that is that because of drugs and it's because of psychiatric illness it's because of overburden of our health care system that is seeing more and more patients that are seeing sicker and sicker and our hospitals that I just had max capacity and cannot afford emergency departments in the funnel for the system senator you know if you can't get an appointment of your doctor's office I know you go to emergency right and it's easy and it's fast and it's simple and I think what Scott's talking about is exactly that I think the other point that I wanted to make is that you mentioned before about health care systems and I think what we're describing to you is integrating into that health care system instead of being the standalone redheaded stepchild of the health care system we need to be part of that and that's not I wish there was a system that's not they can grow with the fire departments either because there's fire departments are doing good work on that front as well all right let me ask you we put a lot of money in the state into expanding community health centers do you have any involvement with them are they playing any role in this should they be playing a more active role thoughts Mike the only area that it put that it doesn't help today is Medicare only pays to go to a hospital you may be able to have them take some less you patients when they're open if we were able to be paid to take them there okay so you are that's an interesting point Scott I didn't realize that you're having a hard time getting the care you pay the immediate care your patients need because the ER's are well let me can add to that yeah so one of the other challenges that we face in all our community hospitals is when you have a serious illness you have to go to a higher level of care okay so it's what documents well you would think but because we've had had such a shortage in the hospital staffing areas quite often we're headed to Connecticut main medical center in Portland out into what you're taking people to Portland main those are the closest available beds in our health care system so that's taking ambulances and crews that are out of service now for six eight hours at a time mention of all my patient I'm not necessarily want to be banging along to me right so you know the the ripple effect from our health care system on to the ambulance services is huge as well right so dog that is unable to accommodate some of units quite often Dartmouth so we go to Albany Medical Center a lot Albany is one where we quite often wait two hours to unload our patients like said Hartford Connecticut is is a daily occurrence for us Bridgeport Connecticut really so again that has a huge effect on our ability to serve the rest of our patients I'd like to echo one thing that Dan just said at the end in that we and I'd like to say if we want to do broke bolt stroke especially at the federal level we need to be have EMS recognizes in the central service and some of it may be just words but those words really matter to us law enforcement firefighting are all essential parts of our public safety EMS is essential part of public safety and our health and yet we feel like in especially our local ambulance services that are scrambling personally I'm selling Christmas trees to get two to three dollars to fundraise just to make things meet these are not sustainable products and so if we want bold strokes we need to be recognized as an essential service and then fund and recognize and support our EMS office give that and then the opportunity of staff to be able to do these broad strokes and leadership right now they're the lowest the smallest EMS office in New England and nothing to against their hard work people but they really could use some help I don't have to tell anybody here but in the midst of all of this you're living in a country that spends twice as much per person on health care as any other country on earth I think we can agree it how that money is spent it's not where it's going insurance companies drug companies not particularly rational our Danielle you've been so this is a young lady we did a video with what a couple years ago right two years ago today actually and you know we were struck by Danielle we bumped into her and my staff did and you know we're trying to attract young people into a volunteer fire departments EMS stuff and Danielle struck us as somebody was very excited about the work she was doing one of you how does the world look from your perspective Daniel well not just being a volunteer firefighter I'm also a registered nurse in Middlebury at Porter Medical Center now and it is really sad seeing people flow into the emergency rooms and we've maxed out down there and I'm on the med surge floor and seeing people have to get treated in the hallways and when they finally do wait a few days to get up to our floor which we can hold 25 and that is if we have an adequate amount of nurses up there and by the time you get up to Porter in the med surge unit many times they have to be transferred up to UVM and that's only if you can take them I had a patient recently that was needing to go to a higher level of care and the wait time was 24 to 48 hours which is horrible for someone that slaves on the line but I've been a firefighter for a few years but I started when I was 15 the cadet program thanks to men like them over there it was scary to start out and not knowing what you're doing I don't have a parent on the fire department so I really just kind of dropped in it was actually after cheerleading practice my mom dropped me off at my first meeting that I could and it's it's really critical to have someone take you under your wing especially when you don't have a family member on the fire department and I know that in a lot of trainings they try to start you off at like the the bottom of the line because I had no idea what I was getting into but I think it would be really critical to have more cadet programs where you're in a training with other people that also have no idea what they're doing it's a lot less scary did your involvement with the fire department end up influencing your decision to become a nurse I actually wanted to be a nurse because I was a patient in the hospital I'm not sure what made me want to be a firefighter I honestly think you guys were really cool and I did an eighth grade challenge you got to just study anything and I chose volunteer firefighting so then I knocked on the doors of the new Haven file volunteer fire department when I was 15 but are we having success in reaching out to young people I think we are I mean we're seeing interestingly enough the smallest demographic in the fire service right now is that under 21 age group so we're working hard at trying to raise that programs like the Cadet Academy which you experienced you know we're trying to grow that and Dean and Peaker in the room and can can attest to that infusing that money that you secured for us before the that program is going to be a help we see a lot of students start in those cadet programs and then continue on in either fire or EMS or some other you know not even sometimes law enforcement it's just hooking them into emergency services giving them that exposure we see them continue that into adulthood so so they're all good things are you getting into schools to talk to kids about the opportunities that are available word we're not we need to that's an avenue that we need to start approaching interestingly enough you know a lot of folks think that the the answer is technical centers and we've had some struggles in technical centers because in Vermont there's such a large volunteer force in the fire service that it doesn't help them achieve their goal of career placement so there's there's so there are so many fewer career positions career opportunities for firefighters in Vermont that that hasn't been one of the big targets of the technical centers but I mean it as chief recon attest we're seeing I think right now we're seeing more fire service career opportunities than I've seen in the last 20 years in Vermont so it's growing it's becoming more popular but we need to find those people that you know we all know that the age of Vermonters is increasing and that's you know as a small town fire chief I can tell you I've knocked on so many doors we need more people in the age group that can serve we need to grow the workforce so that I mean that's that's the focus you know are we reaching out to young women as well absolutely yeah and we're starting to see increases in the numbers of of women registered in our entry level programs which is good and that has continued to climb over the last several years so we're we're we are seeing some successes in pulling women into the fire service I think you made a good point with the technical schools because they actually stopped offering it when I got into high school but I wanted to be a nurse and I knew I didn't want to be a firefighter to get paid for I wanted to be a volunteer firefighter so why would I waste my like class time for something volunteering when I had to go into biology in Latin to become a nurse and but there needs to be something like after school I know I've mentioned before if we could have enough training hours for those cadets that they could get an incentive to not have to do physical education or something like that just so that they can still get like the training hours aren't just adding up for the fire department but they can get some kind of incentive for that in another way so we opened a EMS training Academy down in southern Vermont last year and we have our first where probably have new fame Vermont so Vermont EMS Academy down there and we have our first cohort of high school students this year wonderful they're doing it as for credit as part of their education program so they could then was it hard to attract them or it was very easy so we're looking forward to the outcome of this program and another I mean what's great about that is the immediate problems that you're helping to address but also getting young people into health care I mean there is you've indicated we don't have enough nurses we don't have enough doctors we don't have enough paramedics to get young people interested in health care in general is a major step forward and if you get someone hooked when they're 15 16 they're gonna want to keep going I've been on the fire department for now 10 years and it's just kind of getting your foot in the door because it's a lot harder to start something when you're older when you we got to build a system to keep him it's it doesn't God bless him and nurses are wonderful but I want to build a system where a person who decides they want to be an EMS provider or firefighter who says I can get a job I can keep a job I can make a living wage I can have benefits I don't have to work 10 jobs to do this that's another important piece of this as well and we need an educational program that is free for cost our firefighting program at the Vermont State Fire County is free and you can get all the students in our EMS academies are not and that is an impediment to so far I want to be how much does it get across me 1200 to $1,500 for this is what we're trying to adjust with Wilson right exactly 12 to 1500 just to get any empty license we're beginning to try to address that and I appreciate your help on that really do you know what drives me crazy I gotta tell you when we sit around the table is it's clear we don't have a system alright nobody in the world would deny that the work you're doing is enormously important you're sometimes you're going out and doing something you don't get compensated a nickel for doing it right you're paying people 16 bucks an hour to do very important work but not training the young people that we need we need to really be thinking immediately but we need to be thinking big term big is the state appreciating these problems and addressing them in the bold way do you think is there some yeah I mean listen everybody who works at the state offices of EMS Robotters come up through the system they understand this as much as anybody I think the challenge of course senator is there isn't a simple lever to pull or a switch to flip to make it better you know there's not if it was simple we would have fixed it already but you know I think I think so I think we're making some strides it's complicated unfortunately it is it is our other thoughts team you've been senator thinking of the younger people the cadet programs I think one of our biggest drawbacks is they go out and train with their local fire department and they're going to do ventilation tonight and all they can do is stand back and watch the ventilation being done they're not around because of their age to actually do the definition we take up somebody using a chainsaw in a forestry class at the age of 16 they're allowed to use that because it's educational but as a firefighter they're not allowed to do it because of occupational so we need to change that we've brought this up many times who to see it just we need to be able to train them the same way that we're being trained because sometimes you lose yeah they are being set aside to watch and they want to do hands-on Daniel may want to jump into this discussion but I think we underutilize our young people I think a lot of young people who want more responsibility and we don't give it to them we treat them like little kids and they're not they're adults and who can help who will enjoy doing the real work and help the community doing it I don't think we take advantage of them as much as we should so that's a good point and that's that that was the problem with the career centers they take the course and then they couldn't test out for firefighter one until they turned 18 because they weren't a by-state law they're not allowed to run power equipment or be involved with live fire regulation this is a federal regulation it's an OSHA regulation and bullshit follows it and when you're 16 two years is a lifetime you know so you find something else to do you know that they're not going to want to sit around and I believe me I got it you show up to a car accident and you were told to stand up on the bank because you can't go near the person or at a even just a training you smoke out of building you're out on there on the edge doing nothing which is discouraging and kind of insulting when you show up to help to do something to learn and you're told to just sit there so the same thing in our ems licensure the 18 year old environment they can't become an entee until they're 18 they can't even test until they're 18 national registry will not allow that either so we we face the same battles on the ems side of educating these individuals getting empowered at 16 and 17 and then asking them to wait till their 18th birthday to finally test out Katie we all know about I shouldn't job sorry I said Katie Vanhase is our state director and Haley Perot does our outreach work Katie I Haley do you want to jump into this anything on your mind Haley Haley's been getting all around the state what what do you think I think a lot of what you said that there's a lot of challenges but a lot of untapped opportunity I think I was hearing from Drew about kind of what EMS can do and I know fires similar really beyond sort of what we traditionally have thought of us as EMS and fire and folks that when there's an emergency like COVID or even the flooding I know that it was folks like you all who are out in communities so I think thinking creatively and then also thinking about how we pay you for it and then really interested in getting young folks involved and people seeing themselves as someone who can join a fire department I think what Danielle said about if you don't have that family connection how do you knock on that door I know you did Operation Mayday to try to encourage folks but really just making it very approachable and real for people was that successful operation may day it was for the first year for the first year out of the gate we did an early survey after that event and we counted over 30 new responders entered the fire service so for the first year it was so and I've been working with you on that or we Haley helped us do some outreach to get spread the word you know we have a thing I don't know if you're familiar with called Bernie buzz which gets around the state I think we have 150,000 people on the list and the Bernie buzz did advertise this okay so uses if you think there's something that would be of use statewide with it to try to work with you there's two grant programs to that are critical the fire service AFG right which today's grant so yeah so I know with a continuing resolution sometimes things are up in the air but reauthorization it'll happen all right it but it's totally it but what is the what's the federal contribution how much is AFG how much how much is how big is that part you call I think it's 360 million something like 360 each yeah and usually the local cost shared depending on populations 5% so it's a pretty good so we ended up applying for a safer grant just you know we've recognized staffing at such a crisis right in the state so we put in for a safer grant and we weren't successful unfortunately made it through peer review it just didn't go on the technical review but you know like the city fell off you got $22 million we're asking for 800,000 one firefighter I know I know it gets frustrating so that you know continuing those programs we have had I think some luck in Vermont yes some departments have received grants all right here's what we're trying to do that we had some of you were involved you remember a couple years ago we were on the phone with fire administrator after Biden came in we begged them and I think we ended up having some success I mean given the bureaucracy that if you are a small department filling out these forms is like impossible right 10 to 30 hours of work right for people don't necessarily have the training of other work right right you know we begged them to simplify the process I think they did yes a little bit a little bit and they've created this micro grant program as well so they explain that okay there's a as many of you might want you guys sit up here on my program program that has been around and this year they increased the maximum to 75,000 so again this grant program that's a little more accessible consigns be regional now has more money in it so it's not limited to I think previously 50,000 yeah anything you can do to make the program bigger because there were 8,000 applicants last year less than 10 awards in Vermont I know and which probably was good for Vermont by the way 10 of what's relatively speaking it was good for the 10 that received that right but no way near enough I know yeah is it still limited 2% for EMS yeah so yeah that's why EMS again being 80% of the call volume they do present the money and after that discussion online the center introduced a bill to create essentially an AFG program for EMS because there's a need across the board for fire and EMS instead of competing against and we try to put some money I think into the primary camp bill as well one of the struggles for fire fire departments municipal fire departments and where they differ a little bit from EMS is EMS can bill for their services we don't bill for our services so we're strictly funded by taxpayer dollars so there is a revenue stream for EMS to recover some of their costs it doesn't it's not enough for sure but that's fire there is a difference EMS and fire gets the bill if you had an ambulance you'd build yeah so making sure it's not that different yeah and if fire departments had the able service they would be able to go for some of those services but standalone fire departments don't have that so you're competing for tax money that is really a struggle in some of these small communities when you add in the school budgets and highway funds so it's pretty that's a double-edged sword though too in that for us standalone EMS agencies our select supports look at our hey you can get revenue so I'm going to focus tax dollars on those entities our law enforcement or firefighting and other priorities of the town that can't get revenue I'm going to focus on really trying to increase them and you can go find your revenues in your reimbursements well we know reimbursings for Medicaid and Medicare are really challenging and nowhere near equate to what we need operationally so it's a dual-edged sword I'm not gonna talk about reimbursing remind me again I know that you got the private you got Medicaid Medicare all different that's great private is the best is the highest reimbursement rate we unfortunately to try to shift the amount of money that we can get in from Medicare and Medicaid we have to shift our costs to private insurance so they can pay more so that we can just fund and put the lights on we are fortunate to have our Medicaid rates increased locally in our state legislature so I want to call out all the hard work there but that hasn't solved the problem and that's only a temporary stopgap and Medicare Medicare and drew can speak better to this number I'm not sure if it's 55% or 60% of what normal private insurance would pay and we are forced to come up with 35 40 percent of that funds from somewhere else tax payers fundraisers somewhere we have to do to pay the lights to stay on and 60 to 70 percent of your business is Medicare and Medicaid always all right so you're talking about all 70% of your patients are on Medicare and Medicaid and some have no it's really hard to make up a difference okay and then some have no insurance at all no and I also want to make sure I mentioned it appreciate you being the major co-sponsor and working with Senator Wells to pay for the trips that we talked about that we don't transport but just you know when we talked about you're writing off 20 to 30 percent for people can't pay 30 percent of your call volume 20 to 30 percent more of your call volume is going to and not transporting and this is tried the right factor that's impacting us of mental health drug abuse and homelessness is all well relatively new in Vermont impacting our bottom line and making the when we call we show up whether they pay or not and we will transport always all right so all right let's talk about the trifecta and you know you all know it's it's bad in Vermont it's worse than many other parts of the country all right let's talk about I mean this drug thing is is horrible and I guess you're on the front lines of dealing with that all right give me some examples of what you're experiencing yeah so sometimes we talk about the the impact on the people that are suffering from addiction I want to just kind of highlight the impact on the healthcare workers that are managing it it's not uncommon for us to see the same patient repeatedly and you know just a personal story after doing CPR on the same person four times to show up too late the fifth time and see this person that we've tried to get into the system we've literally gone through the the motions of resuscitating them taking him to the hospital to see them over and over again and really the the end of that is you know on a number five we were we weren't called early enough and it was a negative outcome so there's a huge impact not only on the the people that are suffering from addiction but everybody in the room and the staff that we represent that are going out there every day is seeing these patients over and over again all right let me pick up on Drew's and that's a very important point I mean we do we talk about how we deal with the addict but we're not talking about how we deal with the folks who every day are out there trying to address the problem does what you said resonate? I can recall an instance just recently where my crew responded to a mental health patient who decided to ingest cocaine and took on my local law enforcement officer and they assaulted each other for over 25 minutes and we were having to get our EMS crews get involved and get injured just to be able to safely transport this patient who only in turn after three and a half hours was discharged from our emergency department and reabused for cocaine and called 911 system so that same crew that was just assaulted just injured had to go back and take care of this guy again where he is again swinging at EMS providers this is the system that we're asking people to join to people to stay in to retain I don't know how that's sustainable firstly all right further I think I know the answer to this question I'm gonna ask anyway do we have the kind of treatment available for that person who OD'd on four occasions so that is it so somebody is ODing and ODing what do we do? The patient has to make the choice themselves in order to get the help we can't force them right you know to make that choice I know in rural areas these are people we know on a first name basis when we go to see them like you said you know in in Waterbury the police force that we have are coming from the state police and so they could be two and a half hours away at three in the morning when we're going to give me an example I give what you're dealing with yeah we go to a patient who has overdosed and they call 911 we only say hey is there where are they home now or are they both with those somebody's called 911 what happens are there police available that can come follow us they're aware that it's it's happening and they're gonna send some women they can and so our crews then will stage and wait until it's safe for them to enter the home to take care of that patient wow which is not good health care I presume huh the other thing from the outside looking in I don't do a EMS but from I'm on the select board in our community and our police chief says the biggest the only place to send people in mental health crisis is to call the ambulance and send them to the hospital and then when they get there there's no treatment for you got it and like she says they're right back home and and within hours you're dealing with the same thing again the CEO UVM will tell you they don't have the capabilities they just sit in the emergency room exactly in days because there's no room for places and when they put them to a room it's enormously expensive in there they don't have the capability of treating people what about Prattle bar is the retreat doing much now or retreat treats very very busy we actually have a partnership with the retreat in order to help I know they went to difficult times yeah they're they're back up to about a hundred beds now let's say we work with the retreat every day of the week to help get patients that are stuck in emergency departments around the state so we'll actually go out with ambulances and transport those patients in the retreat to try to bring the amount of time that they're waiting in er's down we've been successful at at cutting the er wait times once they're accepted from about 20 hours down to about eight hours but that's still a long time even after being accepted for mental health can you draw a call to southwest hospital bennington was building some were you thinking of building some capacity as well yes i believe that that is that true down in bennington excuse me senator i was going to add i think there's opportunity here for ems and fire as well first of all i think we have to seize these opportunities when we have a more intimate relationship with these folks who are overdosing and in psychological crisis and perhaps any other arm of the health care service so we need to be able to make that connection immediately it's absurd to think that we're going to give you a narcotic antagonist that is to block your your overdose put you into withdrawals and then say okay see you later right we've got to be able to do something to either connect you to treatment services to connect you to detox connect you to something do we have does anyone here think we have any way near the capability no we need but but i think there's an opportunity um we've begun it we will begin very soon an ems buprenorphine project where our ambulances are carrying medication assisted medication to assist this moment so i think that's a piece that's there i mentioned before about the connection to treatment right away we can't say call me back in five days to get treatment we've got to say this is rock bottom here's somebody that can help you and these peer review these peer coachings are exceptionally important in that time they're they're saying hey we're here and we're ready let's go if you don't seize that and then the other thing i wanted to mention is that i think there's an opportunity especially around psychological crisis to begin to triage where these folks go how we respond to them senator if you and i sat in an er for four days as sane as we might be we will be well talk to yourself i don't want to but the point is nobody can exist in that environment and what our response is generally escalating the situation so we're working on some creative solutions to try to uh for example with dru's team down at the um what's the barracks down there westminster westminster barracks we're triaging people who call for mental health crisis to say look is it the appropriate resource to send state police which sometimes it is is it an appropriate resource to send ems or is it a more appropriate resource to to send you over to nine eight eight the suicide hotline back we have a meeting this afternoon to talk about just that how do we put that intervention point into our call taking system to say look if we can have you talk to a clinician that's better trained more appropriately trained let's get you out of this number of police departments are beginning to do that yep i was for example the state police we just put we're going to put 12 new healthcare workers into our barracks next year so i think there's opportunities i think i think and ems and far can play an important role in that all right all the thoughts senator oh i'd just like to first i would like to say thank you for what you do for us but thank you also for what hailey does for us hailey has is well respected throughout the state in the fire service and i'm sure in the ems and we're we're super happy with that thank you very much my question is is over the years we've introduced on the federal level several bills we were in shellburn that we did a benefits type thing that we introduced and we've always included although it doesn't say ems we've included first responders so that it did include ems but we don't seem to and there's been other states that had their senators or representatives introduced bills for the fire service and ems we just don't seem to go anywhere what can we do to to push these things see we're going to get arrested if we show up on the on the floor i'm pretty sure that sounds i don't want to get political here i really don't but there are some folks who would rather give tax breaks to billionaires and large corporations than funds the enormously important work you're doing and the irony here is this is not just a vermont issue i suspect there are 49 other states that are dealing with exactly the same issues rural health you know we talk about the health care crisis rural health is even worse uh and who is the backbone of rural health is what you guys all over the country are doing right so the irony is you talk about this everyone nods their head and their support all right all right well i can tell you dean is we're going to stay on it and do our best in in all respects uh the safer program is inadequately funded the afG program is inadequately funded the ems stuff is inadequately funded um yeah dan jim just wanted to see if possibly rural states have a lot of power in congress and seem to do well and that's in on your favors yeah our favor you're also very powerful chair of the health committee health education is there maybe some hearings where you can get people to support some things that we could get the word out yeah i mean how they know it but if you could get them to come the hearings are good but that you gotta go and the answer is yes and i'm sure we can get folks not only for vermont but your compatriots from all over the country to make the case and put pressure on the congress act so it's a good idea and i think it's something uh we can do um but we'll also need the help of your national organizations because i am correct i know it's saying this is a national problem none it's not just a vermont problem especially for rural states uh i've talked a little bit about drugs being a new and not new but a significantly increased uh crisis for you guys right mental health covet player role in that do you think is that was that a stimulator what's going on with mental health why do we see so much you know i go into the schools occasionally and the kids will acknowledge that they are dealing with a lot of stress and anxiety daniel is that true yeah i would say so i mean if you don't get to be around your peers and you're not stimulated and you're not used to that schedule that you knew for the last however so many years it does play a big role and when you have to go into a house and you have to like gown up and be scared of what you're walking into and i mean it does adds a whole other factor of stress okay what is on your minds that we did not discuss gone over a lot of stuff so kind of a move towards regional departments and at least discussions about that are starting to come up that makes sense to you that's to me spreading out the resources over a larger population yep to the extent there is something that could be done more long-term maybe discussion about how we could have a federal government or man that's not so much a federal i mean federal government is money but how that money is how they could how it's you know the structure of how who gets the money that's that's the state's decision we are we are no great secret we we're not into county government very much yeah right but you know i could tell you you don't get musky over there and you got south brought in on three separate entities really five minutes apart from each other makes sense and that's so sure it does i think there's creative ideas though senator and i don't think it's entirely incongruent to think about it in the way we think about health care from federal level we have fqhcs we have critical access hospitals that are federally funded i don't have a mature thought on it but but i think there's a process to think about it in that way of of here we have an expensive resource that we're simply not able to pay for it some of these most rural places how do we scaffold that in a way that it's sustainable i'm not saying that it can you know be entirely underwritten but we do it in other arms of health care uh and maybe that's going to be thinking about me as well good brad touched on regionalization it's a conversation that we've had for quite a while now at different levels and i think that we're starting to do it without calling it back because everybody has their own little kingdom that's our biggest problem is we all have our own little kingdom and we don't want you coming into our kingdom and telling us what to do so regionalization is is a tough pill to swallow but i think it's the only way that we're going to be able to afford to be able to have fire service and ems in the future homeland security was probably one of our biggest flaws in that everybody got the same toys so now we don't need you you know where we might have used brad's department to come in and assist us because they had a certain expertise now we have got the money through homeland security to get the material to run that and we we don't have the ability or we don't have the people to staff it so we're no further ahead and then once that piece of equipment is no longer viable we have to figure out how we're going to fund it again if we want to keep that going and i see that as a you know one of the biggest things was uh 9 11 being able to communicate across lines and we're no further ahead really our communication than we were when that happened i mean it is it is terrible and we have these discussions all the time and we don't know the answers but i think we're moving as the cost goes up i think we're moving more towards regionalization and and understanding that we don't all need all the toys um you know the cost of a cost of a new pumper is is upwards of five hundred thousand dollars now you know how do you know i was mayor of the city a long time ago and that was one of the shocks that i discovered god that was expensive it's worse i think regionalization could be formal and informal and um a formal model like drew's model that he's using down south but i think there's also informal models such as up here in ginnick county where the local entity agency may be able to get its first uh ems call out the door with its ambulance but the next call coming in is probably pulling in the town will come over and that happens dozens upon dozens times every single day and that it's a web of individual organizations but they just thought decided to help all of each other out in the name of mutual aid and that's essentially a regionalized model so i don't think it formally needs to have the big old agency come in sometimes there's other local options that can achieve that but i think that's what we're trying to achieve one last thing i want to call out is the health care and wellness of the individual responder um retention is great and important but if they get that one call which drives them out the door that could be decades of learning education and expertise that we will not be able to replace um do we have the counseling and the help for that individual i think on the short term maybe on the long term i'm not so sure we have it but getting us getting me to admit that i have that weakness is the first problem getting me to admit that a call bothered me and that that i want to sit and talk with you to tell me about it peer support is a big thing that we're pushing to you know tell your members to talk to the person that was at the call with you and and get it out well you guys see a lot of dreadful stuff i mean i think every one of us that sits around this table knows at least one person probably more that have left emergency services because of their mental health yes because of what they've experienced because of what they've experienced and how and how uh there wasn't a mechanism for them to manage that and it's a thousand paper cuts too right i mean it's not always the awful and tragic call it's the awful and tragic calls plus low wages plus long hours plus getting up in the middle of the night i mean it's it's not one thing it's a lot of things and they all are cumulative four agencies to make ends meet each of those getting up at three in the morning only to turn over to get to the next agency to try to keep keep my bills paid and losing people to that doesn't help our personnel crisis right i mean we can't afford to lose those people not you know beyond that we can't afford for them to to leave feeling that way because that that's just the start of what they're going to experience in their life and the public can't afford to have us lose them and i think we have seen a culture shift for the younger generation coming in being more cognizant of mental health talking about it being more open about it and how can we support financially those individuals coming up that will be more open and will help advocate for that for us as an industry and the pity of it is it's not that as a nation when i spend enough money spending a whole lot of money that's how we spend we don't spend it on prevention we don't spend it on primary care we don't spend none of the work you're doing but if i end up in the hospital on some surgery i'm gonna come out with a million dollar bill right million dollars go a long way deal with the bobbin right and not just the hundred and thousand dollar trucks is that like my fire department right now we only have a handful of interior firefighters and i'm one of them and my gear is older than that i mean we can't afford to go buy brand new gear and how many years is it that it even lasts more ten like that's crazy for a fire department that's has it we only have about 400 people in my town right now but if someone's house catcher's on fire that's still a house that's caught on fire if the town has thousands of people i mean and it's scary to think that if a tone goes out right now and i put on my gear and you're going into a house that has scary chemicals and i don't have the right gear i mean then i'm just putting my own health online just to end up in the hospital yeah and then i have to call this guy to come get me because i'm no longer healthy and i'll take you to Connecticut thanks yeah i prefer main though but all right i think we have probably raised more questions than provider answers but all right let me just say this uh if you think the problems are overwhelming you're not crazy they are if you think the system is irrational you're right you think we spend the money where we shouldn't be and not spending where we should be you're right if you think congress is not addressing these issues you're right maybe the state legislatures doing better i don't know but uh all right all that i can tell you is this number one from the bottom of my heart and i know i probably speak for everybody in the state of remorseless 640 000 us thank you very much for what you're doing all right and you are heroes and heroines and you don't get the recognition that you do and you're doing it every day on the great stress so thank you and some of us not just me but some of us are more than aware of the issues that we have discussed and we're trying we're trying i mean we just a few months ago brought forth a bipartisan primary healthcare bill which would have gone a long way to address some of the problems we're talking about couldn't quite get the support that we needed so we'll have to come down and do much less than i wanted but some of us are aware of this and we're trying so i want you to know that that don't think it's what you're experiencing is not perceived by some of us in congress and your delegation uh becker and peter i think are there with me um are any else that anyone want to raise just thank you to you too and your staff for supporting us oh you got it it's my honor to support you because you guys have done great work it really is and it's a pleasure to work with people who want doing the great work you're doing all right there's a lot of stuff we're trying we're making some progress uh we're going to stay with it we'll continue communicating tell you what we're doing hearing from you uh but um maybe the last word magulate program leader you're working with dr wilson is going well yeah tell us a little bit about it so we're in week two um it's a program that's been in existence for several years in upstate new york to meet the needs of those in rural areas so it's an online so we're in person on fridays from eight a.m to four p.m um and we've got four different classrooms on the screen in front of us so there's and it's inexpensive that training is reasonably inexpensive yeah i believe that i've been told that the cost is going to be covered so that it's not going that's the money that we got okay that's what we want all right so the idea i made of all the crazy things the idea that people want to do the right thing of to spend what a couple of thousand dollars to get dmd training up to twenty seven to thirty two thousand dollar center for the program and a program for forty five and they say yeah does that make any sense to anybody i mean it's it's unbelievable all right so all right we're trying we've got a enormous amount of work in front of us and let's keep working together thank you all for what you're doing thank you


Hello, everyone, and welcome. This is Melissa Armo with a stock swishing and reviewing Disney, a really nice move in Disney Day. Again, I have so many trades that I've called in this. I did not call a new trade today. There was a recent trade in this, and then there was like a bazillion other ones. I mean, I've lost track of actually how many trades I've called in this, but I'm doing this review here now because for those of you that did do these trades, for, I mean, again, there's just so much time here. I mean, this is a nice move, but I mean, at the same time, there's so much time left. So I'm just, I'm doing the email and I'm gonna send this out to everybody. This is a big move. This trade looks great. You're up a lot if you did any one of the Disney trades that I called. I think that, you know, what you could do here is if you have all the Disney trades on still, if you have them all on and you didn't get out of any, I mean, you could get out of the closest up one like today or even see if we get up to 145, 150.   Pretty sure it's July something. I don't think it's August. I don't know, it is August, August 6. And these are, I've just called some great trades in this, I don't know what else to say. So I think I'm thinking I'll leave it up to everybody.  If you want to get out of one, then get out of one and leave the rest on. If you got out of any of the ones that I called it and do them, well, I have no clue why because this is, you know, really very strong. It's a bullish move. This is probably gonna run up to 142 today, maybe even get over 142. In fact, let's just look up what that exact number was over here. 142.37. If we get over that today, we're gonna go another day in this. I mean, it's, when you're up a lot of money in something, I don't think you can make a mistake. Taking profits, you will never lose money taking profits, but I just wanted to alert everybody that this is running and it was just a beautiful, beautiful, beautiful, beautiful move. And if you took the quick profits on it last week, then fine. But if you held this through, it looks great. And again, you know, you can't err in taking profits. So congratulations to everyone that did the Disney and congratulations to everyone that's still in it. So we'll be watching this here pretty much today to be watching for the 142 area. I mean, that's pretty much what I'm watching for here. Here, we're almost gonna get up to it now. There's two hours left on the clue. All right, good luck everyone and congratulations to everyone that did Disney. Nice option calls in this this year. Bunch, bunch out there. And if you're new to the letter, you may not have gotten some of them, but I'm sure I'll call others. I did not call a new trade in this though today because there was like so many on, you know, so. But if you did it, if you went long Disney today, it's just a day trading and you made money. All right, talked to everybody soon. If you're interested in the Gap Options newsletter, email me at Melissa, thestockswish.com.


Dear students, now we'll move forward in our review of structure prediction strategies. You already know that there are three common strategies that are employed towards predicting protein structures by using their sequences. The first one was homology modeling, the second one was fold recognition or threading and lastly ab initio methods. So in this module we'll be reviewing fold recognition. So in this slide you can see that if we had the primary sequence of proteins that was obtained from either admin degradation or mass spectrometry then we could move towards homology modeling. However, if we had no homologs with 3D structures then we had to move to a different strategy. This strategy is called fold assignment. So once again if you cannot find complete protein structures having similar sequences to your sequence then you have to move to fold recognition. So in fold recognition you started by looking at folds from the library. So these folds were then investigated individually for possibility of being formed by the amino acid sequence. A protein may have multiple folds of course. So here is your amino acid sequence, here is the scoring function and all of that is put into this threading algorithm and you may now know that the most common tool for threading is the eye tesser. You should go and use it sometimes and then the threading software it outputs the predicted structure. Now let's take a look at a step by step flow chart. So you started by looking at the sequence of these proteins. You found the homologs from the sequence databases by blasting them. These were called the templates and then you went for finding the structures of each one of these templates from the PDB and then these PDB structures were searched in the fold database such as SCOP. So for each PDB file you will be having multiple folds, fold 1, fold 2, fold 3. So you will have a list of folds that each structure has. Next you compare the predicted structure and experimental homologs. So if the structure that is predicted is plausible and functional then you select it and you try to create a tertiary structure by creating combinations of the folds and therefore your structure is made. So in conclusion for the fold recognition you may have a low identity and a low sequence alignment score. So in such cases threading is very useful. So threading relies on the fold databases and you have to find different folds from the overall protein structure and then investigate each fold individually to form that fold from the sequence that you have. Also the fold recognition paradigm is extremely useful in cases for novel protein structure identification. So if your protein structure is not there in the PDB then you can use threading towards predicting novel protein structures as well.


I know that all in Parliament are shocked and deeply saddened at the sudden loss of our colleague David Hill who died on Saturday while representing the Parliament playing rugby in Dublin, and I'd like to invite Jamie Greene to say a few words. Thank you very much, Presiding Officer, friends, colleagues. We politicians like to speak but this is one speech I would rather not be making. The news of the sudden passing of our friend and colleague David Hill came as a shock to each and every one of us, but the outpouring of messages of condolence also has been overwhelming, and I hope that brings some comfort to his family, reaching the many messages of kindness from across the political spectrum and watching today's proceedings. Presiding Officer, David Ross Hardyhill was born on 17 April 1991. He passed away on Saturday afternoon doing what he loved, playing rugby with his friends. David was a people person, a true gentleman. He was kind, generous, respected and well liked. He was a friend to all, and our thoughts are not only with his family but those close friends who were enjoying his company on that rugby trip to Ireland. A trip that I joined him on just a few years ago, so I too know how much fun and camaraderie they will all have been sharing this weekend. It may be a cliché, but David really was one of the genuinely nice guys in the world. He was a huge rugby fan. He was actually one of the founding members of this Parliament's rugby team. As it so often does, Presiding Officer, sport brings together those with differences of opinion and different views, and it forges unlikely friendships and alliances. David played scrum half for the Parliament, but also for the Dumfries Science and Dundee University rugby club. He followed our Scottish national team with passion, as a season ticket holder at Murrayfield, but away on trips to England, Ireland and Italy, cheering them on in their wins and their defeats with equal passion. David was a bagpiper. I didn't know this when I first met him. I recall once telling him that I was never overly fond of the bagpipes. But I'm sure you're most excellent, I said. He smiled back wrily and politely in his usual way, thinking plenty but saying nothing. He was an enthusiastic golfer and a man United fan, but politics was his passion. He attended St Michael's Primary and St Joseph's College in Dumfries. He went to Dundee University to study politics and international relations. After graduating, David has been a stalwart of the Scottish Conservative Party for almost a decade. He campaigned and organised and helped with the Better Together campaign in the referendum. He was a campaigner with David Mundell in the Scottish Parliament here. He was part of our party leader Douglas Ross's team in the last election, driving him around from place to place, donning his blue jacket, leaflet bundle in one hand and probably tweeting and taking pictures. More recently, he was head of office for Tom Mason, a retired MSP for many years, but he also helped Annie Wells when she was short of staff and my colleague Sandesh Gohani when he first joined us. More recently, David was my own head of office, taken over from another good egg in this place, Andrew Brown. We often spend more time with our staff here than we do with our own families and friends. I am sure that my endless team WhatsApp messages drove David to utter distraction, but he never, ever once complained. Our staff are always there for us. They shield us, they support us, they humour us and they do so with the sort of humility and patience that I can only aspire to. We cannot do the job that we do without them and I know that that is a story that will be familiar to all of you in this chamber. Our grief here is not unique. Our thoughts and prayers today are with David's family. His father Roger, his mother Sharon, his step-parents Leslie and Gordon, his siblings Alex and Georgia and his two nephews, Freddie and Hunter, who were all special to him and he to them. I take great comfort in the words of David's father who I spoke to on Saturday in our first exchange after learning the awful news. Roger said, David was living his best life and, Presiding Officer, isn't that the highest accolade or aspiration for any of us? He was taken from us living his best life, doing what he loved, with the people he loved. When I arrived at my desk this morning, some kind soul had placed a vase of daffodils on David's desk. They are a very visual reminder that the gloom of winter does and will pass. So I pray that the passage of time will ease the pain of those grieving today. And when we applaud David in the response to the remarks spoken today, let us also applaud each and every one of our own respective teams too. Because David's legacy will be his passion for crossing political boundaries and divisions, with no motivation other than simply to be kind. And that is a lesson we could all learn. Let us be kind and friendly to one another as David was to us. Let us all be a little more like David as we go about our business. Presiding Officer, we will all miss him dearly.