The recording of the session has begun. First off, we want to welcome you to this first webinar of a series of presentations that are building on the genomic special issue, which has just been published online, February 2013. Today's topic is relevance of genomics to healthcare and nursing practice. I want to introduce you to today's presenters. I am Dr. Jean Jenkins. I'm a clinical advisor at the National Human Genome Research Institute at the National Institutes of Health in Bethesda, Maryland. Our second speaker will be Dr. Susan Genaro. Dr. Genaro is the dean and professor at the School of Nursing at Boston College. And she is also, very importantly for us, the editor of the Journal of Nursing Scholarship and has been gracious enough to share her time and expertise with this webinar today as well. So welcome, Dr. Genaro. The third speaker is Dr. Kathleen Calzone. Dr. Calzone is a senior nurse specialist researcher at the National Cancer Institute, also at NIH in Bethesda, Maryland. So the next slide will show you what we plan to cover today. So Kathy, if you can progress the slides. I'm trying. I'm stuck. Today we plan to provide you with an overview of a number of pieces of information. First off, give you some perspectives of the Journal of Nursing Scholarship by the journal editor. Provide you genetics and genomics and relevance to nursing practice, education, and research background information. Give you a summary of the content which is provided in the genomics special issue that we're so excited about. And also then give you a few genomic education resources that you can learn more about genomics should you wish to go to those in the next couple weeks. There will also be an outline of the ongoing webinar series and discussion, questions, and answers towards the end of this presentation. So we hope you'll be able to join us for the whole, say, 45 minutes today so that we can give you this background information. If you can go to the next slide, we'd like to welcome Dr. Susan Genaro, and we appreciate her telling us more about the JNS and their decision as an editor and a board to have actually this genomic special issue. It is the first of its kind, and we're so excited that this is the topic because obviously we feel this is very important for all nurses, and it's a great way for JNS and us to reach out to the international community with this very important topic. So, Dr. Genaro. Thanks so much. It really is, I always say it's a pleasure when I do these things, and it truly is a pleasure because the Journal of Nursing Scholarship is read by more than 130,000 nurses worldwide in more than 103 countries. And so one of the, and you know it is the Journal of Sports, Educated Quality, and the Society of Nursing. So one of the things that the editorial board is most concerned about always is what do nurses need to know around the world? What are the most important things that nurses in each of those 103 countries need to know to improve nursing science and nursing scholarship? And we're very committed to thinking about not only what is globally important, but what's clinically significant. What's really going to help nurses practice better so that we really, our mission is to improve the health of the world. Knowledge helps you to do that. So we've taken a lot of things and making decisions about what we're going to do. Two of those things, of course, are things like how often are articles cited and how often are articles downloaded. And we've had the pleasure in the past of doing a special issue on genetics and genomics in education. And also, a little while ago, doing an article, a special issue on genetics and genomics in practice. We saw how very important the genetics and genomics in education was to see how downloaded it was. And we're very happy to be able to speak with Dr. Jenkins and Dr. Pelzone at NINR in terms of updating the practice issue on where we looked genetics and genomics in practice. And we were very thrilled that they wanted to do that work with us. It wasn't, however, just their interest and the board's sense of this is important. Like every other kind of board in the world, we look at what other thought leaders are thinking and what's important. So when we look at other thought leaders and what's important in nursing practice, we're very aware that the National Institute for Nursing Research, for example, has been funding workshops in the summer for genetics in a long time and for a long time. And they're very concerned about what other science needs to be advanced in terms of metabolomics, et cetera. So we had a real knowledge that this was an important topic that they needed to be there and that we knew people that we could partner with and have a very high quality information republished, which is, of course, it's great to have good ideas, but if you can't bring them to fruition, it doesn't help you. I'm very proud to be able to say that the issue that we have is now out in terms of being online. And so it's all available to you in early view. You can read it and that the print issue will be out in March. So we're online available. And if you're looking for the actual paper copy, you will miss in March. So not only was it a great idea, but it has come to great fruition in terms of actually being available. So that is very important to us. We really think that we have provided absolutely cutting-edge information with this issue that you're seeing around the world that we need and that we're seeing around the world that we need. And we are just thrilled to be able to talk about information in a very interesting way of being able to look at some of the, hear about what some of the articles are today. I'd just like to close by saying that each of those articles also has resources in terms of clinical resources that will be helpful to you in the specialty areas. So it's a very rich issue, not only in terms of specific information, but getting you to other resources that might be helpful to you. And I know that Dr. Jenkins and Dr. Kelzone will also speak about other resources in this webinar series. So thank you very much for Jay and us being able to have this opportunity to bring such important information to the rest of the world. Thank you, Dr. Gennaro. And I'm sorry if some people are having a little difficulty hearing the sound. We are all in different locations, and hopefully you can hear our microphones as we continue to speak. And then I was also typing in response to questions and comments, so I will stop doing that because someone said it was a little loud. So sorry about that. So let's move on to the next portion of the presentation, which is an overview of the relevance of genomics to nursing practice and education by Dr. Kathleen Kelzone. Thank you, Jean. So I want to start out with some basics and related to what we're talking about in the genomic special issue in JNS. And that's the distinction between genetics and genomics because many of us may use these terms interchangeably, but in actual fact, they're a little bit different. Genetics is really the study of single genes. You can think about people who have relatively rare single gene disorders such as cystic fibrosis or people with the BRCA1 or BRCA2 gene mutation that's associated with an inherited susceptibility to breast and other cancers. Whereas genomics is the study of all genes in the genome together and their interaction with each other, the environment, and other psychosocial and cultural factors. It's actually important to understand that our perspective in approaching the genomic special issue is actually genomics. That's what impacts the practice of all registered nurses and in fact, all other healthcare providers. This is not just an issue that nurses are struggling with but all healthcare providers are engaged in this kind of getting up to speed. And genomics is actually the emphasis that we've tried to place on this issue. And so that's the perspective that we're going forward with. So where are we when we begin to think about genomics and what does this have to do with healthcare in general and nursing practice? And you begin to look at sort of what are the major leading causes of death and illness in our country? The majority of those and in fact all of those have some kind of a genomic component be it heart disease, diabetes, vascular disease, Alzheimer's, even things like influenza, what we're dealing with now with the large influenza outbreak in our country and things like suicide. And so there's not to say that there are not other variables that also come into play, not everything is genomic central but in fact genomics plays a role in all of this is in beginning to change the way that we begin to think about these kinds of disorders or diseases or illnesses that people can suffer from that can lead to death. And we're in an interesting era in which we're seeing a lot of emerging science and technology and the output of that input of science and technology is a change in how much it costs to actually do this application of genomics in practice and in research. So Moore's law is sort of that benchmark that has to do with computer technology advancement.  And what you'll see is that over the past several years there's been this massive reduction in cost and that massive reduction in cost has translated to a substantial increase in the growth of the ability to do genetic tests that have both clinical utility meaning that there would be something that you could do with this and analyticality. That means if you actually had this test that you actually knew it was accurate of use. And so what you'll see is that the growth of laboratories doing this hasn't changed which is in the green bars, but the number of tests and the capacity to do this has increased. And you'll see this is only until 2011, this particular slide. And that sort of correlates with that reduction in cost is our ability to do more and more of this and move it out into clinical practice has sort of grown exponentially over the last few years. We've also seen this increase in sort of understanding our genome as a whole. And some of that has to do with something called single nucleotide polymorphisms. They're the things that sort of make each of us somewhat unique and distinct. And it's not just a gene but sort of this individual letter variation between you and me and all the rest of us who are on this call and everyone else that we interact with. And that genetic variation we're learning over time has significant health implications. So this is from June of 2011 and each of these long bars represents a chromosome and each of the little circles represents an area where they've begun to look at these single nucleotide polymorphisms and correlated them with studies looking at disease associations. If you look at the kinds of disease associations that you begin to see, you can see anything from diabetes type one and type two, tuberculosis to different kinds of cancer to cognitive function to a wide range of different kinds of health conditions. All of which are things that nurses in every setting irrespective of their scope of practice. Are they prepared at an associate degree level, a baccalaureate level, a master's level or a DNP level or a researcher? This applies really to everybody in any health condition that it could be associated with. And this has continued to expand. This is the latest catalog slide published by the Genome Institute in July of this past year and what you'll see is a massive increase in the little circles and they're only focusing now on 18 particular traits. Now, genome-wide association studies are interesting in that these may not be things that have as much clinical significance right now as far as risk identification but are very important in sort of understanding underlying disease etiology and beginning to think in a way that we haven't thought about before about new therapeutic alternatives for dealing with these kinds of conditions. And so these are sort of rapidly moving along. We may not see a lot more genome-wide association studies but more sort of how they're beginning to utilize that information to move forward. But what we have seen is an application of this sort of technology in the consumer arena with the direct to consumer marketing and testing which is that the offering of these kinds of tests for a wide range of SNPs, for many health conditions, for an ever decreasing amount of money and this is just one of many of these kinds of companies that offer different kinds of tests for anything from ancestry to health conditions or to participate in research. And so these are tests where in large part many of these companies but certainly not all do not offer sort of the clinical interpretation of this. They actually recommend that people go on to their health care provider in many circumstances to gain more information if there's something that somebody has a question about in relationship to their health. Sort of a worrying thing if you have a patient who comes in to their primary care provider or their nurse practitioner and says, oh, gee, I had this done and what does this mean for me? And are we prepared to answer those kinds of questions? So it is something to begin to think about as this continues to move out into the marketplace by passing the health care community in general at the time of the decision to be tested because they're going directly to the consumer. We're also at a point of beginning to learn a lot more about epigenetics which is the study of genetic variation that is not caused by actually a genetic change in the genetic code in any way but it's sort of how variation can occur with chemicals that can mark a genome in a way that can influence whether a gene is activated or deactivated. And so a number of those kinds of things can be very important and it's an area in which a lot of development is ongoing. So there is really a scope that is really moving things forward at a rate that's really extraordinary. And we're at this point where they've been talking about the race for the thousand dollar genome. And the thousand dollar genome is an intriguing concept because it's a point at which the cost of being able to apply this technology reaches the threshold in which its application into general health care becomes more realistic because of the fact that you could do this cheaper than say doing a single gene disorder test. So to put that in perspective to do a single gene disorder test for say BRCA1 and BRCA2 is well over $3,000 but you could sequence a person's entire genome for $1,000 and are we close to that? What we can say is that we are close to that and in fact there's been some companies that have announced that they've sort of got this within reach. I'm intrigued that this particular announcement which was actually a year ago in January looks something like a size of a color printer but I have a mutation of my technology gene so goodness knows my interpretation of that. But what is clear is that it's not just our ability to utilize this technology and to get all this information. I think that the comment here, the thousand dollar genome and the $100,000 analysis is very accurate. What do we do with that information and how do we apply it ethically and appropriately in health care and utilize this information for health outcomes is absolutely fundamental and this is what it's all about and that's what our issue is trying to address is sort of preparing the nursing workforce at least to begin to understand some of this information as this kind of thing continues to roll out because this influences the practice of all health care not just in any one specific discipline and nurses are at the bedside and in practice in every health care setting and play a huge role in the application of genomics in health care. So we're at this point where we have genome analysis that it can include whole genome sequencing, it can include a wide variety of other kinds of whole genome analysis and so it's at the point where we're really well beyond the time of saying well this might be something that has relevance down the road, it has relevance now and that the progress is moving so rapidly that we struggle to be able to keep up and where we begin to see the applications of this as it moves out into health care is across the entire health care continuum. We can deal with application of genomics and preconception and prenatal testing long before someone is even at the point of delivering. Newborn screening, one of the large studies now actually being offered through the Genome Institute with a number of different people who have applied for that funding is actually looking at whole genome analysis at the time of newborn screening. Being able to utilize genomics for disease susceptibility to characterize who is and is not at risk and what we should do about it to use genomics to actually screen for specific diseases or to diagnose a disease or to even take it one step further which is if a disease is present can you actually characterize that disease to a point of predicting prognosis and informing therapeutic decision making. And this is probably one of the most expanding areas of application of genomics when one begins to think about pharmacogenomics and the application of therapeutic decisions that are not just informed by say the traditional height and weight and other kinds of variables of disease that may be associated with medication decision making but that you add a degree of genomic information that may inform whether someone would respond to something, may inform dosing, may result in a reduction in adverse drug events if you were able to modify and ameliorate some of the medications you might use because you had additional information at the time of prescription and then monitoring for disease burden and recurrence and things like end of life care including even things like pain control and so forth. So the application expands through the entire healthcare continuum and will continue, I hope you have an appreciation, will continue to expand at a very breath of place of what is moving from the bench actually to the bedside. So we're at this point of really thinking about personalized healthcare. Some people call it personalized medicine. I don't think it's all just about medicine. It is about healthcare in general where we're beginning to look at more individualized care by adding genomic information into what was traditional healthcare decision making. So it's not replacing what we already had. It's really adding that additional element to it so that we can even have a more personalized approach to healthcare decision making than what we've had today. And this is really an opportunity to improve health outcomes and when you think about it strategically, it's an opportunity to reduce overall healthcare costs. So what is it then that this means for nursing and what do nurses actually need to be able to do? There are sort of two documents that can help guide that and the first document is the essentials of genetic and genomic nursing. These are in their second edition, their competencies, curricular guidelines and outcome indicators. Outcome indicators are specific areas of knowledge associated with the competency and suggested performance indicators. These competencies apply to all nurses. They're the core competencies. It doesn't matter your level of academic preparation, specialty or practice setting. They've been endorsed by 50 nursing organizations and we hope to have a third edition published. We've had some difficulty getting funding for that. So actually the 2012 vision is put into 2013 since now or in February. This document is open access just as the entire special issue is and can be accessed at this website where you can download the PDF directly to your computer and utilize it as you see fit. The second document is one that's more recent and this is actually leveled then taking the competencies that were already established that apply to everyone is sort of that core set of information of what do people need to be able to know and understand and do and adding an additional level for those nurses who are practicing at a graduate level. And the graduate level was a strategic decision in terms of the competencies because you have to think about the DNPs versus your clinical nurse specialist versus your educators versus your PhD level researchers. A similar process of consensus was conducted to establish these competencies. So they're both documents are available. This document can also be downloaded as the PDF to your computer at the website listed here. And so both of them can inform people are beginning to think about, well, what is it that everybody actually needs to be able to know and do depending on their level of practice? So how does that inform the Journal of Nursing Scholarship special issue? Genomics is actually relevant to all nursing practice. And so it's clear that this is something that is going to increasingly apply to patient care in any setting at any point in the healthcare continuum. And the genomic special issue we're delighted that those papers are open access so that anybody can access them and that it's a resource for nursing education. And that's nursing education at an individual level in an academic setting, in a continuing education level for those people who are in a practice environment. It could be utilized in any way. And so the purpose was really to provide a state of the evidence review by individuals from the interdisciplinary community. So not just nurses providing those evidence reviews but input from other health practitioners who can contribute to the evidence and to talk about the genomics of common health conditions. So this is not an emphasis on single gene disorders. It's about genomics and it's about common health conditions, all of which have relevance to nursing practice and services. The articles provide an overview of genomic science and technology so that there's a baseline in sort of getting people up to speed. And then an international perspective on nursing care and implications based on genomics. There's a discussion of genomic variation and its association with common diseases. It covers pediatrics and adult conditions. What's essential when one begins to move genomics increasingly into the healthcare arena is beginning to think about the ethical, legal and social issues. And so there's an extensive manuscript specific to that. And then what is clear is all of us, we don't know everything. And what are the nursing research priorities that can inform a pathway for going forward? So what we're gonna do is actually just walk you through some of these papers just so that you understand some of what a special issue will provide and make sure that you can sort of think about the kinds of things that may be of interest to you. And the first is the editorial. And the editorial is framed not dissimilarly to what I provided in the background leading up to this today. There were many authors including Dr. Jenkins, but also Dr. Nick Nickle who's from the Universal College of Learning in New Zealand, Dr. Heather Skirtan who's at the University of Plymouth in the United Kingdom, Dr. Greg Thiro who is a family practice position in Maine but also has had a position at the time here in the Genome Institute. And then probably most importantly is the senior author is Dr. Eric Green who is the director of the National Human Genome Research Institute here at the National Institutes of Health. So a wide range of perspectives providing this editorial to sort of set the platform for moving this forward. And you'll see that within the editorial use the same sort of healthcare continuum and how that influences care throughout the healthcare continuum. The first paper is by Dr. Vett Conley and it's on current and emerging approaches in genomics and the technologies that are covered in this particular paper include genome sequencing, genome-wide association studies, epigenomics and gene expression. So sound familiar to what I presented to you but it gives you a flavor of what's provided. And the author set in this is very skilled and did a very nice job of sort of leveling this so that any nurse could understand it. So it's not so science dense that it's not relevant to nurses and their ability to understand that information. The next paper is about the ethical, legal and social issues that are associated with the translation of genomics into healthcare. And Dr. Lori Badzik who is at West Virginia University and also the director of the Center for Ethics for the American Nurses Association is the primary author as well as several other colleagues who contributed to this paper. This particular paper provides a review of the ethical and legal foundations of the translation, confidentiality and privacy of genomic information, issues to consider and inform consent and issues in genetic testing and big issues because this is a verging area associated with biorepositories. One of the common complex diseases that's covered is the integration of genomics and cancer care and this was written by several people including Dr. Erica Santos who's in Brazil. And this particular topic is especially unique in that cancer is sort of the poster child for application of genomics in the knowledge of and treatment of a given health condition. This particular issue or manuscript within the issue provides an overview of cancer etiology, hereditary cancer syndromes but it is not just specific to hereditary cancer syndromes. A discussion of epigenetics and cancer management considerations including things like tumor profiling and targeted therapies. And they utilize a case studies to be able to illustrate the advances as they go through the continuum of cancer care. Thank you Kathy. So I'd like to continue with the issue. You can see that we've tried to capture a lot of content that is applicable not only across the healthcare continuum but also across the life continuum because all nurses who work in all settings see patients not only in the early childhood and adolescent phase but also through the adult stages. So one of the things we wanted to have available that may be more familiar to nurses is a content about newborn screening for nurses. And Dr. Jane DeLuca along with her colleagues including Dr. Alex Kemper provides an overview of current newborn screening activities but then also discusses controversies and ethical considerations that are emerging as this new technology becomes more available. They also discuss the role of the nurses in the newborn screening process and talk about summary of developments that may be coming to bedside soon which is genome sequencing. The next article, an update of childhood genetic disorders by Cynthia Prouse provides information that helps to increase awareness of new developments in genetic disorders that are commonly seen in practice and taught by faculty. And these include common childhood genetic disorders which encompass infants, children and adolescents. But Cynthia and her crew have also provided a number of resources and information that can facilitate your access to services and resources that these children need in follow up to their care. One of the more adult complex diseases that is discussed in a paper by Xu Feng Wang and her colleagues is cardiovascular genomics. They provide a really nice overview of cardiovascular genomics in using three case exemplars, myocardial infarction and coronary artery disease, stroke and sudden cardiac death. They also talk about the benefits and limitations of genetic testing for each of these case examples describing specific implications for nursing. The next article is one by Diane Cybert, excuse me, by Jacqueline Taylor and her colleagues which builds on the cardiovascular information in talking about a metabolic syndrome that has been identified. This cardiovascular syndrome provides information about the METS contributions that are identified as cardiovascular disease, obesity and diabetes genomic risk factors. And they have a number of overlapping genes and polymorphisms associated with METS are described. They are also providing guidance for nurses of what the heck this information means in practice with some of the ambiguity and complexities of genomic information. The next article by Diane Cybert and Dr. Thomas Darling provides an overview of the physical, psychological and ethical issues in caring for individuals with genetic skin disease. Diane uses wonderful case examples and definitions and illustrations of sometimes the complexity of genomic information in understanding genetic skin disorders and explaining inheritance patterns, genomics and treatments. She also highlights the ethical and legal issues and concerns that are important to caring for patients with genetic skin diseases. So this is a nice article to kind of get an overview of where information that is currently available and using in dermatology practices is currently available. The next topic of great interest to nurses is one on genetics autism spectrum disorder. We are seeing more and more cases identified with autism and this article provides an overview of ASD identification and diagnosis with implications for the family. The authors review the genomic contributions to the risk for ASD and highlight how current research on ASD underscores the complexity and understanding of genetic processes involved. The genomics of autism is not yet well understood so repercussions of this lack of complete information for nursing practice education and research are also discussed in this wonderful article of information for you. Building on that information in the adult conditions, Dr. Deborah Schudy and her colleagues provide an overview of the implication of genomics on the nursing care of adults with neuropsychiatric conditions. They provide an overview of the contributions to these disorders including irreversible dementias, Alzheimer disease and Huntington disease. And they also discuss the implications of understanding this information for nursing practice and research, not only in the individuals but their families of which they live. Lastly has been an article provided by Dr. Kathy Calzone and a wonderful group that got together in terms of reviewing the state of the science recommendations for genomic nursing science blueprint. This information was done in collaboration with the National Institute of Nursing Research and we encourage you who are interested in research and those who want to provide a framework to further their own nursing science program to improve health outcomes, to actually look at this article and the table of recommendations that are provided because we think it may be of great value to you and perhaps even those students who are interested in doing research for the future. This special issue we hope provides a world perspective of the impact of genomic knowledge on clinical nursing practice. Obviously you can't discuss everything even in a whole issue. There's probably more information that you are gaining in your own practice and research and education setting that could be a value to other nurses so make sure you build on that information and share in publications and presentations as well. But if you're interested in these open access articles they are accessible at genome.gov and this issue would not have been possible without the support of the Journal of Nursing Scholarships so we really can't thank Susan Genera and her editorial board enough for this opportunity to be able to publish these content of articles all in one place that was actually requested by deans of nursing when we attended and presented at a session not too long ago. So we appreciate the interest and excitement and a special thanks to J&S. We also would like to thank not only our lead editors, Kathy and I of course are on this call and webinar today but Nick Nicol from the University College of Learning in New Zealand gave us an international perspective as part of the lead editorial group. And our advisory board spent many hours reviewing these articles and providing guidance back to the authors. Cynthia Prouse from Cincinnati Children's Hospital Dr. Diane Cybert from Uniform Services University of Health Sciences in Bethesda, Maryland and Dr. Greg Fero who at the time was working in the National Human Genome Research Institute. So we thank them for their support as well in getting this issue to publication. In the last few minutes I wanna provide you with a few resources. If we've webbed your appetite and when you go to the Journal and you see this information you get so excited that you want to learn more. There are resources available. Many resources are listed on the Genetic Genomics Competency Center for Education or G2C2. This is a educational learning repository that currently houses resources for genetic counselors, nurses and physician assistants. And we'll be uploading materials from the pharmacy discipline as well hopefully in the spring. A second resource that may be exciting to some of you who are interested in case studies or teaching to this content and don't actually have the cases in your own clinical setting. The Global Genetics and Genomics Community or G3C for short has unloading case scenarios that encompass many of these things we've talked about today. But hopefully would be of interest to you as you begin to teach more and more about genomics integration into practice. And there are a few more resources identified on the competency and curricular resource page at genome.gov listed here. Many of you as educators may know that JNS has also supported us previously. Last 2011 we did a Journal of Nursing Scholarship year long series where four articles were published across the year that were of interest to educators called Genetics and Genomics and Nursing Education. Those can also be found through JNS or on genome.gov.  It sounds like a different language. There has actually been development of a talking glossary of genetic terms. Not all of the terms that we included in our articles may be in here and you can recommend new terms if you don't understand certain things. But this is a talking glossary that's available at genome.gov but it's also available as an app. For those of you interested in teaching more about family history because that is one of the first genetic tools that healthcare providers can use in their clinical setting. For many years now we've had a Surgeon General Family History tool or My Family Health Portrait that is available to provide to the consumer to go to their families and collect family information that they can then bring into their care provider and share and then hopefully have those red flags identified and be referred appropriately for follow-up should they need that in regards to either a common complex disease that has a genomic contribution or genetic disease if they have that as a history in their family as well. Lastly, I'd like to share with you a competency focus newsletter that Kathy and I provide about three or four times a year. We just have one disseminated in January which talks a lot about the competencies and this special issue and then opportunities for learning more about genetics and genomics. So if you're interested in receiving the copy of the competency focus which of course is free and we distribute it by email or it's also available on that competency curricular page I talked about earlier on genome.gov but you can also send to us and Kathy on the next slide will show you her email. You can send a request to be part of this competency listserv and we try not to overload people or send out extraneous information but send out information that might be of interest to those interested in genomic competency. So we hope you have found this introductory webinar useful. We will have future webinars and as I make sure that this technology work today we will be scheduling those ahead of time and you can go to genome.gov this number here for login information for each of those webinars. The next webinar will occur February 19th and Dr. Conley will be presenting on the current and emerging technology approaches in genomics at 3.30 p.m. Eastern Standard Time. I wanna highlight for you one change. I had an error in the date that I assigned for the March date of March 19th was on our original communication. The March 20th enter date will be for the webinar series presentation by newborn screening and ethical legal and social issues. So if you're interested in attending the March 19th date switch that on your calendar to March 20th and then you can see the March 5th presentations listed here as well and they will continue through May and on the next slide you will see the dates of April 2nd, April 26th and May 7th for discussions about the topics that we will continue on through April and May. Remember if you can't attend them all these sessions will be taped and archived and available on genome.gov and we will now review submitted questions and answer what we can. Kathy will leave this slide on in terms of our contact information if we didn't receive too many slides or you want to send us questions at a later point in time you can always email us. I will go to these questions and see if we've answered some of them. Okay I'm gonna open it up to my other panelists so they can also answer questions as well so hopefully the background noise won't be too noisy. Let me find the questions. Okay so the first question is are there plans for future special issues and publications in JNS or other journals? So I'm assuming that means on other topics. So Dr. Gennaro do you know if there are plans for other future special issues? We do have a call out for a special issue on the evidence underlying basic nursing care that call came out and you can find it in the hard copy and the last issue in 2012. It will also be available when you look at the hard copy issue of 2013, this first genetic issue. We spend a lot of, we don't do so many special issues but when we know something is really important to the community we look for things. So if any of the listeners out there have areas that they're very interested in the board is always very interested in hearing that. Thank you Susan. I know there was a new call for information related to genomics in nursing and research from Dr. Idis Grul. We can add that resource to this listing when I get off and can cut and paste that information so that you will have that available for further information. Next question is will we be able to get a copy of the slides? The slides we use today. Dr. Calzone and I both work for the federal government so our slides are your slides. If it's okay with you Kathy, I'll say that if they wanna email us and request the slides we could provide those. Yeah, I think that's fine. There's no sense in reinventing the wheel. The question is will we receive CNEs today? Unfortunately not. We did not seek out the capability to provide CNEs so those won't be applied for this webinar series unfortunately. We had a comment from Deborah McDonald that we've done a nice overview. I can't see this. Milena from Brazil is on and she said thank you for the opportunity to be part of this amazing initiative and congratulations. And that is the questions that I have on my list of participant attendee submissions. Is there anything else that anybody else would like to know? Okay, I have another one coming in. Where do we get the articles on the website? Right now if you go to genome.gov on the very front page, the home page we are the second story down. There's a small video that you can look at but also it will give you a link to read more and that way you can also link off to either the webinar series listing or also to the articles themselves because they are available online, freely available currently. And as Dr. Gennaro said, the publication or the printed version will be mailed to Sigma Theta Todd members early March. The articles are also available directly from the Journal of Nursing Scholarship website. So people have difficulty accessing them through genome.gov. You can just search and Google for Journal of Nursing Scholarship and they come right up using that method as well. There was a question that says, how do you view the nurses role versus the genetic counselor role and how do you see us working together in a practical healthcare setting? Do they also view genetics regarding the slides? I just want it to the list of resources and websites. Okay, that just ran into another one together. So the discussion about how we work with genetic counselors in particular, but I would also broaden that to be other healthcare providers. There is so much need for genomics to be integrated into practice. And many nurses as well as physicians and pharmacists and our physician assistant colleagues are at the same level of knowledge deficit. We weren't trained in this information and come to it with not a very strong foundation. So we often rely on our specialists like genetic counselors or geneticists to assist us in being able to interpret this information and to be our referral base for patients and families as they need more advanced care than perhaps our expertise allows. We do have some advanced practice nurses who are credentialed in providing counseling and education. So I'll let Dr. Calzone provide that backdrop as well. So I think that the credentialing piece is specific to nurses or genetic counselors who have credentialing in genetics. And those people have extra training in genetics. And again, I'll echo Jeanne's comment that they're really your resource to connect with. But there is certainly not enough genetic counselors or geneticists or credential genetic nurses to go around to deal with the onslaught of genomics into practice, especially when one begins to think about meeting that assistance at the point of care for say pharmacogenomics or therapeutic decision making in diseases such as cancer with targeted therapies or tumor profiling. But they are your resource and there's, you know, everybody should be sort of looking for who is your expert within your own healthcare setting to begin to work closely with as you go forward, depending on what kind of practice you have and what your environment is. That participant also asked if they, nurses take on a genomic versus a genetic view, excuse me, genetic counselors perhaps, did they take on a genomic versus genetic view? And I think we're all at the beginning stages of looking things with a genomic lens. Nurses have been more in specialty care using genetic information in practice in the newborn and early childhood setting, but this genomic perspective is somewhat new, I think not only to nurses, but also to genetic counselors. There's a huge knowledge base emerging, especially around cancer is kind of the poster child of how I think most of these diseases will progress with our knowledge and understanding of the genomic contribution. So I think we're all in a learning stage. Some of their training programs are beginning to incorporate that genomic perspective. And so I think, as Kathy said, we need to seek out our experts. And some of those experts, at least for nursing, are within the International Society of Nurses and Genetics. And they will be having a meeting this October in the Bethesda, Maryland area. And it's a great place that if you get excited about this information and want to learn more, that it's a great place to network with other experts or those of us learning about genetics constantly because it's always changing. There's a question here about how can I register the rest of the webinar for this series. That link is not yet up there. I wanted to make sure that this technology was set up appropriately and it can be recorded and works well. So once we revisit and make sure all this has been done appropriately, I will then have to assign a registration link for each of the upcoming series presentations. So I should be doing that by the end of the week. It won't be there just yet, but I will do it by the end of the week. There is a question, can we put together a group view for future events? Do we need to do individual registration and view? I don't know. I will have to check my book and see if I can find the answer to that and if that's possible, I will put that information up on genome.gov. How do we find out more about genomic education updates? Kathy and I tried to keep up to date on what educational offerings are being provided, whether it's from ISONG or from various facilities across the country. So if you're part of our list serve, we will send out announcements. For instance, the Summer Genetics Institute is coming up and their application process has been opened. So you can go to ninr.gov and look up the Summer Genetics Institute if you want to learn more about that or you could go on genome.gov and pull up our most recent competency focus newsletter or you can send a request to join our list serve and Kathy's put her email up here so you can see that process. Okay, any other fine points that you would like to know more about before we close off this webinar? Well, at our maximum, we had 88 participants in addition to the four panelists that we've had on board. We appreciate your time and hopefully you're getting excited about this opportunity to read more about the implications of genomics for practice education and research and we look forward to hearing from you in the future. Feel free to let us know if you think this was valuable or if there are other things that we should incorporate to make either the technology work better or other information that you'd like to know more about. And so, Kathy, would you like to say anything or Susan before we close out? No, we just thank you for your participation and we hope that you find the special issue valuable and we would welcome any feedback that you have about it so that anything we do in the future could be improved upon. And from the journal, we're very interested in improving the health of the world. People appreciate NIH's working with us and are very interested in hearing any further thoughts any of our participants have.


r So they either have to be going into their third year or later I went to more photon Shrey young nice short print going to Atlanta I don't have it on top of my head. I'm just curious if anybody has this like guy like oh He'd buy his like 1920 rookies or something like that 1819 rookies hollow Justin holiday Rockets bull bull Sure, my bull bull jersey today Lake Wesley, so second second-year jumper Blake Wesley spurs have a good amount of talent even outside of women yama when they get him because Sohan and Brandon were good It's weird how They don't feel like a terrible team they tanked for sure because They're not a worse roster than like the Hornets or even the pistons without kade were Got jay knivey They tanked they They knew what they were doing There's a j dub rookie optics autographs thunder to 99 Thunder are killing it here Kennedy Chandler lime green heart for the nicks to 149 Colorado ready rookie Tyree smarton hawks I'm biased.  He just needs to say healthy and I'm not saying he's gonna be like an all-star but I think he could be Because he's good at the offense he needs to get the shooting down But I think if he stays healthy that'll come around But he could be like the magic starting point guard. I think hollow de rosin and booker Foltz is really good, but He doesn't he doesn't shoot So I don't know if that's logical if you want to like get to a competing standpoint Orange to 199 chris duarte pacers and Cole anthony is more of like the sixth man Like point guard shooting time, which is awesome. That's his he's more aggressive than anything Hollow simons blazers where he goes he plays 24 ish minutes, but he's like the energy guy shooting threes making plays He's like eric bloodstone Yeah, that's pretty solid actually it's decent calm Killian haze is an interesting one hollow bam out of bio heat a lot of people gave up on him quick Drafted super young had to come to the United States probably took a while to get used to it hollow hawks try young Davion Mitchell's a good one too It'd be fun to see got Jeremy so hundred Ricky Spurs Davion was good last like in the playoffs. He was pretty important. He's always gonna be on the floor because he's a good defender And you would imagine like his offensive game will get him to a certain point where he can Play more minutes hollow Jared Allen Cavaliers You hope that for a lot of these guys that they kind of just kind of get their offense on and this Yeah, and obviously not all the guys are talking about will do it But I mean some of them will he get Murray rated or keep and red de mar de rosin going to the bulls It's a 99 color match These are pretty good ones guys. I like those Hollow Montemores wizards, Houston speaking of Davion Mitchell, there he is Blue to 49 for the Kings never finished our our grid Lime green will Barton number to 149 wizards going into the last box here Second box of pearl is up next. Thanks everybody for bearing with us today as we rearranged the schedule and fell behind a bit Trying to fill up some other breaks Hello Deontay Murray and Jimmy Butler Isaiah Jackson. Yeah What's this to 99 is a Lenny Wilkins. Wow a Hawks auto Lenny Wilkins in this Nice retro there for the uh St. Louis Hawks goes to the Atlanta Hawks Tie tie you got basketball thunder Aaron Wiggins Got hollow rated rookie mark Williams Hornets I think um got benefit the math or a rookie for the Patriots I know he's not he's going into a second year, but the um the Hawks AJ Griffin could be a pretty good one Yeah, I know he's going into the second year didn't meet my criteria, but Still hollow Lonzo for the bulls Jeremy Sohan rated rookie Spurs orange Kyle Lowry heat number to 199 I wonder if he becomes free agent Lowry is still on the heat, right? Is he a free agent or Honestly, I don't know Well, he's older, but he's still playing pretty well He can marry rated rookie Kings. Hello Cavs Darius Garland dominators I feel like for him he just needs that team where Hollow Lowry heat They're in the midst of kind of rebuilding, but they're close for the end, but they're not really but They're typically older with some young guys that you wouldn't expect to have been good Got orange mobly to 199 Cavs. So they're in a weird spot They need another one like Jimmy that can just go get a bucket when they need it Hero's kind of like that Trevor Keels He's more like six man type Any guy that's going to be out there to defend as well It's not James Harbin on the O.K. seat Thunder where? Yeah, hollow Hornets Lamello dominators Or he turns into that guy Palo Ben Kara rated rookie Followed by a blue Bruce Brown nuggets now. He's a free agent after that big uh Big year with them the 49 One of the better signings of those off season last year It's only making like seven million hollow Ben Simmons Nets with for an impact player in the NBA As a bargain jane hardy rated rookie mavericks Clubs out of the couple more Last couple here lime green yokich nuggets nuggets had a really nice break To 149 That's player in the world right now garden horses and server and all over shan holmes kings This thing in the world riding horses and Yep, when it also can finally go home Because like cool When can I leave we have to do a parade too? Oh come on We got jazz redemption walker castle rated rookie signatures Jordan Clarkson a 99 jazz Bernard king the 99 nicks Lenny Wilkins a 99 hawks RJ Hampton to 99 magic uh rookie optics autographs a 99 is J. The Williams for the for the uh thunder It's only one rated rookie auto and then chat holm can read the 99 rated rookie great break for the thunder That'll do it. Thanks again everybody moving on to leaf pearl again Can't believe Blake missed us pull the aqua He said it there's like a I sent it to him too. He's like Did you pull out of right after I left? It's like, yeah Like I'm just about immediately All right, leaf pearl again. What's up Jordy? Benjamin, I hope you're doing well You're not at six and six. Let me do a quick update on those spots and type in the names We're on the pearl again a little behind here. We'll probably finish not too far behind the original scheduled end day just Took a detour Got there a different way. We are sold out for the daytime though so I'll tell you what we um We're sold out over here Matt on channel two still has sapphire and update jumbo to fill that you can be find them on the site Halfway full on the sapphire and bowman jumbo has 24 to go. I'm gonna give you a link to his stream Late in channel two Just two baseball breaks left on channel two Glad to hear it Jordy Yeah, usually nothing complain about is uh That's pretty good right there.  I guess that's not really complain. It's more of just like a I'm hungry That's the daytime shift though Get your late lunch All right, then sam tonight with more group breaks everybody on the main channel right here A little bit of this a little bit of that Not yet victor our first group break of it is tomorrow. I don't know if we're gonna have any persons of it But we do have a case tomorrow cos can rip in that I'll be here with kyle So I'm I'm excited to see it waiting on this one a while You can find it. It has a good bit of spots left. You can find that link Well, here's all other breaks right here Hopefully it does Jordy. Hopefully it does The issue with the I think it's a trip with mani ramirez, right mani ramirez is the one that's tough to track down Because they get poppy to sign stuff every year and I I think it was I forget the third person, but if it was mani, yeah Mani stuff sterling. They only have only seen one autograph Yeah, it was last year sterling and he was live in it Actually, why he's like this or two huh interesting huh Come on mani come on mani. Yeah, he's he's a tough one to track down. I think he doesn't do a lot of stuff like in the limelight though. He's a very I think he I think he coaches or something. I don't know. He's very uh He doesn't like to be in the spotlight. I guess what I'm trying to say Very interesting guy Not like a lot of guys that hit a ton of home runs in their career one world series and did all his other stuff All right, let's do it Everybody forced here being 21 22 leaf pearl multi sport one box number six random hit style 11 hits 11 spots will tighten as we go random off at the end. Good luck everybody again get a cut auto in every single box of pearl Last one we pulled a buzz aldrin. Yeah, so sick. It was redemption, but there's probably a numerous reasons that that's a redemption Here we go. I think that's the cut. It's it's there. It should be it might not be though With the other night we opened one of the covers right here I think you do about showing the cut first over there. I think this is it actually. Yeah, this is it Let me see this one No, they're just misplaced that's the cut we're saving that for the end. That's the cut Wow, that's sick though too christiano ronaldo auto eight of eight Cristiano ronaldo auto eight of eight Very good start Like the design on that too quite a bit actually Seven of ten the hulkster auto Hulk hogan auto seven of ten Dude this stuff is so much fun to rip. Oh, yeah I don't know of any other product on earth where you could pull a ronaldo and then a hulk auto back to back I'll just make a stack. I'll just make a stack as you go along Next up another auto here Jersey auto jeff bagwell 204 Basically matthew. I didn't know it was going to be a ronaldo to be fair Just wanted to make sure you ended with the cut Jersey auto jeff bagwell one of four 204 that is a randy johnson four color patch auto three of three or two of three Yeah, randy johnson patch auto two of three a sweet big unit right there Four color debacks patch the autos here. It's all auto so far Oops all autos like oops all punch berries Dual auto akeman and marino five of seven with the jerseys Dual jersey auto akeman and marino to seven Again, we'll send the bags with the hits guys Not not that not know if you want them, but they came like that so you'd like to store like that other auto Multi-auto which way this way One of one dual auto magic johnson joe montana That's pretty fire Magic johnson joe montana dual auto one of one This is a crazy good case or box. I should say magic in montana Dual button relic is tony gwin and for nando tatis jr. I have not seen one of these yet pearls of history Dual game use buttons of gwin and tatis That's a pretty sick one This case is crazy. This this or this box you same case because it's like a case, but this box is crazy Which one did you buy shame the uh the randy johnson? I would guess it's It's yours That's pretty wild relic here satchel page very cool six-way jersey relic And that will be you want to make sure that it is Game used satchel page six-way relic Wizard self-exclippers are in trade talks on a three-team trade That would send chris apps for zingas to the self-ex Marcus smores and draft compensation of the wizards and something else. That's interesting What what did I just read? Got pearl a green pearl maria sharapoba five of eight maria sharapoba pearl five of eight Next is jumbo patch. That is an insanely uh chunky patch Is shack four out of six pearlescent patch shack four of six Part of the awesome, man All right, let's see what that cut auto is four of seven Hap day Hap day cut auto four of seven maple leaf maple leaf gardens limited Hockey club four of seven half day I'll be honest. I have not heard that name before Dang, that's an old cut signature right there Leafs legends. Well, he's holding the cup. So that's how you know it's old for the Leafs Good stuff Hap day cut out of four of seven. All right, let's go ahead and random Uh, very an old but very good hockey player. That's who half day was Yeah, sorry always got a thrush shade of the maple leaves. What do you you have to? The photo was in black and white and he had the cup in his hand. That's that's old What do you want me to I took the low hanging fruit. I'm sorry guys All right names and hits randomized stamina time put them side by side as you get to what three and six nine times All right names first nine times one two three four five six seven eight and nine Zonghan L down to june z and nine times on the hits one two three four five six seven eight and nine Uh, ronaldo auto down to hulk hogan auto All right zonghan with the cr7 philip r randy johnson patch auto shane w with the akeman and marino dual jersey auto to seven edward e the shack patch corey s titis and gwin dual button one of one guan su the sherpa pova pearl john m magic johnson and joe montana dual auto one of one pete m satchel page Sixway jersey dale c jeff bagwell jersey auto brian g the half day cut auto and june z with the hulk hogan auto That's a really good box. Thanks again everybody moving on to select Born in 1901. Yeah, it's kind of wild It's cool, man results are posted For zingas to be traded to the clippers to the selthick's brogdon and claire by the clippers in the scenario for zingos To pick up a 36 million player option as part of the trade. That's an interesting trade. That's for sure Hey, selthick's and clippers are they're trying they're trying to put together a championship rosters They're very much right there it's just They're missing something. Yeah, I think for zingas For zingas might give you guys what They still need that. I think Big man at some point that can defend the paint And do the dirty work because rob Williams the third gets hurt Yeah He's a scorer though He'll take a lot more pressure off on well the thing is though if you guys didn't jail in the word That's the that's the other question. It's all things do need to be healthy It's okay magic coming for him this year magic you're gonna trade for uh yokich I think You're gonna get yokich and curry I could feel it That'd be hilarious No way that we'll get nicola yokich in 10 years We'll get step curry in like eight years. They're gonna be like 42 That's when the magic get all those players I'm surprised we got Vince Carter. We're still kind of in his prime kind of not fully but Not far removed from it because he was He was on the edge. He was early 30s. Yeah once he left Orlando. It's kind of like, all right. All right It's like, yeah He was still over a 20-game score decently efficient. Oh, yeah, I'm sorry He had lost like just a little bit of juice Yeah, Sean Kemp for the magic Dominique Wilkins Dominique Wilkins played like a handful of games to the magic dude. His stats are so bad Yeah, he had been injured I think and then tried to have a some sort of mini comeback But he was older and yeah, you're going to go so much Especially the super athletic ones like Dominique All right guys, let's go ahead and get started on select Everybody forced here up in 2022 select football hobby six box half case number 33 picker team style Got Anthony G with the dolphins Brandon a falcons Brent With the Vikings Charles F patriots Daniel with the Packers David H ram Sturward with the Bucks Edgar B Broncos Edward P Chargers Eric W Panthers Texans and Colts Jordy has the Browns Igor with the Seahawks Jeff and achieves Jeffrey H Steelers Lions and Titans Jeremy H Jets Joey a Raiders Kevin a Giants Logan H Cowboys Maximilian Ravens Michael G. Bills Michael B Saints Nick S Washington Ronnie with the Bengals and the Bears Sean M Has the Niners Spencer D Jaguars Tim Y Cardinals and Todd L Eagles. Let's get started everybody You have someone else fill in the game because listen to that rain. Oh, we got XRC in the very first pack It's kind of how it went on a release day last week. It's a silver sweet level rookie stonehouse from the Titans And it is quarterback five. It's going to be lions XRC prisoner-deception hendon hooker lions They just started raining raining Tri-color concourse Eagles Justin Hurst of 249 Silver rookie Logan Hull Bucks Hamilton Brian Robinson silver field level is Pollard for the Cowboys Do you know it's a 99 is Josh Allen sparks jersey card Buffalo Silver concourse rookie James and Williams lions. Yes, seriously Silver concourse rookie Kaleel Shakir Buffalo field level Allen blue rookie Tyler Algier for Atlanta on the Premier level to 149 the hop silver Premier level Aaron Rodgers Packers Uh, sensations rookie picket Steelers a mere white Raiders to 99 prime selections rookie jersey auto So the Raiders Austin Echler Desperator rookie base. There's a tri-color premier level to 199 Taylor for the Colts And an Eagles to 75 Fletcher Cox auto Jackson Bailey's happy sweet level rookie for the Pats Silver concourse rookie Cam Taylor Britt Bengels So that's hyper rain where if you're leaving work or coming to her if you just wait inside or in your car Wait, that's how hard it's raining. But orange concourse Lawrence for the Jags Nice orange to 49 Let's say silver rookie Kyler Gordon for Chicago Damian Pierce Damian Pierce the on-icons silver rookie going to the Texans Silver Miles Garrett Browns No bowman sapphire the ones Seven and eight are going to be on channel two So here is a link for channel two Red concourse rookie Daniel Ballinger Giants. That one's number two ninety nine A silver concourse Keenan Allen chargers It sounds like it's over that's for it right there Yeah, of course. Good luck PR Cross my homes snapshots of naji We've got a Tyrion Davis price Niners rookie jersey out of 199 Got a J. Terrell Purple Lions Almond Ross St. Brown That one's number 275 Silver rookie Mafe for the Seahawks Chandler Tindall Silver field level Davenport for the Saints Garrett Wilson is 75 rookie jersey going to the Jets White prism there silver concourse rookie Brian Robinson jr. Commanders Brock Purdy neon icons rookie insert Niners silver rookie concourse skymore chiefs Tri-color concourse rookie Jets germane Johnson the second out of 249 Silver golf Lions Clechenson rookie base other XRC Silver sweet level rookie sauce gardener Jets And it is tight end two tight end two is going to be La Porta, right? Tight end two five seventeen Yes, Sam La Porta lions again lions two XRC's Maybe we'll make it a third and get the Jameer Gibbs next Congrats Detroit Gordon Tibidot a sweet level rookie Jonathan Owens going to the Texans That one's numbered to 149 and another Eagles auto Pletcher Cox against a 99 a Purdy on the phenomenon There's a silver concourse rookie Pascal lions concourse rookie blue Pascal lions numbered to 199 Silver juju smith Schuster chiefs Damian Pierce neon icon silver rookie for the Texans and silver Mark Andrews Ravens. Yeah, they sure are Aaron Ketye Who's a blue to a tango by Loa club level for the Dolvins in 99 and silver concourse rookie Drake london falcons I'll see a gold or a black green Snow what's up, dude?  That's gonna go to seattle divan weather spoon Seahawks defense to card 519 Base XRC Say david bell the 25 prime selections crazy patch on this one browns rookie patch auto. That's a 25 They were a pretty inexpensive team to get to one of the last teams to go Good stuff lealand tomorrow daytime is matt Got matt and kyle tomorrow. There's a green dylan palm raiders rookie So let's pull a green. We did it to a five raiders Premier level trying to get focused on it here Come on on. There we go silver hayden hearst going to the bangles silver hutchinson phenomenon rookie lions silver rookie quatoriano texans on the club level silver concourse rookie jacquan brisker bears zappy silver rookie concourse coby brian seahawks Jamo rookie field level for detroit White field level jamar chase. That's a nice looking card out of 35 bangles. Nice little number and gold three of 10 rookie jersey auto calvin austin the third Congrats steelers great color match on this. We're gonna get this one in the mag. This is pretty cameron thomas Sweet level sauce gardener snapshots pickens and silver concourse rookie trayron walker for the jags Tri-colors a jones going to the jags This one's numbered to 149 Silver jalen hurts eagles silver sweet level mohomes for the chiefs sweet level blue nick chubb going to the browns numbered 299 silver concourse derrick car raiders And a white concourse mohomes. That's pretty sick too 7 to 35 Homes there got out pure sweet level silver Kirk cousins vikings Again, everybody matt has baseball breaks over on Channel two. Let me get you a channel two link There you go two links for channel two right there It's got some sapphire and and an update jumbo case Silver snapshots is micah parsons cowboys silver fried with steelers White sweet level cooper cub rams a lot of low numbers now first couple blocks didn't have low numbers now We got low numbers though Out of 35 sweet level olave rookie concourse rookie james wiliams lions Brock perty phenomenon rookie insert the the uh, niners and kenneth walker the third prime selections On the tie-dye rookie patch auto to 25 21 of 25 seattle That is their feels like camo jerseys they they wear Super service so to do i think around veterans day purple juju goes to the uh To the chiefs to 75 silver juju It is happy Silver snapshots dach prescott silver rookie, uh, bernard raymond for the Colts Traylon berks titans ricky jerizida 99 Concourse rookie silver khalil Shakir bills Another white is a scholar thompson rookie concourse for the dolphins Out of 35 7 to 35. There's an olave base before it And silver osmo the second vikings Son of the ashes Rookie jelani woods premier level Colts line green of 49. That's a cool one. James white supervolato patriots. Sweet feet silver concourse key in and out in chargers Blue rookie demon clark going to dalas That one's out of 99 Silver lemar jackson ravens They're likely neon science cook and silver sweet level justin fields bears Silver concourse rookie trevon walker for the jags All right, last couple here, and y'all all sold out daytime matt scott sapphire and bowman update jumbo or not bowman I'm sorry tops update jumbo from last year filling up now visionary short print jamar chase awesome card bangles Super short print visionary pure silver sweet level is dugger patriots purple kenny picket 60 of 75 premier level rookie stealers Tasking half case turn up really nice There's a hamilton and a kyle van noy supervolato now for the pats Tri-color is burrow going to the bangles that one's number to 199 Silver concourse zion johnson chargers or not concourse, but uh premier level silver concourse rookie cold strange patriots Tideye feel level mccaffrey. That's nice. That's nice niners That is sweet silver dj more panthers neon icon silver dak prescott dallas silver rookie kevin harris patriots Tri-color rookie concourse nick bonito to 249 broncos silver concourse rookie aqua new panthers Can you pick a silver concourse rookie christian watson packers? Bailey's happy to 199 patriots in the rookie jersey auto and a watson silver sweet level josh jacob's raiders Is a james robinson jersey card for the jets? 5 out of 49 silver concourse rookie mcbride cardinals Blue rookie premier level tiler smith cowboys. This one's number to 149 berks sweet level titans rookie silver rookie elante taylor sinks Last box of half case 33 right here laurence. We got a redemption brian robinson jr. Rookie signatures prism going to the commanders Stafford there as well Zebra rookie sweet level trayvon walker Really neat card for the jaguars I've never pulled one mic. I don't know if anyone's pulled one here I think someone has I I I haven't hit one though silver sensations nick chubb silver deandre south lions Love to hit one though So judy we got red sweet level joshan watson to to 49 for the browns It's a 39ers george kiddle on the auto Nice jmw. Good luck later on Got dulcet rookie silver concourse mclauren commanders Blue premier level tom brady buccaneers To 149 silver mohomes concourse chiefs Yan icon zappy with a silver sweet level rookie george pickin steelers A almost blue color match jesson herbert chargers number 299 Premier level silver josh alan bills Close out the bar. Yeah, you would dean Tri-color field level packers erin jones number to 75 Sutton silver goff lions How you guys doing today? Tri-color rookie thompson to 249 dolphins Concourse silver sandborn concourse bears rookie rock pretty neon icon silver rookie niners silver gino seahawks Come on. This is auto Gold patch rookie prime robins jr. Robins jr. Commanders to go with the auto in the box Nice gold patch 10 silver iukininers And silver michael pittman jr for the cults Oh, there's a picket field level 2 on quick recap relics of james robinson A trail on berks garret wilson josh alan Gold patch bryan robinson jr. Got autos of bailey zappy with a tie-dyed david bell 25 tiran davis price is a mere white Redemption commanders was bryan robinson jr Two patriot strupple autos first one kyle van noy second one james whites kittle to 30 nice niners hit Two fletcher cox autos to 99 here into 75 on the blue Xrcs were seahawks defense to divan witherspoon lions tight end to sam la porta visionary short print jamar chase bangles purple picket Steelers premiere level to 75 tie-dye prime selections patch auto kenneth walker the third seahawks gold rookie patch auto to 10 is cap and also the third for the Steelers and quarterback five xrc goes lions hendon hooker Thanks again everybody for joining half case 34 coming up next And y'all matt is still live over on lsc2 He's trying to fill up tops update jumbo 2022 Last daytime break coming up sam will be live at five p.m. Eastern everybody so About an hour and 15 minutes from now sam will be live more group breaks Spots available in bowman jumbo through the years mixer 2020 bowman sapphire breaks He's got some spectra team all for basketball prison basketball It's like football in a cool honors and immaculate first off the line mixture tonight for football shifter said the jets are trying to sign dalvin cook Interesting they would have a stable of running backs. That's for sure They have michael carter is your third string running back, uh, you got a lot of running backs Yeah, sam is powered by chat gpt dean He really is He's a bot Sam's gonna walk in this in this room at any minute. I think I feel it You just feel it's after 330. Yeah, like i'm just expecting at this point Maybe he's a little too late because of the rainstorm, but Also, I told him we're a little behind so didn't have to get here like Super early, but yeah, it's it's common. It's common Personal tonight with kyle on channel two everybody channel two Breaks your list it through friday. No big release friday On the sports side of things. I think select football hobby hybrid comes out So not like something super new, but it's a different skew. It's cheaper Look at the disco parallels So that there's breaks up for that on friday That'll be g platinum release today. We have our first case of it tomorrow. It'll crazy release this week next week could be uh Next week could be big though. I think we're looking at Um, well one of my the one i'm looking forward to is top scrimmua for club competitions but there's also potentially select basketball as well as um What's the other big one? Chronicles football would be another decent one too. Oh and painting you one football I think I think those three are scheduled or slated for next week Bowman's best uh bowman's best university as well. So next week could be could be pretty good Hopefully we stay on track for most of those Waiting for leiden ocho Man, we need to hire more people. We're gonna do leiden ocho dean. You want to run leiden ocho? We need we need three through seven Okay leiden gaming has to count in there though, so we need we need four through seven Leiden gaming has to count. That's leiden. It has to count If we're gonna be going to the ocho All right, here we go Everybody forced here up in 2022 select football hobby six box half case number 34 pick a team style You have anthony g with the bills and Two anthony g's anthony ga with the bills anthony go with the dolphins Daniel e packers devon has the browns true k sainter word raiders edward p chargers eric w panthers and texans and cults Igor with the seahawks jeffrey h seahawks lions and titans jeremy h falcons logan h cowboys maximally on ravens michael a giants mike k broncos mohammed with the pats nick s washington paul g bucks ronson has the chiefs and the vikings and the jets robert r bears shawna m niners spencer d bangles and jags tim y cardinals todd l eagles and veto has the rams Good luck y'all. Let's do it Some howls. Let's pull a howl This stuff's on fire right now. Yeah, but I mean it's it's definitely up people are projecting him as like a pretty decent player I mean, he was good in college. So I just wanted to see I think he's pretty good. I think he's just started more last year, honestly But that's asrom revere right there He don't want to lose games if you're trying to develop somebody not even then gold Kyle pits concourse go into the falcons Good start to this one There you go six and ten falcons. There is a scratch to the right of the select logo down to like where his helmet is you can see it there I'll send a box wrapper to the falcon spot One there a good card though falcons hope you get it replaced live trap for all cards How many spots and a break would that be? silver concourse is baker for the rams silver since they uh snapshots mohomes and silver jc horn panthers There's a berks for the titans smear whites Justin herbert jersey card to 99 chargers silver concourse steelen for the vikings silver sensations herbert chargers silver rookie zappy the pats. Yeah, if we do a Hit draft for the 10 box make sure with all cards then uh, we'll have dean run that one on late no, joe silver concourse ricky rashad white bucks try color concourse ricky daniel bellinger giants to 249 Hutchinson sweet level for the lions The silver rams he for the rams silver field level rookie tereq woolen seahawks And a zappy Oh dean you better be careful talking like that Got a rookie concourse blue title lenderbaum ravens to 199 And that's pretty cool bronco super bowl auto de marcus where That's pretty cool right there Well, we know it had to be that team that he played for not the other one Get it because the cowboys Don't do anything in the playoffs here at wilson neon icons Silver concourse joe burrow bangles. I'm gonna take a dig at the Leafs. I gotta take a dig at the cowboys Seems sir. They're like this. They're I mean the Leafs are the cowboys the nhl and the cowboys are the Leafs of the nfl A blue rookie cold strange concourse for the pats numbered to 199 You work for free dude dean. You will get hired immediately silver kerr warner cardinals I'm just waiting for the catch. I'm going to see what dean's catch is But can you pick it? Yeah, we're but what where's the catch concourse maroon darrett car to 149 raiders Got silver rookie kiance ingram cardinals I think you mean to say your paycheck goes to me. Not you work for free just it goes to me Matt corral is 75 on the panthers ricky jersey auto Just has to be late. No, chill. Oh, you're just that's the only catch. All right. Well Like that's kind of easy on our on our ends. I mean, I'll see what I can do Get half of nothing. That's true Can I get a hundred times zero? Okay, thank you Looks good on paper so yeah, of course you get that zero it's like silver rookie neon icons olave sinks silver rookie stingley jr. Texans rookie jersey dad's been ridder for atlanta Whatever started eight years ago the 75 silver concourse mack jones for the fats olave rookie Oh, I'm terrible now Desmond ridder trade land silver concourse rookie emerson rounds rookie light blue dad's been ridder This is the 99 great card falcons the premier level stonehouse silver rookies ion johnson chargers the the surplus breaker Sliver rookie field level Kenneth Walker the third z-hawks. I don't think there's many surplus in the hobby right now Yeah, don't think there are blue rookie michi for the Texans on the premier level These uh checkerboards like the power looking cards are so hard to get the camera to focus on silver concourse jefferson vikings concourse maroon kair elam bills rookie. Sorry. Khalil Shakir same team. It's wrong player to 149 Eagles fletcher cox the 49 on the auto Say a luke fortner It's kappa silver rondale more cardinals I like bregan pristine everybody y'all keep saying all this for pristine pristine. I like bregan pristine Tri-color zay jones jags number to 149 silver concourse rookie dobs packers Here silver neon icons brock pretty rookie niners silver robert woods titans white rookie demon clark cowboys This one's gonna be numbered to 35 silver mclauren commanders Brady there you got algear to 99 rookie jersey auto falcons pure space red concourse rookie pascal lions numbered to 99 Justin tucker auto it's a 30 going to the ravens It's a nice hit right there this stuff sells pretty pretty well I mean he's he's gonna be the goat kicker once all said and done white sweet level to shan watson going to cleveland numbered to 35 silver concourse laurenge jags Silver snapshots trelin berks titans rookie followed by silver miles garret browns That is a sparks jersey to 75 charters mike williams Silver concourse rookie dan bellinger giants Willis silver concourse fields bears Ketsey there is a concourse blue jamar chase that's goes that goes to the bangles This is numbered to 199 london rookie sweet level falcons silver heineke commanders fielish jones to 75 rookie jersey auto for the bears here stop bears coach dick guy tricolor field level burrow to 75 mangles chub silver on the matt ryan for the colts silver field level brady buccaneers We're going into the actual post nfl post the tom brady nfl now silver concourse rookie kenneth walker the third seahawks That's my home as a league tricolor field level packers rookie romeo dobbs to 75 pretty much for him to lose silver concourse taylor for the colts That's pretty freaking good silver givante phenomenon silver davante smith eagles The league willis field level rookie for the titans Halfway tricolor concourse rookie pascal going to the lions. This is numbered to a 249 silver concourse rookie k-dot and buccaneers sauce pickins silver sweet level derrick car raiders Mack jones on the blue Premier level to 149 patriots followed by tony power to 49 cowboy's jersey auto rb1 from rodriguez silver concourse rookie quay walker packers say marcus jones light blue rookie kenyon green texans numbered 299 followed by silver concourse rookie kair elan bills silver sweet level seahawks jordan brooks seiquan field level tricolor jets rookie zonovan knight concourse of 249 with a silver rookie isaac spiller for the chargers and drake london to 199 rookie auto falcons nice hit atlanta doing well in the break now with a numbered a low numbered ritter and a london auto skymore to 75 rookie jersey chiefs silver concourse jamar chase christian watson rookie got ritter daak silver concourse herbert chargers maroon almond rossin brown concourse to 149 detroit and a silver rookie corral panthers silver olave on the phenomenon rookie for the saints and silver davencote vikings apparently might might join the jets or he's gonna go and visit them or they're trying to get him or something like that i don't know something there's some there's a smoke with the with the jets in the davencote nah i mean if they're trying to win you're gonna need you're gonna need depth i don't think i've breezed but he's second year coming off an injury so tricolor to 75 densel ward browns james robinson to 75 on the jets jersey auto he's on the pats now james robinson silver concourse rookie demarvin leal steelers tricolor concourse rookie olave nice numbered for the saints there that'd be to 149 i'm just trying to get the correct focus there we go 98 of 249 silver concourse rookie titans malik willis silver sweet level cult rookie alec pierce damian pierce jumbo jersey to 99 ricky for the texans get him out of here get this shawng guy out of here silver aj brown eagles rock party phenomenon silver javante williams shawns here guys if you didn't hear that if you hear the the the grumpy old man coming in here concourse blue rookie tyquan thorton going to the patriots that's my fortnight partner though there you go to 199 silver rookie alante taylor saints rock perty neon icons ricky silver for the Niners silver jason kelsey bangles oh dude i'm taking a picture of that and sending it right to him dean oh this is good there you go dean dean you can have whatever lane channel you want now concourse tricolor lamar jackson ravens the 249 silver concourse cooper cup rams silver sweet level rookie is uh anger for the cowboys and a perty field level get you on the main channel here i'll go to i'll go to i'll go to the ocho tricolor concourse donovan wilson uh come on dude that i'm telling you the waves of the checkers everything in this product does not want to focus that is the 249 cowboys it is the waves silver dj more panthers it's all of it all the fans it's too wavy to checker boardy to checkery i don't know checkery niners brock perty and a matt corral rookie auto panthers to 199 never a bad thing to get a rookie cubie auto you never you never know what what's gonna happen never know he also wasn't even healthy last year so like he didn't even get a chance to be fair so we will see we'll see come here come give me a chance we know what a bright song stinks if he gets hurt like i don't know what if one corral just gets traded shawn's powered by beer i don't think shawn's powered by beer can't walk with a third to 199 traffic pride rookie jersey auto going to the cardinals for the chicanery uh i don't know i don't know dean making up words i mean you're already part of the latent team it sounds like purple rookie shahid going to the saints that's the 75 on the premier level in the 35 calvin awesome the third stealers rookie auto white silver concourse rookie jacquan brisker for the bears concourse rookie blue is derek singly jr texans number two 199 silver concourse rookie cubie bryant seahawks mack jones silver silver kenneth murray does sam do that that tells me a lot right there white aamon rossane brown on the premier level of the 35 lions silver travel orange jaguars i'm sorry it's easy tricolor james connor club level to 149 cardinals silver concourse rookie is chiccare bills so silver sensations is uh change you some homes silver rookie is uh the teat freer titans london base lave there's mild sanders to 99 eagles on the jersey silver rookie concourse jags drape on walker silver concourse car raiders white concourse dach presscott the 35 cowboys rogers there silver rookie on the premier level magi sanders cardinals silver field level christian kirk for the jags let's go ahead and recap here i'm not the biggest hitting break that time around relics of mild sanders damien pierce sky more mike williams desmond ridder jesson herbert autos of trey mcbryde james robinson tony pollard phyllis jones jr taylor algear matt corral demarcus where as a bronco letcher cox jesson tucker calvin oston the third drape london and matt corral when we had that um blue rookie premier level designator for the falcons there to 99 that's going to do it for the break and the daytime breaks here thanks again everybody talk to you in a moment let sam hop in here and start getting set up matt i believe still has spots for that jumbo tops update case yes the 19 to go there you go thanks again everybody sam's live in a little less than an hour we will see you then grab some spots and matt on matt's break and then sam's breaks thanks everybody


Hey, this is Brett, and this 2012 Ford F-350 Crew Cab, Short Box, Single Rear Wheel, Lariat Ultimate is stock number 12949Z. We are here at Summit Automotive in Fond du Lac, Wisconsin, and used heavy-duty truck headquarters. This 2012 Ford F-350 has the 6.7-liter powerstroke diesel engine. This truck has been fully-safetyed and inspected by our service shop, has a fresh oil and filter change, all the fluids have been checked and tapped off, and this truck is 100% ready to go. This one checks off all the boxes on my particular truck list. It is dark blue metallic. We're going to go all the way around in this video inside underneath, start it up, and take a look under the hood. We shoot all of our videos in 4K, so if you have HD capabilities on your computer, tablet, smartphone, or television, I highly recommend turning them on right now because it is your best way to check out the quality, condition, options, and cleanliness of the vehicle before seen in person, and this one is extremely clean. If you like the video and how we do things here at Summit Automotive, consider clicking the subscribe button in the lower right-hand part of the screen, and then click the bell notifications. You'll get updates every time we do videos here at Summit Automotive. This one comes with the 20-inch polished aluminum rims, and it has Michelin LT 275 65R20 tires, and they have probably about 70% of the tread left. It comes with the Rancho shocks with the FX4 off-road suspension package. Frame and underbody is absolutely perfect. This is a one owner out of Tennessee. Front fender is in excellent shape. Didn't see any dents or dings in there. Headlight lenses are crystal clear, and the only imperfection I saw on the truck is there is a dent on the front bumper, but it does not affect the performance of the truck. Lower balance is in really nice shape, and it does have the factory fog lights. Chrome-trimmed grille, and the hood is absolutely perfect. I love the 20-inch rims on this truck. That would be one of my checkboxes. The Michelin tires, another checkbox. Dark blue metallic, another checkbox. Power stroke diesel, another checkbox. FX4, another checkbox. One owner is super clean. This is from Tennessee. Very little corrosion, another checkbox on my list. Dark blue metallic. I think they only made this color until 2012, but it's got just a little bit of metal flake to it. Really a good looking color. And as you go down this side of the truck, take note of how clean that body is, how reflective and mirror-like that paint is. We take these HD videos, so if you are far away or even if you're close by, you just cannot make the trip down, but you're still interested in purchasing the vehicle. You can see the truck, hear the truck, and have confidence in the vehicle that you're looking at before you even get here. So when you do get here, there's absolutely no surprises, and you can make a smart and informed buying decision from wherever you're at. And if this video helps you make that decision, let your salesman know that you saw the video, that it was helpful, and that Brett sent you. Back rim is in excellent condition as well. No scuffs or scrapes. The back tires look like they have probably about 70, 80% of the tread left. And once again, just look at how clean that frame in the underbody is. Box rails, absolutely no corrosion. That's another checkbox of mine. Frame in the underbody all the way underneath looks really good, has all the remaining factory exhaust, so it's never been altered. Cab corners, lower rockers are absolutely perfect. Another checkbox has some nice Aries chrome step bars. Passenger side box is in pretty nice shape. FX4 Off-Road Suspension Package. Back-up parking sensors. Full towing package, which includes the receiver hitch four pin and seven pin wiring, has the locking tailgate. Tailgate step assist. Tailgate's in excellent shape. Comes with a spray and bed liner, which is another very nice feature on this truck. There's your tailgate step assist. Shuts nice and solidly, and as you go down this side of the truck, it's clean as that passenger side. Driver's side box looks really, really good. And for full disclosure, this back rim is in excellent condition as well. Down the rest of this side of the truck, the cab and the doors all look really good. I didn't see any dents. I didn't see any dings. It does have the driver's side door code entry. We do have the code for this truck. If you ever wanted to figure out what your 11 to 16 door code is on your super duty, in the upper right hand part of the screen, I have a video showing you how to do that. It has the telescopic tow mirrors. They're heated, built in directional signals. They power fold in, power telescope out. Another check box of mine for pulling my camper. Anyways, inside the Lariat Ultimate package gives you the black leather interior. No rips, no tears. Very, very clean. Comes with a set of Husky all-weather floor mats, auto headlamps, power pedals, tilt and telescopic steering wheel, power windows, power locks, power mirrors. These mirrors do power fold in. Like I said, I was like showing both sides so that you know that both sides are working properly. Then it does have the telescope feature. And that works nicely as well. And you do get the memory driver's seat. We'll hop inside, check out the miles, radio and everything that this truck has to offer. You get the built-forward tough animation at the beginning there. You can see that this one only has 13,544 miles on it. Instrument cluster is very nice and clean. Comes with the leather-wrapped steering wheel, Bluetooth and audio controls on the right. Information center controls and cruise controls on the left. No wear or tear on that steering wheel. Speed automatic transmission with the optional tap shift. This one has the factory radio with the navigation system on it. You get AM FM and Sirius XM radio capabilities on this radio. And this is my favorite radio because you can store music on the jukebox here so you can put CDs in and save them to the hard drive on this radio and then play your songs through there. Really a cool system. This was my favorite radio on the Fords. So that's another checkbox of mine. Turn out four-wheel drive, heated and cooled seat buttons. Factory brake controller for up-fitter switches. You get the sync system, of course, so you can do your Bluetooth cell phone, AUGS and a USB jack, stability control and downhill assist control. Passenger side format and seat are in excellent condition as well. No rips or tears on there. Smells extremely clean inside this truck. And it does have the power sunroof and side curtain airbags. So very clean inside. We'll take a quick look at the back seats and then we'll start it up and take a look under the hood. The back seats are just as clean as the front seats. No rips or tears back here. It does have the power sliding rear window with the built-in rear defrost. That headliner is extremely clean. These seats have a storage compartment underneath and they lock with the ignition key. And you get the Husky all-weather floor mat back here as well. Behind these seats is your factory subwoofer and your latch tether anchors. Child safety locks on the back doors and the bottoms of the doors all look extremely good on this truck. All right, we'll start it up. Take a look under the hood. Starts right up. No check engine lights or anything like that. And I would personally like to thank you for checking out the video today and hopefully from this HD video you've been able to verify the quality and condition of this 2012 Ford F350 Lariat Ultimate. Under the hood we have the 6.7 liter Powerstroke diesel engine. Engine bay is very clean, runs very smooth. Once again, this truck has been fully safe and inspected by our service shop. It has a fresh oil and filter change, all the fluids have been checked and topped off. And this truck is 100% ready to go. There's your light working nicely, your shocks are working nicely as well. There's your emissions sticker. And I would highly recommend this 2012 Ford F350 Crew Cab Short Box Lariat Ultimate in dark blue pearl for make quality and condition standpoint and looks options standpoint as well. This is the one that I would get. And to see more pictures of this truck or one of our other 450 new and used cars, trucks, SUVs, minivans, Wranglers, half tons, three quarter tons, one tons. You name it, we've got to go to that website right there. SummitAuto.com, full pictures and descriptions of every single vehicle from two locations. All at SummitAuto.com. If you'd like to check out more HD videos you can go to YouTube.com. Remember to like, subscribe and share on this video and all the videos that you see there. Click the bell notifications, you'll get updates on the videos we do each and every day here at Summit Automotive. In fact, in a second we'll see a link to subscribe to our YouTube channel on the upper left. A link to more F350 videos like this one, the upper right, a link to this vehicle on our website on the lower left. And a link to one of our latest YouTube videos on the lower right. Please check us out. And we are super excited to help you with this Ultra Clean 2012 Ford F350 Crew Cab Short Box Lariat Ultimate FX4 in dark blue metallic with power stroke diesel. Thanks again for checking out the video. Remember to like, subscribe and share. I really appreciate it.


You know, I tell these guys, there's a safest way to do every job that we do and we need to identify that and that's what we need to pursue." Pike County's new safety director says the county's new safety program is making progress. William Spears says after several years without anyone overseeing safety measures, it was like starting from ground zero. You know, there were people showing up in tennis shoes to work and around this equipment around these larger trucks, that's just not a safe thing. Like the judge referred to, if there was cases where the block road, they would have to cut a tree in the road. They didn't have the proper signage. You know, none of this stuff is the fault of the workers. It's just stuff they've never been allowed to have or equipped with. Spears says once a month he visits each of the county road lots and solid waste lots for quick safety meetings they're calling tailgate talks. I know I sound like a broken record on some of this stuff, but it's because we want you going home every day. I have the utmost respect for this court because they're trying to move ahead and they're trying to provide these people with what they need to do things properly and on the same hand they expect us to do it properly and hopefully that can move us forward and get us to where we need to be. You know, we want everybody going home at night. Are we moving as fast as we want? Probably not. But are we moving forward and do we want to make that a steady movement and progressive movement and that's where we want to be.