Wellbeing talk for intern orientation week. ISLHD (Illawarra Shoalhaven Local Health District) presented by Dr Bishan Rajapakse (Emergency Physician, FACEM, PhD) and Dr Skye Macleod (Emergency Fellow /UOW lecturer) - an informal and exploratory talk about strategies for maintaining and promoting wellbeing in the challenging healthcare area of modern medicine
Wellbeing and mentorship - SRMO Orientation Feb 2020Bishan Rajapakse
This talk was part of the orientation for Senior Resident medical officers (SRMOs) working in at Shellharbour ED. The idea behind the talk was to convey the importance of wellbeing for quality patient care, workforce sustainability, and creating a workplace culture that we want to nurture and be proud of!
Em consultants wellbeing talk Dr Bishan Rajapakse & Dr Hughes MakoniBishan Rajapakse
This is a talk given for the ISLHD Wellbeing week for JMOs on 16th September 2019 - Two emergency Physicians sharing their experiences and tips with maintaining wellbeing whilst working in medicine.
This is a power point presentation describing the Shellharbour ED Mentorship program, describing the benefits, goals and expectations of mentorship in the department.
Wellbeing and mentorship - SRMO Orientation Feb 2020Bishan Rajapakse
This talk was part of the orientation for Senior Resident medical officers (SRMOs) working in at Shellharbour ED. The idea behind the talk was to convey the importance of wellbeing for quality patient care, workforce sustainability, and creating a workplace culture that we want to nurture and be proud of!
Em consultants wellbeing talk Dr Bishan Rajapakse & Dr Hughes MakoniBishan Rajapakse
This is a talk given for the ISLHD Wellbeing week for JMOs on 16th September 2019 - Two emergency Physicians sharing their experiences and tips with maintaining wellbeing whilst working in medicine.
This is a power point presentation describing the Shellharbour ED Mentorship program, describing the benefits, goals and expectations of mentorship in the department.
International House webinar - Wellbeing SeasonPhil Longwell
These are the slides from the webinar given as part of the International House World organisation wellbeing season in March 2018. It was a brief look at my research, ahead of presenting this at conference the following month.
The matrix is a tool to help you identify what your overall, long term goals are. In addiction recovery, we call this Good Orderly Direction. The matrix helps you evaluate your options when faced with a problem so you can choose the response that most effectively uses your energy to help you keep moving toward your goals and being the type of person you want to be.
According to Mind, 1:4 of people in the UK will encounter a mental health problem in the UK, each year. Although awareness of mental health as a physical illness is starting to increase, many organisations are still unaware of the impact such illnesses can have on the individual, and the devastating effect poor management practices can have on colleagues in certain situations. Such ignorance is concerning – in far too many cases, anxiety, depression and other conditions are treated with ‘lip service’ at best; or as taboo at worst. This session will try and tackle some of the main, down-to-earth matters surrounding mental health in Higher Education Institutions. Sometimes, performance is affected, and this can have a serious adverse effect on the morale and performance of a team or department at large. How straightforward is it to identify and help people who might be struggling? How is it best to tackle poor performance while, at the same time, help an individual or individuals cope with mental health difficulties? Should HEIs introduce transparent strategic mental health awareness policies at the very top? How would one do that? How might it be possible to change an institutional or departmental climate for the better, with other positive knock-on effects this could have on welfare, happiness and performance? How would it be possible to transform understanding and practice at a local and institutional level? Following a brief presentation, this session will be an open forum for the sharing of experiences, suggestions and best practice.
The session will be a fully interactive improvisation workshop in which delegates will be invited to engage in fun and stimulating exercises designed to improve their communication, teamwork and break through any barriers holding them back. The exercises can be categorised as follows: Resilience: By learning to embrace failure, participants will learn how to take something with negative connotations as an opportunity for learning and growth. In the current climate where huge demands are placed on administrators, conquering the fear of failure and being able to reframe a ‘failure’ as a learning opportunity is key.
Embracing change: Exercises designed to nudge participants out of their comfort zones will help them to see that change is an inevitable and necessary part of growth. They will learn that they have talent in areas that they may never have previously considered.
Public speaking: Through involvement in storytelling exercises, participants will build their confidence in public speaking and presentation through creative play. These exercises will give them tips and tricks that they can take away with them and apply to future presentations.
Teamwork: These exercises will help participants to communicate more clearly and freely within a team and can be used for teambuilding and away days after the conference.
My presentation for the scientist at FIMM (Institute for Molecular Medicine Finland), meant to inspire ideas for collaboration between scientist and health and fitness professionals.
Whole Health in Your Practice Day 2/3 Morning Cristalyne Bell
Whole Health is part of collaborative effort by the Pacific Institute for Research and Evaluation, VA Office of Patient Care and Cultural Transformation, and University of Wisconsin Integrative Health Program to transform healthcare and help people live healthier, happier lives, and more purpose-driven lives.
Learn more: https://wholehealth.wisc.edu/courses-training/whole-health-in-your-practice/
Presentation at the SRMO weekly teaching for Shellharbour Hospital ED - by Dr Mahsa Fateminayyeri, MD - trainee, who covers an approach to sepsis in the ED setting, and highlights the value of a sepsis pathway to expedite antibiotic treatment and provide early resuscitation in order to promote good outcomes
Re-framing Failure into success - EM Fellowship OSCEBishan Rajapakse
This is an old talk given in 2018 about transforming exam failure into success, at the "ACE the OSCE" held at Westmead Sydney. It was a course for Emergency Physicians in training sitting the ACEM fellowship exam
International House webinar - Wellbeing SeasonPhil Longwell
These are the slides from the webinar given as part of the International House World organisation wellbeing season in March 2018. It was a brief look at my research, ahead of presenting this at conference the following month.
The matrix is a tool to help you identify what your overall, long term goals are. In addiction recovery, we call this Good Orderly Direction. The matrix helps you evaluate your options when faced with a problem so you can choose the response that most effectively uses your energy to help you keep moving toward your goals and being the type of person you want to be.
According to Mind, 1:4 of people in the UK will encounter a mental health problem in the UK, each year. Although awareness of mental health as a physical illness is starting to increase, many organisations are still unaware of the impact such illnesses can have on the individual, and the devastating effect poor management practices can have on colleagues in certain situations. Such ignorance is concerning – in far too many cases, anxiety, depression and other conditions are treated with ‘lip service’ at best; or as taboo at worst. This session will try and tackle some of the main, down-to-earth matters surrounding mental health in Higher Education Institutions. Sometimes, performance is affected, and this can have a serious adverse effect on the morale and performance of a team or department at large. How straightforward is it to identify and help people who might be struggling? How is it best to tackle poor performance while, at the same time, help an individual or individuals cope with mental health difficulties? Should HEIs introduce transparent strategic mental health awareness policies at the very top? How would one do that? How might it be possible to change an institutional or departmental climate for the better, with other positive knock-on effects this could have on welfare, happiness and performance? How would it be possible to transform understanding and practice at a local and institutional level? Following a brief presentation, this session will be an open forum for the sharing of experiences, suggestions and best practice.
The session will be a fully interactive improvisation workshop in which delegates will be invited to engage in fun and stimulating exercises designed to improve their communication, teamwork and break through any barriers holding them back. The exercises can be categorised as follows: Resilience: By learning to embrace failure, participants will learn how to take something with negative connotations as an opportunity for learning and growth. In the current climate where huge demands are placed on administrators, conquering the fear of failure and being able to reframe a ‘failure’ as a learning opportunity is key.
Embracing change: Exercises designed to nudge participants out of their comfort zones will help them to see that change is an inevitable and necessary part of growth. They will learn that they have talent in areas that they may never have previously considered.
Public speaking: Through involvement in storytelling exercises, participants will build their confidence in public speaking and presentation through creative play. These exercises will give them tips and tricks that they can take away with them and apply to future presentations.
Teamwork: These exercises will help participants to communicate more clearly and freely within a team and can be used for teambuilding and away days after the conference.
My presentation for the scientist at FIMM (Institute for Molecular Medicine Finland), meant to inspire ideas for collaboration between scientist and health and fitness professionals.
Whole Health in Your Practice Day 2/3 Morning Cristalyne Bell
Whole Health is part of collaborative effort by the Pacific Institute for Research and Evaluation, VA Office of Patient Care and Cultural Transformation, and University of Wisconsin Integrative Health Program to transform healthcare and help people live healthier, happier lives, and more purpose-driven lives.
Learn more: https://wholehealth.wisc.edu/courses-training/whole-health-in-your-practice/
Presentation at the SRMO weekly teaching for Shellharbour Hospital ED - by Dr Mahsa Fateminayyeri, MD - trainee, who covers an approach to sepsis in the ED setting, and highlights the value of a sepsis pathway to expedite antibiotic treatment and provide early resuscitation in order to promote good outcomes
Re-framing Failure into success - EM Fellowship OSCEBishan Rajapakse
This is an old talk given in 2018 about transforming exam failure into success, at the "ACE the OSCE" held at Westmead Sydney. It was a course for Emergency Physicians in training sitting the ACEM fellowship exam
Phase 3 Med Student Orientation SHH ED - 22-07-22.pptxBishan Rajapakse
This is the orientation lecture given to the Phase 3 medical students rotating through the Shellharbour ED. These slides are to be for easy access for students and staff alike.
Shellharbour ED Orientation July 2022- expectations and aspirations overview Bishan Rajapakse
This was an Orientation talk for new doctors doctors working in Shellharbour ED - expectations and a framework for practice. Shellharbour is a lovely peripheral hospital ED situated in the coastal region of Illawarra NSW. We see >30,000 patients per year, with a broad and interesting range of acuity. Our staff is made up of an interesting mix of local and international doctors who embrace a small hospital team spirit, tackling large hospital problems. Our ED is a mixed adult and paediatric ED that is located 30 mins away from a fully serviced Tertiary hospital. We support ACEM Advanced training with a FACEM led department, supported by ACRRM and Senior CMOs in the medical leadership. The department is host to UOW Clinical Medical students, and subspecialty training term or ED Ultrasound. Our hospital is in the process of an upgrade to include short stay an ICU. The work is challenging but rewarding , and embraces the full mix of what a coast peripheral ED can hope to offer.
Paediatric Resuscitation in a Peripheral Hospital ED (6-12-2020)Bishan Rajapakse
Case presentation for regional Paediatric meeting - presents a case of critically ill 16 month old boy with sepsis. Case and case discussion presents the successful resuscitation of critically ill Paediatric patient, highlighting the associated challenges with being in a peripheral hospital setting.
A talk given to at the ACEM (Australasian College of Emergency Medicine) pre-congress workshop for the Annual Scientific Sessions in Hobart, Tasmania 2019.
These are reflections and tips shared by Dr Bishan Rajapakse, an Integrative, Academic, Emergency Physician, along his towards "prioritizing wellbeing" in the first 12 months of working as an Emergency Medicine Specialist in NSW, Australia.
Bishan is an EM Fellow with ACEM and a committee member of the Global Emergency Care committee (GECCo), as well an advocate fo Mental Health and researcher in doctor wellbeing.
1. the road less travelled prioritising wellbeing3Bishan Rajapakse
This is a talk that given at the NSW Emergency Medicine Wellbeing day. I talked about the "importance of prioritising wellbeing" illustrated through the trials and tribulations of my lengthy, yet fruitful training journey - which included basic surgical training, international research, and emergency medicine specialist training.. plus a whole lot of adventure, fun and despair! The aim was to provide some hope, inspiration, and tips for those who are inclined to take the path less travelled!
A great tutorial from Dr Alistair Jones NHS medical educator (http://www.yorkshiremedicaleducation.co.uk/about-us) on ECG syndromes. Beyond the basics (but essential knowledge for training emergency physicians)
Presentation by Dr Jason Wu - resident in Critical Care at TWH, for the critical care journal club report findings of a paper by Kaukonen KM, et al. N Engl J Med. 2015 & update from the recent SMACC conference in Chicago #FOAMed #SMACC (http://www.ncbi.nlm.nih.gov/m/pubmed/25776936/)
The emergency and intensive care management of OP poisoning Bishan Rajapakse
This talk was given at the Wollongong Hospital Intensive Care departments registrar teaching session. The surprise ending video can be found on the following web page whilst scrolling to the bottom ... http://lifeinthefastlane.com/education/international-em/ I hope you enjoy. Comments on the presentation are welcome.
Thank you
This talk on "Fevers in Travellers" focusses history taking skills, diagnosis and treatment of Malaria and some other tropical disease that we may on rare occasions encounter in the urban ED environment of New South Wales. I would like to thank Dr Julian Chow, and his sources, for sharing this comprehensive talk on the topic, which was presented as part of the Wollongong Emergency Medicine registrar teaching program. We would welcome comments and further contributions on this topic.
Airway management in the Emergency Department for TraineesBishan Rajapakse
This is a power point presentation on Airway Management given by our deputy director in Emergency Medicine Training at the Wollongong Hospital, Paul Labana (consultant Emergency Physician) that presents a case illustrating difficulties in airway management and gives an overview of airway management in the emergency department. (Nb another video to do with airway management, and "airway exchange" can be found on this link http://youtu.be/6vaWNknIDQg) - thanks to Paul for sharing his educational material in the name of free open access meducation (#FOAMed)
Opthalmology in the ED - Dr Andrew White (June 2013)Bishan Rajapakse
This comprehensive overview of common ophthalmological presentations that ED registrars may encounter has been kindly shared by Dr Andrew White BMedSci(hons) MBBS PhD FRANZCO, Consultant Ophthalmologist, Westmead Hospital & Sydney Medical School (USyd)
An overview of the management of Rhabdomyolysis, put together for the weekly Emergency Medicine registrar teaching session at Wollongong Hospital ED. Information in the presentation is from both the journals and medicine 2.0 (and in particular "FOAMed" -the free open access medical education network that aims to improve sharing of medical education resources through the web). Enjoy. @trainthetrainer
This was a presentation given by the Vice Chancellor- Professor Ian Young the "Convergence Leadership" forum organised by AIESIC-ANU. It was a great welcome talk that started of what was to be an inspiring and educational day!
These are the slides for the presentation given on "Research and International Emergency Medicine" at the Global Health Drinks forum in Sydney on March 22nd 2012. (http://globalhealthdrinks.org/events/international-emergency-medicine/)
Organophosphate Poisoning Treatment - port headland doctor teaching (31-1-12)Bishan Rajapakse
This is an educational talk about the treatment of organophosphorus poisoning (OP) based upon a talk given at the Australasian college of Emergency Medicine, Annual scientific sessions Nov 2010, canberra. If you liked this presentation; please also check out this page created by one of my senior colleagues (and watch the video) :- http://curriculum.toxicology.wikispaces.net/2.2.7.4.5+Organophosphates
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
Ethnobotany and Ethnopharmacology:
Ethnobotany in herbal drug evaluation,
Impact of Ethnobotany in traditional medicine,
New development in herbals,
Bio-prospecting tools for drug discovery,
Role of Ethnopharmacology in drug evaluation,
Reverse Pharmacology.
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
Students, digital devices and success - Andreas Schleicher - 27 May 2024..pptxEduSkills OECD
Andreas Schleicher presents at the OECD webinar ‘Digital devices in schools: detrimental distraction or secret to success?’ on 27 May 2024. The presentation was based on findings from PISA 2022 results and the webinar helped launch the PISA in Focus ‘Managing screen time: How to protect and equip students against distraction’ https://www.oecd-ilibrary.org/education/managing-screen-time_7c225af4-en and the OECD Education Policy Perspective ‘Students, digital devices and success’ can be found here - https://oe.cd/il/5yV
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
The Art Pastor's Guide to Sabbath | Steve ThomasonSteve Thomason
What is the purpose of the Sabbath Law in the Torah. It is interesting to compare how the context of the law shifts from Exodus to Deuteronomy. Who gets to rest, and why?
1. Intern O-
Week
Wellbeing – in a challenging
healthcare environment
ISLHD Intern Orientation Program
Dr Bishan Rajapakse (FACEM/Phd)
Dr Skye Macleod (EM Fellow/UOW Senior
lecturer)
Wed 25th Jan 2023
4. Aspirations
of this
session
• Start the conversation about wellbeing
• Know who your crisis team will be ahead of
time
• Get yourself a failure buddy
• “Know thyself” and “know thy team”
• Know what drains you and what sustains you,
and find ways to “fill your cup”
• and fill it often; at least daily
5. Why wellbeing – for me?
Topic close to my heart..
• Personal experience of Burnout
• Suicide of Friends
• Student/Doctor representative
• Detrimental to entire Healthcare
community
• More wellbeing à better patient care
Vision - A kinder more compassionate
health care system
6. Wellbeing – points you & your colleagues
raised ? (survey results)
• How do you develop a wellness
routine when roster changes every
10 weeks?
• Who do you turn to professionally
if you are facing tough times?
• Boundary setting around
expectations for overtime?
• What about making mistakes?
• What sort of Mental Health
services are available in ISLHD?
• Long hours and work stress of
internship
• Not being able to balance work and life
• Lack support structures – new to
Wollongong
• Not enough time for mental health
• Unsupportive colleagues & workplace
bullying
• Being too insular in the medical world
(forgetting about the world outside
medicine)
• Having to be a medical Adult
What would you like to ask the wellbeing panel ?
What are the biggest concerns for your
wellbeing in the internship year?
9. What sustains you & what drains you? (your
survey results)…
• Exercise /swimming
• Sunshine/ nature
• Socializing
• Friends and family
• Art
• Music (listening and playing
12. So maybe I should just resign now….?
• There are things you can do to help!
• Day-to-Day
• Take your (uninterrupted / unpaid!) breaks / Team coffee
• Few tasks need to be done immediately
• Sleep, Rest, Exercise and your life outside of medicine
• Claim your unrostered OT
• Social - Relationships, Friends, Family, Pets
• Over a Career
• Mentors
• Debriefing
• Prioritise your health - so you can look after your patients too
• Your Plan B / Plan C job in medicine (a fellowship NOT mandatory!)
• You CAN take leave, drop your FTE, parental leave etc
• Recognise burnout (ideally before it happens)
• Remain humble
14. GETTING
HELP
• DPET / JMO office
• EAP
• Pyschologists
• Cousellors
• GPs
• Mentors (formal / informal)
• Heads of Department –
trusted senior colleagues
(registrars consultants)
• Wellbeing Champions
• Inner circle
• Family and friends
• Community groups
16. Who is your Crisis support crew & plan? Think
about it before you need it (today even)
17. MY CRISIS PLAN- what is yours?
• Department
• Consultant mentors
• Directors of Training/ Department
• potential leave/ time out
• Hospital, Health service & NGOs
• Employee Assistance Program (EAP)
• Psychologist
• Doctors health Advisory service (DHAS)
• DRS4DRS (https://www.drs4drs.com.au)
• External
• Good GP
• Family/Friends
• Community
• Coach
ED mentors
General
Practitioner
18. EAP / Converge – overcoming barriers to
engagement and stigma
To make an appointment,
call Converge International on:
convergeinternational.com.au
Your Mobile Solution for on the go
EAP Support by Converge International
EAP Connect
Install today to find out more
To download search ‘EAP Connect’ in your app store
Manager Assist
Coaching and advice to assist
with a variety of people
management issues and
develop your leadership
competencies.
Employee
Assistance
Program
Lifestyle Assist
Manage addictive
behaviours, promote
nutrition and fitness,
to increase mental and
physical wellbeing.
Career Assist
Career
development and
planning, resume
and job seeking
assistance,
interview skills,
vocational
counselling.
Conflict Assist
Strategies, tools and
coaching to deal with
difficult workplace and personal
situations.
Employee Assist
Support and
counselling for a
broad range of
personal and work
related issues.
Money Assist
Financial
counselling to
help you work
through financial
wellbeing
concerns.
Your wellbeing
is important
Available for up to 3
sessions per issue
per year
Employee Assist is available to immediate family members
Confidential
Free
1300 use eap
(1300 873 327)
19.
20. Peer support – continuing the wellbeing conversation?
• Hand n Hand
• https://www.handnhand.org.au/
• Clinical Supervision?
“ a reflective model used by other
health professions such as psychologists
and nurses, and typically would involve
meeting for an hour fortnightly (face to
face or online) in a group of peer with a
‘supervisor’ to reflect on issues arising
in working as a junior doctor, as a way
to prevent burnout and gain support”
• Co-peers, maybe other senior
peers (perhaps a mix)
• Maybe getting coffee outside of
hospital
• In person/face-face better than
virtual (but virtual better than
no peer support)
Survey Results
21. Mentorship, Coaching .. and the power of
debrief
• Mentor
• Senior Mentor? Formal /.Informal
• Co-Mentor
• “Failure Friend”
• Coaching & coaching course
• Life
• Online
crossing the shaky line from “Surviving” to “Thriving”!
• Debrief
• Verbal, written
• Formal
• Community based
22. Coping with Error…find yourselves a
failure friend
https://bishansworld.wordpress.com/2012/06/20/making-mistakes-stress-
management-and-leading/
“Medical Error: It never gets
easier”
“We just get more skilled in
understanding and coping with
error”
23. Coping with Medical Error
Reflective practice
Writing (eg Journal)
Talking
• Friend
• Mentor
M&M meeting
The “Re-Frame”
changing one’s perspective
• Focus on what you Did do
well
• Consider Systems/Teams
• Learn and Improve & teach
BE KIND!!!
24. • Here’s a title you suggested ->
“Emotional Female. It made me
more mindful/aware of
pressures on some doctors”
Inspiration for Perspiration….
Think, learn and read/listen “outside the box”
26. Can we translate
Meditation into real
Medical practice?
?
Disaster Training
Exercise/Sim
Explore
feasibility in
practice?
27. Looking after Relationships (incl relationship
with self, loved ones & friends /community)
Whatever your
situation - it’s a
challenge
So - check in with
yourself & close
relationships
often
Be kind to
yourself. Re-
charge as often as
you need
They say “work” is like a rubber ball and “family,
friends, health, and spirit” are glass balls.
If you drop the rubber ball of work, it will
bounce back (albeit with some consequence)
If the other four balls fall, they’ll likely be
damaged or shatter
28. Take home points
Know
Know thyself
• What drains you
• What rejuvenates or
inspires you (and plan
time doing this)
Start
Start the
conversation,
about wellbeing
• Experiment with a
“Check-in
Buddy”/Failure Friend
• Have a crisis Plan ;
Proactively engage
with resources, before
you need it
Share
Know that you are
not alone
Have
Have fun in your
Internship!
29. Taking it further /
Questions from the
Audience?
… we will be available to
chat with you in the
morning break
Or email us at
Bishan : Bishan.Rajapakse@health.nsw.gov.au
Skye: smacleod@uow.edu.au
Please scan here to fill out the
feedback survey and share your
comments / reflections on this
session
32. Dr Andy Tagg – Paediatric Emergency Physcian & Medical Educator –
short video on struggles, vulnerability and Wellbeing
https://youtu.be/NY9-n9aok1o