1 00:00:05,400 --> 00:00:09,400 >> I'M SUZANNE WEISS, AND I'M 2 00:00:09,400 --> 00:00:12,120 THE DIRECTOR OF THE DIVISION OF 3 00:00:12,120 --> 00:00:13,720 EXTRAMURAL RESEARCH AT NIDA. 4 00:00:13,720 --> 00:00:19,400 I'M STANDING IN FOR -- 5 00:00:19,400 --> 00:00:21,200 NORKOFF, SHE CAN'T BE WITH US, 6 00:00:21,200 --> 00:00:22,640 SHE IS TESTIFYING BEFORE 7 00:00:22,640 --> 00:00:24,880 CONGRESS AS PART OF THE NIAAA 8 00:00:24,880 --> 00:00:26,400 APPROPRIATIONS MEETING. 9 00:00:26,400 --> 00:00:28,480 SHE SENDS HER REGARDS AND ALSO 10 00:00:28,480 --> 00:00:30,160 SENT A VIDEO WITH HER 11 00:00:30,160 --> 00:00:31,520 PRESENTATION, YOU WILL AT LEAST 12 00:00:31,520 --> 00:00:32,720 HEAR FROM HER VIRTUALLY, SORT 13 00:00:32,720 --> 00:00:33,200 OF. 14 00:00:33,200 --> 00:00:35,520 I WANT TO WELCOME EVERYBODY TO 15 00:00:35,520 --> 00:00:38,080 THE 10th JOINT MEETING OF THE 16 00:00:38,080 --> 00:00:41,240 NATIONAL ADVISORY COUNCILS FOR 17 00:00:41,240 --> 00:00:44,160 NYAH, NCI AND NIDA AND THE 9th 18 00:00:44,160 --> 00:00:45,720 MEETING OF THE COLLABORATIVE 19 00:00:45,720 --> 00:00:48,040 RESEARCH ON ADDICTION AT NIH. 20 00:00:48,040 --> 00:00:53,040 IN ADDITION TO DR. VOLKOFF NOT 21 00:00:53,040 --> 00:00:57,520 BEING HERE, COUNCILMEMBER 22 00:00:57,520 --> 00:00:59,840 PRIASS CAN'T JOIN US, SHE ISN'T 23 00:00:59,840 --> 00:01:01,560 FEELING WELL, WE HOPE SHE 24 00:01:01,560 --> 00:01:03,080 RECOVERS QUICKLY. 25 00:01:03,080 --> 00:01:04,680 WE REARRANGED THE AGENDA TO 26 00:01:04,680 --> 00:01:06,320 GIVE SOME ADDITIONAL TIME TO 27 00:01:06,320 --> 00:01:08,000 OUR SPEAKERS AND ALLOW FOR MORE 28 00:01:08,000 --> 00:01:09,600 QUESTIONS AND THE AGENDA SHOULD 29 00:01:09,600 --> 00:01:12,960 BE UPDATED IN YOUR INVITATION. 30 00:01:12,960 --> 00:01:14,800 BEFORE WE START TODAY, I WANT 31 00:01:14,800 --> 00:01:19,520 TO DO A LAND ACKNOWLEDGMENT. 32 00:01:19,520 --> 00:01:25,560 JULIE, WILL YOU SHARE MY SLIDE. 33 00:01:25,560 --> 00:01:30,400 SO WE ACKNOWLEDGE THAT THE NIH 34 00:01:30,400 --> 00:01:36,360 IS ON THE TRADITIONAL LANDS OF 35 00:01:36,360 --> 00:01:40,040 THE PISCATAWAY AND ANACOSTAN 36 00:01:40,040 --> 00:01:41,200 PEOPLE, PAST AND PRESENT. 37 00:01:41,200 --> 00:01:43,200 WE HONOR THE LAND ITSELF AND 38 00:01:43,200 --> 00:01:45,280 THE PEOPLE WHO HAVE STEWARDED 39 00:01:45,280 --> 00:01:45,760 IT WITH GRATITUDE. 40 00:01:45,760 --> 00:01:47,120 THANK YOU. 41 00:01:47,120 --> 00:01:48,760 THIS IS BEING VIDEOCAST AND 42 00:01:48,760 --> 00:01:51,800 ARCHIVED ON THE NIH VIDEOCAST 43 00:01:51,800 --> 00:01:52,280 SITE. 44 00:01:52,280 --> 00:01:54,640 I THINK WE CAN NOW START WITH 45 00:01:54,640 --> 00:01:56,000 THE NIDA DIRECTOR'S 46 00:01:56,000 --> 00:02:00,480 PRESENTATION AND NORA'S VIDEO. 47 00:02:00,480 --> 00:02:05,680 >> GOOD MORNING, EVERYONE. 48 00:02:05,680 --> 00:02:07,080 I'M NORA VORKOFF, I CAN'T BE 49 00:02:07,080 --> 00:02:08,800 HERE TODAY BECAUSE I HAVE TO 50 00:02:08,800 --> 00:02:10,520 TESTIFY ON THE NIH HEARING AT 51 00:02:10,520 --> 00:02:11,240 THE HOUSE. 52 00:02:11,240 --> 00:02:14,000 I WAS ABLE TO VIDEOTAPE THIS 53 00:02:14,000 --> 00:02:16,080 PRESENTATION TO HIGHLIGHT SOME 54 00:02:16,080 --> 00:02:20,000 ISSUES MOST RELEVANT AND 55 00:02:20,000 --> 00:02:21,560 SUZANNE WEISS WILL BE THERE TO 56 00:02:21,560 --> 00:02:22,200 ANSWER ANY QUESTIONS YOU MAY 57 00:02:22,200 --> 00:02:23,400 HAVE. 58 00:02:23,400 --> 00:02:24,800 MANY THINGS HAVE HAPPENED SINCE 59 00:02:24,800 --> 00:02:26,400 WE LAST MET ONE YEAR. 60 00:02:26,400 --> 00:02:28,400 WE ALWAYS LIKE TO GIVE AN 61 00:02:28,400 --> 00:02:33,160 UPDATE IN TERMS OF WHERE WE 62 00:02:33,160 --> 00:02:35,200 ARE, PARTICULARLY AMONG 63 00:02:35,200 --> 00:02:36,600 TEENAGERS BECAUSE IT'S CHANGED 64 00:02:36,600 --> 00:02:44,040 SIGNIFICANTLY. 65 00:02:44,040 --> 00:02:46,840 STUDENTS REPORTING FOR 8th, 66 00:02:46,840 --> 00:02:48,960 10th AND 12th GRADERS SINCE 67 00:02:48,960 --> 00:02:49,400 2011. 68 00:02:49,400 --> 00:02:51,280 YOU CAN SEE THE SIGNIFICANT 69 00:02:51,280 --> 00:02:52,880 DECLINE THAT'S HAPPENED THROUGH 70 00:02:52,880 --> 00:02:53,760 THE COVID PANDEMIC, 71 00:02:53,760 --> 00:02:55,680 PARTICULARLY WITH THE EMERGENCY 72 00:02:55,680 --> 00:02:58,280 DECLARATION ON MARCH 13th THAT 73 00:02:58,280 --> 00:03:00,840 LED TO THE SOCIAL ISOLATION 74 00:03:00,840 --> 00:03:02,000 WHICH WE BELIEVE ACCOUNTS FOR 75 00:03:02,000 --> 00:03:04,120 WHY WE ARE SEEING SUCH A 76 00:03:04,120 --> 00:03:05,480 SIGNIFICANT REDUCTION. 77 00:03:05,480 --> 00:03:09,560 TO THE EXTENT THAT THE PEER 78 00:03:09,560 --> 00:03:11,200 PRESSURE AND SOCIAL BEHAVIOR AT 79 00:03:11,200 --> 00:03:13,040 THIS STAGE IN LIFE. 80 00:03:13,040 --> 00:03:16,000 ACTUALLY BEING IN ISOLATION 81 00:03:16,000 --> 00:03:17,400 DECREASE THE OPPORTUNITIES TO 82 00:03:17,400 --> 00:03:20,400 INTERACT WITH ONE ANOTHER, 83 00:03:20,400 --> 00:03:21,640 DECREASE THE OPPORTUNITIES TO 84 00:03:21,640 --> 00:03:23,200 TAKE DRUGS. 85 00:03:23,200 --> 00:03:25,600 LOOKING AT HOW LARGE THE 86 00:03:25,600 --> 00:03:29,440 DECREASES ARE. 87 00:03:29,440 --> 00:03:30,880 THAT INCLUDES BASICALLY ALL OF 88 00:03:30,880 --> 00:03:34,120 THE DRUGS WENT DOWN, INCLUDING 89 00:03:34,120 --> 00:03:35,520 VAPING WHICH HAD SOME OF THE 90 00:03:35,520 --> 00:03:37,120 HIGHEST RATES OF USE JUST 91 00:03:37,120 --> 00:03:39,240 BEFORE THE PANDEMIC. 92 00:03:39,240 --> 00:03:44,120 SO THIS SHOWS THIS DATA FOR 93 00:03:44,120 --> 00:03:47,400 ALCOHOL, FOR 8th GRADERS FIRST. 94 00:03:47,400 --> 00:03:49,800 SHOWING INITIALLY THE YEAR 2020 95 00:03:49,800 --> 00:03:52,000 VERSUS 2021. 96 00:03:52,000 --> 00:03:54,160 SIMILARLY FOR 10th GRADERS AND 97 00:03:54,160 --> 00:03:55,800 12th GRADERS AND SAME FOR THE 98 00:03:55,800 --> 00:03:57,400 OTHER DRUGS. 99 00:03:57,400 --> 00:03:58,600 IT DECREASES FROM ONE YEAR TO 100 00:03:58,600 --> 00:03:59,840 THE NEXT. 101 00:03:59,840 --> 00:04:02,040 EVERY SINGLE DROP GOES DOWN. 102 00:04:02,040 --> 00:04:04,880 WE INTERPRET THIS TO INDICATE 103 00:04:04,880 --> 00:04:08,520 TO THE EXTENT THAT THESE 104 00:04:08,520 --> 00:04:09,640 TEENAGERS WERE STARTING FROM 105 00:04:09,640 --> 00:04:10,600 HOME, THEY DIDN'T HAVE THE 106 00:04:10,600 --> 00:04:12,080 OPPORTUNITY TO GET EXPOSED TO 107 00:04:12,080 --> 00:04:13,000 THESE DRUGS. 108 00:04:13,000 --> 00:04:15,320 AT THE END OF THE YEAR, THE 109 00:04:15,320 --> 00:04:16,920 UPDATE FOR 2022, WHICH WILL 110 00:04:16,920 --> 00:04:19,200 GIVE US INFORMATION ABOUT WHAT 111 00:04:19,200 --> 00:04:22,040 HAS HAPPENED TO THESE RATES OF 112 00:04:22,040 --> 00:04:24,160 DRUG USE NOW THAT TEENAGERS ARE 113 00:04:24,160 --> 00:04:28,200 BACK AT SCHOOL. 114 00:04:28,200 --> 00:04:30,280 THE FOURTH AND NEW INITIATIVE 115 00:04:30,280 --> 00:04:33,600 WE STARTED LAST YEAR SINCE WE 116 00:04:33,600 --> 00:04:35,200 LAST MET FOLLOWING ON THE 117 00:04:35,200 --> 00:04:43,400 SUCCESS OF THE HBCD STORY, 118 00:04:43,400 --> 00:04:46,800 ALCOHOL AND DRUG NIDA, IF YOU 119 00:04:46,800 --> 00:04:49,160 OPEN UP OPPORTUNITIES TO THIS 120 00:04:49,160 --> 00:04:51,760 GAP TO UNDERSTAND AND 121 00:04:51,760 --> 00:04:53,400 TRAJECTORIES THAT PUT TEENAGERS 122 00:04:53,400 --> 00:04:56,800 AT HIGHER RISK. 123 00:04:56,800 --> 00:05:01,200 AND TODAY, DR. DEARING WILL BE 124 00:05:01,200 --> 00:05:02,360 GIVING AN UPDATE. 125 00:05:02,360 --> 00:05:04,320 SUFFICE TO SAY IT'S BEEN VERY, 126 00:05:04,320 --> 00:05:06,320 VERY SUCCESSFUL. 127 00:05:06,320 --> 00:05:09,840 IT INSPIRES US TO DO EQUIVALENT 128 00:05:09,840 --> 00:05:12,640 STUDY STARTING IN INFANCY. 129 00:05:12,640 --> 00:05:14,160 A THREE-YEAR PILOT. 130 00:05:14,160 --> 00:05:16,600 THE FINAL AWARDS THROUGH THE 131 00:05:16,600 --> 00:05:21,240 FULL PROJECT WERE GIVEN LAST 132 00:05:21,240 --> 00:05:23,320 YEAR THE SELECTION WAS MADE IN 133 00:05:23,320 --> 00:05:24,800 SEPTEMBER AND OCTOBER, THEY 134 00:05:24,800 --> 00:05:29,480 WERE FUNDED. 135 00:05:29,480 --> 00:05:34,840 IT IS 7500 INFANTS. 136 00:05:34,840 --> 00:05:37,200 WITH BRAIN IMAGING, AND 137 00:05:37,200 --> 00:05:38,440 BEHAVIORAL ASSESSMENTS AND 138 00:05:38,440 --> 00:05:40,200 COGNITIVE ASSESSMENTS AND TO 139 00:05:40,200 --> 00:05:42,200 ASSURE IN THESE PARTICULAR 140 00:05:42,200 --> 00:05:45,080 STORIES WE ARE ONLY ROWE 141 00:05:45,080 --> 00:05:47,120 RECRUITING FOR THOSE INFANTS 142 00:05:47,120 --> 00:05:49,400 THAT WERE EXPOSED TO OPIATE 143 00:05:49,400 --> 00:05:51,840 DRUGS DURING PREGNANCY. 144 00:05:51,840 --> 00:05:54,840 THE PATTERN OF CHEIRO 145 00:05:54,840 --> 00:05:57,200 CHARACTERISTICS OF THESE 146 00:05:57,200 --> 00:05:58,120 PREGNANCIES, WE WILL ENSURE 147 00:05:58,120 --> 00:06:00,400 THERE WILL BE A SIGNIFICANT 148 00:06:00,400 --> 00:06:03,920 GROUP OF INFANTS THAT WILL BE 149 00:06:03,920 --> 00:06:08,240 BORN OF MOTHERS TAKING ALCOHOL, 150 00:06:08,240 --> 00:06:09,280 CANNABINOIDS. 151 00:06:09,280 --> 00:06:12,800 THIS ALLOWS A BETTER 152 00:06:12,800 --> 00:06:14,440 PERSPECTIVE WHAT ARE THE 153 00:06:14,440 --> 00:06:25,040 HARMFUL EFFECTS OF DRUG DURING 154 00:06:25,040 --> 00:06:26,240 PREGNANCY. 155 00:06:26,240 --> 00:06:27,640 THESE WERE THE SITES SELECTED 156 00:06:27,640 --> 00:06:30,040 AND THESE ARE THE DEMOGRAPHICS, 157 00:06:30,040 --> 00:06:33,280 AS YOU SEE WITH THE HBCD, WE 158 00:06:33,280 --> 00:06:35,200 ALSO ENSURE THAT WE HAVE A 159 00:06:35,200 --> 00:06:36,840 HIGHER REPRESENTATION OF 160 00:06:36,840 --> 00:06:38,680 MINORITIES THEN THAT OF GENERAL 161 00:06:38,680 --> 00:06:39,400 POPULATION. 162 00:06:39,400 --> 00:06:42,920 SO THAT THE SAMPLE SIZES ON 163 00:06:42,920 --> 00:06:45,040 WHAT ARE THE EFFECTS ON 164 00:06:45,040 --> 00:06:47,920 MINORITY CHILDREN. 165 00:06:47,920 --> 00:06:50,520 JUST LIKE THE HBCD, WE WILL BE 166 00:06:50,520 --> 00:06:54,000 USING A VARIETY OF TOOLS, 167 00:06:54,000 --> 00:06:54,720 TECHNOLOGIES, ASSESSMENTS TO 168 00:06:54,720 --> 00:06:57,240 ENSURE WE CAN GET THE 169 00:06:57,240 --> 00:06:58,840 PHENOTYPING OF PHYSIOLOGICAL 170 00:06:58,840 --> 00:07:02,400 PROCESSS IN THESE NEONATAL 171 00:07:02,400 --> 00:07:05,280 INFANTS FORMED TO ADOLESCENTS 172 00:07:05,280 --> 00:07:06,200 TO ADD PROSPECTIVELY. 173 00:07:06,200 --> 00:07:08,800 BUT ALSO TO BE ABLE TO 174 00:07:08,800 --> 00:07:10,920 UNDERSTAND HOW ULTIMATELY THEIR 175 00:07:10,920 --> 00:07:13,400 ENVIRONMENT INFLUENCES THOSE 176 00:07:13,400 --> 00:07:15,840 TRAJECTORIES. 177 00:07:15,840 --> 00:07:19,840 AS THE UPDATE I WANTED TO GIVE 178 00:07:19,840 --> 00:07:21,920 YOU, THE OVERDOSE CRISIS. 179 00:07:21,920 --> 00:07:23,560 I THINK THE NEWS HAS BEEN 180 00:07:23,560 --> 00:07:25,640 COVERING VERY MUCH HOW THE 181 00:07:25,640 --> 00:07:27,320 OVERDOSE DEATHS HAVE BEEN 182 00:07:27,320 --> 00:07:29,440 INCREASING AND ACTUALLY 183 00:07:29,440 --> 00:07:30,840 DISCUSSED WITH SIGNIFICANT 184 00:07:30,840 --> 00:07:32,920 OVERDOSE DEATHS FROM ALCOHOL, 185 00:07:32,920 --> 00:07:36,200 IN THE CASE OVER THOSE CRISIS 186 00:07:36,200 --> 00:07:41,880 INITIATED WITH OPIOID OVERDOSES 187 00:07:41,880 --> 00:07:42,600 IT EXACERBATED MARKEDLY. 188 00:07:42,600 --> 00:07:46,920 THIS IS THE LATEST DATA WE HAVE 189 00:07:46,920 --> 00:07:48,560 NOVEMBER 2021. 190 00:07:48,560 --> 00:07:51,880 WHICH THERE WERE CLOSE TO 1007 191 00:07:51,880 --> 00:07:55,160 PEOPLE DYING FROM OVERDOSES. 192 00:07:55,160 --> 00:07:57,040 16% RISE ALL THE WAY FROM 193 00:07:57,040 --> 00:07:58,200 EXTREMELY THE HIGHEST NUMBERS 194 00:07:58,200 --> 00:08:02,720 EVER WE HAD SEEN, OF OF COURSE. 195 00:08:02,720 --> 00:08:05,520 WHEN WE SAW A 30% INCREASE 196 00:08:05,520 --> 00:08:07,800 OVERDOSE MORTALITY FROM 2019. 197 00:08:07,800 --> 00:08:09,840 SO WE SEE THE INCREASES ARE 198 00:08:09,840 --> 00:08:12,920 CONTINUING AND WE ALSO SEE 199 00:08:12,920 --> 00:08:15,520 DRUGS ASSOCIATED WITH THE 200 00:08:15,520 --> 00:08:21,360 OVERDOSES ARE ACTUALLY 201 00:08:21,360 --> 00:08:25,160 DIVERSIFYING, HEROIN ARE 202 00:08:25,160 --> 00:08:26,760 REDUCED SIGNIFICANTLY. 203 00:08:26,760 --> 00:08:28,600 SO ARE OVERDOSES THAT ARE 204 00:08:28,600 --> 00:08:30,320 ACTUALLY ASSOCIATED WITH 205 00:08:30,320 --> 00:08:31,160 PRESCRIPTION OPIOIDS. 206 00:08:31,160 --> 00:08:33,280 WE ARE NOT SEEING INCREASES IN 207 00:08:33,280 --> 00:08:34,680 OVERDOSES WITH METHADONE. 208 00:08:34,680 --> 00:08:37,080 WHICH IS IMPORTANT, BECAUSE THE 209 00:08:37,080 --> 00:08:39,160 CHANGES IN POLICIES TO TAKE 210 00:08:39,160 --> 00:08:40,760 HOME METHADONE THIS WAS CONCERN 211 00:08:40,760 --> 00:08:44,080 THIS WOULD RESULT IN DIVERSION 212 00:08:44,080 --> 00:08:44,840 IN OVERDOSES. 213 00:08:44,840 --> 00:08:46,680 THE DATA IS NOT SHOWING THAT. 214 00:08:46,680 --> 00:08:48,320 ON THE OTHER HAND YOU CAN SEE 215 00:08:48,320 --> 00:08:50,760 THERE'S A SIGNIFICANT RISE IN 216 00:08:50,760 --> 00:08:52,880 OVERDOSES, CONTINUE TO SEE, 217 00:08:52,880 --> 00:08:53,680 FENTANYL. 218 00:08:53,680 --> 00:08:57,600 THIS HAS BEEN DRIVING THE RISES 219 00:08:57,600 --> 00:09:00,400 IN OVERDOSES IN 2015 AND 2016 220 00:09:00,400 --> 00:09:01,520 AND ACCELERATED THE LAST THREE 221 00:09:01,520 --> 00:09:02,480 YEARS. 222 00:09:02,480 --> 00:09:06,640 COCAINE THERE WERE SIGNIFICANT 223 00:09:06,640 --> 00:09:08,280 INCREASES, VERY SIGNIFICANT 224 00:09:08,280 --> 00:09:10,880 INCREASES WITH METHAMPHETAMINE 225 00:09:10,880 --> 00:09:12,560 OVERDOSES. 226 00:09:12,560 --> 00:09:16,000 WE KNOW THESE OVERDOSES HAD 227 00:09:16,000 --> 00:09:19,240 CONTAMINATION WITH FENTANYL. 228 00:09:19,240 --> 00:09:20,400 20% WITH METHAMPHETAMINE. 229 00:09:20,400 --> 00:09:23,480 WE DON'T KNOW THIS IS NOT 230 00:09:23,480 --> 00:09:25,600 RECORDED IN THESE DATA SETS, 231 00:09:25,600 --> 00:09:27,240 WHAT PERCENTAGE OF THESE ONES, 232 00:09:27,240 --> 00:09:29,800 FOR EXAMPLE, HAD ALSO 233 00:09:29,800 --> 00:09:30,760 INTOXICATION WITH ALCOHOL. 234 00:09:30,760 --> 00:09:34,040 ONE WOULD EM PEKT AT LEAST 15% 235 00:09:34,040 --> 00:09:38,040 OF THOSE OVERDOSES OVERALL ARE 236 00:09:38,040 --> 00:09:40,600 ASSOCIATED WITH ALCOHOL. 237 00:09:40,600 --> 00:09:45,560 SIMILARLY, THERE IS ESTIMATED 238 00:09:45,560 --> 00:09:50,280 15% CONTRIBUTION OF BENZO 239 00:09:50,280 --> 00:09:53,480 DIAZEPINES. 240 00:09:53,480 --> 00:09:54,680 THESE INCREASED THE PEOPLE 241 00:09:54,680 --> 00:09:57,960 AFFECTED BY THE OVERDOSE CRISIS. 242 00:09:57,960 --> 00:10:00,000 AMERICANS IN THE DARK BLUE 243 00:10:00,000 --> 00:10:04,160 CURVE WERE MORE LIKELY TO BE 244 00:10:04,160 --> 00:10:05,920 PRESCRIBED OPIOIDS IN THE 245 00:10:05,920 --> 00:10:07,600 OVERDOSE CRISIS FROM OPIATES. 246 00:10:07,600 --> 00:10:09,920 THE NUMBERS WERE EQUIVALENT FOR 247 00:10:09,920 --> 00:10:15,040 THE AMERICAN INDIANS, ALASKA 248 00:10:15,040 --> 00:10:16,320 NATIVES, THEY WERE VERY MUCH IN 249 00:10:16,320 --> 00:10:17,160 PARALLEL. 250 00:10:17,160 --> 00:10:19,960 IN 2015 WHEN WE START TO SEE 251 00:10:19,960 --> 00:10:23,880 THE EMERGENCE AND 2016 OF 252 00:10:23,880 --> 00:10:25,280 FENTANYL ACTUALLY CONTAMINATING 253 00:10:25,280 --> 00:10:26,400 COCAINE AND METHAMPHETAMINE, WE 254 00:10:26,400 --> 00:10:30,000 THEN SEE THE SHARP RISE IN THIS 255 00:10:30,000 --> 00:10:31,080 UNDER-REPRESENTED GROUPS. 256 00:10:31,080 --> 00:10:32,720 RIGHT NOW, THE GROUP WITH THE 257 00:10:32,720 --> 00:10:34,800 FASTEST RATE OF OVERDOSE DEATHS 258 00:10:34,800 --> 00:10:37,200 IS AMONG BLACK AMERICANS. 259 00:10:37,200 --> 00:10:39,720 THIS IS LARGELY TO REFLECT, IN 260 00:10:39,720 --> 00:10:41,840 FACT, THAT NOW WE HAVE TO START 261 00:10:41,840 --> 00:10:44,000 WITH MUCH HIGHER LIKELIHOOD 262 00:10:44,000 --> 00:10:45,640 THAT HEROINE IS CONTAMINATED 263 00:10:45,640 --> 00:10:47,240 WITH FENTANYL. 264 00:10:47,240 --> 00:10:49,320 BUT COCAINE BE CONTAMINATED 265 00:10:49,320 --> 00:10:50,480 WITH FENTANYL. 266 00:10:50,480 --> 00:10:52,320 CERTAINLY COCAINE IS ONE OF THE 267 00:10:52,320 --> 00:10:54,200 DRUGS THAT HAS BEEN FAVORED BY 268 00:10:54,200 --> 00:10:56,080 SOME OF THE BLACK COMMUNITIES. 269 00:10:56,080 --> 00:10:59,800 IN THE CASE OF AMERICAN 270 00:10:59,800 --> 00:11:02,360 INDIANS, ALASKA NATIVES, ONE 271 00:11:02,360 --> 00:11:04,440 DRUG FAVORED BY THIS POPULATION 272 00:11:04,440 --> 00:11:06,200 HAS BEEN METHAMPHETAMINE. 273 00:11:06,200 --> 00:11:08,400 TO THE EXTENT THAT 274 00:11:08,400 --> 00:11:09,360 METHAMPHETAMINE IS CONTAMINATED 275 00:11:09,360 --> 00:11:12,120 THAT, OF COURSE, RISES THE RISK. 276 00:11:12,120 --> 00:11:15,640 WE WANTED TO PAY A TENSION 277 00:11:15,640 --> 00:11:16,800 ATTENTION TO THE NUMBERS 278 00:11:16,800 --> 00:11:18,680 BECAUSE IT TELLS US THE MOTE. 279 00:11:18,680 --> 00:11:21,200 42.9. 280 00:11:21,200 --> 00:11:22,360 COMPARE THAT WITH WHITE 281 00:11:22,360 --> 00:11:26,960 AMERICANS WHICH IS HIGH 282 00:11:26,960 --> 00:11:29,600 COMPARED TO 32.8. 283 00:11:29,600 --> 00:11:31,000 DISPARITIES WE HAVE BEEN ALSO 284 00:11:31,000 --> 00:11:32,640 AWARE DURING THE COVID PANDEMIC. 285 00:11:32,640 --> 00:11:39,880 BUT NOW ARE EMERGING REALLY 286 00:11:39,880 --> 00:11:41,600 FAST, AND UNACCEPTABLE AMONG 287 00:11:41,600 --> 00:11:45,720 MINORITY GROUPS. 288 00:11:45,720 --> 00:11:47,800 WE DON'T CLAIM WE UNDERSTAND 289 00:11:47,800 --> 00:11:50,320 THESE DYNAMICS AND WE CAN 290 00:11:50,320 --> 00:11:51,720 PROVIDE INTERVENTIONS AND 291 00:11:51,720 --> 00:11:53,800 THERAPEUTICS FOR THESE GROUPS. 292 00:11:53,800 --> 00:11:55,200 AND THE FINAL DATA SLIDE IS 293 00:11:55,200 --> 00:11:57,800 THIS ONE, THAT SHOWS FOR THE 294 00:11:57,800 --> 00:12:01,760 FIRST TIME EVER, SINCE IN 2019, 295 00:12:01,760 --> 00:12:04,240 OVERDOSE DEATHS FROM 296 00:12:04,240 --> 00:12:04,840 METHAMPHETAMINE TEENAGERS YOU 297 00:12:04,840 --> 00:12:06,960 CAN SEE THE SECOND PART OF 298 00:12:06,960 --> 00:12:10,600 2019, LOOK AT THIS HUGE RISE IN 299 00:12:10,600 --> 00:12:11,600 OVERDOSE MORTALITY AMONG 300 00:12:11,600 --> 00:12:13,760 TEENAGERS. 301 00:12:13,760 --> 00:12:15,400 15-19 YEARS OF AGE. 302 00:12:15,400 --> 00:12:17,000 THIS RISE IS SOMETHING THAT OF 303 00:12:17,000 --> 00:12:18,880 COURSE WE HAVE NEVER SEEN AND 304 00:12:18,880 --> 00:12:20,600 IT CONTINUES. 305 00:12:20,600 --> 00:12:23,640 IT WAS TOTALLY SURPRISING 306 00:12:23,640 --> 00:12:26,040 BECAUSE TEENAGERS AND CERTAINLY 307 00:12:26,040 --> 00:12:27,200 MONITORING THEM AND MONITORING 308 00:12:27,200 --> 00:12:29,320 THEM IN THE FUTURE HAVE THE 309 00:12:29,320 --> 00:12:33,720 LOWEST RATES OF HEROIN USE. 310 00:12:33,720 --> 00:12:35,760 THIS LIKELY INCREASE THIS VERY 311 00:12:35,760 --> 00:12:38,320 DRAMATIC INCREASE IS LIKELY TO 312 00:12:38,320 --> 00:12:39,760 REFLECT CONTAMINATION OF DRUGS 313 00:12:39,760 --> 00:12:40,800 TEENAGERS ARE GOING TO BE 314 00:12:40,800 --> 00:12:41,200 FAVORING. 315 00:12:41,200 --> 00:12:43,800 IN THE CASE OF TEENAGERS, WE 316 00:12:43,800 --> 00:12:45,640 KNOW THEY FAVOR, AGAIN, NOT 317 00:12:45,640 --> 00:12:48,400 JUST ALCOHOL AND VAPING AND 318 00:12:48,400 --> 00:12:50,120 THEY ALSO FAVOR PRESCRIPTION 319 00:12:50,120 --> 00:12:51,600 DRUGS. 320 00:12:51,600 --> 00:12:53,320 PRESCRIPTION DRUGS CAN BE 321 00:12:53,320 --> 00:12:59,040 STIMULANT, THEY CAN BE BENZO 322 00:12:59,040 --> 00:13:01,120 DIAZEPINE, OPIOID PAIN PILLS. 323 00:13:01,120 --> 00:13:03,000 TO THE EXTENT THESE ARE 324 00:13:03,000 --> 00:13:04,920 CONTAMINATED WITH FENTANYL, WE 325 00:13:04,920 --> 00:13:05,960 BASICALLY, THIS IS LIKELY TO BE 326 00:13:05,960 --> 00:13:08,720 ONE OF THE REASONS WHY THAT 327 00:13:08,720 --> 00:13:10,120 INCREASED RISK IS HAPPENING. 328 00:13:10,120 --> 00:13:14,160 AND IN FACT, DURING THE THREE 329 00:13:14,160 --> 00:13:18,000 YEARS OF 2018-2021, WHEN THEY 330 00:13:18,000 --> 00:13:19,920 HAVE BEEN MONITORING 331 00:13:19,920 --> 00:13:22,000 MANUFACTURE DRUGS THAT CONTAIN 332 00:13:22,000 --> 00:13:25,040 FENTANYL, THESE HAVE INCREASED 333 00:13:25,040 --> 00:13:30,080 IN THREE YEARS, 404. 334 00:13:30,080 --> 00:13:34,880 WE ARE GETTING ILLICITLY 335 00:13:34,880 --> 00:13:36,040 MANUFACTURED MEDICATION FROM 336 00:13:36,040 --> 00:13:40,200 THE WEB IT MAY CONTAIN FENTANYL 337 00:13:40,200 --> 00:13:41,560 IS MUCH HIGHER. 338 00:13:41,560 --> 00:13:44,000 UNDERSTANDING THIS HIGHLIGHTS 339 00:13:44,000 --> 00:13:48,200 NOW, MAY BE OF SERVICE AMONG 340 00:13:48,200 --> 00:13:49,800 TEENAGERS FOR OVERDOSING. 341 00:13:49,800 --> 00:13:51,000 SO HOW DO WE TAKE THIS 342 00:13:51,000 --> 00:13:52,240 INFORMATION IN TERMS OF HOW WE 343 00:13:52,240 --> 00:13:52,920 MOVE FORWARD. 344 00:13:52,920 --> 00:13:55,240 WE STARTED WITH THE OVERDOSE 345 00:13:55,240 --> 00:13:56,200 CRISIS AND TREATMENT WAS 346 00:13:56,200 --> 00:13:57,120 CRUCIAL. 347 00:13:57,120 --> 00:13:58,200 STILL CRUCIAL. 348 00:13:58,200 --> 00:13:59,840 AND WE STILL NEED TO ADVANCE 349 00:13:59,840 --> 00:14:01,440 THE SCIENCE AND PROVIDE THE 350 00:14:01,440 --> 00:14:02,280 TREATMENT THAT IS NOT 351 00:14:02,280 --> 00:14:08,080 SUFFICIENT. 352 00:14:08,080 --> 00:14:09,960 INDISPENSABLE AND CRUCIAL. 353 00:14:09,960 --> 00:14:11,360 THE NOT SUFFICIENT. 354 00:14:11,360 --> 00:14:14,440 THE CLEAR THAT WE ALSO NEED TO 355 00:14:14,440 --> 00:14:16,320 DEPLOY TREATMENT FOR OTHER 356 00:14:16,320 --> 00:14:17,400 SUBSTANCE USE DISORDERS BECAUSE 357 00:14:17,400 --> 00:14:18,760 OF THE HIGH RISK OF 358 00:14:18,760 --> 00:14:22,000 CONTAMINATION OF THE DRUGS, 359 00:14:22,000 --> 00:14:23,840 LEADING TO OVERDOSE. 360 00:14:23,840 --> 00:14:26,120 OVERDOSE TREATMENTS WE USE, 361 00:14:26,120 --> 00:14:28,400 NALOXONE MAY NOT WORK WITH 362 00:14:28,400 --> 00:14:30,320 COMBINATION OF DRUGS INDUCING 363 00:14:30,320 --> 00:14:31,680 DEATH. 364 00:14:31,680 --> 00:14:34,520 IT'S ALSO EVIDENT WE NEED TO 365 00:14:34,520 --> 00:14:37,040 LAUNCH PREVENTION AS A MAJOR 366 00:14:37,040 --> 00:14:41,560 INITIATIVE, IT SHOULD IMPROVE 367 00:14:41,560 --> 00:14:43,200 TEENAGERS THAT MAY BE 368 00:14:43,200 --> 00:14:44,800 EXPERIMENTING WITH DRUGS OR OWE 369 00:14:44,800 --> 00:14:48,200 CAIG ALLEY TAKING DRUGS OR 370 00:14:48,200 --> 00:14:49,400 TAKING OCCASIONAL DRUGS TO 371 00:14:49,400 --> 00:14:51,600 SLEEP BETTER. 372 00:14:51,600 --> 00:14:53,760 THE RISK CURRENTLY EXCEEDS 373 00:14:53,760 --> 00:14:56,360 BECAUSE OF THIS DISPERSION AND 374 00:14:56,360 --> 00:14:59,680 MANUFACTURING OF ILLICITLY 375 00:14:59,680 --> 00:15:00,480 MANUFACTURED DRUGS. 376 00:15:00,480 --> 00:15:03,200 IN ADDITION TO THE SCREENING 377 00:15:03,200 --> 00:15:04,360 AND APPROPRIATE TREATMENT 378 00:15:04,360 --> 00:15:06,200 INTERVENTIONS FOR THOSE TO 379 00:15:06,200 --> 00:15:07,920 PREVENT THEM TO ESCALATING TO 380 00:15:07,920 --> 00:15:09,000 DRUG TAKING. 381 00:15:09,000 --> 00:15:10,960 IT'S CLEAR WE NEED MUCH, MUCH 382 00:15:10,960 --> 00:15:13,000 BETTER DATA. 383 00:15:13,000 --> 00:15:14,640 THE VERY FRUSTRATING TO TRY TO 384 00:15:14,640 --> 00:15:16,120 MAKE DECISIONS WHAT HAPPENS IN 385 00:15:16,120 --> 00:15:16,800 7 MONTHS. 386 00:15:16,800 --> 00:15:17,960 I DON'T KNOW THE SITUATION 387 00:15:17,960 --> 00:15:20,800 RIGHT NOW IN TERMS OF OVERDOSES. 388 00:15:20,800 --> 00:15:22,840 IT'S ALSO CLEAR THAT WHEN WE 389 00:15:22,840 --> 00:15:26,280 SPEAK ABOUT ADDICTION AND WE 390 00:15:26,280 --> 00:15:27,680 UNDERSTAND BIOLOGICAL 391 00:15:27,680 --> 00:15:30,320 COMPONENTS, WE ALSO UNDERSTAND 392 00:15:30,320 --> 00:15:31,720 THAT SOCIAL DETERMINANTS OF 393 00:15:31,720 --> 00:15:33,360 HEALTH ARE CRUCIAL IN 394 00:15:33,360 --> 00:15:35,440 DETERMINING THE RISK OF 395 00:15:35,440 --> 00:15:39,600 VULNERABILITY OF PEOPLE 396 00:15:39,600 --> 00:15:40,400 EXPERIENCING WITH DRUGS. 397 00:15:40,400 --> 00:15:43,680 IF THEY HAVE ADDICTION, SOCIAL 398 00:15:43,680 --> 00:15:44,840 DETERMINANTS OF HEALTH IS 399 00:15:44,840 --> 00:15:45,680 IMPORTANT WHETHER THEY CAN 400 00:15:45,680 --> 00:15:46,240 RECOVER. 401 00:15:46,240 --> 00:15:47,600 I WANT TO THANK YOU VERY MUCH 402 00:15:47,600 --> 00:15:49,240 FOR YOUR ATTENTION. 403 00:15:49,240 --> 00:15:50,920 I'M NOT GOING TO BE THERE TO 404 00:15:50,920 --> 00:15:53,040 ANSWER THE QUESTIONS, BUT AS I 405 00:15:53,040 --> 00:15:56,200 MENTIONED EARLIER ON, DR. 406 00:15:56,200 --> 00:15:57,600 WILSON AND DR. WEISS WILL BE 407 00:15:57,600 --> 00:15:58,760 THERE TO ANSWER ANY QUESTIONS 408 00:15:58,760 --> 00:16:00,080 YOU MAY HAVE. 409 00:16:00,080 --> 00:16:08,000 THANKS VERY MUCH. 410 00:16:08,000 --> 00:16:09,840 >> OKAY, ARE THERE ANY 411 00:16:09,840 --> 00:16:11,720 QUESTIONS THAT WILSON OR I CAN 412 00:16:11,720 --> 00:16:27,280 ANSWER FOR THE GROUP? 413 00:16:27,280 --> 00:16:30,280 I'M NOT SEEING ANY HANDS RAISED. 414 00:16:30,280 --> 00:16:31,000 OH, I DO NOW. 415 00:16:31,000 --> 00:16:34,000 HOWARD? 416 00:16:34,000 --> 00:16:35,200 >> YEAH. 417 00:16:35,200 --> 00:16:37,280 TWO QUESTIONS. 418 00:16:37,280 --> 00:16:44,920 ONE IS, ARE THERE ANY DATA 419 00:16:44,920 --> 00:16:46,840 AVAILABLE ABOUT REGIONAL 420 00:16:46,840 --> 00:16:51,400 DIFFERENCES THAT MIGHT BE 421 00:16:51,400 --> 00:16:53,320 INFORMATIVE ABOUT REGIONAL, YOU 422 00:16:53,320 --> 00:16:57,760 KNOW, HEALTH PRACTICES, MAYBE 423 00:16:57,760 --> 00:16:59,120 STATE-BY-STATE, ETC. 424 00:16:59,120 --> 00:17:01,520 THE SECOND, I'M INTRIGUED WITH 425 00:17:01,520 --> 00:17:03,400 THE RECENT NATURE ARTICLE ON 426 00:17:03,400 --> 00:17:06,040 MAY 5th ABOUT DRIVERS OF HEALTH. 427 00:17:06,040 --> 00:17:09,280 AND I'M WONDERING IF THERE'S A 428 00:17:09,280 --> 00:17:13,200 WAY, IF YOU UNDERSTAND THE 429 00:17:13,200 --> 00:17:20,720 SOCIAL, JUST METHODLOGICALLY 430 00:17:20,720 --> 00:17:22,840 THE SOCIAL DETERMINANTS BEHIND 431 00:17:22,840 --> 00:17:25,640 THE DRIVERS OF, LET'S SAY THE 432 00:17:25,640 --> 00:17:27,280 ADDICTION, CAN YOU ALSO 433 00:17:27,280 --> 00:17:28,920 LEVERAGE THAT KNOWLEDGE TO 434 00:17:28,920 --> 00:17:31,120 UNDERSTAND THE DRIVERS OF THE 435 00:17:31,120 --> 00:17:34,480 SAME KIND OF DRIVERS THAT 436 00:17:34,480 --> 00:17:36,800 PEOPLE THAT ARE NOT ADDICTED? 437 00:17:36,800 --> 00:17:39,640 AND IS THAT A METHODOLOGY THAT 438 00:17:39,640 --> 00:17:42,360 YOU CAN LOOK TO, OR YOU ARE 439 00:17:42,360 --> 00:17:43,880 LOOKING TO? 440 00:17:43,880 --> 00:17:49,680 I'M FAMILIAR WITH SOME OTHER 441 00:17:49,680 --> 00:17:52,000 APPROACHES AT NINH WHERE THAT'S 442 00:17:52,000 --> 00:17:58,120 BEEN USED AND SUCCESSFUL. 443 00:17:58,120 --> 00:18:00,000 >> OF COURSE YOU ARE OPENING A 444 00:18:00,000 --> 00:18:02,560 BROAD RANGE OF SCIENCE IN TERMS 445 00:18:02,560 --> 00:18:03,960 OF SOCIAL INFLUENCES ON HEALTH. 446 00:18:03,960 --> 00:18:06,680 THIS HAS BEEN A MAJOR PART OF 447 00:18:06,680 --> 00:18:08,560 OUR PORTFOLIO FOR AS LONG AS 448 00:18:08,560 --> 00:18:10,640 I'VE BEEN AT NIDA, PROBABLY 20 449 00:18:10,640 --> 00:18:13,200 YEARS AND PROBABLY MUCH LONGER. 450 00:18:13,200 --> 00:18:14,400 LET ME ADDRESS YOUR FIRST 451 00:18:14,400 --> 00:18:16,240 QUESTION, WHICH HAD TO DO WITH 452 00:18:16,240 --> 00:18:17,320 REGIONAL DATA THAT MAY BE 453 00:18:17,320 --> 00:18:19,000 AVAILABLE. 454 00:18:19,000 --> 00:18:20,400 CERTAINLY, THE OVERDOSE DEATH 455 00:18:20,400 --> 00:18:23,640 DATA CAN BE DECOMPOSED DOWN TO 456 00:18:23,640 --> 00:18:24,840 MUCH SMALLER GRANULAR ASPECTS 457 00:18:24,840 --> 00:18:26,280 DOWN TO THE COUNTY LEVEL. 458 00:18:26,280 --> 00:18:28,800 YOU RUN OUT OF CASES, SO THE 459 00:18:28,800 --> 00:18:30,880 ABILITY TO DO A CAREFUL 460 00:18:30,880 --> 00:18:33,200 ANALYSIS AT THOSE VERY LOCAL 461 00:18:33,200 --> 00:18:34,160 LEVELS BECOMES QUITE DIFFICULT 462 00:18:34,160 --> 00:18:35,800 BECAUSE OF THE SMALL NUMBER IN 463 00:18:35,800 --> 00:18:36,880 ANYONE JURISDICTION. 464 00:18:36,880 --> 00:18:38,680 THESE ARE STILL RARE EVENTS, 465 00:18:38,680 --> 00:18:40,400 EVEN THOUGH AS A COUNTRY, AS A 466 00:18:40,400 --> 00:18:43,240 WHOLE, THEY ARE UNFORTUNATELY 467 00:18:43,240 --> 00:18:44,600 ALL TOO COMMON. 468 00:18:44,600 --> 00:18:46,880 BUT WHEN YOU DIVIDE BY THE 469 00:18:46,880 --> 00:18:47,720 3,000 COUNTIES THAT'S MORE 470 00:18:47,720 --> 00:18:48,440 DIFFICULT. 471 00:18:48,440 --> 00:18:51,240 THAT'S ALLOWED US TO LOOK AT 472 00:18:51,240 --> 00:18:53,680 HOTSPOTS LIKE APPALACHIAN 473 00:18:53,680 --> 00:18:55,360 REGION OR UNDERSTANDING HOW THE 474 00:18:55,360 --> 00:18:56,800 SPREAD OF FENTANYL SHIFTED FROM 475 00:18:56,800 --> 00:18:59,880 THE EAST COAST AND MIDWEST TO 476 00:18:59,880 --> 00:19:01,720 THE WEST COAST HAS BEEN HARD 477 00:19:01,720 --> 00:19:10,400 HIT IN THE LAST YEAR AND A HALF. 478 00:19:10,400 --> 00:19:12,680 FENTANYL WASN'T AS PREVALENT 479 00:19:12,680 --> 00:19:15,240 BECAUSE OF THE BLACK TAR 480 00:19:15,240 --> 00:19:16,960 HEROIN, IT TOOK DRUG DEALERS A 481 00:19:16,960 --> 00:19:20,120 LITTLE WHILE TO FIGURE OUT HOW 482 00:19:20,120 --> 00:19:21,760 TO MIMIC WHAT WAS TYPICALLY 483 00:19:21,760 --> 00:19:24,760 USED IN THOSE AREAS WITH 484 00:19:24,760 --> 00:19:27,160 FENTANYL COMPOUNDS OR OTHER 485 00:19:27,160 --> 00:19:28,360 SYNTHETIC OPIOIDS. 486 00:19:28,360 --> 00:19:30,040 THE OTHER ISSUE, AS YOU HEARD 487 00:19:30,040 --> 00:19:32,400 WITH THE OVERDOSE DEATHS IN 488 00:19:32,400 --> 00:19:34,760 TEENAGERS, THE INCREASING 489 00:19:34,760 --> 00:19:37,160 COUNTERFEIT MEDICATIONS HAS 490 00:19:37,160 --> 00:19:41,040 BEEN A PROBLEM IN MANY 491 00:19:41,040 --> 00:19:41,400 JURISDICTIONS. 492 00:19:41,400 --> 00:19:42,600 THE REGIONAL VARIATION BECOMES 493 00:19:42,600 --> 00:19:43,560 AN IMPORTANT CLUE. 494 00:19:43,560 --> 00:19:45,400 I REALLY LIKE YOUR SECOND 495 00:19:45,400 --> 00:19:46,600 QUESTION ABOUT SOCIAL 496 00:19:46,600 --> 00:19:47,920 DETERMINANTS OF HEALTH. 497 00:19:47,920 --> 00:19:49,080 WE ARE PARTNERING WITH GROUPS 498 00:19:49,080 --> 00:19:51,520 LIKE OUR OFFICE OF BEHAVIORAL 499 00:19:51,520 --> 00:19:53,560 AND SOCIAL SCIENCES RESEARCH AT 500 00:19:53,560 --> 00:19:56,360 NIH. 501 00:19:56,360 --> 00:19:59,360 PARTNERS AT NIAAA AND NCI TO 502 00:19:59,360 --> 00:20:00,000 EXAMINE THESE ISSUES WHERE WE 503 00:20:00,000 --> 00:20:01,000 CAN. 504 00:20:01,000 --> 00:20:03,120 BUT THERE ARE ALWAYS 505 00:20:03,120 --> 00:20:04,240 DIFFICULTIES IN MERGING DATA 506 00:20:04,240 --> 00:20:05,000 SETS. 507 00:20:05,000 --> 00:20:07,520 WHILE WE ARE THRILLED WITH 508 00:20:07,520 --> 00:20:09,400 STUDIES LIKE HBCD THAT CAN 509 00:20:09,400 --> 00:20:10,800 COLLECT THIS INFORMATION IN A 510 00:20:10,800 --> 00:20:12,680 LARGE SCALE BASIS FOR A 511 00:20:12,680 --> 00:20:13,600 PARTICULAR POPULATION, IT'S 512 00:20:13,600 --> 00:20:15,640 BEEN MORE DIFFICULT TO LINK, 513 00:20:15,640 --> 00:20:18,760 YOU KNOW, CENSUS DATA OR OTHER 514 00:20:18,760 --> 00:20:20,040 SOCIAL DETERMINANTS OF HEALTH 515 00:20:20,040 --> 00:20:21,680 DATA WITH OUR LARGE SCALE 516 00:20:21,680 --> 00:20:23,000 SURVEYS TO DO THIS IN THE 517 00:20:23,000 --> 00:20:25,480 ADDICTION FIELD. 518 00:20:25,480 --> 00:20:27,120 SO THAT'S AN AREA WE ARE 519 00:20:27,120 --> 00:20:29,920 WORKING TO SOLVE BUT WE HAVEN'T 520 00:20:29,920 --> 00:20:30,600 COMPLETELY ADDRESSED YET. 521 00:20:30,600 --> 00:20:33,240 >> I WAS JUST GOING TO ADD 522 00:20:33,240 --> 00:20:34,400 ABOUT HBCD AND YOU WILL HEAR 523 00:20:34,400 --> 00:20:36,000 MORE ABOUT THIS LATER, BUT I 524 00:20:36,000 --> 00:20:37,200 THINK IT OFFERS US AN 525 00:20:37,200 --> 00:20:39,040 OPPORTUNITY TO BE LOOKING AT 526 00:20:39,040 --> 00:20:40,200 SOCIAL DETERMINANTS OF HEALTH 527 00:20:40,200 --> 00:20:42,400 IN THIS LARGE GROUP AND BE 528 00:20:42,400 --> 00:20:43,800 THINKING OF PREVENTION AND 529 00:20:43,800 --> 00:20:44,840 TRAJECTORIES PEOPLE ARE ON IN 530 00:20:44,840 --> 00:20:47,320 TERMS OF THE IMPACT OF 531 00:20:47,320 --> 00:20:49,400 SUBSTANCE USE OR EVEN THEY ARE 532 00:20:49,400 --> 00:20:50,640 EXPERIMENTING WITH SUBSTANCES. 533 00:20:50,640 --> 00:20:52,200 AS I SAID, YOU WILL HEAR MORE 534 00:20:52,200 --> 00:20:53,840 ABOUT IT, BUT IT'S AT LEAST ONE 535 00:20:53,840 --> 00:20:55,480 WAY OF STARTING TO GET AT THAT 536 00:20:55,480 --> 00:20:56,880 QUESTION FROM THE PREVENTION 537 00:20:56,880 --> 00:20:58,400 SIDE OF IT, RATHER THAN 538 00:20:58,400 --> 00:20:59,440 NECESSARILY FROM THE RECOVERY 539 00:20:59,440 --> 00:21:00,880 SIDE. 540 00:21:00,880 --> 00:21:02,520 >> THE OTHER DATA SYSTEM THAT 541 00:21:02,520 --> 00:21:04,360 WE MIGHT LOOK AT IN THE FUTURE 542 00:21:04,360 --> 00:21:07,800 WILL BE THE ALL OF US COHORT. 543 00:21:07,800 --> 00:21:09,960 WHICH, BECAUSE OFITY SIZE, IF 544 00:21:09,960 --> 00:21:11,800 WE CAN GET GOOD INFORMATION 545 00:21:11,800 --> 00:21:13,920 ABOUT SUBSTANCE USE WITHIN THAT 546 00:21:13,920 --> 00:21:15,440 COHORT, THAT MIGHT PROVIDE AN 547 00:21:15,440 --> 00:21:17,120 OPPORTUNITY TO LOOK AT SOME OF 548 00:21:17,120 --> 00:21:18,520 THESE REALLY ESSENTIAL 549 00:21:18,520 --> 00:21:19,680 QUESTIONS TO REALLY IMPROVE 550 00:21:19,680 --> 00:21:23,880 HEALTH. 551 00:21:23,880 --> 00:21:24,960 >> TRAVIS? 552 00:21:24,960 --> 00:21:26,720 >> YEAH, APOLOGIES FOR NOT 553 00:21:26,720 --> 00:21:29,040 BEING ON CAMERA AGAIN, I'M 554 00:21:29,040 --> 00:21:32,480 STILL UNDER THE WEATHER, SO I 555 00:21:32,480 --> 00:21:34,000 WON'T EXPOSE YOU TO THAT 556 00:21:34,000 --> 00:21:34,840 REALITY. 557 00:21:34,840 --> 00:21:37,600 ONE QUESTION I HAVE IS THIS 558 00:21:37,600 --> 00:21:39,480 TURN TOWARDS STIMULANT 559 00:21:39,480 --> 00:21:41,160 OVERDOSE, WHICH I SEE, YOU 560 00:21:41,160 --> 00:21:43,040 KNOW, THAT FENTANYL IS STILL 561 00:21:43,040 --> 00:21:44,680 THE REAL DOMINANT KIND OF 562 00:21:44,680 --> 00:21:49,160 SCARING EVERYONE OUT THERE, 563 00:21:49,160 --> 00:21:50,760 POLY SUBSTANCE USE IN OVERDOSE. 564 00:21:50,760 --> 00:21:52,840 FOR SOMEONE LIKE ME MUCH MORE 565 00:21:52,840 --> 00:21:53,800 FAMILIAR WITH OPIOIDS, I HAVE 566 00:21:53,800 --> 00:21:55,440 THIS SENSE OF EVERY SINGLE 567 00:21:55,440 --> 00:21:58,960 PERSON WHO DIES FROM AN OPIOID 568 00:21:58,960 --> 00:22:01,200 OVERDOSE DIED A FULLY 569 00:22:01,200 --> 00:22:02,000 PREVENTABLE DEATH BECAUSE WE 570 00:22:02,000 --> 00:22:04,360 HAVE NALOXONE AND IF THEY WERE 571 00:22:04,360 --> 00:22:06,200 USING IN PUBLIC WITHOUT FEAR OF 572 00:22:06,200 --> 00:22:07,880 CALLING FOR RESCUE, ETC., WE 573 00:22:07,880 --> 00:22:08,960 COULD SAVE EVERY SINGLE ONE OF 574 00:22:08,960 --> 00:22:09,520 THEM. 575 00:22:09,520 --> 00:22:11,800 I HAVE THIS REALLY SOLID 576 00:22:11,800 --> 00:22:13,640 NARRATIVE IN MY HEAD WHAT HARM 577 00:22:13,640 --> 00:22:15,800 REDUCTION COULD DO WHEN IT 578 00:22:15,800 --> 00:22:16,520 COMES TO OPIOIDS. 579 00:22:16,520 --> 00:22:18,800 I HAVE TO ADMIT I DON'T HAVE AS 580 00:22:18,800 --> 00:22:22,480 GOOD OF A PICTURE OF WHAT HARM 581 00:22:22,480 --> 00:22:23,720 REDUCTION FOR STIMULANTS LOOKS 582 00:22:23,720 --> 00:22:24,840 LIKE. 583 00:22:24,840 --> 00:22:30,120 AND SO I KNOW THERE ARE 584 00:22:30,120 --> 00:22:31,080 PHARMACEUTICALS, THERAPEUTICS 585 00:22:31,080 --> 00:22:32,640 BEING STUDIED RIGHT NOW. 586 00:22:32,640 --> 00:22:34,320 AND I'M SURE THAT THERE IS 587 00:22:34,320 --> 00:22:36,400 STILL A LOT OF ADVANTAGES OF 588 00:22:36,400 --> 00:22:38,440 USING WITH OTHER PEOPLE AND 589 00:22:38,440 --> 00:22:39,800 AROUND FOLKS WHO ARE TRAINED 590 00:22:39,800 --> 00:22:40,800 MEDICALLY. 591 00:22:40,800 --> 00:22:43,600 BUT I JUST WONDER IF THERE'S 592 00:22:43,600 --> 00:22:45,080 ANYTHING YOU CAN TELL US ABOUT 593 00:22:45,080 --> 00:22:47,200 WHAT WE COULD BE DOING TO 594 00:22:47,200 --> 00:22:48,800 ADVOCATE FOR HARM REDUCTION AND 595 00:22:48,800 --> 00:22:52,120 WHAT SORTS OF DIRECTION RESOIX 596 00:22:52,120 --> 00:22:53,960 RESEARCH NEEDS TO BE GOING AS 597 00:22:53,960 --> 00:22:56,040 THIS TURN TOWARD STIMULANT GETS 598 00:22:56,040 --> 00:22:58,120 WORSE AND WE NEED TO THINK OF 599 00:22:58,120 --> 00:22:59,280 TREATMENT AND HARM REDUCTION 600 00:22:59,280 --> 00:23:03,640 FOR A DIFFERENT CLASS OF DRUGS 601 00:23:03,640 --> 00:23:04,360 THAT RESPONDS DIFFERENTLY. 602 00:23:04,360 --> 00:23:07,200 >> IT'S INTERESTING, BECAUSE 603 00:23:07,200 --> 00:23:09,000 THE TERM OVERDOSE DOESN'T SEEM 604 00:23:09,000 --> 00:23:11,120 RELATABLE TO A POISONING 605 00:23:11,120 --> 00:23:12,600 RELATED TO METHAMPHETAMINE OR 606 00:23:12,600 --> 00:23:13,960 COCAINE. 607 00:23:13,960 --> 00:23:15,600 TYPICALLY THE DEATHS WOULD BE 608 00:23:15,600 --> 00:23:19,600 RELATED TO CARDIOVASCULAR 609 00:23:19,600 --> 00:23:20,120 COMPLICATIONS, STROKES, 610 00:23:20,120 --> 00:23:22,200 SEIZURES AND OTHER ACUTE EVENTS 611 00:23:22,200 --> 00:23:25,920 I THINK OF AS AN OVERDOSE, MORE 612 00:23:25,920 --> 00:23:29,400 OF AN IDIOSYNCRATIC REACTION TO 613 00:23:29,400 --> 00:23:30,320 THE INGESTION ITSELF. 614 00:23:30,320 --> 00:23:33,560 I WOULD POINT OUT THAT NALOXONE 615 00:23:33,560 --> 00:23:35,960 AND THE OPIOID ANTAGONIST COULD 616 00:23:35,960 --> 00:23:38,120 BE VERY HELPFUL, EVEN IN 617 00:23:38,120 --> 00:23:38,760 STIMULANT SITUATIONS. 618 00:23:38,760 --> 00:23:42,240 BECAUSE OF THE CO-MORBIDITY AND 619 00:23:42,240 --> 00:23:43,880 OVERLAP OF THESE SUBSTANCES IN 620 00:23:43,880 --> 00:23:44,800 SO MANY CASES. 621 00:23:44,800 --> 00:23:46,440 EVEN THOUGH PEOPLE ARE TAKING 622 00:23:46,440 --> 00:23:48,800 COCAINE AND THAT MAY CONTRIBUTE 623 00:23:48,800 --> 00:23:50,000 TO IT. 624 00:23:50,000 --> 00:23:53,200 IF WE CAN RESCUE THEIR 625 00:23:53,200 --> 00:23:54,120 RESPIRATORY DEPRESSION THAT MAY 626 00:23:54,120 --> 00:23:55,520 BE ENOUGH TO SAVE THEIR LIFE. 627 00:23:55,520 --> 00:23:58,840 YOU BRING UP THE CASE WHAT IF 628 00:23:58,840 --> 00:24:02,080 IT'S NOT DUE TO OVERLAP. 629 00:24:02,080 --> 00:24:04,800 THIS IS WHERE WE HOPE 630 00:24:04,800 --> 00:24:07,800 MEDICATION WILL PLAY A KEY ROLE. 631 00:24:07,800 --> 00:24:11,640 THERE'S INTERESTING WORK MONO 632 00:24:11,640 --> 00:24:13,280 CLONAL ANTIBODIES THAT MAY HAVE 633 00:24:13,280 --> 00:24:15,560 A RAPID ENOUGH ON SET THEY 634 00:24:15,560 --> 00:24:16,960 COULD BE USEFUL IN OVERDOSES OF 635 00:24:16,960 --> 00:24:17,640 METHAMPHETAMINE. 636 00:24:17,640 --> 00:24:18,920 THAT'S WHERE WE PUT A LOT OF 637 00:24:18,920 --> 00:24:19,920 OUR EFFORT. 638 00:24:19,920 --> 00:24:21,440 I'M NOT SURE HOW THAT WILL 639 00:24:21,440 --> 00:24:23,240 APPLY IN A HARM REDUCTION 640 00:24:23,240 --> 00:24:24,880 SITUATION, BECAUSE I DOUBT WE 641 00:24:24,880 --> 00:24:26,520 WILL BE DISTRIBUTING THAT TO 642 00:24:26,520 --> 00:24:28,360 THE COMMUNITY HARM REDUCTION 643 00:24:28,360 --> 00:24:30,040 GROUPS, BUT WE WILL START WITH 644 00:24:30,040 --> 00:24:31,200 THE CLINICAL APPLICATION AND 645 00:24:31,200 --> 00:24:32,320 EXTEND IT FROM THERE AS 646 00:24:32,320 --> 00:24:32,840 POSSIBLE. 647 00:24:32,840 --> 00:24:35,200 I THINK THERE MAY BE BEHAVIORAL 648 00:24:35,200 --> 00:24:36,600 APPROACHES THAT COULD HELP PLAY 649 00:24:36,600 --> 00:24:38,960 A ROLE IN HARM REDUCTION, BUT 650 00:24:38,960 --> 00:24:41,520 CERTAINLY WE ARE OPEN TO NOVEL 651 00:24:41,520 --> 00:24:45,000 IDEAS ABOUT HOW TO ADDRESS THIS 652 00:24:45,000 --> 00:24:47,520 EMERGING OVERDOSE CRISIS 653 00:24:47,520 --> 00:24:48,680 RELATED TO NON-OPIOIDS. 654 00:24:48,680 --> 00:24:50,080 >> THAT'S JUST REALLY HELPFUL 655 00:24:50,080 --> 00:24:51,960 TO HEAR YOU SAY. 656 00:24:51,960 --> 00:24:53,040 AND SUSAN, IF YOU WANT TO ADD 657 00:24:53,040 --> 00:24:53,800 ANYTHING. 658 00:24:53,800 --> 00:24:55,920 I WILL JUST ADD THAT SORT OF 659 00:24:55,920 --> 00:24:57,560 RESPONSE MAKES ME THINK THIS 660 00:24:57,560 --> 00:24:59,200 REALLY IS AN IMPORTANT AREA FOR 661 00:24:59,200 --> 00:25:00,800 MORE PEOPLE TO BE THINKING 662 00:25:00,800 --> 00:25:02,720 ABOUT, LIKE WHAT'S THE STORY WE 663 00:25:02,720 --> 00:25:05,280 TELL PEOPLE TO PREPARE FOR THE 664 00:25:05,280 --> 00:25:07,160 COMMUNITIES TO THINK ABOUT THE 665 00:25:07,160 --> 00:25:08,520 FUTURE OF RESEARCH, ETC.? 666 00:25:08,520 --> 00:25:09,800 SO THANKS FOR THAT, APPRECIATE 667 00:25:09,800 --> 00:25:10,440 IT. 668 00:25:10,440 --> 00:25:11,840 >> YEAH, THE ONLY THING I WAS 669 00:25:11,840 --> 00:25:14,200 GOING TO ADD IS WE ARE MAKING 670 00:25:14,200 --> 00:25:16,040 THIS A RESEARCH PRIORITY IN 671 00:25:16,040 --> 00:25:17,400 TERMS OF MEDICATIONS 672 00:25:17,400 --> 00:25:20,440 DEVELOPMENT AND LOOK AT BOTH 673 00:25:20,440 --> 00:25:21,400 STIMULANTS AND OPIOIDS. 674 00:25:21,400 --> 00:25:23,240 SO I THINK WE RECOGNIZE THAT. 675 00:25:23,240 --> 00:25:24,640 AND WE ALSO RECOGNIZE THE 676 00:25:24,640 --> 00:25:26,280 IMPORTANCE OF REALLY DEFINING 677 00:25:26,280 --> 00:25:28,160 WHAT AN OVERDOSE WITH A 678 00:25:28,160 --> 00:25:29,120 STIMULANT LOOKS LIKE, WHICH 679 00:25:29,120 --> 00:25:31,440 ISN'T ALL THAT CLEAR EITHER. 680 00:25:31,440 --> 00:25:33,800 AS WILSON SAID IT COULD BE A 681 00:25:33,800 --> 00:25:35,000 CARDIO TOXIC EVENT BUT IT MAY 682 00:25:35,000 --> 00:25:35,720 NOT BE. 683 00:25:35,720 --> 00:25:38,640 I THINK WE HAVE A LONG WAY TO 684 00:25:38,640 --> 00:25:40,200 GO, IT'S VERY IMPORTANT 685 00:25:40,200 --> 00:25:41,440 RESEARCH PRIORITY FOR US. 686 00:25:41,440 --> 00:25:43,360 >> IT IS INTERESTING THAT WE 687 00:25:43,360 --> 00:25:45,480 CALL THESE THINGS OVERDOSES BUT 688 00:25:45,480 --> 00:25:47,120 TECHNICALLY IN THE NATIONAL 689 00:25:47,120 --> 00:25:48,720 CENTER FOR HEALTH STATISTIC 690 00:25:48,720 --> 00:25:50,360 THESE ARE CALLED DRUG 691 00:25:50,360 --> 00:25:52,600 POISONINGS AND IN MY MIND THAT 692 00:25:52,600 --> 00:25:53,440 LABEL ACTUALLY FITS IN THIS 693 00:25:53,440 --> 00:25:53,800 CASE. 694 00:25:53,800 --> 00:25:58,240 WESLEY? 695 00:25:58,240 --> 00:26:01,400 >> YEAH, AS YOU KNOW, THERE 696 00:26:01,400 --> 00:26:03,280 AREN'T VERY GOOD BEHAVIORAL 697 00:26:03,280 --> 00:26:05,240 STRATEGIES TO WORK WITH 698 00:26:05,240 --> 00:26:08,480 STIMULANTS. 699 00:26:08,480 --> 00:26:12,200 THE ONE STRATEGY -- 700 00:26:12,200 --> 00:26:16,320 THAT SEEMS TO HAVE THE LOWEST 701 00:26:16,320 --> 00:26:18,000 EFFECT IS INCENTIVE-BASED 702 00:26:18,000 --> 00:26:18,840 CONTINGENCY MANAGEMENT. 703 00:26:18,840 --> 00:26:21,400 AND THAT'S NOT WIDELY USED. 704 00:26:21,400 --> 00:26:26,920 SO THE QUESTION IS, WHY DOES 705 00:26:26,920 --> 00:26:29,920 THE ADMINISTRATION LAG? 706 00:26:29,920 --> 00:26:32,920 LAST WEEK HBCD CAME OUT WITH A 707 00:26:32,920 --> 00:26:34,560 STIMULANT DOCUMENT THAT SEEMED 708 00:26:34,560 --> 00:26:36,400 MORE LAW ENFORCEMENT ORIENTED 709 00:26:36,400 --> 00:26:37,600 THAN CLINICALLY AND RESEARCH 710 00:26:37,600 --> 00:26:38,480 BASED. 711 00:26:38,480 --> 00:26:39,760 BUT THAT'S ANOTHER STORY. 712 00:26:39,760 --> 00:26:41,320 BUT THE KEY ISSUE IS WE HAVE 713 00:26:41,320 --> 00:26:43,320 BEEN TALKING ABOUT CONTINGENCY 714 00:26:43,320 --> 00:26:46,040 MANAGEMENT FOR OVER A YEAR. 715 00:26:46,040 --> 00:26:47,440 AND THE LIMITATIONS ON IT 716 00:26:47,440 --> 00:26:49,040 CONTINUE TO EXIST. 717 00:26:49,040 --> 00:26:51,960 YET, WE NOW HAVE AN UPTICK IN 718 00:26:51,960 --> 00:26:53,240 OVERDOSE DEATHS. 719 00:26:53,240 --> 00:26:55,160 I'M PARTICULARLY STRUCK BY 720 00:26:55,160 --> 00:26:57,480 NORA'S DATA ON AFRICAN 721 00:26:57,480 --> 00:26:58,440 AMERICANS. 722 00:26:58,440 --> 00:26:59,480 WE HAVE TREATMENT THAT'S 723 00:26:59,480 --> 00:26:59,880 AVAILABLE. 724 00:26:59,880 --> 00:27:01,800 WE HAVE TO TRANSFORM THE 725 00:27:01,800 --> 00:27:02,640 DELIVERY SYSTEM AND NOTHING IS 726 00:27:02,640 --> 00:27:04,800 HAPG. 727 00:27:04,800 --> 00:27:05,680 -- HAPPENING. 728 00:27:05,680 --> 00:27:08,240 I KNOW THAT'S NOT NIDA'S 729 00:27:08,240 --> 00:27:09,240 PRINCIPLE ROLE BUT IT WOULD BE 730 00:27:09,240 --> 00:27:15,200 NICE TO HAVE MORE RESEARCH FROM 731 00:27:15,200 --> 00:27:20,360 NIAAA AND NIDA FOR DEMAND THAT 732 00:27:20,360 --> 00:27:22,080 COME FROM STIMULANTS AND OTHER 733 00:27:22,080 --> 00:27:22,720 DRUGS, ACTUALLY. 734 00:27:22,720 --> 00:27:24,960 >> I CERTAINLY HAVE OBSERVED 735 00:27:24,960 --> 00:27:26,440 YOUR ENCOURAGEMENT OF THE 736 00:27:26,440 --> 00:27:28,000 FEDERAL GOVERNMENT TO CHANGE 737 00:27:28,000 --> 00:27:29,880 THE BARRIERS TO THE 738 00:27:29,880 --> 00:27:31,960 IMPLEMENTATION OF AN EFFECTIVE 739 00:27:31,960 --> 00:27:34,120 BEHAVIORAL APPROACH TO REDUCING 740 00:27:34,120 --> 00:27:37,560 DRUG CONSUMPTION AND DRUG USE. 741 00:27:37,560 --> 00:27:39,840 NAMELY CONTINGENCY MANAGEMENT 742 00:27:39,840 --> 00:27:41,760 APPROACHES AND I APPLAUD YOUR 743 00:27:41,760 --> 00:27:43,920 EFFORTS TO HELP CHANGE THE 744 00:27:43,920 --> 00:27:45,280 DIALOGUE REGARDING THESE. 745 00:27:45,280 --> 00:27:47,200 I CAN ASSURE YOU, WE HEAR YOU. 746 00:27:47,200 --> 00:27:49,560 TO THE EXTENT WE ARE ABLE TO 747 00:27:49,560 --> 00:27:51,400 PARTNER WITH MULTIPLE HEALTH 748 00:27:51,400 --> 00:27:52,600 AND HUMAN SERVICES GROUPS TO 749 00:27:52,600 --> 00:27:55,160 COME UP WITH SOLUTIONS TO SOME 750 00:27:55,160 --> 00:27:57,000 OF THE FINANCIAL, 751 00:27:57,000 --> 00:27:58,680 ADMINISTRATIVE AND TECHNICAL 752 00:27:58,680 --> 00:27:59,800 BARRIERS TO IMPLEMENTATION, WE 753 00:27:59,800 --> 00:28:02,640 ARE DOING EVERYTHING WE CAN. 754 00:28:02,640 --> 00:28:04,520 I'M HOPEFUL THAT WE WILL SEE 755 00:28:04,520 --> 00:28:05,720 SOME SOLUTIONS SOON. 756 00:28:05,720 --> 00:28:06,880 >> THANK YOU. 757 00:28:06,880 --> 00:28:08,760 >> BUT JUST LIKE YOU, YOU KNOW 758 00:28:08,760 --> 00:28:09,920 THAT UNTIL YOU SEE THEM OUT 759 00:28:09,920 --> 00:28:13,000 THERE ON THE STREET, IT'S A 760 00:28:13,000 --> 00:28:14,400 THEORETICAL ADVANCE SO FAR, BUT 761 00:28:14,400 --> 00:28:17,880 WE ARE PUSHING FOR IT. 762 00:28:17,880 --> 00:28:24,000 >> THANKS, APPRECIATE IT. 763 00:28:24,000 --> 00:28:27,240 >> I CAN CERTAINLY SPEAK THAT 764 00:28:27,240 --> 00:28:30,080 NORA IS A STRONG ADVOCATE FOR 765 00:28:30,080 --> 00:28:31,960 ENCOURAGING THE IMPLEMENTATION 766 00:28:31,960 --> 00:28:32,600 OF EFFECTIVE INTERVENTIONS AND 767 00:28:32,600 --> 00:28:34,920 THIS IS ONE OF THE WELL-KNOWN 768 00:28:34,920 --> 00:28:37,960 EFFECTIVE INTERVENTIONS. 769 00:28:37,960 --> 00:28:44,800 >> THANKS, AGAIN. 770 00:28:44,800 --> 00:28:46,560 >> I DON'T SEE ANY FURTHER 771 00:28:46,560 --> 00:28:48,240 QUESTIONS RIGHT NOW. 772 00:28:48,240 --> 00:28:51,800 SO GEORGE, DO YOU WANT TO TAKE 773 00:28:51,800 --> 00:28:54,600 OVER AND DO YOUR PRESENTATION? 774 00:28:54,600 --> 00:28:56,680 >> SURE, THANK YOU, SUSAN. 775 00:28:56,680 --> 00:28:58,200 IT'S A REAL PLEASURE TO BE WITH 776 00:28:58,200 --> 00:29:00,960 YOU ALL. 777 00:29:00,960 --> 00:29:02,600 I DECIDED TODAY THAT I WOULD 778 00:29:02,600 --> 00:29:05,640 TALK ABOUT A TOPIC THAT'S 779 00:29:05,640 --> 00:29:07,320 LOOMING LARGE IN THE ALCOHOL 780 00:29:07,320 --> 00:29:09,200 COMMUNITY AND THE ALCOHOL FIELD. 781 00:29:09,200 --> 00:29:10,200 AND THAT'S CLOSING THE 782 00:29:10,200 --> 00:29:11,040 TREATMENT GAP. 783 00:29:11,040 --> 00:29:13,120 WE WILL BE DEVOTING A LOT OF 784 00:29:13,120 --> 00:29:16,360 ENERGY TO THIS. 785 00:29:16,360 --> 00:29:17,640 NIAAA DURING THIS YEAR. 786 00:29:17,640 --> 00:29:20,080 AND IT WILL ALSO BE THE 787 00:29:20,080 --> 00:29:22,200 SUBJECT TO GETTING A BIT OF A 788 00:29:22,200 --> 00:29:26,800 PREVIEW WITH MY TALKS TO RSA, 789 00:29:26,800 --> 00:29:29,920 CPDP AND EVEN ASCP, AMERICAN 790 00:29:29,920 --> 00:29:31,840 SOCIETY OF CLINICAL PSYCHO 791 00:29:31,840 --> 00:29:33,400 PHARMACOLOGY. 792 00:29:33,400 --> 00:29:37,560 NEXT SLIDE, JOHN? 793 00:29:37,560 --> 00:29:39,200 SO I'M GOING TO QUICKLY TALK 794 00:29:39,200 --> 00:29:41,240 ABOUT THE SCOPE OF ALCOHOL 795 00:29:41,240 --> 00:29:42,120 RELATED PROBLEMS IN THE UNITED 796 00:29:42,120 --> 00:29:45,000 STATES AND AN UPDATE DURING THE 797 00:29:45,000 --> 00:29:46,120 COVID-19 PANDEMIC. 798 00:29:46,120 --> 00:29:47,760 SIMILAR TO WHAT NORA SHOWED. 799 00:29:47,760 --> 00:29:53,240 I WILL TALK ABOUT DRINKING TO 800 00:29:53,240 --> 00:29:56,000 COPE DURING THE PANDEMIC AND 801 00:29:56,000 --> 00:29:56,600 ALCOHOL-RELATED HARMS DURING 802 00:29:56,600 --> 00:29:59,720 THE PANDEMIC. 803 00:29:59,720 --> 00:30:02,480 THE REST WILL BE NIAAA'S 804 00:30:02,480 --> 00:30:03,640 EFFORTS TO CLOSE THE TREATMENT 805 00:30:03,640 --> 00:30:04,800 GAP. 806 00:30:04,800 --> 00:30:06,720 TOO FEW PEOPLE WHO NEED HELP, 807 00:30:06,720 --> 00:30:09,240 GET HELP. 808 00:30:09,240 --> 00:30:15,240 AND ADVANCING MEDICATIONS, NEW 809 00:30:15,240 --> 00:30:17,120 RESOURCES INCLUDING THE HEALTH 810 00:30:17,120 --> 00:30:18,520 PROFESSIONALS CORE RESOURCE, 811 00:30:18,520 --> 00:30:21,840 WHICH WE LAUNCHED YESTERDAY. 812 00:30:21,840 --> 00:30:22,800 RECOVERY, TELEHEALTH, STIGMA 813 00:30:22,800 --> 00:30:23,640 AND DIVERSITY. 814 00:30:23,640 --> 00:30:24,640 NEXT SLIDE. 815 00:30:24,640 --> 00:30:28,440 SO WHAT ARE THE SCOPE OF 816 00:30:28,440 --> 00:30:29,040 ALCOHOL-RELATED PROBLEMS, AND 817 00:30:29,040 --> 00:30:30,400 WHAT IS THE UPDATE DURING THE 818 00:30:30,400 --> 00:30:31,000 PANDEMIC? 819 00:30:31,000 --> 00:30:32,880 YOU HEARD A LITTLE BIT ABOUT 820 00:30:32,880 --> 00:30:33,600 THIS FROM NORA. 821 00:30:33,600 --> 00:30:39,200 NEXT SLIDE. 822 00:30:39,200 --> 00:30:40,800 YOU KNOW, DEATHS INVOLVING 823 00:30:40,800 --> 00:30:42,240 ALCOHOL HAVE BEEN INCREASING 824 00:30:42,240 --> 00:30:43,400 FOR SOME TIME. 825 00:30:43,400 --> 00:30:47,520 THE LATEST FIGURES FROM THE CDC 826 00:30:47,520 --> 00:30:48,520 ARE 140,000 ANNUAL DEATHS IN 827 00:30:48,520 --> 00:30:52,280 THE LAST FEW YEARS. 828 00:30:52,280 --> 00:30:53,240 DEATH CERTIFICATES THEMSELVES, 829 00:30:53,240 --> 00:30:56,240 WE SAW AN INCREASE OF 25% IN 830 00:30:56,240 --> 00:30:58,600 THE FIRST YEAR OF THE PANDEMIC, 831 00:30:58,600 --> 00:30:59,400 THAT'S BEING SUSTAINED THE 832 00:30:59,400 --> 00:31:02,200 SECOND YEAR OF THE PANDEMIC. 833 00:31:02,200 --> 00:31:07,760 ALCOHOL WAS LISTED AS NORA 834 00:31:07,760 --> 00:31:10,320 SAID, ONE OUT OF SIX OVERDOSE 835 00:31:10,320 --> 00:31:39,680 DRUGS. 836 00:31:39,680 --> 00:31:42,080 SITUATION AND WHY IS THAT 837 00:31:42,080 --> 00:31:43,200 EXACERBATING WHAT'S GOING ON 838 00:31:43,200 --> 00:31:44,600 DURING THE PANDEMIC? 839 00:31:44,600 --> 00:31:46,440 FOR US, YOU HAVE PROBABLY SEEN 840 00:31:46,440 --> 00:31:48,360 THE OTHER SIDE BEFORE, ALCOHOL 841 00:31:48,360 --> 00:31:49,760 AND MENTAL HEALTH IS THE 842 00:31:49,760 --> 00:31:50,920 ELEPHANT IN THE ROOM. 843 00:31:50,920 --> 00:31:52,840 OF COURSE I'M RIGHT HERE IN THE 844 00:31:52,840 --> 00:31:54,480 ROOM AND NO ONE EVEN 845 00:31:54,480 --> 00:31:56,880 ACKNOWLEDGES ME. 846 00:31:56,880 --> 00:31:58,480 PAUL SUMMER GUARD SAID IT YEARS 847 00:31:58,480 --> 00:32:02,800 AGO, IF YOU HAVE NEVER SEEN AN 848 00:32:02,800 --> 00:32:04,000 INDIVIDUAL SEVERE ALCOHOL USE 849 00:32:04,000 --> 00:32:06,600 DISORDER IN YOUR PRACTICE, YOU 850 00:32:06,600 --> 00:32:08,360 ARE DILUTIONAL. 851 00:32:08,360 --> 00:32:10,200 IT CORRELATES WITH POOR MENTAL 852 00:32:10,200 --> 00:32:11,640 HEALTH. 853 00:32:11,640 --> 00:32:13,560 COMMONLY USED IN AN EFFORT TO 854 00:32:13,560 --> 00:32:14,280 COPE WITH SYMPTOMS. 855 00:32:14,280 --> 00:32:17,600 IN THE END IT MAKES PROGNOSES 856 00:32:17,600 --> 00:32:19,920 WORSE. 857 00:32:19,920 --> 00:32:22,880 MENTAL HEALTH CONDITIONS 858 00:32:22,880 --> 00:32:24,040 COMPLICATE TREATMENT FOR 859 00:32:24,040 --> 00:32:26,720 ALCOHOL USE DISORDER. 860 00:32:26,720 --> 00:32:27,920 THE COVID-19 PANDEMIC 861 00:32:27,920 --> 00:32:29,600 CONTRIBUTED TO A DECLINE IN 862 00:32:29,600 --> 00:32:33,040 MENTAL HEALTH. 863 00:32:33,040 --> 00:32:35,080 THE WORLD HEALTH ORGANIZATION 864 00:32:35,080 --> 00:32:37,440 ESTIMATES THE FOLLOWING GLOBAL 865 00:32:37,440 --> 00:32:40,280 CHANGES, 28% INCREASES IN CASES 866 00:32:40,280 --> 00:32:42,600 OF MAJOR DEPRESSIVE DISORDER, 867 00:32:42,600 --> 00:32:44,560 26% INCREASE IN CASES OF 868 00:32:44,560 --> 00:32:45,680 ANXIETY DISORDERS. 869 00:32:45,680 --> 00:32:50,600 WE ARE SEEING INCREASES IN THE 870 00:32:50,600 --> 00:32:51,920 DEATHS AND DESPAIR PRIOR TO THE 871 00:32:51,920 --> 00:32:52,920 PANDEMIC. 872 00:32:52,920 --> 00:32:54,600 THE PANDEMIC BROUGHT INCREASES 873 00:32:54,600 --> 00:32:56,200 IN ANXIETY AND DEPRESSION FOR 874 00:32:56,200 --> 00:32:59,720 PEOPLE OF ALL AGES, BUT 875 00:32:59,720 --> 00:33:00,480 PARTICULARLY ADOLESCENTS AND 876 00:33:00,480 --> 00:33:03,920 YOUNG ADULTS. 877 00:33:03,920 --> 00:33:06,040 AMONG 9-12th GRADERS, 37% 878 00:33:06,040 --> 00:33:07,560 REPORTED SYMPTOMS OF POOR 879 00:33:07,560 --> 00:33:09,600 MENTAL HEALTH. 880 00:33:09,600 --> 00:33:11,240 44% REPORTED PERSISTENT 881 00:33:11,240 --> 00:33:13,440 FEELINGS OF SADNESS OR 882 00:33:13,440 --> 00:33:19,400 HOPELESSNESS. 883 00:33:19,400 --> 00:33:20,800 20% SERIOUSLY CONSIDERED 884 00:33:20,800 --> 00:33:23,200 SUICIDE, AND 9 ATTEMPTED 885 00:33:23,200 --> 00:33:25,880 SUICIDE, ALL WORSE FOR FEMALES. 886 00:33:25,880 --> 00:33:27,360 THE TREATMENT GAP GREW. 887 00:33:27,360 --> 00:33:29,800 MORE NEEDED IT BUT DIDN'T 888 00:33:29,800 --> 00:33:32,440 RECEIVE IT. 889 00:33:32,440 --> 00:33:36,320 IN A SENSE, I LUMP THIS IN WITH 890 00:33:36,320 --> 00:33:37,720 SOCIAL DETERMINANTS OF HEALTH 891 00:33:37,720 --> 00:33:40,520 IS THE MENTAL HEALTH STATUS AND 892 00:33:40,520 --> 00:33:41,440 ENVIRONMENTAL CHANGES THAT 893 00:33:41,440 --> 00:33:42,720 OCCURRED AND STRESS THAT 894 00:33:42,720 --> 00:33:44,560 OCCURRED DURING THE PANDEMIC, 895 00:33:44,560 --> 00:33:46,400 IT CONTRIBUTES TO ALL OF THESE 896 00:33:46,400 --> 00:33:47,360 CHANGES. 897 00:33:47,360 --> 00:33:50,440 AND GIVEN THE LENGTH BETWEEN 898 00:33:50,440 --> 00:33:52,080 POOR MENTAL HEALTH AND ALCOHOL 899 00:33:52,080 --> 00:33:53,880 USE, ONE MIGHT EXPECT MORE 900 00:33:53,880 --> 00:33:54,880 DRINKING TO COPE DURING THE 901 00:33:54,880 --> 00:33:55,520 PANDEMIC. 902 00:33:55,520 --> 00:33:56,680 NEXT SLIDE. 903 00:33:56,680 --> 00:33:57,800 IN FACT, THAT'S WHAT WE HAVE 904 00:33:57,800 --> 00:33:59,520 SEEN. 905 00:33:59,520 --> 00:34:01,360 STUDIES SUGGEST ABOUT ONE IN 906 00:34:01,360 --> 00:34:03,200 FOUR PEOPLE BEGAN DRINKING MORE 907 00:34:03,200 --> 00:34:05,040 DURING THE PANDEMIC, ONE IN 908 00:34:05,040 --> 00:34:06,400 FOUR DRANK LESS. 909 00:34:06,400 --> 00:34:08,040 DRINKING TO COPE WAS A COMMON 910 00:34:08,040 --> 00:34:10,000 REASON FOR THOSE INCREASING 911 00:34:10,000 --> 00:34:13,840 CONSUMPTION. 912 00:34:13,840 --> 00:34:15,240 LONGITUDINAL STUDY FOUND RIGHT 913 00:34:15,240 --> 00:34:17,800 BEFORE THE PANDEMIC PEOPLE WERE 914 00:34:17,800 --> 00:34:19,680 48% MORE LIKELY TO INDICATE 915 00:34:19,680 --> 00:34:21,600 THEY DRANK TO FORGET THEIR 916 00:34:21,600 --> 00:34:24,000 WORRIES EARLY IN THE PANDEMIC. 917 00:34:24,000 --> 00:34:29,200 THE ODDS OF DRINKING WERE 918 00:34:29,200 --> 00:34:34,000 HIGHER WHEN RESPONDENTS COPE TO 919 00:34:34,000 --> 00:34:34,840 DEAL WITH DEPRESSION AND OONK 920 00:34:34,840 --> 00:34:36,760 IET. 921 00:34:36,760 --> 00:34:40,000 ANXIETY. 922 00:34:40,000 --> 00:34:43,360 OTHER STUDIES SUGGESTED HAVING 923 00:34:43,360 --> 00:34:45,200 A PSYCHOLOGICAL WELL-BEING 924 00:34:45,200 --> 00:34:46,400 IMPACTED NEGATIVELY BY THE 925 00:34:46,400 --> 00:34:48,760 PANDEMIC WAS ASSOCIATED WITH 926 00:34:48,760 --> 00:34:49,600 MORE DRINKING. 927 00:34:49,600 --> 00:34:52,200 SO ALL THIS PUT TOGETHER IS 928 00:34:52,200 --> 00:34:53,600 CONCERNING, GIVEN THE DRINKING 929 00:34:53,600 --> 00:34:55,000 TO COPE INCREASES THE 930 00:34:55,000 --> 00:34:56,640 LIKELIHOOD OF ALCOHOL USE 931 00:34:56,640 --> 00:34:58,480 DISORDER AND RELATED HARMS. 932 00:34:58,480 --> 00:34:59,880 IF ANYTHING, THE PANDEMIC HAS 933 00:34:59,880 --> 00:35:03,040 REALLY SHOWN A LIGHT ON THIS 934 00:35:03,040 --> 00:35:05,600 ASPECT OF THE ADDICTION CYCLE 935 00:35:05,600 --> 00:35:08,200 THAT DRIVES ALCOHOL MISUSE AND 936 00:35:08,200 --> 00:35:09,360 ALCOHOL USE DISORDER. 937 00:35:09,360 --> 00:35:16,680 NEXT SLIDE. 938 00:35:16,680 --> 00:35:33,800 I WILL GO THROUGH THIS QUICKLY. 939 00:35:33,800 --> 00:35:37,040 WE ARE SEEING 25% INCREASE IN 940 00:35:37,040 --> 00:35:39,960 ALCOHOL DEATHS AND THIS IS 941 00:35:39,960 --> 00:35:41,280 DIRECTLY ATTRIBUTED TO DEATH 942 00:35:41,280 --> 00:35:42,600 CERTIFICATES. 943 00:35:42,600 --> 00:35:44,640 AND IT'S BEING, THE LATEST DATA 944 00:35:44,640 --> 00:35:47,400 INDICATE THIS IS PERSISTING 945 00:35:47,400 --> 00:35:48,400 INTO 2021. 946 00:35:48,400 --> 00:35:50,760 THE NEXT SLIDE JUST SHOWS YOU 947 00:35:50,760 --> 00:35:54,000 THAT THERE'S AN INCREASE IN A 948 00:35:54,000 --> 00:35:55,200 VARIETY OF ALCOHOL-RELATED 949 00:35:55,200 --> 00:35:56,400 HARMS THAT PARALLEL THESE 950 00:35:56,400 --> 00:35:57,600 INCREASES IN DEATHS. 951 00:35:57,600 --> 00:35:59,640 INCREASES IN THE PERCENTAGES OF 952 00:35:59,640 --> 00:36:03,200 EMERGENCY DEPARTMENT VISITS AND 953 00:36:03,200 --> 00:36:04,600 INVOLVE ACUTE ALCOHOL 954 00:36:04,600 --> 00:36:05,320 CONSUMPTION. 955 00:36:05,320 --> 00:36:08,360 AS I SAID, GOING TO ANY MAJOR 956 00:36:08,360 --> 00:36:09,040 MEDICAL CENTER IN THE UNITED 957 00:36:09,040 --> 00:36:10,800 STATES ON A FRIDAY OR SATURDAY 958 00:36:10,800 --> 00:36:12,240 NIGHT, HALF OF THE PEOPLE THERE 959 00:36:12,240 --> 00:36:14,080 ARE BECAUSE OF ALCOHOL. 960 00:36:14,080 --> 00:36:16,000 INCREASING THE INCIDENTS OF 961 00:36:16,000 --> 00:36:18,080 ALCOHOL WITHDRAWAL IN 962 00:36:18,080 --> 00:36:19,000 HOSPITALIZED PATIENTS, 963 00:36:19,000 --> 00:36:21,560 INCREASES OF DEATH WITH ALCOHOL 964 00:36:21,560 --> 00:36:22,720 ASSOCIATED LIVER DISEASE, 965 00:36:22,720 --> 00:36:24,280 GREATER THAN PRIOR YEARS. 966 00:36:24,280 --> 00:36:25,920 HALF OF LIVER DISEASE IN THIS 967 00:36:25,920 --> 00:36:27,120 COUNTRY IS NOW CAUSED BY 968 00:36:27,120 --> 00:36:30,200 ALCOHOL. 969 00:36:30,200 --> 00:36:33,200 14% IN ALCOHOL RELATED FATALITY 970 00:36:33,200 --> 00:36:36,000 ACCIDENTS. 971 00:36:36,000 --> 00:36:37,600 AND ALCOHOL-RELATED HEPATITIS. 972 00:36:37,600 --> 00:36:39,000 PARTICULARLY FOR WOMEN AND 973 00:36:39,000 --> 00:36:41,000 YOUNGER PEOPLE UNDER THE AGE OF 974 00:36:41,000 --> 00:36:41,160 40. 975 00:36:41,160 --> 00:36:43,080 AT LEAST IN MY BOOK, THAT'S A 976 00:36:43,080 --> 00:36:43,560 YOUNGER PERSON. 977 00:36:43,560 --> 00:36:46,400 NEXT SLIDE. 978 00:36:46,400 --> 00:36:48,760 SO WHAT ABOUT A DIRECTION SOME 979 00:36:48,760 --> 00:36:53,640 OF THESE ISSUES IN A WAY THAT 980 00:36:53,640 --> 00:36:57,640 MAYBE WILL HAVE AN IMPACT ON 981 00:36:57,640 --> 00:36:59,200 DISCOURAGING TRENDS. 982 00:36:59,200 --> 00:37:01,200 SOMEONE NEEDS TO MUTE. 983 00:37:01,200 --> 00:37:02,720 CLOSING THE TREATMENT GAP, I 984 00:37:02,720 --> 00:37:05,960 WILL TALK ABOUT QUICKLY, 985 00:37:05,960 --> 00:37:07,080 MEDICATIONS, RESOURCES, 986 00:37:07,080 --> 00:37:08,280 RECOVERY DEFINITION, SCREENING 987 00:37:08,280 --> 00:37:09,920 AND BRIEF INTERVENTION, 988 00:37:09,920 --> 00:37:11,880 TELEHEALTH, DIVERSITY AND 989 00:37:11,880 --> 00:37:12,520 EQUITY. 990 00:37:12,520 --> 00:37:14,160 THIS IS A BIG PROJECT. 991 00:37:14,160 --> 00:37:15,480 THIS IS A LARGE PART OF OUR 992 00:37:15,480 --> 00:37:16,040 PORTFOLIO. 993 00:37:16,040 --> 00:37:17,200 NEXT SLIDE. 994 00:37:17,200 --> 00:37:23,440 SO YOU KNOW, WE HAVE 995 00:37:23,440 --> 00:37:24,000 EFFECTIVE-EVIDENCE-BASED 996 00:37:24,000 --> 00:37:26,000 BEHAVIORAL TREATMENTS,S 997 00:37:26,000 --> 00:37:27,520 COGNITIVE BEHAVIORAL THERAPY, 998 00:37:27,520 --> 00:37:28,760 MOTIVATIONAL INTERVIEWING. 999 00:37:28,760 --> 00:37:31,120 AND LES CLARKE, I FORGOT TO ADD 1000 00:37:31,120 --> 00:37:33,440 THE SLIDE THAT HAS CONTINGENCY 1001 00:37:33,440 --> 00:37:35,280 MANAGEMENT ON IT, SO THAT'S A 1002 00:37:35,280 --> 00:37:36,280 THIRD. 1003 00:37:36,280 --> 00:37:38,880 WE HAVE THREE FDA APPROVED 1004 00:37:38,880 --> 00:37:40,280 MEDICATIONS FOR TREATMENT OF 1005 00:37:40,280 --> 00:37:42,000 AUD, MOST OF YOU ARE FAMILIAR 1006 00:37:42,000 --> 00:37:43,640 WITH, BUT I'M NOT SURE 1007 00:37:43,640 --> 00:37:44,760 PHYSICIANS ARE FAMILIAR WITH. 1008 00:37:44,760 --> 00:37:47,120 BUT LESS THAN 10% OF PEOPLE 1009 00:37:47,120 --> 00:37:48,760 WITH ALCOHOL USE DISORDER GET 1010 00:37:48,760 --> 00:37:50,960 ANY TREATMENT WHAT SO OFFER. 1011 00:37:50,960 --> 00:37:53,200 SO THE GOALS ARE UP, SIMILAR TO 1012 00:37:53,200 --> 00:37:55,480 THOSE OF NIDA, WE ARE IN THE 1013 00:37:55,480 --> 00:37:57,360 SAME BOAT DEVELOPMENT AND 1014 00:37:57,360 --> 00:38:00,400 REFINEMENT OF BETTER BEHAVIORAL 1015 00:38:00,400 --> 00:38:04,080 TREATMENTS, IDENTIFYING NOVEL 1016 00:38:04,080 --> 00:38:06,360 TARGETS, IDENTIFY SUPPORT 1017 00:38:06,360 --> 00:38:07,120 MEDICATIONS DEVELOPMENT TRIAL 1018 00:38:07,120 --> 00:38:08,200 POINTS. 1019 00:38:08,200 --> 00:38:09,880 SUPPORT RESEARCH TO DEFINE 1020 00:38:09,880 --> 00:38:10,800 RECOVERY, I WILL SHOW YOU A 1021 00:38:10,800 --> 00:38:12,920 SLIDE ON THAT. 1022 00:38:12,920 --> 00:38:18,600 HEALTH SERVICES, INTEGRATING 1023 00:38:18,600 --> 00:38:20,000 PREVENTION, EARLY DETECTION, 1024 00:38:20,000 --> 00:38:23,640 INTERVENTION AND TREATMENT. 1025 00:38:23,640 --> 00:38:24,800 AND DISSEMINATE PROFESSIONAL 1026 00:38:24,800 --> 00:38:26,000 CORE RESOURCE I WILL TALK ABOUT 1027 00:38:26,000 --> 00:38:26,720 IN A MINUTE. 1028 00:38:26,720 --> 00:38:28,360 NEXT SLIDE. 1029 00:38:28,360 --> 00:38:30,200 NORA MENTIONED SCREENING AND 1030 00:38:30,200 --> 00:38:31,600 BRIEF INTERVENTION WITH 1031 00:38:31,600 --> 00:38:32,800 SUBSTANCE USE DISORDERS. 1032 00:38:32,800 --> 00:38:33,720 THIS IS A BIG ISSUE WITH 1033 00:38:33,720 --> 00:38:34,440 ALCOHOL. 1034 00:38:34,440 --> 00:38:36,720 THE GOOD NEWS IS WE ARE DOING 1035 00:38:36,720 --> 00:38:37,480 SCREENING. 1036 00:38:37,480 --> 00:38:41,400 THE BAD NEWS IS WE ARE NOT 1037 00:38:41,400 --> 00:38:42,360 DOING INTERVENTIONS FOR 1038 00:38:42,360 --> 00:38:42,800 TREATMENT. 1039 00:38:42,800 --> 00:38:45,160 THAT'S WHAT THIS SLIDE SHOWS 1040 00:38:45,160 --> 00:38:47,040 80% PLUS PEOPLE SAW A CLINICIAN 1041 00:38:47,040 --> 00:38:50,080 IN THE LAST YEAR, THAT'S GOOD. 1042 00:38:50,080 --> 00:38:52,600 70% WERE ASKED AT LEAST ONE 1043 00:38:52,600 --> 00:38:55,360 QUESTION ABOUT THEIR ALCOHOL 1044 00:38:55,360 --> 00:38:56,800 CONSUMPTIONS, THAT'S GOOD. 1045 00:38:56,800 --> 00:38:59,560 ONLY 12% WERE OFFERED 1046 00:38:59,560 --> 00:39:01,320 INTERVENTION INFORMATION. 1047 00:39:01,320 --> 00:39:03,440 ONLY 5% WERE ADVISED ABOUT 1048 00:39:03,440 --> 00:39:04,320 TREATMENT OPTIONS OR OTHER 1049 00:39:04,320 --> 00:39:05,800 RESOURCES. 1050 00:39:05,800 --> 00:39:08,800 EVEN THOSE WITH SEVERE ALCOHOL 1051 00:39:08,800 --> 00:39:13,160 USE DISORDER IS STILL ABYSMAL, 1052 00:39:13,160 --> 00:39:15,160 23% GETTING ADVICE AND 12% FOR 1053 00:39:15,160 --> 00:39:16,680 REFERRAL. 1054 00:39:16,680 --> 00:39:18,040 IMPORTANTLY, SCREENING FOR 1055 00:39:18,040 --> 00:39:19,680 ALCOHOL MISUSE CAN HELP 1056 00:39:19,680 --> 00:39:21,640 CLINICIANS SPOT OTHER 1057 00:39:21,640 --> 00:39:22,720 HEALTH-RELATED ISSUES. 1058 00:39:22,720 --> 00:39:25,800 THERE ARE 20 DIFFERENT DISEASES 1059 00:39:25,800 --> 00:39:26,880 EXACERBATED OR CAUSED BY 1060 00:39:26,880 --> 00:39:29,200 ALCOHOL. 1061 00:39:29,200 --> 00:39:33,600 ADULTS WHO BINGE DRINK ARE MORE 1062 00:39:33,600 --> 00:39:41,920 LIKELY TO REPORT SUICIDAL 1063 00:39:41,920 --> 00:39:42,400 IDEATIONS. 1064 00:39:42,400 --> 00:39:44,120 NEXT SLIDE. 1065 00:39:44,120 --> 00:39:46,400 WE HAVE ENGAGED IN THE LAST 3-4 1066 00:39:46,400 --> 00:39:48,720 YEARS IN A NUMBER OF OUTREACHES 1067 00:39:48,720 --> 00:39:51,240 TO THE PUBLIC OF RESOURCES, OF 1068 00:39:51,240 --> 00:39:52,640 KNOWLEDGE WE ACTUALLY HAVE IN 1069 00:39:52,640 --> 00:39:53,320 THE ALCOHOL FIELD. 1070 00:39:53,320 --> 00:39:56,280 WE HAVE A WEBSITE THAT'S 1071 00:39:56,280 --> 00:39:57,480 POPULAR CALLED RETHINKING 1072 00:39:57,480 --> 00:40:00,000 DRINKING THAT HELPS INDIVIDUALS 1073 00:40:00,000 --> 00:40:02,560 ASSESS THEIR DRINKING HABITS 1074 00:40:02,560 --> 00:40:04,600 AND FIND WAYS TO MAKE A CHANGE. 1075 00:40:04,600 --> 00:40:07,200 WE LAUNCHED THE NIAAA TREATMENT 1076 00:40:07,200 --> 00:40:08,600 NAVIGATOR, THIS IS AN ONLINE 1077 00:40:08,600 --> 00:40:10,440 RESOURCE TO HELP YOU UNDERSTAND 1078 00:40:10,440 --> 00:40:11,200 TREATMENT OPTIONS. 1079 00:40:11,200 --> 00:40:12,800 WHAT IS AN ALCOHOL USE DISORDER. 1080 00:40:12,800 --> 00:40:15,400 WHAT IS THE SPECTRUM OF AN 1081 00:40:15,400 --> 00:40:16,600 ALCOHOL USE DISORDER. 1082 00:40:16,600 --> 00:40:18,880 BUT YOU CAN ALSO LOCATE TYPING 1083 00:40:18,880 --> 00:40:22,920 IN YOUR ZIP CODE USING SAMSA 1084 00:40:22,920 --> 00:40:24,720 NEARBY TREATMENT, INCLUDING 1085 00:40:24,720 --> 00:40:25,720 TELEHEALTH OPTIONS. 1086 00:40:25,720 --> 00:40:28,360 THIS NOW INCLUDES A PORTAL FOR 1087 00:40:28,360 --> 00:40:30,640 HEALTHCARE PROFESSIONALS TO 1088 00:40:30,640 --> 00:40:33,520 EXPAND, INCLUDE PROVIDERS 1089 00:40:33,520 --> 00:40:34,880 OFFERING SCIENCE-BASED AND 1090 00:40:34,880 --> 00:40:36,520 BACKED ALCOHOL USE DISORDER 1091 00:40:36,520 --> 00:40:38,440 TREATMENTS TO MEET THE VERY 1092 00:40:38,440 --> 00:40:40,960 NEEDS OF PATIENTS. 1093 00:40:40,960 --> 00:40:44,520 I WANT TO SPEND A LITTLE TIME 1094 00:40:44,520 --> 00:40:48,680 HERE ON OUR HEALTHCARE 1095 00:40:48,680 --> 00:40:50,480 PROFESSIONALS, WE LAUNCHED THIS 1096 00:40:50,480 --> 00:40:51,720 YESTERDAY, THE WEBSITE IS UP 1097 00:40:51,720 --> 00:40:53,280 AND RUNNING. 1098 00:40:53,280 --> 00:40:55,120 AN EDUCATIONAL TOOL INCLUDES 1099 00:40:55,120 --> 00:40:57,920 MODULES ON EDUCATION AND 1100 00:40:57,920 --> 00:41:00,040 PRIMARY CARE, ADDRESSING 1101 00:41:00,040 --> 00:41:00,680 STIGMA, MEDICATION INTERACTIONS 1102 00:41:00,680 --> 00:41:01,400 AND MORE. 1103 00:41:01,400 --> 00:41:03,600 THE NEXT SLIDE. 1104 00:41:03,600 --> 00:41:10,360 SHOWS YOU, IT WAS LAUNCHED 1105 00:41:10,360 --> 00:41:10,640 YESTERDAY. 1106 00:41:10,640 --> 00:41:11,360 NEXT SLIDE. 1107 00:41:11,360 --> 00:41:16,760 WHAT IS IN OUR HEALTHCARE 1108 00:41:16,760 --> 00:41:20,280 PROFESSIONALS CORE RESOURCE? 1109 00:41:20,280 --> 00:41:21,200 WHAT EVERY HEALTHCARE 1110 00:41:21,200 --> 00:41:22,320 PROFESSIONAL NEEDS TO KNOW 1111 00:41:22,320 --> 00:41:23,080 ABOUT ALCOHOL. 1112 00:41:23,080 --> 00:41:26,600 WHEN I SAY EVERY HEALTHCARE 1113 00:41:26,600 --> 00:41:27,280 PROFESSIONAL, PHARMACISTS, 1114 00:41:27,280 --> 00:41:30,080 PHYSICIAN ASSIST APT, NURSES, 1115 00:41:30,080 --> 00:41:31,800 CLINICAL PSYCHOLOGISTS, AIMED 1116 00:41:31,800 --> 00:41:35,360 AT PRIMARY CARE DOCS BUT ALSO 1117 00:41:35,360 --> 00:41:36,160 BOARD CERTIFIED ADDICTION 1118 00:41:36,160 --> 00:41:36,960 SPECIALISTS. 1119 00:41:36,960 --> 00:41:39,600 IT WAS DEVELOPED BY NIAAA WITH 1120 00:41:39,600 --> 00:41:42,400 GUIDANCE FROM PRACTICING 1121 00:41:42,400 --> 00:41:44,480 PHYSICIANS AND CLINICAL 1122 00:41:44,480 --> 00:41:45,520 PSYCHOLOGISTS WITH BUSY 1123 00:41:45,520 --> 00:41:47,320 CLINICIANS IN MIND. 1124 00:41:47,320 --> 00:41:48,480 THE HEALTHCARE PROFESSIONAL 1125 00:41:48,480 --> 00:41:51,480 CORE RESOURCE ARTICLES PROVIDE 1126 00:41:51,480 --> 00:41:52,000 USER-FRIENDLY PRACTICAL 1127 00:41:52,000 --> 00:41:54,000 OVERVIEWS OF FOUNDATIONAL 1128 00:41:54,000 --> 00:41:55,600 KNOWLEDGE FOR UNDERSTANDING 1129 00:41:55,600 --> 00:41:56,360 ALCOHOL-RELATED PROBLEMS. 1130 00:41:56,360 --> 00:41:59,160 FOUR ARTICLES OF THAT, CLINICAL 1131 00:41:59,160 --> 00:42:00,520 IMPACTS OF ALCOHOL, FOUR 1132 00:42:00,520 --> 00:42:02,600 ARTICLES. 1133 00:42:02,600 --> 00:42:06,400 HOW TO PUT IT ALL TOGETHER TO 1134 00:42:06,400 --> 00:42:07,920 PROMOTE PRACTICE CHANGE IN YOUR 1135 00:42:07,920 --> 00:42:09,200 PRACTICE. 1136 00:42:09,200 --> 00:42:10,600 THEY ARE ALL LIVING DOCUMENTS 1137 00:42:10,600 --> 00:42:12,480 THAT COULD BE UPDATED REGULARLY. 1138 00:42:12,480 --> 00:42:14,160 I WOULD LOVE YOUR INPUT, 1139 00:42:14,160 --> 00:42:15,920 EVERYONE OF YOU, ON BOTH 1140 00:42:15,920 --> 00:42:17,720 COUNCILS. 1141 00:42:17,720 --> 00:42:20,920 AND WE ALSO, YOU CAN RECEIVE 1142 00:42:20,920 --> 00:42:22,200 CONTINUING EDUCATION CREDIT. 1143 00:42:22,200 --> 00:42:23,640 IT'S FREE. 1144 00:42:23,640 --> 00:42:28,840 IT CAN RANG FROM 0.7 TO 1 1145 00:42:28,840 --> 00:42:30,480 CREDIT HOUR, WHICH COULD LEAD 1146 00:42:30,480 --> 00:42:33,280 TO ALMOST 11 CREDIT HOURS TOTAL. 1147 00:42:33,280 --> 00:42:35,800 NEXT SLIDE. 1148 00:42:35,800 --> 00:42:37,720 SO THIS IS WHAT IT LOOKS LIKE, 1149 00:42:37,720 --> 00:42:39,920 IF YOU WERE TO CLICK ON THE 1150 00:42:39,920 --> 00:42:41,200 LINK. 1151 00:42:41,200 --> 00:42:43,360 THERE'S THE BASICS. 1152 00:42:43,360 --> 00:42:44,720 THERE ARE TAKE-AWAYS WHICH 1153 00:42:44,720 --> 00:42:46,800 SUMMARIZE THE ARTICLE AND 1154 00:42:46,800 --> 00:42:48,480 RESOURCES, REFERENCES AND 1155 00:42:48,480 --> 00:42:49,600 SEEING THE CREDIT AT THE END OF 1156 00:42:49,600 --> 00:42:52,000 THE THIS IS THE ONE ON DEFINING 1157 00:42:52,000 --> 00:42:53,560 HOW MUCH ALCOHOL IS TOO MUCH. 1158 00:42:53,560 --> 00:42:54,080 NEXT SLIDE. 1159 00:42:54,080 --> 00:42:56,000 THIS IS THE ONE ON SUPPORT 1160 00:42:56,000 --> 00:42:58,160 RECOVERY, IT'S A MARATHON, NOT 1161 00:42:58,160 --> 00:42:59,520 A SPRINT. 1162 00:42:59,520 --> 00:43:05,120 TAKE AWAYS, RESOURCES, CME. 1163 00:43:05,120 --> 00:43:05,600 NEXT SLIDE. 1164 00:43:05,600 --> 00:43:08,880 I WANT YOU TO SEE HOW MANY 1165 00:43:08,880 --> 00:43:11,200 PEOPLE WE ENLISTED TO HELP 1166 00:43:11,200 --> 00:43:15,440 PRODUCE THIS ENORMOUS EFFORT. 1167 00:43:15,440 --> 00:43:20,200 LED BY RAY LYTTON, THEIR WORK 1168 00:43:20,200 --> 00:43:26,120 ON THIS WAS PROINDIGENOUS. 1169 00:43:26,120 --> 00:43:27,400 MANY ARE LISTENING TO THIS 1170 00:43:27,400 --> 00:43:28,200 PRESENTATION. 1171 00:43:28,200 --> 00:43:30,080 NEXT SLIDE. 1172 00:43:30,080 --> 00:43:34,680 AND THE CONTRIBUTORS AROUND 1173 00:43:34,680 --> 00:43:39,320 NIAAA RAY LYTTON AND LAURA WERE 1174 00:43:39,320 --> 00:43:41,760 OUR LEADERS AND JUST DID A 1175 00:43:41,760 --> 00:43:42,640 FANTASTIC JOB. 1176 00:43:42,640 --> 00:43:46,280 THERE IS A LOT OF HELP FROM 1177 00:43:46,280 --> 00:43:47,680 EVERYONE IN THE INSTITUTE. 1178 00:43:47,680 --> 00:43:48,400 NEXT SLIDE. 1179 00:43:48,400 --> 00:43:52,440 THIS IS WHERE YOU CAN DPIEND IT. 1180 00:43:52,440 --> 00:43:53,800 -- FIND IT. 1181 00:43:53,800 --> 00:43:55,240 BRIDGET WILL PUT IT IN THE LINK 1182 00:43:55,240 --> 00:43:56,400 IN THE CHAT FOR YOU ALL. 1183 00:43:56,400 --> 00:43:59,520 NEXT SLIDE. 1184 00:43:59,520 --> 00:44:02,200 SO WHAT ABOUT OTHER ISSUES AND 1185 00:44:02,200 --> 00:44:04,880 THINGS THAT WE HAVE ADVANCED ON 1186 00:44:04,880 --> 00:44:06,280 CLOSING THE TREATMENT GAP? 1187 00:44:06,280 --> 00:44:08,600 ONE IS WE PUBLISHED IN AMERICAN 1188 00:44:08,600 --> 00:44:12,120 JOURNAL OF PSYCHIATRY JUST A 1189 00:44:12,120 --> 00:44:15,360 FEW WEEKS AGO, THE DEVELOPMENT 1190 00:44:15,360 --> 00:44:17,720 OF AN NIAAA DEFINITION OF 1191 00:44:17,720 --> 00:44:18,440 RECOVERY. 1192 00:44:18,440 --> 00:44:21,960 WE KNOW THAT PEOPLE GET TO 1193 00:44:21,960 --> 00:44:22,200 TREATMENT. 1194 00:44:22,200 --> 00:44:25,400 WE KNOW THEY CAN GO TO A 28-DAY 1195 00:44:25,400 --> 00:44:26,320 REHABILITATION PROGRAM. 1196 00:44:26,320 --> 00:44:28,840 THEY CAN DO OUTPATIENT PROGRAMS. 1197 00:44:28,840 --> 00:44:31,920 BUT WHAT WE DON'T KNOW IS WHAT 1198 00:44:31,920 --> 00:44:33,960 IN THOSE PROGRAMS ACTUALLY 1199 00:44:33,960 --> 00:44:36,800 ALLOWED THEM TO RECOVER AND 1200 00:44:36,800 --> 00:44:38,200 STAY RECOVERED FOR A YEAR OR 1201 00:44:38,200 --> 00:44:39,280 THREE YEARS? 1202 00:44:39,280 --> 00:44:40,920 SO MOST PEOPLE WHO NEED 1203 00:44:40,920 --> 00:44:41,880 TREATMENT RECEIVE NO TREATMENT 1204 00:44:41,880 --> 00:44:42,840 OF ANY KIND. 1205 00:44:42,840 --> 00:44:45,400 LITTLE IS KNOWN ABOUT WHAT 1206 00:44:45,400 --> 00:44:46,800 SUSTAINS LONG-TERM RECOVERY. 1207 00:44:46,800 --> 00:44:48,200 TO ENHANCE HEALTH, WE ARE 1208 00:44:48,200 --> 00:44:49,880 EXPANDING THE FOCUS ON 1209 00:44:49,880 --> 00:44:51,960 LONG-TERM RECOVERY. 1210 00:44:51,960 --> 00:44:55,200 NIAAA IS DEFINE RECOVERY FROM 1211 00:44:55,200 --> 00:44:56,600 SUBSTANCE USE DISORDER, 1212 00:44:56,600 --> 00:45:00,360 FEEDBACK FROM KEY QUALITY 1213 00:45:00,360 --> 00:45:01,800 RESEARCHERS. 1214 00:45:01,800 --> 00:45:04,120 RECOVERY IS VIEWED BOTH A 1215 00:45:04,120 --> 00:45:06,000 PROCESS OF BEHAVIORAL CHANGE 1216 00:45:06,000 --> 00:45:07,120 AND OUTCOME, INCORPORATES TIME 1217 00:45:07,120 --> 00:45:11,200 PERIODS FOR TWO KEY COMPONENTS. 1218 00:45:11,200 --> 00:45:13,240 REMISSION FROM DSM-5, AUD AND 1219 00:45:13,240 --> 00:45:16,920 CESSATION FROM HEAVY DRINKING, 1220 00:45:16,920 --> 00:45:17,800 A NON-ABSTINENT RECOVERY 1221 00:45:17,800 --> 00:45:18,360 OUTCOME. 1222 00:45:18,360 --> 00:45:20,440 IT ALSO EMPHASIZES THE 1223 00:45:20,440 --> 00:45:22,600 IMPORTANCE OF BIO PSYCHO SOCIAL 1224 00:45:22,600 --> 00:45:24,680 FUNCTIONING, QUALITY OF LIFE 1225 00:45:24,680 --> 00:45:25,840 AND ENHANCING RECOVERY OUTCOMES. 1226 00:45:25,840 --> 00:45:27,640 NEXT SLIDE. 1227 00:45:27,640 --> 00:45:29,600 WE ARE ALSO RECOGNIZED THERE'S 1228 00:45:29,600 --> 00:45:33,800 BEEN A HUGE INCREASE IN 1229 00:45:33,800 --> 00:45:35,200 COVID-19 PANDEMIC CAUSED A 1230 00:45:35,200 --> 00:45:37,160 RAPID EXPANSION IN THE USE OF 1231 00:45:37,160 --> 00:45:39,320 TELEHEALTH. 1232 00:45:39,320 --> 00:45:40,240 EVIDENCE SUGGESTS TELEHEALTH 1233 00:45:40,240 --> 00:45:42,600 CAN BE EFFECTIVE FOR ADDRESSING 1234 00:45:42,600 --> 00:45:44,480 ALCOHOL MISUSE AND CAN REACH 1235 00:45:44,480 --> 00:45:46,120 PEOPLE WHO CAN'T OTHERWISE GET 1236 00:45:46,120 --> 00:45:47,040 SUPPORT. 1237 00:45:47,040 --> 00:45:51,920 SUPPORTING A VARIETY OF 1238 00:45:51,920 --> 00:45:53,360 TELEHEALTH SUPPORT, SCREENING 1239 00:45:53,360 --> 00:45:54,600 BY CLINICIANS BY PHONE OR VIDEO 1240 00:45:54,600 --> 00:45:57,640 CHAT. 1241 00:45:57,640 --> 00:45:59,960 CBT WITH CLINICIAN OR SELF 1242 00:45:59,960 --> 00:46:02,800 GUIDED, TELEHEALTH TO ADDRESS 1243 00:46:02,800 --> 00:46:04,920 PTSD AND ALCOHOL USE FOLLOWING 1244 00:46:04,920 --> 00:46:06,800 SEXUAL A SUELT. 1245 00:46:06,800 --> 00:46:08,840 VIDEO CONFERENCING BASED MI FOR 1246 00:46:08,840 --> 00:46:11,400 ALCOHOL MISUSE AND MEDICATION. 1247 00:46:11,400 --> 00:46:13,080 YOU CAN LINK UP WITH THESE IN 1248 00:46:13,080 --> 00:46:16,080 THE TREATMENT NAVIGATOR. 1249 00:46:16,080 --> 00:46:19,080 WE ANTICIPATE A LARGER ROLE 1250 00:46:19,080 --> 00:46:20,720 FORETELL HELIth FOR ALCOHOL 1251 00:46:20,720 --> 00:46:21,400 PREVENTION GOING FORWARD. 1252 00:46:21,400 --> 00:46:24,000 I BELIEVE THERE WILL BE FURTHER 1253 00:46:24,000 --> 00:46:24,960 DEVELOPMENT AND VALIDATION OF 1254 00:46:24,960 --> 00:46:26,360 SOME OF THESE APPROACHES. 1255 00:46:26,360 --> 00:46:28,000 WHEN YOU THINK OF RURAL 1256 00:46:28,000 --> 00:46:29,880 COMMUNITIES, WHEN I TOURED 1257 00:46:29,880 --> 00:46:33,040 ALASKA THREE OR FOUR YEARS AGO 1258 00:46:33,040 --> 00:46:36,600 NOW, YOU KNOW, THERE WAS A 1259 00:46:36,600 --> 00:46:38,920 DRAMATIC NEED FOR THE ABILITY 1260 00:46:38,920 --> 00:46:40,800 TO UTILIZE TELEHEALTH AND 1261 00:46:40,800 --> 00:46:44,360 TELEMEDICINE FOR DIAGNOSIS AND 1262 00:46:44,360 --> 00:46:45,560 FOR SOME ASPECTS OF TREATMENT. 1263 00:46:45,560 --> 00:46:47,640 SO WE WILL SEE HOW THIS FALLS 1264 00:46:47,640 --> 00:46:48,400 OUT. 1265 00:46:48,400 --> 00:46:50,080 THE NEXT SLIDE. 1266 00:46:50,080 --> 00:46:53,120 WORDS MATTER. 1267 00:46:53,120 --> 00:46:54,960 NORA VOLKOW AND JOSH GORDON AND 1268 00:46:54,960 --> 00:46:59,600 I WROTE A PAPER FOR 1269 00:46:59,600 --> 00:47:01,000 NEUROPSYCHOPHARMACOLOGY. 1270 00:47:01,000 --> 00:47:04,040 WE CAN HELP BY CONSISTENTLY 1271 00:47:04,040 --> 00:47:07,800 USING NON PEJORATIVE, 1272 00:47:07,800 --> 00:47:08,760 NON-STIGMATIZING LANGUAGE TO 1273 00:47:08,760 --> 00:47:09,960 DESCRIBE THESE CONCERNS AND THE 1274 00:47:09,960 --> 00:47:12,280 PEOPLE WHO ARE AFFECTED BY THEM. 1275 00:47:12,280 --> 00:47:14,600 I'VE TRIED AT LEAST TO USE 1276 00:47:14,600 --> 00:47:16,720 WORDS LIKE ALCOHOLIC AND 1277 00:47:16,720 --> 00:47:18,320 ALCOHOL ABUSE, WHICH ARE 1278 00:47:18,320 --> 00:47:19,760 STIGMATIZING. 1279 00:47:19,760 --> 00:47:21,600 USE ALCOHOL USE DISORDER 1280 00:47:21,600 --> 00:47:24,360 INSTEAD OF ALCOHOL ABUSE, 1281 00:47:24,360 --> 00:47:25,080 ALCOHOL DEPENDENCE AND 1282 00:47:25,080 --> 00:47:26,920 ALCOHOLISM. 1283 00:47:26,920 --> 00:47:29,000 USE ALCOHOL MISUSE. 1284 00:47:29,000 --> 00:47:30,400 USE FIRST-PERSON LANGUAGE TO 1285 00:47:30,400 --> 00:47:31,720 DESCRIBE PEOPLE WITH ALCOHOL 1286 00:47:31,720 --> 00:47:34,120 RELATED PROBLEMS. 1287 00:47:34,120 --> 00:47:36,000 A PERSON WITH ALCOHOL USE 1288 00:47:36,000 --> 00:47:40,160 DISORDER INSTEAD OF ALCOHOLIC. 1289 00:47:40,160 --> 00:47:41,120 USE ALCOHOL-ASSOCIATED LIVER 1290 00:47:41,120 --> 00:47:43,000 DISEASE, INSTEAD OF ALCOHOLIC 1291 00:47:43,000 --> 00:47:43,680 LIVER DISEASE. 1292 00:47:43,680 --> 00:47:45,520 NEXT SLIDE. 1293 00:47:45,520 --> 00:47:47,880 CAN WE MORE EFFECTIVELY ADDRESS 1294 00:47:47,880 --> 00:47:49,280 DIVERSITY AND HEALTH DISPARITIS 1295 00:47:49,280 --> 00:47:50,440 IN THE ALCOHOL FIELD? 1296 00:47:50,440 --> 00:47:53,240 MOST OF YOU KNOW THIS IS A HUGE 1297 00:47:53,240 --> 00:47:54,520 ENTERPRISE AND EFFORT AT THE 1298 00:47:54,520 --> 00:47:55,400 NIH NOW. 1299 00:47:55,400 --> 00:47:57,240 IT'S A VERY HIGH PRIORITY. 1300 00:47:57,240 --> 00:48:00,760 WE SHARE THAT HIGH PRIORITY AT 1301 00:48:00,760 --> 00:48:00,960 NIAAA. 1302 00:48:00,960 --> 00:48:03,160 WE FULLY SUPPORT AND ARE 1303 00:48:03,160 --> 00:48:05,960 CONTRIBUTED TO THE INITIATIVE, 1304 00:48:05,960 --> 00:48:08,240 COORDINATED EFFORT TO PROMOTE 1305 00:48:08,240 --> 00:48:11,800 RACIAL EQUITY AND INCLUSION IN 1306 00:48:11,800 --> 00:48:13,440 NIH AND LARGER ENTERPRISE. 1307 00:48:13,440 --> 00:48:17,200 WE ARE FOCUSING ON THREE AREAS, 1308 00:48:17,200 --> 00:48:19,040 IMPROVING THE NIAAA WORKPLACE 1309 00:48:19,040 --> 00:48:20,200 AND CULTURE, INCREASING 1310 00:48:20,200 --> 00:48:22,800 DIVERSITY AND EQUITY IN THE 1311 00:48:22,800 --> 00:48:25,200 NIAAA SCIENTIFIC AND 1312 00:48:25,200 --> 00:48:26,440 ADMINISTRATIVE WORKFORCE AND 1313 00:48:26,440 --> 00:48:27,600 THE RESEARCH PORTFOLIO. 1314 00:48:27,600 --> 00:48:29,880 NEXT SLIDE IS SOME QUICK 1315 00:48:29,880 --> 00:48:31,760 EXAMPLES OF THINGS WE ARE DOING 1316 00:48:31,760 --> 00:48:34,560 IN THE HEALTH SERVICES PROJECTS 1317 00:48:34,560 --> 00:48:36,440 TO ADDRESS HEALTH DISPARITIES. 1318 00:48:36,440 --> 00:48:38,800 WE KNOW THAT HEALTH DISPARITIES 1319 00:48:38,800 --> 00:48:41,360 ARE CONTRIBUTING TO HEALTH 1320 00:48:41,360 --> 00:48:42,800 DISPARITIES AND SUBSTANCE USE 1321 00:48:42,800 --> 00:48:44,040 DISORDERS AND ALCOHOL USE 1322 00:48:44,040 --> 00:48:45,160 DISORDERS IN PARTICULAR. 1323 00:48:45,160 --> 00:48:47,960 ONE PROJECT WE ARE DOING IS 1324 00:48:47,960 --> 00:48:52,000 ASSISTING THE EFFECTIVENESS OF 1325 00:48:52,000 --> 00:48:54,600 FEEDBACK INTERVENTION AMONG 1326 00:48:54,600 --> 00:48:56,680 LATIN-X AND INDIVIDUALS WITH 1327 00:48:56,680 --> 00:48:59,480 ALCOHOL MISUSE AND ANXIETY 1328 00:48:59,480 --> 00:49:00,360 WITHIN COMMUNITY-BASED HEALTH 1329 00:49:00,360 --> 00:49:01,800 CLINICS. 1330 00:49:01,800 --> 00:49:04,160 ANOTHER IS FOLLOW-UP ENGAGEMENT 1331 00:49:04,160 --> 00:49:05,080 AFTER ALCOHOL-RELATED 1332 00:49:05,080 --> 00:49:07,200 HOSPITALIZATIONS AND ASSESSING 1333 00:49:07,200 --> 00:49:08,400 ALCOHOL-RELATED OUTCOMES ACROSS 1334 00:49:08,400 --> 00:49:10,000 RACIAL AND ETHNIC GROUPS, 1335 00:49:10,000 --> 00:49:11,680 INCLUDING ANALYSIS OF SOCIAL 1336 00:49:11,680 --> 00:49:12,600 DETERMINANTS OF HEALTH. 1337 00:49:12,600 --> 00:49:16,800 AND A THIRD STUDY IS EXAMINING 1338 00:49:16,800 --> 00:49:18,400 BARRIERS TO ALCOHOL USE 1339 00:49:18,400 --> 00:49:20,720 DISORDER CARE BY SURVEYING 1340 00:49:20,720 --> 00:49:22,560 MEDICAID HEALTH PLAN POLICIES 1341 00:49:22,560 --> 00:49:23,960 RELATED TO DELIVERY AND 1342 00:49:23,960 --> 00:49:25,360 MANAGEMENT OF TREATMENT, AND 1343 00:49:25,360 --> 00:49:26,800 RELATIONSHIP WITH ACCESS TO AND 1344 00:49:26,800 --> 00:49:30,040 OUTCOMES OF CARE FOR 1345 00:49:30,040 --> 00:49:31,440 RACIAL/ETHNIC MINORITIES WOMEN 1346 00:49:31,440 --> 00:49:33,240 AND RURAL AMERICANS. 1347 00:49:33,240 --> 00:49:35,480 I KNOW NIDA IS ENGAGED IN 1348 00:49:35,480 --> 00:49:36,840 SIMILAR EFFORTS. 1349 00:49:36,840 --> 00:49:38,160 AND SO FINALLY, CAN I GO BACK 1350 00:49:38,160 --> 00:49:41,120 ONE? 1351 00:49:41,120 --> 00:49:41,920 I DID THAT ONE. 1352 00:49:41,920 --> 00:49:42,800 NEXT SLIDE. 1353 00:49:42,800 --> 00:49:43,800 AND THAT'S IT. 1354 00:49:43,800 --> 00:49:45,640 THIS IS MY LAST SLIDE. 1355 00:49:45,640 --> 00:49:47,480 TO SUMMARIZE WHAT I SAID, THE 1356 00:49:47,480 --> 00:49:49,320 PANDEMIC HAS HAD DRAMATIC 1357 00:49:49,320 --> 00:49:52,160 IMPACTS ON GLOBAL MENTAL HEALTH 1358 00:49:52,160 --> 00:49:53,560 ESPECIALLY AMONG FEMALES AND 1359 00:49:53,560 --> 00:49:54,720 YOUNGER PEOPLE, NEARLY A 1360 00:49:54,720 --> 00:49:56,360 QUARTER OF PEOPLE INCREASED 1361 00:49:56,360 --> 00:49:58,440 DRINKING DURING THE PANDEMIC. 1362 00:49:58,440 --> 00:49:59,280 NEWFOUNDLAND/LABRADOR INCREASES 1363 00:49:59,280 --> 00:50:00,600 REPORTED AMONG WOMEN AND SOME 1364 00:50:00,600 --> 00:50:02,080 MINORITY GROUPS. 1365 00:50:02,080 --> 00:50:03,160 INDIVIDUALS WHO INCREASED THEIR 1366 00:50:03,160 --> 00:50:04,560 DRINKING WERE MORE LIKELY TO 1367 00:50:04,560 --> 00:50:06,160 DRINK TO COPE WITH STRESS. 1368 00:50:06,160 --> 00:50:08,000 THERE'S EVIDENCE FOR INCREASED 1369 00:50:08,000 --> 00:50:09,200 HARMS, PARTICULARLY RELATED TO 1370 00:50:09,200 --> 00:50:11,080 LIVER DAMAGE AND DEATH, RELATED 1371 00:50:11,080 --> 00:50:11,800 TO ALCOHOL USE DURING THE 1372 00:50:11,800 --> 00:50:12,960 PANDEMIC. 1373 00:50:12,960 --> 00:50:14,600 CLOSING THE TREATMENT GAP IS 1374 00:50:14,600 --> 00:50:16,680 CRITICAL FOR ADDRESSING THE 1375 00:50:16,680 --> 00:50:22,360 CHALLENGES OF ALCOHOL MISUSE. 1376 00:50:22,360 --> 00:50:23,280 AND MULTIPLE STRATEGIES ENGAGED 1377 00:50:23,280 --> 00:50:26,160 TO CLOSE THE TREATMENT GAP. 1378 00:50:26,160 --> 00:50:27,000 ADVANCING MEDICATIONS, 1379 00:50:27,000 --> 00:50:31,360 SCREENING AND BRIEF 1380 00:50:31,360 --> 00:50:32,000 INTERVENTION, REFERRAL TO 1381 00:50:32,000 --> 00:50:32,760 TREATMENT. 1382 00:50:32,760 --> 00:50:34,840 SO THANK YOU VERY MUCH. 1383 00:50:34,840 --> 00:50:38,120 I WANT TO THANK RACHEL ANDERSON 1384 00:50:38,120 --> 00:50:40,200 FOR THE INITIAL SLIDES AND 1385 00:50:40,200 --> 00:50:42,320 AARON WHITE AND RICHARD SIMMONS 1386 00:50:42,320 --> 00:50:44,080 AND TRISH POWELL FOR HELP WITH 1387 00:50:44,080 --> 00:50:45,400 THIS PRESENTATION. 1388 00:50:45,400 --> 00:50:47,200 I'M HAPPY TO ANSWER ANY 1389 00:50:47,200 --> 00:50:48,800 QUESTIONS, IF THERE'S TIME FOR 1390 00:50:48,800 --> 00:50:49,360 COMMENTS. 1391 00:50:49,360 --> 00:50:52,200 I THINK I DID IT WITHIN MY 20 1392 00:50:52,200 --> 00:50:53,960 MINUTES, ALMOST. 1393 00:50:53,960 --> 00:50:54,760 SUSAN? 1394 00:50:54,760 --> 00:50:56,640 >> YEAH, WE HAVE ABOUT TEN 1395 00:50:56,640 --> 00:51:15,520 MINUTES FOR QUESTIONS. 1396 00:51:15,520 --> 00:51:18,600 >> I NOTICED PEOPLE DID TALK 1397 00:51:18,600 --> 00:51:20,000 ABOUT SOCIAL DETERMINANTS BOTH 1398 00:51:20,000 --> 00:51:22,600 WITH NIDA AND NIAAA. 1399 00:51:22,600 --> 00:51:24,920 BUT I REALLY HAVEN'T HEARD MUCH 1400 00:51:24,920 --> 00:51:26,560 ABOUT HOMELESSNESS AS A 1401 00:51:26,560 --> 00:51:28,400 VARIABLE AND RESEARCH PARADIGM. 1402 00:51:28,400 --> 00:51:30,920 IT WOULD BE NICE IF I COULD 1403 00:51:30,920 --> 00:51:32,360 HEAR SOME COMMENTS ABOUT 1404 00:51:32,360 --> 00:51:36,360 HOMELESSNESS AS A FOCUS, BOTH 1405 00:51:36,360 --> 00:51:38,440 NIAAA AND NIDA, IN TERMS OF 1406 00:51:38,440 --> 00:51:40,800 HELPING US DEVELOP STRATEGY 1407 00:51:40,800 --> 00:51:43,600 THAT'S ARE MORE APPROPRIATE FOR 1408 00:51:43,600 --> 00:51:44,560 THE HOMELESS POPULATION. 1409 00:51:44,560 --> 00:51:46,520 >> THAT'S A REALLY GOOD 1410 00:51:46,520 --> 00:51:47,800 QUESTION, WEST. 1411 00:51:47,800 --> 00:51:50,800 I'M NOT AT ALL SURE WHETHER WE 1412 00:51:50,800 --> 00:51:52,960 HAVE ANYTHING IN OUR PORTFOLIO 1413 00:51:52,960 --> 00:51:54,520 THAT SPECIFICALLY ADDRESSES 1414 00:51:54,520 --> 00:51:54,720 THAT. 1415 00:51:54,720 --> 00:51:57,000 AND IT'S SOMETHING THAT WE 1416 00:51:57,000 --> 00:52:00,280 SHOULD LOOK INTO. 1417 00:52:00,280 --> 00:52:10,600 WE CERTAINLY WORK WITH DELICIO 1418 00:52:10,600 --> 00:52:12,600 CHABLY ON SOME OF THESE ISSUES. 1419 00:52:12,600 --> 00:52:14,240 TRISH, MAYBE YOU WOULD LIKE TO 1420 00:52:14,240 --> 00:52:15,200 MAKE A COMMENT? 1421 00:52:15,200 --> 00:52:16,800 BECAUSE YOU MAY BE MORE AWARE 1422 00:52:16,800 --> 00:52:18,520 OF WHAT'S IN OUR PORTFOLIO THAN 1423 00:52:18,520 --> 00:52:19,360 I AM. 1424 00:52:19,360 --> 00:52:20,800 >> GEORGE, I JUST WANTED TO 1425 00:52:20,800 --> 00:52:22,440 COMMENT, WE HAD A GRANT SEVERAL 1426 00:52:22,440 --> 00:52:25,240 YEARS AGO NOW THAT LOOKED AT 1427 00:52:25,240 --> 00:52:26,880 HOMELESSNESS AND ALCOHOL USE 1428 00:52:26,880 --> 00:52:27,800 DISORDER TREATMENT AND FOUND 1429 00:52:27,800 --> 00:52:30,360 THAT IT WAS VERY EFFECTIVE TO 1430 00:52:30,360 --> 00:52:33,640 GET PEOPLE'S HOME SITUATIONS 1431 00:52:33,640 --> 00:52:34,840 STABILIZED FIRST. 1432 00:52:34,840 --> 00:52:37,160 AND THAT THEY DIDN'T NEED TO BE 1433 00:52:37,160 --> 00:52:40,240 AB STIN NENT WHICH WAS OFTEN A 1434 00:52:40,240 --> 00:52:42,440 REQUIREMENT FOR HOUSING FOR 1435 00:52:42,440 --> 00:52:42,680 PEOPLE. 1436 00:52:42,680 --> 00:52:46,560 SO THAT WAS JUST ONE PROJECTD 1437 00:52:46,560 --> 00:52:47,240 THAT INDICATED EXACTLY YOUR 1438 00:52:47,240 --> 00:52:49,120 POINT. 1439 00:52:49,120 --> 00:52:50,200 ADDRESSING HOMELESSNESS AND NOT 1440 00:52:50,200 --> 00:52:51,280 REQUIRING ABSTINENCE FIRST WAS 1441 00:52:51,280 --> 00:52:53,800 EFFECTIVE. 1442 00:52:53,800 --> 00:52:55,280 >> NOW I REMEMBER COMMUNITY 1443 00:52:55,280 --> 00:52:55,920 COMMUNITY REINFORCEMENT 1444 00:52:55,920 --> 00:53:02,640 APPROACHES THAT WE DO STUDY AND 1445 00:53:02,640 --> 00:53:05,040 SUPPORT, ADDRESSING PEOPLE 1446 00:53:05,040 --> 00:53:07,600 HAVING A HOME, A SAFE PLACE TO 1447 00:53:07,600 --> 00:53:09,920 BE AND A JOB ARE KEY PARTS OF 1448 00:53:09,920 --> 00:53:11,720 OF THAT KIND OF APPROACH. 1449 00:53:11,720 --> 00:53:13,440 AND WE CERTAINLY SUPPORT THAT. 1450 00:53:13,440 --> 00:53:14,800 BUT YOU KNOW, YOU HAVE RAISED 1451 00:53:14,800 --> 00:53:17,320 AN ISSUE I THINK WE COULD LOOK 1452 00:53:17,320 --> 00:53:19,920 AT IN A LITTLE MORE DETAIL, 1453 00:53:19,920 --> 00:53:21,560 BECAUSE YOU ARE RIGHT. 1454 00:53:21,560 --> 00:53:23,640 HOMELESSNESS IS A BIG ISSUE IN 1455 00:53:23,640 --> 00:53:25,720 ALL OUR MAJOR CITIES IN THE 1456 00:53:25,720 --> 00:53:27,360 UNITED STATES NOW. 1457 00:53:27,360 --> 00:53:29,720 >> PARTICULARLY, DURING THE 1458 00:53:29,720 --> 00:53:30,880 PANDEMIC, SO IT'S BECOME AN 1459 00:53:30,880 --> 00:53:31,600 ISSUE. 1460 00:53:31,600 --> 00:53:33,280 >> POINT WELL TAKEN. 1461 00:53:33,280 --> 00:53:35,560 >> YEP. 1462 00:53:35,560 --> 00:53:37,240 >> WE AGREE. 1463 00:53:37,240 --> 00:53:41,560 I WOULD JUST WANT TO ADD FROM 1464 00:53:41,560 --> 00:53:42,480 NIAAA'S PERSPECTIVE, WE HAVE 1465 00:53:42,480 --> 00:53:43,680 WORK IN THIS FIELD. 1466 00:53:43,680 --> 00:53:47,120 WHAT ABOUT PERSONS WHO ARE HIV 1467 00:53:47,120 --> 00:53:48,960 INFECTED AND HAVE SUBSTANCE USE 1468 00:53:48,960 --> 00:53:51,080 DISORDERS AND NEED TO MAINTAIN 1469 00:53:51,080 --> 00:53:53,000 TREATMENT FOR A CHRONIC 1470 00:53:53,000 --> 00:53:54,040 HEALTHCARE CONDITION. 1471 00:53:54,040 --> 00:53:55,680 THAT'S A NOTORIOUS ISSUE AS 1472 00:53:55,680 --> 00:53:57,520 WELL THAT WE HAVE A LITTLE 1473 00:53:57,520 --> 00:53:59,280 RESEARCH ON THAT SHOWS 1474 00:53:59,280 --> 00:53:59,920 PROMISING APPROACHES. 1475 00:53:59,920 --> 00:54:00,880 >> THANK YOU. 1476 00:54:00,880 --> 00:54:03,240 THANK YOU, BOTH. 1477 00:54:03,240 --> 00:54:07,040 >> WE ARE VERY INTERESTED IN 1478 00:54:07,040 --> 00:54:08,920 TOBACCO USE AND HOMELESS AND 1479 00:54:08,920 --> 00:54:10,520 HAVE A COUPLE GRANTS IN OUR 1480 00:54:10,520 --> 00:54:11,720 PORTFOLIO LOOKING AT THAT AND 1481 00:54:11,720 --> 00:54:13,080 THERE ARE WAYS TO ADDRESS 1482 00:54:13,080 --> 00:54:15,440 CESSATION. 1483 00:54:15,440 --> 00:54:16,840 TOBACCO USE IS VERY HIGH, AS 1484 00:54:16,840 --> 00:54:17,760 YOU CAN IMAGINE. 1485 00:54:17,760 --> 00:54:18,920 >> YEAH. 1486 00:54:18,920 --> 00:54:21,560 THANK YOU, BILL. 1487 00:54:21,560 --> 00:54:25,400 >> I LOVE THAT EFFORT PUT 1488 00:54:25,400 --> 00:54:27,560 TOWARDS PUTTING THE RESOURCES 1489 00:54:27,560 --> 00:54:30,960 TO EDUCATE THE HEALTHCARE 1490 00:54:30,960 --> 00:54:32,120 PROFESSIONALS ABOUT ALCOHOL 1491 00:54:32,120 --> 00:54:33,520 MISUSE. 1492 00:54:33,520 --> 00:54:36,480 I'M WONDERING WHETHER YOU ARE 1493 00:54:36,480 --> 00:54:37,640 CONSIDERING BRINGING THAT 1494 00:54:37,640 --> 00:54:39,920 RESOURCES TO PEOPLE, BY HAVING 1495 00:54:39,920 --> 00:54:42,240 WORKSHOPS AND CONFERENCES TO 1496 00:54:42,240 --> 00:54:46,040 LET MORE OF OF THE SCIENTISTS 1497 00:54:46,040 --> 00:54:47,680 KNOW ABOUT THESE RESOURCES? 1498 00:54:47,680 --> 00:54:50,640 I KNOW THAT RESOURCES, ONE HAS 1499 00:54:50,640 --> 00:54:52,680 TO GO THERE TO GET IT, BUT TO 1500 00:54:52,680 --> 00:54:54,720 SORT OF BRING THEM TO GROUPS 1501 00:54:54,720 --> 00:54:56,080 THAT MIGHT ALREADY BE USING 1502 00:54:56,080 --> 00:54:58,960 THEM. 1503 00:54:58,960 --> 00:55:01,360 >> THAT'S A VERY GOOD IDEA. 1504 00:55:01,360 --> 00:55:05,680 YOU MADE ME THINK OF WCBR. 1505 00:55:05,680 --> 00:55:07,360 >> YEAH, EXACTLY. 1506 00:55:07,360 --> 00:55:10,320 A PAROCHIAL GROUP, I MIGHT ADD. 1507 00:55:10,320 --> 00:55:12,200 BUT NEVERTHELESS THEY DO AN 1508 00:55:12,200 --> 00:55:13,200 OUTREACH TO COMMUNITIES IN 1509 00:55:13,200 --> 00:55:14,720 THEIR MEETING. 1510 00:55:14,720 --> 00:55:16,880 THE LUNCH WAS YESTERDAY, SO WE 1511 00:55:16,880 --> 00:55:19,720 PLAN ON GETTING EVERYBODY 1512 00:55:19,720 --> 00:55:22,280 INVOLVED FROM A.P.A. 1513 00:55:22,280 --> 00:55:24,480 BOTH A.P.A.'S, A.P.S. 1514 00:55:24,480 --> 00:55:25,120 A.T.N.P. 1515 00:55:25,120 --> 00:55:26,520 WE WILL BE TAPPING INTO A 1516 00:55:26,520 --> 00:55:27,600 NUMBER OF OF ORGANIZATIONSMENT 1517 00:55:27,600 --> 00:55:29,760 ONE OF THE THINGS I MEANT TO 1518 00:55:29,760 --> 00:55:32,400 MENTION IS OUR CLINICIANS AND 1519 00:55:32,400 --> 00:55:35,920 OUR AAA CLINICAL PROGRAM, 1520 00:55:35,920 --> 00:55:43,720 NOTABLY, IT NANCY DEESCANARDOS 1521 00:55:43,720 --> 00:55:47,160 IS PASSIONATE CONVERTING THE 1522 00:55:47,160 --> 00:55:49,960 CORE RESOURCE INTO A CORE 1523 00:55:49,960 --> 00:55:50,920 CURRICULUM FOR SCHOOLS. 1524 00:55:50,920 --> 00:55:52,560 THAT'S UNDER WAY. 1525 00:55:52,560 --> 00:55:53,640 THERE'S A GROUP ALREADY MEETING 1526 00:55:53,640 --> 00:55:54,680 TO WORK ON THAT. 1527 00:55:54,680 --> 00:55:56,800 BECAUSE THEY ARE PICKING UP 1528 00:55:56,800 --> 00:56:00,400 WITH THE YOUNGER DOCTORS THAT 1529 00:56:00,400 --> 00:56:02,520 THERE IS JUST A CRYING NEED FOR 1530 00:56:02,520 --> 00:56:03,640 MORE INFORMATION. 1531 00:56:03,640 --> 00:56:07,440 AND SO, WE HOPE IT WILL, IT 1532 00:56:07,440 --> 00:56:09,080 WILL PROVIDE, I THINK YOUR 1533 00:56:09,080 --> 00:56:10,160 POINT IS REALLY WELL TAKEN 1534 00:56:10,160 --> 00:56:11,120 THOUGH. 1535 00:56:11,120 --> 00:56:13,200 WE NEED TO ADJUST IT FOR THE 1536 00:56:13,200 --> 00:56:16,120 PUBLIC AS WELL AS FOR THE 1537 00:56:16,120 --> 00:56:18,160 HEALTHCARE PROFESSIONALS. 1538 00:56:18,160 --> 00:56:19,320 AND FOR RESEARCHERS, FOR THAT 1539 00:56:19,320 --> 00:56:19,840 MATTER. 1540 00:56:19,840 --> 00:56:23,120 I WILL BE PRESENTING AT R.S.A. 1541 00:56:23,120 --> 00:56:26,120 SHELLY? 1542 00:56:26,120 --> 00:56:32,000 >> THANKS. 1543 00:56:32,000 --> 00:56:33,640 >> SHELLY, YOU ARE MUTED. 1544 00:56:33,640 --> 00:56:35,000 >> YOU SLIPPED ONTO MUTE, 1545 00:56:35,000 --> 00:56:35,520 SHELLY. 1546 00:56:35,520 --> 00:56:36,760 >> SORRY ABOUT THAT. 1547 00:56:36,760 --> 00:56:37,760 THANK YOU, GEORGE FOR THAT 1548 00:56:37,760 --> 00:56:39,000 PRESENTATION. 1549 00:56:39,000 --> 00:56:40,360 I APPRECIATED SO MANY ASPECTS 1550 00:56:40,360 --> 00:56:41,560 OF IT. 1551 00:56:41,560 --> 00:56:42,520 THERE'S LOTS TO DISCUSS. 1552 00:56:42,520 --> 00:56:45,320 ONE THING I AGREE COMPLETELY, 1553 00:56:45,320 --> 00:56:46,920 THE DISSEMINATION YOU NOW DO 1554 00:56:46,920 --> 00:56:48,280 FOR THIS WONDERFUL CORE 1555 00:56:48,280 --> 00:56:50,160 RESOURCES WILL BE REALLY 1556 00:56:50,160 --> 00:56:53,000 IMPORTANT AND SOMEHOW LETTING 1557 00:56:53,000 --> 00:56:55,760 MAYBE STATE, PEOPLE WHO HAVE TO 1558 00:56:55,760 --> 00:56:57,440 QUALIFY FOR C.M.E.'S FOR, YOU 1559 00:56:57,440 --> 00:56:59,800 KNOW, STATE MEDICAL LICENSES, 1560 00:56:59,800 --> 00:57:01,200 LETTING STATE BOARDS KNOW THESE 1561 00:57:01,200 --> 00:57:03,320 ARE NOW AVAILABLE FOR PEOPLE. 1562 00:57:03,320 --> 00:57:04,600 THERE'S A WHOLE RANGE OF 1563 00:57:04,600 --> 00:57:05,920 THINGS, WE DON'T HAVE TO 1564 00:57:05,920 --> 00:57:07,280 OUTLINE THEM ALL HERE. 1565 00:57:07,280 --> 00:57:10,080 BUT GETTING THAT WORD OUT FOR 1566 00:57:10,080 --> 00:57:11,480 DISSEMINATION ACROSS MULTIPLE 1567 00:57:11,480 --> 00:57:14,680 SPECIALTIES THESE COULD BE USED 1568 00:57:14,680 --> 00:57:15,600 WOULD BE REALLY IMPORTANT. 1569 00:57:15,600 --> 00:57:17,720 WE HAVE BEEN TALKING FOR 1570 00:57:17,720 --> 00:57:20,320 DECADES HOW POORLY INFORMED 1571 00:57:20,320 --> 00:57:22,200 CLINICIANS ARE REGARDING 1572 00:57:22,200 --> 00:57:23,600 ALCOHOL USE DISORDERS AND 1573 00:57:23,600 --> 00:57:24,480 INDICATIONS EARLIER ON IN THE 1574 00:57:24,480 --> 00:57:25,960 PROCESS. 1575 00:57:25,960 --> 00:57:27,920 SO THIS IS GREAT. 1576 00:57:27,920 --> 00:57:31,400 I ALSO REALLY APPRECIATE THE 1577 00:57:31,400 --> 00:57:36,960 EMPHASIS THAT NIAAA IS TAKING 1578 00:57:36,960 --> 00:57:37,680 ON CO-CURRENT DISORDERS. 1579 00:57:37,680 --> 00:57:39,520 THIS IS SOMETHING THE PEOPLE IN 1580 00:57:39,520 --> 00:57:41,920 THE FIELD HAVE BEEN TALKING 1581 00:57:41,920 --> 00:57:44,200 ABOUT FOR YEARS, GENDER 1582 00:57:44,200 --> 00:57:46,800 DIFFERENCES, WOMEN WITH 1583 00:57:46,800 --> 00:57:48,440 ALCOHOL-RELATED PROBLEMS 1584 00:57:48,440 --> 00:57:49,880 INCLUDING PTSD AND ANXIETY AND 1585 00:57:49,880 --> 00:57:50,960 DEPRESSION. 1586 00:57:50,960 --> 00:57:52,320 WHICH ARE OFTEN DRIVERS. 1587 00:57:52,320 --> 00:57:54,920 AND IT'S BEEN VERY HARD FOR 1588 00:57:54,920 --> 00:57:58,600 WOMEN TO GET THE TREATMENT. 1589 00:57:58,600 --> 00:58:02,040 SO I THINK, I THINK GRANT 1590 00:58:02,040 --> 00:58:03,200 ANNOUNCEMENTS WILL FOLLOW, IN 1591 00:58:03,200 --> 00:58:06,440 TERMS OF LOOKING AT THE 1592 00:58:06,440 --> 00:58:07,600 CO-OCCURRING MENTAL HEALTH 1593 00:58:07,600 --> 00:58:09,480 CONDITIONS WE KNOW ARE 1594 00:58:09,480 --> 00:58:10,400 INCREDIBLY IMPORTANT IN 1595 00:58:10,400 --> 00:58:12,480 TREATING PEOPLE WITH 1596 00:58:12,480 --> 00:58:13,680 ALCOHOL-USE DISORDERS AND 1597 00:58:13,680 --> 00:58:16,000 ESPECIALLY WE CAN INTERVENE 1598 00:58:16,000 --> 00:58:17,160 SOONER RATHER THAN LATER WITH 1599 00:58:17,160 --> 00:58:18,680 PEOPLE WITH PSYCHIATRIC 1600 00:58:18,680 --> 00:58:19,520 DISORDERS. 1601 00:58:19,520 --> 00:58:21,600 BECAUSE WE SEE ALCOHOL-USE 1602 00:58:21,600 --> 00:58:22,560 DISORDERS BEGINNING TO EVOLVE 1603 00:58:22,560 --> 00:58:26,280 IN PEOPLE WHO HAVE OTHER 1604 00:58:26,280 --> 00:58:27,200 CO-OCCURRING PSYCHIATRIC 1605 00:58:27,200 --> 00:58:29,080 DISORDERS REALLY ACROSS THE 1606 00:58:29,080 --> 00:58:30,720 WHOLE AGE SPECTRUM. 1607 00:58:30,720 --> 00:58:32,840 I WANTED TO COMMENT ON THE 1608 00:58:32,840 --> 00:58:34,920 HORRIBLE, TERRIBLE RISING RATES 1609 00:58:34,920 --> 00:58:37,320 YOU SHOWED, EPIDEMIOLOGICKLY, 1610 00:58:37,320 --> 00:58:39,520 AND ESPECIALLY IN WOMEN AND 1611 00:58:39,520 --> 00:58:40,000 GIRLS. 1612 00:58:40,000 --> 00:58:41,880 THIS IS SOMETHING WE SAW BEFORE 1613 00:58:41,880 --> 00:58:43,920 THE PANDEMIC WAS ACCELERATING 1614 00:58:43,920 --> 00:58:45,120 AND WORSE DURING THE PANDEMIC 1615 00:58:45,120 --> 00:58:46,280 FOR ALL THE REASONS YOU 1616 00:58:46,280 --> 00:58:47,040 OUTLINED. 1617 00:58:47,040 --> 00:58:50,040 ONE THING NOT MENTIONED PERHAPS 1618 00:58:50,040 --> 00:58:52,840 AS A THIRD RAIL IS THE 1619 00:58:52,840 --> 00:58:53,720 INCREDIBLE ADVERTISING CAMPAIGN 1620 00:58:53,720 --> 00:58:55,880 THAT'S GONE ON FOR YEARS AND 1621 00:58:55,880 --> 00:58:57,480 DECADES PRIOR TO THE PANDEMIC 1622 00:58:57,480 --> 00:58:59,720 TARGETING WOMEN AND THE 1623 00:58:59,720 --> 00:59:02,320 MULTIPLE BEVERAGES THAT HAVE 1624 00:59:02,320 --> 00:59:08,560 BEEN MARKETED, WE HAD VODKAS, 1625 00:59:08,560 --> 00:59:11,760 BEERS AND WINES MARKETED TO 1626 00:59:11,760 --> 00:59:12,520 MOMS. 1627 00:59:12,520 --> 00:59:15,720 THIS HAS BEEN GOING ON PRIOR TO 1628 00:59:15,720 --> 00:59:17,240 THE PANDEMIC FOR YEARS. 1629 00:59:17,240 --> 00:59:19,760 WE KNOW ADVERTISING CAN 1630 00:59:19,760 --> 00:59:22,400 ACTUALLY BE A RESPONSE TO 1631 00:59:22,400 --> 00:59:23,160 BEHAVIORAL CHANGE IN THE 1632 00:59:23,160 --> 00:59:24,000 POPULATION. 1633 00:59:24,000 --> 00:59:26,360 AS WE KNOW, WE HAVE EXPERTS ON 1634 00:59:26,360 --> 00:59:27,760 THIS, ON THIS CALL. 1635 00:59:27,760 --> 00:59:30,640 IT'S BEEN A DRIVER OF 1636 00:59:30,640 --> 00:59:31,520 BEHAVIORAL CHANGE INCLUDING 1637 00:59:31,520 --> 00:59:32,520 TOBACCO. 1638 00:59:32,520 --> 00:59:33,440 THAT'S BEEN CONCERNING. 1639 00:59:33,440 --> 00:59:36,240 I KNOW THERE'S A LOT TO BE SAID 1640 00:59:36,240 --> 00:59:39,560 ABOUT THAT ASPECT OF THINGS. 1641 00:59:39,560 --> 00:59:41,920 AND FINALLY, YOU GAVE A GREAT 1642 00:59:41,920 --> 00:59:43,120 CARTOON OF THE ELEPHANT IN THE 1643 00:59:43,120 --> 00:59:44,040 ROOM. 1644 00:59:44,040 --> 00:59:45,440 ANOTHER ELEPHANT IN THE ROOM 1645 00:59:45,440 --> 00:59:46,600 THAT'S REALLY HARD TO DISCUSS 1646 00:59:46,600 --> 00:59:49,160 IS HOW WE REALLY MANAGE OUR 1647 00:59:49,160 --> 00:59:50,800 HEALTHCARE SYSTEM, WHICH REALLY 1648 00:59:50,800 --> 00:59:53,800 DOES NOT PROVIDE ADEQUATE 1649 00:59:53,800 --> 00:59:56,440 INCENTIVES FOR ALL OF OUR 1650 00:59:56,440 --> 00:59:58,080 CLINICIANS ACROSS MULTIPLE 1651 00:59:58,080 --> 01:00:00,320 SPECIALTIES TO BE DOING CASE 1652 01:00:00,320 --> 01:00:04,320 IDENTIFICATION EARLY ON DOING 1653 01:00:04,320 --> 01:00:04,960 THE INTERVENTIONS NEEDEDMENT 1654 01:00:04,960 --> 01:00:07,200 THAT'S AN ALL OF US SITUATION. 1655 01:00:07,200 --> 01:00:09,320 THAT'S AN ALL OF US CONCERN, 1656 01:00:09,320 --> 01:00:10,920 ACROSS ALL OF OUR INSTITUTE 1657 01:00:10,920 --> 01:00:12,160 THAT'S ARE TOGETHER TODAY. 1658 01:00:12,160 --> 01:00:13,880 I JUST WANTED TO MAKE THESE FEW 1659 01:00:13,880 --> 01:00:15,320 COMMENTS. 1660 01:00:15,320 --> 01:00:20,560 I REALLY APPLAUD, REALLY ALL OF 1661 01:00:20,560 --> 01:00:22,240 THESE INSTITUTES AND THE AMOUNT 1662 01:00:22,240 --> 01:00:26,760 OF AMAZING ACTIVITY IS REALLY, 1663 01:00:26,760 --> 01:00:29,160 YOU KNOW, JUST DESERVES A LOT 1664 01:00:29,160 --> 01:00:30,120 OF CONGRATULATIONS FROM US IN 1665 01:00:30,120 --> 01:00:31,160 THE FIELD. 1666 01:00:31,160 --> 01:00:33,280 I JUST WANTED TO CALL ATTENTION 1667 01:00:33,280 --> 01:00:36,960 TO SOME OF THESE OTHER AREAS, 1668 01:00:36,960 --> 01:00:38,000 SO THANKS. 1669 01:00:38,000 --> 01:00:40,720 >> THANKS, I WROTE IT ALL DOWN. 1670 01:00:40,720 --> 01:00:41,960 I COULD RESPOND TO ALL THAT, 1671 01:00:41,960 --> 01:00:43,640 BUT I THINK WE WILL LET OTHER 1672 01:00:43,640 --> 01:00:46,240 PEOPLE ASK OTHER QUESTIONS. 1673 01:00:46,240 --> 01:00:47,920 YOU MEAN, WE -- YOU KNOW, I 1674 01:00:47,920 --> 01:00:49,520 DO WANT TO MAKE ONE COMMENT, 1675 01:00:49,520 --> 01:00:55,120 WHICH IS THAT NORA WILCOFF AND 1676 01:00:55,120 --> 01:00:57,400 TOM McLELLAN AND I ARE 1677 01:00:57,400 --> 01:00:58,760 INTERESTED IN WHAT TOM LIKES TO 1678 01:00:58,760 --> 01:01:02,120 CALL AND WE ARE STARTING TO USE 1679 01:01:02,120 --> 01:01:03,240 THE TERM PRE-ADDICTION. 1680 01:01:03,240 --> 01:01:07,120 THE WORKING TO INTERVENE, 1681 01:01:07,120 --> 01:01:10,600 PREVENT, TREAT INDIVIDUALS WHO 1682 01:01:10,600 --> 01:01:12,920 HAVE LOW TO MODERATE ALCOHOL 1683 01:01:12,920 --> 01:01:15,480 USE DISORDER OR SUBSTANCE USE 1684 01:01:15,480 --> 01:01:16,880 DISORDER AS OPPOSED TO WAITING 1685 01:01:16,880 --> 01:01:18,080 FOR THE SEVERE CASE. 1686 01:01:18,080 --> 01:01:19,880 I THINK YOU TOUCHED ON THAT ON 1687 01:01:19,880 --> 01:01:21,600 A NUMBER OF YOUR POINTS. 1688 01:01:21,600 --> 01:01:23,000 THAT'S SOMETHING WE ARE QUITE 1689 01:01:23,000 --> 01:01:24,080 INTERESTED IN, YOU WILL SEE 1690 01:01:24,080 --> 01:01:26,840 MORE ABOUT THAT COMING DOWN. 1691 01:01:26,840 --> 01:01:28,720 WES, YOU HAD ANOTHER QUESTION? 1692 01:01:28,720 --> 01:01:30,560 >> BASICALLY, I WANTED TO 1693 01:01:30,560 --> 01:01:31,920 PIGGYBACK ON WHAT SHELLY WAS 1694 01:01:31,920 --> 01:01:33,360 SAYING. 1695 01:01:33,360 --> 01:01:37,520 DON'T FORGET COMMUNITY HEALTH 1696 01:01:37,520 --> 01:01:40,600 CENTERS AND HRSA'S AGENDA TO 1697 01:01:40,600 --> 01:01:42,000 PROMOTE ADDICTION IN TERMS OF 1698 01:01:42,000 --> 01:01:43,360 THE CORE CURRICULUM. 1699 01:01:43,360 --> 01:01:45,280 THIS WILL BE GREAT. 1700 01:01:45,280 --> 01:01:47,560 AND FOR COUNSELLORS THEY MIGHT 1701 01:01:47,560 --> 01:01:49,240 BENEFIT FROM THE SAME TYPE OF 1702 01:01:49,240 --> 01:01:50,680 MATERIAL, IN PART, ESPECIALLY 1703 01:01:50,680 --> 01:01:53,680 AS WE ARE USING COUNSELORS AS 1704 01:01:53,680 --> 01:01:55,560 FIRST LINE INTERVENTION AND 1705 01:01:55,560 --> 01:01:58,120 COMMUNITY HEALTH CENTERS AND 1706 01:01:58,120 --> 01:01:59,600 MENTAL HEALTH CENTERS, AS WE 1707 01:01:59,600 --> 01:02:01,200 MOVE TOWARD AN INTEGRATED 1708 01:02:01,200 --> 01:02:01,960 PARADIGM. 1709 01:02:01,960 --> 01:02:04,200 HAVING THIS INFORMATION 1710 01:02:04,200 --> 01:02:05,640 AVAILABLE AS SHELLY IS POINTING 1711 01:02:05,640 --> 01:02:07,520 OUT TO EVERYONE WHO IS DEALING 1712 01:02:07,520 --> 01:02:08,920 WITH ANYONE WHO PRESENTS WITH 1713 01:02:08,920 --> 01:02:11,000 ANY KIND OF BEHAVIORAL HEALTH 1714 01:02:11,000 --> 01:02:18,040 ISSUE WOULD BE TERRIBLY HELPFUL. 1715 01:02:18,040 --> 01:02:19,160 HRSA'S COMMUNITY HEALTH CENTER 1716 01:02:19,160 --> 01:02:21,520 THING IS A MAJOR DELIVERY 1717 01:02:21,520 --> 01:02:22,560 MECHANISM FOR PRIMARY CARE IN 1718 01:02:22,560 --> 01:02:23,840 AMERICA. 1719 01:02:23,840 --> 01:02:25,040 >> YEAH, THANKS, WES. 1720 01:02:25,040 --> 01:02:27,320 SO I WOULD URGE ALL OF YOU WHO 1721 01:02:27,320 --> 01:02:28,960 HAVE OTHER IDEAS OF 1722 01:02:28,960 --> 01:02:30,000 DISSEMINATION TO SEND US AN 1723 01:02:30,000 --> 01:02:30,840 EMAIL. 1724 01:02:30,840 --> 01:02:31,760 HAPPY TO RECEIVE IT. 1725 01:02:31,760 --> 01:02:34,800 YOU CAN SEND IT TO ME AND I 1726 01:02:34,800 --> 01:02:37,800 WILL PASS IT ON OR RAY LITEN, 1727 01:02:37,800 --> 01:02:39,200 MANY OF YOU KNOW RAY. 1728 01:02:39,200 --> 01:02:41,240 I SEE CHARLIE HAS ONE MORE 1729 01:02:41,240 --> 01:02:41,800 COMMENT. 1730 01:02:41,800 --> 01:02:43,680 >> I JUST WANTED TO REMIND 1731 01:02:43,680 --> 01:02:45,080 PEOPLE, WE ALSO HAVE THE ROUND 1732 01:02:45,080 --> 01:02:45,920 TABLE DISCUSSION AT THE END OF 1733 01:02:45,920 --> 01:02:46,720 THE DAY. 1734 01:02:46,720 --> 01:02:48,360 SO IF WE DON'T GET TO COVER 1735 01:02:48,360 --> 01:02:50,240 EVERYTHING AT THIS TIME, WE CAN 1736 01:02:50,240 --> 01:02:51,240 COME BACK TO IT. 1737 01:02:51,240 --> 01:02:52,560 BUT CHARLES? 1738 01:02:52,560 --> 01:02:55,520 >> YES, GEORGE, I REALLY 1739 01:02:55,520 --> 01:02:57,800 APPRECIATE THE IDEA NORA 1740 01:02:57,800 --> 01:03:01,000 INTRODUCED YESTERDAY AND 1741 01:03:01,000 --> 01:03:02,920 PRE-ADDICTION AND NECESSITY TO 1742 01:03:02,920 --> 01:03:03,880 IDENTIFY THOSE QUALITIES. 1743 01:03:03,880 --> 01:03:06,160 BUT SOMETHING ABOUT THE DSM 1744 01:03:06,160 --> 01:03:08,960 CRITERIA, THEY ARE KIND OF 1745 01:03:08,960 --> 01:03:11,080 BINARY, NOT QUANTITATIVE IN THE 1746 01:03:11,080 --> 01:03:13,400 SENSE -- CAN YOU EXPAND A 1747 01:03:13,400 --> 01:03:15,280 LITTLE MORE WHAT YOU THINK 1748 01:03:15,280 --> 01:03:18,400 PRE-ADDICTION IS OR REFER ME TO 1749 01:03:18,400 --> 01:03:19,720 A PUBLICATION, GIVE US A SENSE 1750 01:03:19,720 --> 01:03:22,760 OF WHAT ARE THE QUALITIES THAT 1751 01:03:22,760 --> 01:03:24,160 ENABLES SOMEONE TO GO FROM A 1752 01:03:24,160 --> 01:03:26,960 MILD ALL THE WAY TO A SEVERE 1753 01:03:26,960 --> 01:03:28,320 SUBSTANCE USE DISORDER THAT ARE 1754 01:03:28,320 --> 01:03:28,880 PREDICTED. 1755 01:03:28,880 --> 01:03:30,160 >> CHARLIE, THAT'S A REALLY 1756 01:03:30,160 --> 01:03:31,120 GOOD QUESTION. 1757 01:03:31,120 --> 01:03:35,000 BUT I WOULD TAKE UP THE REST OF 1758 01:03:35,000 --> 01:03:36,640 OUR TIME TO ANSWER IT CAREFULLY. 1759 01:03:36,640 --> 01:03:43,440 THERE IS A PAPER IN PRESS ON 1760 01:03:43,440 --> 01:03:44,840 LANCE PSYCHIATRY ON THIS. 1761 01:03:44,840 --> 01:03:47,040 I DON'T KNOW THAT IT'S 1762 01:03:47,040 --> 01:03:48,280 COMPLETELY ACCEPTED. 1763 01:03:48,280 --> 01:03:52,120 LET'S PUT IT THIS WAY, IT'S IN 1764 01:03:52,120 --> 01:03:54,160 PROGRESS, WITH NORA, TOM AND I. 1765 01:03:54,160 --> 01:04:00,920 YOU KNOW, I WOULD JUST SAY DSM 1766 01:04:00,920 --> 01:04:02,760 V IS NOT PERFECT BY ANY STRETCH. 1767 01:04:02,760 --> 01:04:04,520 BUT IT WOULD BE A START. 1768 01:04:04,520 --> 01:04:11,160 WHAT OUR ARGUMENT WOULD BE, IF 1769 01:04:11,160 --> 01:04:12,880 YOU MEET ANY OF THE TWO 1770 01:04:12,880 --> 01:04:29,440 CRITERIA. 1771 01:04:29,440 --> 01:04:31,920 WHETHER YOU WANT TO AMPLIFY 1772 01:04:31,920 --> 01:04:33,720 THAT. 1773 01:04:33,720 --> 01:04:36,280 >> I THINK IT'S ALWAYS HARD TO 1774 01:04:36,280 --> 01:04:37,920 QUANTIFY THINGS IN DSM. 1775 01:04:37,920 --> 01:04:46,720 AS I SAID YESTERDAY, THE MILD 1776 01:04:46,720 --> 01:04:48,800 TO MODERATE TO SEVERE IS AN 1777 01:04:48,800 --> 01:04:51,320 IMPROVEMENT OVER THE LAST ROUND. 1778 01:04:51,320 --> 01:04:53,880 IT ENABLES, LIKE A PICK 2, IT'S 1779 01:04:53,880 --> 01:04:55,520 ANY TWO THAT SHOW UP IN A 1780 01:04:55,520 --> 01:04:56,920 PATIENT COULD BE THE TWO, YOU 1781 01:04:56,920 --> 01:05:02,520 WOULD SAY THIS IS A MILD AND AN 1782 01:05:02,520 --> 01:05:04,600 INDICATOR THAT MAYBE SOME 1783 01:05:04,600 --> 01:05:06,800 APPROPRIATE LEVEL INTERVENTION. 1784 01:05:06,800 --> 01:05:23,120 COULD BE APPLIED HERE. 1785 01:05:23,120 --> 01:05:25,320 JUST TO ENGAGE SOMEONE, THAT'S 1786 01:05:25,320 --> 01:05:27,080 NOT SOMETHING WE HAVE. 1787 01:05:27,080 --> 01:05:28,520 THAT WOULD ALREADY BE AN 1788 01:05:28,520 --> 01:05:30,120 IMPROVEMENT, JUST A SINGLE 1789 01:05:30,120 --> 01:05:32,720 SESSION OF A CONVERSATION BASED 1790 01:05:32,720 --> 01:05:34,120 ON TWO SYMPTOMS THAT SHOW UP ON 1791 01:05:34,120 --> 01:05:35,200 A SCREENER. 1792 01:05:35,200 --> 01:05:35,960 I MEAN, THAT'S ALREADY 1793 01:05:35,960 --> 01:05:38,160 SOMETHING. 1794 01:05:38,160 --> 01:05:39,320 BUT I UNDERSTAND WHAT YOU ARE 1795 01:05:39,320 --> 01:05:40,920 SAYING ABOUT THE QUANTIFICATION. 1796 01:05:40,920 --> 01:05:43,920 THE ONLY WAY WE QUANTIFY IS A 1797 01:05:43,920 --> 01:05:46,720 TWO, AS A THREE, FOUR AND A 1798 01:05:46,720 --> 01:05:48,600 FIVE, ACROSS-THE-BOARD AND THE 1799 01:05:48,600 --> 01:05:49,200 THRESHOLD CUT POINTS. 1800 01:05:49,200 --> 01:05:54,920 >> THANK YOU. 1801 01:05:54,920 --> 01:05:56,800 >> BILL, WE CAN CONTINUE 1802 01:05:56,800 --> 01:05:58,640 TALKING ABOUT THIS MORE IN THE 1803 01:05:58,640 --> 01:05:59,520 AFTERNOON ROUND TABLE. 1804 01:05:59,520 --> 01:06:01,320 BUT I JUST WANTED TO TURN IT 1805 01:06:01,320 --> 01:06:03,840 OVER TO BILL KLEIN FROM NCI TO 1806 01:06:03,840 --> 01:06:05,520 TALK TO US NOW. 1807 01:06:05,520 --> 01:06:06,720 >> ALL RIGHT. 1808 01:06:06,720 --> 01:06:09,720 GOOD MORNING, GOOD AFTERNOON, 1809 01:06:09,720 --> 01:06:11,320 WHERE R YOU ARE, LET ME SHARE 1810 01:06:11,320 --> 01:06:15,280 MY SCREEN. 1811 01:06:15,280 --> 01:06:18,600 CAN EVERYONE SEE THAT? 1812 01:06:18,600 --> 01:06:19,720 >> YES. 1813 01:06:19,720 --> 01:06:23,000 >> OKAY, TERRIFIC. 1814 01:06:23,000 --> 01:06:24,840 SO I WANTED TO GIVE YOU A SENSE 1815 01:06:24,840 --> 01:06:28,120 WHERE WE ARE AT NCI, A NUMBER 1816 01:06:28,120 --> 01:06:30,760 OF DIFFERENT TOPICS. 1817 01:06:30,760 --> 01:06:33,400 TOPICS RELATIVE TO KRANS, 1818 01:06:33,400 --> 01:06:34,560 TOBACCO, ALCOHOL AND CANNABIS. 1819 01:06:34,560 --> 01:06:40,280 I JUST WANT TO START BY TALKING 1820 01:06:40,280 --> 01:06:42,120 A LITTLE ABOUT LEADERSHIP AT 1821 01:06:42,120 --> 01:06:42,560 NCI. 1822 01:06:42,560 --> 01:06:44,920 I THINK YOU PROBABLY HAVE HEARD 1823 01:06:44,920 --> 01:06:46,760 OUR NCI DIRECTOR RECENTLY 1824 01:06:46,760 --> 01:06:47,440 DEPARTED. 1825 01:06:47,440 --> 01:06:50,080 AS YOU MAY OR MAY NOT KNOW, THE 1826 01:06:50,080 --> 01:06:51,920 NCI DIRECTOR IS A PRESIDENTIAL 1827 01:06:51,920 --> 01:06:53,080 APPOINTEE. 1828 01:06:53,080 --> 01:06:54,480 SO OUR DIRECTORS DON'T LAST 1829 01:06:54,480 --> 01:06:56,560 QUITE AS LONG AS DIRECTORS OF 1830 01:06:56,560 --> 01:06:59,480 OTHER INSTITUTES. 1831 01:06:59,480 --> 01:07:01,360 AND NED OUR DIRECTOR WHO HAS 1832 01:07:01,360 --> 01:07:03,720 DONE A TERRIFIC JOB, AND BY THE 1833 01:07:03,720 --> 01:07:05,800 WAY VERY SUPPORTIVE OF OUR WORK 1834 01:07:05,800 --> 01:07:07,720 ON TOBACCO AND OTHER SUBSTANCES. 1835 01:07:07,720 --> 01:07:09,000 NED DECIDED IT WAS TIME TO STEP 1836 01:07:09,000 --> 01:07:09,800 DOWN. 1837 01:07:09,800 --> 01:07:11,240 HE HAS MOVED ONTO DIFFERENT 1838 01:07:11,240 --> 01:07:11,920 THINGS. 1839 01:07:11,920 --> 01:07:13,080 WE ARE AWAITING THE APPOINTMENT 1840 01:07:13,080 --> 01:07:14,960 OF A NEW DIRECTOR, WHICH OFTEN 1841 01:07:14,960 --> 01:07:16,000 CAN TAKE SOME TIME. 1842 01:07:16,000 --> 01:07:17,320 THIS IS A PRESIDENTIAL 1843 01:07:17,320 --> 01:07:18,960 APPOINTMENT BUT NOT ONE THAT 1844 01:07:18,960 --> 01:07:20,240 NEEDS TO BE CONFIRMED BY THE 1845 01:07:20,240 --> 01:07:21,080 SENATE. 1846 01:07:21,080 --> 01:07:22,520 THAT'S ONE HOOP WE DON'T HAVE 1847 01:07:22,520 --> 01:07:23,800 TO JUMP THROUGH. 1848 01:07:23,800 --> 01:07:24,840 BUT WE AWAITING THE APPOINTMENT 1849 01:07:24,840 --> 01:07:26,920 OF A NEW DIRECTOR. 1850 01:07:26,920 --> 01:07:31,600 MOREOVER, AS YOU MAY OR MAY NOT 1851 01:07:31,600 --> 01:07:34,200 BOB CROW RETIRED LAST YEAR. 1852 01:07:34,200 --> 01:07:37,320 HE RETIRED AT THE END OF 2021. 1853 01:07:37,320 --> 01:07:39,520 AND OUR NEW DIRECTOR, LISTED ON 1854 01:07:39,520 --> 01:07:43,120 THE SLIDE IS KATRINA GODDARD, 1855 01:07:43,120 --> 01:07:45,200 GENETIC EPIDEMIOLOGIST, I'VE 1856 01:07:45,200 --> 01:07:47,240 BEEN DOING MY BEST TO KEEP HER 1857 01:07:47,240 --> 01:07:50,040 UP TO SPEED WHAT'S GOING ON 1858 01:07:50,040 --> 01:07:51,920 WITH KRAN, ABCD AND OTHER 1859 01:07:51,920 --> 01:07:53,560 PROJECTS WHICH WE COLLABORATE 1860 01:07:53,560 --> 01:07:54,520 WITH OTHER INSTITUTES. 1861 01:07:54,520 --> 01:07:55,680 SHE IS SUPPORTIVE OF OF THE 1862 01:07:55,680 --> 01:07:57,320 WORK WE ARE DOING AS WELL. 1863 01:07:57,320 --> 01:07:59,120 IF YOU DON'T KNOW OUR DIVISION 1864 01:07:59,120 --> 01:08:00,880 OR CHART, WE HAVE FOUR PROGRAMS 1865 01:08:00,880 --> 01:08:01,840 IN OUR DIVISION. 1866 01:08:01,840 --> 01:08:05,320 I LEAD THE BEHAVIORAL RESEARCH 1867 01:08:05,320 --> 01:08:10,920 PROGRAM, ONE ON HEALTHCARE, AND 1868 01:08:10,920 --> 01:08:11,680 EPIDEMIOLOGY AND GENOMICS. 1869 01:08:11,680 --> 01:08:13,320 HERE IS AN OUTLINE WHAT I WOULD 1870 01:08:13,320 --> 01:08:14,800 LIKE TO COVER IN MY TIME. 1871 01:08:14,800 --> 01:08:18,200 I WILL TALK ABOUT TOBACCO, 1872 01:08:18,200 --> 01:08:19,440 ALCOHOL AND CANNABIS WORK. 1873 01:08:19,440 --> 01:08:23,920 I WANT TO SAY A BIT ABOUT OUR 1874 01:08:23,920 --> 01:08:25,600 INVESTMENTS IN NATIVE AMERICAN 1875 01:08:25,600 --> 01:08:30,040 AND ALASKAN WORK. 1876 01:08:30,040 --> 01:08:31,520 STARTING WITH TOBACCO, I WANTED 1877 01:08:31,520 --> 01:08:33,280 TO GIVE YOU A FLAVOR FOR WHERE 1878 01:08:33,280 --> 01:08:37,240 WE ARE IN OUR PORTFOLIO. 1879 01:08:37,240 --> 01:08:38,480 OUR TOBACCO BRANCH IN OUR 1880 01:08:38,480 --> 01:08:40,440 DIVISION IS ONE OF THE LARGEST 1881 01:08:40,440 --> 01:08:42,120 BRANCHES, BOTH IN TERMS OF 1882 01:08:42,120 --> 01:08:42,800 DOLLARS AND STAFF. 1883 01:08:42,800 --> 01:08:44,680 WE HAVE PROBABLY THE MOST 1884 01:08:44,680 --> 01:08:46,080 PROGRAM DIRECTORS IN THAT 1885 01:08:46,080 --> 01:08:47,480 BRANCH RELATIVE TO OTHER 1886 01:08:47,480 --> 01:08:48,640 BRANCHES IN OUR DIVISION. 1887 01:08:48,640 --> 01:08:51,200 AND WE THINK THAT'S 1888 01:08:51,200 --> 01:08:53,720 APPROPRIATE, GIVEN THE FACT 1889 01:08:53,720 --> 01:08:56,040 THAT TOBACCO IS THE LEADING 1890 01:08:56,040 --> 01:08:58,360 CAUSE OF PREVENTABLE DEATH AND 1891 01:08:58,360 --> 01:08:59,320 PREVENTABLE CANCER AS WELL. 1892 01:08:59,320 --> 01:09:01,960 WE HAVE OVER 100 GRANTS IN OUR 1893 01:09:01,960 --> 01:09:03,320 PORTFOLIO, TOTALING OVER $54 1894 01:09:03,320 --> 01:09:04,760 MILLION IN DIRECT FUNDING. 1895 01:09:04,760 --> 01:09:07,120 RIGHT NOW WE ARE ENGAGED IN A 1896 01:09:07,120 --> 01:09:08,680 PORTFOLIO ANALYSIS FOR OUR 2021 1897 01:09:08,680 --> 01:09:09,480 PORTFOLIO. 1898 01:09:09,480 --> 01:09:11,720 I WANTED TO GIVE YOU AN EARLY 1899 01:09:11,720 --> 01:09:13,160 PEEK WHAT THIS LOOKS LIKE, WE 1900 01:09:13,160 --> 01:09:15,480 ARE STILL IN PROCESS. 1901 01:09:15,480 --> 01:09:16,400 THESE NUMBERS ARE SQUISHY. 1902 01:09:16,400 --> 01:09:17,760 BUT WANTED TO GIVE YOU A FEEL. 1903 01:09:17,760 --> 01:09:20,200 AS YOU CAN SEE HERE, WE HAVE A 1904 01:09:20,200 --> 01:09:21,840 BIG FOCUS ON CESSATION. 1905 01:09:21,840 --> 01:09:24,360 THAT'S ONE OF OF OUR BREAD AND 1906 01:09:24,360 --> 01:09:26,040 BUTTER TOPICS AT NCI. 1907 01:09:26,040 --> 01:09:30,240 P OF OUR GRANTS FOCUS ON MANY 1908 01:09:30,240 --> 01:09:32,320 TYPES OF GRANTS FOR CESSATION. 1909 01:09:32,320 --> 01:09:33,840 MOST OF THESE GRANTS ARE FOR 1910 01:09:33,840 --> 01:09:34,400 ADULTS. 1911 01:09:34,400 --> 01:09:36,520 WE ALSO DO A LOT OF WORK ON 1912 01:09:36,520 --> 01:09:39,800 POLICY RESEARCH, BECAUSE A LOT 1913 01:09:39,800 --> 01:09:43,240 OF TOBACCO POLICY INFLUENCES 1914 01:09:43,240 --> 01:09:44,400 TOBACCO-RELATED BEHAVIOR AND 1915 01:09:44,400 --> 01:09:45,800 FUNDED RESEARCH LOOKING AT 1916 01:09:45,800 --> 01:09:46,720 INDUSTRY DOCUMENTS IN THE PAST. 1917 01:09:46,720 --> 01:09:48,240 WE HAVE DONE A LOT OF WORK IN 1918 01:09:48,240 --> 01:09:48,960 THIS SPACE. 1919 01:09:48,960 --> 01:09:50,520 YOU CAN SEE SOME OF THE OTHER 1920 01:09:50,520 --> 01:09:52,400 TOPICS HERE AS WELL. 1921 01:09:52,400 --> 01:09:54,240 THIS SLIDE IS INTERESTING 1922 01:09:54,240 --> 01:09:55,880 BECAUSE IT SHOWS YOU A BIT 1923 01:09:55,880 --> 01:09:58,720 WHERE THE FOCUS IS ON PRODUCTS. 1924 01:09:58,720 --> 01:10:02,160 MOST OF FOCUS IN PASSPORT 1925 01:10:02,160 --> 01:10:03,800 PORTFOLIO HAS BEEN ON 1926 01:10:03,800 --> 01:10:04,960 COMBUSTIBLES BUT YOU CAN SEE 1927 01:10:04,960 --> 01:10:06,840 OTHERS ARE CATCHING UP. 1928 01:10:06,840 --> 01:10:09,720 WE ARE FOCUSING A GREAT DEAL 1929 01:10:09,720 --> 01:10:15,280 LATELY ON POLY USE OF TOBACCO 1930 01:10:15,280 --> 01:10:16,640 PRODUCTSMENT THIS SLIDE SHOWS 1931 01:10:16,640 --> 01:10:18,520 WHERE THE FOCUS IS, YOU CAN SEE 1932 01:10:18,520 --> 01:10:21,360 AT THE TOP, YOUTH AND YOUNG 1933 01:10:21,360 --> 01:10:22,720 ADULTS. 1934 01:10:22,720 --> 01:10:24,600 THAT'S WHEN CIGARETTE USE AND 1935 01:10:24,600 --> 01:10:25,800 TOBACCO USE IN GENERAL TENDS TO 1936 01:10:25,800 --> 01:10:26,680 BEGIN. 1937 01:10:26,680 --> 01:10:27,760 THAT'S A BIG FOCUS OF OUR 1938 01:10:27,760 --> 01:10:28,320 PORTFOLIO. 1939 01:10:28,320 --> 01:10:29,720 BUT ONE THING THAT IS NOT 1940 01:10:29,720 --> 01:10:31,360 STRONG IN OUR PORTFOLIO, WE ARE 1941 01:10:31,360 --> 01:10:33,720 LOOKING TO BUILD IS, AN 1942 01:10:33,720 --> 01:10:35,320 UNDERSTANDING HOW TO ADDRESS 1943 01:10:35,320 --> 01:10:37,160 CESSATION IN THE YOUTH AND 1944 01:10:37,160 --> 01:10:38,320 YOUNG ADULT POPULATION. 1945 01:10:38,320 --> 01:10:39,560 WHAT THE LITERATURE HAS SHOWN 1946 01:10:39,560 --> 01:10:41,120 IS MANY OF THE TREATMENT THAT'S 1947 01:10:41,120 --> 01:10:43,720 ARE SUCCESSFUL WITH ADULTS ARE 1948 01:10:43,720 --> 01:10:45,320 RELATIVELY SUCCESSFUL WITH 1949 01:10:45,320 --> 01:10:53,320 ADULTS, WHICH INCLUDES 1950 01:10:53,320 --> 01:10:56,320 PHARMACOLOGICAL INTERVENTIONS 1951 01:10:56,320 --> 01:10:59,720 LIKE BUPROPRION AND COGNITIVE 1952 01:10:59,720 --> 01:11:00,880 BEHAVIORAL THERAPY THEY DON'T 1953 01:11:00,880 --> 01:11:02,400 SEEM TO WORK AS WELL IN THIS 1954 01:11:02,400 --> 01:11:02,960 POPULATION. 1955 01:11:02,960 --> 01:11:04,840 THAT SHOULDN'T BE SURPRISING 1956 01:11:04,840 --> 01:11:06,680 GIVEN THEIR BRAINS ARE AT 1957 01:11:06,680 --> 01:11:07,840 DIFFERENT STAGE, DIFFERENT 1958 01:11:07,840 --> 01:11:09,320 LEVEL OF DEVELOPMENT AND ALSO 1959 01:11:09,320 --> 01:11:11,520 THEY TEND TO BE RESPONSIVE TO 1960 01:11:11,520 --> 01:11:13,920 DIFFERENT KINDS OF STIMULI. 1961 01:11:13,920 --> 01:11:16,000 WE REALLY NEED MORE EFFORTS TO 1962 01:11:16,000 --> 01:11:16,840 ADDRESS CESSATION IN THIS 1963 01:11:16,840 --> 01:11:18,120 POPULATION. 1964 01:11:18,120 --> 01:11:19,320 AND PARTICULARLY GIVEN THE 1965 01:11:19,320 --> 01:11:20,560 PRODUCTS THEY ARE USING ARE A 1966 01:11:20,560 --> 01:11:21,840 LITTLE DIFFERENT. 1967 01:11:21,840 --> 01:11:24,680 THERE'S MUCH MORE USE OF 1968 01:11:24,680 --> 01:11:26,040 E-CIGARETTES THAN COMBUSTIBLES 1969 01:11:26,040 --> 01:11:27,440 IN THIS POPULATION. 1970 01:11:27,440 --> 01:11:28,880 AND THAT PROFILE MAY LEAD TO A 1971 01:11:28,880 --> 01:11:30,320 DIFFERENT KIND OF THERAPY, A 1972 01:11:30,320 --> 01:11:33,520 DIFFERENT KIND OF APPROACH. 1973 01:11:33,520 --> 01:11:35,120 SO SOMETHING ELSE I WANTED TO 1974 01:11:35,120 --> 01:11:36,720 MENTION THAT'S A MAJOR PRIORITY 1975 01:11:36,720 --> 01:11:39,320 FOR US IS LOOKING AT CESSATION 1976 01:11:39,320 --> 01:11:40,480 IN CANCER PATIENTS. 1977 01:11:40,480 --> 01:11:43,040 IT MAY SHOCK YOU TO KNOW UP 1978 01:11:43,040 --> 01:11:44,920 UNTIL VERY RECENTLY, TOBACCO 1979 01:11:44,920 --> 01:11:46,880 CESSATION WAS NOT A PRIORITY AT 1980 01:11:46,880 --> 01:11:47,920 CANCER CENTERS. 1981 01:11:47,920 --> 01:11:51,000 SOME HAD IT, SOME DIDN'T, BUT 1982 01:11:51,000 --> 01:11:51,920 IT WASN'T SOMETHING AT THE 1983 01:11:51,920 --> 01:11:53,600 FRONT OF THEIR RADAR SCREEN. 1984 01:11:53,600 --> 01:11:54,720 WE CHANGED THAT. 1985 01:11:54,720 --> 01:11:58,880 WE HAD GIVEN SUPPLEMENTS TO 52 1986 01:11:58,880 --> 01:12:00,120 CANCER CENTERS TO DEVELOP 1987 01:12:00,120 --> 01:12:01,400 INFRASTRUCTURE FOR TOBACCO 1988 01:12:01,400 --> 01:12:03,680 CESSATION FOR THEIR PATIENTS. 1989 01:12:03,680 --> 01:12:07,720 THIS MONEY CAME FROM THE CANCER 1990 01:12:07,720 --> 01:12:08,920 MOONSHOT INITIATIVE, CAME OUT 1991 01:12:08,920 --> 01:12:13,600 OF THE BIDEN -- SORRY, OBAMA 1992 01:12:13,600 --> 01:12:14,920 ADMINISTRATION. 1993 01:12:14,920 --> 01:12:18,480 AND BIDEN TRYING TO KICK START 1994 01:12:18,480 --> 01:12:21,320 A MOONSHOT 2.0 RIGHT NOW WHICH 1995 01:12:21,320 --> 01:12:22,720 WILL HOPEFULLY FUND RESEARCH IN 1996 01:12:22,720 --> 01:12:24,280 THIS AND OTHER AREAS. 1997 01:12:24,280 --> 01:12:25,520 THIS CAME OUT OF CANCER 1998 01:12:25,520 --> 01:12:26,080 MOONSHOT. 1999 01:12:26,080 --> 01:12:29,520 WE HAVE BEEN FUNDING TO BUILD A 2000 01:12:29,520 --> 01:12:30,240 TOBACCO CESSATION 2001 01:12:30,240 --> 01:12:30,920 INFRASTRUCTURE FOR SEVERAL 2002 01:12:30,920 --> 01:12:32,120 YEARS. 2003 01:12:32,120 --> 01:12:34,240 WE HAVE HOPE FOR SUSTAINMENT. 2004 01:12:34,240 --> 01:12:35,400 WE HAVE BEEN TALKING ABOUT A 2005 01:12:35,400 --> 01:12:36,560 NUMBER OF DIFFERENT WAYS TO 2006 01:12:36,560 --> 01:12:37,960 MAKE SURE THIS INFRASTRUCTURE 2007 01:12:37,960 --> 01:12:44,400 IS SUSTAINEDMENT 2008 01:12:44,400 --> 01:12:45,000 EX TALKING ABOUT A NUMBER OF 2009 01:12:45,000 --> 01:12:45,560 DIFFERENT WAYS TO MAKE SURE 2010 01:12:45,560 --> 01:12:46,080 THIS INFRASTRUCTURE IS 2011 01:12:46,080 --> 01:12:46,360 SUSTAINEDMENT 2012 01:12:53,880 --> 01:12:54,520 INCLUDING MOTIVATIONAL 2013 01:12:54,520 --> 01:12:55,520 TREATMENTS FOR THOSE WHO ARE 2014 01:12:55,520 --> 01:12:56,600 NOT WILLING TO MAKE A QUIT 2015 01:12:56,600 --> 01:12:58,160 ATTEMPT. 2016 01:12:58,160 --> 01:13:00,120 AND AGAIN, THE COMMITMENT TO 2017 01:13:00,120 --> 01:13:01,320 SUSTAINING THIS PROGRAM IS VERY 2018 01:13:01,320 --> 01:13:03,960 IMPORTANT TO US. 2019 01:13:03,960 --> 01:13:06,040 I WANT TO MENTION ALSO WE 2020 01:13:06,040 --> 01:13:09,200 CONTINUE IN OUR LINE OF TOBACCO 2021 01:13:09,200 --> 01:13:09,720 MONOGRAPHS. 2022 01:13:09,720 --> 01:13:13,160 YOU MAY BE AWARE THIS IS ONE OF 2023 01:13:13,160 --> 01:13:15,920 OUR MAJOR CONTRIBUTIONS TO THE 2024 01:13:15,920 --> 01:13:16,920 TOBACCO LITERATURE, THESE 2025 01:13:16,920 --> 01:13:17,320 MONOGRAPHS. 2026 01:13:17,320 --> 01:13:19,480 WE ARE UP TO 23 NOW. 2027 01:13:19,480 --> 01:13:21,600 THIS FOCUSES ON SMOKING AND 2028 01:13:21,600 --> 01:13:22,760 CANCER PATIENTS IN PARTICULAR. 2029 01:13:22,760 --> 01:13:26,320 WE HAVE A GROUP OF EDITORS, THE 2030 01:13:26,320 --> 01:13:27,520 COMMITTEE YOU CAN SEE THE LIST 2031 01:13:27,520 --> 01:13:28,920 ON THE SLIDE HEREMENT WE HOPE 2032 01:13:28,920 --> 01:13:30,520 TO HAVE THIS MONOGRAPH OUT IN 2033 01:13:30,520 --> 01:13:40,520 THE NEXT MONTH OR SO. 2034 01:13:40,520 --> 01:13:44,880 YOU MAY NOT REALIZE, CANCER 2035 01:13:44,880 --> 01:13:46,480 SURVIVEORSHIP IS GROWING BY 2036 01:13:46,480 --> 01:13:47,600 LEAPS AND BOUNDS. 2037 01:13:47,600 --> 01:13:49,680 IF YOU LOOKED AT CANCER 50 2038 01:13:49,680 --> 01:13:51,760 YEARS AGO, IT WAS OFTEN THOUGHT 2039 01:13:51,760 --> 01:13:53,400 OF AS A DEATH SENTENCE BUT 2040 01:13:53,400 --> 01:13:55,040 THAT'S NOT THE CASE ANY MORE, 2041 01:13:55,040 --> 01:13:56,920 IT'S NOW MORE OF A CHRONIC 2042 01:13:56,920 --> 01:13:59,720 DISEASE FOR MANY TYPES OF 2043 01:13:59,720 --> 01:14:01,640 CANCER, WE NEED TO ADDRESS 2044 01:14:01,640 --> 01:14:04,360 PREVENTION IN THE CANCER 2045 01:14:04,360 --> 01:14:06,320 SURVIVEORSHIP COMMUNITY, THAT 2046 01:14:06,320 --> 01:14:07,440 INCLUDES TOBACCO CESSATION. 2047 01:14:07,440 --> 01:14:09,320 I ALSO JUST WANT TO MENTION 2048 01:14:09,320 --> 01:14:10,960 BRIEFLY WE CONTINUE TO PUT 2049 01:14:10,960 --> 01:14:18,480 INVESTMENTS IN OUR 2050 01:14:18,480 --> 01:14:20,040 SMOKEFREE.GOV INITIATIVES. 2051 01:14:20,040 --> 01:14:22,840 WITH FDA AND CDC, A TOOL TO 2052 01:14:22,840 --> 01:14:24,720 HELP SMOKERS QUIT. 2053 01:14:24,720 --> 01:14:28,440 DESIGNED IN SUCH A WAY TO BE 2054 01:14:28,440 --> 01:14:30,600 EBB IN SPACE BUT POSITIVE IN 2055 01:14:30,600 --> 01:14:31,680 ITS APPROACH. 2056 01:14:31,680 --> 01:14:33,320 IT DOESN'T BLAME. 2057 01:14:33,320 --> 01:14:34,000 GEORGE MENTIONED THE IMPORTANCE 2058 01:14:34,000 --> 01:14:37,920 OF OF NOT USING STIGMATIZING 2059 01:14:37,920 --> 01:14:39,120 WORDS, THAT'S IMPORTANT IN 2060 01:14:39,120 --> 01:14:40,480 FRAMING THE LANGUAGE. 2061 01:14:40,480 --> 01:14:41,920 HE FOCUSES ON THE POSITIVE. 2062 01:14:41,920 --> 01:14:43,200 IT'S BEEN SHOWN TO BE VERY 2063 01:14:43,200 --> 01:14:44,000 EFFECTIVE. 2064 01:14:44,000 --> 01:14:45,920 IT HELPS OUR GRANTEE COMMUNITY. 2065 01:14:45,920 --> 01:14:48,720 MANY OF OUR GRANTEES USE IT IN 2066 01:14:48,720 --> 01:14:49,600 THEIR STUDIES. 2067 01:14:49,600 --> 01:14:51,960 SOMETIMES IN FACT AS A CONTROL 2068 01:14:51,960 --> 01:14:53,200 FOR NEW INITIATIVES OR NEW 2069 01:14:53,200 --> 01:14:55,280 APPROACHES THEY ARE ATTEMPTING 2070 01:14:55,280 --> 01:15:01,440 TO BUILD. 2071 01:15:01,440 --> 01:15:05,840 I ALSO WANT TO MENTION A LOT OF 2072 01:15:05,840 --> 01:15:07,240 OUR WORK INFORMS POLICY. 2073 01:15:07,240 --> 01:15:08,680 FIRST OF ALL, IF YOU ARE 2074 01:15:08,680 --> 01:15:10,520 READING THE NEWS LATELY, AND 2075 01:15:10,520 --> 01:15:12,040 WHO WANTS TO READ THE NEWS 2076 01:15:12,040 --> 01:15:13,120 LATELY. 2077 01:15:13,120 --> 01:15:16,680 YOU MIGHT HAVE NOTICED FDA NOW 2078 01:15:16,680 --> 01:15:18,520 HAS A PROPOSED RULE ON 2079 01:15:18,520 --> 01:15:20,320 FLAVORINGS AND ALSO USE OF 2080 01:15:20,320 --> 01:15:22,000 MENTHOL AND CIGARETTES THE AND 2081 01:15:22,000 --> 01:15:24,800 A LOT OF THE LANGUAGE IN THOSE 2082 01:15:24,800 --> 01:15:26,280 RULES COMES FROM RESEARCH WE 2083 01:15:26,280 --> 01:15:27,400 HAVE SUPPORTED. 2084 01:15:27,400 --> 01:15:28,800 INCLUDING RESEARCH THAT'S BEEN 2085 01:15:28,800 --> 01:15:29,920 SUMMARIZED IN SOME OUR 2086 01:15:29,920 --> 01:15:31,840 MONOGRAPHS. 2087 01:15:31,840 --> 01:15:33,440 FOR EXAMPLE, MONOGRAPH 9 2088 01:15:33,440 --> 01:15:35,520 FOCUSES ON CIGARS, HEALTH 2089 01:15:35,520 --> 01:15:36,520 EFFECTS AND TRENDS, AS YOU CAN 2090 01:15:36,520 --> 01:15:37,440 SEE HERE. 2091 01:15:37,440 --> 01:15:39,960 THERE WAS A BIG FOCUS ON THAT 2092 01:15:39,960 --> 01:15:42,720 MONOGRAPH IN FLAVORS AND CIGARS 2093 01:15:42,720 --> 01:15:45,280 AND NOW FDA IS MOVING TO GET 2094 01:15:45,280 --> 01:15:49,240 RID OF FLAVORED CIGARS. 2095 01:15:49,240 --> 01:15:50,360 ANOTHER EXAMPLE I WANT TO 2096 01:15:50,360 --> 01:15:52,520 MENTION, WHICH I THINK IS VERY 2097 01:15:52,520 --> 01:15:53,760 TIMELY AND RELATIVE TO THE 2098 01:15:53,760 --> 01:15:56,200 TOPIC TODAY, THE FOCUS TODAY OF 2099 01:15:56,200 --> 01:15:57,840 THIS MEETING IS WE FUNDED 2100 01:15:57,840 --> 01:15:59,520 NETWORKS TO LAY THE GROUNDWORK 2101 01:15:59,520 --> 01:16:02,200 FOR THE NAVAJO NATIONS ACT OF 2102 01:16:02,200 --> 01:16:02,800 2021. 2103 01:16:02,800 --> 01:16:04,880 THIS IS REALLY NOTABLE. 2104 01:16:04,880 --> 01:16:08,360 THE FIRST COMPREHENSIVE BAN ON 2105 01:16:08,360 --> 01:16:10,720 COMMERCIAL PRODUCTS ON AMERICAN 2106 01:16:10,720 --> 01:16:11,200 INDIAN TRIBAL LANDS. 2107 01:16:11,200 --> 01:16:14,000 THIS IS A REALLY BIG DEAL. 2108 01:16:14,000 --> 01:16:19,320 WE THANK SCOTT WIESHOU AND 2109 01:16:19,320 --> 01:16:20,960 HERNANDEZ WHO PUT A LOT OF TIME 2110 01:16:20,960 --> 01:16:21,920 MAKING THIS HAPPEN. 2111 01:16:21,920 --> 01:16:24,720 OF COURSE ON THE BOTTOM I 2112 01:16:24,720 --> 01:16:28,240 INDICATE FDA PROPOSES RULES 2113 01:16:28,240 --> 01:16:29,680 PROHIBITING MENTHOL CIGARETTES 2114 01:16:29,680 --> 01:16:30,640 AND FLAVORED CIGARS. 2115 01:16:30,640 --> 01:16:33,920 NOT ONLY DOES OUR MONOGRAPH DO 2116 01:16:33,920 --> 01:16:35,320 THIS BUT MUCH OF THE RESEARCH 2117 01:16:35,320 --> 01:16:36,480 IN OUR PORTFOLIO. 2118 01:16:36,480 --> 01:16:41,640 ALL RIGHT, SO MOVING TO ALCOHOL. 2119 01:16:41,640 --> 01:16:43,240 THIS IS NOT SOMETHING THAT'S 2120 01:16:43,240 --> 01:16:45,120 GOTTEN A GREAT DEAL OF 2121 01:16:45,120 --> 01:16:46,040 ATTENTION UNTIL RECENTLY. 2122 01:16:46,040 --> 01:16:47,640 THAT'S THE LINK BETWEEN ALCOHOL 2123 01:16:47,640 --> 01:16:48,680 AND CANCERMENT ALCOHOL HAS BEEN 2124 01:16:48,680 --> 01:16:50,960 THOUGHT TO BE RELATED TO AT 2125 01:16:50,960 --> 01:16:53,120 LEAST SEVEN DIFFERENT TYPES OF 2126 01:16:53,120 --> 01:16:54,160 CANCERS, INCLUDING G.I. CANCERS 2127 01:16:54,160 --> 01:16:58,360 AND TWO OF THE LEADING CAUSES 2128 01:16:58,360 --> 01:17:03,400 OF CANCER DEATH, BREAST CANCER 2129 01:17:03,400 --> 01:17:04,320 AND COLORECTAL CANCER. 2130 01:17:04,320 --> 01:17:06,920 IT'S UP THERE ON THE LIST FOR 2131 01:17:06,920 --> 01:17:09,560 CANCER-RELATED DEATH. 2132 01:17:09,560 --> 01:17:12,560 CIGARETTE SMOKING IS UP ON THE 2133 01:17:12,560 --> 01:17:12,720 TOP. 2134 01:17:12,720 --> 01:17:16,480 ALCOHOL IS COMPARABLE TO UV 2135 01:17:16,480 --> 01:17:17,880 RADIATION, SEDENTARY BEHAVIOR 2136 01:17:17,880 --> 01:17:20,480 AND SEVERAL OTHER RISK FACTORS. 2137 01:17:20,480 --> 01:17:22,840 IT'S TO BE TAKEN SERIOUSLY. 2138 01:17:22,840 --> 01:17:24,680 WE HAVE BEEN TAKING TIME, HAVE 2139 01:17:24,680 --> 01:17:27,680 BEEN IN TOUCH WITH NIAAA AND 2140 01:17:27,680 --> 01:17:29,120 WORKING WITH GEORGE AND OTHERS 2141 01:17:29,120 --> 01:17:30,520 WHAT KINDS OF THINGS WE COULD 2142 01:17:30,520 --> 01:17:33,120 BE DOING AT NCI TO ADDRESS THIS. 2143 01:17:33,120 --> 01:17:35,040 HERE ARE A COUPLE SCREEN SHOTS 2144 01:17:35,040 --> 01:17:37,480 OF THINGS WE HAVE BEEN DOING. 2145 01:17:37,480 --> 01:17:38,840 WE PUBLISHED PAPERS, INCLUDING 2146 01:17:38,840 --> 01:17:40,840 A DRAMA COMMENTARY ON THE LEFT 2147 01:17:40,840 --> 01:17:42,880 THAT FOCUSES ON THE CLINICAL 2148 01:17:42,880 --> 01:17:44,160 NEEDS, WITH REGARD TO ALCOHOL 2149 01:17:44,160 --> 01:17:45,200 AND CANCER. 2150 01:17:45,200 --> 01:17:47,080 WE FIND, FOR EXAMPLE, MANY 2151 01:17:47,080 --> 01:17:48,480 PHYSICIANS ARE NOT ADDRESSING 2152 01:17:48,480 --> 01:17:50,040 ALCOHOL USE WITH CANCER 2153 01:17:50,040 --> 01:17:51,760 PATIENTS AND WITH THE GENERAL 2154 01:17:51,760 --> 01:17:53,160 POPULATION DESPITE THE DATA 2155 01:17:53,160 --> 01:17:54,240 SHOWING ALCOHOL IS A RISK 2156 01:17:54,240 --> 01:17:54,800 FACTOR. 2157 01:17:54,800 --> 01:17:56,920 WE HAVE HAD A NUMBER OF 2158 01:17:56,920 --> 01:17:59,040 WEBINARS, SO THOSE ARE DEPICTED 2159 01:17:59,040 --> 01:18:00,520 IN THE LOWER LEFT. 2160 01:18:00,520 --> 01:18:03,280 AND ALSO HAD A MEETING IN LATE 2161 01:18:03,280 --> 01:18:04,200 DECEMBER 2020, IN WHICH WE 2162 01:18:04,200 --> 01:18:05,920 TRIED TO GET A SENSE WHAT THE 2163 01:18:05,920 --> 01:18:06,960 GAPS ARE. 2164 01:18:06,960 --> 01:18:08,680 AND THAT LED TO A PAPER, AS YOU 2165 01:18:08,680 --> 01:18:12,600 CAN SEE ON THE BOTTOM RIGHT, 2166 01:18:12,600 --> 01:18:14,480 CANCER EPIDEMIOLOGY BIO MARKERS 2167 01:18:14,480 --> 01:18:16,640 AND PREVENTION, INCLUDING MAJOR 2168 01:18:16,640 --> 01:18:17,840 FIGURES DOING RESEARCH BETWEEN 2169 01:18:17,840 --> 01:18:19,680 ALCOHOL AND CANCER. 2170 01:18:19,680 --> 01:18:21,280 AS YOU PROBABLY KNOW, THE 2171 01:18:21,280 --> 01:18:22,920 PROFILE FOR ALCOHOL JUST LOOKS 2172 01:18:22,920 --> 01:18:26,920 VERY DIFFERENT THAN TOBACCO. 2173 01:18:26,920 --> 01:18:29,920 TOBACCO TENDS TO BE A LOWER SGS 2174 01:18:29,920 --> 01:18:31,520 TYPE OF DRUG. 2175 01:18:31,520 --> 01:18:35,080 AND ALCOHOL TENDS TO BE MORE 2176 01:18:35,080 --> 01:18:35,680 HIGHER SCS. 2177 01:18:35,680 --> 01:18:38,280 THAT ENDS UP BEING AN 2178 01:18:38,280 --> 01:18:39,440 INTERESTING ISSUE WITH 2179 01:18:39,440 --> 01:18:40,360 COMMUNICATION, AND REGARD TO 2180 01:18:40,360 --> 01:18:42,280 HOW TO THINK ABOUT IT, BOTH 2181 01:18:42,280 --> 01:18:44,120 FROM A RESEARCH PERSPECTIVE AND 2182 01:18:44,120 --> 01:18:45,320 APPLIED POLICY PERSPECTIVE. 2183 01:18:45,320 --> 01:18:47,600 WE HAVE TALKED A LOT ABOUT HOW 2184 01:18:47,600 --> 01:18:48,800 TO ADDRESS THAT, AND THE 2185 01:18:48,800 --> 01:18:50,920 CONTEXT OF THE WORK THAT WE DO. 2186 01:18:50,920 --> 01:18:52,320 THIS IS NOT SOMETHING THAT IS 2187 01:18:52,320 --> 01:18:54,000 GOING TO GO AWAY. 2188 01:18:54,000 --> 01:18:56,520 WE KNOW FOR EXAMPLE, THERE'S A 2189 01:18:56,520 --> 01:18:58,080 LINEAR RELATIONSHIP BETWEEN 2190 01:18:58,080 --> 01:18:59,720 ALCOHOL USE AND BREAST CANCER 2191 01:18:59,720 --> 01:19:00,520 RISK. 2192 01:19:00,520 --> 01:19:02,320 THAT FLIES IN THE FACE OF THE 2193 01:19:02,320 --> 01:19:04,480 J-CURVE IN THE CASE WHERE 2194 01:19:04,480 --> 01:19:05,640 MODERATE DRINKING MAY BE 2195 01:19:05,640 --> 01:19:07,040 HEALTHY, THAT DOESN'T SEEM TO 2196 01:19:07,040 --> 01:19:08,640 BE HOLDING UP, AT LEAST IN 2197 01:19:08,640 --> 01:19:09,920 REGARDS TO CERTAIN TYPES OF 2198 01:19:09,920 --> 01:19:10,520 CANCER. 2199 01:19:10,520 --> 01:19:12,880 LET ME SAY A BIT ABOUT CANNABIS. 2200 01:19:12,880 --> 01:19:14,040 THIS IS NEW FOR US. 2201 01:19:14,040 --> 01:19:15,920 WE DON'T HAVE MUCH OF A 2202 01:19:15,920 --> 01:19:18,120 PORTFOLIO ON CANNABIS. 2203 01:19:18,120 --> 01:19:20,360 NIDA HAS DONE MUCH MORE WITH 2204 01:19:20,360 --> 01:19:21,760 CANNABIS THAN WE HAVE, BUT IT'S 2205 01:19:21,760 --> 01:19:22,920 SOMETHING WE NEED TODAY JUMP 2206 01:19:22,920 --> 01:19:23,680 INTO. 2207 01:19:23,680 --> 01:19:25,280 I WILL MENTION A COUPLE WAYS 2208 01:19:25,280 --> 01:19:26,440 WHICH WE HAVE DONE THAT. 2209 01:19:26,440 --> 01:19:28,120 FIRST OF ALL, WE ARE VERY 2210 01:19:28,120 --> 01:19:29,520 INTERESTED IN UNDERSTANDING HOW 2211 01:19:29,520 --> 01:19:30,640 CANNABIS IS RELATED TO TOBACCO 2212 01:19:30,640 --> 01:19:32,760 USE. 2213 01:19:32,760 --> 01:19:34,360 CLEARLY, ONE CAN CERTIFY AS A 2214 01:19:34,360 --> 01:19:35,640 GATEWAY FOR THE OTHER. 2215 01:19:35,640 --> 01:19:37,200 WE SEE A LOT OF CO-USE. 2216 01:19:37,200 --> 01:19:38,600 WE ARE INTERESTED IN 2217 01:19:38,600 --> 01:19:39,760 UNDERSTANDING WHAT THAT LOOKS 2218 01:19:39,760 --> 01:19:41,920 LIKE AND HAVE BEEN ENGAGED IN 2219 01:19:41,920 --> 01:19:43,120 PROVIDING FUNDING TO 2220 01:19:43,120 --> 01:19:45,480 INVESTIGATORS TO LOOK AT THIS 2221 01:19:45,480 --> 01:19:45,800 RELATIONSHIP. 2222 01:19:45,800 --> 01:19:47,320 WE ARE ALSO INTERESTED IN 2223 01:19:47,320 --> 01:19:48,520 UNDERSTANDING HOW CANNABIS IS 2224 01:19:48,520 --> 01:19:50,640 BEING USED BY OUR CANCER 2225 01:19:50,640 --> 01:19:51,920 PATIENTS PARTICULARLY AT CANCER 2226 01:19:51,920 --> 01:19:52,760 CENTERS. 2227 01:19:52,760 --> 01:19:55,760 RECENTLY AS YOU CAN SEE HERE, 2228 01:19:55,760 --> 01:19:57,120 WE GIVEN ADMINISTRATIVE 2229 01:19:57,120 --> 01:19:58,600 SUPPLEMENTS TO A NUMBER OF 2230 01:19:58,600 --> 01:19:59,760 CANCER CENTERS A IS KRO THE 2231 01:19:59,760 --> 01:20:02,280 COUNTRY TO DO A BETTER JOB 2232 01:20:02,280 --> 01:20:03,960 WHAT'S TRACKING AMONG THEIR 2233 01:20:03,960 --> 01:20:05,040 CANCER PATIENTS. 2234 01:20:05,040 --> 01:20:06,600 THERE ARE TWO WAYS TO THINK 2235 01:20:06,600 --> 01:20:07,800 ABOUT CANNABIS IN THE CONTEXT 2236 01:20:07,800 --> 01:20:08,720 OF CANCER. 2237 01:20:08,720 --> 01:20:10,680 ONE IS AS A PREDICTIVE RISK 2238 01:20:10,680 --> 01:20:11,600 FACTOR. 2239 01:20:11,600 --> 01:20:14,360 CANNABIS CAN BE A GATEWAY TO 2240 01:20:14,360 --> 01:20:16,040 TOBACCO USE, PREDICTIVE OF A 2241 01:20:16,040 --> 01:20:18,640 VARIETY OF CANCER OUTCOMES, OF 2242 01:20:18,640 --> 01:20:20,920 COURSE. 2243 01:20:20,920 --> 01:20:22,200 CANNABIS ITSELF IS BEING USED 2244 01:20:22,200 --> 01:20:22,840 IN TREATMENT. 2245 01:20:22,840 --> 01:20:25,160 SO WE HAD A MEETING IN LATE 2246 01:20:25,160 --> 01:20:26,120 DECEMBER OF 2020. 2247 01:20:26,120 --> 01:20:28,240 COVERING A NUMBER OF DIFFERENT 2248 01:20:28,240 --> 01:20:30,120 TOPICS IN THIS UNIVERSE. 2249 01:20:30,120 --> 01:20:32,400 SO FOR EXAMPLE, NON MEDICAL 2250 01:20:32,400 --> 01:20:35,000 CANNABIS USE AND CANCER 2251 01:20:35,000 --> 01:20:36,680 EPIDEMIOLOGY, CANCER BIOLOGY 2252 01:20:36,680 --> 01:20:38,080 AND PREVENTION, NAVIGATING 2253 01:20:38,080 --> 01:20:38,840 RESEARCH CHALLENGES FOR 2254 01:20:38,840 --> 01:20:39,680 CANNABIS RESEARCH. 2255 01:20:39,680 --> 01:20:40,920 SO TRIED TO COVER THE SPECTRUM 2256 01:20:40,920 --> 01:20:42,120 HERE. 2257 01:20:42,120 --> 01:20:45,960 AS A RESULT OF THIS, WE ARE NOW 2258 01:20:45,960 --> 01:20:48,320 TRYING TO THINK ABOUT WHAT KIND 2259 01:20:48,320 --> 01:20:49,880 OF INITIATIVES WE SHOULD PUT 2260 01:20:49,880 --> 01:20:51,960 OUT THERE TO GET A SENSE WHAT 2261 01:20:51,960 --> 01:20:53,320 THE CANNABIS LANDSCAPE WILL BE 2262 01:20:53,320 --> 01:20:55,960 OVER THE NEXT 10-20 YEARS, 2263 01:20:55,960 --> 01:20:57,560 RELEVANT TO CANCER AND CANCER 2264 01:20:57,560 --> 01:20:58,320 OUTCOMES. 2265 01:20:58,320 --> 01:21:00,960 SO HOW AND WHY ARE CANCER 2266 01:21:00,960 --> 01:21:02,120 PATIENTS USING CANNABIS? 2267 01:21:02,120 --> 01:21:04,480 WE NEED TO UNDERSTAND MODE, 2268 01:21:04,480 --> 01:21:05,400 DOSAGE, FREQUENCY, WHAT 2269 01:21:05,400 --> 01:21:06,560 PRODUCTS THEY ARE USING BECAUSE 2270 01:21:06,560 --> 01:21:08,480 THERE ARE SO MANY OPTIONS WHA. 2271 01:21:08,480 --> 01:21:11,400 ARE THE BENEFITS AND HARMS. 2272 01:21:11,400 --> 01:21:12,680 YOU HAVE TO THINK ABOUT THAT 2273 01:21:12,680 --> 01:21:15,000 WITH REGARD TO CANCER AND ITS 2274 01:21:15,000 --> 01:21:16,480 TREATMENTS. 2275 01:21:16,480 --> 01:21:18,520 DOES CANNABIS USE MODERATE 2276 01:21:18,520 --> 01:21:19,920 EFFECTS OF CANCER TREATMENTS 2277 01:21:19,920 --> 01:21:21,760 THE WAY NUTRITION AND PHYSICAL 2278 01:21:21,760 --> 01:21:23,440 ACTIVITY ARE NOW BEING FOUND TO 2279 01:21:23,440 --> 01:21:25,760 DOMENT WHAT ABOUT CO-MORBIDITY 2280 01:21:25,760 --> 01:21:26,920 WITH OTHER MEDICATIONS? 2281 01:21:26,920 --> 01:21:28,800 AGAIN, THIS IS A FAIRLY NEW 2282 01:21:28,800 --> 01:21:30,920 TOPIC FOR US BUT ONE WE CLEARLY 2283 01:21:30,920 --> 01:21:33,280 NEED TO JUMP INTO HEAD-FIRST 2284 01:21:33,280 --> 01:21:36,320 GIVEN THE GREATER ACCESSIBILITY 2285 01:21:36,320 --> 01:21:38,400 OF CANNABIS IN THE POPULATION. 2286 01:21:38,400 --> 01:21:39,760 LET ME MOVE TO WORK WE ARE 2287 01:21:39,760 --> 01:21:45,880 DOING IN THE AMERICAN INDIAN 2288 01:21:45,880 --> 01:21:47,000 ALASKA NATIVE SPACE. 2289 01:21:47,000 --> 01:21:48,640 I WANTED TO NOTE THE 2290 01:21:48,640 --> 01:21:50,240 INTERVENTION RESEARCH TO 2291 01:21:50,240 --> 01:21:54,520 IMPROVE NATIVE AMERICAN HEALTH 2292 01:21:54,520 --> 01:21:59,120 INITIATIVE OR THE RINA. 2293 01:21:59,120 --> 01:22:03,920 WE INITIATED THIS INITIATIVE IN 2294 01:22:03,920 --> 01:22:06,720 2011, NOW LED BY NIDA STARTING 2295 01:22:06,720 --> 01:22:07,200 2021. 2296 01:22:07,200 --> 01:22:10,320 WE HAVE A NUMBER OF IC'S 2297 01:22:10,320 --> 01:22:11,240 INSTITUTES AND CENTERS, 2298 01:22:11,240 --> 01:22:12,720 INVOLVED AND FUNDED A NUMBER OF 2299 01:22:12,720 --> 01:22:13,560 DIFFERENT GRANTS. 2300 01:22:13,560 --> 01:22:14,480 INCLUDING ONE ON SMOKING 2301 01:22:14,480 --> 01:22:15,440 CESSATION. 2302 01:22:15,440 --> 01:22:18,000 BUT THE ENTIRE FOCUS HERE IS TO 2303 01:22:18,000 --> 01:22:20,360 TRY TO DESIGN INTERVENTIONS TO 2304 01:22:20,360 --> 01:22:21,320 ADDRESS HEALTH BEHAVIORS THAT 2305 01:22:21,320 --> 01:22:23,240 HAVE AN IMPACT ON CANCER AND 2306 01:22:23,240 --> 01:22:25,680 OTHER OUTCOMES. 2307 01:22:25,680 --> 01:22:26,680 HERE IS ANOTHER ONE. 2308 01:22:26,680 --> 01:22:29,680 WE HAVE BEEN INTERESTED IN COLO 2309 01:22:29,680 --> 01:22:31,760 RECTAL CANCER SCREENING IN 2310 01:22:31,760 --> 01:22:32,920 AMERICAN INDIAN COMMUNITIES. 2311 01:22:32,920 --> 01:22:35,280 WE AGAIN ARE USING OUR CANCER 2312 01:22:35,280 --> 01:22:37,560 MOONSHOT FUNDS FOR THIS. 2313 01:22:37,560 --> 01:22:39,720 WE SUPPLEMENTED NCI DESIGNATED 2314 01:22:39,720 --> 01:22:41,120 CANCER CENTERS TO TAKE A LOOK 2315 01:22:41,120 --> 01:22:43,240 AT CANCER SCREENING IN SPECIAL 2316 01:22:43,240 --> 01:22:44,360 POPULATIONS, PARTICULARLY THE 2317 01:22:44,360 --> 01:22:45,320 AMERICAN INDIAN POPULATION. 2318 01:22:45,320 --> 01:22:47,600 THIS IS A PARALLEL EFFORT TO 2319 01:22:47,600 --> 01:22:49,560 ACCESS, WHICH I THINK IS A FUN 2320 01:22:49,560 --> 01:22:50,640 ACRONYM. 2321 01:22:50,640 --> 01:22:54,600 THIS STANDS FOR ACCELERATING 2322 01:22:54,600 --> 01:22:55,760 COLORECTAL CANCER SCREENING 2323 01:22:55,760 --> 01:22:59,480 THROUGH FOLLOW-UP AND SCIENCE. 2324 01:22:59,480 --> 01:23:01,560 CANCER MOONSHOT FUNDED 2325 01:23:01,560 --> 01:23:03,440 INITIATIVE THAT LOOKS AT HOW WE 2326 01:23:03,440 --> 01:23:06,560 CAN REALLY INCREASE COLORECTAL 2327 01:23:06,560 --> 01:23:07,400 CANCER SCREENING AND MAKE IT 2328 01:23:07,400 --> 01:23:08,400 EASIER. 2329 01:23:08,400 --> 01:23:09,320 THREE INVESTIGATORS ARE IN 2330 01:23:09,320 --> 01:23:11,000 PLACE WHERE'S THERE IS A HIGH 2331 01:23:11,000 --> 01:23:12,640 POPULATION OF AMERICAN INDIANS. 2332 01:23:12,640 --> 01:23:14,760 AND A LOT OF FOCUS ON THESE 2333 01:23:14,760 --> 01:23:16,600 GRANTS IS TO TRY TO INCREASE 2334 01:23:16,600 --> 01:23:20,400 SCREENING IN THOSE POPULATIONS. 2335 01:23:20,400 --> 01:23:22,960 SO JUST A BIT ABOUT FUNDING. 2336 01:23:22,960 --> 01:23:25,280 ONE OF THE GREAT RESOURCES WE 2337 01:23:25,280 --> 01:23:27,120 HAVE AT NCI IS OUR CANCER 2338 01:23:27,120 --> 01:23:28,040 CENTERS. 2339 01:23:28,040 --> 01:23:30,840 THEY DO A GREAT JOB OF 2340 01:23:30,840 --> 01:23:33,360 ADDRESSING MAJOR RESEARCH 2341 01:23:33,360 --> 01:23:35,520 PRIORITIES IN WAYS THAT 2342 01:23:35,520 --> 01:23:37,920 LEVERAGE OUR FUNDING BECAUSE WE 2343 01:23:37,920 --> 01:23:39,800 HAVE TO USE THAT INFRASTRUCTURE 2344 01:23:39,800 --> 01:23:42,520 TO THE BEST WE CAN. 2345 01:23:42,520 --> 01:23:44,320 TO ADDRESS SOME OF THE RESEARCH 2346 01:23:44,320 --> 01:23:46,920 QUESTIONS WE HAVE. 2347 01:23:46,920 --> 01:23:49,720 OBVIOUSLY MOST OF OUR RESEARCH 2348 01:23:49,720 --> 01:23:50,920 GOES TO INITIATOR RESEARCH AND 2349 01:23:50,920 --> 01:23:52,520 THAT'S THE WAY IT SHOULD BE. 2350 01:23:52,520 --> 01:23:53,880 BUT SOMETIMES WE HAVE QUESTIONS 2351 01:23:53,880 --> 01:23:55,960 THAT ARE VERY TIME-SENSITIVE 2352 01:23:55,960 --> 01:23:57,160 AND IT'S USEFUL TO HAVE THIS 2353 01:23:57,160 --> 01:23:58,120 INFRASTRUCTURE TO WORK WITH. 2354 01:23:58,120 --> 01:24:00,000 OVER THE LAST SEVERAL YEARS WE 2355 01:24:00,000 --> 01:24:01,440 HAVE BEEN PROVIDING SUPPLEMENTS 2356 01:24:01,440 --> 01:24:03,920 AS I INDICATED ON OTHER SLIDES 2357 01:24:03,920 --> 01:24:06,720 TO OUR CANCER CENTERS TO 2358 01:24:06,720 --> 01:24:07,240 ADDRESS TIME-SENSITIVE 2359 01:24:07,240 --> 01:24:07,920 QUESTIONS. 2360 01:24:07,920 --> 01:24:09,560 SOME HAVE CENTERED ON TOPICS 2361 01:24:09,560 --> 01:24:11,440 RELATIVE TO THIS GROUP. 2362 01:24:11,440 --> 01:24:12,360 INCLUDING TOBACCO CESSATION, 2363 01:24:12,360 --> 01:24:15,440 CANNABIS USE AND ALSO THE 2364 01:24:15,440 --> 01:24:18,320 CANCER CENTER CESSATION 2365 01:24:18,320 --> 01:24:19,480 INITIATIVE OR C3I I MENTIONED 2366 01:24:19,480 --> 01:24:20,840 BEFORE. 2367 01:24:20,840 --> 01:24:22,000 BRIEFLY, I WILL MENTION WE HAVE 2368 01:24:22,000 --> 01:24:23,680 A NUMBER OF FUNDING INITIATIVES 2369 01:24:23,680 --> 01:24:24,360 ON THE STREET. 2370 01:24:24,360 --> 01:24:26,280 YOU CAN GO TO OUR WEBSITE AND 2371 01:24:26,280 --> 01:24:28,320 SEE THESE AND OTHERS, OF COURSE. 2372 01:24:28,320 --> 01:24:31,840 WE HAVE A NO C ON MECHANISMS OF 2373 01:24:31,840 --> 01:24:34,680 CANNABIS AND CANNABINOID ACTION. 2374 01:24:34,680 --> 01:24:37,480 ANOTHER ADMINISTRATIVE 2375 01:24:37,480 --> 01:24:38,600 SUPPLEMENTS. 2376 01:24:38,600 --> 01:24:40,200 ONE ON POLICY EFFECTS ON 2377 01:24:40,200 --> 01:24:44,840 ALCOHOL AND CANNABIS, TOBACCO. 2378 01:24:44,840 --> 01:24:47,920 IF YOU DON'T REMEMBER A NOCI, 2379 01:24:47,920 --> 01:24:48,840 REPLACEMENT FOR PROGRAM 2380 01:24:48,840 --> 01:24:49,760 ANNOUNCEMENT. 2381 01:24:49,760 --> 01:24:50,760 JUST AN ANNOUNCEMENT OF 2382 01:24:50,760 --> 01:24:51,520 SOMETHING WHICH WE ARE 2383 01:24:51,520 --> 01:24:55,280 INTERESTED. 2384 01:24:55,280 --> 01:24:58,280 WE ALSO HAVE A NUMBER OF 2385 01:24:58,280 --> 01:24:59,680 P.A.R.'S AND R.F.A.'S IN THESE 2386 01:24:59,680 --> 01:25:00,440 AREAS. 2387 01:25:00,440 --> 01:25:02,120 I WON'T GO THROUGH ALL OF THEM 2388 01:25:02,120 --> 01:25:04,440 BUT THESE ARE ALL DESIGNED TO 2389 01:25:04,440 --> 01:25:05,080 CAPTURE MORE RESEARCH IN THE 2390 01:25:05,080 --> 01:25:06,320 SPACE. 2391 01:25:06,320 --> 01:25:08,120 BECAUSE OUR PORTFOLIO IS RATHER 2392 01:25:08,120 --> 01:25:10,200 WEEK IN MANY OF THE AREAS I'VE 2393 01:25:10,200 --> 01:25:11,160 TALKED ABOUT. 2394 01:25:11,160 --> 01:25:13,520 I WILL PASS THROUGH THIS AND GO 2395 01:25:13,520 --> 01:25:15,080 TO THIS POINT, I WANT TO MAKE, 2396 01:25:15,080 --> 01:25:17,120 WHICH I TRY TO MAKE IN ALL OF 2397 01:25:17,120 --> 01:25:18,240 OUR PRESENTATIONS, WHICH IS 2398 01:25:18,240 --> 01:25:19,600 THAT WE DON'T JUST HAVE GRANTS 2399 01:25:19,600 --> 01:25:20,720 IN OUR PORTFOLIO. 2400 01:25:20,720 --> 01:25:23,320 WE ALSO DEVELOP A NUMBER OF 2401 01:25:23,320 --> 01:25:26,680 DATA COLLECTION OPPORTUNITIES. 2402 01:25:26,680 --> 01:25:28,800 AND RESOURCES ONE IS THE HEALTH 2403 01:25:28,800 --> 01:25:29,960 INFORMATION NATIONAL TREND 2404 01:25:29,960 --> 01:25:34,760 SURVEY, WHICH WE DO YEARLY OR 2405 01:25:34,760 --> 01:25:37,280 BIYEARLY BASIS. 2406 01:25:37,280 --> 01:25:40,720 HENCE CONTAINS DATA ON ALCOHOL 2407 01:25:40,720 --> 01:25:43,040 RISK PERCEPTIONS, TOBACCO USE, 2408 01:25:43,040 --> 01:25:44,200 E-CIGARETTE AND SO ON. 2409 01:25:44,200 --> 01:25:46,040 THESE ARE PUBLIC USE DATA 2410 01:25:46,040 --> 01:25:47,440 AVAILABLE TO ANYONE. 2411 01:25:47,440 --> 01:25:48,640 COULD BE DOWNLOADED QUITE 2412 01:25:48,640 --> 01:25:49,040 EASILY. 2413 01:25:49,040 --> 01:25:51,800 WHEN I WAS A FACULTY MEMBER AT 2414 01:25:51,800 --> 01:25:52,760 UNIVERSITY OF PITTSBURGH BEFORE 2415 01:25:52,760 --> 01:25:54,640 COMING HERE TO THE NATIONAL 2416 01:25:54,640 --> 01:25:56,040 CANCER INSTITUTE, ONE OF THE 2417 01:25:56,040 --> 01:25:58,480 THINGS I DID WAS DOWNLOAD HINTS 2418 01:25:58,480 --> 01:25:59,080 FOR THEM. 2419 01:25:59,080 --> 01:26:01,320 IT'S A GREAT WAY TO GET A 2420 01:26:01,320 --> 01:26:02,440 FIRST-YEAR PUBLICATION. 2421 01:26:02,440 --> 01:26:03,960 IT'S A REALLY EASY DATA SET TO 2422 01:26:03,960 --> 01:26:05,480 USE. 2423 01:26:05,480 --> 01:26:06,880 NOT AS COMPLICATED AS SOME 2424 01:26:06,880 --> 01:26:08,240 OTHERS AND HAS MANY OF THE 2425 01:26:08,240 --> 01:26:09,640 KINDS OF QUESTIONS AND 2426 01:26:09,640 --> 01:26:11,520 CONSTRUCTS OF INTEREST TO THIS 2427 01:26:11,520 --> 01:26:12,920 GROUP, TO THIS AUDIENCE. 2428 01:26:12,920 --> 01:26:15,280 WE ALSO PUT A LOT OF INVESTMENT 2429 01:26:15,280 --> 01:26:18,320 IN THE TOBACCO USE SUPPLEMENT 2430 01:26:18,320 --> 01:26:19,320 CURRENT POPULATION SURVEY. 2431 01:26:19,320 --> 01:26:21,520 SO THIS, OF COURSE, IS A HUGE 2432 01:26:21,520 --> 01:26:22,320 SAMPLE. 2433 01:26:22,320 --> 01:26:23,960 THINK ABOUT THE CURRENT 2434 01:26:23,960 --> 01:26:25,440 POPULATION SURVEY, RIGHT? 2435 01:26:25,440 --> 01:26:26,720 WE ARE TALKING TENS OF 2436 01:26:26,720 --> 01:26:28,880 THOUSANDS OF PEOPLE RATHER THAN 2437 01:26:28,880 --> 01:26:30,080 2,000 OR 3,000. 2438 01:26:30,080 --> 01:26:31,440 THESE DATA HAVE BEEN 2439 01:26:31,440 --> 01:26:32,600 PARTICULARLY USEFUL IN TRACKING 2440 01:26:32,600 --> 01:26:35,160 THE USE OF DIFFERENT KINDS OF 2441 01:26:35,160 --> 01:26:36,360 TOBACCO PRODUCTS OVER TIME. 2442 01:26:36,360 --> 01:26:38,280 IN ADDITION TO THAT, WE ARE 2443 01:26:38,280 --> 01:26:40,320 ABLE TO LINK THOSE TOBACCO USE 2444 01:26:40,320 --> 01:26:45,120 DATA TO THE NATIONAL 2445 01:26:45,120 --> 01:26:46,080 LONGITUDINAL MORTALITY STUDY, 2446 01:26:46,080 --> 01:26:49,400 WHICH IS USEFUL, WE CAN UNLINK 2447 01:26:49,400 --> 01:26:50,120 DIFFERENT PATTERNS AND 2448 01:26:50,120 --> 01:26:51,760 DIFFERENT TYPES OF TOBACCO 2449 01:26:51,760 --> 01:26:53,120 PRODUCTS TO CANCER OUTCOMES. 2450 01:26:53,120 --> 01:26:55,240 AS NOTED IN THE SLIDE WE ARE 2451 01:26:55,240 --> 01:26:58,280 PREPARING TO FIELD THE NEXT 2452 01:26:58,280 --> 01:26:59,520 WAVE, REVISING THE 2453 01:26:59,520 --> 01:27:02,080 QUESTIONNAIRE TO REMOVE 2454 01:27:02,080 --> 01:27:04,200 OUTDATED ITEMS AND REVISE BASED 2455 01:27:04,200 --> 01:27:05,640 ON RESAANICH SOUTH AND CONSUMER 2456 01:27:05,640 --> 01:27:08,680 DATA. 2457 01:27:08,680 --> 01:27:09,600 THE TOBACCO LANDSCAPE IS 2458 01:27:09,600 --> 01:27:11,680 CHANGING ON A REGULAR BASISMENT 2459 01:27:11,680 --> 01:27:13,320 WE ARE CONSTANTLY NEEDING TO 2460 01:27:13,320 --> 01:27:15,440 CHANGE AND RETHINK ITEMS IN ALL 2461 01:27:15,440 --> 01:27:17,160 OF THESE SURVEYS. 2462 01:27:17,160 --> 01:27:19,160 ALSO, I HIGHLIGHT HERE WE HAVE 2463 01:27:19,160 --> 01:27:21,520 A FOUR-PART WEBINAR SERIES IN 2464 01:27:21,520 --> 01:27:23,680 2021 THAT'S STILL AVAILABLE 2465 01:27:23,680 --> 01:27:25,560 ALONG WITH ALL OF OUR WEBINARS 2466 01:27:25,560 --> 01:27:26,800 AND I ENCOURAGE YOU TO TAKE A 2467 01:27:26,800 --> 01:27:30,120 LOOK AT THOSE. 2468 01:27:30,120 --> 01:27:31,760 AND JUST BY SAYING WE HAVE A 2469 01:27:31,760 --> 01:27:33,120 WEBSITE AND I ENCOURAGE YOU TO 2470 01:27:33,120 --> 01:27:34,520 TAKE A LOOK AT THAT. 2471 01:27:34,520 --> 01:27:36,400 IT HAS FUNDING OPPORTUNITIES, 2472 01:27:36,400 --> 01:27:37,960 CAREER OPPORTUNITIES, ALL OF 2473 01:27:37,960 --> 01:27:38,920 OUR RESEARCH PRIORITIES. 2474 01:27:38,920 --> 01:27:41,520 WE HAVE A TWITTER FEED AND A 2475 01:27:41,520 --> 01:27:43,400 NEWSLETTER THAT GOES OUT ON A 2476 01:27:43,400 --> 01:27:44,520 QUARTERLY BASIS. 2477 01:27:44,520 --> 01:27:45,920 WE ENCOURAGE PEOPLE TO SIGN UP 2478 01:27:45,920 --> 01:27:47,200 FOR THAT AS WELL. 2479 01:27:47,200 --> 01:27:48,480 THAT WAS IT FOR ME. 2480 01:27:48,480 --> 01:27:50,120 I'M HAPPY TO TAKE ANY QUESTIONS 2481 01:27:50,120 --> 01:28:00,120 IF WE HAVE SOME TIME. 2482 01:28:00,120 --> 01:28:01,600 >> I HAVE A QUESTION. 2483 01:28:01,600 --> 01:28:03,600 THANK YOU SO MUCH FOR THAT 2484 01:28:03,600 --> 01:28:04,280 PRESENTATION, IT'S REALLY GREAT 2485 01:28:04,280 --> 01:28:08,280 TO HEAR THE COLLABORATIONS WITH 2486 01:28:08,280 --> 01:28:10,120 NIAAA AND EMPHASIS ON ALCOHOL 2487 01:28:10,120 --> 01:28:12,240 AND FOCUS ON CANNABIS. 2488 01:28:12,240 --> 01:28:14,320 SO BROADENING THAT PORTFOLIO. 2489 01:28:14,320 --> 01:28:16,920 I WANT TO JUST RAISE ONE OTHER 2490 01:28:16,920 --> 01:28:19,760 ASPECT WHICH WE DO QUITE A BIT 2491 01:28:19,760 --> 01:28:22,080 OF WORK THAT HAS TO DO WITH 2492 01:28:22,080 --> 01:28:23,680 TRAUMATIC STRESS AND THE 2493 01:28:23,680 --> 01:28:26,240 LANDSCAPE OF TRAUMA AND ITS 2494 01:28:26,240 --> 01:28:27,800 EFFECTS CURRENTLY. 2495 01:28:27,800 --> 01:28:31,880 PARTICULARLY, WE HAVE A LOT OF 2496 01:28:31,880 --> 01:28:33,520 INFORMATION NOW ON BRAIN 2497 01:28:33,520 --> 01:28:38,640 MECHANISMS BY WHICH THESE 2498 01:28:38,640 --> 01:28:40,000 REALLY HORRENDOUS DISASTROUS 2499 01:28:40,000 --> 01:28:42,920 EVENTS OCCURRING ON A DAILY 2500 01:28:42,920 --> 01:28:45,680 BASIS ARE AFFECTING OUR SELF 2501 01:28:45,680 --> 01:28:47,320 CONTROL, OUR ABILITY TO 2502 01:28:47,320 --> 01:28:48,640 REGULATE OUR EMOTIONS AND USE 2503 01:28:48,640 --> 01:28:49,240 PATTERNS. 2504 01:28:49,240 --> 01:28:50,840 ALMOST LIKE THE CAUSE OF CAUSES. 2505 01:28:50,840 --> 01:28:55,320 THE REASON I BRING IT UP, YOU 2506 01:28:55,320 --> 01:28:57,160 KNOW, VERY WELL LOOKS LIKE IT 2507 01:28:57,160 --> 01:28:59,640 COULD BE, WHEN WE TARGET 2508 01:28:59,640 --> 01:29:01,280 BEHAVIORS THAT ARE SORT OF DOWN 2509 01:29:01,280 --> 01:29:02,920 THE ROAD A LITTLE BIT. 2510 01:29:02,920 --> 01:29:05,960 SO THINKING ABOUT PREVENTION 2511 01:29:05,960 --> 01:29:07,000 AND EARLY INTERVENTION, IT 2512 01:29:07,000 --> 01:29:18,720 WOULD BE IMPORTANT TO RECOGNIZE 2513 01:29:18,720 --> 01:29:21,640 THOSE FACTORS. 2514 01:29:21,640 --> 01:29:26,240 THINGS LEADING TO MAJOR 2515 01:29:26,240 --> 01:29:27,640 DELETERIOUS EFFECTS OF TRAUMA 2516 01:29:27,640 --> 01:29:29,240 ON PEOPLE AND WHEN WE START TO 2517 01:29:29,240 --> 01:29:31,640 THINK AT WHO IS AT RISK FOR 2518 01:29:31,640 --> 01:29:34,400 HEALTH BEHAVIORS, OF COURSE 2519 01:29:34,400 --> 01:29:35,520 THOSE ADVERSITY-RELATED CANCER 2520 01:29:35,520 --> 01:29:36,040 RISK. 2521 01:29:36,040 --> 01:29:37,440 IT SEEMS LIKE IT'S AN 2522 01:29:37,440 --> 01:29:44,640 OPPORTUNITY THAT IS NOT -- AN 2523 01:29:44,640 --> 01:29:46,480 OPPORTUNITY WASTED IN TERMS OF 2524 01:29:46,480 --> 01:29:47,440 TARGETING AND PUTTING SOME 2525 01:29:47,440 --> 01:29:48,120 FOCUS ON IT. 2526 01:29:48,120 --> 01:29:49,360 ANY THOUGHTS OF THAT? 2527 01:29:49,360 --> 01:29:51,320 >> YEAH, THANK YOU. 2528 01:29:51,320 --> 01:29:52,040 REALLY INTERESTING THOUGHTS AND 2529 01:29:52,040 --> 01:29:52,520 QUESTION. 2530 01:29:52,520 --> 01:29:55,360 I THINK A LOT OF THE FOCUS ORE 2531 01:29:55,360 --> 01:29:58,360 THE LAST SAY 40-50 YEARS IN 2532 01:29:58,360 --> 01:30:00,280 CANCER EPIDEMIOLOGY HAS BEEN ON 2533 01:30:00,280 --> 01:30:06,440 SINGLE EXPOSURES. 2534 01:30:06,440 --> 01:30:09,240 OFTEN THEY FOCUSED ON 2535 01:30:09,240 --> 01:30:10,360 ENVIRONMENTAL AND BEHAVIORAL 2536 01:30:10,360 --> 01:30:11,960 FACTORS LIKE TOBACCO AND LESS 2537 01:30:11,960 --> 01:30:12,960 ON STRESS. 2538 01:30:12,960 --> 01:30:15,040 THERE'S BEEN MORE INTEREST THE 2539 01:30:15,040 --> 01:30:17,120 LAST 10-15 YEARS ON THE EFFECTS 2540 01:30:17,120 --> 01:30:21,400 OF STRESS AND WORK OF PSYCHO 2541 01:30:21,400 --> 01:30:23,120 NEUROLOGY HAS BEEN HELPFUL TO 2542 01:30:23,120 --> 01:30:24,640 HELP US UNDERSTAND THE LINKS 2543 01:30:24,640 --> 01:30:25,880 BETWEEN STRESS AND CANCER 2544 01:30:25,880 --> 01:30:26,520 DEVELOPMENT. 2545 01:30:26,520 --> 01:30:28,320 ONE OF THE INTERESTING FINDINGS 2546 01:30:28,320 --> 01:30:30,880 IN THAT LITERATURE IS THAT 2547 01:30:30,880 --> 01:30:32,720 STRESS, DOES NOT SEEM TO BE A 2548 01:30:32,720 --> 01:30:34,640 GREAT PREDICTOR OF CANCER 2549 01:30:34,640 --> 01:30:35,640 INITIATION, PER SE. 2550 01:30:35,640 --> 01:30:38,840 BUT IT DOES SEEM TO BE A 2551 01:30:38,840 --> 01:30:40,840 PREDICTOR OF TUMOR DEVELOPMENT. 2552 01:30:40,840 --> 01:30:42,760 SO ONCE SOMEONE DOES HAVE 2553 01:30:42,760 --> 01:30:45,120 CANCER, STRESS CAN ACCELERATE 2554 01:30:45,120 --> 01:30:49,960 THE DEVELOPMENT OF TUMORS AND 2555 01:30:49,960 --> 01:30:51,120 SECONDARY CANCERS AND 2556 01:30:51,120 --> 01:30:52,520 RECURRENCE AND THE STRESS 2557 01:30:52,520 --> 01:30:56,120 ITSELF COULD LEAD TO BEHAVIORS, 2558 01:30:56,120 --> 01:30:57,800 AS YOU ARE INDICATING, LIKE 2559 01:30:57,800 --> 01:31:00,320 ALCOHOL USE WHICH WILL FURTHER 2560 01:31:00,320 --> 01:31:01,680 ACCELERATE TUMOR DEVELOPMENT 2561 01:31:01,680 --> 01:31:03,640 AND SECONDARY CANCERS AND SO ON. 2562 01:31:03,640 --> 01:31:04,760 THESE ARE PATTERNS THAT REALLY 2563 01:31:04,760 --> 01:31:05,960 NEED TO BE UNDERSTOOD. 2564 01:31:05,960 --> 01:31:09,680 ONE OF THE FORTUNATE ASPECTS OF 2565 01:31:09,680 --> 01:31:11,120 HAVING A SURVIVEORSHIP 2566 01:31:11,120 --> 01:31:13,240 COMMUNITY LIVING MUCH LONGER IS 2567 01:31:13,240 --> 01:31:15,320 WE CAN DO LONGITUDINAL STUDIES 2568 01:31:15,320 --> 01:31:17,200 AND TRACK THIS OVER TIME AND 2569 01:31:17,200 --> 01:31:19,720 GET A BETTER SENSE HOW CANCER 2570 01:31:19,720 --> 01:31:21,360 IS INITIATED, HOW IT DEVELOPS 2571 01:31:21,360 --> 01:31:27,200 OVER TIME AND HOW COMBINATIONS 2572 01:31:27,200 --> 01:31:29,480 OF STRESS, BEHAVIORAL, 2573 01:31:29,480 --> 01:31:31,600 ENVIRONMENTAL EXPOSURES. 2574 01:31:31,600 --> 01:31:33,040 THE EPIDEMIOLOGY LITERATURE IS 2575 01:31:33,040 --> 01:31:34,920 MOVING AWAY FROM SINGLE 2576 01:31:34,920 --> 01:31:35,760 EXPOSURES AND LOOKING MORE AT 2577 01:31:35,760 --> 01:31:36,560 PATTERNS. 2578 01:31:36,560 --> 01:31:38,400 YOU READ IN THE NEWSPAPER, RED 2579 01:31:38,400 --> 01:31:40,320 MEAT IS BAD FOR YOU, THIS IS 2580 01:31:40,320 --> 01:31:41,440 BAD FOR YOU, THAT IS BAD FOR 2581 01:31:41,440 --> 01:31:42,200 YOU. 2582 01:31:42,200 --> 01:31:44,520 WELL, WHAT WE ARE LEARNING, THE 2583 01:31:44,520 --> 01:31:46,160 NOT ABOUT A SINGLE FOOD 2584 01:31:46,160 --> 01:31:48,040 EXPOSURE, IT'S ABOUT THE 2585 01:31:48,040 --> 01:31:50,080 COMBINATION OF FOOD EXPOSURES, 2586 01:31:50,080 --> 01:31:51,720 PATTERNS OF EATING. 2587 01:31:51,720 --> 01:31:54,120 THERE'S FOCUS ON 2588 01:31:54,120 --> 01:31:55,360 TIME-RESTRICTED EATING. 2589 01:31:55,360 --> 01:31:57,120 YOU SHOULD EAT WITHIN A CERTAIN 2590 01:31:57,120 --> 01:31:58,320 PERIOD OF TIME DURING THE DAY 2591 01:31:58,320 --> 01:31:59,760 AND THAT'S JUST AS IMPORTANT OF 2592 01:31:59,760 --> 01:32:03,320 WHAT YOU ARE EATING OR MAYBE 2593 01:32:03,320 --> 01:32:05,680 CLOSE TO AS IMPORTANT. 2594 01:32:05,680 --> 01:32:06,560 PUTTING EPIDEMIOLOGY IN A 2595 01:32:06,560 --> 01:32:07,640 DIFFERENT PLACE THAN IT WAS 2596 01:32:07,640 --> 01:32:08,200 BEFORE. 2597 01:32:08,200 --> 01:32:09,720 I THINK YOUR QUESTIONS REALLY 2598 01:32:09,720 --> 01:32:11,480 RAISE SOME OF THE DIFFERENT 2599 01:32:11,480 --> 01:32:13,560 KINDS OF CONSTRUCT THAT COULD 2600 01:32:13,560 --> 01:32:17,040 BE MEASURED IN EPIDEMIOLOGICAL 2601 01:32:17,040 --> 01:32:17,960 STUDIES AND ADDRESS 2602 01:32:17,960 --> 01:32:18,320 INTERVENTIONS. 2603 01:32:18,320 --> 01:32:19,160 >> THANK YOU. 2604 01:32:19,160 --> 01:32:20,080 IT'S GOOD TO HEAR. 2605 01:32:20,080 --> 01:32:22,200 I WOULD JUST FOLLOW-UP THIS 2606 01:32:22,200 --> 01:32:27,840 REALLY HAS IMPACT ON THE 2607 01:32:27,840 --> 01:32:28,720 INTERGENERATIONALLY TOO. 2608 01:32:28,720 --> 01:32:31,720 TO YOUR POINT ABOUT PATTERNS OR 2609 01:32:31,720 --> 01:32:34,760 ACCUMULATION OF RISK, TRAUMATIC 2610 01:32:34,760 --> 01:32:36,040 STRESS, WITH BEHAVIORS, WITH 2611 01:32:36,040 --> 01:32:38,960 CHOICES, WHICH IS REALLY WHAT I 2612 01:32:38,960 --> 01:32:41,120 WAS TARGETING, HEALTH CHOICES, 2613 01:32:41,120 --> 01:32:43,280 NOT A STATIC THING, IT'S VERY 2614 01:32:43,280 --> 01:32:44,440 DYNAMIC AND VERY MUCH HAPPENING 2615 01:32:44,440 --> 01:32:46,520 IN THE BRAIN AND THE BODY 2616 01:32:46,520 --> 01:32:49,280 JOINTLY ON A DAILY BASIS. 2617 01:32:49,280 --> 01:32:50,920 BUT AFFECTING RISK IN CHILDREN. 2618 01:32:50,920 --> 01:32:53,280 SO THESE ARE MODIFIABLE FACTORS 2619 01:32:53,280 --> 01:32:55,280 THAT WE HAVE NOT PUT ENOUGH 2620 01:32:55,280 --> 01:32:56,520 RESOURCES IN. 2621 01:32:56,520 --> 01:32:58,600 I JUST, AGAIN, URGE US TO 2622 01:32:58,600 --> 01:33:01,280 BROADEN OUR THINKING ABOUT 2623 01:33:01,280 --> 01:33:03,600 INTERVENTIONS, IN THE 2624 01:33:03,600 --> 01:33:05,480 PREVENTION, BOTH PRIMARY 2625 01:33:05,480 --> 01:33:07,560 PREVENTION BUT SECONDARY 2626 01:33:07,560 --> 01:33:08,920 PREVENTION LEVEL TOO, WHERE WE 2627 01:33:08,920 --> 01:33:10,200 ARE OFTEN READY, STILL COMING 2628 01:33:10,200 --> 01:33:11,640 AT THIS FROM A TREATMENT 2629 01:33:11,640 --> 01:33:12,160 PERSPECTIVE. 2630 01:33:12,160 --> 01:33:13,800 EVEN WHEN WE THINK ABOUT 2631 01:33:13,800 --> 01:33:14,320 PRE-ADDICTION. 2632 01:33:14,320 --> 01:33:16,160 WE WANT TO TREAT PEOPLE WHO ARE 2633 01:33:16,160 --> 01:33:17,200 ALREADY DOWN THE ROAD. 2634 01:33:17,200 --> 01:33:21,240 AND WE ARE NOT PAYING AS MUCH 2635 01:33:21,240 --> 01:33:23,560 ATTENTION TO ALL THE SIGNS AND 2636 01:33:23,560 --> 01:33:27,360 SYMPTOMS, NOT JUST SOCIALLY BUT 2637 01:33:27,360 --> 01:33:28,320 BIOLOGICALLY AND BEHAVIORALLY 2638 01:33:28,320 --> 01:33:30,680 THAT EXIST WE CAN START TO 2639 01:33:30,680 --> 01:33:33,040 ADDRESS IT AND START TO AFFECT 2640 01:33:33,040 --> 01:33:34,040 CHILDREN EARLY ON. 2641 01:33:34,040 --> 01:33:34,920 >> THANK YOU VERY MUCH. 2642 01:33:34,920 --> 01:33:36,720 AND BY THE WAY, I ALSO JUST 2643 01:33:36,720 --> 01:33:38,600 WANT TO POINT OUT, RELATED TO 2644 01:33:38,600 --> 01:33:39,760 YOUR COMMENTS AND GEORGE'S 2645 01:33:39,760 --> 01:33:41,200 COMMENTS ABOUT THE EFFECTS OF 2646 01:33:41,200 --> 01:33:42,640 THE PANDEMIC, WE NEED TO BE 2647 01:33:42,640 --> 01:33:44,520 LOOKING AT HOW ALL THESE 2648 01:33:44,520 --> 01:33:46,480 BEHAVIORS AND STRESS EXPOSURES, 2649 01:33:46,480 --> 01:33:48,520 HOW THAT IS GOING TO PLAY OUT 2650 01:33:48,520 --> 01:33:50,640 IN CANCER RISK SAY 20 YEARS 2651 01:33:50,640 --> 01:33:51,800 FROM NOW POST PANDEMIC. 2652 01:33:51,800 --> 01:33:54,560 ONE THING WE ARE SEEING IN THE 2653 01:33:54,560 --> 01:33:56,200 LITERATURE, OBESITY RATES STILL 2654 01:33:56,200 --> 01:33:58,320 GO UP, PERHAPS FASTER THAN WE 2655 01:33:58,320 --> 01:34:02,320 EXPECTED, GIVEN THE PANDEMIC. 2656 01:34:02,320 --> 01:34:03,600 ALCOHOL USE HAS GONE UP 2657 01:34:03,600 --> 01:34:05,080 APPRECIATEBLY. 2658 01:34:05,080 --> 01:34:06,920 IF THOSE ALL THOSE THINGS ARE 2659 01:34:06,920 --> 01:34:08,520 PREDICTIVE OF CANCER OUTCOMES 2660 01:34:08,520 --> 01:34:10,680 THEN WHAT IS CANCER GOING TO 2661 01:34:10,680 --> 01:34:13,120 LOOK LIKE 10-20 YEARS FROM NOW? 2662 01:34:13,120 --> 01:34:14,920 WE ARE CONCERNED ABOUT THATMENT 2663 01:34:14,920 --> 01:34:16,520 CANCER SCREENINGS ARE DOWN TOO. 2664 01:34:16,520 --> 01:34:19,080 THEY CAME BACK UP AGAIN WHEN 2665 01:34:19,080 --> 01:34:20,440 HEALTH SERVICES OPENED BACK UP. 2666 01:34:20,440 --> 01:34:23,280 BUT NED, OUR PREVIOUS DIRECTOR 2667 01:34:23,280 --> 01:34:25,400 ESTIMATED THERE MAY BE 10,000 2668 01:34:25,400 --> 01:34:26,360 ADDITIONAL DEATHS FROM CANCER 2669 01:34:26,360 --> 01:34:28,640 BECAUSE OF THE LACK OF 2670 01:34:28,640 --> 01:34:29,760 SCREENING IN 2020 AT THE 2671 01:34:29,760 --> 01:34:31,160 BEGINNING OF THE PANDEMIC. 2672 01:34:31,160 --> 01:34:33,040 I'M INTERESTED IN DOING SOME 2673 01:34:33,040 --> 01:34:34,680 MODELING HOW ALL THESE 2674 01:34:34,680 --> 01:34:36,800 DIFFERENT EXPOSURES ARE GOING 2675 01:34:36,800 --> 01:34:39,120 TO AFFECT CANCER MORBIDITY AND 2676 01:34:39,120 --> 01:34:40,480 MORTALITY DOWN THE ROAD. 2677 01:34:40,480 --> 01:34:42,640 LOOKS LIKE WE HAVE A BUNCH OF 2678 01:34:42,640 --> 01:34:43,520 HANDS UP. 2679 01:34:43,520 --> 01:34:44,920 I'M NOT SURE WHO WAS FIRST. 2680 01:34:44,920 --> 01:34:46,520 >> I ALSO WANT TO BE MINDFUL OF 2681 01:34:46,520 --> 01:34:47,720 TIME. 2682 01:34:47,720 --> 01:34:49,360 MAYBE IF WE CAN TAKE THE NEXT 2683 01:34:49,360 --> 01:34:50,840 TWO QUESTION THAT'S HAVE BEEN 2684 01:34:50,840 --> 01:34:52,840 WAITING AND GO BACK TO THE 45 2685 01:34:52,840 --> 01:34:53,760 MINUTE DISCUSSION PERIOD WE 2686 01:34:53,760 --> 01:34:54,960 HAVE AT THE END. 2687 01:34:54,960 --> 01:34:55,680 >> TERRIFIC. 2688 01:34:55,680 --> 01:34:57,080 >> THANK YOU SO MUCH. 2689 01:34:57,080 --> 01:34:58,520 BILL, THANK YOU SO MUCH FOR 2690 01:34:58,520 --> 01:34:59,680 THAT GREAT OVERVIEW. 2691 01:34:59,680 --> 01:35:03,400 AS YOU KNOW, PLACEMATERS. 2692 01:35:03,400 --> 01:35:04,560 PLACE MATTERS. 2693 01:35:04,560 --> 01:35:09,920 I WORRY ABOUT CANNABIS RESEARCH. 2694 01:35:09,920 --> 01:35:11,760 IT'S NOT LEGALIZED FEDERALLY 2695 01:35:11,760 --> 01:35:11,920 YET. 2696 01:35:11,920 --> 01:35:13,160 MAYBE THAT'S SOMETHING YOU CAN 2697 01:35:13,160 --> 01:35:14,400 ADDRESS WHERE THAT RESEARCH IS 2698 01:35:14,400 --> 01:35:15,520 BEING DONE. 2699 01:35:15,520 --> 01:35:17,360 BUT FOR ME, MORE IMPORTANTLY, 2700 01:35:17,360 --> 01:35:20,240 WE KNOW OFTEN TIMES THE 2701 01:35:20,240 --> 01:35:20,920 COMPREHENSIVE CANCER CENTERS, 2702 01:35:20,920 --> 01:35:23,720 THOUGH THEY MAY BE LOCATED IN 2703 01:35:23,720 --> 01:35:25,160 REGIONS WITH A LOT OF 2704 01:35:25,160 --> 01:35:28,000 DIVERSITY, THERE'S NOT A LOT OF 2705 01:35:28,000 --> 01:35:28,640 DIVERSITY WALKING THROUGH THE 2706 01:35:28,640 --> 01:35:29,400 DOOR. 2707 01:35:29,400 --> 01:35:31,040 I WORRY ABOUT THE WORK BEING 2708 01:35:31,040 --> 01:35:32,880 DONE, MY QUESTION IS WHETHER OR 2709 01:35:32,880 --> 01:35:34,520 NOT THE SUPPLEMENTS OR ANY 2710 01:35:34,520 --> 01:35:36,160 OTHER FUNDING MECHANISMS ARE 2711 01:35:36,160 --> 01:35:41,320 ACTUALLY BEING LEVERAGED TO 2712 01:35:41,320 --> 01:35:42,680 REQUIRE INCLUSIVE BEHAVIORS, 2713 01:35:42,680 --> 01:35:44,120 NOT ONLY INCLUDING CANCER 2714 01:35:44,120 --> 01:35:48,480 CENTERS THAT ARE 2715 01:35:48,480 --> 01:35:49,720 NON-COMPREHENSIVE, NON N.C.I. 2716 01:35:49,720 --> 01:35:51,240 DESIGNATED. 2717 01:35:51,240 --> 01:35:52,160 MORE PARTICULARLY, THOSE 2718 01:35:52,160 --> 01:35:54,360 CENTERS THAT ARE TREATING 2719 01:35:54,360 --> 01:35:57,880 PEOPLE WHO HAVE BEEN 2720 01:35:57,880 --> 01:35:58,640 MARGINALIZED AND 2721 01:35:58,640 --> 01:35:59,280 DISENFRANCHISED. 2722 01:35:59,280 --> 01:36:00,480 CAN YOU SPEAK TO THAT A LITTLE 2723 01:36:00,480 --> 01:36:01,240 BIT? 2724 01:36:01,240 --> 01:36:02,600 >> YES. 2725 01:36:02,600 --> 01:36:05,440 EVEN THOUGH THESE SUPPLEMENTS 2726 01:36:05,440 --> 01:36:08,040 ARE GOING TO THE DESIGNATED 2727 01:36:08,040 --> 01:36:08,960 CANCER CENTERS WE ARE NOW 2728 01:36:08,960 --> 01:36:10,160 ENGAGED WITH THE COMMISSION ON 2729 01:36:10,160 --> 01:36:11,680 CANCER TO TRY TO SPREAD THAT 2730 01:36:11,680 --> 01:36:12,760 OUT ACROSS THE COUNTRY. 2731 01:36:12,760 --> 01:36:16,080 IT'S NOT JUST THE NCI 2732 01:36:16,080 --> 01:36:17,680 DESIGNATED CANCER CENTERS BUT 2733 01:36:17,680 --> 01:36:19,800 ALL THE CANCER CENTERS GETTING 2734 01:36:19,800 --> 01:36:21,920 GUIDELINES AND RESOURCES TO 2735 01:36:21,920 --> 01:36:25,120 INCORPORATE SOME TOBACCO 2736 01:36:25,120 --> 01:36:25,800 CESSATION INFRASTRUCTURE INTO 2737 01:36:25,800 --> 01:36:26,720 THEIR WORK FLOW. 2738 01:36:26,720 --> 01:36:29,120 WITH REGARD TO DIVERSITY 2739 01:36:29,120 --> 01:36:30,760 ISSUES, I'M HAPPY TO SAY WE ARE 2740 01:36:30,760 --> 01:36:32,200 WORKING TOWARD OUR CANCER 2741 01:36:32,200 --> 01:36:33,760 CENTERS HAVING A D.E.I. 2742 01:36:33,760 --> 01:36:34,960 REQUIREMENT. 2743 01:36:34,960 --> 01:36:37,280 THE A REQUIREMENT THAT WOULD 2744 01:36:37,280 --> 01:36:38,120 INFLUENCE THEIR ABILITY TO GET 2745 01:36:38,120 --> 01:36:38,680 FUNDED. 2746 01:36:38,680 --> 01:36:40,840 AND SO THE IDEA IS TO BE ABLE 2747 01:36:40,840 --> 01:36:42,960 TO BRING IN STAFF MEMBERS WHO 2748 01:36:42,960 --> 01:36:44,560 CAN HELP BUILD THE DIVERSITY OF 2749 01:36:44,560 --> 01:36:47,160 THEIR STAFF AND OF THEIR 2750 01:36:47,160 --> 01:36:51,360 CLINICAL POPULATIONS. 2751 01:36:51,360 --> 01:36:52,520 IT'S PROBABLY NOT A SURPRISE 2752 01:36:52,520 --> 01:36:54,360 SOME OF THE SAME INDIVIDUALS 2753 01:36:54,360 --> 01:36:55,760 OCCUPYING THOSE ROLES ARE ALSO 2754 01:36:55,760 --> 01:36:57,360 THE ONES DOING THE POPULATION 2755 01:36:57,360 --> 01:36:59,080 SCIENCE WORK IN THE CANCER 2756 01:36:59,080 --> 01:37:01,520 CENTERS AND THEREFORE MIGHT BE 2757 01:37:01,520 --> 01:37:04,080 THE ONES INVOLVED IN THE 2758 01:37:04,080 --> 01:37:05,920 INITIATIVES WITH MORE 2759 01:37:05,920 --> 01:37:07,080 BEHAVIORAL AND POPULATION 2760 01:37:07,080 --> 01:37:07,800 SCIENCE FOCUS. 2761 01:37:07,800 --> 01:37:10,920 THAT LEADS TO SOME SYNERGISM, I 2762 01:37:10,920 --> 01:37:12,520 THINK THAT MIGHT BE EFFECTIVE. 2763 01:37:12,520 --> 01:37:14,200 BUT YOU ARE ABSOLUTELY RIGHT. 2764 01:37:14,200 --> 01:37:16,520 THERE'S A PROBLEM IN TERMS OF 2765 01:37:16,520 --> 01:37:17,520 DIVERSITY, OF NOT ONLY 2766 01:37:17,520 --> 01:37:19,120 DIVERSITY OF THE PATIENT 2767 01:37:19,120 --> 01:37:20,480 POPULATIONS BUT OF THOSE 2768 01:37:20,480 --> 01:37:23,120 WORKING IN THESE CANCER CENTERS 2769 01:37:23,120 --> 01:37:26,360 TEND TO BE MORE ACADEMIC AND 2770 01:37:26,360 --> 01:37:28,680 HIGHER SCS AND THAT HAS A 2771 01:37:28,680 --> 01:37:29,880 HIGHER IMPACT ON TREATMENT. 2772 01:37:29,880 --> 01:37:32,920 >> I HAVE A QUICK QUESTION. 2773 01:37:32,920 --> 01:37:35,920 I'M JUST WONDERING IF N.C.I. 2774 01:37:35,920 --> 01:37:37,760 HAS SUPPORTED OR PLANNING TO 2775 01:37:37,760 --> 01:37:39,640 SUPPORT STUDIES LOOKING AT THE 2776 01:37:39,640 --> 01:37:41,320 ASSOCIATION BETWEEN CANCER PAIN 2777 01:37:41,320 --> 01:37:45,040 AND ALCOHOL USE. 2778 01:37:45,040 --> 01:37:45,720 >> THANK YOU. 2779 01:37:45,720 --> 01:37:47,360 WE HAVE BEEN VERY INTERESTED IN 2780 01:37:47,360 --> 01:37:48,080 THE PAIN LITERATURE. 2781 01:37:48,080 --> 01:37:49,680 IN FACT WE HAVE BEEN SPENDING 2782 01:37:49,680 --> 01:37:51,360 MORE TIME LOOKING AT SOME OF 2783 01:37:51,360 --> 01:37:52,520 THE INEQUITIES IN PAIN 2784 01:37:52,520 --> 01:37:53,920 MANAGEMENT AND HOW THAT PLAYS 2785 01:37:53,920 --> 01:37:54,800 OUT OVER TIME. 2786 01:37:54,800 --> 01:37:56,040 BUT I THINK YOU ARE ABSOLUTELY 2787 01:37:56,040 --> 01:37:56,720 RIGHT. 2788 01:37:56,720 --> 01:37:57,680 ALCOHOL IS GOING TO BE 2789 01:37:57,680 --> 01:37:59,080 SOMETHING WE NEED TO THINK OF 2790 01:37:59,080 --> 01:38:01,160 IN THE PAIN CONTEXT. 2791 01:38:01,160 --> 01:38:03,080 BECAUSE SOMETIMES IT'S EVEN 2792 01:38:03,080 --> 01:38:04,680 ENCOURAGED BY PHYSICIANS AS A 2793 01:38:04,680 --> 01:38:06,320 WAY OF ADDRESSING PAIN. 2794 01:38:06,320 --> 01:38:08,880 AS A FORM OF PALLIATIVE CARE. 2795 01:38:08,880 --> 01:38:11,200 AND THAT'S PROBLEMATIC IF IT'S 2796 01:38:11,200 --> 01:38:13,280 THEN IN-TURN GOING TO INCREASE 2797 01:38:13,280 --> 01:38:15,320 THEIR RISK OF SECONDARY CANCERS 2798 01:38:15,320 --> 01:38:16,320 AND RECURRENCE. 2799 01:38:16,320 --> 01:38:18,240 THAT'S A BIT OF A FRAUGHT TOPIC. 2800 01:38:18,240 --> 01:38:21,240 I THINK IT'S INTERESTING TO 2801 01:38:21,240 --> 01:38:22,400 IMAGINE DOING MORE RESEARCH ON 2802 01:38:22,400 --> 01:38:24,120 THE LINK OF ALCOHOL USE AND 2803 01:38:24,120 --> 01:38:25,200 PAIN MANAGEMENT. 2804 01:38:25,200 --> 01:38:26,400 I DON'T THINK WE HAVE TOO MUCH 2805 01:38:26,400 --> 01:38:27,800 OF THAT IN OUR PORTFOLIO. 2806 01:38:27,800 --> 01:38:29,960 DO WE HAVE TIME FOR LAURA'S 2807 01:38:29,960 --> 01:38:35,320 QUESTION? 2808 01:38:35,320 --> 01:38:36,920 >> IF IT'S QUICK, OTHERWISE WE 2809 01:38:36,920 --> 01:38:37,880 CAN COME BACK. 2810 01:38:37,880 --> 01:38:39,120 >> SORRY, I THINK IT COULD BE A 2811 01:38:39,120 --> 01:38:39,720 QUICK QUESTION. 2812 01:38:39,720 --> 01:38:41,320 I JUST WANT TO GIVE YOU AN 2813 01:38:41,320 --> 01:38:43,600 OPPORTUNITY TO SPEAK TO VAPING, 2814 01:38:43,600 --> 01:38:45,200 AS OPPOSED TO TOBACCO USE. 2815 01:38:45,200 --> 01:38:47,280 IF YOU HAVE SEEN THE LANDSCAPE 2816 01:38:47,280 --> 01:38:48,680 OF THOSE TWO DRUGS CHANGE WITH 2817 01:38:48,680 --> 01:38:49,400 THE PANDEMIC? 2818 01:38:49,400 --> 01:38:51,320 THANK YOU FOR YOUR 2819 01:38:51,320 --> 01:38:51,760 PRESENTATION, REALLY 2820 01:38:51,760 --> 01:38:52,480 INTERESTING. 2821 01:38:52,480 --> 01:38:54,520 >> YEAH, SURE, I WILL JUST SAY 2822 01:38:54,520 --> 01:38:55,920 BRIEFLY, GIVEN THE TIME LIMB 2823 01:38:55,920 --> 01:38:57,600 TAIGS BECAUSE THAT'S A BIG 2824 01:38:57,600 --> 01:38:59,240 QUESTION, WE DO NOESIG RECEIPT 2825 01:38:59,240 --> 01:39:01,400 USE IS CONTINUING TO GO DOWN, 2826 01:39:01,400 --> 01:39:03,920 VAPING IS CONTINUING TO GO UP. 2827 01:39:03,920 --> 01:39:05,600 WE AREN'T SURE HOW MUCH TO 2828 01:39:05,600 --> 01:39:07,160 TRUST DATA. 2829 01:39:07,160 --> 01:39:09,240 NORA MENTIONED VAPING WENT DOWN 2830 01:39:09,240 --> 01:39:11,200 IN THE PANDEMIC IN ADOLESCENCE, 2831 01:39:11,200 --> 01:39:13,520 THAT SOUNDS LIKE A GOOD THING 2832 01:39:13,520 --> 01:39:15,920 BUT WE ARE NERVOUS ABOUT THE 2833 01:39:15,920 --> 01:39:19,880 DATA, BECAUSE THE ADOLESCENTS 2834 01:39:19,880 --> 01:39:21,960 WERE FILLING OUT THE SURVEYS 2835 01:39:21,960 --> 01:39:24,040 WITH THEIR PARENTS NEXT TO THEM. 2836 01:39:24,040 --> 01:39:25,400 WE ARE TRACKING THIS QUITE A 2837 01:39:25,400 --> 01:39:27,280 BIT, WE NEED A BETTER SENSE OF 2838 01:39:27,280 --> 01:39:29,400 WHAT'S GOING ON WITH VAPING. 2839 01:39:29,400 --> 01:39:31,520 TOBACCO INDUSTRY IS MOVING MORE 2840 01:39:31,520 --> 01:39:32,680 TOWARDS VAPING AND TRYING TO 2841 01:39:32,680 --> 01:39:34,520 GET RID OF CIGARETTES BUT IN 2842 01:39:34,520 --> 01:39:36,360 THE SAME BREATH THEY WANT TO 2843 01:39:36,360 --> 01:39:38,440 MOVE PEOPLE MORE TOWARD 2844 01:39:38,440 --> 01:39:41,280 E-CIGARETTES WHICH HAVE THEIR 2845 01:39:41,280 --> 01:39:42,920 OWN PROBLEMS SO SOMETHING WE 2846 01:39:42,920 --> 01:39:43,880 DEFINITELY NEED TO GET A HANDLE 2847 01:39:43,880 --> 01:39:44,800 ON. 2848 01:39:44,800 --> 01:39:46,640 >> OKAY, THANKS VERY MUCH. 2849 01:39:46,640 --> 01:39:52,040 WE SHOULD MOVE ON SO AS NOT TO 2850 01:39:52,040 --> 01:39:55,960 GIVE ABCD A SHORT -- 2851 01:39:55,960 --> 01:39:58,520 SHE AND HER COLLEAGUES 2852 01:39:58,520 --> 01:40:00,800 ELIZABETH HOFMANN AND KIM 2853 01:40:00,800 --> 01:40:03,880 LEBLANC WILL BE PRESENTING ON 2854 01:40:03,880 --> 01:40:12,720 THE ABCD UPDATE TODAY. 2855 01:40:12,720 --> 01:40:15,720 KAIA? 2856 01:40:15,720 --> 01:40:18,520 >> SORRY, I WAS HAVING TROUBLE 2857 01:40:18,520 --> 01:40:19,440 UNMUTING. 2858 01:40:19,440 --> 01:40:20,360 CAN YOU HEAR ME NOW? 2859 01:40:20,360 --> 01:40:21,520 >> YES. 2860 01:40:21,520 --> 01:40:22,480 >> GREAT. 2861 01:40:22,480 --> 01:40:24,360 >> THANK YOU, SUSAN, I'M HAPPY 2862 01:40:24,360 --> 01:40:26,680 TO BE HERE. 2863 01:40:26,680 --> 01:40:28,320 I'M HERE TO GIVE YOU AN UPDATE 2864 01:40:28,320 --> 01:40:30,640 ON THE ADOLESCENT BRAIN 2865 01:40:30,640 --> 01:40:32,080 COGNITIVE DEVELOPMENT STUDY. 2866 01:40:32,080 --> 01:40:34,880 I'M ACTUALLY GOING TO KEEP MY 2867 01:40:34,880 --> 01:40:35,840 OVERARCHING COMMENTS BRIEF, SO 2868 01:40:35,840 --> 01:40:38,640 THAT WE CAN SPEND MORE TIME ON 2869 01:40:38,640 --> 01:40:40,480 THE SCIENCE, GOT SOME EXCITING 2870 01:40:40,480 --> 01:40:41,480 PAPERS TO PRESENT AT THE END OF 2871 01:40:41,480 --> 01:40:42,080 THE TALK. 2872 01:40:42,080 --> 01:40:44,200 BUT I DID WANT TO GIVE YOU ALL 2873 01:40:44,200 --> 01:40:46,120 AN UPDATE ON HOW THE STUDY IS 2874 01:40:46,120 --> 01:40:47,720 GOING, IN TERMS OF RETENTION. 2875 01:40:47,720 --> 01:40:50,320 SOME OF OUR ACTIVITIES RELATED 2876 01:40:50,320 --> 01:40:52,320 TO JUSTICE, EQUITY, DIVERSITY 2877 01:40:52,320 --> 01:40:53,680 AND INCLUSION. 2878 01:40:53,680 --> 01:40:57,120 SO THE DATA BEING COLLECTED AND 2879 01:40:57,120 --> 01:40:58,680 PUBLICATIONS COMING OUT ON 2880 01:40:58,680 --> 01:41:00,400 COVID-19, AS WELL AS DATA 2881 01:41:00,400 --> 01:41:02,040 SHARING IN USE, BEFORE WE 2882 01:41:02,040 --> 01:41:03,680 TRANSITION INTO THREE REALLY 2883 01:41:03,680 --> 01:41:05,720 EXCITING PAPERS BEING PRESENTED 2884 01:41:05,720 --> 01:41:07,520 BY ELIZABETH HOFMANN AND KIM 2885 01:41:07,520 --> 01:41:08,520 LEBLANC. 2886 01:41:08,520 --> 01:41:10,600 SO BY WAY OF RETENTION, WE ARE 2887 01:41:10,600 --> 01:41:13,200 REALLY PROUD TO SAY WE ARE 2888 01:41:13,200 --> 01:41:15,120 STILL RETAINING ABOUT, JUST 2889 01:41:15,120 --> 01:41:18,120 OVER 98% OF THE ABCD COHORT. 2890 01:41:18,120 --> 01:41:20,920 WHAT WE CONSIDER SOMEBODY -- 2891 01:41:20,920 --> 01:41:22,960 WE CONSIDER EVERYBODY RETAIN 2892 01:41:22,960 --> 01:41:24,800 UNTIL THEY OFFICIALLY WITHDRAW 2893 01:41:24,800 --> 01:41:26,680 BECAUSE WE DO MAKE A CONCERTED 2894 01:41:26,680 --> 01:41:28,840 EFFORT TO BRING BACK PEOPLE WHO 2895 01:41:28,840 --> 01:41:29,840 HAVE, FOR EXAMPLE, MISSED 2896 01:41:29,840 --> 01:41:31,400 VISITS. 2897 01:41:31,400 --> 01:41:32,800 OUR RETENTION RATE REMAINS VERY 2898 01:41:32,800 --> 01:41:33,280 HIGH. 2899 01:41:33,280 --> 01:41:35,800 BUT ALSO WE ARE TRACKING HOW 2900 01:41:35,800 --> 01:41:38,360 MANY PEOPLE ATTEND EACH VISIT. 2901 01:41:38,360 --> 01:41:42,120 SO NOW AS YOU RECALL, ABCD 2902 01:41:42,120 --> 01:41:44,920 BEGAN ENROLLMENT IN 2016. 2903 01:41:44,920 --> 01:41:48,680 AND WE HAVE ANNUAL VISITS AS 2904 01:41:48,680 --> 01:41:53,040 WELL AS MID-YEAR CHECK-INS. 2905 01:41:53,040 --> 01:41:54,480 THIS GRAPH,WHICH YOU HAVE SEEN 2906 01:41:54,480 --> 01:41:57,000 OVER THE YEARS, TRACKS HOW MANY 2907 01:41:57,000 --> 01:41:58,600 PARTICIPANTS HAVE COMPLETED 2908 01:41:58,600 --> 01:42:00,760 VISITS AT EACH VISIT. 2909 01:42:00,760 --> 01:42:02,120 BASELINE, SIX MONTHS, ONE YEAR, 2910 01:42:02,120 --> 01:42:03,120 ETC.. 2911 01:42:03,120 --> 01:42:06,120 HERE WE SEE FLAT LINE IN 2020 2912 01:42:06,120 --> 01:42:09,120 WHEN WE SUSPENDED OUR TWO-YEAR 2913 01:42:09,120 --> 01:42:11,200 FOLLOW-UP VISITS BUT HAVE SINCE 2914 01:42:11,200 --> 01:42:12,800 RECOVERED AND WERE ABLE TO 2915 01:42:12,800 --> 01:42:14,400 COMPLETE MOST OF THOSE. 2916 01:42:14,400 --> 01:42:16,320 SO OF COURSE, THE NICE LINES WE 2917 01:42:16,320 --> 01:42:19,760 HAD EARLY ON HAVE BEEN A LITTLE 2918 01:42:19,760 --> 01:42:21,200 BIT MORE COMPLICATED AS TIME 2919 01:42:21,200 --> 01:42:22,800 HAS MOVED ON. 2920 01:42:22,800 --> 01:42:24,880 BUT WE ARE ABLE TO BRING IN 2921 01:42:24,880 --> 01:42:28,560 MOST OF OUR PARTICIPANTS. 2922 01:42:28,560 --> 01:42:30,880 EITHER REMOTELY, IN A HYBRID 2923 01:42:30,880 --> 01:42:31,760 FASHION OR IN PERSON. 2924 01:42:31,760 --> 01:42:33,680 I WILL GET TO THAT IN A SECOND. 2925 01:42:33,680 --> 01:42:36,520 ONE THING YOU MAY NOTICE, THE 2926 01:42:36,520 --> 01:42:37,280 FOUR-YEAR FOLLOW-UPS WHICH 2927 01:42:37,280 --> 01:42:39,040 BEGAN AT THE END OF 2020, 2928 01:42:39,040 --> 01:42:40,160 THERE'S A LITTLE BIT OF A LAG 2929 01:42:40,160 --> 01:42:40,920 HERE. 2930 01:42:40,920 --> 01:42:43,320 WE ARE HOPING THAT WILL, THAT 2931 01:42:43,320 --> 01:42:46,160 WE ARE AT LEAST CONTINUING, THE 2932 01:42:46,160 --> 01:42:47,600 SLOPE IS SIMILAR TO PREVIOUS 2933 01:42:47,600 --> 01:42:49,240 YEARS BUT WE HAD TO DELAY 2934 01:42:49,240 --> 01:42:52,320 THINGS A LITTLE BIT BECAUSE OF 2935 01:42:52,320 --> 01:42:53,680 PANDEMIC-RELATED FACTORS. 2936 01:42:53,680 --> 01:42:55,800 CONTINUALLY, WE CONTINUE TO 2937 01:42:55,800 --> 01:42:58,120 MONITOR THE DEMOGRAPHICS OF OUR 2938 01:42:58,120 --> 01:42:59,600 PARTICIPANTS TO ENSURE THE 2939 01:42:59,600 --> 01:43:01,920 EFFORTS MADE TO RECRUIT A 2940 01:43:01,920 --> 01:43:03,120 DIVERSE SAMPLE ARE CONTINUED 2941 01:43:03,120 --> 01:43:03,720 THROUGHOUT THE COURSE OF THE 2942 01:43:03,720 --> 01:43:04,520 STUDY. 2943 01:43:04,520 --> 01:43:05,960 YOU HAVE SEEN ME PRESENT ON 2944 01:43:05,960 --> 01:43:07,080 THESE BEFORE. 2945 01:43:07,080 --> 01:43:08,960 THIS IS DATA FROM THE 2946 01:43:08,960 --> 01:43:10,120 THREE-YEAR FOLLOW-UP VISIT. 2947 01:43:10,120 --> 01:43:12,640 WHICH IS NOW LARGELY COMPLETE. 2948 01:43:12,640 --> 01:43:15,280 AND YOU CAN SEE THAT, AGAIN, 2949 01:43:15,280 --> 01:43:18,320 JUST TO ORIENT YOU, THIS INNER 2950 01:43:18,320 --> 01:43:20,160 CIRCLE, INNER RING IS THE 2951 01:43:20,160 --> 01:43:21,800 DEMOGRAPHIC BREAK DOWN WHEN 2952 01:43:21,800 --> 01:43:24,120 THEY WERE RECRUITED AND THE 2953 01:43:24,120 --> 01:43:26,480 OUTER RING IS THOSE THAT 2954 01:43:26,480 --> 01:43:28,120 COMPLETED THE THREE-YEAR 2955 01:43:28,120 --> 01:43:28,360 FOLLOW-UP. 2956 01:43:28,360 --> 01:43:29,960 WE HAVE PRETTY GOOD CONCORDANCE 2957 01:43:29,960 --> 01:43:31,840 WITH RESPECT TO RACE, 2958 01:43:31,840 --> 01:43:33,720 ETHNICITY, INCOME AND HOUSEHOLD 2959 01:43:33,720 --> 01:43:35,680 EDUCATION. 2960 01:43:35,680 --> 01:43:38,280 WE ARE RETAINING A DIVERSE 2961 01:43:38,280 --> 01:43:39,120 COHORT OF PARTICIPANTS IN THE 2962 01:43:39,120 --> 01:43:40,880 STUDY. 2963 01:43:40,880 --> 01:43:43,160 WHEN COVID HIT, WE, LIKE 2964 01:43:43,160 --> 01:43:43,880 EVERYBODY ELSE, EXPERIENCED 2965 01:43:43,880 --> 01:43:45,520 SHUT DOWNS FOR A PERIOD OF TIME. 2966 01:43:45,520 --> 01:43:48,320 THIS OCCURRED IN THE MIDDLE OF 2967 01:43:48,320 --> 01:43:49,400 COMPLETING OUR TWO-YEAR 2968 01:43:49,400 --> 01:43:50,440 FOLLOW-UP VISITS. 2969 01:43:50,440 --> 01:43:51,840 SO WE DID TRANSITION. 2970 01:43:51,840 --> 01:43:55,120 WE HAD ABOUT 70% COMPLETE THE 2971 01:43:55,120 --> 01:43:55,680 TWO-YEAR FOLLOW-UP VISITS 2972 01:43:55,680 --> 01:43:57,680 BEFORE THE SHUT DOWN OCCURRED. 2973 01:43:57,680 --> 01:43:59,240 AND THEN TRANSITIONED TO REMOTE 2974 01:43:59,240 --> 01:44:01,520 AND HYBRIDS FOR THE REST OF THE 2975 01:44:01,520 --> 01:44:02,400 TWO-YEAR FOLLOW-UP VISITS. 2976 01:44:02,400 --> 01:44:05,920 THESE WERE ALSO IMPACTED ARE 2977 01:44:05,920 --> 01:44:07,560 THREE AND FOUR-YEAR VISITS. 2978 01:44:07,560 --> 01:44:09,480 THAT WAS REALLY GEARING UP WHEN 2979 01:44:09,480 --> 01:44:10,400 THE PANDEMIC FIRST HIT. 2980 01:44:10,400 --> 01:44:12,040 WE HAD MANY MORE OF OUR 2981 01:44:12,040 --> 01:44:14,120 PARTICIPANTS HAVE TO COMPLETE 2982 01:44:14,120 --> 01:44:15,960 THEIR VISITS REMOTELY. 2983 01:44:15,960 --> 01:44:18,320 BUT BECAUSE OF THAT, WE WERE 2984 01:44:18,320 --> 01:44:19,960 ABLE TO COLLECT MOST OF THE 2985 01:44:19,960 --> 01:44:22,320 DATA, BUT WE DID MISS THE NEURO 2986 01:44:22,320 --> 01:44:25,040 IMAGING IN SOME OF THE BIO 2987 01:44:25,040 --> 01:44:26,360 SPECIMEN COLLECTION FROM A 2988 01:44:26,360 --> 01:44:29,120 LARGE NUMBER OF PARTICIPANTS IN 2989 01:44:29,120 --> 01:44:30,080 THAT FOLLOW-UP TIME PERIOD. 2990 01:44:30,080 --> 01:44:32,160 AS THE FOUR YEARS RESUMED, MOST 2991 01:44:32,160 --> 01:44:35,080 OF THE SITES HAD OPENED TO SOME 2992 01:44:35,080 --> 01:44:36,120 DEGREE. 2993 01:44:36,120 --> 01:44:38,680 BUT WE STILL CONTINUE TO HAVE 2994 01:44:38,680 --> 01:44:40,120 SOME PARTICIPANTS PARTICIPATE 2995 01:44:40,120 --> 01:44:41,720 REMOTELY, BUT LARGE GROUP 2996 01:44:41,720 --> 01:44:43,320 PARTICIPATED IN A HYBRID 2997 01:44:43,320 --> 01:44:43,800 FASHION. 2998 01:44:43,800 --> 01:44:45,160 MOST PEOPLE WOULD COME TO THE 2999 01:44:45,160 --> 01:44:47,760 SITES TO DO THE SPECIMEN 3000 01:44:47,760 --> 01:44:48,680 COLLECTION AND IMAGING, BUT 3001 01:44:48,680 --> 01:44:50,560 CONDUCT THE REST OF THE VISITS 3002 01:44:50,560 --> 01:44:52,120 AT HOME TO MINIMIZE THE AMOUNT 3003 01:44:52,120 --> 01:44:54,080 OF TIME THEY WERE IN CONTACT 3004 01:44:54,080 --> 01:44:55,360 WITH PEOPLE, WITH STAFF AT THE 3005 01:44:55,360 --> 01:44:55,960 SITES. 3006 01:44:55,960 --> 01:44:59,200 AND THEN WE ALSO HAD SITES THAT 3007 01:44:59,200 --> 01:45:00,680 TRANSITIONED TO FULLY IN PERSON. 3008 01:45:00,680 --> 01:45:02,320 SO THEY WERE ABLE TO DO THE 3009 01:45:02,320 --> 01:45:04,160 ENTIRE VISIT IN PERSON. 3010 01:45:04,160 --> 01:45:06,920 THE MAIN REASONS FOR THE REMOTE 3011 01:45:06,920 --> 01:45:08,520 VISITS, OF COURSE, VARIED OVER 3012 01:45:08,520 --> 01:45:09,040 TIME. 3013 01:45:09,040 --> 01:45:11,600 BUT IT WAS OFTEN THE CASE IF 3014 01:45:11,600 --> 01:45:14,480 PARTICIPANTS HAD M.R.I. 3015 01:45:14,480 --> 01:45:15,320 CONTRAINDICATIONS THEY JUST 3016 01:45:15,320 --> 01:45:17,320 OPTED NOT TO COME IN AT ALL, SO 3017 01:45:17,320 --> 01:45:18,920 WE DID THOSE REMOTELY. 3018 01:45:18,920 --> 01:45:20,560 THERE WERE STILL SOME FAMILIES 3019 01:45:20,560 --> 01:45:22,200 NOT WILLING TO COME INTO THE 3020 01:45:22,200 --> 01:45:23,560 CENTER BECAUSE OF CONCERNS 3021 01:45:23,560 --> 01:45:24,480 ABOUT COVID. 3022 01:45:24,480 --> 01:45:27,400 BECAUSE OF THIS TRANSITION, 3023 01:45:27,400 --> 01:45:30,160 ABCD, IN THE BEGINNING, WE 3024 01:45:30,160 --> 01:45:33,520 REALLY CREDIT OURSELVES ACROSS 3025 01:45:33,520 --> 01:45:35,120 ALL 21 SITES EVERYBODY WAS 3026 01:45:35,120 --> 01:45:36,520 GETTING THE SAME PROTOCOL. 3027 01:45:36,520 --> 01:45:37,920 BUT BECAUSE OF THIS TRANSITION 3028 01:45:37,920 --> 01:45:42,320 TO HYBRID AND REMOTE, THAT 3029 01:45:42,320 --> 01:45:45,440 INTRODUCES SOME VARIABILITY IN 3030 01:45:45,440 --> 01:45:47,600 HOW PEOPLE ARE COMPLETING THOSE 3031 01:45:47,600 --> 01:45:48,360 DIFFERENT ASPECTS OF THE 3032 01:45:48,360 --> 01:45:48,960 PROTOCOLS. 3033 01:45:48,960 --> 01:45:51,960 SO A COUPLE OF QUESTIONS THAT 3034 01:45:51,960 --> 01:45:53,640 THE ABCD CONSORTIUM IS 3035 01:45:53,640 --> 01:45:54,560 INVESTIGATING AND TRYING TO 3036 01:45:54,560 --> 01:45:56,920 ADDRESS IS WHAT THE IMPACT OF 3037 01:45:56,920 --> 01:45:58,320 THESE HYBRID ASSESSMENTS MAY BE 3038 01:45:58,320 --> 01:45:59,680 ON DATA QUALITY. 3039 01:45:59,680 --> 01:46:03,040 SO WE HAVE NEURO COGNITIVE 3040 01:46:03,040 --> 01:46:04,240 TESTS THAT WHEN THEY ARE DONE 3041 01:46:04,240 --> 01:46:06,600 IN THE CENTERS ARE VERY TIGHTLY 3042 01:46:06,600 --> 01:46:07,240 CONTROLLED, IN TERMS OF 3043 01:46:07,240 --> 01:46:12,440 ENVIRONMENT. 3044 01:46:12,440 --> 01:46:14,560 AND SO ABCD COGNITIVE WORKLOAD 3045 01:46:14,560 --> 01:46:17,400 ARE LOOKING AT WHETHER THERE 3046 01:46:17,400 --> 01:46:18,800 ARE DIFFERENTIAL IMPACTS ON THE 3047 01:46:18,800 --> 01:46:20,680 QUALITY OF DATA WHETHER 3048 01:46:20,680 --> 01:46:22,080 PARTICIPANTS DID THESE REMOTELY 3049 01:46:22,080 --> 01:46:24,960 OR IN PERSON. 3050 01:46:24,960 --> 01:46:26,000 WE ARE ALSO LOOKING INTO THE 3051 01:46:26,000 --> 01:46:29,320 IMPACT OF THE HYBRID VERSUS 3052 01:46:29,320 --> 01:46:34,120 IN-PERSON, VERSUS REMOTE VISITS 3053 01:46:34,120 --> 01:46:36,680 ON PARTICIPATION, PARTICULARLY 3054 01:46:36,680 --> 01:46:37,760 FOR DIFFERENT DEMOGRAPHIC 3055 01:46:37,760 --> 01:46:38,560 GROUPS. 3056 01:46:38,560 --> 01:46:41,640 WE HAVE SEEN ANECDOTALLY HAVING 3057 01:46:41,640 --> 01:46:43,680 REMOTE OPTIONS HAS INCREASED 3058 01:46:43,680 --> 01:46:44,920 PARTICIPATION AMONG SOME GROUPS 3059 01:46:44,920 --> 01:46:46,760 BUT ALSO MADE IT MORE DIFFICULT 3060 01:46:46,760 --> 01:46:49,880 TO OTHER GROUPS DUE TO, FOR 3061 01:46:49,880 --> 01:46:50,760 EXAMPLE, INTERNET CONNECTIVITY. 3062 01:46:50,760 --> 01:46:53,520 WE NEED TO DO AN IN-DEPTH DIVE 3063 01:46:53,520 --> 01:46:55,240 TO UNDERSTAND THAT AND WHETHER 3064 01:46:55,240 --> 01:46:57,120 THAT IN TURN AFFECTS THE 3065 01:46:57,120 --> 01:46:58,520 COMPLETENESS OF THE DATA FOR 3066 01:46:58,520 --> 01:47:00,200 GROUPS THAT MAY NOT HAVE BEEN 3067 01:47:00,200 --> 01:47:02,520 ABLE TO COMPLETE ALL OF THE 3068 01:47:02,520 --> 01:47:03,680 ELEMENTS IF THEY ARE NOT COMING 3069 01:47:03,680 --> 01:47:04,440 IN PERSON. 3070 01:47:04,440 --> 01:47:06,080 THESE ARE A COUPLE ISSUES WE 3071 01:47:06,080 --> 01:47:07,520 ARE WORKING THROUGH AND ALL OF 3072 01:47:07,520 --> 01:47:09,640 THIS WILL BE SHARED WITH THE 3073 01:47:09,640 --> 01:47:10,680 SCIENTIFIC COMMUNITY, AS PEOPLE 3074 01:47:10,680 --> 01:47:12,840 ARE ACCESSING THE DATA SO THEY 3075 01:47:12,840 --> 01:47:14,680 ARE AWARE OF WHAT THEY NEED TO 3076 01:47:14,680 --> 01:47:16,400 BE THINKING ABOUT IN TERMS OF 3077 01:47:16,400 --> 01:47:17,280 DATA ANALYSIS. 3078 01:47:17,280 --> 01:47:19,600 I WOULD NOW LIKE TO GIVE YOU AN 3079 01:47:19,600 --> 01:47:22,200 UPDATE ON OUR JEDI ACTIVITIES. 3080 01:47:22,200 --> 01:47:25,240 LAST YEAR, I THINK I INTRODUCED 3081 01:47:25,240 --> 01:47:27,120 THIS INITIATIVE WITHIN ABCD, 3082 01:47:27,120 --> 01:47:28,560 WHICH IS REALLY FOCUSED ON 3083 01:47:28,560 --> 01:47:29,520 THREE AREAS. 3084 01:47:29,520 --> 01:47:31,120 ONE IS LOOKING AT THE METHODS 3085 01:47:31,120 --> 01:47:33,920 THAT ARE BEING IMPLEMENTED, 3086 01:47:33,920 --> 01:47:36,040 ABCD TO MAKE SURE THEY ARE 3087 01:47:36,040 --> 01:47:36,920 SENSITIVE AND INCLUSIVE. 3088 01:47:36,920 --> 01:47:46,680 THE SECOND IS TO MAXIMIZE. 3089 01:47:46,680 --> 01:47:49,240 AND THE THIRD IS FOR ABCD TO 3090 01:47:49,240 --> 01:47:52,280 TAKE A ROLE IN ACCESSING AND 3091 01:47:52,280 --> 01:47:53,920 UTILIZING THE DATA ARE DOING SO 3092 01:47:53,920 --> 01:47:54,880 IN A RESPONSIBLE WAY. 3093 01:47:54,880 --> 01:47:57,640 I JUST WANT TO HIGHLIGHT A FEW 3094 01:47:57,640 --> 01:47:58,600 OF THE THING THAT'S HAVE 3095 01:47:58,600 --> 01:48:01,320 HAPPENED IN THE PAST YEAR. 3096 01:48:01,320 --> 01:48:04,280 SO FIRST, WE ARE SEARCHING FOR 3097 01:48:04,280 --> 01:48:08,000 AN ASSOCIATE DIRECTOR TO BE 3098 01:48:08,000 --> 01:48:09,760 PART OF THE COORDINATING CENTER 3099 01:48:09,760 --> 01:48:10,320 LEADERSHIP TEAM. 3100 01:48:10,320 --> 01:48:11,920 WE HAVE THESE ACTIVITIES THAT 3101 01:48:11,920 --> 01:48:13,640 HAVE BEEN ONGOING BUT THE 3102 01:48:13,640 --> 01:48:15,640 REALLY BEEN A GRASSROOTS EFFORT. 3103 01:48:15,640 --> 01:48:17,360 WE NEED TO HAVE SOMEBODY THAT 3104 01:48:17,360 --> 01:48:19,440 IS INTEGRAL IN THE COORDINATING 3105 01:48:19,440 --> 01:48:21,320 CENTER TO SERVE IN A LEADERSHIP 3106 01:48:21,320 --> 01:48:22,480 ROLL OVER SEEING ALL OF THIS. 3107 01:48:22,480 --> 01:48:25,080 SO IF YOU KNOW OF ANYONE WHO IS 3108 01:48:25,080 --> 01:48:26,200 INTERESTED, PLEASE HAVE THEM 3109 01:48:26,200 --> 01:48:28,080 REACH OUT TO US, AND I CAN GIVE 3110 01:48:28,080 --> 01:48:29,120 YOU MORE INFORMATION ON THAT 3111 01:48:29,120 --> 01:48:30,360 POSITION. 3112 01:48:30,360 --> 01:48:33,120 WE ALSO BROADENED OUR STEERING 3113 01:48:33,120 --> 01:48:34,560 COMMITTEE MEMBERSHIP. 3114 01:48:34,560 --> 01:48:37,360 LIKE MANY ASPECTS OF SCIENCE, 3115 01:48:37,360 --> 01:48:39,240 WE RECOGNIZE ABCD, WE DO NOT 3116 01:48:39,240 --> 01:48:41,320 HAVE A VERY DIVERSE 3117 01:48:41,320 --> 01:48:42,240 PARTICULARLY LEADERSHIP GROUP 3118 01:48:42,240 --> 01:48:46,120 WITHIN THE CONSHORT SCHUMM. 3119 01:48:46,120 --> 01:48:46,840 -- CONSORTIUM. 3120 01:48:46,840 --> 01:48:49,200 THE WAY THE STEERING COMMITTEE 3121 01:48:49,200 --> 01:48:50,400 WAS ORIGINALLY POPULATED IS 3122 01:48:50,400 --> 01:48:52,240 LIMITING IT TO P.I.'S. 3123 01:48:52,240 --> 01:48:55,920 WE HAVE VERY FEW P.I.'S OF 3124 01:48:55,920 --> 01:48:57,320 COLOR WITHIN ABCD, SO TO MAKE 3125 01:48:57,320 --> 01:48:59,720 SURE WE HAVE DIVERSITY, WE 3126 01:48:59,720 --> 01:49:00,920 BROADENED THAT MEMBERSHIP TO 3127 01:49:00,920 --> 01:49:03,520 INCLUDE MEMBERS OF OUR JEDI 3128 01:49:03,520 --> 01:49:05,600 ADVISORY COUNCIL WHO ARE NOT 3129 01:49:05,600 --> 01:49:07,760 P.I.'S, BUT CAN PROVIDE THAT 3130 01:49:07,760 --> 01:49:09,680 IMPORTANT PERSPECTIVE. 3131 01:49:09,680 --> 01:49:11,800 SO, WE ADDED TWO MEMBERS OF 3132 01:49:11,800 --> 01:49:14,160 THAT ADVISORY COUNCIL WHO ARE A 3133 01:49:14,160 --> 01:49:17,720 LITTLE BIT JUNIOR IN STAGE OF 3134 01:49:17,720 --> 01:49:19,160 CAREER, BUT VERY VALUABLE IN 3135 01:49:19,160 --> 01:49:20,840 TERMS OF BRINGING THIS 3136 01:49:20,840 --> 01:49:22,320 PERSPECTIVE TO OUR 3137 01:49:22,320 --> 01:49:22,920 DECISION-MAKING BODY. 3138 01:49:22,920 --> 01:49:26,080 WITH RESPECT TO THE DIVERSITY 3139 01:49:26,080 --> 01:49:27,120 SENSITIVE-METHODS GROUP. 3140 01:49:27,120 --> 01:49:28,520 THEY HAVE REALLY DONE AN 3141 01:49:28,520 --> 01:49:32,520 AMAZING JOB OF REVIEWING THE 3142 01:49:32,520 --> 01:49:34,840 EXISTING PROTOCOL, AS WELL AS 3143 01:49:34,840 --> 01:49:36,480 ANY ANCILLARY STUDIES THAT ARE 3144 01:49:36,480 --> 01:49:38,360 BEING PROPOSED TO ENSURE THE 3145 01:49:38,360 --> 01:49:39,320 LANGUAGE BEING INCLUDED IN AND 3146 01:49:39,320 --> 01:49:41,200 THE WAY THEY ARE BEING 3147 01:49:41,200 --> 01:49:43,240 IMPLEMENTED ARE SENSITIVE TO 3148 01:49:43,240 --> 01:49:44,960 DIVERSE PARTICIPANTS WITHIN 3149 01:49:44,960 --> 01:49:45,360 ABCD. 3150 01:49:45,360 --> 01:49:47,240 AS A RESULT OF THAT, WE HAVE 3151 01:49:47,240 --> 01:49:49,320 MADE CHANGES TO THE WORDING OF 3152 01:49:49,320 --> 01:49:51,680 QUESTIONS OR THE PLACEMENT OF 3153 01:49:51,680 --> 01:49:54,080 QUESTIONS IN CONTEXT WITHIN THE 3154 01:49:54,080 --> 01:49:55,120 ABCD PROTOCOL. 3155 01:49:55,120 --> 01:49:59,600 WE HAVE ALSO ADDED SOME 3156 01:49:59,600 --> 01:50:03,320 TRAINING ON, AS WELL AS SCRIPTS 3157 01:50:03,320 --> 01:50:04,000 FOR CULTURALLY SENSITIVE 3158 01:50:04,000 --> 01:50:05,680 COLLECTION AND OTHER ASPECTS OF 3159 01:50:05,680 --> 01:50:06,760 THE PROTOCOL. 3160 01:50:06,760 --> 01:50:09,840 WE HAD A REALLY EXCITING 3161 01:50:09,840 --> 01:50:11,360 PROGRAM, PILOT PROGRAM LAUNCHED 3162 01:50:11,360 --> 01:50:14,920 AT ONE OF THE ABCD SITES AT THE 3163 01:50:14,920 --> 01:50:17,120 UNIVERSITY OF VERMONT, CALLED 3164 01:50:17,120 --> 01:50:19,480 THE SCIENTIFIC TRAINING AND 3165 01:50:19,480 --> 01:50:21,160 ADDICTION RESEARCH TECHNIQUES. 3166 01:50:21,160 --> 01:50:23,360 THIS WAS DESIGNED -- ONE OF 3167 01:50:23,360 --> 01:50:24,760 THE THINGS I MENTIONED WE WANT 3168 01:50:24,760 --> 01:50:29,000 TO DO WITH ABCD IS INCREASE THE 3169 01:50:29,000 --> 01:50:30,680 DIVERSITY OF CONSORTIUM ITSELF 3170 01:50:30,680 --> 01:50:33,920 BUT WE ALSO WANT ABCD TO BE A 3171 01:50:33,920 --> 01:50:35,520 PIVOTAL PLACE FOR INCREASING 3172 01:50:35,520 --> 01:50:37,880 THE DIVERSITY OF SCIENTIFIC 3173 01:50:37,880 --> 01:50:38,600 WORKFORCE MORE BROADLY. 3174 01:50:38,600 --> 01:50:40,480 BECAUSE WE HAVE THIS RICH DATA 3175 01:50:40,480 --> 01:50:42,120 SET, WE WANT TO MAKE SURE 3176 01:50:42,120 --> 01:50:43,720 PEOPLE FROM UNDER REPRESENTED 3177 01:50:43,720 --> 01:50:45,120 GROUPS IN SCIENCE, ONE, 3178 01:50:45,120 --> 01:50:46,680 RECOGNIZE THEY HAVE ACCESS TO 3179 01:50:46,680 --> 01:50:48,000 THIS, AND UNDERSTAND HOW TO USE 3180 01:50:48,000 --> 01:50:49,080 IT. 3181 01:50:49,080 --> 01:50:52,680 SO THIS PROGRAM, WHICH WAS JUST 3182 01:50:52,680 --> 01:50:56,040 LAUNCHED THIS YEAR, BROUGHT IN 3183 01:50:56,040 --> 01:50:58,360 12 UNDER-REPRESENTED SCHOLARS 3184 01:50:58,360 --> 01:51:01,240 AT THE PRE-DOC, POST-DOC AND 3185 01:51:01,240 --> 01:51:02,240 EARLY INVESTIGATOR LEVEL TO 3186 01:51:02,240 --> 01:51:04,200 LEARN MORE ABOUT THE DATA SET 3187 01:51:04,200 --> 01:51:05,880 ITSELF. 3188 01:51:05,880 --> 01:51:07,520 THE A YEAR-LONG PROGRAM WHICH 3189 01:51:07,520 --> 01:51:10,040 BY THE END WE HOPE THEY WILL 3190 01:51:10,040 --> 01:51:10,680 HAVE PUBLICATIONS READY FOR 3191 01:51:10,680 --> 01:51:11,480 SUBMISSION. 3192 01:51:11,480 --> 01:51:13,280 IT WAS AN EARLY LAUNCH TO THIS 3193 01:51:13,280 --> 01:51:13,840 PROGRAM. 3194 01:51:13,840 --> 01:51:16,560 THERE WAS A LOT OF BI 3195 01:51:16,560 --> 01:51:17,080 DIRECTIONAL INFORMATION 3196 01:51:17,080 --> 01:51:17,520 COMMUNICATED. 3197 01:51:17,520 --> 01:51:21,040 WE GOT TO LEARN A LOT ABOUT 3198 01:51:21,040 --> 01:51:22,240 WHAT THEIR CHALLENGES HAVE BEEN. 3199 01:51:22,240 --> 01:51:24,320 AS WELL AS PROVIDING THEM, NOT 3200 01:51:24,320 --> 01:51:25,720 ONLY WITH INFORMATION ABOUT THE 3201 01:51:25,720 --> 01:51:27,840 DATA SET, BUT HANDS ON ACTIVITY 3202 01:51:27,840 --> 01:51:30,120 AND THEN MENTORS THAT ARE 3203 01:51:30,120 --> 01:51:31,880 WORKING WITH THEM TO DEVELOP 3204 01:51:31,880 --> 01:51:32,840 THEIR PROGRAMS. 3205 01:51:32,840 --> 01:51:35,480 IT WAS REALLY EXCITING TO SEE 3206 01:51:35,480 --> 01:51:36,920 THESE SCHOLARS TAKE SOME RISKS 3207 01:51:36,920 --> 01:51:38,720 IN THEIR SCIENCE TO GO INTO 3208 01:51:38,720 --> 01:51:43,720 AREAS THAT THEY HAD NOT BEEN 3209 01:51:43,720 --> 01:51:45,760 INVOLVED WITH IN THE PAST, BUT 3210 01:51:45,760 --> 01:51:48,400 SAW THE POTENTIAL FROM THE ABCD 3211 01:51:48,400 --> 01:51:49,480 DATA SET. 3212 01:51:49,480 --> 01:51:51,320 I'M EXCITED TO SEE WHERE THEY 3213 01:51:51,320 --> 01:51:52,640 TAKE IT FROM HERE. 3214 01:51:52,640 --> 01:51:55,320 THE LAST AREA IS RESPONSIBLE 3215 01:51:55,320 --> 01:51:57,440 DATA USE, THERE WAS A PAPER 3216 01:51:57,440 --> 01:51:59,280 PUBLISHED TALKING ABOUT HOW THE 3217 01:51:59,280 --> 01:52:00,320 CONSIDERATIONS THAT PEOPLE NEED 3218 01:52:00,320 --> 01:52:02,520 TO THINK ABOUT WHEN USING OPEN 3219 01:52:02,520 --> 01:52:04,920 DATA SETS LIKE THE ABCD STUDY 3220 01:52:04,920 --> 01:52:05,680 DATA. 3221 01:52:05,680 --> 01:52:06,920 YOU KNOW, I THINK THIS IS JUST 3222 01:52:06,920 --> 01:52:08,480 A BEGINNING. 3223 01:52:08,480 --> 01:52:10,320 BUT CONCRETE CHANGES THAT HAVE 3224 01:52:10,320 --> 01:52:12,440 HAPPENED SINCE THIS JEDI 3225 01:52:12,440 --> 01:52:14,480 INITIATIVE HAS BEEN LAUNCHED 3226 01:52:14,480 --> 01:52:15,800 WITHIN ABCD. 3227 01:52:15,800 --> 01:52:19,000 AND I'M REALLY PROUD WE ARE 3228 01:52:19,000 --> 01:52:20,880 TACKLING ISSUES YOU THINK NIH 3229 01:52:20,880 --> 01:52:23,440 AS A WHOLE, NEEDS TO DO MORE SO. 3230 01:52:23,440 --> 01:52:25,320 SO ONE AREA IN PARTICULAR, I 3231 01:52:25,320 --> 01:52:30,640 THINK IS THIS LOOK AT 3232 01:52:30,640 --> 01:52:31,720 DIVERSITY-SENSITIVE METHODS. 3233 01:52:31,720 --> 01:52:36,560 MANY METHODS IN ABCD WERE 3234 01:52:36,560 --> 01:52:38,520 INITIALLY CHOSEN BECAUSE THEY 3235 01:52:38,520 --> 01:52:40,120 WERE WELL-ESTABLISHED. 3236 01:52:40,120 --> 01:52:41,840 THAT MEANS THEY WERE OFTEN NOT 3237 01:52:41,840 --> 01:52:44,280 LOOKED AT FOR THE INCLUSIVITY 3238 01:52:44,280 --> 01:52:45,440 OF THE LANGUAGE BECAUSE THEY 3239 01:52:45,440 --> 01:52:46,480 HAVE BEEN AROUND FOR A VERY 3240 01:52:46,480 --> 01:52:47,760 LONG TIME. 3241 01:52:47,760 --> 01:52:48,960 TAKING THIS NEW LENS AND 3242 01:52:48,960 --> 01:52:50,920 LOOKING AT THESE METHODS HAS 3243 01:52:50,920 --> 01:52:52,920 BEEN VALUABLE FROM THE 3244 01:52:52,920 --> 01:52:53,880 PERIRESPECTIVE OF UNDERSTANDING 3245 01:52:53,880 --> 01:52:55,320 WE ARE GETTING THE DATA WE WANT 3246 01:52:55,320 --> 01:52:57,360 TO GET OUT OF THE MEASURES, AS 3247 01:52:57,360 --> 01:52:59,000 WELL AS MAKING SURE OUR 3248 01:52:59,000 --> 01:53:00,480 PARTICIPANTS AND STAFF ARE 3249 01:53:00,480 --> 01:53:01,640 COMFORTABLE WITH THE WAY THE 3250 01:53:01,640 --> 01:53:02,320 QUESTIONS ARE WORDED. 3251 01:53:02,320 --> 01:53:04,200 I THINK THAT WILL SPEAK TO 3252 01:53:04,200 --> 01:53:06,320 ENSURING WE HAVE DIVERSE 3253 01:53:06,320 --> 01:53:06,960 REPRESENTATION IN SCIENCE 3254 01:53:06,960 --> 01:53:14,360 MOVING FORWARD. 3255 01:53:14,360 --> 01:53:16,000 AND AS NIH, WE ARE ASKING 3256 01:53:16,000 --> 01:53:17,400 INVESTIGATORS TO USE CERTAIN 3257 01:53:17,400 --> 01:53:19,280 MEASURES FOR COMMON DATA 3258 01:53:19,280 --> 01:53:20,880 ELEMENTS, FOR EXAMPLE, IT'S 3259 01:53:20,880 --> 01:53:22,040 INCUMBENT ON US TO MAKE SURE 3260 01:53:22,040 --> 01:53:23,920 WHAT WE ARE ASKING YOU ALL TO 3261 01:53:23,920 --> 01:53:27,160 USE ARE MEASURES THAT MEET THIS 3262 01:53:27,160 --> 01:53:28,640 INCLUSIVITY. 3263 01:53:28,640 --> 01:53:30,680 SO I'M HOPING THAT IS SOMETHING 3264 01:53:30,680 --> 01:53:34,720 THAT WILL CONTINUE TO EVOLVE AT 3265 01:53:34,720 --> 01:53:35,680 NIH MORE BROADLY. 3266 01:53:35,680 --> 01:53:37,720 SO I WOULD NOW LIKE TO JUST 3267 01:53:37,720 --> 01:53:39,560 TRANSITION A LITTLE BIT INTO 3268 01:53:39,560 --> 01:53:40,800 COVID-19. 3269 01:53:40,800 --> 01:53:44,320 AND LAST YEAR YOU MENTIONED 3270 01:53:44,320 --> 01:53:47,320 THAT WE HAD LAUNCHED SOME 3271 01:53:47,320 --> 01:53:49,400 SURVEYS DURING THE PANDEMIC TO 3272 01:53:49,400 --> 01:53:51,080 COLLECT INFORMATION ON THE 3273 01:53:51,080 --> 01:53:53,400 IMPACT OF THE PANDEMIC ON THE 3274 01:53:53,400 --> 01:53:55,000 YOUTH AND ABCD STUDY. 3275 01:53:55,000 --> 01:53:56,400 SO THIS GOES BEYOND THE 3276 01:53:56,400 --> 01:53:58,520 STANDARD ANNUAL AND MID-YEAR 3277 01:53:58,520 --> 01:54:01,520 VISITS THAT WERE PART OF THE 3278 01:54:01,520 --> 01:54:02,360 REGULAR PROTOCOL. 3279 01:54:02,360 --> 01:54:04,920 AND AS PART OF THAT, OF COURSE, 3280 01:54:04,920 --> 01:54:07,000 ALONG WITH EVERYTHING ELSE IN 3281 01:54:07,000 --> 01:54:08,400 ABCD WE STATED TO THE PUBLIC 3282 01:54:08,400 --> 01:54:10,520 AND IT'S RESULTED IN A NUMBER 3283 01:54:10,520 --> 01:54:11,680 OF PUBLICATIONS ALREADY LOOKING 3284 01:54:11,680 --> 01:54:14,080 AT THE IMPACT OF THE PANDEMIC 3285 01:54:14,080 --> 01:54:17,560 ON THE YOUTH AND ABCD STUDIES. 3286 01:54:17,560 --> 01:54:19,320 LARGELY FOCUSED ON MENTAL 3287 01:54:19,320 --> 01:54:20,360 HEALTH OUTCOMES. 3288 01:54:20,360 --> 01:54:22,240 ALSO LOOK AT SUBSTANCE USE. 3289 01:54:22,240 --> 01:54:23,520 SCREEN TIME. 3290 01:54:23,520 --> 01:54:25,240 PHYSICAL ACTIVITY. 3291 01:54:25,240 --> 01:54:27,120 IMPACTS ON LEARNING. 3292 01:54:27,120 --> 01:54:29,400 SPECIFIC IMPACTS, AS WELL AS 3293 01:54:29,400 --> 01:54:31,160 RESILIENCY FACTORS FROM 3294 01:54:31,160 --> 01:54:32,720 MARGINALIZED COMMUNITIES. 3295 01:54:32,720 --> 01:54:35,320 IT'S BEEN EXCITING TO SEE THE 3296 01:54:35,320 --> 01:54:36,200 SCIENTIFIC COMMUNITY EMBRACE 3297 01:54:36,200 --> 01:54:38,520 THIS DATA AND REALLY LOOK AT, 3298 01:54:38,520 --> 01:54:39,640 NOT ONLY WHAT'S HAPPENING 3299 01:54:39,640 --> 01:54:41,040 WITHIN THE PANDEMIC BUT BEING 3300 01:54:41,040 --> 01:54:44,560 ABLE TO TAKE SOME OF THIS DATA 3301 01:54:44,560 --> 01:54:46,720 AND LOOK AT SOME OF THE 3302 01:54:46,720 --> 01:54:47,840 PRE-PANDEMIC DATA TO SEE 3303 01:54:47,840 --> 01:54:49,280 DIFFERENCES THAT HAVE EMERGED. 3304 01:54:49,280 --> 01:54:51,120 IN FACT, TO THE QUESTION THAT 3305 01:54:51,120 --> 01:54:54,400 WAS DISCUSSED EARLIER ABOUT 3306 01:54:54,400 --> 01:54:56,280 VAPING, WITHIN ABCD, WE 3307 01:54:56,280 --> 01:54:59,040 ACTUALLY HAVE SEEN THAT WHILE 3308 01:54:59,040 --> 01:55:00,920 ALCOHOL USE DECREASED FROM 3309 01:55:00,920 --> 01:55:02,800 PRE-PANDEMIC TO DURING THE 3310 01:55:02,800 --> 01:55:03,920 PANDEMIC, NICOTINE USE 3311 01:55:03,920 --> 01:55:12,520 INCREASED. 3312 01:55:12,520 --> 01:55:13,920 THOSE INVESTIGATORS ARE LOOKING 3313 01:55:13,920 --> 01:55:16,240 AT ADDITIONAL TIME POINTS OF 3314 01:55:16,240 --> 01:55:18,360 THAT DATA TO SEE IF THAT 3315 01:55:18,360 --> 01:55:19,120 CHANGED OVER TIME DURING THE 3316 01:55:19,120 --> 01:55:21,640 PANDEMIC. 3317 01:55:21,640 --> 01:55:22,800 IN ADDITION, ABCD HAS NOW 3318 01:55:22,800 --> 01:55:25,360 BECOME A PART OF THE RECOVER 3319 01:55:25,360 --> 01:55:27,040 INITIATIVE AT NIH, WHICH IS A 3320 01:55:27,040 --> 01:55:30,000 STUDY OF LONG COVID. 3321 01:55:30,000 --> 01:55:31,360 THAT WAS LAUNCHED A FEW MONTHS 3322 01:55:31,360 --> 01:55:32,320 AGO. 3323 01:55:32,320 --> 01:55:35,160 SO, FOR THE RECOVER INITIATIVE, 3324 01:55:35,160 --> 01:55:36,760 THE PEDIATRIC COHORT AIMS TO 3325 01:55:36,760 --> 01:55:40,280 LOOK AT THE INCIDENTS 3326 01:55:40,280 --> 01:55:48,560 PREVALENCE AND LONG-TERM IS 3327 01:55:48,560 --> 01:55:49,520 SEQUELLAE OF SARS-COV-2. 3328 01:55:49,520 --> 01:55:53,680 AND TO UNDERSTAND THE 3329 01:55:53,680 --> 01:55:54,920 PATHOBIOLOGY AND MECHANISMS OF 3330 01:55:54,920 --> 01:55:55,720 LONG COVID. 3331 01:55:55,720 --> 01:55:58,760 SO THIS A VERY LARGE INITIATIVE 3332 01:55:58,760 --> 01:56:00,000 AND ABCD IS JUST A SMALL PART 3333 01:56:00,000 --> 01:56:01,880 OF IT. 3334 01:56:01,880 --> 01:56:04,440 MOST IS FOCUSED ON ENROLLING 3335 01:56:04,440 --> 01:56:06,320 PEOPLE EITHER ACUTELY INFECTED 3336 01:56:06,320 --> 01:56:07,680 WITH COVID-19 OR HAD COVID-19 3337 01:56:07,680 --> 01:56:10,960 IN THE PAST AND ARE INVOLVED IN 3338 01:56:10,960 --> 01:56:12,640 THIS POST-ACUTE INFECTED COHORT. 3339 01:56:12,640 --> 01:56:14,720 SO THE MAIN RECOVER STUDY IS 3340 01:56:14,720 --> 01:56:16,360 GOING TO TAKE THESE, AS WELL AS 3341 01:56:16,360 --> 01:56:20,120 THOSE THAT ARE UNINFECTED, TAKE 3342 01:56:20,120 --> 01:56:22,200 THESE 6,000 PARTICIPANTS AND GO 3343 01:56:22,200 --> 01:56:31,440 THROUGH DIFFERENT TIERS OF 3344 01:56:31,440 --> 01:56:31,960 FACTORS, CARDIOVASCULAR, 3345 01:56:31,960 --> 01:56:33,280 COGNITIVE. 3346 01:56:33,280 --> 01:56:34,720 BUT FOR ABCD, WE THOUGHT IT WAS 3347 01:56:34,720 --> 01:56:38,080 IMPORTANT TO BE IN THIS 3348 01:56:38,080 --> 01:56:40,680 INITIATIVE TO UNDERSTAND THE 3349 01:56:40,680 --> 01:56:43,360 IMPACT OF COVID ON OUR COHORT 3350 01:56:43,360 --> 01:56:45,320 GIVEN A LOT OF THE OUTCOME WES 3351 01:56:45,320 --> 01:56:49,320 ARE LOOKING AT AT ABCD ARE 3352 01:56:49,320 --> 01:56:51,000 IMPACTED BY SARS-COV-2 AND THE 3353 01:56:51,000 --> 01:56:52,080 PANDEMIC ITSELF. 3354 01:56:52,080 --> 01:57:00,680 SO OUR GOAL IS TO GET ANTIBODY 3355 01:57:00,680 --> 01:57:02,480 TESTING, IDENTIFY PEOPLE WHO 3356 01:57:02,480 --> 01:57:03,640 HAD COVID-19 EXPOSURE AND THEN 3357 01:57:03,640 --> 01:57:05,800 BE ABLE TO LOOK AT THOSE WHO 3358 01:57:05,800 --> 01:57:06,960 MAY OR MAY NOT DEVELOP LONG 3359 01:57:06,960 --> 01:57:07,400 COVID. 3360 01:57:07,400 --> 01:57:09,040 SO WE ARE REALLY JUST GOING TO 3361 01:57:09,040 --> 01:57:11,120 BE INVOLVED IN THIS FIRST TIER, 3362 01:57:11,120 --> 01:57:14,120 BECAUSE WE HAVE SO MUCH DATA 3363 01:57:14,120 --> 01:57:15,720 WITHIN ABCD ITSELF THAT WE WILL 3364 01:57:15,720 --> 01:57:17,360 BE ABLE TO ASSOCIATE WITH THAT 3365 01:57:17,360 --> 01:57:19,920 DATA TO LOOK AT LONG-TERM 3366 01:57:19,920 --> 01:57:21,120 OUTCOMES. 3367 01:57:21,120 --> 01:57:24,120 THERE ARE OVERLAP BETWEEN ABCD 3368 01:57:24,120 --> 01:57:27,160 SITES AND SITES INVOLVED IN THE 3369 01:57:27,160 --> 01:57:28,120 MORE IN-DEPTH CHARACTERIZATION 3370 01:57:28,120 --> 01:57:29,360 OF LONG COVID. 3371 01:57:29,360 --> 01:57:30,920 SO THERE'S A POSSIBILITY IF WE 3372 01:57:30,920 --> 01:57:32,120 IDENTIFY CASES THEY MAY BECOME 3373 01:57:32,120 --> 01:57:35,120 PART OF THE MAIN STUDY. 3374 01:57:35,120 --> 01:57:37,520 FOR ABCD ITSELF, WE ARE REALLY 3375 01:57:37,520 --> 01:57:40,320 FOCUSED ON THE COLLECTING 3376 01:57:40,320 --> 01:57:42,560 ANTIBODY DATA AND SOME SURVEY 3377 01:57:42,560 --> 01:57:44,640 DATA ON LONG COVID SYMPTOMS TO 3378 01:57:44,640 --> 01:57:46,720 BE ABLE TO LOOK, FROM A 3379 01:57:46,720 --> 01:57:49,520 POPULATION STANDPOINT AT THE 3380 01:57:49,520 --> 01:57:50,920 PREVALENCE OF INFECTION AND 3381 01:57:50,920 --> 01:57:52,360 LONG COVID IN ADOLESCENCE. 3382 01:57:52,360 --> 01:57:54,920 BECAUSE WE HAVE PRE-PANDEMIC, 3383 01:57:54,920 --> 01:57:56,560 DURING PANDEMIC AND LONG-TERM 3384 01:57:56,560 --> 01:57:58,480 FOLLOW-UP, WE THINK WE ARE IN A 3385 01:57:58,480 --> 01:58:01,080 UNIQUE PLACE TO BE ABLE TO LOOK 3386 01:58:01,080 --> 01:58:03,720 AT THESE PRE-INFECTION RISK AND 3387 01:58:03,720 --> 01:58:04,720 RESILIENCY FACTORS. 3388 01:58:04,720 --> 01:58:06,920 SINCE MOST OF THE OTHER STUDIES 3389 01:58:06,920 --> 01:58:08,360 ARE ENROLLING CURRENTLY 3390 01:58:08,360 --> 01:58:09,840 INFECTED OR RECENTLY INFECTED 3391 01:58:09,840 --> 01:58:15,760 BUT DON'T HAVE THE PRE-PANDEMIC 3392 01:58:15,760 --> 01:58:16,720 PHENOTYPING WE DO. 3393 01:58:16,720 --> 01:58:18,160 BECAUSE OF THAT, WE THINK WE 3394 01:58:18,160 --> 01:58:19,760 WILL BE ABLE TO ISOLATE THE 3395 01:58:19,760 --> 01:58:21,120 DIFFERENCES BETWEEN THE EFFECTS 3396 01:58:21,120 --> 01:58:26,720 OF THE INFECTION ITSELF, AS 3397 01:58:26,720 --> 01:58:28,320 WELL AS PRE-PANDEMIC AND 3398 01:58:28,320 --> 01:58:29,520 GENERAL PANDEMIC IMPACTS. 3399 01:58:29,520 --> 01:58:33,360 AND OF COURSE, BECAUSE ABCD 3400 01:58:33,360 --> 01:58:35,240 ITSELF HAS IN-DEPTH BRAIN 3401 01:58:35,240 --> 01:58:37,880 COGNITIVE AND MENTAL HEALTH 3402 01:58:37,880 --> 01:58:39,920 PHENOTYPING THAT WILL CONTINUE 3403 01:58:39,920 --> 01:58:41,800 MUCH LONGER THAN ANY OF THESE 3404 01:58:41,800 --> 01:58:43,160 OTHER STUDIES WE THINK WE ARE 3405 01:58:43,160 --> 01:58:45,720 IN A UNIQUE POSITION TO 3406 01:58:45,720 --> 01:58:48,080 UNDERSTAND ANY CONTRIBUTORS TO 3407 01:58:48,080 --> 01:58:51,560 ANY LONG-TERM OUTCOMES WE SEE. 3408 01:58:51,560 --> 01:58:53,160 THAT'S GOING TO GET OFF THE 3409 01:58:53,160 --> 01:58:56,200 GROUND SOON TO COLLECT THAT 3410 01:58:56,200 --> 01:58:57,560 ANTIBODY DATA AND SURVEY 3411 01:58:57,560 --> 01:58:58,080 QUESTIONNAIRE. 3412 01:58:58,080 --> 01:58:59,800 I WOULD NOW LIKE TO TRANSITION 3413 01:58:59,800 --> 01:59:02,360 A LITTLE BIT INTO OUR DATA 3414 01:59:02,360 --> 01:59:06,080 RELEASES AND JUST HOW ABCD DATA 3415 01:59:06,080 --> 01:59:07,720 IS BEING USED MORE GENERALLY. 3416 01:59:07,720 --> 01:59:09,800 AS YOU KNOW WE RELEASE DATA 3417 01:59:09,800 --> 01:59:13,560 EVERY YEAR, WHAT WE HAVE OUT IS 3418 01:59:13,560 --> 01:59:14,720 4.0, INCLUDES LONGITUDINAL DATA 3419 01:59:14,720 --> 01:59:16,600 FOR THE BRAIN IMAGING. 3420 01:59:16,600 --> 01:59:19,520 WE HAVE THE TWO-YEAR COHORT 3421 01:59:19,520 --> 01:59:20,520 DATA AVAILABLE. 3422 01:59:20,520 --> 01:59:22,640 ALL OF THE COVID-19 3423 01:59:22,640 --> 01:59:23,920 SUPPLEMENTAL DATA THAT HAS BEEN 3424 01:59:23,920 --> 01:59:25,440 COLLECTED TO DATE. 3425 01:59:25,440 --> 01:59:27,520 WE ALSO RECENTLY RELEASED SOME 3426 01:59:27,520 --> 01:59:28,920 NEW FUNDING OPPORTUNITY 3427 01:59:28,920 --> 01:59:29,800 ANNOUNCEMENTS FOR OUR 3428 01:59:29,800 --> 01:59:32,960 INVESTIGATORS TO USE ABCD DATA 3429 01:59:32,960 --> 01:59:38,240 FOR A VARIETY OF PURPOSES. 3430 01:59:38,240 --> 01:59:41,720 NIDA HAS TWO RFA'S OUT. 3431 01:59:41,720 --> 01:59:44,080 THESE AREN'T SPECIFIC TO ABCD 3432 01:59:44,080 --> 01:59:46,600 BUT WE ENCOURAGE THOSE WHO WANT 3433 01:59:46,600 --> 01:59:49,400 TO USE ABCD DATA FOR OUTCOMES 3434 01:59:49,400 --> 01:59:52,160 TO APPLY FOR THESE RFA'S. 3435 01:59:52,160 --> 01:59:53,840 WE ISSUED A PROGRAM 3436 01:59:53,840 --> 01:59:56,200 ANNOUNCEMENT SPEF ECTO ABCD BUT 3437 01:59:56,200 --> 02:00:01,800 CAN BE FOCUSED ON OTHER 3438 02:00:01,800 --> 02:00:02,840 AND AS A RESULT OF THIS WE ARE 3439 02:00:02,840 --> 02:00:05,880 SEEING A NICE UPTICK IN PEOPLE 3440 02:00:05,880 --> 02:00:11,200 BEING FUNDED TO ANALYZE ABCD 3441 02:00:11,200 --> 02:00:13,760 DATA AND NOW FUNDED 73 3442 02:00:13,760 --> 02:00:16,560 LEVERAGING ABCD DATA AS OF LAST 3443 02:00:16,560 --> 02:00:17,160 DECEMBER. 3444 02:00:17,160 --> 02:00:19,400 THIS IS REALLY JUST TO SHOW THAT 3445 02:00:19,400 --> 02:00:21,320 WHILE MANY OF THESE ARE RESEARCH 3446 02:00:21,320 --> 02:00:26,120 GRANTS AND MANY ARE RO1s WE'RE 3447 02:00:26,120 --> 02:00:27,840 SEEING A DIVERSITY OF GRANT 3448 02:00:27,840 --> 02:00:29,720 MECHANISMS PEOPLE ARE LYING FOR 3449 02:00:29,720 --> 02:00:32,520 AND IN DIFFERENT MECHANISMS 3450 02:00:32,520 --> 02:00:33,840 WHICH IS REALLY EXCITING. 3451 02:00:33,840 --> 02:00:35,040 WE'RE SEEING DIFFERENT 3452 02:00:35,040 --> 02:00:36,760 INSTITUTES AND CENTERS VERY 3453 02:00:36,760 --> 02:00:39,680 INTERESTED IN GRANTS LEVERAGING 3454 02:00:39,680 --> 02:00:41,240 ABCD DATA. 3455 02:00:41,240 --> 02:00:48,760 WHILE NIMH HAD HAS THE MOST 3456 02:00:48,760 --> 02:00:50,920 THERE'S MANY NOT INVOLVED IN 3457 02:00:50,920 --> 02:00:53,840 SUPPORTING THE ABCD DATA ITSELF 3458 02:00:53,840 --> 02:00:56,240 AND ANALYZING THE DATA THERE AND 3459 02:00:56,240 --> 02:01:01,440 INCLUDES NIBIB, DENTAL 3460 02:01:01,440 --> 02:01:03,440 CRANIOFACIAL RESEARCH AND KIDNEY 3461 02:01:03,440 --> 02:01:06,680 DISEASES AND NIEHS. 3462 02:01:06,680 --> 02:01:09,720 AND THEN IN TERMS OF 3463 02:01:09,720 --> 02:01:10,480 PUBLICATIONS THE FIELD CONTINUES 3464 02:01:10,480 --> 02:01:13,400 TO BE VERY PRODUCTIVE IN ITS USE 3465 02:01:13,400 --> 02:01:15,920 OF ABCD DATA. 3466 02:01:15,920 --> 02:01:18,440 IT'S NOW UP TO ABOUT 345 AS OF 3467 02:01:18,440 --> 02:01:23,160 THIS MORNING AND YOU CAN SEE WE 3468 02:01:23,160 --> 02:01:25,520 CONTINUE TO SEE MANY NON-ABC 3469 02:01:25,520 --> 02:01:28,000 INVESTIGATORS USING ABCD DATA 3470 02:01:28,000 --> 02:01:30,560 WHICH IS REALLY EXCITING. 3471 02:01:30,560 --> 02:01:33,880 I NOW WANT TO TRANSITION INTO 3472 02:01:33,880 --> 02:01:35,120 SOME OF THE RESEARCH FINDINGS 3473 02:01:35,120 --> 02:01:37,000 AND I'VE MENTIONED IN THE PAST 3474 02:01:37,000 --> 02:01:39,480 THAT WE HAD SOME RESEARCH 3475 02:01:39,480 --> 02:01:45,680 QUESTIONS THAT CAME OUT WITH THE 3476 02:01:45,680 --> 02:01:49,360 RFA FOR ABCD QUESTIONS AND MANY 3477 02:01:49,360 --> 02:01:56,400 QUESTIONS USING ABCD DATA BUT 3478 02:01:56,400 --> 02:01:59,560 LOOKING AT HOW THE FIELD ARE 3479 02:01:59,560 --> 02:02:00,520 TAKING ADVANTAGE OF LARGE ABCD 3480 02:02:00,520 --> 02:02:03,640 DATA SETS AND LOOK AT HOW WE'RE 3481 02:02:03,640 --> 02:02:05,200 CONDUCTING PARTICULARLY NEURO 3482 02:02:05,200 --> 02:02:06,200 IMAGING RESEARCH. 3483 02:02:06,200 --> 02:02:07,440 THE FOCUS OF THE PRESENTATIONS 3484 02:02:07,440 --> 02:02:09,920 YOU'RE GOING TO HEAR NOW FROM 3485 02:02:09,920 --> 02:02:11,120 ELIZABETH AND KIM ARE DOING 3486 02:02:11,120 --> 02:02:11,920 THAT. 3487 02:02:11,920 --> 02:02:13,680 TAKING A LOOK AT HOW WE COMBINE 3488 02:02:13,680 --> 02:02:14,720 DATA WITH OTHER DATA SETS OR 3489 02:02:14,720 --> 02:02:18,880 LOOK AT IT ALONGSIDE OTHER DATA 3490 02:02:18,880 --> 02:02:20,560 SETS AND HOW THAT INFORMS HOW 3491 02:02:20,560 --> 02:02:21,800 WE'RE GOING TO THINK ABOUT HOW 3492 02:02:21,800 --> 02:02:24,000 TO DO SCIENCE MOVING FORWARD. 3493 02:02:24,000 --> 02:02:25,880 I THINK THIS IS SOMETHING THAT'S 3494 02:02:25,880 --> 02:02:28,920 BEEN EXCITING TO SEE A SHIFT 3495 02:02:28,920 --> 02:02:30,960 MAYBE BECAUSE OF SOME OF THESE 3496 02:02:30,960 --> 02:02:37,400 LARGE-SCALE ANALYSES AND HOW WE 3497 02:02:37,400 --> 02:02:42,360 LOOK ANEUR NEUREURA NEUR RESEARCH MOVING 3498 02:02:42,360 --> 02:02:50,760 FORWARD AND I'LL TURN IT OVER TO 3499 02:02:50,760 --> 02:02:52,400 ELIZABETH HOFFMAN. 3500 02:02:52,400 --> 02:02:58,240 >> I'LL TELL YOU ABOUT A COUPLE 3501 02:02:58,240 --> 02:03:03,760 PAPERS THAT ARE IMPORTANT THAT 3502 02:03:03,760 --> 02:03:07,840 SHOW ABCD USED TO INFORM FROM 3503 02:03:07,840 --> 02:03:11,600 MOVING THE NEURAL IMAGING FIELD 3504 02:03:11,600 --> 02:03:11,840 FORWARD. 3505 02:03:11,840 --> 02:03:13,880 THE FIRST PAPER AND COLLEAGUES A 3506 02:03:13,880 --> 02:03:14,840 COUPLE MONTHS AGO IN NATURE LOOK 3507 02:03:14,840 --> 02:03:19,440 AT THE IMPLICATIONS OF SMALL 3508 02:03:19,440 --> 02:03:20,720 SAMPLES IN RAIN WIDE 3509 02:03:20,720 --> 02:03:22,640 ASSOCIATIONS STUDIES. 3510 02:03:22,640 --> 02:03:25,000 THEY'RE A PARTICULAR TIME OF 3511 02:03:25,000 --> 02:03:27,840 PARADIGM THAT LINKS INDIVIDUAL 3512 02:03:27,840 --> 02:03:32,680 VARIABILITY IN BRAIN TO 3513 02:03:32,680 --> 02:03:34,320 VARIATION IN BEHAVIOR. 3514 02:03:34,320 --> 02:03:37,880 THERE'S NEURAL IMAGING STUDIES 3515 02:03:37,880 --> 02:03:39,720 BROADLY WHICH THOUGH WHILE 3516 02:03:39,720 --> 02:03:40,760 PROBLEMATIC FOR SOME THEY 3517 02:03:40,760 --> 02:03:41,760 CONTRIBUTE TO REPLICATION 3518 02:03:41,760 --> 02:03:45,320 FAILURES THAT HAVE BEEN OBSERVED 3519 02:03:45,320 --> 02:03:46,720 IN BRAIN WIDE ASSOCIATIONS. 3520 02:03:46,720 --> 02:03:48,640 PREVIOUS GWAS STUDIES WITH 3521 02:03:48,640 --> 02:03:53,520 RELATIVELY SMALL SAMPLE SIZES 3522 02:03:53,520 --> 02:03:56,920 HAVE ASSOCIATIONS THAT HAVE BEEN 3523 02:03:56,920 --> 02:04:03,600 EXACERBATED BY PUBLICATION BIAS. 3524 02:04:03,600 --> 02:04:06,480 THIS MEANS INTERPRETATIONS MAY 3525 02:04:06,480 --> 02:04:07,440 NOT BE TRUE. 3526 02:04:07,440 --> 02:04:10,640 AND THEY LEVERAGED DATA FROM 3527 02:04:10,640 --> 02:04:13,720 THREE OF THE LARGEST STUDIES OF 3528 02:04:13,720 --> 02:04:15,640 ABCD AND THE CONNECTOME STUDY 3529 02:04:15,640 --> 02:04:19,120 FROM YOUTH TO MIDDLE TO LATE 3530 02:04:19,120 --> 02:04:21,920 ADULTHOOD. 3531 02:04:21,920 --> 02:04:23,640 THEY BEGAN WITH ABCD AND USED 3532 02:04:23,640 --> 02:04:25,920 UKB TO LOOK AT NEW VARIANT 3533 02:04:25,920 --> 02:04:28,760 EFFECT SIZE DISTRIBUTIONS AND 3534 02:04:28,760 --> 02:04:29,600 EXAMINED ASSOCIATIONS BETWEEN 3535 02:04:29,600 --> 02:04:31,400 BRAIN AND BEHAVIORAL PHENOTYPES 3536 02:04:31,400 --> 02:04:33,120 AND THEY FOCUS ON THE NETWORK 3537 02:04:33,120 --> 02:04:36,440 YOU CAN SEE BELOW AND THE 3538 02:04:36,440 --> 02:04:39,720 PHENOTYPES THEY INTERROGATED 3539 02:04:39,720 --> 02:04:46,720 WERE MEASURES AND THE SUB SCALES 3540 02:04:46,720 --> 02:04:49,760 AND PERFORMED MULTIVARIATE 3541 02:04:49,760 --> 02:04:51,320 ANALYSIS AS A FUNCTION OF SAMPLE 3542 02:04:51,320 --> 02:05:01,520 SIZE AND LOOKING AT SAMPLE SIZE 3543 02:05:01,520 --> 02:05:03,120 AS SMALL AS 35. 3544 02:05:03,120 --> 02:05:05,400 I DON'T HAVE TIME GO THROUGH ALL 3545 02:05:05,400 --> 02:05:07,480 THE RICH INFORMATION THAT'S 3546 02:05:07,480 --> 02:05:10,280 CONVEYED IN THIS PAPER AND 3547 02:05:10,280 --> 02:05:12,040 ENCOURAGE YOU TO LOOK AT THE 3548 02:05:12,040 --> 02:05:13,560 PAPER AFTERWARD BUT LOOK AT THE 3549 02:05:13,560 --> 02:05:15,320 MAIN TAKE-HOME RESULTS FROM THE 3550 02:05:15,320 --> 02:05:15,760 STUDY. 3551 02:05:15,760 --> 02:05:19,240 THE FIRST IS THERE'S LESS 3552 02:05:19,240 --> 02:05:20,720 VARIABILITY IN EFFECT SIZES AS 3553 02:05:20,720 --> 02:05:21,680 SAMPLE SIZE INCREASES. 3554 02:05:21,680 --> 02:05:24,000 THIS IS AN ANALYSIS LOOKING AT 3555 02:05:24,000 --> 02:05:29,600 THE VARIATE ASSOCIATION STUDY. 3556 02:05:29,600 --> 02:05:35,800 THIS IS DATA FROM THE ABCD AND 3557 02:05:35,800 --> 02:05:37,280 IN THE SAMPLE SIZE AGAINST 3558 02:05:37,280 --> 02:05:39,320 EFFECT SIDES YOU CAN SEE THE 3559 02:05:39,320 --> 02:05:41,440 POSSIBLE CORRELATIONS NARROWS AS 3560 02:05:41,440 --> 02:05:42,960 SAMPLE SIZE INCREASES. 3561 02:05:42,960 --> 02:05:45,880 SO THAT A LARGER EFFECT FROM A 3562 02:05:45,880 --> 02:05:52,280 SMALL SAMPLE SIZE IS LIKELY A 3563 02:05:52,280 --> 02:05:55,120 FALSE POSITIVE. 3564 02:05:55,120 --> 02:05:56,600 THIS IS DRIVEN HOME FROM THE 3565 02:05:56,600 --> 02:05:59,680 FIGURE ON THE RIGHT SHOWING THE 3566 02:05:59,680 --> 02:06:00,960 COGNITIVE ABILITY. 3567 02:06:00,960 --> 02:06:02,520 WE SEE ONE, THE EFFECT SIZE 3568 02:06:02,520 --> 02:06:06,320 TENDS TO BE INFLATED IN SMALL 3569 02:06:06,320 --> 02:06:09,320 SAMPLE SIZE AND REMARKABLY TWO 3570 02:06:09,320 --> 02:06:12,800 SMALL SAMPLES PRODUCE OPPOSITE 3571 02:06:12,800 --> 02:06:26,720 EFFECT SO A .58 VERSUS A -.6. 3572 02:06:26,720 --> 02:06:29,520 AND SO THE NEXT SET OF ANALYSES 3573 02:06:29,520 --> 02:06:34,920 THEY LOOKED AT MULTIVARIATE 3574 02:06:34,920 --> 02:06:37,080 ASSOCIATIONS AND FOUND 3575 02:06:37,080 --> 02:06:38,480 ASSOCIATIONS AS MUCH DOUBLING IN 3576 02:06:38,480 --> 02:06:40,240 SIZE COMPARED TO THE 3577 02:06:40,240 --> 02:06:45,880 MULTIVARIATE AND FOUND GREATER 3578 02:06:45,880 --> 02:06:47,520 CONCORDAN 3579 02:06:47,520 --> 02:06:51,600 CONCORDANCE REPLICATES AND THESE 3580 02:06:51,600 --> 02:06:54,720 HAVE GREAT IMPLICATIONS FOR 3581 02:06:54,720 --> 02:07:13,360 THINKING ABOUT REPRODUCIBILITY. 3582 02:07:13,360 --> 02:07:17,920 IN THE PAST YEAR THE STATISTICAL 3583 02:07:17,920 --> 02:07:19,240 POWER INCREASES. 3584 02:07:19,240 --> 02:07:19,760 AND I'M SUDDENLY GETTING 3585 02:07:19,760 --> 02:07:23,200 FEEDBACK. 3586 02:07:23,200 --> 02:07:25,480 I HOPE NO ONE ELSE IS GETTING 3587 02:07:25,480 --> 02:07:30,720 THAT. 3588 02:07:30,720 --> 02:07:32,760 BUT IMPORTANTLY THIS DOES NOT 3589 02:07:32,760 --> 02:07:35,440 MEAN THAT SMALL AND NEURAL 3590 02:07:35,440 --> 02:07:38,920 IMAGING IS NOT VALID FOR OTHER 3591 02:07:38,920 --> 02:07:45,120 PARADIGMS AND THIS IS SUPER 3592 02:07:45,120 --> 02:07:47,720 IMPORTANT AND AS MANY KNOWL 3593 02:07:47,720 --> 02:07:48,360 IMAGING IS NOT VALID FOR OTHER 3594 02:07:48,360 --> 02:07:48,920 PARADIGMS AND THIS IS SUPER 3595 02:07:48,920 --> 02:07:49,600 IMPORTANT AND AS MANY KNOW IMAGING 3596 02:07:49,600 --> 02:07:50,240 IS NOT VALID FOR OTHER PARADIGMS 3597 02:07:50,240 --> 02:07:50,880 AND THIS IS SUPER IMPORTANT AND 3598 02:07:50,880 --> 02:07:51,200 AS MANY KNOWO 3599 02:07:51,200 --> 02:07:51,840 IMAGING IS NOT VALID FOR OTHER 3600 02:07:51,840 --> 02:07:52,400 PARADIGMS AND THIS IS SUPER 3601 02:07:52,400 --> 02:07:53,080 IMPORTANT AND AS MANY KNOWIMAGING 3602 02:07:53,080 --> 02:07:53,880 IS NOT VALID FOR OTHER PARADIGMS 3603 02:07:53,880 --> 02:07:54,520 AND THIS IS SUPER IMPORTANT AND 3604 02:07:54,520 --> 02:07:56,280 AS MANY KNOW NEUROIMAGING COULD 3605 02:07:56,280 --> 02:07:58,920 BE WRIT LARGE BAD OR THE FIELD 3606 02:07:58,920 --> 02:08:01,520 IS DOOMED AND THE SENIOR AUTHOR 3607 02:08:01,520 --> 02:08:04,600 OF THIS PAPER TWEETED OUT THIS 3608 02:08:04,600 --> 02:08:07,760 LAY FRIENDLY CLEAR ABSTRACT THAT 3609 02:08:07,760 --> 02:08:11,360 REALLY IDENTIFIES THE KEY 3610 02:08:11,360 --> 02:08:13,520 MESSAGE WHICH IS THE PAPER IS 3611 02:08:13,520 --> 02:08:18,520 ABOUT BWAS AND SAMPLE SIZES AND 3612 02:08:18,520 --> 02:08:20,320 NEUROIMAGING IS GREAT AND MANY 3613 02:08:20,320 --> 02:08:22,400 TYPES OF MRI ARE VALUABLE AT 3614 02:08:22,400 --> 02:08:24,320 SMALL SAMPLE SIZES AND LARGE 3615 02:08:24,320 --> 02:08:27,640 SAMPLE SIZE NEEDED WITH THE 3616 02:08:27,640 --> 02:08:29,000 BRAIN WIDE ASSOCIATION STUDIES 3617 02:08:29,000 --> 02:08:29,960 AND LOOKING AT ASSOCIATIONS 3618 02:08:29,960 --> 02:08:31,480 BETWEEN BRAIN AND NON-BRAIN 3619 02:08:31,480 --> 02:08:36,680 BEHAVIOR. 3620 02:08:36,680 --> 02:08:43,720 SO NEURO IMAGING IS NOT DOOMED 3621 02:08:43,720 --> 02:08:46,000 AND THAT'S THE KEY POINT FROM 3622 02:08:46,000 --> 02:08:47,640 THE STUDY AND I'LL MOVE ON AND 3623 02:08:47,640 --> 02:08:50,080 WE'LL TAKE QUESTIONS LATER. 3624 02:08:50,080 --> 02:08:52,400 THIS IS ANOTHER METHODOLOGICAL 3625 02:08:52,400 --> 02:08:53,520 PROOF OF CONCEPT PAPER AND I 3626 02:08:53,520 --> 02:08:54,720 DON'T HAVE TIME TO GET INTO ALL 3627 02:08:54,720 --> 02:08:57,360 THE DETAILS BUT I DO WANT TO 3628 02:08:57,360 --> 02:08:59,160 CONVEY THE OVER ARCHING 3629 02:08:59,160 --> 02:08:59,720 LIMITATIONS THE PAPER 3630 02:08:59,720 --> 02:09:06,280 IMPORTANTLY RAISES. 3631 02:09:06,280 --> 02:09:16,480 SO THEY LOOKED AT CIVILIZATION 3632 02:09:16,480 --> 02:09:17,560 AND MACHINE LEARNING ARE USED IN 3633 02:09:17,560 --> 02:09:19,520 POPULATION SCIENCE AND MEDICINE 3634 02:09:19,520 --> 02:09:21,400 AND RECENTLY CONCERNS HAVE BEEN 3635 02:09:21,400 --> 02:09:23,600 RAISED ABOUT THE VALIDITY OF 3636 02:09:23,600 --> 02:09:25,960 THESE APPROACHES FOR SPECIFIC 3637 02:09:25,960 --> 02:09:28,920 POPULATIONS THAT COULD INCREASE 3638 02:09:28,920 --> 02:09:29,920 RATHER THAN ALLEVIATE IT. 3639 02:09:29,920 --> 02:09:34,160 WE AND OUR COLLEAGUES 3640 02:09:34,160 --> 02:09:37,080 INVESTIGATED ALGORITHMICS FROM 3641 02:09:37,080 --> 02:09:38,560 THE PROJECT AND ABCD STUDY AND 3642 02:09:38,560 --> 02:09:41,560 THE CONCLUSION IS PREDICTIVE 3643 02:09:41,560 --> 02:09:45,920 MODELS AND PHENOTYPES FROM 3644 02:09:45,920 --> 02:09:47,800 FUNCTIONAL CONNECTIVITY DATA DO 3645 02:09:47,800 --> 02:09:48,920 NOT THE AMERICAN POPULATIONS NOW 3646 02:09:48,920 --> 02:09:51,120 THAT YOU KNOW THE CONCLUSIONS 3647 02:09:51,120 --> 02:09:52,080 THE NEXT COUPLE SLIDES WILL SHOW 3648 02:09:52,080 --> 02:09:54,680 YOU HOW THEY GOT THERE. 3649 02:09:54,680 --> 02:09:57,920 SO THEY WERE INTERESTED IN LOOK 3650 02:09:57,920 --> 02:10:00,080 AT PREDICTION ACCURACY AND THE 3651 02:10:00,080 --> 02:10:01,920 FIRST THING THEY DID IMPORTANTLY 3652 02:10:01,920 --> 02:10:04,400 WAS TO MATCH AFRICAN AMERICAN 3653 02:10:04,400 --> 02:10:09,840 AND WHITE AMERICANS ON 3654 02:10:09,840 --> 02:10:11,040 DEMOGRAPHICS AS WELL BEHAVIORAL 3655 02:10:11,040 --> 02:10:12,320 PERFORMS SOME YOU CAN SEE HERE. 3656 02:10:12,320 --> 02:10:13,440 THEY DID A COUPLE THINGS. 3657 02:10:13,440 --> 02:10:16,200 FIRST THEY LOOKED AT PREDICTION 3658 02:10:16,200 --> 02:10:17,200 ACCURACY AND THEN THEY COMPARED 3659 02:10:17,200 --> 02:10:20,720 THAT PREDICTION ACCURACY WHEN 3660 02:10:20,720 --> 02:10:22,360 THE MODELS WERE ON THE ENTIRE 3661 02:10:22,360 --> 02:10:24,240 SAMPLE WHICH MIMICS THE DOMINANT 3662 02:10:24,240 --> 02:10:24,880 APPROACH CURRENTLY TAKEN IN THE 3663 02:10:24,880 --> 02:10:27,080 FIELD. 3664 02:10:27,080 --> 02:10:31,400 AND THEY FOUND IN GENERAL GIVEN 3665 02:10:31,400 --> 02:10:34,400 THE ACTUAL SCORES ON A 3666 02:10:34,400 --> 02:10:37,400 PARTICULAR MEASURE PREDICTION 3667 02:10:37,400 --> 02:10:39,240 ERRORS WERE LARGER IN AFRICAN 3668 02:10:39,240 --> 02:10:40,800 AMERICANS THAN IN WHITE 3669 02:10:40,800 --> 02:10:41,080 AMERICANS. 3670 02:10:41,080 --> 02:10:43,880 AND THIS IS COGNITIVE TESTS 3671 02:10:43,880 --> 02:10:46,920 AGAINST THE DETERMINATION WHICH 3672 02:10:46,920 --> 02:10:51,120 IS A MEASURE AND INDICATES THE 3673 02:10:51,120 --> 02:10:52,120 PREDICTED BEHAVIORAL SCORES FROM 3674 02:10:52,120 --> 02:10:54,600 SCORES OF THE SAME GROUP. 3675 02:10:54,600 --> 02:10:56,920 YOU CAN SEE BLUE ARE AFRICAN 3676 02:10:56,920 --> 02:10:58,960 AMERICAN AND GREEN ARE WHITE 3677 02:10:58,960 --> 02:11:01,480 AMERICAN AND THE DEVIATION IS 3678 02:11:01,480 --> 02:11:02,480 BIGGER FOR AFRICAN AMERICAN 3679 02:11:02,480 --> 02:11:03,000 PARTICIPANTS. 3680 02:11:03,000 --> 02:11:07,120 THIS IS NOT AS GOOD FOR THESE 3681 02:11:07,120 --> 02:11:07,440 MEASURES. 3682 02:11:07,440 --> 02:11:09,440 THEY ALSO FOUND MOST MEASURES IN 3683 02:11:09,440 --> 02:11:11,440 THE BEHAVIOR CHECKLIST LOOKING 3684 02:11:11,440 --> 02:11:13,880 AT SOCIAL PROBLEMS AND BEHAVIOR 3685 02:11:13,880 --> 02:11:18,520 HAD HIGHER PREDICTED SCORES IN 3686 02:11:18,520 --> 02:11:20,760 AFRICAN AMERICAN PARTICIPANTS AS 3687 02:11:20,760 --> 02:11:22,800 COMPARED TO WHITE AMERICAN 3688 02:11:22,800 --> 02:11:23,160 PARTICIPANTS. 3689 02:11:23,160 --> 02:11:25,520 THIS HAS IMPLICATIONS FOR 3690 02:11:25,520 --> 02:11:28,880 PERPETUATING STIGMA AND BIAS 3691 02:11:28,880 --> 02:11:29,160 UNWHITINGLY. 3692 02:11:29,160 --> 02:11:33,280 AND I SHOULD ALSO POINT OUT THIS 3693 02:11:33,280 --> 02:11:35,920 WAS DONE IN AN ANALYSIS IN ABCD 3694 02:11:35,920 --> 02:11:37,800 AND SIMILAR FINDINGS WERE 3695 02:11:37,800 --> 02:11:42,480 OBSERVED. 3696 02:11:42,480 --> 02:11:45,120 IN THE NEXT SET OF ANALYSES WE 3697 02:11:45,120 --> 02:11:48,280 WANTED TO LOOK AT SUB SAMPLES OF 3698 02:11:48,280 --> 02:11:49,840 PARTICIPANTS AND SEE IF IT'S 3699 02:11:49,840 --> 02:11:52,280 POSSIBLE TO OBTAIN A MORE 3700 02:11:52,280 --> 02:11:53,120 PREDICTIVE MODEL. 3701 02:11:53,120 --> 02:11:54,680 TRAINING WAS PERFORMED 3702 02:11:54,680 --> 02:11:56,960 SEPARATELY IN THE ANALYSIS ON 3703 02:11:56,960 --> 02:11:57,880 WHITE AMERICAN AND AFRICAN 3704 02:11:57,880 --> 02:11:59,520 AMERICAN PARTICIPANTS USING DATA 3705 02:11:59,520 --> 02:12:02,920 FROM ABCD AND THIS IS ONLY DONE 3706 02:12:02,920 --> 02:12:04,120 IN ABCD BECAUSE THERE'S NOT 3707 02:12:04,120 --> 02:12:06,200 ENOUGH SAMPLE SIZE FOR UNDER 3708 02:12:06,200 --> 02:12:07,440 REPRESENTED GROUPS. 3709 02:12:07,440 --> 02:12:09,160 THE ANALYSIS GOING FORWARD ON 3710 02:12:09,160 --> 02:12:10,680 ABCD. 3711 02:12:10,680 --> 02:12:13,720 AND THEY FOUND FOR THE SAME ON 3712 02:12:13,720 --> 02:12:15,440 AFRICAN AMERICAN PARTICIPANTS 3713 02:12:15,440 --> 02:12:16,280 EIGHT OUT THEIR 36 MEASURES 3714 02:12:16,280 --> 02:12:19,200 SHOWED GREATER PREDICTION 3715 02:12:19,200 --> 02:12:21,480 ACCURACY FOR AFRICAN AMERICAN 3716 02:12:21,480 --> 02:12:27,480 PARTICIPANTS THAN WHITE AMERICAN 3717 02:12:27,480 --> 02:12:28,480 PARTICIPANTS AND THERE'S STILL 3718 02:12:28,480 --> 02:12:30,040 SOMETHING ELSE GOING ON THERE 3719 02:12:30,040 --> 02:12:31,760 BUT IMPORTANTLY IN CONTRAST TO 3720 02:12:31,760 --> 02:12:35,520 THAT FOR THE MODEL CHANGE ONLY 3721 02:12:35,520 --> 02:12:36,800 ON WHITE AMERICANS THERE WAS 3722 02:12:36,800 --> 02:12:41,880 GREATER PREDICTION ACCURACY ON 3723 02:12:41,880 --> 02:12:43,440 AFRICAN AMERICAN WHITE AMERICAN 3724 02:12:43,440 --> 02:12:49,440 IN TWO OF THE MATCHES AND ON 3725 02:12:49,440 --> 02:12:51,280 AFRICAN AMERICAN IT INCREASED 3726 02:12:51,280 --> 02:12:53,840 PREDICTION ACCURACY BUT NOT 3727 02:12:53,840 --> 02:12:54,640 COMPLETELY SO WE STILL DON'T 3728 02:12:54,640 --> 02:12:56,000 HAVE THE WHOLE STORY. 3729 02:12:56,000 --> 02:12:57,320 IF WE'RE GOING TO PUT ALL THIS 3730 02:12:57,320 --> 02:13:00,880 TOGETHER A QUICK RECAP OF THIS 3731 02:13:00,880 --> 02:13:03,240 THE FINDINGS SHOWED FIRSTLY BIAS 3732 02:13:03,240 --> 02:13:07,360 PREDICTION OF BEHAVIOR IN NEURO 3733 02:13:07,360 --> 02:13:09,920 COGNITION WHEN PREDICTING MODELS 3734 02:13:09,920 --> 02:13:11,480 FROM WHITE AMERICAN AND AFRICAN 3735 02:13:11,480 --> 02:13:16,720 AMERICANS USING THE STANDARD 3736 02:13:16,720 --> 02:13:17,800 TRAINING APPROACH. 3737 02:13:17,800 --> 02:13:19,320 AND THEN IN SUBSEQUENT ANALYSIS 3738 02:13:19,320 --> 02:13:20,280 THEY FOUND THE DIFFERENCE IN THE 3739 02:13:20,280 --> 02:13:22,280 TWO GROUPS WAS PARTLY RELATED TO 3740 02:13:22,280 --> 02:13:26,320 THE DOMINANCE OF WHITE AMERICANS 3741 02:13:26,320 --> 02:13:27,400 IN THE DATA SETS. 3742 02:13:27,400 --> 02:13:29,920 CLEARLY THE BIG CONCLUSION WAS 3743 02:13:29,920 --> 02:13:32,040 WE NEED MORE DATA FROM UNDER 3744 02:13:32,040 --> 02:13:33,280 REPRESENTED GROUPS NOT JUST IN 3745 02:13:33,280 --> 02:13:34,600 THE U.S. BUT GLOBALLY IN ORDER 3746 02:13:34,600 --> 02:13:36,160 TO ANSWER SOME OF THESE 3747 02:13:36,160 --> 02:13:38,320 QUESTIONS AND REALLY IN ORDER TO 3748 02:13:38,320 --> 02:13:40,640 DO COMPREHENSIVE ANALYSIS AND 3749 02:13:40,640 --> 02:13:42,280 ETHICAL MODELLING. 3750 02:13:42,280 --> 02:13:45,880 AND THIS IS TO SHOW YOU THE 3751 02:13:45,880 --> 02:13:49,320 DISTRIBUTION OF DEMOGRAPHICS OF 3752 02:13:49,320 --> 02:13:53,080 RACE, ETHNICITY IN THE THREE 3753 02:13:53,080 --> 02:13:57,080 LARGE DATA SETS AND YOU SEE THE 3754 02:13:57,080 --> 02:14:01,520 WHITE AMERICANS AND THE U.K. BIO 3755 02:14:01,520 --> 02:14:07,520 BANK HAD 80% AND MOST ARE 3756 02:14:07,520 --> 02:14:12,200 EUROPEAN ANCESTRY AND WE STILL 3757 02:14:12,200 --> 02:14:13,320 NEED MORE DATA FROM UNDER 3758 02:14:13,320 --> 02:14:15,040 REPRESENTED GROUPS AND NEED MORE 3759 02:14:15,040 --> 02:14:15,960 DATA TO UNDERSTAND WHY THE 3760 02:14:15,960 --> 02:14:17,160 ERRORS ARE HAPPENING IN THE 3761 02:14:17,160 --> 02:14:19,000 FIRST PLACE. 3762 02:14:19,000 --> 02:14:20,720 IT'S NOT JUST TRAINING ON SUB 3763 02:14:20,720 --> 02:14:22,360 POPULATIONS BUT COULD THERE BE 3764 02:14:22,360 --> 02:14:23,960 BIAS AT FOR EXAMPLE DIFFERENT 3765 02:14:23,960 --> 02:14:26,800 STAGES OF THE PROCESSING 3766 02:14:26,800 --> 02:14:29,360 PIPELINE ALL OF WHICH HAVE BEEN 3767 02:14:29,360 --> 02:14:30,680 OPTIMIZED FOR A POPULATION 3768 02:14:30,680 --> 02:14:32,360 DOMINATE WHITE EUROPEANS OR 3769 02:14:32,360 --> 02:14:32,960 WHITE AMERICANS. 3770 02:14:32,960 --> 02:14:36,120 BUT IN ORDER TO DO THAT KIND OF 3771 02:14:36,120 --> 02:14:37,520 ANALYSIS WE NEED MORE DATA FROM 3772 02:14:37,520 --> 02:14:41,880 UNDER REPRESENTED GROUPS TO DO 3773 02:14:41,880 --> 02:14:44,800 THAT KIND OF ANALYSES AS WELL AS 3774 02:14:44,800 --> 02:14:45,880 OTHER ANALYSES. 3775 02:14:45,880 --> 02:14:48,520 TAKEN TOGETHER THE PAPERS NICELY 3776 02:14:48,520 --> 02:14:50,920 DEMONSTRATE HOW ABCD CAN BE USED 3777 02:14:50,920 --> 02:14:53,840 TO EXPOSE LIMITATIONS IN WIDELY 3778 02:14:53,840 --> 02:14:55,400 ADOPTED METHODOLOGIES AND 3779 02:14:55,400 --> 02:14:55,920 APPROACHES AND INFORM 3780 02:14:55,920 --> 02:14:58,640 CONSIDERATION FOR HOW TO DO THIS 3781 02:14:58,640 --> 02:14:59,720 BETTER IN THE FUTURE. 3782 02:14:59,720 --> 02:15:01,520 AND THAT'S ALL I HAVE. 3783 02:15:01,520 --> 02:15:05,400 I'M HAPPY TO TAKE QUESTIONS AT 3784 02:15:05,400 --> 02:15:07,520 IS THE END BUT I'M SEND THINGS 3785 02:15:07,520 --> 02:15:08,520 OVER TO KIM. 3786 02:15:08,520 --> 02:15:10,720 >> THANKS, ELIZABETH. 3787 02:15:10,720 --> 02:15:14,920 I'LL BE PRESENTING ON AN 3788 02:15:14,920 --> 02:15:15,840 EXCITING PAPER IN NATURE 3789 02:15:15,840 --> 02:15:17,840 DEVELOPING BRAIN CHARTS FOR THE 3790 02:15:17,840 --> 02:15:23,120 HUMAN LIFE SPAN. 3791 02:15:23,120 --> 02:15:26,400 SO GROWTH CHARTS HAVE EXISTED 3792 02:15:26,400 --> 02:15:28,320 FOR HEIGHT AND WEIGHT AND HEAD 3793 02:15:28,320 --> 02:15:31,480 CIRCUMFERENCE AND DEMONSTRATED 3794 02:15:31,480 --> 02:15:32,280 THE UTILITY OF NORMS TO 3795 02:15:32,280 --> 02:15:35,720 BENCHMARK TRAJECTORIES IN 3796 02:15:35,720 --> 02:15:36,000 DEVELOPMENT. 3797 02:15:36,000 --> 02:15:37,520 HAVING SOMETHING LIKE THIS FOR 3798 02:15:37,520 --> 02:15:39,160 BRAIN DEVELOPMENT WOULD BE A 3799 02:15:39,160 --> 02:15:44,280 MASSIVE IMPROVEMENT IN THE 3800 02:15:44,280 --> 02:15:45,160 FIELD. 3801 02:15:45,160 --> 02:15:49,840 CONSIDERING EARLY LIFE IS 3802 02:15:49,840 --> 02:15:52,560 INFLUENCED BY NEURAL 3803 02:15:52,560 --> 02:15:53,720 TRAJECTORIES AND DISORDERS AND 3804 02:15:53,720 --> 02:15:57,280 LATE CHANGE IN BRAIN MORPHOLOGY 3805 02:15:57,280 --> 02:16:00,800 CAN INDICATE NEURODEGENERATIVE 3806 02:16:00,800 --> 02:16:01,080 DISORDERS. 3807 02:16:01,080 --> 02:16:03,160 THE CHALLENGE IS THAT 3808 02:16:03,160 --> 02:16:05,320 NEUROIMAGING DATA IS HIGHLY 3809 02:16:05,320 --> 02:16:06,360 SENSITIVE TO VARIATION AND 3810 02:16:06,360 --> 02:16:08,720 PLATFORMS AND SEQUENCES AND 3811 02:16:08,720 --> 02:16:11,680 STATISTICAL ANALYSES AND 3812 02:16:11,680 --> 02:16:11,920 ETCETERA. 3813 02:16:11,920 --> 02:16:13,920 LARGE SCALE DATA SETS LIKE ABCD 3814 02:16:13,920 --> 02:16:16,120 AND RECENT ADVANTAGES HAVE MADE 3815 02:16:16,120 --> 02:16:17,720 IT POSSIBLE TO BE ABLE TO 3816 02:16:17,720 --> 02:16:20,720 HARMONIZE ACROSS THE DATA SETS. 3817 02:16:20,720 --> 02:16:24,320 IMPORTANTLY ABCD STUDY HAS 3818 02:16:24,320 --> 02:16:26,000 CONTINUED TO DEVELOP FROM THESE 3819 02:16:26,000 --> 02:16:28,920 TRAJECTORIES FROM THE INCEPTION. 3820 02:16:28,920 --> 02:16:32,160 IN THE STUDY THEY HARMONIZED 3821 02:16:32,160 --> 02:16:35,000 ACROSS DATA FROM OVER 100 3822 02:16:35,000 --> 02:16:38,080 PRIMARY STUDIES, 100,000 HUMAN 3823 02:16:38,080 --> 02:16:39,720 PARTICIPANTS FROM 115 DAYS POST 3824 02:16:39,720 --> 02:16:40,640 CONCEPTION TO 100 YEARS OF AGE 3825 02:16:40,640 --> 02:16:43,880 AND YOU CAN SEE WHERE THE ABCD 3826 02:16:43,880 --> 02:16:45,880 STUDY FALLS HIGHLIGHTED IN THE 3827 02:16:45,880 --> 02:16:49,440 RED BAR THERE. 3828 02:16:49,440 --> 02:16:56,600 AND SO THEY DEVELOPED MODELS ON 3829 02:16:56,600 --> 02:17:01,000 GRAY MEYER VOLUME AND 3830 02:17:01,000 --> 02:17:03,520 SUBCORTICAL GRAY MEYER VOLUME 3831 02:17:03,520 --> 02:17:05,120 AND CORTICAL THICKNESS VOLUME 3832 02:17:05,120 --> 02:17:18,480 AND SURFACE AREA. 3833 02:17:18,480 --> 02:17:20,160 HERE IS THE RAW DATA AND BLUE 3834 02:17:20,160 --> 02:17:21,760 FOR MALES AND RED FOR FEMALES. 3835 02:17:21,760 --> 02:17:24,920 THE NEXT ONE DOWN IS THE 3836 02:17:24,920 --> 02:17:26,680 NORMATIVE TRAJECTORIES DERIVED 3837 02:17:26,680 --> 02:17:29,600 FROM THE RAW DATA WITH THE PEAK 3838 02:17:29,600 --> 02:17:31,360 VALUE THERE I'VE PUT IN THE TEXT 3839 02:17:31,360 --> 02:17:34,840 OF 5.9 YEAR FOR THE PEAK OF 3840 02:17:34,840 --> 02:17:35,840 AGREE MATTER VOLUME. 3841 02:17:35,840 --> 02:17:36,880 THIS WAS OBSERVED THREE YEARS 3842 02:17:36,880 --> 02:17:44,320 LATER THAN PREVIOUSLY REPORTED. 3843 02:17:44,320 --> 02:17:45,720 THAT WAS BASED ON SMALLER 3844 02:17:45,720 --> 02:17:49,480 EXAMPLES AND THE ONE ON THE 3845 02:17:49,480 --> 02:17:52,320 BOTTOM FOR VOLUME AVERAGE 3846 02:17:52,320 --> 02:17:52,800 GROWTH. 3847 02:17:52,800 --> 02:17:54,760 FOR WHITE MATTER VOLUME SLOWER 3848 02:17:54,760 --> 02:17:55,920 AND LONGER DEVELOPMENT THERE 3849 02:17:55,920 --> 02:17:59,240 WITH A PEAK AROUND 28.7 YEARS. 3850 02:17:59,240 --> 02:18:01,520 HOWEVER, THE PEAK RATE OF GROWTH 3851 02:18:01,520 --> 02:18:02,120 IS STILL AROUND 2.4 YEARS OF 3852 02:18:02,120 --> 02:18:06,720 AGE. 3853 02:18:06,720 --> 02:18:08,960 THE SUBCORTICAL GRAY MATTER 3854 02:18:08,960 --> 02:18:13,520 VOLUME PEAKING AROUND 14.4 YEARS 3855 02:18:13,520 --> 02:18:15,360 OF AGE. 3856 02:18:15,360 --> 02:18:17,040 AND VENTRICULAR VOLUME WHICH IS 3857 02:18:17,040 --> 02:18:20,040 PEAKING AT THE END OF LIFE. 3858 02:18:20,040 --> 02:18:21,520 INTERESTINGLY CORTICAL THICKNESS 3859 02:18:21,520 --> 02:18:23,760 WAS ALMOST THE OPPOSITE THAN 3860 02:18:23,760 --> 02:18:27,320 VENTRICULAR VOLUME WHICH PEAKS 3861 02:18:27,320 --> 02:18:29,920 BEFORE BIRTH AND WENT DOWN IN A 3862 02:18:29,920 --> 02:18:39,680 SIMILAR FASHION. 3863 02:18:39,680 --> 02:18:40,760 IN ADDITION THERE'S THESE 3864 02:18:40,760 --> 02:18:42,400 PHENOTYPES AND PEAK VOLUMES FOR 3865 02:18:42,400 --> 02:18:43,720 DIFFERENT BRAIN REGIONS. 3866 02:18:43,720 --> 02:18:45,920 ON THE LIGHT COLORS HERE EARLIER 3867 02:18:45,920 --> 02:18:48,400 AGE BEFORE 5 UP TO THE DEEP RED 3868 02:18:48,400 --> 02:18:48,800 PAST 9. 3869 02:18:48,800 --> 02:18:50,960 IN GENERAL WHAT THEY'RE FINDING 3870 02:18:50,960 --> 02:18:53,040 IS THE PRIMARY SENSORY REACHED 3871 02:18:53,040 --> 02:18:57,400 PEAK VOLUME EARLIEST AND SHOWED 3872 02:18:57,400 --> 02:19:01,120 THE FASTEST POST-PEAK DECLINE 3873 02:19:01,120 --> 02:19:05,360 AND OTHER THE OTHER END THE 3874 02:19:05,360 --> 02:19:06,480 FRONTAL TEMPORAL SHOWED SLOWER 3875 02:19:06,480 --> 02:19:08,920 DECLINES WITH THE LATEST BEING 3876 02:19:08,920 --> 02:19:09,920 THE INSULA. 3877 02:19:09,920 --> 02:19:14,280 IT RECAPITULATES A GRADIENT FROM 3878 02:19:14,280 --> 02:19:16,680 THE CORTEX PREVIOUSLY ASSOCIATED 3879 02:19:16,680 --> 02:19:17,920 WITH BRAIN STRUCTURE AND 3880 02:19:17,920 --> 02:19:25,520 FUNCTION. 3881 02:19:25,520 --> 02:19:27,720 THE CHART THAT PUTS THE 3882 02:19:27,720 --> 02:19:29,000 MILESTONES TOGETHER FROM WHAT I 3883 02:19:29,000 --> 02:19:30,440 MENTIONED PREVIOUSLY AND THEY 3884 02:19:30,440 --> 02:19:34,720 COMPARED THEM TO ALL THESE 3885 02:19:34,720 --> 02:19:35,560 NON-MRI MILESTONES. 3886 02:19:35,560 --> 02:19:39,120 ONE IS THE GRAY MATTER TO WHITE 3887 02:19:39,120 --> 02:19:40,360 MATTER VOLUME DIFFERENTIATION 3888 02:19:40,360 --> 02:19:43,520 PERIOD AND BELIEVE IT MAY 3889 02:19:43,520 --> 02:20:02,200 REFLECT CHANGES IN MYELINATION 3890 02:20:02,200 --> 02:20:05,880 AND WHAT IS OCCURS IN PEAKS IN 3891 02:20:05,880 --> 02:20:07,480 PUBERTY AND OTHER WHITE AND 3892 02:20:07,480 --> 02:20:08,960 WEIGHT DEVELOPMENT PEAKS. 3893 02:20:08,960 --> 02:20:12,720 THE NEXT SLIDE IS THE MORE 3894 02:20:12,720 --> 02:20:15,280 NEUROPSYCHIATRIC ASPECT. 3895 02:20:15,280 --> 02:20:20,080 YOU CAN SEE IN THE BLACK BOX THE 3896 02:20:20,080 --> 02:20:23,320 DIAGNOSTIC AGE RANGE FOR 3897 02:20:23,320 --> 02:20:23,960 PSYCHIATRIC CONDITIONS AND THIS 3898 02:20:23,960 --> 02:20:25,920 IS SHOWING THE ONSET OF SYMPTOMS 3899 02:20:25,920 --> 02:20:27,920 CAN OCCUR WAY BEFORE YOUR 3900 02:20:27,920 --> 02:20:30,080 ACTUALLY GETTING DIAGNOSED WITH 3901 02:20:30,080 --> 02:20:30,600 DISORDERS. 3902 02:20:30,600 --> 02:20:34,320 BEING ABLE TO CHART BRAIN 3903 02:20:34,320 --> 02:20:36,320 MORPHOLOGY ACROSS THE LIFE SPAN 3904 02:20:36,320 --> 02:20:39,920 WOULD BE AN ADVANCE TOWARDS 3905 02:20:39,920 --> 02:20:41,720 IDENTIFYING IMAGING MARKERS 3906 02:20:41,720 --> 02:20:44,120 ACROSS A MULTITUDE OF 3907 02:20:44,120 --> 02:20:45,880 PSYCHOLOGICAL AND NEUROLOGICAL 3908 02:20:45,880 --> 02:20:48,720 DISEASES. 3909 02:20:48,720 --> 02:20:50,520 SO THAT POINT THEY DEVELOPED 3910 02:20:50,520 --> 02:20:52,240 THESE SCORES. 3911 02:20:52,240 --> 02:20:54,480 THESE ARE SCORES THAT CAN 3912 02:20:54,480 --> 02:20:55,720 BENCHMARK EACH SCAN IN THE 3913 02:20:55,720 --> 02:20:59,280 CONTEXT OF NORMATIVE AGE-RELATED 3914 02:20:59,280 --> 02:20:59,720 TRENDS. 3915 02:20:59,720 --> 02:21:16,920 THE BLACK LINE THESE CENTILE 3916 02:21:16,920 --> 02:21:23,240 SCORES SHOW MAJOR DES -- 3917 02:21:23,240 --> 02:21:25,320 DEPRESSIVE DISORDER AND 3918 02:21:25,320 --> 02:21:25,920 SCHIZOPHRENIA AND ALZHEIMER'S 3919 02:21:25,920 --> 02:21:28,400 DISEASE AND OTHERS AND SHOWING 3920 02:21:28,400 --> 02:21:32,280 FOR MALES AND FEMALE AND GRAY 3921 02:21:32,280 --> 02:21:34,320 AND WHITE MATTER VOLUME AND 3922 02:21:34,320 --> 02:21:36,360 VENTRICULAR VOLUME. 3923 02:21:36,360 --> 02:21:38,800 THE LARGEST DEVIATIONS WERE SEEN 3924 02:21:38,800 --> 02:21:41,840 FOR ALZHEIMER'S DISEASE, MILD 3925 02:21:41,840 --> 02:21:44,720 COGNITIVE IMPAIRMENT AND 3926 02:21:44,720 --> 02:21:47,480 SCHIZOPHRENIA AND SEX-SPECIFIC 3927 02:21:47,480 --> 02:21:47,720 EFFECTS. 3928 02:21:47,720 --> 02:21:50,160 FOR SCHIZOPHRENIA THE IMPACT ON 3929 02:21:50,160 --> 02:21:52,880 VOLUME WAS GREATER FOR FEMALES 3930 02:21:52,880 --> 02:21:54,520 THAN MALES AND REVERSE WAS TRUE 3931 02:21:54,520 --> 02:21:58,600 FOR ADHD WHERE THERE WERE 3932 02:21:58,600 --> 02:21:59,800 DIFFERENCES IN THE VOLUMETRIC 3933 02:21:59,800 --> 02:22:01,520 DIFFERENCES FOR MALES THAN 3934 02:22:01,520 --> 02:22:04,960 FEMALES. 3935 02:22:04,960 --> 02:22:07,400 SO IN CONCLUSION IT'S A PROOF OF 3936 02:22:07,400 --> 02:22:09,920 PRINCIPLE FOR DEFYING THE 3937 02:22:09,920 --> 02:22:12,400 NORMATIVE TRAJECTORIES OF 3938 02:22:12,400 --> 02:22:14,520 SEX-RELATED GENES IN PHENOTYPES 3939 02:22:14,520 --> 02:22:17,880 ACROSS THE LIFE SPAN AND TO BE 3940 02:22:17,880 --> 02:22:21,400 ABLE TO QUANTIFY THE BRAIN SCANS 3941 02:22:21,400 --> 02:22:23,680 COLLECTED ACROSS MULTIPLE 3942 02:22:23,680 --> 02:22:25,120 CLINICAL DISORDERS AND THIS OPEN 3943 02:22:25,120 --> 02:22:28,760 RESOURCE TO BE ABLE TO BENCHMARK 3944 02:22:28,760 --> 02:22:30,560 BRAIN MORPHOLOGY FOR FUTURE OR 3945 02:22:30,560 --> 02:22:31,640 CONCURRENT STUDIES. 3946 02:22:31,640 --> 02:22:33,320 I ENCOURAGE YOU TO CHECK THE 3947 02:22:33,320 --> 02:22:35,040 LINK LATER AND SEE WHAT YOU CAN 3948 02:22:35,040 --> 02:22:40,640 DO AND HOPE THEY'LL BE ADDING 3949 02:22:40,640 --> 02:22:40,960 FO 3950 02:22:40,960 --> 02:22:42,520 MORE DATA TO FILL OUT THE CHARTS 3951 02:22:42,520 --> 02:22:45,800 GOING FORWARD AND WITH MAJOR 3952 02:22:45,800 --> 02:22:46,040 CAVEATS. 3953 02:22:46,040 --> 02:22:48,120 AND RELATED TO WHAT ELIZABETH 3954 02:22:48,120 --> 02:22:51,800 MENTIONED IT'S BIASSED TOWARDS 3955 02:22:51,800 --> 02:22:53,160 EUROPEAN AND WHITE AMERICAN 3956 02:22:53,160 --> 02:22:54,480 POPULATIONS AND HIGHLIGHTING THE 3957 02:22:54,480 --> 02:22:55,720 IMPORTANCE OF GREATER DIVERSITY 3958 02:22:55,720 --> 02:22:59,120 IN OUR IMAGING STUDIES TO CREATE 3959 02:22:59,120 --> 02:22:59,720 BETTER TRAJECTORIES MORE 3960 02:22:59,720 --> 02:23:05,840 ACCURATE TRAJECTORIES. 3961 02:23:05,840 --> 02:23:09,720 HOPEFULLY ABCD AND OTHERS CAN 3962 02:23:09,720 --> 02:23:10,000 CONTRIBUTE. 3963 02:23:10,000 --> 02:23:17,880 AND THE FETAL AND NEONATAL 3964 02:23:17,880 --> 02:23:19,480 GROUPS WERE UNDER REPRESENTED 3965 02:23:19,480 --> 02:23:25,480 AND THESE ARE NOT IMMEDIATELY 3966 02:23:25,480 --> 02:23:27,200 AVAILABLE FOR USE BUT SHOWS THIS 3967 02:23:27,200 --> 02:23:29,440 IS ACHIEVABLE IN A GLOBAL SCALE 3968 02:23:29,440 --> 02:23:34,840 AND OVER THE ENTIRE LIFE COURSE. 3969 02:23:34,840 --> 02:23:36,480 >> THANK YOU, KIM AND ELIZABETH. 3970 02:23:36,480 --> 02:23:38,600 I WANT TO DO A FINAL THANK YOU 3971 02:23:38,600 --> 02:23:41,320 TO ALL THE FEDERAL PARTNERS THAT 3972 02:23:41,320 --> 02:23:42,800 WE HAVE FOR ABCD. 3973 02:23:42,800 --> 02:23:45,400 TO THE 21 RESEARCH SITES AND 3974 02:23:45,400 --> 02:23:46,800 COORDINATING CENTERS AND THE 3975 02:23:46,800 --> 02:23:48,640 DATA ANALYSIS AND INFORMATICS 3976 02:23:48,640 --> 02:23:49,880 CENTER AND HUNDREDS OF 3977 02:23:49,880 --> 02:23:53,320 INVESTIGATORS AND TRAINEES AND 3978 02:23:53,320 --> 02:23:56,880 MORE RESEARCH ASSISTANTS AND 3979 02:23:56,880 --> 02:23:57,920 STAFF PARTICULARLY DURING THE 3980 02:23:57,920 --> 02:24:00,480 PANDEMIC HAVE BEEN HEROIC IN 3981 02:24:00,480 --> 02:24:01,920 MAINTAINING THE COHORT AND DATA 3982 02:24:01,920 --> 02:24:05,080 COLLECTION AS WELL AS THEY HAVE. 3983 02:24:05,080 --> 02:24:07,320 AS WELL AS OF COURSE THE NEARLY 3984 02:24:07,320 --> 02:24:09,000 12,000 PARTICIPANTS IN AND THEIR 3985 02:24:09,000 --> 02:24:09,280 FAMILIES. 3986 02:24:09,280 --> 02:24:11,800 WE HAVE TIME FOR QUESTIONS FOR 3987 02:24:11,800 --> 02:24:13,480 ANY OF US I THINK. 3988 02:24:13,480 --> 02:24:18,400 THANK YOU. 3989 02:24:18,400 --> 02:24:25,920 >> THANK YOU. 3990 02:24:25,920 --> 02:24:26,680 THAT WAS A WONDERFUL 3991 02:24:26,680 --> 02:24:28,600 PRESENTATION AND OVERVIEW OF THE 3992 02:24:28,600 --> 02:24:29,760 ABCD STUDY. 3993 02:24:29,760 --> 02:24:30,920 SO EXCITING THAT IT'S AT THIS 3994 02:24:30,920 --> 02:24:31,120 STAGE. 3995 02:24:31,120 --> 02:24:33,120 I JUST WANTED TO POINT OUT A 3996 02:24:33,120 --> 02:24:34,080 COUPLE THINGS BECAUSE I THINK 3997 02:24:34,080 --> 02:24:35,480 WE'RE DEALING WITH THIS IN THE 3998 02:24:35,480 --> 02:24:38,400 FIELD AND YOU DID MENTION THAT 3999 02:24:38,400 --> 02:24:41,000 BUT I WANTED TO FOR THOSE WHO 4000 02:24:41,000 --> 02:24:43,960 ARE NOT NEUROIMAGERS AND DON'T 4001 02:24:43,960 --> 02:24:47,200 DO THIS WORK TO WALK AWAY 4002 02:24:47,200 --> 02:24:50,360 THINKING THESE ARE STATIC 4003 02:24:50,360 --> 02:24:50,640 MEASURES. 4004 02:24:50,640 --> 02:24:53,400 DEVELOPMENT IS VERY DYNAMIC IN 4005 02:24:53,400 --> 02:24:54,520 WHAT NEUROSCIENTISTS ARE TELLING 4006 02:24:54,520 --> 02:24:58,120 US IS A LOT OF DYNAMIC CHANGES 4007 02:24:58,120 --> 02:25:00,640 OCCURRING THROUGH DEVELOPMENT IN 4008 02:25:00,640 --> 02:25:03,200 RESPONSE TO SOCIAL AND 4009 02:25:03,200 --> 02:25:05,560 ENVIRONMENTAL FACTORS AFFECTING 4010 02:25:05,560 --> 02:25:08,080 ABILITIES AND SO TOO THAT IS A 4011 02:25:08,080 --> 02:25:09,320 MAJOR CONTRIBUTION OF WHY LARGER 4012 02:25:09,320 --> 02:25:13,200 SAMPLES ARE NEEDED AND TO 4013 02:25:13,200 --> 02:25:15,440 POO-POO WHAT SINGLE SITE THINGS 4014 02:25:15,440 --> 02:25:17,320 WHEN A LOT OF TIMES THOSE 4015 02:25:17,320 --> 02:25:18,920 STUDIES ARE IN FACT CONTROLLING 4016 02:25:18,920 --> 02:25:20,040 FOR A LOT OF THINGS WHICH YOU 4017 02:25:20,040 --> 02:25:21,600 CANNOT DO IN A LARGE SCALE. 4018 02:25:21,600 --> 02:25:23,840 THERE ARE TRADE-OFFS WHEN YOU DO 4019 02:25:23,840 --> 02:25:25,640 THE MULTI-SITE STUDIES AND 4020 02:25:25,640 --> 02:25:26,480 THAT'S IMPORTANT. 4021 02:25:26,480 --> 02:25:27,520 IT'S UNFORTUNATE IT'S BEEN 4022 02:25:27,520 --> 02:25:32,400 STATED AND COME OUT IN THE WAY 4023 02:25:32,400 --> 02:25:36,200 IT HAS BECAUSE THERE'S ACCURATE 4024 02:25:36,200 --> 02:25:37,920 REPLICABLE BRAIN BEHAVIOR 4025 02:25:37,920 --> 02:25:40,600 ASSOCIATIONS INFORMING CLINICAL 4026 02:25:40,600 --> 02:25:41,720 OUTCOMES AND TREATMENT 4027 02:25:41,720 --> 02:25:43,160 DEVELOPMENT AND PREVENTION 4028 02:25:43,160 --> 02:25:43,480 DEVELOPMENT. 4029 02:25:43,480 --> 02:25:44,760 I WANTED TO HIGHLIGHT THAT AND 4030 02:25:44,760 --> 02:25:47,120 THE OTHER THING IS THE RESTING 4031 02:25:47,120 --> 02:25:48,800 STATE FUNCTIONAL CONNECTIVITIES 4032 02:25:48,800 --> 02:25:52,600 IS ONLY ONE ASPECT AND THAT'S 4033 02:25:52,600 --> 02:25:55,560 WHAT WAS SHOWN AND THERE'S 4034 02:25:55,560 --> 02:25:56,520 GROWING LITERATURE SHOWING 4035 02:25:56,520 --> 02:26:01,920 RESTING STATE DOES NOT PREDICT 4036 02:26:01,920 --> 02:26:07,000 BEHAVIOR IN A WAY ACROSS 4037 02:26:07,000 --> 02:26:08,880 VALIDATED WITH SPECIFICITY 4038 02:26:08,880 --> 02:26:10,720 COMPARED TO TAFT AND GRAY MATTER 4039 02:26:10,720 --> 02:26:12,800 VOLUME IS ONLY ONE ASPECT AND IT 4040 02:26:12,800 --> 02:26:15,520 ALSO CHANGES WITH FOUR DAYS OF 4041 02:26:15,520 --> 02:26:16,840 AN INTERVENTION YOU SEE CHANGES 4042 02:26:16,840 --> 02:26:18,200 IN GRAY MATTER VOLUME. 4043 02:26:18,200 --> 02:26:21,640 I THINK WHEN WE START SAYING THE 4044 02:26:21,640 --> 02:26:23,400 WORD NEUROIMAGING IT'S AS IF 4045 02:26:23,400 --> 02:26:25,480 IT'S ONE STATIC MEASURE AND IT'S 4046 02:26:25,480 --> 02:26:29,920 REALLY PROBLEMATIC AND I WOULD 4047 02:26:29,920 --> 02:26:33,360 HOPE GIVEN ABCD INVOLVES SO MANY 4048 02:26:33,360 --> 02:26:34,720 INVESTIGATORS AND NOW 4049 02:26:34,720 --> 02:26:37,080 COLLABORATORS AND OTHERS, IT 4050 02:26:37,080 --> 02:26:38,600 WOULD BE REALLY IMPORTANT FOR 4051 02:26:38,600 --> 02:26:41,240 THEM TO BE PRESS RELEASES WIND 4052 02:26:41,240 --> 02:26:43,480 UP BEING A CATCHY THING BUT WILL 4053 02:26:43,480 --> 02:26:45,120 NOT BE USEFUL FOR OUR FIELD IF 4054 02:26:45,120 --> 02:26:47,600 WE'RE THROWING THIS KIND OF 4055 02:26:47,600 --> 02:26:53,040 THING OUT IN THE WAY IT -- 4056 02:26:53,040 --> 02:26:55,520 >> WE TOTALLY AGREE. 4057 02:26:55,520 --> 02:26:59,240 WE'VE BEEN HAVING A LOT OF 4058 02:26:59,240 --> 02:27:00,320 CONVERSATIONS ABOUT HOW WE 4059 02:27:00,320 --> 02:27:01,920 CHANGE THIS MESSAGE THAT SEEMS 4060 02:27:01,920 --> 02:27:06,320 TO HAVE GOTTEN OUT THERE AND I 4061 02:27:06,320 --> 02:27:08,800 KNOW THAT NICO AND SCOTT ARE 4062 02:27:08,800 --> 02:27:10,520 PLANNING A COMMENTARY TO FOCUS 4063 02:27:10,520 --> 02:27:15,720 IN ON THE ISSUES YOU RAISED. 4064 02:27:15,720 --> 02:27:18,600 THIS IS NOT EVERY NEUROIMAGING 4065 02:27:18,600 --> 02:27:20,120 STUDY BUT WHEN THE PRESS GET 4066 02:27:20,120 --> 02:27:21,400 AHOLD OF SOMETHING THEY TEND TO 4067 02:27:21,400 --> 02:27:23,320 NOT BE AS NUANCED AS WE WOULD 4068 02:27:23,320 --> 02:27:25,320 HOPE THEY WOULD BE. 4069 02:27:25,320 --> 02:27:29,720 >> CAN I JUST FOLLOW-UP WITH ONE 4070 02:27:29,720 --> 02:27:32,120 THING, ONE IS A GRIPE WHICH 4071 02:27:32,120 --> 02:27:33,040 YOU'VE ADDRESSED AND THE EITHER 4072 02:27:33,040 --> 02:27:37,480 PIECE IS THE DYNAMIC CHANGES 4073 02:27:37,480 --> 02:27:39,480 OCCURRING EVEN IN THE AGE GROUPS 4074 02:27:39,480 --> 02:27:41,480 BETWEEN 5 AND 7. 4075 02:27:41,480 --> 02:27:42,440 IT'S NOT GETTING CAPTURED 4076 02:27:42,440 --> 02:27:45,000 BECAUSE YOU'RE NOT BRINGING IN 4077 02:27:45,000 --> 02:27:46,840 THOSE FACTORS INTO YOU'RE 4078 02:27:46,840 --> 02:27:47,120 MODELLING. 4079 02:27:47,120 --> 02:27:49,680 FOR EXAMPLE, RACE IS ONLY ONE 4080 02:27:49,680 --> 02:27:50,280 FACTOR. 4081 02:27:50,280 --> 02:27:53,400 WHAT ABOUT POVERTY AND ABOUT 4082 02:27:53,400 --> 02:27:55,720 ECONOMIC HARDSHIPS AND TRAUMA. 4083 02:27:55,720 --> 02:28:00,320 THERE'S SO MANY FACTORS DIRECTLY 4084 02:28:00,320 --> 02:28:01,400 AFFECTING VOLUME, RESTING STATE 4085 02:28:01,400 --> 02:28:03,120 CHANGES FROM DAY TO DAY, MONTH 4086 02:28:03,120 --> 02:28:04,160 TO MONTH. 4087 02:28:04,160 --> 02:28:05,800 HOW ARE THESE THINGS GOING TO 4088 02:28:05,800 --> 02:28:07,520 GET ACCOUNTED FOR UP THE ABCD 4089 02:28:07,520 --> 02:28:09,240 DATA SET? 4090 02:28:09,240 --> 02:28:09,760 >> RIGHT. 4091 02:28:09,760 --> 02:28:10,640 THAT'S A GOOD POINT. 4092 02:28:10,640 --> 02:28:13,600 THAT PAPER I MENTIONED IN 4093 02:28:13,600 --> 02:28:14,840 PSYCHOLOGICAL SCIENCE ABOUT 4094 02:28:14,840 --> 02:28:16,040 RESPONSIBLE DATA USE HIGHLIGHTS 4095 02:28:16,040 --> 02:28:17,320 THOSE VERY ISSUES. 4096 02:28:17,320 --> 02:28:20,600 IT FOCUSES IN ON ALL THE 4097 02:28:20,600 --> 02:28:21,920 CONTEXTUAL DATA WE DO COLLECT IN 4098 02:28:21,920 --> 02:28:23,760 ABCD THAT SHOULD BE INCORPORATED 4099 02:28:23,760 --> 02:28:25,520 INTO MODELS WHEN PEOPLE ARE 4100 02:28:25,520 --> 02:28:27,160 LOOKING AT THESE OUTCOMES AND 4101 02:28:27,160 --> 02:28:30,120 THE DEVELOPMENT CONTEXT LIKE YOU 4102 02:28:30,120 --> 02:28:34,840 SAID, THIS IS A DYNAMIC STAGE OF 4103 02:28:34,840 --> 02:28:35,120 DEVELOPMENT. 4104 02:28:35,120 --> 02:28:37,320 PEOPLE SHOULDN'T BE DRAWING 4105 02:28:37,320 --> 02:28:38,800 DETERMINATES TO CONCLUSIONS FROM 4106 02:28:38,800 --> 02:28:39,440 WHAT THEY'RE SEEING BECAUSE 4107 02:28:39,440 --> 02:28:41,760 THERE'S CHANGES IN THE 4108 02:28:41,760 --> 02:28:43,040 ENVIRONMENTS THAT CAN 4109 02:28:43,040 --> 02:28:44,480 POTENTIALLY CHANGE TRAJECTORIES. 4110 02:28:44,480 --> 02:28:49,880 WE ARE TRYING TO GET THAT 4111 02:28:49,880 --> 02:28:52,640 MESSAGE OUT THERE AND THEY NEED 4112 02:28:52,640 --> 02:28:56,160 TO LOOK AT THE FACTORS WE DO 4113 02:28:56,160 --> 02:28:57,560 COLLECT DATA ON IN ABCD. 4114 02:28:57,560 --> 02:29:00,160 I THINK MAKES IT A MUCH RICHER 4115 02:29:00,160 --> 02:29:05,920 DATA SET BUT OFTEN ARE LEFT OUT 4116 02:29:05,920 --> 02:29:09,840 A 4117 02:29:09,840 --> 02:29:10,920 AND PEOPLE ARE LOSING THE 4118 02:29:10,920 --> 02:29:12,000 RICHNESS OF THE DATA SET IN 4119 02:29:12,000 --> 02:29:15,440 TERMS OF ALL THE FACTORS THAT 4120 02:29:15,440 --> 02:29:17,080 CONTRIBUTE TO THE OUTCOMES OF 4121 02:29:17,080 --> 02:29:17,320 INTEREST. 4122 02:29:17,320 --> 02:29:24,520 I THINK THAT'S ONE OF THE THINGS 4123 02:29:24,520 --> 02:29:26,160 BECAUSE THE DATA EXISTS IT JUST 4124 02:29:26,160 --> 02:29:29,920 NEEDS TO BE INCORPORATED IN THE 4125 02:29:29,920 --> 02:29:38,720 MODELS. 4126 02:29:38,720 --> 02:29:39,560 >> ON THE POSITIVE SIDE IT'S 4127 02:29:39,560 --> 02:29:40,720 EXTRAORDINARY TO SEE WHAT THE 4128 02:29:40,720 --> 02:29:43,560 DATA ARE CAPTURING AND TO THINK 4129 02:29:43,560 --> 02:29:46,720 WITH SOMETHING LIKE THE GLOBAL 4130 02:29:46,720 --> 02:29:51,520 PANDEMIC AND AN IMPACT THAT'S A 4131 02:29:51,520 --> 02:29:55,480 NATURAL EXPERIMENT IN AN ENTIRE 4132 02:29:55,480 --> 02:29:59,280 POPULATION WE'LL BE ABLE TO LOOK 4133 02:29:59,280 --> 02:30:01,000 AND SEE PREDICTION THAT'S 4134 02:30:01,000 --> 02:30:02,680 AMAZING AND WITH ALL THE PAPERS 4135 02:30:02,680 --> 02:30:06,920 COMING OUT IS HOW CAN WE PREPARE 4136 02:30:06,920 --> 02:30:08,880 THE LAY PUBLIC EVEN OUR FELLOW 4137 02:30:08,880 --> 02:30:09,840 SCIENTIST FOR ALL THESE THINGS 4138 02:30:09,840 --> 02:30:11,800 ARE NOT THE SAME AND BASICALLY 4139 02:30:11,800 --> 02:30:12,920 IT'S TRUE WITH REGARD TO THE 4140 02:30:12,920 --> 02:30:17,480 MEASURES AND WITH REGARD TO HOW 4141 02:30:17,480 --> 02:30:18,920 THEY'RE HANDLED AND IT IS FILLED 4142 02:30:18,920 --> 02:30:23,520 WITH SUBTLETY AND FILLED WITH 4143 02:30:23,520 --> 02:30:27,320 POSSIBILITY AND PITFALLS, RIGHT. 4144 02:30:27,320 --> 02:30:29,360 HOW DO WE GET GOOD WRITERS TO 4145 02:30:29,360 --> 02:30:31,880 TRY HARD IN FRAMING THESE VERY 4146 02:30:31,880 --> 02:30:37,320 IMPORTANT PAPERS TO MAKE SOME OF 4147 02:30:37,320 --> 02:30:40,120 THESE DISTINCTIONS SO THAT THE 4148 02:30:40,120 --> 02:30:41,520 HEADLINES CAN'T BE 4149 02:30:41,520 --> 02:30:43,440 OVERSIMPLIFIED TO THE POINT OF 4150 02:30:43,440 --> 02:30:45,520 BEING A DISMISSAL OF ALL BRAIN 4151 02:30:45,520 --> 02:30:47,720 DATA OR ALL ABCD OR ALL 4152 02:30:47,720 --> 02:30:48,200 WHATEVER. 4153 02:30:48,200 --> 02:30:48,840 IT CAN BE QUITE EXTREME WHAT 4154 02:30:48,840 --> 02:30:52,560 HAPPENS. 4155 02:30:52,560 --> 02:30:59,360 >> AND I THINK ONE OF THE OTHER 4156 02:30:59,360 --> 02:31:02,840 ASPECTS OF THAT IS AND PUTTING 4157 02:31:02,840 --> 02:31:03,880 THE DATA OUT THERE SO PEOPLE CAN 4158 02:31:03,880 --> 02:31:07,520 USE IT IS GREAT BUT WITH THAT 4159 02:31:07,520 --> 02:31:08,320 COMES PITFALLS AS WELL BECAUSE 4160 02:31:08,320 --> 02:31:09,880 NOT EVERYBODY IS GOING TO 4161 02:31:09,880 --> 02:31:11,880 INCLUDE THE CONTEXTUAL FACTORS 4162 02:31:11,880 --> 02:31:13,040 THEY NEED TO BE INCLUDING IN 4163 02:31:13,040 --> 02:31:15,000 DEVELOPING THEIR MODELS. 4164 02:31:15,000 --> 02:31:19,400 SO WE ARE LEAVING UP TO THE 4165 02:31:19,400 --> 02:31:20,400 SCIENTIFIC COMMUNITY TO EVALUATE 4166 02:31:20,400 --> 02:31:23,560 THE SCIENCE THAT'S COMING OUT 4167 02:31:23,560 --> 02:31:25,280 BECAUSE IT'S NOT JUST THAT BUT 4168 02:31:25,280 --> 02:31:29,000 THE PAPERS COMING OUT AND HOW DO 4169 02:31:29,000 --> 02:31:31,840 YOU WEIGH THE PAPERS AGAINST 4170 02:31:31,840 --> 02:31:32,640 EACH OTHER. 4171 02:31:32,640 --> 02:31:34,320 THERE'S DIFFERENT LEVELS. 4172 02:31:34,320 --> 02:31:52,320 >> ABSOLUTELY. 4173 02:31:52,320 --> 02:31:54,760 AND LOOKING AT ABCD INVESTIGATOR 4174 02:31:54,760 --> 02:31:55,960 PAPERS AND OTHERS TO SEE WHAT 4175 02:31:55,960 --> 02:31:57,840 WE'RE SEEING AND PUT IT INTO A 4176 02:31:57,840 --> 02:31:59,560 PACKAGE THE LAY AUDIENCE CAN 4177 02:31:59,560 --> 02:32:01,520 UNDERSTAND WHAT THE TAKE-HOME 4178 02:32:01,520 --> 02:32:03,600 MESSAGE IS. 4179 02:32:03,600 --> 02:32:04,560 IT'S VERY COMPLEX. 4180 02:32:04,560 --> 02:32:06,280 >> IT'S A CHALLENGE WITH THE 4181 02:32:06,280 --> 02:32:08,680 RICHNESS OF ALL THE VARIABLES 4182 02:32:08,680 --> 02:32:11,760 EVEN FOR WELL-INTENTIONED PEER 4183 02:32:11,760 --> 02:32:12,120 INVESTIGATORS. 4184 02:32:12,120 --> 02:32:15,480 THERE'S SO MANY POSSIBLE THINGS 4185 02:32:15,480 --> 02:32:16,000 TO INCLUDE. 4186 02:32:16,000 --> 02:32:18,320 IT'S QUITE SOMETHING TO 4187 02:32:18,320 --> 02:32:18,560 NAVIGATE. 4188 02:32:18,560 --> 02:32:22,600 SO YES, PLENTY OF CHALLENGES. 4189 02:32:22,600 --> 02:32:25,760 >> AND WITH RESPECT SPECIFICALLY 4190 02:32:25,760 --> 02:32:28,520 TO SOME OF THE HEALTH 4191 02:32:28,520 --> 02:32:29,920 DISPARITIES ANALYSES IS WHEN WE 4192 02:32:29,920 --> 02:32:37,880 WANT TO ENCOURAGE PEOPLE TO LOOK 4193 02:32:37,880 --> 02:32:39,680 AT THE DATA AND ENGAGE THE 4194 02:32:39,680 --> 02:32:41,560 COMMUNITIES THEMSELVES TO 4195 02:32:41,560 --> 02:32:43,800 UNDERSTAND THE CONTEXTUAL 4196 02:32:43,800 --> 02:32:44,680 FACTORS MOST RELEVANT TO THE 4197 02:32:44,680 --> 02:32:45,600 COMMUNITIES THEY NEED TO INCLUDE 4198 02:32:45,600 --> 02:32:47,680 IN THEIR MODELS IF THEY'RE NOT 4199 02:32:47,680 --> 02:32:51,000 PART OF THOSE COMMUNITIES. 4200 02:32:51,000 --> 02:32:53,920 EVEN THOUGH RESEARCHERS MAY NOT 4201 02:32:53,920 --> 02:32:56,840 BE PART OF THE CONSORTIUM THEY 4202 02:32:56,840 --> 02:32:57,920 CAN STILL TALK TO THE 4203 02:32:57,920 --> 02:32:59,680 COMMUNITIES OF WHICH THAT DATA 4204 02:32:59,680 --> 02:33:10,800 REPRESENTS TO UNDERSTAND. 4205 02:33:10,800 --> 02:33:11,200 AHMED. 4206 02:33:11,200 --> 02:33:13,520 >> AS SOMEBODY WHO'S DONE A LOT 4207 02:33:13,520 --> 02:33:15,560 OF IMAGING OVER MY CAREER I TAKE 4208 02:33:15,560 --> 02:33:16,400 A DIFFERENT PERSPECTIVE. 4209 02:33:16,400 --> 02:33:18,200 THIS HAS SIGNIFICANT 4210 02:33:18,200 --> 02:33:19,360 IMPLICATIONS FOR SMALLER SAMPLE 4211 02:33:19,360 --> 02:33:21,880 SIZES BUT ESPECIALLY IN THE 4212 02:33:21,880 --> 02:33:23,240 CONTEXT OF THESE DISCUSSIONS AND 4213 02:33:23,240 --> 02:33:26,800 IN COUNCIL FROM A FUNDING AGENCY 4214 02:33:26,800 --> 02:33:29,840 PERSPECTIVE THERE'S A SIDE WE 4215 02:33:29,840 --> 02:33:35,000 HAVE TO CONSIDER WHICH IS THAT 4216 02:33:35,000 --> 02:33:40,840 REALLY ALL THE BWAS WERE ABOUT 4217 02:33:40,840 --> 02:33:51,160 EFFECT SIZES AND RELIABILITY AND 4218 02:33:51,160 --> 02:33:53,840 POWER. 4219 02:33:53,840 --> 02:33:54,920 DEF 4220 02:33:54,920 --> 02:33:56,280 >> AND THE PEOPLE IN A DIFFICULT 4221 02:33:56,280 --> 02:33:58,720 SPOT ARE THE TRAINEES BECAUSE 4222 02:33:58,720 --> 02:34:03,600 THAT'S WHERE WHAT CAN ADVANCE 4223 02:34:03,600 --> 02:34:06,040 YOUR CAREER LIVES ANDEF 4224 02:34:06,040 --> 02:34:06,680 >> AND THE PEOPLE IN A DIFFICULT 4225 02:34:06,680 --> 02:34:07,280 SPOT ARE THE TRAINEES BECAUSE 4226 02:34:07,280 --> 02:34:07,880 THAT'S WHERE WHAT CAN ADVANCE 4227 02:34:07,880 --> 02:34:08,360 YOUR CAREER LIVES ANDF 4228 02:34:08,360 --> 02:34:09,000 >> AND THE PEOPLE IN A DIFFICULT 4229 02:34:09,000 --> 02:34:09,600 SPOT ARE THE TRAINEES BECAUSE 4230 02:34:09,600 --> 02:34:10,200 THAT'S WHERE WHAT CAN ADVANCE 4231 02:34:10,200 --> 02:34:11,440 YOUR CAREER LIVES A D 4232 02:34:11,440 --> 02:34:12,080 >> AND THE PEOPLE IN A DIFFICULT 4233 02:34:12,080 --> 02:34:12,680 SPOT ARE THE TRAINEES BECAUSE 4234 02:34:12,680 --> 02:34:13,280 THAT'S WHERE WHAT CAN ADVANCE 4235 02:34:13,280 --> 02:34:15,000 YOUR CAREER LIVES A>> AND THE PEOPLE IN A DIFFICULT 4236 02:34:15,000 --> 02:34:15,600 SPOT ARE THE TRAINEES BECAUSE 4237 02:34:15,600 --> 02:34:16,200 THAT'S WHERE WHAT CAN ADVANCE 4238 02:34:16,200 --> 02:34:16,920 YOUR CAREER LIVES AND WE NEED TO 4239 02:34:16,920 --> 02:34:17,520 LOOK HOW WE STRUCTURE THOSE 4240 02:34:17,520 --> 02:34:18,160 FUNDING REQUESTS SHOULD THERE BE 4241 02:34:18,160 --> 02:34:18,800 AN ELEMENT OF EVERY PROPOSAL 4242 02:34:18,800 --> 02:34:24,320 THAT USES PUBLIC DATA WELL 4243 02:34:24,320 --> 02:34:27,120 POWERED AND ENSURE FOLKS 4244 02:34:27,120 --> 02:34:29,920 STARTING IN THEIR CAREER AND THE 4245 02:34:29,920 --> 02:34:30,920 LAB MEMBERS TIME WILL CONTRIBUTE 4246 02:34:30,920 --> 02:34:33,320 TO PUBLICATIONS TO GET THEM 4247 02:34:33,320 --> 02:34:35,160 THEIR NEXT POSITION AND TENURE, 4248 02:34:35,160 --> 02:34:37,320 AND SO FORTH, THEY'RE PUT IN A 4249 02:34:37,320 --> 02:34:38,400 POSITION TO SUCCEED AND NOT GET 4250 02:34:38,400 --> 02:34:41,080 CRUSHED BY WHAT'S COMING WHICH 4251 02:34:41,080 --> 02:34:45,120 IS A BWAS LIKE TRANSITION IN THE 4252 02:34:45,120 --> 02:34:49,480 FIELD THAT I'M PRETTY SURE HIGH 4253 02:34:49,480 --> 02:34:50,840 PROFILE PUBLICATIONS WILL START 4254 02:34:50,840 --> 02:34:52,600 ACCEPTING SMALL SAMPLE SIZES 4255 02:34:52,600 --> 02:34:55,640 LESS AND LESS AND FRANKLY NOT 4256 02:34:55,640 --> 02:34:57,000 WITHOUT A REPLICATION AND I 4257 02:34:57,000 --> 02:34:58,280 WORRY FOR THE YOUNGER FOLKS. 4258 02:34:58,280 --> 02:35:01,920 >> I AGREE BUT GOING BACK TO 4259 02:35:01,920 --> 02:35:03,600 REGINA'S COMMENTS IN WE HAVE A 4260 02:35:03,600 --> 02:35:06,720 LOT OF CONVERSATION THIS WHEN 4261 02:35:06,720 --> 02:35:09,280 ABCD STARTED AND THERE'S A LOT 4262 02:35:09,280 --> 02:35:11,320 OF WE CAN LEARN FROM ABCD AND 4263 02:35:11,320 --> 02:35:13,360 LARGE STUDIES LIKE ABCD BUT WE 4264 02:35:13,360 --> 02:35:15,720 NEED SOME SMALLER STUDIES TO GO 4265 02:35:15,720 --> 02:35:18,800 MORE IN DEPTH. 4266 02:35:18,800 --> 02:35:20,920 WE DON'T WANT TO RULE OUT 4267 02:35:20,920 --> 02:35:22,120 SMALLER STUDIES AND I THINK 4268 02:35:22,120 --> 02:35:24,120 THAT'S THE POINT ELIZABETH WAS 4269 02:35:24,120 --> 02:35:25,520 MAKING THERE'S STILL VALUE IN 4270 02:35:25,520 --> 02:35:26,760 SMALLER STUDIES BUT WE NEED TO 4271 02:35:26,760 --> 02:35:28,160 THINK ABOUT WHAT IS HAPPENING IN 4272 02:35:28,160 --> 02:35:30,760 THE FIELD AND I THINK WITH 4273 02:35:30,760 --> 02:35:33,400 RESPECT TO THIS FINDING IN 4274 02:35:33,400 --> 02:35:35,360 PARTICULAR AND WHAT WE'RE 4275 02:35:35,360 --> 02:35:36,160 TALKING ABOUT IN TERMS OF HOW 4276 02:35:36,160 --> 02:35:38,640 THE MESSAGING HAS BEEN ON IT, I 4277 02:35:38,640 --> 02:35:40,200 THINK TO YOUR POINT ABOUT HOW 4278 02:35:40,200 --> 02:35:41,920 IT'S GOING TO IMPACT TRAINEES WE 4279 02:35:41,920 --> 02:35:47,480 NEED TO MAKE SURE REVIEWERS ARE 4280 02:35:47,480 --> 02:35:50,200 ALSO THINKING ABOUT THIS VERY 4281 02:35:50,200 --> 02:35:53,160 SPECIFIC TO THE STUDY THE 4282 02:35:53,160 --> 02:35:54,400 PROPOSALS THEY'RE EVALUATING AND 4283 02:35:54,400 --> 02:35:55,320 WHETHER THEY CAN BE DONE IN 4284 02:35:55,320 --> 02:35:57,320 SMALLER SAMPLES. 4285 02:35:57,320 --> 02:35:58,840 I DON'T THINK -- IT IS VERY 4286 02:35:58,840 --> 02:36:01,520 COMPLICATED BUT I THINK WE NEED 4287 02:36:01,520 --> 02:36:04,480 TO RAISE THE LEVEL OF AWARENESS 4288 02:36:04,480 --> 02:36:06,000 ABOUT WHERE THIS DOES HAVE AN 4289 02:36:06,000 --> 02:36:07,920 IMPACT AND NOT AND I DON'T KNOW 4290 02:36:07,920 --> 02:36:10,840 ELIZABETH IF YOU WANT TO SAY 4291 02:36:10,840 --> 02:36:12,640 ANYTHING TO THIS KIND OF GLOBAL 4292 02:36:12,640 --> 02:36:15,160 ISSUE. 4293 02:36:15,160 --> 02:36:17,720 >> I THINK YOU SUMMED IT UP. 4294 02:36:17,720 --> 02:36:21,720 WE WANT TO BE CAREFUL ABOUT THE 4295 02:36:21,720 --> 02:36:24,080 MESSAGING AND CAREFUL ABOUT THE 4296 02:36:24,080 --> 02:36:26,040 MESSAGING AND IDENTIFYING WHERE 4297 02:36:26,040 --> 02:36:28,320 LARGE SAMPLES ARE MOST 4298 02:36:28,320 --> 02:36:29,840 CRITICALLY NEEDED AND 4299 02:36:29,840 --> 02:36:31,040 UNDERSTANDING IF THERE ARE MANY 4300 02:36:31,040 --> 02:36:35,880 TYPE OF PARADIGMS WHERE SMALL 4301 02:36:35,880 --> 02:36:40,520 SAMPLE SIZES ARE REFLECTED IN 4302 02:36:40,520 --> 02:36:42,280 GUIDES PUT FORWARD. 4303 02:36:42,280 --> 02:36:46,520 >> ONE OF THE OTHER THINGS ABCD 4304 02:36:46,520 --> 02:36:49,640 IS NOT ABLE TO DO AND WE'RE 4305 02:36:49,640 --> 02:36:51,720 COLLECTING DATA ON 10,000-FOOT 4306 02:36:51,720 --> 02:36:53,880 LEVEL AND SOMETIMES WE NEED THE 4307 02:36:53,880 --> 02:36:56,800 STUDIES TO BE DONE WITH MORE 4308 02:36:56,800 --> 02:36:57,680 GRANULAR LEVEL OF DETAIL WE 4309 02:36:57,680 --> 02:37:01,520 CAN'T DO IN A STUDY THIS LARGE. 4310 02:37:01,520 --> 02:37:03,320 I THINK IT'S IMPORTANT WE DON'T 4311 02:37:03,320 --> 02:37:04,680 LOSE SIGHT OF THAT. 4312 02:37:04,680 --> 02:37:06,160 THE SMALLER STUDIES ARE REALLY 4313 02:37:06,160 --> 02:37:08,560 IMPORTANT BECAUSE THEY'RE ABLE 4314 02:37:08,560 --> 02:37:11,040 TO GO INTO MORE GREATER DEPTH ON 4315 02:37:11,040 --> 02:37:12,720 CERTAIN AREAS. 4316 02:37:12,720 --> 02:37:15,520 >> JUST TO MAKE CLEAR I'M NOT 4317 02:37:15,520 --> 02:37:16,840 SAYING SMALL STUDIES AREN'T 4318 02:37:16,840 --> 02:37:17,440 VALUABLE BUT THEY'RE NOT 4319 02:37:17,440 --> 02:37:20,520 VALUABLE WITHOUT A REPLICATION. 4320 02:37:20,520 --> 02:37:23,920 AS A REVIEWER I'VE BEEN TURNING 4321 02:37:23,920 --> 02:37:26,280 DOWN PAPERS THAT ARE SMALLER 4322 02:37:26,280 --> 02:37:27,320 SAMPLE SIZE THAT DON'T HAVE 4323 02:37:27,320 --> 02:37:29,480 REPLICATION FOR YEARS BECAUSE 4324 02:37:29,480 --> 02:37:31,520 THIS TREND HAS BEEN OBVIOUS FOR 4325 02:37:31,520 --> 02:37:32,640 EASILY A DECADE. 4326 02:37:32,640 --> 02:37:34,920 THE ISSUE IS AS A FUNDING 4327 02:37:34,920 --> 02:37:36,880 AGENCY, WE NEED TO MAKE SURE 4328 02:37:36,880 --> 02:37:39,760 THAT WE LOOK ESPECIALLY AT 4329 02:37:39,760 --> 02:37:41,040 TRAINEE GRANTS FROM THE 4330 02:37:41,040 --> 02:37:46,560 PERSPECTIVE OF IF IN FIVE YEARS 4331 02:37:46,560 --> 02:37:52,120 THEY GENERATE THIS KNOWLEDGE 4332 02:37:52,120 --> 02:37:53,120 THEIR PROPOSING AND WILL THERE 4333 02:37:53,120 --> 02:37:55,200 BE AN OPPORTUNITY TO REPLICATION 4334 02:37:55,200 --> 02:37:56,840 AND WHAT CAN WE DO AS FUNDING 4335 02:37:56,840 --> 02:37:59,000 AGENCIES DO TO HELP THEM AND NOT 4336 02:37:59,000 --> 02:38:05,520 PUSH THEM TO THE VOID. 4337 02:38:05,520 --> 02:38:07,120 >> AND SUSAN, LET ME KNOW WHEN 4338 02:38:07,120 --> 02:38:09,360 WE'RE OUT OF TIME. 4339 02:38:09,360 --> 02:38:10,840 >> YEAH, SO WE'RE ALREADY OUT OF 4340 02:38:10,840 --> 02:38:11,920 TIME BUT WHY DON'T WE TAKE THE 4341 02:38:11,920 --> 02:38:13,800 NEXT TWO QUESTIONS AND THEN TAKE 4342 02:38:13,800 --> 02:38:15,120 A BREAK AND THEN AGAIN WE HAVE 4343 02:38:15,120 --> 02:38:17,960 TIME BUILT IN AT THE END TO 4344 02:38:17,960 --> 02:38:21,000 CONTINUE THIS DISCUSSION. 4345 02:38:21,000 --> 02:38:22,960 >> I THINK THAT'S FINE, SUSAN. 4346 02:38:22,960 --> 02:38:24,120 WE CAN TALK ABOUT THIS LATER. 4347 02:38:24,120 --> 02:38:26,440 IN FACT I WANT TO BRING UP 4348 02:38:26,440 --> 02:38:27,960 SOMETHING I HOPE -- I SUSPECT 4349 02:38:27,960 --> 02:38:30,680 WE'RE ALL THINKING ABOUT WHICH 4350 02:38:30,680 --> 02:38:33,320 IS SORT OF THE THEMES OF THE 4351 02:38:33,320 --> 02:38:34,760 LAST TWO DAYS AND I SIT ON 4352 02:38:34,760 --> 02:38:36,720 COUNCIL FOR NIDA AND WE HAD OUR 4353 02:38:36,720 --> 02:38:38,440 MEETING YESTERDAY AND ONE HAS 4354 02:38:38,440 --> 02:38:39,760 BEEN INEQUITY. 4355 02:38:39,760 --> 02:38:43,320 WE KNOW THE ISSUES WE'RE ALL 4356 02:38:43,320 --> 02:38:45,120 HERE TO TALK ABOUT ARE 4357 02:38:45,120 --> 02:38:46,320 DISPROPORTIONATELY HITTING MORE 4358 02:38:46,320 --> 02:38:49,320 COMMUNITIES INCLUDING MY 4359 02:38:49,320 --> 02:38:51,560 COMMUNITY, THE AMERICAN INDIAN 4360 02:38:51,560 --> 02:38:52,720 COMMUNITY AND TWO, WE'RE 4361 02:38:52,720 --> 02:38:53,320 INTERESTED IN THE SOCIAL 4362 02:38:53,320 --> 02:38:54,760 DETERMINATES OF HEALTH AND THE 4363 02:38:54,760 --> 02:38:56,320 CONTEXT THROUGH WHICH THE 4364 02:38:56,320 --> 02:38:57,880 FINDINGS YOU JUST PRESENTED MAY 4365 02:38:57,880 --> 02:38:59,720 UNFOLD AND THINK I HEARD OTHERS 4366 02:38:59,720 --> 02:39:00,920 BRINGING UP TRAUMA AND STRESS. 4367 02:39:00,920 --> 02:39:03,320 SO WHEN I PUT THOSE TWO THINGS 4368 02:39:03,320 --> 02:39:05,600 TOGETHER I'M REALLY STRUGGLING 4369 02:39:05,600 --> 02:39:09,000 ETHICALLY WITH THE FACT THAT 4370 02:39:09,000 --> 02:39:11,120 THESE DATA REPRESENT A VERY 4371 02:39:11,120 --> 02:39:13,520 BIASSED PRIVILEGED SAMPLE AND AT 4372 02:39:13,520 --> 02:39:17,720 WHAT POINT DO WE JUST SAY NO? 4373 02:39:17,720 --> 02:39:21,720 AT WHAT POINT DO WE DEMAND THE 4374 02:39:21,720 --> 02:39:23,720 RESOURCES LIKE THIS GET PUT TO 4375 02:39:23,720 --> 02:39:24,920 COMMUNITIES HIT THE HARDEST 4376 02:39:24,920 --> 02:39:25,640 RATHER THAN SAYING IT'S NOT 4377 02:39:25,640 --> 02:39:27,920 FUNDED WELL ENOUGH TO GET THE 4378 02:39:27,920 --> 02:39:28,680 GRANULAR DATA? 4379 02:39:28,680 --> 02:39:30,240 IT'S NOT A DISCUSSION JUST FOR 4380 02:39:30,240 --> 02:39:32,640 YOU ALL BUT SOMETHING THAT IS ON 4381 02:39:32,640 --> 02:39:33,760 MY MIND THROUGHOUT THE PAST TWO 4382 02:39:33,760 --> 02:39:37,520 DAYS AND WOULD LIKE TO FLAG IT 4383 02:39:37,520 --> 02:39:46,240 NOR ROUNDTABLE DISCUSSION LATER. 4384 02:39:46,240 --> 02:39:49,320 >> MINE IS QUICK AND WE CAN TALK 4385 02:39:49,320 --> 02:39:50,720 LATER THIS AFTERNOON BUT FROM 4386 02:39:50,720 --> 02:39:53,880 THE PERSPECTIVE OF A YOUNG 4387 02:39:53,880 --> 02:39:56,560 TRAINEE OR INVESTIGATOR THE IDEA 4388 02:39:56,560 --> 02:39:59,320 OF AN OVER SIMPLIFIED YOU CAN'T 4389 02:39:59,320 --> 02:40:00,320 GET PUBLISHED UNLESS HAVE YOU 4390 02:40:00,320 --> 02:40:04,760 HUNDREDS OR THOUSANDS IS 4391 02:40:04,760 --> 02:40:05,960 OFF-PUTTING WHEN YOU HAVE 4392 02:40:05,960 --> 02:40:07,520 DETRACTORS FOR PEOPLE GOING IN 4393 02:40:07,520 --> 02:40:10,680 THE FIELD ANYWAY WITH THE 4394 02:40:10,680 --> 02:40:14,080 UNCERTAINTY OF FUNDING AND 4395 02:40:14,080 --> 02:40:17,880 PANDEMICS AND WHATNOT AND 4396 02:40:17,880 --> 02:40:19,800 REPLICABILITY AND SMALL-TEST 4397 02:40:19,800 --> 02:40:21,720 PARADIGMS CAN TAKE YOU VERY FAR. 4398 02:40:21,720 --> 02:40:27,720 VERY IMPORTANT FOR THAT TO 4399 02:40:27,720 --> 02:40:27,960 HAPPEN. 4400 02:40:27,960 --> 02:40:30,320 AND IN ALL THIS SWAY AND 4401 02:40:30,320 --> 02:40:32,120 WONDERFUL DATA FROM 10,000 FEET. 4402 02:40:32,120 --> 02:40:33,840 THAT'S IT. 4403 02:40:33,840 --> 02:40:38,760 >> THANK YOU. 4404 02:40:38,760 --> 02:40:39,600 >> OKAY. 4405 02:40:39,600 --> 02:40:41,320 WHY DON'T WE TAKE A 10-MINUTE 4406 02:40:41,320 --> 02:40:44,560 BREAK NOW AND COME BACK AND HEAR 4407 02:40:44,560 --> 02:40:50,200 FROM DR. STACY RASMUS AND THEN 4408 02:40:50,200 --> 02:40:51,280 THE ROUNDTABLE. 4409 02:40:51,280 --> 02:40:52,040 PLEASE COME BACK AT 1:50. 4410 02:40:52,040 --> 02:40:53,280 THANK YOU. 4411 02:40:53,280 --> 02:40:54,960 >> HELLO, EVERYONE. 4412 02:40:54,960 --> 02:40:56,960 IT'S A REAL PLEASURE TO 4413 02:40:56,960 --> 02:40:59,240 INTRODUCE DR. STACY RASMUS THE 4414 02:40:59,240 --> 02:41:01,800 DIRECTOR OF THE CENTER FOR 4415 02:41:01,800 --> 02:41:03,600 ALASKAN NATIVE HEALTH AT THE 4416 02:41:03,600 --> 02:41:04,960 UNIVERSITY OF ALASKA FAIRBANKS 4417 02:41:04,960 --> 02:41:07,560 AND OVER HAS TWO DECADES OF 4418 02:41:07,560 --> 02:41:09,080 EXPERIENCE WORKING WITH AMERICAN 4419 02:41:09,080 --> 02:41:12,680 INDIAN AND ALASKAN NATIVE 4420 02:41:12,680 --> 02:41:14,320 COMMUNITIES AND SHE'S BUILT AN 4421 02:41:14,320 --> 02:41:15,640 INTERNATIONAL PROGRAM OF 4422 02:41:15,640 --> 02:41:18,560 RESEARCH FOCUSSING ON THE 4423 02:41:18,560 --> 02:41:20,480 PROMOTION OF INDIGENOUS 4424 02:41:20,480 --> 02:41:23,560 STRENGTHS, WELL BEING AND 4425 02:41:23,560 --> 02:41:25,200 RESILIENCE IN ALASKA. 4426 02:41:25,200 --> 02:41:27,640 THE ARCTIC AND THE PACIFIC 4427 02:41:27,640 --> 02:41:29,280 NORTHWEST. 4428 02:41:29,280 --> 02:41:32,360 DR. RASMUS LEADS A RESEARCH 4429 02:41:32,360 --> 02:41:33,680 PROGRAM FOR UNDERSTANDING THE 4430 02:41:33,680 --> 02:41:39,200 INTERSECTIONS OF SUICIDE, MENTAL 4431 02:41:39,200 --> 02:41:43,600 HEALTH AND SUBSTANCE USE 4432 02:41:43,600 --> 02:41:44,360 DISORDERS. 4433 02:41:44,360 --> 02:41:47,240 HE'S RECEIVED AN Ph.D. FROM 4434 02:41:47,240 --> 02:41:49,760 ANTHROPOLOGY FROM THE UNIVERSITY 4435 02:41:49,760 --> 02:41:53,240 OF ALASKA FAIRBANKS AND HAS A 4436 02:41:53,240 --> 02:41:57,240 FASCINATING BACKGROUND AND 4437 02:41:57,240 --> 02:41:57,560 PUBLICATIONS. 4438 02:41:57,560 --> 02:41:59,240 SHE'S GOING TO TALK ABOUT 4439 02:41:59,240 --> 02:42:04,840 SOLUTIONS TO END SUICIDE AND 4440 02:42:04,840 --> 02:42:07,160 PREVENT SUBSTANCE USE DISORDER 4441 02:42:07,160 --> 02:42:09,440 IN ALASKA AND BUILDING 4442 02:42:09,440 --> 02:42:11,280 MULTI--LEVEL STRENGTHS AND 4443 02:42:11,280 --> 02:42:13,480 PROTECTIVE FACTORS WITHIN THE 4444 02:42:13,480 --> 02:42:14,480 ALASKA NATIVE COMMUNITIES AND 4445 02:42:14,480 --> 02:42:16,880 CULTURES TO REDUCE RISK. 4446 02:42:16,880 --> 02:42:18,680 DR. RASMUS. 4447 02:42:18,680 --> 02:42:20,200 >> THANK YOU SO MUCH, DR. KOOB. 4448 02:42:20,200 --> 02:42:21,240 IT'S GOOD TO SEE YOU AGAIN. 4449 02:42:21,240 --> 02:42:40,560 LET ME SHARE MY SCREEN. 4450 02:42:40,560 --> 02:42:41,280 MY SCREEN SHOWING? 4451 02:42:41,280 --> 02:42:43,000 >> LOOKS GOOD. 4452 02:42:43,000 --> 02:42:44,320 >> I APPRECIATE THE INTRODUCTION 4453 02:42:44,320 --> 02:42:47,320 AND I'M HONORED TO HAVE BEEN 4454 02:42:47,320 --> 02:42:56,440 ASKED TO PRESENT TO THIS COUNCIL 4455 02:42:56,440 --> 02:42:58,920 I'M EXCITED TO SHARE WORK I 4456 02:42:58,920 --> 02:43:02,080 THINK WILL ILLUMINATE 4457 02:43:02,080 --> 02:43:02,480 DISCUSSIONS. 4458 02:43:02,480 --> 02:43:06,840 I'VE BEEN LISTENING ALL MORNING 4459 02:43:06,840 --> 02:43:11,280 TO DISCUSSIONS AND AT FIRST I 4460 02:43:11,280 --> 02:43:15,120 WAS CONCERNED MY PRESENTATION 4461 02:43:15,120 --> 02:43:16,600 MAY SEEM OFF-CENTERED FROM 4462 02:43:16,600 --> 02:43:19,680 DISCUSSION BUT I FEEL IT 4463 02:43:19,680 --> 02:43:26,000 ENVELOPS THE DATA WE'RE SEEING 4464 02:43:26,000 --> 02:43:28,560 AND THE EMPATHY AROUND COMMUNITY 4465 02:43:28,560 --> 02:43:30,000 ENGAGEMENT AND FOCUSSING ON 4466 02:43:30,000 --> 02:43:35,280 POPULATIONS AT HIGHEST NEED HIKE 4467 02:43:35,280 --> 02:43:40,480 FOUR AMERICAN INDIAN AND ALASKA 4468 02:43:40,480 --> 02:43:42,680 NATIVE POPULATIONS AND WANT TO 4469 02:43:42,680 --> 02:43:48,160 SHOW YOU YOUNG PEOPLE GROWING UP 4470 02:43:48,160 --> 02:43:50,960 LIVING THEIR OUR INDIGENOUS 4471 02:43:50,960 --> 02:43:52,480 LIVES ON THE LAND AND BECOMING 4472 02:43:52,480 --> 02:43:54,280 MELT THE AND WELL THROUGH 4473 02:43:54,280 --> 02:43:55,440 TRADITIONAL WAYS AND BUILDING 4474 02:43:55,440 --> 02:44:02,840 THOSE STRENGTHS TO BE ABLE TO 4475 02:44:02,840 --> 02:44:05,920 WELL RESIST THE IMPOSED FORCES 4476 02:44:05,920 --> 02:44:07,080 AND BECOME WELL IN THEIR LIVES. 4477 02:44:07,080 --> 02:44:11,280 SO WE'RE GOING TO LOOK AT A 4478 02:44:11,280 --> 02:44:15,400 PREVENTIVE INTERVENTION THAT 4479 02:44:15,400 --> 02:44:20,160 AGAIN HAS BEEN BASED ON 4480 02:44:20,160 --> 02:44:26,400 COMMUNITY AND CULTURAL PRACTS 4481 02:44:26,400 --> 02:44:27,680 AND PROCESSES AND SYSTEMS AND 4482 02:44:27,680 --> 02:44:30,600 THIS INTERVENTION HAS ALWAYS 4483 02:44:30,600 --> 02:44:32,480 BEEN HERE IN THE ALASKAN 4484 02:44:32,480 --> 02:44:33,160 COMMUNITIES WE'LL TALK ABOUT OUR 4485 02:44:33,160 --> 02:44:39,440 WAYS OUR PARTNERSHIP AT THE 4486 02:44:39,440 --> 02:44:46,280 UNIVERSITY AND OUR RESEARCH HAS 4487 02:44:46,280 --> 02:44:47,680 GROWN THE INTERVENTION AND 4488 02:44:47,680 --> 02:44:50,800 DOCUMENT THE PROCESS AND 4489 02:44:50,800 --> 02:44:55,120 PREDICTIVE FACTORS DO REDUCE 4490 02:44:55,120 --> 02:44:56,520 RISK FOR SUICIDE AND ALCOHOL 4491 02:44:56,520 --> 02:44:59,240 MISUSE IN PARTICULAR. 4492 02:44:59,240 --> 02:45:02,000 I WANT TO FIRST ACKNOWLEDGE OUR 4493 02:45:02,000 --> 02:45:04,000 ELDERS AND TEACHERS AND MENTORS. 4494 02:45:04,000 --> 02:45:07,400 WITH RESPECT TO ALL THE ELDERS 4495 02:45:07,400 --> 02:45:12,080 AND ALSO TO THE DENE PEOPLE OF 4496 02:45:12,080 --> 02:45:14,600 THE LANDS THAT ARE OWNED I STAND 4497 02:45:14,600 --> 02:45:20,880 UPON AND PRESENT TO YOU TODAY. 4498 02:45:20,880 --> 02:45:29,080 SO I WANT TO EMPHASIZE I THINK 4499 02:45:29,080 --> 02:45:37,680 IT'S IMPORTANT THAT WE WE CHANGE 4500 02:45:37,680 --> 02:45:39,000 THE PARADIGM AND NARRATIVE IN 4501 02:45:39,000 --> 02:45:40,480 HOW WE LOOK AT DISPARITIES AND 4502 02:45:40,480 --> 02:45:45,280 LOOK AT HOW WE CAN BE BUILDING 4503 02:45:45,280 --> 02:45:47,640 STRENGTHS AND RESILIENCE AND 4504 02:45:47,640 --> 02:45:50,320 ACKNOWLEDGING THAT PARTICULARLY 4505 02:45:50,320 --> 02:45:52,880 WITHIN SPEAKING TO OUR 4506 02:45:52,880 --> 02:45:54,680 INDIGENOUS COMMUNITIES OUR 4507 02:45:54,680 --> 02:45:55,480 INDIGENOUS COMMUNITIES IN ALASKA 4508 02:45:55,480 --> 02:46:02,960 AND ACROSS OUR WORLD HAVE A 4509 02:46:02,960 --> 02:46:05,280 HISTORY OF HEALTH, HEALING AND 4510 02:46:05,280 --> 02:46:08,800 STRENGTH OVERCOMING MANY PRIOR 4511 02:46:08,800 --> 02:46:13,840 EPIDEMICS, PANDEMICS, FLOODS AND 4512 02:46:13,840 --> 02:46:15,480 STARVATION AND MANY DIFFERENT 4513 02:46:15,480 --> 02:46:16,920 OBSTACLES AND NEED TO HAVE WAYS 4514 02:46:16,920 --> 02:46:19,560 TO DRAW UPON OUR STRENGTHS AS 4515 02:46:19,560 --> 02:46:23,000 PEOPLE IN COMMUNITIES TO BE ABLE 4516 02:46:23,000 --> 02:46:24,280 TO COMBAT AND REDUCE THE 4517 02:46:24,280 --> 02:46:28,040 INEQUITIES AND DISPARITIES. 4518 02:46:28,040 --> 02:46:30,960 SO WE'LL ACKNOWLEDGE THAT AND 4519 02:46:30,960 --> 02:46:33,760 LOOK AT THE WAYS WHERE PEOPLE IN 4520 02:46:33,760 --> 02:46:39,200 ALASKA ARE WORKING TO DEFINE THE 4521 02:46:39,200 --> 02:46:44,880 PROBLEM AND OUR SOLUTIONS MUST 4522 02:46:44,880 --> 02:46:45,760 COME FROM COMMUNITIES FOR 4523 02:46:45,760 --> 02:46:47,080 COMMUNITIES MOST IMPACTED. 4524 02:46:47,080 --> 02:46:48,760 WE'LL LOOK AT THE WAY THE 4525 02:46:48,760 --> 02:46:49,520 COMMUNITIES ARE DRIVING THOSE 4526 02:46:49,520 --> 02:46:52,840 SOLUTIONS AND FINALLY WE'LL LOOK 4527 02:46:52,840 --> 02:46:59,280 AT THE WAYS THAT RESEARCH CAN 4528 02:46:59,280 --> 02:47:02,840 SUPPORT COMMUNITIES AND REALLY 4529 02:47:02,840 --> 02:47:07,640 PRODUCE DATA THAT CAN 4530 02:47:07,640 --> 02:47:10,560 DEMONSTRATE THE WAY THAT 4531 02:47:10,560 --> 02:47:12,280 CREATING CHANGE PARTICULARLY IN 4532 02:47:12,280 --> 02:47:14,080 CULTURAL AND SYSTEMS-LEVEL 4533 02:47:14,080 --> 02:47:16,560 CHANGE CAN IMPACT INDIVIDUAL 4534 02:47:16,560 --> 02:47:17,480 YOUNG PEOPLE'S LIVES AND HEALTH 4535 02:47:17,480 --> 02:47:23,320 OUTCOMES. 4536 02:47:23,320 --> 02:47:33,080 SO AND CULTURE'S PROTECTIVE. 4537 02:47:33,080 --> 02:47:35,240 WE HEAR A LOT AND MUST 4538 02:47:35,240 --> 02:47:39,680 ACKNOWLEDGE THE IMPAIRMENT AND 4539 02:47:39,680 --> 02:47:43,680 TRAUMA EXPERIENCED BY NATIVE 4540 02:47:43,680 --> 02:47:47,320 PEOPLE ALSO RECOGNIZE TO COMBAT 4541 02:47:47,320 --> 02:47:49,080 ADVERSITY AND TRAUMA AND 4542 02:47:49,080 --> 02:47:51,880 CHILDHOOD EXPERIENCE WE NEED TO 4543 02:47:51,880 --> 02:47:53,920 ENGAGE IN WHAT'S PROTECTIVE AND 4544 02:47:53,920 --> 02:47:55,160 CONNECTION TO CULTURE AND 4545 02:47:55,160 --> 02:47:58,440 IDENTITY IS PROTECTIVE. 4546 02:47:58,440 --> 02:47:59,240 FINALLY, IT'S ALCOHOL AND OTHER 4547 02:47:59,240 --> 02:48:03,760 DRUGS WERE NOT PART OF OUR 4548 02:48:03,760 --> 02:48:14,000 HISTORIES. 4549 02:48:14,000 --> 02:48:16,240 ALASKA VERY LARGE AND WE HAVE A 4550 02:48:16,240 --> 02:48:18,280 VERY DIVERSE INDIGENOUS 4551 02:48:18,280 --> 02:48:19,680 POPULATION. 4552 02:48:19,680 --> 02:48:23,000 WE HAVE OVER 180,000 TRIBAL 4553 02:48:23,000 --> 02:48:26,760 MEMBERS ACROSS OUR STATE FROM 4554 02:48:26,760 --> 02:48:28,760 VERY DIVERSE CULTURAL REGIONAL 4555 02:48:28,760 --> 02:48:41,880 GROUPS, AND HAVE OVER 158 TRIBES 4556 02:48:41,880 --> 02:48:44,720 RECOGNIZED AND I'LL FOCUS ON ONE 4557 02:48:44,720 --> 02:48:54,480 SPECIFIC REGION THE CENTRAL 4558 02:48:54,480 --> 02:48:56,440 REGION AND IN OUR STATE WE HAVE 4559 02:48:56,440 --> 02:49:01,560 ONE OF OUR MOST REMOTE COMMUNITY 4560 02:49:01,560 --> 02:49:07,480 S OF OUR NATION ARE IN AALASKA 4561 02:49:07,480 --> 02:49:11,000 -- ALASKA AND THERE'S A 4562 02:49:11,000 --> 02:49:12,600 REGIONAL HUB SERVING 59 4563 02:49:12,600 --> 02:49:16,080 FEDERALLY RECOGNIZED TRIBES AND 4564 02:49:16,080 --> 02:49:16,760 COMMUNES. 4565 02:49:16,760 --> 02:49:19,200 THE HUB COMMUNITY IS RIGHT IN 4566 02:49:19,200 --> 02:49:20,960 THE MIDDLE AND YOU'LL BE SEEING 4567 02:49:20,960 --> 02:49:23,360 PHOTOS AND IMAGES FROM WHAT 4568 02:49:23,360 --> 02:49:25,360 WE'RE DOING THE RED DOTS ARE 4569 02:49:25,360 --> 02:49:28,400 WHERE WE HAVE OUR INTERVENTION 4570 02:49:28,400 --> 02:49:29,560 AND CLINICAL TRIAL ONGOING IN 4571 02:49:29,560 --> 02:49:34,120 THE APPLIED COMMUNITIES HERE. 4572 02:49:34,120 --> 02:49:36,880 THIS COMMUNITY THERE'S 350 MILES 4573 02:49:36,880 --> 02:49:38,160 FROM BETHEL AND YOU MUST TAKE 4574 02:49:38,160 --> 02:49:40,200 PLANES TO GET THERE AND THAT'S 4575 02:49:40,200 --> 02:49:43,680 WHERE SERVICES ARE REALLY 4576 02:49:43,680 --> 02:49:45,880 CENTERED. 4577 02:49:45,880 --> 02:49:47,320 THEY'RE VERY LIMITED, CLINICAL 4578 02:49:47,320 --> 02:49:49,480 AND REALLY MENTAL HEALTH 4579 02:49:49,480 --> 02:49:50,880 SERVICES IN THE ACTUAL 4580 02:49:50,880 --> 02:49:51,200 COMMUNITIES. 4581 02:49:51,200 --> 02:49:54,120 YOU HAVE TO GO TO BETHEL OR TO 4582 02:49:54,120 --> 02:49:54,400 ANCHORAGE. 4583 02:49:54,400 --> 02:49:57,560 AND AGAIN THERE'S OTHER 4584 02:49:57,560 --> 02:49:59,640 SPECIFICS OF THIS REGION AND WE 4585 02:49:59,640 --> 02:50:02,800 HAVE DISPARITIES AROUND ALCOHOL 4586 02:50:02,800 --> 02:50:05,760 BUT THERE'S LOCAL OPTIONS AND 4587 02:50:05,760 --> 02:50:07,640 THERE'S CERTAIN STRATEGIES FOR 4588 02:50:07,640 --> 02:50:10,480 ONGOING IN THE REGION BUT 4589 02:50:10,480 --> 02:50:14,440 HAVEN'T SEEN THE KINDS OF REAL 4590 02:50:14,440 --> 02:50:16,880 CHANGE THAT WE WANT TO SEE IN 4591 02:50:16,880 --> 02:50:18,480 COMMUNITIES AROUND DISPARITIES 4592 02:50:18,480 --> 02:50:21,480 AND COMMUNITIES WITH ALCOHOL USE 4593 02:50:21,480 --> 02:50:23,480 DISORDERS AND ACCIDENTAL DEATH 4594 02:50:23,480 --> 02:50:25,880 ALCOHOL RELATED ARE THE SECOND 4595 02:50:25,880 --> 02:50:28,680 LEADING CAUSE OF DEATH AND 4596 02:50:28,680 --> 02:50:30,600 SUICIDE 15 TO 29 YEARS OF AGE IS 4597 02:50:30,600 --> 02:50:31,800 THE LEADING CAUSE OF THIS. 4598 02:50:31,800 --> 02:50:35,680 WE HAVE SERIOUS HEALTH ISSUES 4599 02:50:35,680 --> 02:50:37,560 THAT CAME FROM THE TRANSITION 4600 02:50:37,560 --> 02:50:40,880 FROM LIVING A TRADITIONAL WAY OF 4601 02:50:40,880 --> 02:50:42,600 LIFE WHERE THERE WAS ALL THE 4602 02:50:42,600 --> 02:50:44,080 PROTECTIVE RESOURCES IN PLACE 4603 02:50:44,080 --> 02:50:47,120 AND HOW THAT BECAME FRAGMENTED. 4604 02:50:47,120 --> 02:50:48,880 WE'LL TALK ABOUT HOW OUR 4605 02:50:48,880 --> 02:50:49,520 INTERVENTION BUILDS BACK IN 4606 02:50:49,520 --> 02:50:53,200 THOSE PROTECTION. 4607 02:50:53,200 --> 02:50:55,600 WE HAVE THE HIGHEST SIDE 4608 02:50:55,600 --> 02:50:58,480 DISPARITIES AND RATES IN THE 4609 02:50:58,480 --> 02:51:00,320 NATION AND MOST IMPACTING THREE 4610 02:51:00,320 --> 02:51:03,600 REGIONS BUT THE REGION WE WORK 4611 02:51:03,600 --> 02:51:05,920 IN EXPERIENCES THE HIGHEST 4612 02:51:05,920 --> 02:51:07,560 SUICIDE RATES. 4613 02:51:07,560 --> 02:51:09,440 NATIONALLY UNFORTUNATELY SOME 4614 02:51:09,440 --> 02:51:11,400 COMMUNITIES OF THE 59 4615 02:51:11,400 --> 02:51:13,480 COMMUNITIES AND WHAT'S IMPORTANT 4616 02:51:13,480 --> 02:51:14,920 TO NOTE IS THAT IT'S A 4617 02:51:14,920 --> 02:51:15,840 PERCENTAGE OF THOSE COMMUNITIES 4618 02:51:15,840 --> 02:51:18,120 THAT MAKE UP THE DISPARITIES. 4619 02:51:18,120 --> 02:51:20,720 WE HAVE ONE COMMUNITY THAT HAS A 4620 02:51:20,720 --> 02:51:25,560 RATE OF SUICIDE OF 212 PER 4621 02:51:25,560 --> 02:51:27,640 100,000 AND THE NATIONAL RATE IS 4622 02:51:27,640 --> 02:51:33,440 13 PER 100,000. 4623 02:51:33,440 --> 02:51:37,080 SO AGAIN IT'S VERY DIRE AND 4624 02:51:37,080 --> 02:51:41,320 UNFORTUNATELY THE SUICIDE IS 4625 02:51:41,320 --> 02:51:43,880 IMPACTING MOST UPON YOUNG 4626 02:51:43,880 --> 02:51:45,760 PEOPLE, YOUNG ALASKAN PEOPLE AND 4627 02:51:45,760 --> 02:51:48,520 THE MAJORITY OF DEATHS BY 4628 02:51:48,520 --> 02:51:49,880 SUICIDE ARE BY YOUNG ALASKAN 4629 02:51:49,880 --> 02:51:51,600 NATIVE MEN. 4630 02:51:51,600 --> 02:51:54,320 ALCOHOL IS INVOLVED IN OUR STATS 4631 02:51:54,320 --> 02:52:01,680 VARY BETWEEN 55% AND 60% OF 4632 02:52:01,680 --> 02:52:02,480 SUICIDE AND THERE'S ALCOHOL 4633 02:52:02,480 --> 02:52:08,880 INVOLVED AND AGAIN THIS IS A 4634 02:52:08,880 --> 02:52:10,240 PROBLEM IMPACTING DATA AND THIS 4635 02:52:10,240 --> 02:52:11,280 IS FROM OUR OPIOID STATE 4636 02:52:11,280 --> 02:52:12,440 DASHBOARD AND WE SAW OVER THE 4637 02:52:12,440 --> 02:52:15,040 PANDEMIC AND THE LAST FEW YEARS 4638 02:52:15,040 --> 02:52:17,320 WE'VE SEEN ALASKA HAS SEEN SOME 4639 02:52:17,320 --> 02:52:20,440 OF THE HIGHEST INCREASES IN DRUG 4640 02:52:20,440 --> 02:52:24,960 OVERDOSE DEATHS WHERE WE HAD A 4641 02:52:24,960 --> 02:52:30,400 68% INCREASE JUST FROM 2020 TO 4642 02:52:30,400 --> 02:52:34,280 2021 AND UNFORTUNATELY IN THE 4643 02:52:34,280 --> 02:52:35,960 REGION WHERE WE WERE DOING OUR 4644 02:52:35,960 --> 02:52:39,680 WORK ALCOHOL WAS THE DRUG THAT 4645 02:52:39,680 --> 02:52:42,280 WAS MOST ASSOCIATED WITH THE 4646 02:52:42,280 --> 02:52:44,880 DEATHS AND UNFORTUNATELY WE'RE 4647 02:52:44,880 --> 02:52:46,880 SEEING IN THE REGION WHERE WE 4648 02:52:46,880 --> 02:52:49,680 WORK IS EXPERIENCING SOME OF THE 4649 02:52:49,680 --> 02:52:54,520 HIGHEST RATES NOW RELATED TO 4650 02:52:54,520 --> 02:53:07,600 OPIOID OVERDOSE. 4651 02:53:07,600 --> 02:53:10,560 SO INDIGENOUS KNOWLEDGE DRIVES 4652 02:53:10,560 --> 02:53:12,680 OUR UNDERSTANDING OF WHAT THE 4653 02:53:12,680 --> 02:53:14,920 PROBLEM IS RELATED TO YOUTH 4654 02:53:14,920 --> 02:53:15,160 SUICIDE. 4655 02:53:15,160 --> 02:53:17,400 IT WAS VERY IMPORTANT THAT THIS 4656 02:53:17,400 --> 02:53:19,880 WORK BEGAN OVER 28 YEARS AGO AND 4657 02:53:19,880 --> 02:53:22,160 WORKING TOGETHER WITH 4658 02:53:22,160 --> 02:53:22,480 COMMUNITIES. 4659 02:53:22,480 --> 02:53:24,880 AND THE FIRST SLIDE WITH THE 4660 02:53:24,880 --> 02:53:27,720 ELDERS IS WITH THE ELDERS FROM 4661 02:53:27,720 --> 02:53:32,200 THE COMMUNITY THE COMMUNITIES 4662 02:53:32,200 --> 02:53:35,400 NEXT TO IT AND ELDERS CAME 4663 02:53:35,400 --> 02:53:39,120 FORWARD AND I WAS A HEALTH 4664 02:53:39,120 --> 02:53:40,760 CLINICIAN AND SERVED THOSE 4665 02:53:40,760 --> 02:53:43,200 COMMUNITIES AND I DID THAT WHILE 4666 02:53:43,200 --> 02:53:48,280 DOING MY Ph.D. AND ELDERS CAME 4667 02:53:48,280 --> 02:53:55,640 FORWARD AND ASKED US AND ENGAGED 4668 02:53:55,640 --> 02:54:02,320 US AND SAID WE KNOW WHAT'S GOING 4669 02:54:02,320 --> 02:54:03,800 ON WITH ON YOU YOUNG PEOPLE. 4670 02:54:03,800 --> 02:54:05,600 THEY'RE DISCONNECTED FROM WHO 4671 02:54:05,600 --> 02:54:06,680 THEY ARE AND THIS HAPPENED TO US 4672 02:54:06,680 --> 02:54:07,640 IN OUR COMMUNITIES. 4673 02:54:07,640 --> 02:54:09,720 WE HAVE TO COME BACK TOGETHER 4674 02:54:09,720 --> 02:54:10,960 AROUND OUR YOUNG PEOPLE IN THE 4675 02:54:10,960 --> 02:54:14,040 WAYS OF OUR ANCESTORS WHERE WE 4676 02:54:14,040 --> 02:54:15,560 NEVER HAD HEARD. 4677 02:54:15,560 --> 02:54:18,080 WE NEVER KNEW OF A YOUNG PERSON 4678 02:54:18,080 --> 02:54:19,280 WHO DIED BY SUICIDE. 4679 02:54:19,280 --> 02:54:20,400 THESE ARE THE ELDERS. 4680 02:54:20,400 --> 02:54:25,760 THE ELDERS OF TODAY WHO GREW UP 4681 02:54:25,760 --> 02:54:33,840 IN THE ABORIGINAL SYSTEM AND THE 4682 02:54:33,840 --> 02:54:35,280 ALASKAN NATIVE ANCESTRAL WAY OF 4683 02:54:35,280 --> 02:54:37,520 LIFE. 4684 02:54:37,520 --> 02:54:41,120 ELDERS TALKED ABOUT GROWING UP 4685 02:54:41,120 --> 02:54:43,640 AND IT WAS A CENTRAL HOUSE AND 4686 02:54:43,640 --> 02:54:45,600 IT SERVED SO MANY FUNCTIONS. 4687 02:54:45,600 --> 02:54:47,320 IT WAS THE SPIRITUAL CENTER. 4688 02:54:47,320 --> 02:54:50,240 IT WAS THE UNIVERSITY. 4689 02:54:50,240 --> 02:54:53,080 IT WAS WHERE YOU MADE YOUR TOOLS 4690 02:54:53,080 --> 02:54:56,400 AND YOU FIGURED OUT WHAT TO DO 4691 02:54:56,400 --> 02:54:58,280 WITH THE WEATHER FRONT COMING IN 4692 02:54:58,280 --> 02:55:00,200 AND FIGURED OUT WHERE THE GAME 4693 02:55:00,200 --> 02:55:03,600 WERE AND PROCESSED MEAT AND 4694 02:55:03,600 --> 02:55:08,080 DISTRIBUTE RESOURCES. 4695 02:55:08,080 --> 02:55:10,000 THIS STRUCTURE AND IT'S A 4696 02:55:10,000 --> 02:55:14,080 STRUCTURE AND THIS COMMUNAL 4697 02:55:14,080 --> 02:55:15,520 HOUSE BUT IT'S A VERB AS WELL 4698 02:55:15,520 --> 02:55:23,480 IT'S A WAY OF COMING TOGETHER 4699 02:55:23,480 --> 02:55:26,280 AND IT WAS A SYSTEM THAT 4700 02:55:26,280 --> 02:55:38,520 SUPPORTED THE STRUCTURAL EQUITY. 4701 02:55:38,520 --> 02:55:40,480 THEY WOULD CONNECT A YOUNG 4702 02:55:40,480 --> 02:55:41,680 PERSONAL WITH THE RESOURCES AND 4703 02:55:41,680 --> 02:55:47,520 HEALING THAT NEEDED TO HAPPEN IN 4704 02:55:47,520 --> 02:55:50,280 THE QASGIQ. 4705 02:55:50,280 --> 02:55:59,440 AND IN COMPARISON THE COLONIAL 4706 02:55:59,440 --> 02:56:01,720 THERE WAS SETTLEMENT OF ALASKAN 4707 02:56:01,720 --> 02:56:04,400 PEOPLE TO VILLAGES AND 4708 02:56:04,400 --> 02:56:05,760 FRAGMENTATION OF THE STRUCTURAL 4709 02:56:05,760 --> 02:56:12,440 SYSTEM AND WAY OF LIFE IS 4710 02:56:12,440 --> 02:56:15,680 RELATIVELY VERY RECENT. 4711 02:56:15,680 --> 02:56:18,320 AND THIS THAT WAS REDRAWN. 4712 02:56:18,320 --> 02:56:19,680 WE HAVE YOUTH MATERIALS WE USE 4713 02:56:19,680 --> 02:56:34,320 TO TALK ABOUT THIS. 4714 02:56:34,320 --> 02:56:37,080 1960s IS WHEN THIS BEGAN TO J 4715 02:56:37,080 --> 02:56:42,040 CURVE AND FROM 1967 TO 19 77 THE 4716 02:56:42,040 --> 02:56:44,000 SUICIDE RATES FOR YOUNG PEOPLE 4717 02:56:44,000 --> 02:56:45,840 DOUBLE AND DOUBLE AGAIN FROM 4718 02:56:45,840 --> 02:56:50,640 1977 TO 1987 AND WENT UP SOME 4719 02:56:50,640 --> 02:56:52,000 MORE AND THEN JUST STAYED. 4720 02:56:52,000 --> 02:56:55,720 THEY'VE JUST STAYED AT VERY HIGH 4721 02:56:55,720 --> 02:56:56,360 LEVELS. 4722 02:56:56,360 --> 02:56:58,520 AND WE HAVEN'T ON THE SCALE WE 4723 02:56:58,520 --> 02:56:59,960 WANT TO SEE WE HAVEN'T SEEN THE 4724 02:56:59,960 --> 02:57:03,000 KINDS OF CHANGE WE WANT TO SEE 4725 02:57:03,000 --> 02:57:05,440 AS OF YET BUT ON A COMMUNITY 4726 02:57:05,440 --> 02:57:07,960 LEVEL AND WHEN COMMUNITIES TOOK 4727 02:57:07,960 --> 02:57:09,480 ACTION THROUGH THIS PROCESS AND 4728 02:57:09,480 --> 02:57:14,640 THROUGH THE DEVELOPMENT OF THE 4729 02:57:14,640 --> 02:57:17,920 QASGIQ AND THE MODEL 4730 02:57:17,920 --> 02:57:20,280 INTERVENTION WITH COMMUNITIES 4731 02:57:20,280 --> 02:57:21,440 TOGETHER TO COME AROUND YOUNG 4732 02:57:21,440 --> 02:57:23,480 PEOPLE AND BRING IN ALL THE 4733 02:57:23,480 --> 02:57:25,560 RESOURCES AND TRY AND HEAL SOME 4734 02:57:25,560 --> 02:57:26,920 OF THAT FRAGMENTATION. 4735 02:57:26,920 --> 02:57:29,040 AND THAT'S REALLY WHAT THIS 4736 02:57:29,040 --> 02:57:32,560 PROCESS IS ABOUT. 4737 02:57:32,560 --> 02:57:36,680 SO THIS IS OUR LOGIC MODEL AN 4738 02:57:36,680 --> 02:57:40,240 INDIGENOUS THEORY OF CHANGE. 4739 02:57:40,240 --> 02:57:41,600 WHERE REALLY THE COMMUNITY 4740 02:57:41,600 --> 02:57:43,680 WANTED TO MOVE UPSTREAM. 4741 02:57:43,680 --> 02:57:46,240 REALLY WANTED TO GO AND WORK 4742 02:57:46,240 --> 02:57:47,280 WITH YOUNG PEOPLE AND BUILD 4743 02:57:47,280 --> 02:57:50,960 THOSE STRENGTHS, GIVE YOUNG 4744 02:57:50,960 --> 02:57:53,440 PEOPLE REASONS FOR LIFE. 4745 02:57:53,440 --> 02:57:55,640 AND THE ELDERS TOLD US, IT'S NOT 4746 02:57:55,640 --> 02:57:56,680 JUST THAT WE DON'T WANT OUR 4747 02:57:56,680 --> 02:58:00,760 YOUNG PEOPLE TO DIE, WE WANT OUR 4748 02:58:00,760 --> 02:58:05,080 YOUNG PEOPLE TO WANT TO LIVE AND 4749 02:58:05,080 --> 02:58:06,480 TO HAVE A PURPOSE AND KNOW THEY 4750 02:58:06,480 --> 02:58:09,680 HAVE A PURPOSE AND TO KNOW HOW 4751 02:58:09,680 --> 02:58:11,960 NEEDED THEY ARE TO US. 4752 02:58:11,960 --> 02:58:14,520 AND SO THE WHOLE FIRST PART OF 4753 02:58:14,520 --> 02:58:20,080 THE INTERVENTION SAY -- IS A 4754 02:58:20,080 --> 02:58:21,160 COMMUNITY TRYING TO DRAW FROM 4755 02:58:21,160 --> 02:58:22,960 THE NEW AND OLD WAYS TO COME 4756 02:58:22,960 --> 02:58:24,920 TOGETHER AROUND YOUNG PEOPLE TO 4757 02:58:24,920 --> 02:58:25,880 BUILD PROTECTIVE FACTORS AND IT 4758 02:58:25,880 --> 02:58:28,480 STARTS AT THE COMMUNITY LEVEL. 4759 02:58:28,480 --> 02:58:30,000 CHANGE STARTS -- THE COMMUNITY 4760 02:58:30,000 --> 02:58:31,160 CHANGES FIRST. 4761 02:58:31,160 --> 02:58:34,320 BEFORE WE DO ANY ACTIVITIES WITH 4762 02:58:34,320 --> 02:58:35,520 YOUNG PEOPLE WE BUILD A 4763 02:58:35,520 --> 02:58:37,000 COMMUNITY PROCESS AROUND AND 4764 02:58:37,000 --> 02:58:40,480 THEN GAIN FAMILIES AND YOUNG 4765 02:58:40,480 --> 02:58:42,400 PEOPLE IN ACTIVITIES. 4766 02:58:42,400 --> 02:58:44,800 AND WHAT WE DO WITH OUR RESEARCH 4767 02:58:44,800 --> 02:58:45,880 IS WE MEASURE THE BUILDING OF 4768 02:58:45,880 --> 02:58:50,680 PROTECTIVE FACTORS. 4769 02:58:50,680 --> 02:58:53,560 WE WANT TO END SHOWING HOW AS AN 4770 02:58:53,560 --> 02:58:55,680 OUTCOME FOR OUR RESEARCH AND WE 4771 02:58:55,680 --> 02:58:58,160 DID MEASURE COMMUNITY LEVEL 4772 02:58:58,160 --> 02:58:59,640 OUTCOMES OF OUR RESEARCH AND HOW 4773 02:58:59,640 --> 02:59:01,440 COMMUNITY LEVEL OUTCOMES IMPACT 4774 02:59:01,440 --> 02:59:03,280 INDIVIDUAL LEVEL OUTCOMES. 4775 02:59:03,280 --> 02:59:10,600 SO WHEN WE'RE RECENTERING AND 4776 02:59:10,600 --> 02:59:12,640 HAVING QASGIQ TODAY WE SEE 4777 02:59:12,640 --> 02:59:13,200 MEANINGFUL CHANGE. 4778 02:59:13,200 --> 02:59:18,800 I KNOW I'M COMING UP AGAINST 4779 02:59:18,800 --> 02:59:22,920 TIME. 4780 02:59:22,920 --> 02:59:32,280 HERE'S IMAGING FROM THIS IS 4781 02:59:32,280 --> 02:59:33,680 CHANGE TAKING PLACE NOW AND OUR 4782 02:59:33,680 --> 02:59:35,480 RESEARCH CAN HAVE REAL TIME 4783 02:59:35,480 --> 02:59:37,080 IMPACTS AND WE HAVE VERY SMALL 4784 02:59:37,080 --> 02:59:39,680 SAMPLES SO I'M BIAS TO THE 4785 02:59:39,680 --> 02:59:41,480 MEANINGFULNESS OF SMALL SAMPLES 4786 02:59:41,480 --> 02:59:43,960 AND TO US TO DISCOUNT SMALL 4787 02:59:43,960 --> 02:59:46,640 SAMPLES AND SOMETIMES EVEN THE 4788 02:59:46,640 --> 02:59:50,640 TERM TALKING ABOUT SMALL SAMPLES 4789 02:59:50,640 --> 02:59:51,760 WE'RE TALKING ABOUT OUR PEOPLE 4790 02:59:51,760 --> 02:59:55,800 AND EVERY YOUNG PERSON'S LIFE NO 4791 02:59:55,800 --> 02:59:58,680 MATTER IF IT'S ONE 100 OR 4792 02:59:58,680 --> 03:00:04,120 100,000 MATTERS JUST THE SAME. 4793 03:00:04,120 --> 03:00:05,320 I WANT TO SHOW THE CHANGE 4794 03:00:05,320 --> 03:00:07,400 PROCESS THAT'S HAPPENING AND 4795 03:00:07,400 --> 03:00:11,440 THIS INTERVENTION REALLY ENGAGES 4796 03:00:11,440 --> 03:00:13,320 CULTURE PREVENTION. 4797 03:00:13,320 --> 03:00:14,960 IT BUILDS PROTECTIVE CULTURAL 4798 03:00:14,960 --> 03:00:18,000 EXPERIENCES AS A WAY OF 4799 03:00:18,000 --> 03:00:19,480 MITIGATING AND BUILD COPING AND 4800 03:00:19,480 --> 03:00:22,440 OTHER RESILIENT STRATEGIES TO 4801 03:00:22,440 --> 03:00:23,440 PROTECT AGAINST RISK. 4802 03:00:23,440 --> 03:00:27,640 RISK FROM TRAUMA, FROM ADVERSE 4803 03:00:27,640 --> 03:00:31,280 CHILDHOOD EXPERIENCES AND 4804 03:00:31,280 --> 03:00:32,080 EMPOWERS THE INDIGENOUS 4805 03:00:32,080 --> 03:00:33,240 KNOWLEDGE TO CREATE THE 4806 03:00:33,240 --> 03:00:35,400 SOLUTIONS AND TO DELIVER THE 4807 03:00:35,400 --> 03:00:35,680 SOLUTIONS. 4808 03:00:35,680 --> 03:00:38,800 AS I SAID IN A SERVICE REGION AT 4809 03:00:38,800 --> 03:00:41,400 THIS TIME IT'S JUST NOT 4810 03:00:41,400 --> 03:00:43,680 ACHIEVABLE TO HAVE A LICENSED 4811 03:00:43,680 --> 03:00:44,840 MENTAL HEALTH CLINICIAN IN EVERY 4812 03:00:44,840 --> 03:00:49,280 COMMUNITY ALL 59 COMMUNITIES. 4813 03:00:49,280 --> 03:00:55,080 THE PROCESS IS SENDING OUT 4814 03:00:55,080 --> 03:00:56,960 CLINICIANS TO ESSENTIALLY THE 4815 03:00:56,960 --> 03:00:58,720 STOP GAP PRICE HAVE NOT BEEN 4816 03:00:58,720 --> 03:00:58,960 WORKING. 4817 03:00:58,960 --> 03:01:01,200 WE MUST TRY OTHER WAYS. 4818 03:01:01,200 --> 03:01:03,440 AGAIN, THIS IS A 4819 03:01:03,440 --> 03:01:03,880 COMMUNITY-DELIVERED 4820 03:01:03,880 --> 03:01:05,280 INTERVENTION. 4821 03:01:05,280 --> 03:01:06,320 THE ELDERS IN THE COMMUNITY 4822 03:01:06,320 --> 03:01:11,160 EYEFIDE -- IDENTIFY PROTECTIVE 4823 03:01:11,160 --> 03:01:12,640 FACTORS AND IDENTIFY COMMUNITIES 4824 03:01:12,640 --> 03:01:14,640 THAT HAVE PROTECTIVE FACTORS. 4825 03:01:14,640 --> 03:01:16,560 THIS IS AN ONLINE MANUAL. 4826 03:01:16,560 --> 03:01:18,520 I ENCOURAGE YOU TO CHECK THIS 4827 03:01:18,520 --> 03:01:18,880 OUT. 4828 03:01:18,880 --> 03:01:22,680 THERE'S VIDEOS, THERE'S BETTER 4829 03:01:22,680 --> 03:01:23,560 EXPLANATIONS THAN I'M GIVING 4830 03:01:23,560 --> 03:01:27,920 WITHIN THE MANUAL. 4831 03:01:27,920 --> 03:01:29,120 THIS IS ONE OF THE COMMUNITIES 4832 03:01:29,120 --> 03:01:32,320 AND ALL THE IMAGES I'M GOING TO 4833 03:01:32,320 --> 03:01:34,240 SHOW YOU TOOK PLACE OVER THE 4834 03:01:34,240 --> 03:01:36,960 PANDEMIC BECAUSE THE PANDEMIC 4835 03:01:36,960 --> 03:01:39,720 ABSOLUTELY WE WERE HALFWAY 4836 03:01:39,720 --> 03:01:41,400 THROUGH OUR CLINICAL TRIAL AND 4837 03:01:41,400 --> 03:01:44,600 THREE COMMUNITIES FOR COVID 4838 03:01:44,600 --> 03:01:48,160 PROTECTIONS THE TRIBES SHUT THE 4839 03:01:48,160 --> 03:01:51,600 PROJECT DOWN AND ONE COMMUNITY 4840 03:01:51,600 --> 03:01:56,800 BY TRIBAL MANDATE, BY RESOLUTION 4841 03:01:56,800 --> 03:01:59,080 WANTED ACTIVITY AND RESEARCH TO 4842 03:01:59,080 --> 03:02:03,680 CONTINUE SO IT DID. 4843 03:02:03,680 --> 03:02:05,480 IT WAS TRANSFORMATIVE FOR YOUNG 4844 03:02:05,480 --> 03:02:10,440 PEOPLE DURING THE PANDEMIC. 4845 03:02:10,440 --> 03:02:12,040 AGAIN, A LOT OF THE ACTIVITIES 4846 03:02:12,040 --> 03:02:14,720 ARE OUT ON THE LAND AND THIS IS 4847 03:02:14,720 --> 03:02:23,640 A REAL KEY BENEFIT TO BEING THIS 4848 03:02:23,640 --> 03:02:26,040 CLOSE TO A LAND-BASED WAY OF 4849 03:02:26,040 --> 03:02:27,320 LIFE AND GENERATED THIS URGENCY 4850 03:02:27,320 --> 03:02:31,240 OF WOW, OUR WAY OF LIFE, THIS IS 4851 03:02:31,240 --> 03:02:38,000 WHAT WE HAVE, PLANES LITERALLY 4852 03:02:38,000 --> 03:02:38,800 STOPPED FLYING TO COMMUNITIES 4853 03:02:38,800 --> 03:02:43,240 AND ALL RESTRICTIONS WERE LIFT 4854 03:02:43,240 --> 03:02:47,200 AND FOODS WERE PRIMARY 4855 03:02:47,200 --> 03:02:47,600 RESOURCES. 4856 03:02:47,600 --> 03:02:50,160 THIS COMMUNITY ACTIVELY ENGAGED 4857 03:02:50,160 --> 03:02:51,920 YOUNG PEOPLE THE WHOLE TIME 4858 03:02:51,920 --> 03:02:53,680 THROUGH THE PANDEMIC. 4859 03:02:53,680 --> 03:02:57,280 THESE ARE RIGHTS OF PASSAGE. 4860 03:02:57,280 --> 03:03:00,080 GIVING YOUNG MEN AND WOMEN BOTH 4861 03:03:00,080 --> 03:03:02,800 BUT GIVING A SENSE OF THIS IS MY 4862 03:03:02,800 --> 03:03:05,400 PURPOSE NOW I'M A PROVIDER FOR 4863 03:03:05,400 --> 03:03:09,440 MY FAMILY. 4864 03:03:09,440 --> 03:03:19,480 I TAKE CARE AND REALIZING YOUR 4865 03:03:19,480 --> 03:03:21,480 POWER AND USEFULNESS AND GIVING 4866 03:03:21,480 --> 03:03:27,480 IS FUNDAMENTAL TO BUILDING THOSE 4867 03:03:27,480 --> 03:03:31,680 STRENGTHS AND REASONS FOR LIFE 4868 03:03:31,680 --> 03:03:39,280 AND HEALTHY BODIES ARE HEALTHY 4869 03:03:39,280 --> 03:03:41,440 MINDS AND WE KNOW THE 4870 03:03:41,440 --> 03:03:44,560 ASSOCIATION BETWEEN HEALTH AND 4871 03:03:44,560 --> 03:03:46,560 MENTAL HEALING AND WE KNOW THE 4872 03:03:46,560 --> 03:03:48,840 LEADER OF THIS COMMUNITY PROJECT 4873 03:03:48,840 --> 03:03:50,080 PUT TOGETHER WHEN THEY WERE 4874 03:03:50,080 --> 03:03:54,480 HAULING A WHALE UP ON SHORE SHE 4875 03:03:54,480 --> 03:03:56,480 REMEMBERED HANGING UP AT THE 4876 03:03:56,480 --> 03:03:58,680 SCHOOL ARE HISTORICAL PHOTOS AND 4877 03:03:58,680 --> 03:04:00,000 SHE PUT THESE PHOTOS TOGETHER 4878 03:04:00,000 --> 03:04:04,680 AND SAID, THIS IS HOW WE'RE 4879 03:04:04,680 --> 03:04:05,400 CONNECTING OUR YOUNG PEOPLE 4880 03:04:05,400 --> 03:04:08,360 AGAIN STRENGTHS FROM THE 4881 03:04:08,360 --> 03:04:09,320 ANCESTORS TODAY AND AGAIN THESE 4882 03:04:09,320 --> 03:04:12,160 ARE THE OTHER COMMUNITIES WHO 4883 03:04:12,160 --> 03:04:14,160 ARE STILL PARTICIPATING IN OUR 4884 03:04:14,160 --> 03:04:17,680 WORK AND INVENTION WORK AND WHAT 4885 03:04:17,680 --> 03:04:19,880 WE'VE SEEN FROM THE FIRST TRIAL 4886 03:04:19,880 --> 03:04:24,160 WE'VE SEEN WONDERFUL AND 4887 03:04:24,160 --> 03:04:30,000 EXCITING OUTCOMES AND THERE'S AN 4888 03:04:30,000 --> 03:04:31,280 EVIDENCE BASE GROWING THAT 4889 03:04:31,280 --> 03:04:32,480 SUPPORT BUILDING PROTECTIVE 4890 03:04:32,480 --> 03:04:44,680 FACTORS S A USE DISORDER 4891 03:04:44,680 --> 03:04:47,400 PREVENTION AND WE HAVE DONE 4892 03:04:47,400 --> 03:04:48,160 PILOTS AND FEASIBILITY TRIALS 4893 03:04:48,160 --> 03:04:49,520 AND OUR FIRST AND SECOND 4894 03:04:49,520 --> 03:04:50,640 PREVENTION TRIAL. 4895 03:04:50,640 --> 03:04:52,480 WE HAVE DATA THAT SHOWS HOW WE 4896 03:04:52,480 --> 03:04:57,200 GET TO ACHIEVE THESE OUTCOMES 4897 03:04:57,200 --> 03:04:59,400 FOR REASONS FOR LIFE AND 4898 03:04:59,400 --> 03:05:01,360 SOBRIETY WE CALL IT REFLECTIVE 4899 03:05:01,360 --> 03:05:10,080 PROCESSES ABOUT ALCOHOL. 4900 03:05:10,080 --> 03:05:11,680 IN CONCLUSION I WANT TO TOUCH ON 4901 03:05:11,680 --> 03:05:14,080 OUR OUTCOMES FROM INTERVENTION 4902 03:05:14,080 --> 03:05:16,920 SCIENCE AND IN MY TITLE SLIDE I 4903 03:05:16,920 --> 03:05:21,440 SHOULD HAVE ACKNOWLEDGED MY 4904 03:05:21,440 --> 03:05:27,160 PARTNER IN ALL THIS RAND MY 4905 03:05:27,160 --> 03:05:36,280 MENTOR DR. JAMES ALL EN AND 4906 03:05:36,280 --> 03:05:41,480 UNDERSTANDING HOW STRUCTURAL 4907 03:05:41,480 --> 03:05:59,760 FACTORS IN THIS AND IN 4908 03:05:59,760 --> 03:06:01,560 DEVELOPING MEASURES IS HOW TO 4909 03:06:01,560 --> 03:06:05,640 MEASURE AND HOW DO WE MEASURE 4910 03:06:05,640 --> 03:06:07,280 THESE PROTECTIVE FACTORS? 4911 03:06:07,280 --> 03:06:11,480 WE HAD TO CREATE THE MEASURES 4912 03:06:11,480 --> 03:06:15,320 AND THAT AGAIN WAS THROUGH OUR 4913 03:06:15,320 --> 03:06:17,320 PROCESSES OF IDENTIFYING THE 4914 03:06:17,320 --> 03:06:20,000 FUNDAMENTAL AND QUITE UNIVERSAL 4915 03:06:20,000 --> 03:06:22,280 COMPONENTS OF WHAT'S PROTECTIVE 4916 03:06:22,280 --> 03:06:27,560 FOR YOUNG PEOPLE AND AGAIN 4917 03:06:27,560 --> 03:06:31,000 LINKING IT TO CREATING REASONS 4918 03:06:31,000 --> 03:06:35,480 FOR LIFE AND THINKING ABOUT 4919 03:06:35,480 --> 03:07:06,640 RISKY ALCOHOL USE. 4920 03:07:06,640 --> 03:07:07,960 AND THE MEASURES WERE DEVELOP 4921 03:07:07,960 --> 03:07:09,280 THROUGH THE LONGITUDINAL 4922 03:07:09,280 --> 03:07:09,480 PROCESS. 4923 03:07:09,480 --> 03:07:14,280 WE CONDUCT OUR MEASURES WITH 4924 03:07:14,280 --> 03:07:15,320 THIS COOL SURVEY APP AND WERE 4925 03:07:15,320 --> 03:07:17,920 STILL ABLE TO DO SURVEYS WITH 4926 03:07:17,920 --> 03:07:19,160 YOUNG PEOPLE IN THE ACTIVE 4927 03:07:19,160 --> 03:07:20,280 COMMUNITIES OVER THE PANDEMIC 4928 03:07:20,280 --> 03:07:25,800 BECAUSE WE TRANSFERRED TO BE 4929 03:07:25,800 --> 03:07:27,800 ABLE TO SEND LINKS ON 4930 03:07:27,800 --> 03:07:29,720 SMARTPHONES AND WERE ABLE TO 4931 03:07:29,720 --> 03:07:31,960 STILL COLLECT DATA DURING THE 4932 03:07:31,960 --> 03:07:37,880 PANDEMIC. 4933 03:07:37,880 --> 03:07:41,440 THIS IS FROM THE PILOT STUDY. 4934 03:07:41,440 --> 03:07:44,480 WE HAVE A DYNAMIC WEIGHT LISTED 4935 03:07:44,480 --> 03:07:48,400 DESIGN MODEL THAT ALLOWED US TO 4936 03:07:48,400 --> 03:07:49,840 LOOK AT DOSE RESPONSE EFFECTS. 4937 03:07:49,840 --> 03:07:51,680 THAT'S HOW WE MEASURE BY THE 4938 03:07:51,680 --> 03:07:53,520 AMOUNT OF ACTIVITIES YOUNG 4939 03:07:53,520 --> 03:07:55,880 PEOPLE GO TO AND THE TYPE OF 4940 03:07:55,880 --> 03:07:57,040 ACTIVITIES YOUNG PEOPLE ARE 4941 03:07:57,040 --> 03:08:03,080 GOING TO AND WE ALSO LOOK AT 4942 03:08:03,080 --> 03:08:03,920 EXPOSURE TO COMMUNITY THE 4943 03:08:03,920 --> 03:08:09,800 COMMUNITY PROTECTIVE FACTORS. 4944 03:08:09,800 --> 03:08:12,280 AND WE FOUND THE HIGHER DOSE 4945 03:08:12,280 --> 03:08:14,000 EQUALS LARGER RESPONSE 4946 03:08:14,000 --> 03:08:17,080 PARTICULARLY FOR YOUNG PEOPLE 4947 03:08:17,080 --> 03:08:19,480 WHO COME IN WITH LOW PROTECTION 4948 03:08:19,480 --> 03:08:20,840 PARTICULARLY LOW COMMUNITY AND 4949 03:08:20,840 --> 03:08:22,760 FAMILY PROTECTION. 4950 03:08:22,760 --> 03:08:24,760 WE SEE THE MOST RESPONSE AND 4951 03:08:24,760 --> 03:08:34,520 MOST CHANGE IN YOUNG PEOPLE. 4952 03:08:34,520 --> 03:08:38,000 SO I REFERENCED OUR 20-YEAR 4953 03:08:38,000 --> 03:08:43,080 PROCESS AND I CAME HERE TO BE A 4954 03:08:43,080 --> 03:08:47,480 PART OF THE PEOPLE AWAKENING 4955 03:08:47,480 --> 03:08:50,080 PROJECT AT ALASKA FAIRBANKS FOR 4956 03:08:50,080 --> 03:08:54,040 MY Ph.D. AND I'VE BEEN HERE 4957 03:08:54,040 --> 03:08:59,360 SINCE AND A PART OF DIFFERENT 4958 03:08:59,360 --> 03:09:03,640 PROJECTS AND PREE RECENTLY WE'VE 4959 03:09:03,640 --> 03:09:09,400 BEEN AWARDED A PROJECT TO LOOK 4960 03:09:09,400 --> 03:09:13,960 AT DEVELOPING A BRIEF AND LOOK 4961 03:09:13,960 --> 03:09:15,480 AT THE PROTECTIVE FACTORS AND 4962 03:09:15,480 --> 03:09:18,880 TEACHINGS AND THE MODULES PUT 4963 03:09:18,880 --> 03:09:22,400 TOGETHER IN THE LONGER, LARGER 4964 03:09:22,400 --> 03:09:24,000 COMMUNITY-BASED WORK TO BE 4965 03:09:24,000 --> 03:09:29,120 DELIVERED IN CLINICAL SETTINGS 4966 03:09:29,120 --> 03:09:30,560 WITH YOUNG PEOPLE SO WE'RE 4967 03:09:30,560 --> 03:09:31,680 EXCITED TO START THAT AND THAT'S 4968 03:09:31,680 --> 03:09:35,480 OUR TEAM. 4969 03:09:35,480 --> 03:09:46,240 I APPRECIATE YOU TAKING TIME TO 4970 03:09:46,240 --> 03:09:47,400 LEARN A LITTLE BIT MORE ABOUT 4971 03:09:47,400 --> 03:09:47,720 OUR WORK. 4972 03:09:47,720 --> 03:09:51,800 I'LL STOP THERE. 4973 03:09:51,800 --> 03:10:03,880 >> THANK YOU. 4974 03:10:03,880 --> 03:10:05,960 >> I'LL LEAD OFF AND SEE HOW 4975 03:10:05,960 --> 03:10:09,120 MANY PEOPLE COME IN BUT DO YOU 4976 03:10:09,120 --> 03:10:15,640 SEE A WAY THAT SOME OF THE CORE 4977 03:10:15,640 --> 03:10:18,880 PRINCIPLES YOUR DEVELOPING THIS 4978 03:10:18,880 --> 03:10:22,240 THIS COMMUNITY CAN BE 4979 03:10:22,240 --> 03:10:25,320 GENERALIZED TO NOT ONLY OTHER 4980 03:10:25,320 --> 03:10:26,000 ALASKAN COMMUNITIES BUT OTHER 4981 03:10:26,000 --> 03:10:27,720 INDIGENOUS COMMUNITIES ACROSS 4982 03:10:27,720 --> 03:10:29,000 THE UNITED STATES THAT ARE 4983 03:10:29,000 --> 03:10:32,080 HIGHLY VARIED AND EXTEND TO 4984 03:10:32,080 --> 03:10:42,720 OTHER DISPARITY GROUPS? 4985 03:10:42,720 --> 03:10:47,400 WHAT DO YOU THINK IS THE 4986 03:10:47,400 --> 03:10:47,720 30-VIEW? 4987 03:10:47,720 --> 03:10:49,880 >> I REMEMBER EARLY ON IN SOME 4988 03:10:49,880 --> 03:10:55,680 OF OUR EARLIER PROJECT REVIEWS 4989 03:10:55,680 --> 03:11:03,520 WE WOULD THAT WOULD BE A CONCERN 4990 03:11:03,520 --> 03:11:07,040 AND THERE'S 25 PEOPLE IN THE 4991 03:11:07,040 --> 03:11:07,480 REGI 4992 03:11:07,480 --> 03:11:11,480 REGION HOW IS THIS SPECIFIC 4993 03:11:11,480 --> 03:11:13,920 TAILORED INTERVENTION -- WHAT 4994 03:11:13,920 --> 03:11:15,880 IMPACT WILL THAT HAVE FOR THE 4995 03:11:15,880 --> 03:11:16,080 NATION? 4996 03:11:16,080 --> 03:11:21,080 THERE'S A SLIDE EARLY ON THAT 4997 03:11:21,080 --> 03:11:27,040 SAID EVERY COMMUNITY HAS A 4998 03:11:27,040 --> 03:11:31,640 QASGIQ SO THEY HAVE A SYSTEM, A 4999 03:11:31,640 --> 03:11:40,920 STRUM -- STRUCTURE, A WAY OF 5000 03:11:40,920 --> 03:11:43,400 WORK TOGETHER AND EVERY 5001 03:11:43,400 --> 03:11:47,040 COMMUNITY AND CULTURE HAS 5002 03:11:47,040 --> 03:11:49,840 PROTECTIVE CULTURES AND A FAMILY 5003 03:11:49,840 --> 03:11:50,680 DOES AND WHAT WE HAVE BEEN 5004 03:11:50,680 --> 03:11:56,120 SHOWING AND PUBLISHED ON THIS IS 5005 03:11:56,120 --> 03:11:59,520 ABSOLUTELY THERE'S TRANSLATION 5006 03:11:59,520 --> 03:12:01,960 ALREADY HAPPENING AND STARTING 5007 03:12:01,960 --> 03:12:06,680 HERE IN THE INTERIOR WITHAGE 5008 03:12:14,200 --> 03:12:21,280 -- ATHBASCAN COMMUNITY AND 5009 03:12:21,280 --> 03:12:26,400 FACTORS AND BECOMING WHO YOU ARE 5010 03:12:26,400 --> 03:12:31,040 AS A PERSON AND TOOLS FOR LIFE 5011 03:12:31,040 --> 03:12:34,880 AND THE PROTECTIVE FACTORS 5012 03:12:34,880 --> 03:12:39,680 IDENTIFIED IN THIS DEMONSTRATION 5013 03:12:39,680 --> 03:12:43,640 AND THOSE ABSOLUTELY ARE I WOULD 5014 03:12:43,640 --> 03:12:46,400 SAY UNIVERSAL TO BUILD 5015 03:12:46,400 --> 03:12:49,080 PROTECTIONS FOR ALL YOUNG 5016 03:12:49,080 --> 03:12:49,280 PEOPLE. 5017 03:12:49,280 --> 03:12:56,280 THERE'S NO REASON AT ALL WHY THE 5018 03:12:56,280 --> 03:12:57,680 WHILE THE AMERICANS CAN'T LEARN 5019 03:12:57,680 --> 03:13:07,600 FROM LEARN FROM AND TAKE FROM 5020 03:13:07,600 --> 03:13:09,120 AMERICAN INDIAN ALASKAN NATIVE 5021 03:13:09,120 --> 03:13:11,040 PEOPLE AND HOW MANY TIMES DO WE 5022 03:13:11,040 --> 03:13:12,640 SEE THAT SOMETHING DEVELOPED 5023 03:13:12,640 --> 03:13:18,280 WITH THAT POPULATION REFERENCED 5024 03:13:18,280 --> 03:13:27,280 IN THE ABCD STUDY SO AND WHY 5025 03:13:27,280 --> 03:13:30,400 WOULD IT NOT BE TRANSFERRABLE 5026 03:13:30,400 --> 03:13:31,040 AND EVIDENCE-BASED PRACTICE 5027 03:13:31,040 --> 03:13:33,560 WE'RE FINDING IN OUR 5028 03:13:33,560 --> 03:13:33,880 COMMUNITIES? 5029 03:13:33,880 --> 03:13:35,760 YOU ALSO ARE INTERVENTION IS 5030 03:13:35,760 --> 03:13:37,000 ABOUT THE FUNCTION OF IT. 5031 03:13:37,000 --> 03:13:38,600 HOW IT WORKS, THE COMPONENTS 5032 03:13:38,600 --> 03:13:40,520 THAT WORK AND HOW THE COMMUNITY 5033 03:13:40,520 --> 03:13:42,320 WORKS TOGETHER TO DELIVER IT. 5034 03:13:42,320 --> 03:13:47,240 IT'S NOT SO MUCH IT'S FOR. 5035 03:13:47,240 --> 03:13:51,440 IT'S GOING TO BE TOUGH TO GO 5036 03:13:51,440 --> 03:13:52,440 SEAL HUNTING HERE IN THE 5037 03:13:52,440 --> 03:13:57,360 INTERIOR BUT INSTEAD WE'LL GET 5038 03:13:57,360 --> 03:13:59,680 GR 5039 03:13:59,680 --> 03:14:00,280 GRAYLING AND THAT CAN TRANSLATE 5040 03:14:00,280 --> 03:14:02,360 TO OTHER CULTURES AND 5041 03:14:02,360 --> 03:14:02,720 COMMUNITIES. 5042 03:14:02,720 --> 03:14:04,280 DOES THAT HELP, DR. KOOB? 5043 03:14:04,280 --> 03:14:05,440 >> THAT'S GREAT. 5044 03:14:05,440 --> 03:14:06,760 I'M NOT SURE WHO'S FIRST BUT 5045 03:14:06,760 --> 03:14:11,480 I'LL CALL ON MELISSA FIRST TO 5046 03:14:11,480 --> 03:14:23,480 ASK HER QUESTION AND THEN REG 5047 03:14:23,480 --> 03:14:24,560 REGITA. 5048 03:14:24,560 --> 03:14:26,000 >> IT'S GREAT TO HEAR UPDATES ON 5049 03:14:26,000 --> 03:14:26,880 YOUR WORK. 5050 03:14:26,880 --> 03:14:30,560 I WANTED TO ASK IF YOU CAN 5051 03:14:30,560 --> 03:14:32,320 ELABORATE MORE ON THE POINT I 5052 03:14:32,320 --> 03:14:35,480 THINK YOU MADE TWICE ON 5053 03:14:35,480 --> 03:14:39,720 MEASURING CONTEXTUAL OR 5054 03:14:39,720 --> 03:14:42,440 COMMUNITY AND HOW THEY RELATE TO 5055 03:14:42,440 --> 03:14:43,480 BEHAVIORS AND CHANGES. 5056 03:14:43,480 --> 03:14:45,080 THE QUESTION FOR MY QUESTION IS 5057 03:14:45,080 --> 03:14:48,880 I'M EXCITED SOME NIH FUNDED 5058 03:14:48,880 --> 03:14:53,800 RESEARCH ON MEASURING STRUCTURAL 5059 03:14:53,800 --> 03:14:55,480 RACISM THAT PREDICT HEALTH AND 5060 03:14:55,480 --> 03:14:56,440 WONDER IF YOU CAN TALK MORE 5061 03:14:56,440 --> 03:14:59,480 ABOUT THAT BECAUSE I FIND IT 5062 03:14:59,480 --> 03:15:12,480 REALLY EXCITING. 5063 03:15:12,480 --> 03:15:15,320 >> WE HAVE STRATEGIES FOR 5064 03:15:15,320 --> 03:15:19,080 LOOKING THE THE FACTORS 5065 03:15:19,080 --> 03:15:20,120 IMPACTING YOUNG PEOPLE. 5066 03:15:20,120 --> 03:15:22,280 THE YOUTH RESPONDENT MEASURES 5067 03:15:22,280 --> 03:15:23,760 AROUND YOUTH PERCEPTIONS OF 5068 03:15:23,760 --> 03:15:25,600 THEIR COMMUNITY AND YOUTH 5069 03:15:25,600 --> 03:15:26,880 ENGAGEMENT WITHIN THEIR 5070 03:15:26,880 --> 03:15:27,120 COMMUNITY. 5071 03:15:27,120 --> 03:15:30,280 WE ASK YOUNG PEOPLE IN OUR 5072 03:15:30,280 --> 03:15:30,880 COMMUNITY-PROTECTIVE FACTORS 5073 03:15:30,880 --> 03:15:35,760 MEASURES ASK YOUNG PEOPLE TO 5074 03:15:35,760 --> 03:15:45,720 THINK ABOUT THEIR COMMUNITY AND 5075 03:15:45,720 --> 03:15:47,120 HOW REPORT HOW CONNECTED THEY 5076 03:15:47,120 --> 03:15:51,640 ARE TO ELDERS IN THE COMMUNITY 5077 03:15:51,640 --> 03:15:54,680 AND INTERGENERATIONAL CONNECTS. 5078 03:15:54,680 --> 03:15:56,640 WE HAVE YOUTH REPORT MEASURES 5079 03:15:56,640 --> 03:16:00,920 ABOUT COMMUNITY-LEVEL FACTORS. 5080 03:16:00,920 --> 03:16:02,960 WE ASK THEM IF THEY ATTEND 5081 03:16:02,960 --> 03:16:03,720 TRIBAL COUNCIL MEETINGS AND 5082 03:16:03,720 --> 03:16:10,160 OTHER WAYS OF LOOKING AT THE 5083 03:16:10,160 --> 03:16:12,400 CONNECTIONS TO THE STRUCTURAL 5084 03:16:12,400 --> 03:16:13,640 FACTORS AND ASK THEM WHAT'S 5085 03:16:13,640 --> 03:16:17,080 AVAILABLE IN TERMS OF 5086 03:16:17,080 --> 03:16:18,760 OPPORTUNITIES FOR EMPLOYMENT FOR 5087 03:16:18,760 --> 03:16:21,080 HEALTH AND SUPPORT AND WE ALSO 5088 03:16:21,080 --> 03:16:22,520 DO SOCIAL NETWORK ANALYSIS THAT 5089 03:16:22,520 --> 03:16:25,200 GETS TO THE INTERGENERATIONAL 5090 03:16:25,200 --> 03:16:28,160 CONNECTIONS AND HOW THAT IS 5091 03:16:28,160 --> 03:16:29,480 BUILT THROUGH THE PROCESS AND 5092 03:16:29,480 --> 03:16:35,480 THEN IN THE STUDY WE HAVE A 5093 03:16:35,480 --> 03:16:36,840 PROTECTIVE COMMUNITY FACTORS 5094 03:16:36,840 --> 03:16:37,480 SCALE. 5095 03:16:37,480 --> 03:16:39,600 SO WE ASK ADULTS -- THIS IS THE 5096 03:16:39,600 --> 03:16:44,800 FIRST TIME WE GET ADULT 5097 03:16:44,800 --> 03:16:48,080 PERCEPTIONS OF HOW HEALTHY AND 5098 03:16:48,080 --> 03:16:53,320 FUNCTIONING ADULTS FEEL AROUND 5099 03:16:53,320 --> 03:16:55,640 LIKE THE TRIBAL GOVERNANCE 5100 03:16:55,640 --> 03:16:57,280 STRUCTURE, THE SPIRITUAL 5101 03:16:57,280 --> 03:16:59,040 STRUCTURE, ARE THERE MORE THAN 5102 03:16:59,040 --> 03:17:04,280 ONE CHURCH, DO PEOPLE INTERACT? 5103 03:17:04,280 --> 03:17:05,160 DOES THE CHURCH SUPPORT 5104 03:17:05,160 --> 03:17:05,760 TRADITIONAL PRACTICES? 5105 03:17:05,760 --> 03:17:12,440 WE ASK ADULTS ABOUT THAT AND WE 5106 03:17:12,440 --> 03:17:14,360 HAVE FOUND THROUGH THIS A 5107 03:17:14,360 --> 03:17:15,800 COLLABORATIVE HUB NOW CONNECTED 5108 03:17:15,800 --> 03:17:19,560 WE CONNECT THE TWO PROJECTS 5109 03:17:19,560 --> 03:17:20,920 TOGETHER BUT WE FOUND 5110 03:17:20,920 --> 03:17:22,960 COMMUNITIES WHERE ADULTS ARE 5111 03:17:22,960 --> 03:17:24,520 CONTRIBUTING HIGHER FUNCTIONING 5112 03:17:24,520 --> 03:17:27,280 MORE COHESION WITHIN SYSTEM 5113 03:17:27,280 --> 03:17:29,480 LEVEL FACTORS ARE LOWER RATES OF 5114 03:17:29,480 --> 03:17:30,600 SUICIDE FOR YOUNG PEOPLE. 5115 03:17:30,600 --> 03:17:31,200 THAT'S ANOTHER WAY WE MEASURE 5116 03:17:31,200 --> 03:17:38,880 IT. 5117 03:17:38,880 --> 03:17:42,480 >> THIS IS IMPORTANT WORK AND IT 5118 03:17:42,480 --> 03:17:43,800 WAS LOVELY TO HEAR ABOUT THE 5119 03:17:43,800 --> 03:17:45,120 OVERVIEW. 5120 03:17:45,120 --> 03:17:46,880 I WANTED TO GO IN A LITTLE BIT 5121 03:17:46,880 --> 03:17:47,480 DEEPER. 5122 03:17:47,480 --> 03:17:51,280 I LOVE THE COMMUNITY CENTER AND 5123 03:17:51,280 --> 03:17:52,600 YOUR ILLUSTRATION OF THAT. 5124 03:17:52,600 --> 03:17:55,280 THERE WERE A FEW QUESTIONS I HAD 5125 03:17:55,280 --> 03:17:59,240 ABOUT IF YOU CAN SPEAK TO 5126 03:17:59,240 --> 03:17:59,800 DRDR. 5127 03:17:59,800 --> 03:18:02,080 DR. KOOB'S POINT, AS WELL IF 5128 03:18:02,080 --> 03:18:03,680 THERE'S A MANUAL YOU HAVE AND 5129 03:18:03,680 --> 03:18:06,680 WHO DELIVERS THE INTERVENTION 5130 03:18:06,680 --> 03:18:08,640 AND ARE THERE PEER COUNSELORS? 5131 03:18:08,640 --> 03:18:10,240 THE REASON I'M ASKING IS IT'S 5132 03:18:10,240 --> 03:18:15,680 GREAT THE RESOURCES YOU HAVE. 5133 03:18:15,680 --> 03:18:18,440 I'M WONDERING WHAT ABOUT WE KNOW 5134 03:18:18,440 --> 03:18:20,440 CONNECTING AND ENGAGING THEM IS 5135 03:18:20,440 --> 03:18:22,400 IMPORTANT AND HAVING A HUB OF 5136 03:18:22,400 --> 03:18:23,240 CONNECT BUT SOMEONE REACHING OUT 5137 03:18:23,240 --> 03:18:24,360 AND BRINGING THEM IN WHETHER 5138 03:18:24,360 --> 03:18:27,080 IT'S A BUNCH OF PEOPLE OR A 5139 03:18:27,080 --> 03:18:27,480 FAMILY MEMBER. 5140 03:18:27,480 --> 03:18:29,480 IT WASN'T -- I WASN'T SURE IF 5141 03:18:29,480 --> 03:18:32,040 THERE WERE ACTUALLY TARGET POINT 5142 03:18:32,040 --> 03:18:33,880 PEOPLE WHO WERE DRAWING OUT 5143 03:18:33,880 --> 03:18:35,120 THOSE WHO WERE VULNERABLE. 5144 03:18:35,120 --> 03:18:39,960 IF YOU CAN SPEAK TO THAT SOME 5145 03:18:39,960 --> 03:18:41,600 MORE. 5146 03:18:41,600 --> 03:18:45,480 >> THIS IS A LINK TO OUR ONLINE 5147 03:18:45,480 --> 03:18:50,520 MANUAL OF SORTS THOUGH WE ALWAYS 5148 03:18:50,520 --> 03:18:52,560 EMPHASIZE THIS INTERVENTION 5149 03:18:52,560 --> 03:18:55,680 ISN'T A COOK BACK AND FOLLOW 5150 03:18:55,680 --> 03:18:58,240 STEP 123 AND YOU GET THIS 5151 03:18:58,240 --> 03:18:59,480 HEALTHY YOUNG PERSON SO I'LL TRY 5152 03:18:59,480 --> 03:19:01,200 TO BE BRIEF IN MY RESPONSE BUT I 5153 03:19:01,200 --> 03:19:04,880 DO ENCOURAGE YOU TO LOOK AT THE 5154 03:19:04,880 --> 03:19:07,200 MANUAL AND THE INTRODUCTION AND 5155 03:19:07,200 --> 03:19:07,760 THE MODEL. 5156 03:19:07,760 --> 03:19:10,240 REALLY DESCRIBE OUR 5157 03:19:10,240 --> 03:19:15,360 IMPLEMENTATION PROCESS BUT THIS 5158 03:19:15,360 --> 03:19:16,720 ESSENTIALLY THIS INTERVENTION 5159 03:19:16,720 --> 03:19:21,200 GOES OVER A TWO TO THREE YEAR 5160 03:19:21,200 --> 03:19:26,560 PROCESS AND IN THE FIRST MONTHS 5161 03:19:26,560 --> 03:19:27,320 IT'S CREATING THE COMMUNITY 5162 03:19:27,320 --> 03:19:30,840 DRIVING GROUP BECAUSE IT'S A 5163 03:19:30,840 --> 03:19:31,280 COMMUNITY-DELIVERED 5164 03:19:31,280 --> 03:19:32,920 INTERVENTIONS AND I WOULDN'T 5165 03:19:32,920 --> 03:19:35,360 CALL IT PEER COUNSELING PER SE 5166 03:19:35,360 --> 03:19:37,880 BUT DRAWING FROM OUR LOCAL 5167 03:19:37,880 --> 03:19:39,640 EXPERTISE BUT IT'S A COMMUNITY 5168 03:19:39,640 --> 03:19:40,400 APPROACH SO THE COMMUNITY ALL 5169 03:19:40,400 --> 03:19:45,040 COMES TOGETHER AND YES, WE HIRE 5170 03:19:45,040 --> 03:19:46,080 TWO COORDINATORS. 5171 03:19:46,080 --> 03:19:48,520 WE GENERALLY TRY TO HIRE A MAN 5172 03:19:48,520 --> 03:19:50,120 AND A WOMAN FOR BALANCE AND 5173 03:19:50,120 --> 03:19:53,480 STRUCTURE WITHIN THIS CULTURE 5174 03:19:53,480 --> 03:19:54,080 THAT'S APPROPRIATE. 5175 03:19:54,080 --> 03:19:56,560 AND SO WE HIRE TWO COORDINATORS 5176 03:19:56,560 --> 03:20:03,520 AND THESE ARE INDIVIDUALS WHO 5177 03:20:03,520 --> 03:20:04,640 HAVE KNOWLEDGEABLE AND 5178 03:20:04,640 --> 03:20:07,080 COMFORTABLE WITH THE TEACHINGS 5179 03:20:07,080 --> 03:20:08,000 OF THE CULTURE. 5180 03:20:08,000 --> 03:20:09,360 THAT'S THE FOREMOST 5181 03:20:09,360 --> 03:20:13,480 QUALIFICATION AND BEING A 5182 03:20:13,480 --> 03:20:14,360 RESPECTED MEMBER OF THE 5183 03:20:14,360 --> 03:20:15,880 COMMUNITY AND SOMEONE TO BE 5184 03:20:15,880 --> 03:20:17,480 CONSIDERED A GOOD ROLE MODEL FOR 5185 03:20:17,480 --> 03:20:18,560 YOUNG PEOPLE. 5186 03:20:18,560 --> 03:20:19,040 THAT'S PARAMOUNT. 5187 03:20:19,040 --> 03:20:24,080 WE HIRED TWO COORDINATORS. 5188 03:20:24,080 --> 03:20:32,520 THEY COMMUNITY TOGETHER AND HAVE 5189 03:20:32,520 --> 03:20:37,520 AND WE HAVE AND THEY COME UP 5190 03:20:37,520 --> 03:20:39,520 WITH THE ACTIVITIES THEY'LL DO 5191 03:20:39,520 --> 03:20:41,040 BASED ON THE SEASONAL CALENDAR 5192 03:20:41,040 --> 03:20:42,360 AND THERE'S A SELECT GROUP. 5193 03:20:42,360 --> 03:20:43,280 THERE'S TWO COORDINATORS. 5194 03:20:43,280 --> 03:20:46,280 THEY DON'T JUST DO ALL THE 5195 03:20:46,280 --> 03:20:47,080 ACTIVITIES, THEY BRING IN 5196 03:20:47,080 --> 03:20:51,600 EXPERTS BECAUSE THE TWO 5197 03:20:51,600 --> 03:20:53,760 COORDINATORS MAY NOT KNOW HOW TO 5198 03:20:53,760 --> 03:20:58,320 MAKE BUILD SPEAR THROWER AND 5199 03:20:58,320 --> 03:21:00,560 THINGS BUT OTHER MEMBERS OF THE 5200 03:21:00,560 --> 03:21:01,480 COMMUNITIES DO AND YOU BRING 5201 03:21:01,480 --> 03:21:05,880 THEM IN AS INSTRUCTORS AND THEN 5202 03:21:05,880 --> 03:21:08,120 WE HAVE THE ACTIVITIES WITH 5203 03:21:08,120 --> 03:21:13,200 YOUNG PEOPLE AND USUALLY WE DO 5204 03:21:13,200 --> 03:21:14,440 SO IT'S DONE THAT WAY. 5205 03:21:14,440 --> 03:21:18,000 >> IF I MAY, SUSAN, ONE MORE 5206 03:21:18,000 --> 03:21:19,240 QUESTION FROM JILL BECKER AND 5207 03:21:19,240 --> 03:21:19,720 LET YOU OPEN IT UP FOR 5208 03:21:19,720 --> 03:21:25,480 EVERYBODY. 5209 03:21:25,480 --> 03:21:26,160 >> IT'S WONDERFUL WORK. 5210 03:21:26,160 --> 03:21:28,120 THANK YOU FOR ALL YOU'RE DOING. 5211 03:21:28,120 --> 03:21:30,080 YOU MENTION THE INCIDENTS OF 5212 03:21:30,080 --> 03:21:32,960 SUICIDE IN YOUNG MEN WAS 5213 03:21:32,960 --> 03:21:37,000 SIGNIFICANTLY GREATER THAN FOR 5214 03:21:37,000 --> 03:21:39,000 YOUNG WOMEN AND YOU USE MEN AND 5215 03:21:39,000 --> 03:21:40,680 WOMEN AS COUNSELORS. 5216 03:21:40,680 --> 03:21:43,200 ARE THERE DIFFERENT STRATEGIES 5217 03:21:43,200 --> 03:21:45,400 YOU'RE USING FOR YOUNG MEN 5218 03:21:45,400 --> 03:21:50,080 VERSUS YOUNG WOMEN IN THE 5219 03:21:50,080 --> 03:21:52,360 COMMUNITY AND HOW DOES THAT 5220 03:21:52,360 --> 03:21:53,640 FACTOR INTO THE PROFESSION. 5221 03:21:53,640 --> 03:21:57,360 >> IT'S SUICIDE DEATHS THAT ARE 5222 03:21:57,360 --> 03:21:59,440 HIGHER AMONG ALASKAN MEN AND 5223 03:21:59,440 --> 03:22:00,400 SUICIDE ATTEMPTS AND 5224 03:22:00,400 --> 03:22:02,920 HOSPITALIZATIONS FOR SUICIDE 5225 03:22:02,920 --> 03:22:09,640 TEAMS ARE HIGHER AMONG YOUNG 5226 03:22:09,640 --> 03:22:09,840 WOMEN. 5227 03:22:09,840 --> 03:22:12,280 AND THIS IS A UNIVERSAL 5228 03:22:12,280 --> 03:22:15,600 PREVENTION STRATEGY. 5229 03:22:15,600 --> 03:22:16,960 THAT WAS ANOTHER PART OF YOUR 5230 03:22:16,960 --> 03:22:17,880 QUESTION ABOUT HOW WE BRING 5231 03:22:17,880 --> 03:22:18,720 PEOPLE IN. 5232 03:22:18,720 --> 03:22:20,480 IT'S ALL YOUNG PEOPLE. 5233 03:22:20,480 --> 03:22:21,840 THE COMMUNITY IDENTIFIED THOUGH 5234 03:22:21,840 --> 03:22:25,280 A FOCUS ON 12 TO 18 YEAR OLDS 5235 03:22:25,280 --> 03:22:29,280 BUT WE NEVER TURN PEOPLE AWAY 5236 03:22:29,280 --> 03:22:30,920 WHO IF YOU'RE 19 OR 20 YOU'LL 5237 03:22:30,920 --> 03:22:34,000 STILL BE A PART OF IT SO IT'S 5238 03:22:34,000 --> 03:22:38,760 UNIVERSAL INTERVENTION PROCESS 5239 03:22:38,760 --> 03:22:42,560 AND SO IN THAT YOUNG MEN AND 5240 03:22:42,560 --> 03:22:47,480 WOMEN ARE INVOLVED BUT THERE'S 5241 03:22:47,480 --> 03:22:50,360 TAILORING AROUND BEING A YOUNG 5242 03:22:50,360 --> 03:22:52,600 MAN YOU'RE TAUGHT TO BE A 5243 03:22:52,600 --> 03:22:59,440 POWERFUL MAN AND PROVIDER BUT 5244 03:22:59,440 --> 03:23:01,880 YES, TRADITIONAL GENDER ROLES 5245 03:23:01,880 --> 03:23:04,400 ARE AN IMPORTANT ASPECT OF THIS 5246 03:23:04,400 --> 03:23:05,440 TEACHING AND RECOGNIZING 5247 03:23:05,440 --> 03:23:07,600 TRADITIONAL GENDER ROLES AND HOW 5248 03:23:07,600 --> 03:23:11,600 THOSE HAVE CHANGED AND HOW 5249 03:23:11,600 --> 03:23:13,840 TRADITIONAL GENDER ROLES FOR 5250 03:23:13,840 --> 03:23:15,680 YOUNG MEN IN PARTICULAR HAVE 5251 03:23:15,680 --> 03:23:17,480 CHANGED SIGNIFICANTLY OR IN WAYS 5252 03:23:17,480 --> 03:23:22,560 THAT ARE AGAIN IMPACTING YOUNG 5253 03:23:22,560 --> 03:23:27,680 MEN AND THEIR SENSE OF PURPOSE 5254 03:23:27,680 --> 03:23:30,240 AND PLACE AND CONTRIBUTION TO 5255 03:23:30,240 --> 03:23:30,520 COMMUNITY. 5256 03:23:30,520 --> 03:23:33,640 IN THAT WAY I WOULD SAY 5257 03:23:33,640 --> 03:23:36,320 ACTIVITIES ARE TAILORED TO 5258 03:23:36,320 --> 03:23:38,800 ADDRESS GENDER ROLES AND THE 5259 03:23:38,800 --> 03:23:41,880 TRANSITION AND HOW TODAY TO BE A 5260 03:23:41,880 --> 03:23:47,840 HEALTHY YOUNG MAN OR WOMAN. 5261 03:23:47,840 --> 03:23:51,560 >> THANKS, STACY. 5262 03:23:51,560 --> 03:23:54,440 I WAS STRUCK BY YOUR COMMENT 5263 03:23:54,440 --> 03:23:55,720 ABOUT TRYING TO BRING THE 5264 03:23:55,720 --> 03:23:58,160 CULTURAL INTERVENTIONS TO OTHER 5265 03:23:58,160 --> 03:24:00,680 COMMUNITIES AND I DON'T KNOW IF 5266 03:24:00,680 --> 03:24:06,280 YOU'VE READ THE BOOK DREAM LAND 5267 03:24:06,280 --> 03:24:07,600 WRITTEN YEARS AGO TALKING ABOUT 5268 03:24:07,600 --> 03:24:10,040 THE BEGINNING OF THE OPIOID 5269 03:24:10,040 --> 03:24:13,200 CRISIS AND DREAM LAND REFERRED 5270 03:24:13,200 --> 03:24:15,680 TO THE SWIMMING POOL IN THE 5271 03:24:15,680 --> 03:24:17,480 COMMUNITY CULTURE AND THE 5272 03:24:17,480 --> 03:24:20,120 DISILLUSION OF THE COMMUNITY 5273 03:24:20,120 --> 03:24:21,760 THAT WAS A FACTOR THAT LED TO 5274 03:24:21,760 --> 03:24:23,680 THE OPIOID CRISIS AND WITHOUT 5275 03:24:23,680 --> 03:24:25,040 RESTRUCTURING OR BRINGING THE 5276 03:24:25,040 --> 03:24:28,240 COMMUNITY BACK TOGETHER, WE WERE 5277 03:24:28,240 --> 03:24:29,720 NOT GOING TO MAKE PROGRESS. 5278 03:24:29,720 --> 03:24:30,560 I THINK WE'RE STILL SUFFERING 5279 03:24:30,560 --> 03:24:34,480 FROM THAT BUT I THINK THE IDEA 5280 03:24:34,480 --> 03:24:35,480 OF LEARNING FROM WHAT YOU'RE 5281 03:24:35,480 --> 03:24:39,680 DOING AND TRYING TO FIND WAYS TO 5282 03:24:39,680 --> 03:24:44,240 TRANSFER IS IMPORTANT. 5283 03:24:44,240 --> 03:24:52,200 THANK YOU. 5284 03:24:52,200 --> 03:24:57,680 >> WE'VE RECENTLY RESOURCE ED -- 5285 03:24:57,680 --> 03:25:02,680 RECEIVED FUNDING FROM DOD AND 5286 03:25:02,680 --> 03:25:08,680 DOING A TRANSLATION OF THIS 5287 03:25:08,680 --> 03:25:14,320 INTERVENTION AND WORKING WITH 5288 03:25:14,320 --> 03:25:23,480 OUR ARMY BASE HERE AND IT'S A 5289 03:25:23,480 --> 03:25:28,160 CULTURE THAT'S VERY SIMILAR IN A 5290 03:25:28,160 --> 03:25:32,000 LOT OF WAYS TO TRIBAL CULTURES 5291 03:25:32,000 --> 03:25:34,240 AND NATIONS I'VE HAD IN 5292 03:25:34,240 --> 03:25:35,880 DISCUSSIONS WITH OUR ARMY 5293 03:25:35,880 --> 03:25:40,640 GENERAL FOR ALASKAN COMMAND AND 5294 03:25:40,640 --> 03:25:42,400 HE GETS IT IN TERMS OF WHAT AT 5295 03:25:42,400 --> 03:25:44,480 THE SYSTEM LEVEL NEEDS TO HAPPEN 5296 03:25:44,480 --> 03:25:50,200 FOR SOLDIERS AND IN ALASKA WE'RE 5297 03:25:50,200 --> 03:25:52,840 HAVING CLUSTERING AFTER CLUST 5298 03:25:52,840 --> 03:25:54,600 ERS OF SUICIDE AMONG SERVICE 5299 03:25:54,600 --> 03:25:54,840 MEMBERS. 5300 03:25:54,840 --> 03:25:57,480 I WAS ENCOURAGE THE MILITARY'S 5301 03:25:57,480 --> 03:26:02,600 RESPONSE AND BEING ABLE TO SEE 5302 03:26:02,600 --> 03:26:04,800 HOW THIS COULD TRANSLATE INTO A 5303 03:26:04,800 --> 03:26:05,960 CONTEXT LIKE THAT. 5304 03:26:05,960 --> 03:26:07,640 WE'LL BE DOING THAT AND IT 5305 03:26:07,640 --> 03:26:12,240 SHOULD BE INTERESTING. 5306 03:26:12,240 --> 03:26:13,760 >> WE'RE FINALLY AT THE OPEN 5307 03:26:13,760 --> 03:26:15,680 TABLE DISCUSSION AND THIS CAN BE 5308 03:26:15,680 --> 03:26:17,320 A CONTINUATION OF ANY 5309 03:26:17,320 --> 03:26:20,240 DISCUSSIONS STARTED EARLIER OR 5310 03:26:20,240 --> 03:26:23,280 ANYTHING ELSE YOU'D LIKE TO 5311 03:26:23,280 --> 03:26:23,560 BRING UP. 5312 03:26:23,560 --> 03:26:28,480 ARE THERE ANY -- DOES ANYONE 5313 03:26:28,480 --> 03:26:38,320 WANT TO START? 5314 03:26:38,320 --> 03:26:43,240 >> I WAS INTRIGUED BY THE 5315 03:26:43,240 --> 03:26:45,320 EFFORTS OF INCREASING EQUITY, 5316 03:26:45,320 --> 03:26:47,480 DIVERSITY AND INCLUSION IN ABCD 5317 03:26:47,480 --> 03:26:55,040 AND THE START PROGRAM. 5318 03:26:55,040 --> 03:27:00,080 I'M WONDERING ABOUT DEVELOPING 5319 03:27:00,080 --> 03:27:02,320 GUIDELINES FOR HOW IT PLACE DATA 5320 03:27:02,320 --> 03:27:03,640 IN CONTEXT AND GATHER CONTEXTUAL 5321 03:27:03,640 --> 03:27:07,960 FACTORS IF YOU THINK THE START 5322 03:27:07,960 --> 03:27:09,240 PROGRAM COULD A WAY TO DEVELOP 5323 03:27:09,240 --> 03:27:12,040 THOSE KINDS OF GUIDELINES FOR 5324 03:27:12,040 --> 03:27:12,680 RESEARCHERS EITHER WITHIN OR 5325 03:27:12,680 --> 03:27:16,520 WITHOUT OUTSIDE THE STUDY USING 5326 03:27:16,520 --> 03:27:18,240 DATA AND THE VARIOUS ASPECTS OF 5327 03:27:18,240 --> 03:27:21,400 IT THAT NEED TO ATTEND TO 5328 03:27:21,400 --> 03:27:25,400 WHATEVER IT IS, RACE, ETHNICITY, 5329 03:27:25,400 --> 03:27:26,280 DIVERSITY AND CONTEXTUAL 5330 03:27:26,280 --> 03:27:27,080 FACTORS. 5331 03:27:27,080 --> 03:27:32,760 >> THERE WAS A GREAT DISCUSSION 5332 03:27:32,760 --> 03:27:37,160 AT THE KICKOFF MEETING AMONG THE 5333 03:27:37,160 --> 03:27:40,280 YOUNG SCHOLARS ON THEIR 5334 03:27:40,280 --> 03:27:42,640 PERSPECTIVES AND WHAT SHOULD BE 5335 03:27:42,640 --> 03:27:45,200 INCLUDE AND ONE OF THE FOLKS ON 5336 03:27:45,200 --> 03:27:46,880 THE ABCD GROUP DISCUSSING 5337 03:27:46,880 --> 03:27:48,760 RESPONSIBLE DATA USE WAS PART OF 5338 03:27:48,760 --> 03:27:49,640 THE COHORT. 5339 03:27:49,640 --> 03:27:50,880 WE ARE HAVING THE CONVERSATIONS 5340 03:27:50,880 --> 03:27:54,560 AND WE'RE TRYING TO BROADEN THE 5341 03:27:54,560 --> 03:27:55,440 CONVERSATIONS AND FIND DIFFERENT 5342 03:27:55,440 --> 03:28:01,080 WAYS TO GET THE SCIENTIFIC 5343 03:28:01,080 --> 03:28:03,080 COMMUNITY AT LARGE INVOLVED IN 5344 03:28:03,080 --> 03:28:03,640 THE DISCUSSIONS. 5345 03:28:03,640 --> 03:28:04,880 IT'S SOMETHING WITH A PUSH FOR 5346 03:28:04,880 --> 03:28:11,520 OPEN DATA HAS BEEN LAGGING. 5347 03:28:11,520 --> 03:28:16,640 AND IF PEOPLE ARE GOING TO 5348 03:28:16,640 --> 03:28:17,960 ACCESS THE DATA SET WE NEED TO 5349 03:28:17,960 --> 03:28:21,080 BE THINKING OF THIS FROM TO THE 5350 03:28:21,080 --> 03:28:21,400 O 5351 03:28:21,400 --> 03:28:22,040 OUTSET AND TRYING TO CATCH UP 5352 03:28:22,040 --> 03:28:28,640 NOW. 5353 03:28:28,640 --> 03:28:31,040 >> MAY BE PART OF THE OPEN USE 5354 03:28:31,040 --> 03:28:31,520 FOR DATA. 5355 03:28:31,520 --> 03:28:32,680 >> THAT'S SOMETHING WE'VE BEEN 5356 03:28:32,680 --> 03:28:35,520 IN DISCUSSIONS ABOUT FOR SOME 5357 03:28:35,520 --> 03:28:36,760 TIME. 5358 03:28:36,760 --> 03:28:39,120 THERE'S A NEED FOR TRAINING 5359 03:28:39,120 --> 03:28:41,080 BEFORE GETTING ACCESS TO DATA IN 5360 03:28:41,080 --> 03:28:45,840 HOW TO DO THIS IN A RESPONSIBLE 5361 03:28:45,840 --> 03:28:46,920 WAY. 5362 03:28:46,920 --> 03:28:49,360 ELIZABETH HAS BEEN TALKING TO 5363 03:28:49,360 --> 03:28:50,880 ALL OF US WHO HAS BEEN DOING A 5364 03:28:50,880 --> 03:28:52,000 GOOD JOB IN DEVELOPING TRAINING 5365 03:28:52,000 --> 03:28:54,240 FOR HOW TO ETHICALLY AND 5366 03:28:54,240 --> 03:28:56,200 RESPONSIBLY ANALYZE THESE KINDS 5367 03:28:56,200 --> 03:29:00,240 OF LARGE DATA SETS SO WE CAN 5368 03:29:00,240 --> 03:29:02,560 INCORPORATE THAT INTO OUR DATA 5369 03:29:02,560 --> 03:29:12,400 ACCESS MODEL MOVING FORWARD. 5370 03:29:12,400 --> 03:29:17,280 >> IDEALLY IT WOULD BE BROADER 5371 03:29:17,280 --> 03:29:22,400 EFFORT AND HOPING TO DEVELOP AND 5372 03:29:22,400 --> 03:29:31,680 TAKE THEIR LEAD AND WITH AND WE 5373 03:29:31,680 --> 03:29:34,080 HAVE A DATA MANAGEMENT POLICY IN 5374 03:29:34,080 --> 03:29:39,640 PLACE TO ACCESS THE DATA PEOPLE 5375 03:29:39,640 --> 03:29:41,720 WOULD HAVE TO HAVE SOME 5376 03:29:41,720 --> 03:29:46,760 COMPLETION AND THEN KEEPING THAT 5377 03:29:46,760 --> 03:29:50,600 UP SO THEY'RE NOT DOING 5378 03:29:50,600 --> 03:29:53,480 TRAINING AND ANALYSIS AND NEVER 5379 03:29:53,480 --> 03:29:55,680 COMING BACK AND WANT IT BUILT IN 5380 03:29:55,680 --> 03:30:05,120 SO PEOPLE ARE AWARE AND EDUCATED 5381 03:30:05,120 --> 03:30:06,400 AND HAVE KNOWLEDGE AND REACHING 5382 03:30:06,400 --> 03:30:07,800 DATA USERS ACROSS THE SPECTRUM 5383 03:30:07,800 --> 03:30:16,720 OF TRAINING. 5384 03:30:16,720 --> 03:30:18,400 AND IT'S LIKELY TO POTENTIALLY 5385 03:30:18,400 --> 03:30:22,480 USE DATA IN WAYS THAT ARE NOT 5386 03:30:22,480 --> 03:30:25,160 NECESSARILY INFORMATIVE OR 5387 03:30:25,160 --> 03:30:27,240 CONTEXTUALLY INFORMED. 5388 03:30:27,240 --> 03:30:29,960 THIS UNDER SCORES THE IMPORTANCE 5389 03:30:29,960 --> 03:30:35,480 OF A TRAINING MODULE. 5390 03:30:35,480 --> 03:30:39,560 >> AN WE'LL NEED A SYSTEM FOR 5391 03:30:39,560 --> 03:30:40,880 ADJUDICATING FOR CASES WHEN 5392 03:30:40,880 --> 03:30:42,240 PEOPLE MISUSE THE DATA AND 5393 03:30:42,240 --> 03:30:44,240 SOMETHING ALL OF US IS DOING AND 5394 03:30:44,240 --> 03:30:47,920 WE'RE TRYING TO LEARN FROM TERMS 5395 03:30:47,920 --> 03:30:48,880 OF THEIR EXPERIENCE IN TO DO 5396 03:30:48,880 --> 03:30:56,240 THAT EFFECTIVELY. 5397 03:30:56,240 --> 03:30:59,480 >> WITHOUT ANTAGONIZING PEOPLE 5398 03:30:59,480 --> 03:31:11,480 YOU WANT TO USE THE DATA AND 5399 03:31:11,480 --> 03:31:13,560 BRINGING IN DATA AND DIVERSITY 5400 03:31:13,560 --> 03:31:14,760 LIKE WITH START AND THEN HAVE 5401 03:31:14,760 --> 03:31:17,080 YOU PEOPLE LIKELY IN THE EARLY 5402 03:31:17,080 --> 03:31:18,880 STAGES OF THEIR CAREER AND WHO 5403 03:31:18,880 --> 03:31:20,280 YOU REALLY WANT TO BE ABLE TO 5404 03:31:20,280 --> 03:31:26,000 ALSO HAVE AT THE TABLE ARE 5405 03:31:26,000 --> 03:31:28,080 PEOPLE WHO REPRESENT DIVERSE 5406 03:31:28,080 --> 03:31:30,240 BACKGROUNDS AND HAVE THE 5407 03:31:30,240 --> 03:31:35,240 EXPERIENCE AND TRACK RECORD AND 5408 03:31:35,240 --> 03:31:38,680 MAYBE THIS NEW TO THEM OR CAN BE 5409 03:31:38,680 --> 03:31:39,760 THE BIGGEST LEADERS OF CHANGE 5410 03:31:39,760 --> 03:31:50,440 AND APPROACH. 5411 03:31:50,440 --> 03:31:53,200 >> AM I ON VIDEO OR MUTE? 5412 03:31:53,200 --> 03:32:03,280 YOU CAN BE HEARD. 5413 03:32:03,280 --> 03:32:04,880 IT'S GREAT TO LEARN ABOUT THE 5414 03:32:04,880 --> 03:32:06,720 TRAINING AND HOW SUCCESSFUL IT'S 5415 03:32:06,720 --> 03:32:08,000 BEEN BUT IN TERMS OF THE JOB WE 5416 03:32:08,000 --> 03:32:15,240 HAVE TO HELP GUIDE WORKING 5417 03:32:15,240 --> 03:32:15,760 PRACTS 5418 03:32:15,760 --> 03:32:21,240 PRACTSES -- PRACTICES TO GRANTS 5419 03:32:21,240 --> 03:32:22,640 AND IT STRIKES ME IN THE WORK 5420 03:32:22,640 --> 03:32:23,800 I'VE BEEN DOING WITH THE 5421 03:32:23,800 --> 03:32:25,600 NATIONAL ADVISORY GROUP BUT 5422 03:32:25,600 --> 03:32:26,680 AALSO APPLIES TO OTHER GROUPS 5423 03:32:26,680 --> 03:32:29,480 AND THAT'S THE ROLE OF THE 5424 03:32:29,480 --> 03:32:34,320 PROJECT MANAGERS. 5425 03:32:34,320 --> 03:32:37,280 YOU KNOW THE PROJECT MANAGERS 5426 03:32:37,280 --> 03:32:39,680 HAVE A LOT OF EMPOWERMENT AND IN 5427 03:32:39,680 --> 03:32:41,480 THE ONCOLOGY SPACE THEY'LL 5428 03:32:41,480 --> 03:32:45,680 PROBABLY HAVE MORE WITH THE MOON 5429 03:32:45,680 --> 03:32:49,320 SHOT TWO TO PASS THE SCIENTIFIC 5430 03:32:49,320 --> 03:32:50,680 ADVISORS AND EMPOWER MORE AND 5431 03:32:50,680 --> 03:32:53,480 MORE THE PROJECT MANAGERS. 5432 03:32:53,480 --> 03:32:55,600 I'M WONDERING IF THERE'S OTHERS 5433 03:32:55,600 --> 03:32:59,480 IN THIS CALL OR GROUP WHO STILL 5434 03:32:59,480 --> 03:33:02,880 SEE THE SAME DYNAMIC AND THE 5435 03:33:02,880 --> 03:33:04,040 PROJECT MANAGERS ARE TRAINED IN 5436 03:33:04,040 --> 03:33:07,560 THIS AND HOW THEY INTERACT WITH 5437 03:33:07,560 --> 03:33:09,320 THE GRANT APPLICANTS AND HOW 5438 03:33:09,320 --> 03:33:11,520 THEY TRAIN THEM IN DIFFERENT 5439 03:33:11,520 --> 03:33:25,200 VENUES GOING FORWARD. 5440 03:33:25,200 --> 03:33:27,040 YOU CALL THEM PROGRAM MANAGERS 5441 03:33:27,040 --> 03:33:30,480 IN DIFFERENT INSTITUTES. 5442 03:33:30,480 --> 03:33:32,080 >> IT'S HARD TO ANSWER BAYS 5443 03:33:32,080 --> 03:33:34,240 THERE'S A VARIETY OF MECHANISMS 5444 03:33:34,240 --> 03:33:37,040 BY WHICH WE SUPPORT THINGS AND 5445 03:33:37,040 --> 03:33:38,680 IN ONLY DO WE HAVE PROGRAM 5446 03:33:38,680 --> 03:33:41,480 MANAGERS OVERSEEING THE PROJECTS 5447 03:33:41,480 --> 03:33:45,360 THAT THEY'RE PART OF LIKE FOR 5448 03:33:45,360 --> 03:33:51,320 EXAMPLE THE ABCD STUDY BUT I 5449 03:33:51,320 --> 03:33:56,840 THINK THE POINT IS IMPORTANT AND 5450 03:33:56,840 --> 03:33:58,200 WE HAD A DISCUSSION ABOUT DATA 5451 03:33:58,200 --> 03:33:59,920 SHARING AND ACCESS AND THE MORE 5452 03:33:59,920 --> 03:34:02,680 WE GET INTO THIS SORT OF THING 5453 03:34:02,680 --> 03:34:03,600 AS WELL AS HAVING THESE LARGE 5454 03:34:03,600 --> 03:34:05,480 DATABASES THE MORE IMPORTANT IT 5455 03:34:05,480 --> 03:34:07,600 BECOMES THAT PEOPLE ARE USING 5456 03:34:07,600 --> 03:34:08,600 THEM RESPONSIBLY AND KNOW HOW TO 5457 03:34:08,600 --> 03:34:10,520 USE THEM AND KNOW WHAT THE 5458 03:34:10,520 --> 03:34:11,240 LIMITATIONS ARE AND WHAT THEY 5459 03:34:11,240 --> 03:34:16,400 CAN SAY AND HOW TO CONTEXTUALIZE 5460 03:34:16,400 --> 03:34:22,040 THEIR QUESTIONS OR HOW TO BE 5461 03:34:22,040 --> 03:34:23,280 THOUGHTFUL ABOUT THE QUESTIONS 5462 03:34:23,280 --> 03:34:24,920 AND ABCD BROUGHT TO OUR 5463 03:34:24,920 --> 03:34:26,240 ATTENTION PEOPLE CAN MISUSE THE 5464 03:34:26,240 --> 03:34:31,000 DATA IN WAYS THAT COULD BE 5465 03:34:31,000 --> 03:34:32,480 HARMFUL AND MAKING SURE PEOPLE 5466 03:34:32,480 --> 03:34:34,400 ARE KNOWLEDGEABLE AND THOUGHTFUL 5467 03:34:34,400 --> 03:34:36,080 AND FINDING WAYS TO ADJUDICATE 5468 03:34:36,080 --> 03:34:37,400 WHETHER OR NOT THAT'S REALLY 5469 03:34:37,400 --> 03:34:39,680 HAPPENED AND HOW DO WE KEEP 5470 03:34:39,680 --> 03:34:42,160 PEOPLE FROM DOING THAT AND WE'RE 5471 03:34:42,160 --> 03:34:45,120 OPENING UP A WHOLE OTHER SERIES 5472 03:34:45,120 --> 03:34:46,080 OF QUESTIONS WHICH INVOLVES 5473 03:34:46,080 --> 03:34:51,040 TRAINING AND IT INVOLVES 5474 03:34:51,040 --> 03:34:58,240 TRAINING IN AREAS PEOPLE MAY NOT 5475 03:34:58,240 --> 03:35:05,200 HAVE YESTERDAY. 5476 03:35:05,200 --> 03:35:06,240 WE'RE TRYING TO LEARN FROM EACH 5477 03:35:06,240 --> 03:35:10,240 OTHER AND FIGURE OUT HOW TO DO 5478 03:35:10,240 --> 03:35:10,800 AND THAT CREATE REASONABLE 5479 03:35:10,800 --> 03:35:19,960 EXPECTATIONS. 5480 03:35:19,960 --> 03:35:25,560 >> I THINK THERE'S STRUCTURES IN 5481 03:35:25,560 --> 03:35:31,680 PLACE TO ENSURE PROGRAM 5482 03:35:31,680 --> 03:35:33,680 DIRECTORS DO NOT GO OUT LOOSEY 5483 03:35:33,680 --> 03:35:35,680 GOOSEY IN TERMS OF HOW THEY 5484 03:35:35,680 --> 03:35:40,880 INTERACT WITH THE SCIENTIFIC 5485 03:35:40,880 --> 03:35:41,320 COMMUNITY. 5486 03:35:41,320 --> 03:35:46,400 THERE WOULD NOT BE AN INITIATIVE 5487 03:35:46,400 --> 03:35:49,240 WITHIN THE NCI THAT WOULD BYPASS 5488 03:35:49,240 --> 03:35:50,560 THE BOARD OF SCIENTIFIC ADVISORS 5489 03:35:50,560 --> 03:35:53,680 OR ANY OTHER OF THE OTHER BOARDS 5490 03:35:53,680 --> 03:35:58,040 OR COMMITTEES IN PLACE. 5491 03:35:58,040 --> 03:36:01,480 I'M SURE THAT'S THE SAME WITH 5492 03:36:01,480 --> 03:36:08,960 ANY OF THE I.C.s. 5493 03:36:08,960 --> 03:36:11,080 >> SOME OF THE INITIATIVES I 5494 03:36:11,080 --> 03:36:12,160 TALKED ABOUT WERE MOONSHOT 5495 03:36:12,160 --> 03:36:13,800 INITIATIVES BUT ULTIMATELY WERE 5496 03:36:13,800 --> 03:36:18,000 WORKED ON AND DEVELOPED AND 5497 03:36:18,000 --> 03:36:20,360 FLUSHED OUT BY OUR PROGRAM 5498 03:36:20,360 --> 03:36:29,240 OFFICERS AN WENT THROUGH BSA. 5499 03:36:29,240 --> 03:36:29,760 >> HAVE WE ADDRESSED YOUR 5500 03:36:29,760 --> 03:36:36,440 CONCERNS? 5501 03:36:36,440 --> 03:36:38,760 >> I'M CONFUSED BECAUSE THE 5502 03:36:38,760 --> 03:36:44,200 CONVERSATION WITH KEITH FLAHERTY 5503 03:36:44,200 --> 03:36:47,480 AND OTHERS IS THE PLANNING FOR 5504 03:36:47,480 --> 03:36:49,800 MOONSHOT 2 WILL NOT GO THROUGH 5505 03:36:49,800 --> 03:36:50,400 BSA. 5506 03:36:50,400 --> 03:36:52,640 >> MOONSHOT 2 WOULD BE A 5507 03:36:52,640 --> 03:36:54,480 PRESIDENTIAL INITIATIVE AND KEEP 5508 03:36:54,480 --> 03:36:58,080 THIS CORRECT, THEY'VE BEEN 5509 03:36:58,080 --> 03:36:59,480 PLANNING FOR THE MOONSHOT 5510 03:36:59,480 --> 03:37:03,080 INITIATIVE IT MUST GO THROUGH 5511 03:37:03,080 --> 03:37:04,320 THE NATIONAL CANCER ADVISORY 5512 03:37:04,320 --> 03:37:04,520 BOARD. 5513 03:37:04,520 --> 03:37:07,640 THAT'S THE NCI'S PRESIDENTIAL 5514 03:37:07,640 --> 03:37:16,720 APPOINTED BOARD. 5515 03:37:16,720 --> 03:37:19,200 >> OKAY, GREAT. 5516 03:37:19,200 --> 03:37:20,920 >> YOU'RE GOOD? 5517 03:37:20,920 --> 03:37:22,440 >> WITH YOU I ALWAYS LOVE TO BE 5518 03:37:22,440 --> 03:37:22,640 GOOD. 5519 03:37:22,640 --> 03:37:24,040 YOU MAKE ME BE GOOD. 5520 03:37:24,040 --> 03:37:25,840 >> I THINK IT'S A MATTER OF 5521 03:37:25,840 --> 03:37:26,560 PROCESS. 5522 03:37:26,560 --> 03:37:28,480 IT'S A PRESIDENTIAL INITIATIVE. 5523 03:37:28,480 --> 03:37:29,520 THERE WILL BE PRIORITIES 5524 03:37:29,520 --> 03:37:31,680 IDENTIFIED AS THERE WERE BY THE 5525 03:37:31,680 --> 03:37:34,960 BLUE RIBBON PANEL IN THE FIRST 5526 03:37:34,960 --> 03:37:37,400 MOONSHOT BUT ULTIMATELY IT 5527 03:37:37,400 --> 03:37:38,240 DRIBBLES DOWN TO THE STAFF AND 5528 03:37:38,240 --> 03:37:39,560 THEY END UP BEING THE ONES TO 5529 03:37:39,560 --> 03:37:40,600 DEVELOP THE INITIATIVES AND 5530 03:37:40,600 --> 03:37:42,560 THERE'S A PROCESS FOR THAT TO 5531 03:37:42,560 --> 03:37:44,880 HAVE IT APPROVED BY OUR PROGRAMS 5532 03:37:44,880 --> 03:37:45,880 LEADERS GROUP AND THE DIRECTOR 5533 03:37:45,880 --> 03:37:47,440 AND THE DIRECTORS OF OUR VARIOUS 5534 03:37:47,440 --> 03:37:51,640 DIVISIONS AND ULTIMATELY UP TO 5535 03:37:51,640 --> 03:37:58,480 BSA. 5536 03:37:58,480 --> 03:38:02,240 >> IF IT'S A CONCEPT INITIATIVE 5537 03:38:02,240 --> 03:38:04,880 THEY MUST BE APPROVED BY THE BSA 5538 03:38:04,880 --> 03:38:08,800 AND WHEN THE GRANTS COME IN, 5539 03:38:08,800 --> 03:38:11,480 SECOND-LEVEL PEER REVIEW OCCURS 5540 03:38:11,480 --> 03:38:18,360 WITH THE NCAB HOWEVER, THOUGH 5541 03:38:18,360 --> 03:38:22,360 THAT'S A PROCESS WHEN IT'S A 5542 03:38:22,360 --> 03:38:25,680 PRESIDENTIAL INITIATIVE, THE 5543 03:38:25,680 --> 03:38:29,080 IMMEDIATE DISCUSSION WOULD OCCUR 5544 03:38:29,080 --> 03:38:40,480 WITH THE CANCER ADVISORY GROUP. 5545 03:38:40,480 --> 03:38:44,840 >> I WANT TO BRING BACK UP THE 5546 03:38:44,840 --> 03:38:46,560 CONVERSATION WITH CHANGING THE 5547 03:38:46,560 --> 03:38:52,400 WAY WE APPROACH ALL OF THIS SO 5548 03:38:52,400 --> 03:38:55,080 EQUITY IS FRONT AND CENTER. 5549 03:38:55,080 --> 03:38:56,800 EVERYTHING'S GETTING WORSE IN 5550 03:38:56,800 --> 03:38:57,920 TERMS OF INEQUITIES. 5551 03:38:57,920 --> 03:38:59,480 THE PANDEMIC ONLY EXACERBATED 5552 03:38:59,480 --> 03:39:00,480 IT. 5553 03:39:00,480 --> 03:39:02,680 IF WE KEEP DOING SCIENCE THE WAY 5554 03:39:02,680 --> 03:39:03,720 WE'VE BEEN DOING IT, WHY WOULD 5555 03:39:03,720 --> 03:39:05,480 WE EXPECT A DIFFERENCE IN OUR 5556 03:39:05,480 --> 03:39:05,960 OUTCOMES? 5557 03:39:05,960 --> 03:39:10,080 I THINK STACY'S PRESENTATION AND 5558 03:39:10,080 --> 03:39:14,200 ALL THIS WONDERFUL WORK AROUND 5559 03:39:14,200 --> 03:39:15,680 COMMUNITY-DRIVEN, 5560 03:39:15,680 --> 03:39:16,280 COMMUNITY-BASED PARTICIPATORY 5561 03:39:16,280 --> 03:39:17,200 RESEARCH IS A PARADIGM SHIFT. 5562 03:39:17,200 --> 03:39:18,400 PEOPLE DON'T GET IT. 5563 03:39:18,400 --> 03:39:20,760 THEY THINK IT'S A QUALITATIVE 5564 03:39:20,760 --> 03:39:21,200 METHOD. 5565 03:39:21,200 --> 03:39:23,560 IT'S NOT. 5566 03:39:23,560 --> 03:39:24,600 IT'S IN APPROACH. 5567 03:39:24,600 --> 03:39:26,520 IT RELATES TO THE CONVERSATION 5568 03:39:26,520 --> 03:39:29,400 OF MOONSHOT INITIATIVES SORT OF 5569 03:39:29,400 --> 03:39:30,680 IN CAN WE CHANGE THE WAY 5570 03:39:30,680 --> 03:39:33,520 RESOURCES ARE ALLOCATED SO THAT 5571 03:39:33,520 --> 03:39:34,760 RELATIONAL COMMUNITY OUTREACH 5572 03:39:34,760 --> 03:39:39,680 AND PERIODS ARE MUCH LONGER SO 5573 03:39:39,680 --> 03:39:44,760 THAT AND CHRISTINA, YOU ARE 5574 03:39:44,760 --> 03:39:49,040 RUNNING THIS STUDY AND I MARVEL 5575 03:39:49,040 --> 03:39:52,560 AT HOW FAST YOU HAVE TO RAMP IT 5576 03:39:52,560 --> 03:39:54,600 UP WITHOUT RESOURCES AND CURIOUS 5577 03:39:54,600 --> 03:39:59,560 WHAT PEOPLE'S GRAND IDEAS ARE 5578 03:39:59,560 --> 03:40:02,040 AND I KNOW THERE'S TASK FORCES 5579 03:40:02,040 --> 03:40:07,640 AND ALL SORTS OF THINGS BUT I 5580 03:40:07,640 --> 03:40:10,840 WOULD LOVE RADICAL THINKING AND 5581 03:40:10,840 --> 03:40:12,240 DEMAND IF TAXPAYER FUNDS ARE 5582 03:40:12,240 --> 03:40:15,640 GOING TO THESE MAJOR STUDIES, 5583 03:40:15,640 --> 03:40:17,680 THEY SERVE THE PEOPLE WHO ARE 5584 03:40:17,680 --> 03:40:32,040 PART. 5585 03:40:32,040 --> 03:40:36,040 >> I CAN SPEAK TO THE FACT THAT 5586 03:40:36,040 --> 03:40:38,240 WITHIN OUR OWN INSTITUTES WE'RE 5587 03:40:38,240 --> 03:40:39,640 WORKING HARD TO ADDRESS THE 5588 03:40:39,640 --> 03:40:41,480 ISSUES YOU'VE RAISED. 5589 03:40:41,480 --> 03:40:47,480 I THINK BILL MENTIONED THIS WITH 5590 03:40:47,480 --> 03:40:51,280 THE CENTERS AT NCI AND IT CAME 5591 03:40:51,280 --> 03:40:53,000 UP AT OUR COUNCIL TODAY ABOUT 5592 03:40:53,000 --> 03:40:53,960 REQUIRING OUR CENTERS TO HAVE A 5593 03:40:53,960 --> 03:40:58,600 DIVERSITY PLAN. 5594 03:40:58,600 --> 03:41:04,240 SO WE'RE AT THAT AND THERE ARE 5595 03:41:04,240 --> 03:41:06,760 MULTIPLE INITIATIVES THERE'S 5596 03:41:06,760 --> 03:41:11,120 INITIATIVES GOING ON AT NIH ON 5597 03:41:11,120 --> 03:41:12,480 DISPARITIES AND EQUITY AND SO 5598 03:41:12,480 --> 03:41:13,960 FORTH BUT WE'RE ALL COMING UP 5599 03:41:13,960 --> 03:41:15,240 WITH INDIVIDUAL PLANS FOR OUR 5600 03:41:15,240 --> 03:41:19,640 INSTITUTES AND THOSE ARE BEING 5601 03:41:19,640 --> 03:41:21,400 REVIEWED CURRENTLY I UNDERSTAND 5602 03:41:21,400 --> 03:41:23,360 YOUR FRUSTRATION AND UNDERSTAND 5603 03:41:23,360 --> 03:41:24,240 THE FRUSTRATION WITH WHAT 5604 03:41:24,240 --> 03:41:28,320 HAPPENED DURING THE PANDEMIC BUT 5605 03:41:28,320 --> 03:41:30,760 THE ONLY BEING THE ETERNAL 5606 03:41:30,760 --> 03:41:31,880 OPTIMIST IS THINGS ARE UNDERWAY 5607 03:41:31,880 --> 03:41:33,720 AND I THINK THERE'S GOING TO BE 5608 03:41:33,720 --> 03:41:34,240 CHANGE. 5609 03:41:34,240 --> 03:41:39,640 IT'S GOING ON THE NUMBER ONE 5610 03:41:39,640 --> 03:41:41,480 PRIORITY IN OUR STRATEGIC PLAN 5611 03:41:41,480 --> 03:41:42,800 WILL BE DIVERSITY AND EQUITY AND 5612 03:41:42,800 --> 03:41:44,880 UTILIZING THAT AS AN ENGINE TO 5613 03:41:44,880 --> 03:41:46,480 IMPROVE THE INNOVATIVENESS OF 5614 03:41:46,480 --> 03:41:48,320 RESEARCH. 5615 03:41:48,320 --> 03:41:51,080 I'M STOP THERE AND MAYBE SOMEONE 5616 03:41:51,080 --> 03:41:51,880 WANTS TO COMMENT. 5617 03:41:51,880 --> 03:41:59,600 I KNOW NORA WOULD IF SHE WERE 5618 03:41:59,600 --> 03:42:00,080 HERE. 5619 03:42:00,080 --> 03:42:03,680 >> AND STARTING IN 2020 NORA 5620 03:42:03,680 --> 03:42:08,760 LAUNCHED OUR RACIAL EQUITY 5621 03:42:08,760 --> 03:42:10,800 INITIATIVE DESIGNED TO SOME OF 5622 03:42:10,800 --> 03:42:12,320 THE LONG-STANDING SOCIAL 5623 03:42:12,320 --> 03:42:13,320 INEQUITIES AS OUR COMPONENT OF 5624 03:42:13,320 --> 03:42:14,880 THE WORLD WE HAVE THE MOST 5625 03:42:14,880 --> 03:42:15,520 INFLUENCE ON. 5626 03:42:15,520 --> 03:42:17,520 WE CERTAINLY SEE THIS AS BEING 5627 03:42:17,520 --> 03:42:19,640 WELL BEYOND JUST THE SCIENTIFIC 5628 03:42:19,640 --> 03:42:24,040 ENTERPRISE BUT EXTENDING TO MANY 5629 03:42:24,040 --> 03:42:24,240 ASPECTS. 5630 03:42:24,240 --> 03:42:25,680 THIS HAS THREE MAJOR COMPONENTS. 5631 03:42:25,680 --> 03:42:31,200 ONE IS TO FOCUS INTERNALLY 5632 03:42:31,200 --> 03:42:32,360 THERE'S AN EQUITY PLAN 5633 03:42:32,360 --> 03:42:33,560 DEVELOPMENT FOR EACH INSTITUTE 5634 03:42:33,560 --> 03:42:36,480 UNDERWAY NOW TO LOOK INTERNALLY 5635 03:42:36,480 --> 03:42:37,640 AT OUR OWN INTERNAL WORKPLACE 5636 03:42:37,640 --> 03:42:41,480 ISSUES. 5637 03:42:41,480 --> 03:42:45,760 ONLY IF WE GET OUR OWN HOUSE IN 5638 03:42:45,760 --> 03:42:47,600 ORDER CAN WE WORK WITH THE 5639 03:42:47,600 --> 03:42:49,280 EXTERNAL COMMUNITY ON OTHER 5640 03:42:49,280 --> 03:42:49,520 ISSUES. 5641 03:42:49,520 --> 03:42:52,080 THE OTHER COMPONENTS ONE IS 5642 03:42:52,080 --> 03:42:53,480 FOCUSSING ON WORKFORCE 5643 03:42:53,480 --> 03:43:00,120 DIVERSITY. 5644 03:43:00,120 --> 03:43:06,000 WE HAVE A DREADFUL SITUATION IN 5645 03:43:06,000 --> 03:43:09,520 TERMS OF LACK OF DIVERSE AND 5646 03:43:09,520 --> 03:43:11,440 VERY FEW ALASKAN NATIVE ARE 5647 03:43:11,440 --> 03:43:13,640 PRINCIPLE INVESTIGATE AND VERY 5648 03:43:13,640 --> 03:43:14,160 FEW AFRICAN AMERICAN ARE 5649 03:43:14,160 --> 03:43:15,920 INVESTIGATORS AND LEADERS OF OUR 5650 03:43:15,920 --> 03:43:16,480 PROJECTS. 5651 03:43:16,480 --> 03:43:18,960 THIS IS A COUPLE OF EXAMPLES OF 5652 03:43:18,960 --> 03:43:22,920 PLACES WHERE WE ARE PUTTING IN 5653 03:43:22,920 --> 03:43:26,680 EXTRA EFFORTS TO ADDRESS 5654 03:43:26,680 --> 03:43:28,120 LONG-STANDING DISPARITIES AND I 5655 03:43:28,120 --> 03:43:29,480 CAN'T TELL WHETHER YOUR COMMENT 5656 03:43:29,480 --> 03:43:30,240 FOCUSES ON THE WORKFORCE OR THE 5657 03:43:30,240 --> 03:43:31,800 HEALTH DISPARITIES. 5658 03:43:31,800 --> 03:43:33,720 IT'S A LITTLE BIT OF BOTH, I 5659 03:43:33,720 --> 03:43:33,920 THINK. 5660 03:43:33,920 --> 03:43:36,400 IT'S BY CHANGING THE WORKFORCE 5661 03:43:36,400 --> 03:43:38,240 WE MAY HAVE BETTER OPPORTUNITIES 5662 03:43:38,240 --> 03:43:40,400 TO ADDRESS HEALTH DISPARITIES. 5663 03:43:40,400 --> 03:43:43,440 I WOULD POINT A CONVERSATION WE 5664 03:43:43,440 --> 03:43:45,400 HAD YESTERDAY SEVERAL ARE AWARE 5665 03:43:45,400 --> 03:43:51,520 OF AT THE NIDA COUNCIL REGARDING 5666 03:43:51,520 --> 03:43:56,200 OUR MERIT AWARDS THESE AWARDS 5667 03:43:56,200 --> 03:43:58,360 THAT BRING RECOGNITION AND EASE 5668 03:43:58,360 --> 03:43:59,080 OF FUNDING. 5669 03:43:59,080 --> 03:44:01,560 THAT'S THE MOST PRACTICAL ISSUE 5670 03:44:01,560 --> 03:44:04,880 IT GIVES LONGER TERM FUNDING FOR 5671 03:44:04,880 --> 03:44:05,480 VERY ESTABLISHED SENIOR 5672 03:44:05,480 --> 03:44:12,280 INVESTIGATORS. 5673 03:44:12,280 --> 03:44:13,680 BECAUSE OF THE INEQUITIES AND 5674 03:44:13,680 --> 03:44:16,520 DISPARITIES IN HOW THEY'RE 5675 03:44:16,520 --> 03:44:18,800 AWARDED WE'LL LOOK HARDER AT 5676 03:44:18,800 --> 03:44:20,240 THAT AND ONE EXAMPLE WHERE WE'VE 5677 03:44:20,240 --> 03:44:22,040 PUT IN EFFORTS JUST IN THE LAST 5678 03:44:22,040 --> 03:44:22,760 COUPLE DAYS. 5679 03:44:22,760 --> 03:44:27,680 I'LL ALSO POINT OUT SEVERAL HAVE 5680 03:44:27,680 --> 03:44:29,520 BEEN HEAVILY INVOLVED IN THE 5681 03:44:29,520 --> 03:44:32,880 RAPID DIAGNOSTICS FOR UNDER 5682 03:44:32,880 --> 03:44:33,960 SERVED POPULATIONS INITIATIVE 5683 03:44:33,960 --> 03:44:35,240 PART OF THE COVID PROGRAM TO 5684 03:44:35,240 --> 03:44:38,840 BRING TESTING TO UNDER SERVED 5685 03:44:38,840 --> 03:44:41,200 POPULATIONS AND THAT HAS BEEN A 5686 03:44:41,200 --> 03:44:44,560 VERY MUCH A COMMUNITY-BASED 5687 03:44:44,560 --> 03:44:45,480 PARTICIPATORY RESEARCH PROGRAM 5688 03:44:45,480 --> 03:44:46,760 BUT ALSO STRUGGLED WITH DATA 5689 03:44:46,760 --> 03:44:48,080 SHARING AND COORDINATION. 5690 03:44:48,080 --> 03:44:50,280 I WAS INTERESTED IN THE PREVIOUS 5691 03:44:50,280 --> 03:44:51,680 DISCUSSION AROUND HOW DO WE 5692 03:44:51,680 --> 03:44:56,720 ASSURE THAT DATA SHARING IS DONE 5693 03:44:56,720 --> 03:44:58,800 IN A WAY THAT PAYS ATTENTION TO 5694 03:44:58,800 --> 03:45:02,840 THE NUANCES OF THE ORIGINAL DATA 5695 03:45:02,840 --> 03:45:05,520 AND DOESN'T MISINTERPRET THEM 5696 03:45:05,520 --> 03:45:07,200 BECAUSE THAT HAS A HUGE 5697 03:45:07,200 --> 03:45:08,840 IMPLICATION IN FROM MULTIPLE 5698 03:45:08,840 --> 03:45:09,240 PLACES. 5699 03:45:09,240 --> 03:45:13,200 IT'S A LITTLE BIT OF A RAMBLING 5700 03:45:13,200 --> 03:45:14,200 ANSWER BUT YOU HAVE OUR 5701 03:45:14,200 --> 03:45:18,280 ATTENTION AND BY BRINGING IT UP 5702 03:45:18,280 --> 03:45:19,680 HERE YOU INCREASE THE VISIBILITY 5703 03:45:19,680 --> 03:45:21,160 OF THE IMPORTANT ENTRENCHED 5704 03:45:21,160 --> 03:45:23,520 ISSUES WE LOVE YOUR IDEAS ON HOW 5705 03:45:23,520 --> 03:45:31,680 TO SOLVE THEM. 5706 03:45:31,680 --> 03:45:39,680 >>I DON'T HAVE A LOT OF MORE 5707 03:45:39,680 --> 03:45:44,000 SPECIFIC TO SAY EXCEPT HOW WE'VE 5708 03:45:44,000 --> 03:45:48,240 LOOKED AT THESE DISORDERS AND 5709 03:45:48,240 --> 03:45:50,040 ARE WE GOING TO WE'RE NOT GOING 5710 03:45:50,040 --> 03:45:50,880 TO BE ADDRESS THESE RIGHT AWAY 5711 03:45:50,880 --> 03:45:57,280 BUT I THINK THE MORE THAT WE ARE 5712 03:45:57,280 --> 03:45:59,480 THINKING ABOUT IT AND 5713 03:45:59,480 --> 03:46:00,600 INCORPORATING THEM INTO 5714 03:46:00,600 --> 03:46:01,800 OPPORTUNITIES AND MORE THINGS 5715 03:46:01,800 --> 03:46:03,640 WILSON SAID ABOUT INCORPORATING 5716 03:46:03,640 --> 03:46:04,640 RESEARCHERS FOCUSSED ON THAT AND 5717 03:46:04,640 --> 03:46:06,480 MORE SOCIAL SCIENTISTS OR 5718 03:46:06,480 --> 03:46:12,000 BEHAVIORAL SCIENTISTS THAT ARE 5719 03:46:12,000 --> 03:46:12,760 COMING FROM DIFFERENT 5720 03:46:12,760 --> 03:46:13,080 BACKGROUNDS. 5721 03:46:13,080 --> 03:46:15,280 THOSE ARE THINGS WE'RE VERY MUCH 5722 03:46:15,280 --> 03:46:16,240 AWARE OF AND VERY MUCH TRYING TO 5723 03:46:16,240 --> 03:46:18,400 CHANGE IN THE WAY IN WHICH WE 5724 03:46:18,400 --> 03:46:20,560 ARE DOING THINGS BUT PROBABLY 5725 03:46:20,560 --> 03:46:23,520 NOT FAST ENOUGH BUT WE ARE 5726 03:46:23,520 --> 03:46:26,000 TRYING TO GET THERE. 5727 03:46:26,000 --> 03:46:31,360 >> I WOULD ADD DR. VOLKOW HAS 5728 03:46:31,360 --> 03:46:33,880 SPECIFICALLY ASKED OUR STAFF AS 5729 03:46:33,880 --> 03:46:37,440 THEY'RE MAKING RECOMMENDATIONS 5730 03:46:37,440 --> 03:46:38,640 FOR CONSIDERATION TO SUPPORT 5731 03:46:38,640 --> 03:46:40,080 LESS-RESOURCED INSTITUTIONS AS 5732 03:46:40,080 --> 03:46:40,280 WELL. 5733 03:46:40,280 --> 03:46:42,480 THE MINORITY-SERVING 5734 03:46:42,480 --> 03:46:43,120 INSTITUTIONS, HISTORICALLY BLACK 5735 03:46:43,120 --> 03:46:45,840 COLLEGES AND UNIVERSITIES AND 5736 03:46:45,840 --> 03:46:48,880 OTHER NON-RO1 INSTITUTIONS ARE 5737 03:46:48,880 --> 03:46:50,520 GETTING A PARTICULARLY CAREFUL 5738 03:46:50,520 --> 03:46:54,600 LOOK IN OUR FUNDING AS ANOTHER 5739 03:46:54,600 --> 03:46:56,720 WAY TO WE HOPE WILL BEGIN TO 5740 03:46:56,720 --> 03:46:57,920 ADDRESS THE STRUCTURAL 5741 03:46:57,920 --> 03:46:58,520 INEQUITIES IN DISTRIBUTION OF 5742 03:46:58,520 --> 03:47:13,560 FUNDING. 5743 03:47:13,560 --> 03:47:18,120 >> SO MANY IMPORTANT 5744 03:47:18,120 --> 03:47:18,880 DISCUSSIONS. 5745 03:47:18,880 --> 03:47:21,200 I LIKE ALL THE DISCUSSION ABOUT 5746 03:47:21,200 --> 03:47:22,560 INCREASING DIVERSITY, EQUITY AND 5747 03:47:22,560 --> 03:47:24,560 INCLUSION WITHIN OUR SCIENCE 5748 03:47:24,560 --> 03:47:29,520 COMMUNITY AND WHETHER WE 5749 03:47:29,520 --> 03:47:33,560 INTEGRATE INTO BIO SKETCHES AND 5750 03:47:33,560 --> 03:47:37,400 ASK FOR WHAT THE DIVERSITY OF 5751 03:47:37,400 --> 03:47:39,280 THE LAB LOOKS LIKE AND FOR WHAT 5752 03:47:39,280 --> 03:47:40,600 PEOPLE ARE DOING WITHIN THEIR 5753 03:47:40,600 --> 03:47:41,840 OWN INSTITUTION AND WHAT THEIR 5754 03:47:41,840 --> 03:47:42,520 PORTFOLIO LOOKS LIKE. 5755 03:47:42,520 --> 03:47:44,880 THE MORE OF THOSE METRICS ARE 5756 03:47:44,880 --> 03:47:49,240 INTEGRATED FULLY INTO THE ENTIRE 5757 03:47:49,240 --> 03:47:51,880 SCIENCE PROCESS THE MORE 5758 03:47:51,880 --> 03:47:52,520 FACILITATES PEOPLE REALLY PAYING 5759 03:47:52,520 --> 03:47:54,560 ATTENTION TO IT AND DOING IT. 5760 03:47:54,560 --> 03:47:57,200 I THOUGHT YESTERDAY'S DISCUSSION 5761 03:47:57,200 --> 03:47:59,640 THE IDEA ALSO OF INCREASING THE 5762 03:47:59,640 --> 03:48:01,800 ABILITY FOR PEOPLE WHO ARE 5763 03:48:01,800 --> 03:48:04,920 MENTORS AND MENTEES AND JUNIOR 5764 03:48:04,920 --> 03:48:10,800 AND SENIOR FACULTY ACROSS 5765 03:48:10,800 --> 03:48:11,680 MULTIPLE INSTITUTIONS TO SHARE 5766 03:48:11,680 --> 03:48:13,680 THEIR EXPERIENCES WITH OTHERS 5767 03:48:13,680 --> 03:48:15,520 FROM MULTIPLE COMMUNITIES AND 5768 03:48:15,520 --> 03:48:18,480 BACKGROUNDS AND THIRD I JUST 5769 03:48:18,480 --> 03:48:25,560 THOUGHT IT'S A REMARKABLE 5770 03:48:25,560 --> 03:48:27,680 PRESENTATION ABOUT WORKING WITH 5771 03:48:27,680 --> 03:48:32,720 COMMUNITIES SO THE CAN ADVANCE 5772 03:48:32,720 --> 03:48:33,880 THE PRESENTATION SOMETIMES WHAT 5773 03:48:33,880 --> 03:48:37,680 WE HAVE IN RESEARCH IS THAT YOU 5774 03:48:37,680 --> 03:48:40,200 CAN CULTURALLY ADAPT 5775 03:48:40,200 --> 03:48:40,520 INTERVENTIONS. 5776 03:48:40,520 --> 03:48:44,520 THAT'S NOT COUNTER TO SCALING 5777 03:48:44,520 --> 03:48:45,680 UP. 5778 03:48:45,680 --> 03:48:51,400 I THINK YOU CAN SCALE UP BY 5779 03:48:51,400 --> 03:48:52,720 TAKING THINGS THAT WORK AND 5780 03:48:52,720 --> 03:48:55,440 HAVING COMMUNITIES ADAPT THOSE 5781 03:48:55,440 --> 03:48:57,240 OR CONSIDER THEM FOR ADAPTATION 5782 03:48:57,240 --> 03:48:58,880 DEPENDING ON WHAT IS OR ISN'T 5783 03:48:58,880 --> 03:48:59,480 VIABLE FOR THAT PARTICULAR 5784 03:48:59,480 --> 03:49:04,960 COMMUNITY AND IT'S A WAY TO 5785 03:49:04,960 --> 03:49:07,360 CONSIDER HOW TO ADVANCE POSSIBLE 5786 03:49:07,360 --> 03:49:09,600 RFAs FOR THOSE KINDS OF THINGS 5787 03:49:09,600 --> 03:49:14,120 SO THE WORK STACY'S DOING I 5788 03:49:14,120 --> 03:49:16,080 THINK SOMEBODY PUT IN THE CHAT 5789 03:49:16,080 --> 03:49:19,080 ABOUT A CONSORTIA OF COMMUNITIES 5790 03:49:19,080 --> 03:49:20,320 THAT WANT TO ADAPT PARTICULAR 5791 03:49:20,320 --> 03:49:22,360 THINGS SAY FROM STACY'S MODEL 5792 03:49:22,360 --> 03:49:25,320 AND IT WOULD BE WAY BEYOND 5793 03:49:25,320 --> 03:49:25,560 ALASKA. 5794 03:49:25,560 --> 03:49:29,040 IT COULD BE IN ALL SORTS OF 5795 03:49:29,040 --> 03:49:30,960 COMMUNITIES THAT REALLY ALMOST 5796 03:49:30,960 --> 03:49:32,960 TO THIS POINT ARE EXTREMELY HARD 5797 03:49:32,960 --> 03:49:34,440 HIT BY ALL THESE THINGS. 5798 03:49:34,440 --> 03:49:35,840 JUST IN THE LAST HOUR I'VE 5799 03:49:35,840 --> 03:49:41,520 GOTTEN LIKE FOUR TEXTS TRYING TO 5800 03:49:41,520 --> 03:49:47,520 GET ADOLESCENTS INTO TREATMENT. 5801 03:49:47,520 --> 03:49:50,200 FOUR TEXTS. 5802 03:49:50,200 --> 03:49:51,960 THIS GOES ON ALL DAY. 5803 03:49:51,960 --> 03:49:54,640 WHAT WE CAN DO TO MOVE THE 5804 03:49:54,640 --> 03:49:56,240 AGENDA FORWARD AS FAST AS WE CAN 5805 03:49:56,240 --> 03:50:05,520 COULD BE WELCOME OUT HERE 5806 03:50:05,520 --> 03:50:22,080 WELCOME IN THE FIELD. 5807 03:50:22,080 --> 03:50:24,680 >> I'VE DONE WORK WITH COMPANIES 5808 03:50:24,680 --> 03:50:27,480 IN HOW TO MOVE THE NEEDLE AND 5809 03:50:27,480 --> 03:50:30,320 WHO IS REVIEWING THE STUDIES. 5810 03:50:30,320 --> 03:50:32,240 I CAN TELL YOU -- I'M A BASIC 5811 03:50:32,240 --> 03:50:34,160 SCIENTIST BUT AT THE SAME TIME I 5812 03:50:34,160 --> 03:50:35,480 DO COMMUNITY ENGAGED RESEARCH 5813 03:50:35,480 --> 03:50:39,320 AND I CAN TELL YOU THAT THERE 5814 03:50:39,320 --> 03:50:40,240 ARE PEOPLE WHO DON'T UNDERSTAND 5815 03:50:40,240 --> 03:50:42,040 HOW IT DO COMMUNITY-ENGAGED 5816 03:50:42,040 --> 03:50:42,880 RESEARCH DOING PRESENTATIONS AND 5817 03:50:42,880 --> 03:50:45,080 I KNOW PANELS GET TOGETHER BUT 5818 03:50:45,080 --> 03:50:51,600 SOMETIMES PEOPLE ARE TRYING BE 5819 03:50:51,600 --> 03:50:57,400 INNOVATIVE AND THE OTHER THING 5820 03:50:57,400 --> 03:50:59,040 THAT'S IMPORTANT I LOVED WHEN 5821 03:50:59,040 --> 03:51:00,840 NCI WAS DOING THE SUPPLEMENT AND 5822 03:51:00,840 --> 03:51:02,680 YOU DO IT ROUTINELY FOR THE 5823 03:51:02,680 --> 03:51:04,480 CANCER CENTERS AND IT ENABLES 5824 03:51:04,480 --> 03:51:05,360 FOR CAPACITY BUILDING. 5825 03:51:05,360 --> 03:51:09,960 THAT'S WHAT'S REALLY NEEDED. 5826 03:51:09,960 --> 03:51:12,280 I KNOW THERE'S FOCUS ON MINORITY 5827 03:51:12,280 --> 03:51:15,040 SERVING INSTITUTIONS BUT I CAN'T 5828 03:51:15,040 --> 03:51:16,880 TELL YOU HOW STRUCK BY THE 5829 03:51:16,880 --> 03:51:19,640 INEQUITY EXISTS JUST BY THE 5830 03:51:19,640 --> 03:51:20,880 STRUCTURAL BARRIERS NO JUST 5831 03:51:20,880 --> 03:51:22,120 GETTING RESEARCH DONE SOMETIMES 5832 03:51:22,120 --> 03:51:23,680 AT THE MINORITY SERVING 5833 03:51:23,680 --> 03:51:28,080 INSTITUTIONS. 5834 03:51:28,080 --> 03:51:29,840 IT'S IMPORTANT TO LOOK AT 5835 03:51:29,840 --> 03:51:35,480 PARTNERSHIPS AND WAYS TO BUILD 5836 03:51:35,480 --> 03:51:39,640 CAPACITY AND THERE'S ONE EXAMPLE 5837 03:51:39,640 --> 03:51:40,880 AND HOLDING PEOPLE'S FEET TO THE 5838 03:51:40,880 --> 03:51:42,240 FIRE. 5839 03:51:42,240 --> 03:51:43,880 WE NOW HOW TO WRITE A GRANT. 5840 03:51:43,880 --> 03:51:46,880 IT'S WHAT THE ACTUAL OUTCOMES 5841 03:51:46,880 --> 03:51:52,080 AND BEING REAL CLEAR EVEN FROM 5842 03:51:52,080 --> 03:51:54,480 THE COMPREHENSIVE CANCER 5843 03:51:54,480 --> 03:51:56,680 STANDPOINT AND IF YOU HAVE 5844 03:51:56,680 --> 03:51:57,880 COMMUNITIES IN YOUR BACKYARD 5845 03:51:57,880 --> 03:52:03,480 BECAUSE YOU HAVEN'T HAD THE TIME 5846 03:52:03,480 --> 03:52:04,680 TO BUILD THOSE OPPORTUNITIES 5847 03:52:04,680 --> 03:52:08,040 THOSE ARE REAL-WORLD METRICS WE 5848 03:52:08,040 --> 03:52:11,680 HOPEFULLY START TO HOLD PEOPLE 5849 03:52:11,680 --> 03:52:18,400 ACCOUNTABLE TO. 5850 03:52:18,400 --> 03:52:20,800 >> SO WE'VE KIND OF OVER TIME 5851 03:52:20,800 --> 03:52:23,240 AND I THOUGHT THE LAST COMMENT 5852 03:52:23,240 --> 03:52:27,640 WAS GOOD TO END ON BUT TINA GO 5853 03:52:27,640 --> 03:52:31,880 AHEAD. 5854 03:52:31,880 --> 03:52:35,480 I NOW HAVE TO TALK ABOUT SEX AS 5855 03:52:35,480 --> 03:52:37,120 A PSYCHOLOGICAL VARIABLE AND 5856 03:52:37,120 --> 03:52:39,320 TALK ABOUT RIGOR AND 5857 03:52:39,320 --> 03:52:40,520 REPRODUCIBILITY AND MAYBE WE 5858 03:52:40,520 --> 03:52:46,920 SHOULD REQUIRE GRANT APPLICANTS 5859 03:52:46,920 --> 03:52:48,560 TO SAY HOW THEY'LL HANDLE 5860 03:52:48,560 --> 03:52:51,680 DISPARITIES AND THINKING OF THIS 5861 03:52:51,680 --> 03:52:53,360 RECOVER PROJECT IS FOCUSSED ON 5862 03:52:53,360 --> 03:52:55,520 LONG COVID BUT THERE'S PROBABLY 5863 03:52:55,520 --> 03:52:57,080 A LOT OF HEALTH DISPARITY 5864 03:52:57,080 --> 03:53:01,200 QUESTIONS THAT CAN BE INTEGRATED 5865 03:53:01,200 --> 03:53:04,920 INTO THAT PROCESS OF WHO DID AND 5866 03:53:04,920 --> 03:53:07,600 DIDN'T GET TESTED AND WHO GOT 5867 03:53:07,600 --> 03:53:08,440 VACCINATED AND SO ON. 5868 03:53:08,440 --> 03:53:16,240 >> ALL GREAT SUGGESTIONS. 5869 03:53:16,240 --> 03:53:18,680 >> WELL, WE ARE OVER TIME. 5870 03:53:18,680 --> 03:53:20,640 I WANT TO THANK EVERYONE I THINK 5871 03:53:20,640 --> 03:53:21,680 THESE WERE IMPORTANT 5872 03:53:21,680 --> 03:53:22,320 DISCUSSIONS. 5873 03:53:22,320 --> 03:53:24,640 A LOT TO GO BACK TO NORA WITH TO 5874 03:53:24,640 --> 03:53:29,120 LET HER CONSIDER IT AS WELL AND 5875 03:53:29,120 --> 03:53:31,640 I REALLY APPRECIATE EVERYBODY'S 5876 03:53:31,640 --> 03:53:35,040 CONTRIBUTIONS. 5877 03:53:35,040 --> 03:53:35,240 GEORGE. 5878 03:53:35,240 --> 03:53:37,360 >> I THINK I'M CHARGED WITH 5879 03:53:37,360 --> 03:53:39,680 CLOSING US OUT AND I WANT TO 5880 03:53:39,680 --> 03:53:47,480 THANK EVERYONE FOR WOOF WONDERFUL 5881 03:53:47,480 --> 03:53:52,480 INTERACTIONS AND NOTES. 5882 03:53:52,480 --> 03:53:53,880 WONDERFUL CRAN MEETING AND DON'T 5883 03:53:53,880 --> 03:53:58,240 FORGET TO SEND SUGGESTIONS ON 5884 03:53:58,240 --> 03:54:00,000 DESEMINATION OF THE HEALTH CARE 5885 03:54:00,000 --> 03:54:01,080 PROFESSIONALS CORE RESOURCE. 5886 03:54:01,080 --> 03:54:01,520 I'M GETTING IT DOWN. 5887 03:54:01,520 --> 04:09:39,600 SEE YOU ALL.